Breaking (into) the Circle: Group Work for Change in the English Classroom.

ERIC Educational Resources Information Center

Roskelly, Hephzibah

This book offers a tested method for utilizing groups in the English classroom. It uses theory and ethnography to document why groups succeed and how to remedy them when they are failing. Five chapters focus on: (1) "Group Work Matters" (e.g., how to make groups worth it, the need for groups, and the process of finding communication);…

Learners' Experiences of Learning Support in Selected Western Cape Schools

ERIC Educational Resources Information Center

Bojuwoye, Olaniyi; Moletsane, Mokgadi; Stofile, Sindiswa; Moolla, Nadeen; Sylvester, Fredrick

2014-01-01

The study explored Western Cape primary and secondary school learners' experiences regarding the provision and utilization of support services for improving learning. A qualitative interpretive approach was adopted and data gathered through focus group interviews involving 90 learners. Results revealed that learners received and utilized various…

In Their Own Words: Best Practices for Advising Millennial Students about Majors

ERIC Educational Resources Information Center

Montag, Tamara; Campo, Jill; Weissman, Julie; Walmsley, Angela; Snell, Alex

2012-01-01

Utilizing generational theory, we explored the relationship between Millennial characteristics and students' major selection and academic advising experiences. We conducted focus groups of students with senior standing at a private, midwestern university, and we utilized a closed coding technique to analyze the qualitative data. Consistent with…

Instructional Utilization of the Internet in Public School Settings.

ERIC Educational Resources Information Center

Milheim, William D.

1997-01-01

Discussion of use of the Internet in educational settings focuses on providing specific information for elementary and secondary school personnel to increase their awareness and utilization of the Internet. Topics include accessing the Internet; school access; origins of the Internet; electronic mail; discussion groups, or listservs; newsgroups;…

The Room Itself is Active: How Classroom Design Impacts Student Engagement

ERIC Educational Resources Information Center

Rands, Melissa L.; Gansemer-Topf, Ann M.

2017-01-01

A responsive case study evaluation approach utilizing interviews and focus groups collected student and faculty perspectives on examined how instructors and students utilized a newly redesigned active learning space at Iowa State University and the relationship of this design with environmental and behavioral factors of student engagement. The…

Combining Causal Model and Focus Group Discussions Experiences Learned from a Socio-Anthropological Research on the Differing Perceptions of Caretakers and Health Professionals on Children's Health (Bolivia/Peru)

ERIC Educational Resources Information Center

Lefevre, Pierre; de Suremain, Charles-Edouard; Rubin de Celis, Emma; Sejas, Edgar

2004-01-01

The paper discusses the utility of constructing causal models in focus groups. This was experienced as a complement to an in-depth ethnographic research on the differing perceptions of caretakers and health professionals on child's growth and development in Peru and Bolivia. The rational, advantages, difficulties and necessary adaptations of…

Using focus groups to develop interventions to promote colorectal cancer screening among Vietnamese Americans.

PubMed

Nguyen, Bang H; Vo, Phuong H; Doan, Hiep T; McPhee, Stephen J

2006-01-01

Colorectal cancer is the third most common cancer in Vietnamese Americans. Their colorectal screening rates are lower than the rates of whites. Four focus groups were conducted to identify Vietnamese American sources and credibility of health information, media utilization, and intervention approaches. Vietnamese Americans trusted doctors and patient testimonials and had access to, and received most of their health information from, Vietnamese- language print and electronic media. Recommended intervention approaches include promoting doctors' recommendation of screening and using Vietnamese-language mass media, print materials, and oral presentations. Focus groups are useful in determining communication channels and intervention approaches.

What Is Group Process?: Integrating Process Work into Psychoeducational Groups

ERIC Educational Resources Information Center

Mills, Bethany; McBride, Dawn Lorraine

2016-01-01

Process work has long been a tenet of successful counseling outcomes. However, there is little literature available that focuses on how to best integrate process work into group settings--particularly psychoeducational groups that are content heavy and most often utilized in a school setting. In this article, the authors provide an overview of the…

Effects of wellness programs in family medicine.

PubMed

McGrady, Angele; Brennan, Julie; Lynch, Denis

2009-06-01

The objective of this research was to determine the effects of wellness programs on quality of life and utilization in an academic family medicine practice in two small controlled studies. One offered stress management and problem solving; the second offered a broader wellness intervention. Outcome measures consisted of scores on the Beck Anxiety Inventory, Hamilton Depression Inventory, CES-D (depression), Health Related Quality of Life, SF-12, and the number of office visits in 6 months. Subjects were randomly assigned to intervention or control groups. Statistical analysis compared pre-test and post-test values of the dependent variables between groups. In study one, where the focus was on relaxation, significant differences between groups were observed in anxiety at post-test (p < .03); the intervention group had lower anxiety levels. In study two which had a more general focus, significant group differences were found in days of poor mental health and number of days of depressed mood; the intervention group had fewer days of poor mental health (p < .05) and depression (p < .05) at post-test. No differences were found in utilization in either study. Based on the results of this research, short term wellness programs can be implemented in family practice and are effective in improving quality of life, but not in deceasing utilization in family practice patients. Matching the design of the program to specific patient needs may increase retention and effectiveness.

In-Situ Resource Utilization for the Moon, Mars and Beyond...

NASA Technical Reports Server (NTRS)

Trigwell, Steve

2010-01-01

For any future manned exploration to the moon, Mars, or beyond, there is a significant need to reduce the cost and logistics of transporting the raw materials such as oxygen, water, and fuel required to sustain human activity. Current research at Kennedy Space Center is focused on utilizing the resources at the destination to produce these requirements on-site, i.e. to live off the land. This program, known as In-situ Resource Utilization (ISRU), is the focus of the Applied Science and Technology research group here at KSC. This slide presentation will introduce the laboratories and highlight current research in ISRU to produce oxygen, water, and fuel components from lunar and Martian regolith.

Medical pluralism of the Chinese in London: an exploratory study.

PubMed

Rochelle, Tina L; Marks, David F

2010-11-01

This study was designed to examine the extent of medical pluralism among the Chinese in London. Members of the London Chinese community were recruited through Chinese organizations in London and participated in six focus groups. A total of 48 Chinese men and women aged 24-74 years were asked to talk about their health behaviour and health utilization patterns. Transcripts of the focus group discussions underwent thematic analysis to explore and describe the utilization of traditional Chinese medicine (TCM) and Western medicine (WM) of informants and factors that impacted on utilization. Findings focus on participants' evaluation of TCM and WM as two systems of health provision, how informants used these two health systems, and the reasons associated with use of these two systems. Utilization of TCM and WM varied. Concurrent use of TCM and WM was common. The National Health Service was generally perceived as difficult to use, with concerns over the language barrier, and communicating with and being able to trust health providers. The UK TCM trade was perceived as being aimed at the non-Chinese market and there were issues of trust related to the regulation of UK TCM. Although none of these issues are unique to the Chinese in the UK, previous experience with different approaches to health care, particularly TCM, may make the experience of such barriers more extreme.

Student Perceptions on the Impact of Career and Technical Education Programs: A Mixed-Methods Study

ERIC Educational Resources Information Center

Eimers, Kimberly

2017-01-01

This mixed-methods study analyzed student perceptions regarding the impact of career and technical education (CTE) programs on student engagement, mind-set, support of teachers, and school climate. The Tripod 7C instrument was utilized to gather quantitative data, while focus groups were utilized for gathering qualitative data. Survey results…

Applied Self-Statement Modification and Applied Modified Desensitization in the Treatment of Speech Anxiety: The Synergy Hypothesis.

ERIC Educational Resources Information Center

Melanson, Diane C.

A study examined the relative effectiveness and synergistic effect of two treatments for reducing speech anxiety--Self-Statement Modification (SSM), a therapy focused on modification of cognitive behavior; and Modified Desensitization (MD), a therapy focused on physiological variables, utilizing relaxation training, group hierarchy construction,…

Psychology of Learning Spaces: Impact on Teaching and Learning

ERIC Educational Resources Information Center

Granito, Vincent J.; Santana, Mary E.

2016-01-01

New research is emerging that focuses on the role the physical classroom space plays in the teaching-learning dynamic. The purpose of this exploratory research is to describe the students' and instructors' perspectives of how the classroom space and environment impact teaching and learning. Focus groups were utilized with data points coming from…

Utilizing Cross-Cultural Curricula To Improve Interpersonal Job Skills Training.

ERIC Educational Resources Information Center

Barker, Shirl A.

2002-01-01

An experimental group of 65 secondary vocational students received cross-cultural training focused on interpersonal communication and job skills. Compered with 65 controls, the experimental group had significantly better interpersonal skills. Differences in terms of gender, ethnicity, and rural/urban location were found. (Contains 18 references.)…

Interaction among Undergraduate Students: Does Age Matter?

ERIC Educational Resources Information Center

Gregoryk, Kerry; Eighmy, Myron

2009-01-01

This mixed method study described the interaction preferences among generational groups of undergraduate students and how these preferences factor into classroom interaction. The study utilized a two-phase process, starting with qualitative data gathered from focus groups. A published instrument was used to qualify participants for one of four…

'Better than nothing' is not good enough: challenges to introducing evidence-based approaches for traumatized populations.

PubMed

Clark, James J; Sprang, Ginny; Freer, Benjamin; Whitt-Woosley, Adrienne

2012-04-01

Focus group data were generated by a larger, mixed-methods investigation on treatment practices among therapists working with significantly traumatized populations in a primarily rural, underdeveloped region of the USA. This paper explores reasons behind low utilization of evidence-based practices (EBPs) that putatively would benefit poor communities where these behavioural health care providers serve. Eight focus groups of 45 licensed and certified behavioural health professionals were conducted over a 6-month period of time in 2006. Sites were selected based on Beale code designations with representation from urban, rural, and rural with urban influence providers. Potential respondents were selected from licensing board membership rosters and invited to participate in the study. Focus groups were facilitated by trained interviewers using a semi-structured interview schedule that focused on how participants defined, assessed, and understood trauma, as well as the information therapists utilized to determine interventions for clients with trauma histories. Focus group transcripts were analysed using qualitative data reduction methods and six major themes emerged regarding the limited use of EBPs: complexity of trauma identification, issues with manualized assessment, role of treatment settings, conditions for innovation success and failure, untangling cultural effects, and defining successful treatment outcomes. These findings shed light on the endurance of insufficient behavioural health infrastructures despite therapists' access to scientifically validated treatments for trauma spectrum and co-morbid mental disorders suffered by children and adults. Such insights have implications for the success of global dissemination of validated behavioural health interventions. © 2010 Blackwell Publishing Ltd.

Breast cancer survivorship program: testing for cross-cultural relevance.

PubMed

Chung, Lynna K; Cimprich, Bernadine; Janz, Nancy K; Mills-Wisneski, Sharon M

2009-01-01

Taking CHARGE, a theory-based self-management program, was developed to assist women with survivorship concerns that arise after breast cancer treatment. Few such programs have been evaluated for cultural relevance with diverse groups. This study determined the utility and cultural relevance of the program for African American (AA) breast cancer survivors. Two focus groups were held with AA women (n = 13), aged 41 to 72 years, who had completed primary treatment. Focus group participants assessed the program content, format, materials, and the self-regulation process. Content analysis of audiotapes was conducted using an open, focused coding process to identify emergent themes regarding program relevance and topics requiring enhancement and/or further emphasis. Although findings indicated that the program's content was relevant to participants' experiences, AA women identified need for cultural enhancements in spirituality, self-preservation, and positive valuations of body image. Content areas requiring more emphasis included persistent fatigue, competing demands, disclosure, anticipatory guidance, and age-specific concerns about body image/sexuality. Suggested improvements to program materials included portable observation logs, additional resources, more photographs of younger AA women, vivid colors, and images depicting strength. These findings provide the basis for program enhancements to increase the utility and cultural relevance of Taking CHARGE for AA survivors and underscore the importance of evaluating interventions for racially/ethnically diverse groups.

"A'ole" Drugs! Cultural Practices and Drug Resistance of Rural Hawai'ian Youths

ERIC Educational Resources Information Center

Po'A-Kekuawela, Ka'Ohinani; Okamoto, Scott K.; Nebre, La Risa H.; Helm, Susana; Chin, Coralee I. H.

2009-01-01

This qualitative study examined how Native Hawai'ian youths from rural communities utilized cultural practices to promote drug resistance and/or abstinence. Forty-seven students from five different middle schools participated in gender-specific focus groups that focused on the cultural and environmental contexts of drug use for Native Hawai'ian…

Using participatory action research in a community-based initiative addressing complex mental health needs.

PubMed

Knightbridge, Stephen M; King, Robert; Rolfe, Timothy J

2006-04-01

This paper describes the first phase of a larger project that utilizes participatory action research to examine complex mental health needs across an extensive group of stakeholders in the community. Within an objective qualitative analysis of focus group discussions the social ecological model is utilized to explore how integrative activities can be informed, planned and implemented across multiple elements and levels of a system. Seventy-one primary care workers, managers, policy-makers, consumers and carers from across the southern metropolitan and Gippsland regions of Victoria, Australia took part in seven focus groups. All groups responded to an identical set of focusing questions. Participants produced an explanatory model describing the service system, as it relates to people with complex needs, across the levels of social ecological analysis. Qualitative themes analysis identified four priority areas to be addressed in order to improve the system's capacity for working with complexity. These included: (i) system fragmentation; (ii) integrative case management practices; (iii) community attitudes; and (iv) money and resources. The emergent themes provide clues as to how complexity is constructed and interpreted across the system of involved agencies and interest groups. The implications these findings have for the development and evaluation of this community capacity-building project were examined from the perspective of constructing interventions that address both top-down and bottom-up processes.

How does the New Cooperative Medical Scheme influence health service utilization? A study in two provinces in rural China.

PubMed

Yu, Baorong; Meng, Qingyue; Collins, Charles; Tolhurst, Rachel; Tang, Shenglan; Yan, Fei; Bogg, Lennart; Liu, Xiaoyun

2010-05-10

Many countries are developing health financing mechanisms to pursue the goal of universal coverage. In China, a rural health insurance system entitled New Cooperative Medical Scheme (NCMS) is being developed since 2003. Although there is concern about whether the NCMS will influence the serious situation of inequity in health service utilization in rural China, there is only limited evidence available. This paper aims to assess the utilisation of outpatient and inpatient services among different income groups and provinces under NCMS in rural China. Using multistage sampling processes, a cross-sectional household survey including 6,147 rural households and 22,636 individuals, was conducted in six counties in Shandong and Ningxia Provinces, China. Chi-square test, Poisson regression and log-linear regression were applied to analyze the association between NCMS and the utilization of outpatient and inpatient services and the length of stay for inpatients. Qualitative methods including individual interview and focus group discussion were applied to explain and complement the findings from the household survey. NCMS coverage was 95.9% in Shandong and 88.0% in Ningxia in 2006. NCMS membership had no significant association with outpatient service utilization regardless of income level and location.Inpatient service utilization has increased for the high income group under NCMS, but for the middle and low income, the change was not significant. Compared with non-members, NCMS members from Ningxia used inpatient services more frequently, while members from Shandong had a longer stay in hospital.High medical expenditure, low reimbursement rate and difference in NCMS policy design between regions were identified as the main reasons for the differences in health service utilization. Outpatient service utilization has not significantly changed under NCMS. Although utilization of inpatient service in general has increased under NCMS, people with high income tend to benefit more than the low income group. While providing financial protection against catastrophic medical expenditure is the principal focus of NCMS, this study recommends that outpatient services should be incorporated in future NCMS policy development. NCMS policy should also be more equity oriented to achieve its policy goal.

Can Faith and Hospice Coexist: Is the African American Church the Key to Increased Hospice Utilization for African Americans?

PubMed

Townsend, Apollo; March, Alice L; Kimball, Jan

2017-01-01

African Americans are twice as likely as Caucasian Americans to choose aggressive hospital treatment when death is imminent. Repeat hospitalizations are traumatic for patients and drain patient and health system resources. Hospice care is a specialized alternative that vastly improves patient quality of life at end-of-life. This study was conducted to determine if hospices partnering with African American churches to disseminate hospice education materials could increase utilization of hospice services by African Americans. Members of two African American churches (N = 34) participated in focus group discussions to elicit beliefs about hospice care. Focus group transcripts were coded and comments were grouped according to theme. Six themes were identified. Lack of knowledge about hospice services and spiritual beliefs emerged as the top two contributing factors for underutilization of hospice services. Study findings support partnerships between hospices and African American churches to provide hospice education to the African American community. © The Author(s) 2015.

An Information and Referral Model for Improving Self-Help Group Utilization.

ERIC Educational Resources Information Center

Wollert, Richard

This paper describes the Self-Help Information Service (SIS), and summarizes data evaluating the program. Associated with a generally focused information and referral service (I&R), SIS was designed to facilitate research on self-help groups. Its specific goals were to develop and maintain a telephone referral service disseminating self-help…

Heritage and Identity: Ethnic Minority Students from South Asia in Hong Kong

ERIC Educational Resources Information Center

Gu, Mingyue; Patkin, John

2013-01-01

This article investigates the language attitudes, language practices and identity construction of a group of ethnic minority students in a secondary school in Hong Kong. Drawing on data from focus group and individual interviews, this research shows that the ethnic minority students negotiate and contest their heritage identity by utilizing their…

Sexual Orientation Microaggressions: "Death by a Thousand Cuts" for Lesbian, Gay, and Bisexual Youth

ERIC Educational Resources Information Center

Nadal, Kevin L.; Issa, Marie-Anne; Leon, Jayleen; Meterko, Vanessa; Wideman, Michelle; Wong, Yinglee

2011-01-01

In recent years, there has been a growth of literature examining the mental health impacts of microaggressions, which are defined as subtle forms of discrimination toward oppressed groups. The current study utilized a qualitative focus group method and directed content analysis to categorize several types of sexual orientation microaggressions…

Predictors of physical therapy clinic performance in the treatment of patients with low back pain syndromes.

PubMed

Resnik, Linda; Liu, Dawei; Mor, Vince; Hart, Dennis L

2008-09-01

Little is known about organizational and service delivery factors related to quality of care in physical therapy. This study sought to identify characteristics related to differences in practice outcomes and service utilization. The sample comprised 114 outpatient clinics and 1,058 therapists who treated 16,281 patients with low back pain syndromes during the period 2000-2001. Clinics participated with the Focus on Therapeutic Outcomes, Inc (FOTO) database. Hierarchical linear models were used to risk adjust treatment outcomes and number of visits per treatment episode. Aggregated residual scores from these models were used to classify each clinic into 1 of 3 categories in each of 3 types of performance groups: (1) effectiveness, (2) utilization, and (3) overall performance (ie, composite measure of effectiveness and utilization). Relationships between clinic classification and the following independent variables were examined by multinomial logistic regression: years of therapist experience, number of physical therapists, ratio of physical therapists to physical therapist assistants, proportion of patients with low back pain syndromes, number of new patients per physical therapist per month, utilization of physical therapist assistants, and setting. Clinics that were lower utilizers of physical therapist assistants were 6.6 times more likely to be classified into the high effectiveness group compared with the low effectiveness group, 6.7 times more likely to be classified in the low utilization group compared with the high utilization group, and 12.4 times more likely to be classified in the best performance group compared with the worst performance group. Serving a higher proportion of patients with low back pain syndromes was associated with an increased likelihood of being classified in the lowest or middle group. Years of physical therapist experience was inversely associated with being classified in the middle utilization group compared with the highest utilization group. These findings suggest that, in the treatment of patients with low back pain syndromes, clinics that are low utilizers of physical therapist assistants are more likely to provide superior care (ie, better patient outcomes and lower service use).

Use of focus groups in a library's strategic planning process.

PubMed

Higa-Moore, Mori Lou; Bunnett, Brian; Mayo, Helen G; Olney, Cynthia A

2002-01-01

The use of focus groups to determine patron satisfaction with library resources and services is extensive and well established. This article demonstrates how focus groups can also be used to help shape the future direction of a library as part of the strategic planning process. By responding to questions about their long-term library and information needs, focus group participants at the University of Texas Southwestern Medical Center at Dallas Library contributed an abundance of qualitative patron data that was previously lacking from this process. The selection and recruitment of these patrons is discussed along with the line of questioning used in the various focus group sessions. Of special interest is the way the authors utilized these sessions to mobilize and involve the staff in creating the library's strategic plan. This was accomplished not only by having staff members participate in one of the sessions but also by sharing the project's major findings with them and instructing them in how these findings related to the library's future. The authors' experience demonstrates that focus groups are an effective strategic planning tool for libraries and emphasizes the need to share information broadly, if active involvement of the staff is desired in both the development and implementation of the library's strategic plan.

Use of focus groups in a library's strategic planning process

PubMed Central

Higa-Moore, Mori Lou; Bunnett, Brian; Mayo, Helen G.; Olney, Cynthia A.

2002-01-01

The use of focus groups to determine patron satisfaction with library resources and services is extensive and well established. This article demonstrates how focus groups can also be used to help shape the future direction of a library as part of the strategic planning process. By responding to questions about their long-term library and information needs, focus group participants at the University of Texas Southwestern Medical Center at Dallas Library contributed an abundance of qualitative patron data that was previously lacking from this process. The selection and recruitment of these patrons is discussed along with the line of questioning used in the various focus group sessions. Of special interest is the way the authors utilized these sessions to mobilize and involve the staff in creating the library's strategic plan. This was accomplished not only by having staff members participate in one of the sessions but also by sharing the project's major findings with them and instructing them in how these findings related to the library's future. The authors' experience demonstrates that focus groups are an effective strategic planning tool for libraries and emphasizes the need to share information broadly, if active involvement of the staff is desired in both the development and implementation of the library's strategic plan. PMID:11838465

Regional health care planning: a methodology to cluster facilities using community utilization patterns

PubMed Central

2013-01-01

Background Community-based health care planning and regulation necessitates grouping facilities and areal units into regions of similar health care use. Limited research has explored the methodologies used in creating these regions. We offer a new methodology that clusters facilities based on similarities in patient utilization patterns and geographic location. Our case study focused on Hospital Groups in Michigan, the allocation units used for predicting future inpatient hospital bed demand in the state’s Bed Need Methodology. The scientific, practical, and political concerns that were considered throughout the formulation and development of the methodology are detailed. Methods The clustering methodology employs a 2-step K-means + Ward’s clustering algorithm to group hospitals. The final number of clusters is selected using a heuristic that integrates both a statistical-based measure of cluster fit and characteristics of the resulting Hospital Groups. Results Using recent hospital utilization data, the clustering methodology identified 33 Hospital Groups in Michigan. Conclusions Despite being developed within the politically charged climate of Certificate of Need regulation, we have provided an objective, replicable, and sustainable methodology to create Hospital Groups. Because the methodology is built upon theoretically sound principles of clustering analysis and health care service utilization, it is highly transferable across applications and suitable for grouping facilities or areal units. PMID:23964905

Regional health care planning: a methodology to cluster facilities using community utilization patterns.

PubMed

Delamater, Paul L; Shortridge, Ashton M; Messina, Joseph P

2013-08-22

Community-based health care planning and regulation necessitates grouping facilities and areal units into regions of similar health care use. Limited research has explored the methodologies used in creating these regions. We offer a new methodology that clusters facilities based on similarities in patient utilization patterns and geographic location. Our case study focused on Hospital Groups in Michigan, the allocation units used for predicting future inpatient hospital bed demand in the state's Bed Need Methodology. The scientific, practical, and political concerns that were considered throughout the formulation and development of the methodology are detailed. The clustering methodology employs a 2-step K-means + Ward's clustering algorithm to group hospitals. The final number of clusters is selected using a heuristic that integrates both a statistical-based measure of cluster fit and characteristics of the resulting Hospital Groups. Using recent hospital utilization data, the clustering methodology identified 33 Hospital Groups in Michigan. Despite being developed within the politically charged climate of Certificate of Need regulation, we have provided an objective, replicable, and sustainable methodology to create Hospital Groups. Because the methodology is built upon theoretically sound principles of clustering analysis and health care service utilization, it is highly transferable across applications and suitable for grouping facilities or areal units.

Focus Group Evaluation of the LIVE Network—An Audio Music Program to Promote ART Adherence Self-Management

PubMed Central

Holstad, Marcia McDonnell; Baumann, Maya; Ofotokun, Ighovwerha; Logwood, Steven J.

2013-01-01

We present the results of 3 focus groups conducted to assess the utility, appeal, and feasibility of the LIVE Network (LN), a 70-minute audio music program developed to educate and motivate HIV-infected persons to adhere to antiretroviral therapy (ART) and self-manage medication-related side effects. Participants included 15 African American, 2 caucasian, and 1 race unknown HIV-infected persons who had been taking ART for at least 6 months. In general, the LN was well liked, relevant, educational, and motivational. It empowered and motivated participants to be responsible for their adherence self-care. One of the more surprising findings was how freely focus group participants shared the program with family and friends as a means of education and also as a means of disclosure. Moreover, the positive reception of the LN by individuals outside of the focus groups, especially children and adolescents, speaks well for the potential broad appeal of this type of program. PMID:24013689

Quality of life in epilepsy (QOLIE): insights about epilepsy and support groups from people with epilepsy (San Francisco Bay Area, USA).

PubMed

Chung, Kenny; Liu, Yuan; Ivey, Susan L; Huang, Debbie; Chung, Corina; Guo, Wenting; Tseng, Winston; Ma, Daveena

2012-06-01

This study evaluated quality of life (QOL) in people with epilepsy (PWE) in the San Francisco Bay Area. This was a qualitative study examining QOL through the use of focus groups and of the QOLIE-31-P survey instrument. Six focus groups were conducted to examine self-reported challenges due to epilepsy. Focus groups were conducted for individuals who did and did not attend support groups. Individuals with epilepsy reported substantial difficulties with finances, physical and psychosocial functioning. Also, limited knowledge about services and relatively negative feelings toward self were common among newly diagnosed participants. Many of the issues surrounding QOL and challenges were shared across groups. Epilepsy-related social services appeared to be useful in helping PWE cope and in increasing PWE's awareness of key enabling services. Although many individuals with epilepsy reported poor QOL and other challenges, epilepsy-related services may be under-utilized due to a lack of awareness. Copyright © 2012 Elsevier Inc. All rights reserved.

Characteristics of utility cyclists in Queensland, Australia: an examination of the associations between individual, social, and environmental factors and utility cycling.

PubMed

Sahlqvist, Shannon L; Heesch, Kristiann C

2012-08-01

Initiatives to promote utility cycling in countries like Australia and the US, which have low rates of utility cycling, may be more effective if they first target recreational cyclists. This study aimed to describe patterns of utility cycling and examine its correlates, among cyclists in Queensland, Australia. An online survey was administered to adult members of a state-based cycling community and advocacy group (n=1813). The survey asked about demographic characteristics and cycling behavior, motivators and constraints. Utility cycling patterns were described, and logistic regression modeling was used to examine associations between utility cycling and other variables. Forty-seven percent of respondents reported utility cycling: most did so to commute (86%). Most journeys (83%) were >5 km. Being male, younger, employed full-time, or university-educated increased the likelihood of utility cycling (P<.05). Perceiving cycling to be a cheap or a convenient form of transport was associated with utility cycling (P<.05). The moderate rate of utility cycling among recreational cyclists highlights a potential to promote utility cycling among this group. To increase utility cycling, strategies should target female and older recreational cyclists and focus on making cycling a cheap and convenient mode of transport.

EPA Solar Utilization in Higher Education Networking and Information Sharing Group

EPA Pesticide Factsheets

EPA's Green Power Partnership has a number of initiatives that focus on the collective green power efforts within specific sectors and renewable energy procurement strategies, which provide recognition opportunities for Partners and increase awareness.

The Enhancement of Simulation Based Learning Exercises through Formalised Reflection, Focus Groups and Group Presentation

ERIC Educational Resources Information Center

Mawdesley, M.; Long, G.; Al-jibouri, S.; Scott, D.

2011-01-01

Computer based simulations and games can be useful tools in teaching aspects of construction project management that are not easily transmitted through traditional lecture based approaches. However, it can be difficult to quantify their utility and it is essential to ensure that students are achieving the learning outcomes required rather than…

An Examination of Health Information Management by the Deaf

ERIC Educational Resources Information Center

Karras, Elizabeth

2010-01-01

Little is known about how Deaf people perceive, access, and utilize interpersonal and media sources for health information. In light of the scarcity of research on health information management among this group, a two-phase study was conducted that included eight focus groups (N=39) and survey data (N=366) with Deaf participants to determine the…

[High utilization of health insurance services by the elderly--analysis of hospital and drug utilization data].

PubMed

Nordheim, Johanna; Maaz, Asja; Winter, Maik H J; Kuhlmey, Adelheid; Hofmann, Werner

2006-01-01

The present contribution discusses the utilization of the healthcare system by elderly patients in Germany. First, the paper focuses on the detailed characterization of a group of people aged 60 years or more (N = 73,454). Second, the objective is to analyze the data for high utilization of healthcare services by older men and women. The analysis is based on data regularly recorded by a German health insurance agency for the year 2000. High utilization is operationalized by a 10% cutoff for users with the highest number of treatments, highest costs and/or other criteria depending on the respective health service sector. The insured group investigated received approximately 1.4 million prescriptions, producing costs of 42 million E. High utilizers account for 32% of all prescriptions and 44% of the costs, respectively. At the same time, the age groups with the highest prescription rates do not cause the highest costs: So the relationship between age and prescription drug expenses as well as between age and prescription rates does not display an arithmetically increasing pattern. Within the timeframe investigated 26,000 hospital treatments were accounted for by 21.75% of the elderly under research. In total, they caused expenses of 88 million E. High utilization in the hospital sector was operationalized by four criteria. Sex- and age-specific analysis of high utilization of hospital treatment revealed that the four different criteria apply to different insured groups. In summary, the high utilization of healthcare services appears to be a multidimensional phenomenon.

Age Differences in Consumer Decision Making under Option Framing: From the Motivation Perspective

PubMed Central

Peng, Huamao; Xia, Shiyong; Ruan, Fanglin; Pu, Bingyan

2016-01-01

Option framing effect is the phenomena that participants often accept more options when they are asked to delete undesired options from a full model (subtractive framing) than they do when they are instructed to add desired options to a base model (additive framing). Whether the same effect exists in different age groups is less well known. To explore the roles of age and purchase motivations on the option framing effect for automobiles purchases, this study adopted a 3 (age group: younger, middle-aged, vs. older) × 2 (option framing: additive vs. subtractive) × 2 (focus condition: information vs. emotion) mixed design. To manipulate purchase motivations, participants in the three age groups were instructed to focus on the ratio of utility and price of options (information-focus) or the extent of pleasure induced by the options (emotion-focus) when they made purchase decisions in two framing conditions. The results revealed similar option framing effect across all age groups in the information-focus condition regarding the total price paid for accepted options. In contrast, the framing effect was not found in the emotion-focus condition. In addition, older adults accepted more options and an overall higher price than younger and middle-aged adults in both focus conditions. This difference was more obvious in the emotion-focus condition than in the information-focus condition. Moreover, both the number of accepted options and the total accepted price of the younger group in the information-focus condition were higher than those in the emotion-focus condition, whereas the older and middle-aged groups accepted same number of options and price between two focus conditions. These results imply that purchase motivation is a moderator of the option framing effect and age characteristics linked with motivations must be considered in sales. PMID:27872603

Age Differences in Consumer Decision Making under Option Framing: From the Motivation Perspective.

PubMed

Peng, Huamao; Xia, Shiyong; Ruan, Fanglin; Pu, Bingyan

2016-01-01

Option framing effect is the phenomena that participants often accept more options when they are asked to delete undesired options from a full model (subtractive framing) than they do when they are instructed to add desired options to a base model (additive framing). Whether the same effect exists in different age groups is less well known. To explore the roles of age and purchase motivations on the option framing effect for automobiles purchases, this study adopted a 3 (age group: younger, middle-aged, vs. older) × 2 (option framing: additive vs. subtractive) × 2 (focus condition: information vs. emotion) mixed design. To manipulate purchase motivations, participants in the three age groups were instructed to focus on the ratio of utility and price of options (information-focus) or the extent of pleasure induced by the options (emotion-focus) when they made purchase decisions in two framing conditions. The results revealed similar option framing effect across all age groups in the information-focus condition regarding the total price paid for accepted options. In contrast, the framing effect was not found in the emotion-focus condition. In addition, older adults accepted more options and an overall higher price than younger and middle-aged adults in both focus conditions. This difference was more obvious in the emotion-focus condition than in the information-focus condition. Moreover, both the number of accepted options and the total accepted price of the younger group in the information-focus condition were higher than those in the emotion-focus condition, whereas the older and middle-aged groups accepted same number of options and price between two focus conditions. These results imply that purchase motivation is a moderator of the option framing effect and age characteristics linked with motivations must be considered in sales.

Eight Weeks of Strength and Power Training Improves Club Head Speed in Collegiate Golfers.

PubMed

Oranchuk, Dustin J; Mannerberg, Jason M; Robinson, Tracey L; Nelson, Megan C

2018-02-14

Club head speed (CHS) is a major determinant of drive distance, a key component of golf performance. The purpose of this study was to determine the indirect effects of an eight-week strength and power program on CHS. Twelve (6 male, 6 female) NCAA Division II golfers (20.3±1.5 years) randomly assigned to an intervention or control group, underwent either a periodized strength and power program consisting of high-load barbell movements or a bodyweight and rotational movement focused resistance training program. Outcomes were CHS, countermovement jump (CMJ) height, and 1RM back squat (BS), power clean (PC), and deadlift (DL). Dependent t-tests were utilized to assess differences in outcome variables pre-to-post for each group, independent t-tests were utilized to assess differences between groups, and Pearson correlations were utilized to assess associations between CHS and outcome variables. On average, the intervention group experienced improvements in all outcome variables except peak CHS (p=0.60); the control group displayed no changes in any outcome variable except a decrease in average CHS (p=0.028). Compared to the control group, the intervention group experienced greater improvements in average CHS, BS, PC, and average and peak CMJ height (p<0.05). Additionally, CHS had large associations with PC (r=0.70, p=0.012), BS (r=0.64, p=0.025), DL (r=0.54, p=0.068) and CMJ (r=0.73, p=0.007). These results suggest improving muscular strength and power by increasing PC, BS, and CMJ is associated with increased CHS in collegiate golfers. Integrating a high-load, barbell-focused strength and power program may be beneficial for improving CHS and indirectly, golf performance.

Effect of Web Assisted Education Supported by Six Thinking Hats on Students' Academic Achievement in Science and Technology Classes

ERIC Educational Resources Information Center

Ercan, Orhan; Bilen, Kadir

2014-01-01

Advances in computer technologies and adoption of related methods and techniques in education have developed parallel to each other. This study focuses on the need to utilize more than one teaching method and technique in education rather than focusing on a single teaching method. By using the pre-test post-test and control group semi-experimental…

A Qualitative Evaluation of Student Learning and Skills Use in a School-Based Mindfulness and Yoga Program

PubMed Central

Mirabal-Beltran, Roxanne; Cluxton-Keller, Fallon; Gould, Laura Feagans; Greenberg, Mark T.; Mendelson, Tamar

2016-01-01

Previous studies on school-based mindfulness and yoga programs have focused primarily on quantitative measurement of program outcomes. This study used qualitative data to investigate program content and skills that students remembered and applied in their daily lives. Data were gathered following a 16-week mindfulness and yoga intervention delivered at three urban schools by a community non-profit organization. We conducted focus groups and interviews with nine classroom teachers who did not participate in the program and held six focus groups with 22 fifth and sixth grade program participants. This study addresses two primary research questions: (1) What skills did students learn, retain, and utilize outside the program? and (2) What changes did classroom teachers expect and observe among program recipients? Four major themes related to skill learning and application emerged as follows: (1) youths retained and utilized program skills involving breath work and poses; (2) knowledge about health benefits of these techniques promoted self-utilization and sharing of skills; (3) youths developed keener emotional appraisal that, coupled with new and improved emotional regulation skills, helped de-escalate negative emotions, promote calm, and reduce stress; and (4) youths and teachers reported realistic and optimistic expectations for future impact of acquired program skills. We discuss implications of these findings for guiding future research and practice. PMID:26918064

Diabetes Care Management Teams Did Not Reduce Utilization When Compared With Traditional Care: A Randomized Cluster Trial.

PubMed

Kearns, Patrick

2017-10-01

PURPOSE: Health services research evaluates redesign models for primary care. Care management is one alternative. Evaluation includes resource utilization as a criterion. Compare the impact of care-manager teams on resource utilization. The comparison includes entire panes of patients and the subset of patients with diabetes. DESIGN: Randomized, prospective, cohort study comparing change in utilization rates between groups, pre- and post-intervention. METHODOLOGY: Ten primary care physician panels in a safety-net setting. Ten physicians were randomized to either a care-management approach (Group 1) or a traditional approach (Group 2). Care managers focused on diabetes and the cardiovascular cluster of diseases. Analysis compared rates of hospitalization, 30-day readmission, emergency room visits, and urgent care visits. Analysis compared baseline rates to annual rates after a yearlong run-in for entire panels and the subset of patients with diabetes. RESULTS: Resource utilization showed no statistically significant change between baseline and Year 3 (P=.79). Emergency room visits and hospital readmission increased for both groups (P=.90), while hospital admissions and urgent care visits decreased (P=.73). Similarly, utilization was not significantly different for patients with diabetes (P=.69). CONCLUSIONS: A care-management team approach failed to improve resource utilization rates by entire panels and the subset of diabetic patients compared to traditional care. This reinforces the need for further evidentiary support for the care-management model's hypothesis in the safety net.

New Challenges for a Core Procedure: Development of a Faculty Workshop for Skills Maintenance for Abdominal Hysterectomy.

PubMed

Berkowitz, Lori R; James, Kaitlyn; Petrusa, Emil; York-Best, Carey; Kaimal, Anjali J

2018-02-05

To describe the development of a low-cost educational module for OB/GYN faculty skills maintenance for total abdominal hysterectomy (TAH), a low frequency core procedure in obstetrics and gynecology. After review of existing educational tools and utilization of a modified Delphi method to establish consensus regarding key procedural components for skills maintenance, a 2-hour workshop was developed to review knowledge and participate in a simulation focused on the critical steps in performing TAH. An expert in TAH delivered a lecture highlighting important surgical considerations. Participants then rotated through simulation stations for critical steps in TAH: dissecting the bladder, identifying the ureter, and closing the cuff. Knowledge gains were assessed with a written pre- and posttest. Consecutive focus groups were conducted with participants on effectiveness of the workshop, and suggestions for improvement. Ideas identified in the first focus group were incorporated into the second workshop. Massachusetts General Hospital, an academic tertiary care facility with a single Obstetrics and Gynecology faculty group, located in Boston, Massachusetts. Eligible participants were recruited via email from full time specialists in General Obstetrics and Gynecology at Massachusetts General Hospital. Of the 25 eligible gynecology faculty subjects, 22 participated (88%). On pre or post-test comparison, 70% of participants scored higher on the posttest, demonstrating an increase in knowledge of critical TAH surgical steps. Focus group analyses identified the need for increased review and training demonstrations of TAH, and recommended continued offering of the workshop. Based on focus group responses and pre or posttest comparisons, the workshop was deemed feasible and enhanced short-term learning. Future directions include utilizing more challenging anatomic models and simulation scenarios and optimizing integration of expert demonstration and individualized coaching, as well as identifying regionally tailored surgical workshop programming. Copyright © 2018 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Consumer Opinions of Health Information Exchange, e-Prescribing, and Personal Health Records.

PubMed

Cochran, Gary L; Lander, Lina; Morien, Marsha; Lomelin, Daniel E; Brittin, Jeri; Reker, Celeste; Klepser, Donald G

2015-01-01

Consumer satisfaction is a crucial component of health information technology (HIT) utilization, as high satisfaction is expected to increase HIT utilization among providers and to allow consumers to become full participants in their own healthcare management. The primary objective of this pilot study was to identify consumer perspectives on health information technologies including health information exchange (HIE), e-prescribing (e-Rx), and personal health records (PHRs). Eight focus groups were conducted in seven towns and cities across Nebraska in 2013. Each group consisted of 10-12 participants. Discussions were organized topically in the following categories: HIE, e-Rx, and PHR. The qualitative analysis consisted of immersion and crystallization to develop a coding scheme that included both preconceived and emergent themes. Common themes across focus groups were identified and compiled for each discussion category. The study had 67 participants, of which 18 (27 percent) were male. Focus group findings revealed both perceived barriers and benefits to the adoption of HIT. Common HIT concerns expressed across focus groups included privacy and security of medical information, decreases in quality of care, inconsistent provider participation, and the potential cost of implementation. Positive expectations regarding HIT included better accuracy and completeness of information, and improved communication and coordination between healthcare providers. Improvements in patient care were expected as a result of easy physician access to consolidated information across providers as well as the speed of sharing and availability of information in an emergency. In addition, participants were optimistic about patient empowerment and convenient access to and control of personal health data. Consumer concerns focused on privacy and security of the health information, as well as the cost of implementing the technologies and the possibility of an unintended negative impact on the quality of care. While negative perceptions present barriers for potential patient acceptance, benefits such as speed and convenience, patient oversight of health data, and safety improvements may counterbalance these concerns.

Consumer Opinions of Health Information Exchange, e-Prescribing, and Personal Health Records

PubMed Central

Cochran, Gary L.; Lander, Lina; Morien, Marsha; Lomelin, Daniel E.; Brittin, Jeri; Reker, Celeste; Klepser, Donald G.

2015-01-01

Background Consumer satisfaction is a crucial component of health information technology (HIT) utilization, as high satisfaction is expected to increase HIT utilization among providers and to allow consumers to become full participants in their own healthcare management. Objective The primary objective of this pilot study was to identify consumer perspectives on health information technologies including health information exchange (HIE), e-prescribing (e-Rx), and personal health records (PHRs). Methods Eight focus groups were conducted in seven towns and cities across Nebraska in 2013. Each group consisted of 10–12 participants. Discussions were organized topically in the following categories: HIE, e-Rx, and PHR. The qualitative analysis consisted of immersion and crystallization to develop a coding scheme that included both preconceived and emergent themes. Common themes across focus groups were identified and compiled for each discussion category. Results The study had 67 participants, of which 18 (27 percent) were male. Focus group findings revealed both perceived barriers and benefits to the adoption of HIT. Common HIT concerns expressed across focus groups included privacy and security of medical information, decreases in quality of care, inconsistent provider participation, and the potential cost of implementation. Positive expectations regarding HIT included better accuracy and completeness of information, and improved communication and coordination between healthcare providers. Improvements in patient care were expected as a result of easy physician access to consolidated information across providers as well as the speed of sharing and availability of information in an emergency. In addition, participants were optimistic about patient empowerment and convenient access to and control of personal health data. Conclusion Consumer concerns focused on privacy and security of the health information, as well as the cost of implementing the technologies and the possibility of an unintended negative impact on the quality of care. While negative perceptions present barriers for potential patient acceptance, benefits such as speed and convenience, patient oversight of health data, and safety improvements may counterbalance these concerns. PMID:26604874

Cultural Adaptation of a Cognitive Behavior Therapy Guided Self-Help Program for Mexican American Women with Binge Eating Disorders

ERIC Educational Resources Information Center

Shea, Munyi; Cachelin, Fary; Uribe, Luz; Striegel, Ruth H.; Thompson, Douglas; Wilson, G. Terence

2012-01-01

Data on the compatibility of evidence-based treatment in ethnic minority groups are limited. This study utilized focus group interviews to elicit Mexican American women's (N = 12) feedback on a cognitive behavior therapy guided self-help program for binge eating disorders. Findings revealed 6 themes to be considered during the cultural adaptation…

Coordination and safety procedures for mail delivery on roadways without shoulders : technical report.

DOT National Transportation Integrated Search

2009-08-01

This research utilized interviews, focus groups, and surveys of U.S. Postal Service (USPS) and Texas Department of Transportation (TxDOT) employees to determine safety and coordination issues related to mail delivery on rural, two-lane highways witho...

Connecting Families to Their Health Record and Care Team: The Use, Utility, and Impact of a Client/Family Health Portal at a Children’s Rehabilitation Hospital

PubMed Central

Maxwell, Joanne; Karmali, Amir; Hagens, Simon; Pinto, Madhu; Williams, Laura; Adamson, Keith

2017-01-01

Background Health care portals have the potential to provide consumers with timely, transparent access to health care information and engage them in the care process. Objective The objective was to examine the use, utility, and impact on engagement in care and caregiver-provider communication of a client/family portal providing access to electronic health records (EHRs) and secure, 2-way e-messaging with care providers. Methods We conducted a prospective, mixed-methods study involving collection of caregivers’ portal usage information over a 14-month period (from portal introduction in January 2015 to the end of the study period in March 2016), a Web-based survey for caregivers administered after a minimum of 2 months’ exposure to the portal and repeated 2 months later, and focus groups or individual interviews held with caregivers and service providers at the same points in time. The survey assessed caregivers’ perceptions of the utility of and satisfaction with the EHR and e-messaging, and the portal’s impact on client engagement and perceptions of caregiver-provider communication. A total of 18 caregivers (parents) completed surveys and 6 also took part in focus groups or interviews. In addition, 5 service providers from different disciplines took part in focus groups or interviews. Results Although usage patterns varied, the typical pattern was a steady level of use (2.5 times a month over an average of 9 months), which is higher than typically reported use. The portal pages most frequently accessed were the home page, health record main page, appointment main page, and reports main page. The Web-based survey captured caregivers’ perceptions of usefulness of and satisfaction with the EHR and portal messaging, as well as the portal’s impact on their engagement in care and perceptions of caregiver-provider communication. The surveys indicated a moderate degree of utility of and satisfaction with the portal features, and a low but emerging impact on engagement in care and caregiver-provider communication (survey scales measuring these outcomes displayed excellent internal consistency, with Cronbach alpha ranging from .89 to .95). Qualitative themes from focus groups and interviews supported and extended the survey findings. Caregivers and service providers saw appreciable information benefits and provided recommendations to increase portal use and utility. Caregivers focused on the scope of organizational adoption of the portal system and indicated their hopes for the future of the portal, whereas service providers were concerned about how to best manage their investment of time and effort in preparing client-friendly reports and messaging clients via the portal. Conclusions Overall, the findings show the promise of the portal and the need for ongoing evaluation to show the portal’s ultimate potential in enhancing engagement in care and communication with care providers. PMID:28385680

A novel stress and coping workplace program reduces illness and healthcare utilization.

PubMed

Rahe, Richard H; Taylor, C Barr; Tolles, Robbyn L; Newhall, Lynn M; Veach, Tracy L; Bryson, Susan

2002-01-01

The purpose of this study was to determine if a novel workplace stress management program, delivered either face-to-face or by self-help, would reduce illness and health services utilization among participants. Five hundred one volunteers were randomly allocated to one of three groups: full intervention, which received assessment and personalized self-study feedback and was offered six face-to-face, small-group sessions; partial intervention, a self-help group that received assessment and personalized feedback by mail; and a wait-list control group. All participants completed questionnaires for stress, anxiety, and coping at the start of the study and 6 and 12 months later. Health reports were completed at 0, 3, 6, 9, and 12 months. A subsample of subjects who subscribed to a single health maintenance organization provided objectively recorded doctor visit data across the study year. All three groups reported significant improvement in their stress, anxiety, and coping across the year. Full intervention participants showed a more rapid reduction in negative responses to stress than did participants from the other groups. Full-intervention subjects also reported fewer days of illness than subjects in the other groups. Objectively measured physician visits showed a large (34%) reduction in healthcare utilization for full intervention subjects in the HMO subsample. These results indicated that a work-site program that focuses on stress, anxiety, and coping measurement along with small-group educational intervention can significantly reduce illness and healthcare utilization.

Diagnosing and managing anorexia nervosa in UK primary care: a focus group study.

PubMed

Hunt, D; Churchill, R

2013-08-01

Anorexia is a leading cause of adolescent hospital admission and death from psychiatric disorder. Despite the potential role of general practitioners in diagnosis, appropriate referral and coordinating treatment, few existing studies provide fine-grained accounts of GPs' beliefs about anorexia. To identify GPs' understandings and experiences of diagnosing and managing patients with anorexia in primary care. Case-based focus groups with co-working general practitioners in the East Midlands region of England were used to explore attitudes towards issues common to patients with eating disorders. Group discussions were transcribed and analysed using corpus linguistic and discourse analytic approaches. Participants' discussion focused on related issues of making hesitant diagnoses, the utility of the body mass index, making referrals and overcoming patient resistance. Therapeutic relationships with patients with anorexia are considered highly complex, with participants using diagnostic tests as rhetorical strategies to help manage communicative obstacles. Overcoming patient repudiation and securing referrals are particular challenges with this patient group. Successfully negotiating these problems appears to require advanced communication skills.

Internal Medicine Resident Engagement with a Laboratory Utilization Dashboard: Mixed Methods Study.

PubMed

Kurtzman, Gregory; Dine, Jessica; Epstein, Andrew; Gitelman, Yevgenly; Leri, Damien; Patel, Miltesh S; Ryskina, Kyra

2017-09-01

The objective of this study was to measure internal medicine resident engagement with an electronic medical record-based dashboard providing feedback on their use of routine laboratory tests relative to service averages. From January 2016 to June 2016, residents were e-mailed a snapshot of their personalized dashboard, a link to the online dashboard, and text summarizing the resident and service utilization averages. We measured resident engagement using e-mail read-receipts and web-based tracking. We also conducted 3 hour-long focus groups with residents. Using grounded theory approach, the transcripts were analyzed for common themes focusing on barriers and facilitators of dashboard use. Among 80 residents, 74% opened the e-mail containing a link to the dashboard and 21% accessed the dashboard itself. We did not observe a statistically significant difference in routine laboratory ordering by dashboard use, although residents who opened the link to the dashboard ordered 0.26 fewer labs per doctor-patient-day than those who did not (95% confidence interval, -0.77 to 0.25; = 0 .31). While they raised several concerns, focus group participants had positive attitudes toward receiving individualized feedback delivered in real time. © 2017 Society of Hospital Medicine.

Turkish University Students' Motivation to Learn English: Integration into International Community

ERIC Educational Resources Information Center

Bektas-Cetinkaya, Yesim

2012-01-01

This article explores Turkish university students' motivation and orientations toward learning English in a globalizing world. The study utilizes questionnaire responses and a focus group interview. Factor analysis of questionnaire data revealed three independent orientations, namely, "Integration into International Community,"…

Stressors influencing Middle Eastern women's perceptions of the risk of cardiovascular disease: a focus group study.

PubMed

Gholizadeh, Leila; Digiacomo, Michelle; Salamonson, Yenna; Davidson, Patricia M

2011-08-01

To better understand Australia-dwelling Middle Eastern women's lack of service utilization in cardiovascular health, we undertook a study to investigate their understandings and meanings of cardiovascular disease (CVD) and its risk factors. Eight focus groups were conducted in community settings with Turkish, Persian, and Arab women. We found that the women understated their risk of CVD, faced many barriers in reducing their risks, and perceived stress as the most significant contributor to CVD. Women described their stress as primarily emanating from issues surrounding migration and acculturation. Implications for development and delivery of tailored health interventions for Middle Eastern women are discussed.

Evaluation of technology-enhanced flagger devices : focus group and survey studies in Kansas.

DOT National Transportation Integrated Search

2009-04-01

Flagger-controlled work zones, by their very nature tend to utilize fewer traffic control measures than other work zones. Often these work zones are in place for only a short duration of time, so adding signing or positive protection beyond the minim...

Race Discourse and the US Confederate Flag

ERIC Educational Resources Information Center

Holyfield, Lori; Moltz, Matthew Ryan; Bradley, Mindy S.

2009-01-01

Research reveals that racial hierarchies and "color-blind" racism is maintained through discourse. The current study utilizes exploratory data from focus groups in a predominantly white southern university in the United States to examine race talk, the Confederate Flag, and the construction of southern white identity. Drawing from…

Microaggressions within Families: Experiences of Multiracial People

ERIC Educational Resources Information Center

Nadal, Kevin L.; Sriken, Julie; Davidoff, Kristin C.; Wong, Yinglee; McLean, Kathryn

2013-01-01

This study illustrates the types of multiracial microaggressions, or subtle forms of discrimination toward multiracial people, that transpire in family settings. Utilizing a Consensual Qualitative Research (CQR) Method and a Qualitative Secondary Analysis (QSA), multiracial participants ("N" = 9) were interviewed in three focus groups to describe…

Whole-brain MRI phenotyping in dysplasia-related frontal lobe epilepsy.

PubMed

Hong, Seok-Jun; Bernhardt, Boris C; Schrader, Dewi S; Bernasconi, Neda; Bernasconi, Andrea

2016-02-16

To perform whole-brain morphometry in patients with frontal lobe epilepsy and evaluate the utility of group-level patterns for individualized diagnosis and prognosis. We compared MRI-based cortical thickness and folding complexity between 2 frontal lobe epilepsy cohorts with histologically verified focal cortical dysplasia (FCD) (13 type I; 28 type II) and 41 closely matched controls. Pattern learning algorithms evaluated the utility of group-level findings to predict histologic FCD subtype, the side of the seizure focus, and postsurgical seizure outcome in single individuals. Relative to controls, FCD type I displayed multilobar cortical thinning that was most marked in ipsilateral frontal cortices. Conversely, type II showed thickening in temporal and postcentral cortices. Cortical folding also diverged, with increased complexity in prefrontal cortices in type I and decreases in type II. Group-level findings successfully guided automated FCD subtype classification (type I: 100%; type II: 96%), seizure focus lateralization (type I: 92%; type II: 86%), and outcome prediction (type I: 92%; type II: 82%). FCD subtypes relate to diverse whole-brain structural phenotypes. While cortical thickening in type II may indicate delayed pruning, a thin cortex in type I likely results from combined effects of seizure excitotoxicity and the primary malformation. Group-level patterns have a high translational value in guiding individualized diagnostics. © 2016 American Academy of Neurology.

Concept mapping and network analysis: an analytic approach to measure ties among constructs.

PubMed

Goldman, Alyssa W; Kane, Mary

2014-12-01

Group concept mapping is a mixed-methods approach that helps a group visually represent its ideas on a topic of interest through a series of related maps. The maps and additional graphics are useful for planning, evaluation and theory development. Group concept maps are typically described, interpreted and utilized through points, clusters and distances, and the implications of these features in understanding how constructs relate to one another. This paper focuses on the application of network analysis to group concept mapping to quantify the strength and directionality of relationships among clusters. The authors outline the steps of this analysis, and illustrate its practical use through an organizational strategic planning example. Additional benefits of this analysis to evaluation projects are also discussed, supporting the overall utility of this supplemental technique to the standard concept mapping methodology. Copyright © 2014 Elsevier Ltd. All rights reserved.

Effects of instructional focus on learning a classical ballet movement, the pirouette.

PubMed

Denardi, Renata Alvares; Corrêa, Umberto Cesar

2013-01-01

This study investigated how changes in the focus of instruction might affect the learning by individuals who are not trained dancers of a complex classical ballet movement, the pirouette. Seventy-two volunteer college students were divided into six groups according to the focus of instruction: (1.) head, (2.) arms, (3.) trunk, (4.) knees, (5.) feet, and (6.) controls. In the acquisition phase, all groups performed 160 trials, over 2 consecutive days. At the beginning of each day, they received verbal instruction regarding some of the general principles involved in performance of the pirouette and viewed a video that illustrated those principles. Each group (head, arms, etc., exclusive of controls) was then given specific directions for controlling focus on its body part while performing the movement. After a week, all participants were asked to complete a retention test, with no additional instruction. The trials were videotaped with two cameras (frontally and laterally), and the results were analyzed by 10 specially trained examiners, utilizing Movement Pattern and Error of Performance measures. They revealed that all groups improved in the acquisition phase, and the improvement was maintained in the retention test. No differences were revealed between groups. It was concluded that generalized instruction in basic principles of the movement was more effective than focus on specific body parts in the teaching and learning of the pirouette.

Reflective practice groups for nurses: a consultation liaison psychiatry nursing initiative: part 2--the evaluation.

PubMed

Dawber, Chris

2013-06-01

This paper outlines an evaluation of reflective practice groups (RPG) involving nurses and midwives from three clinical nursing specialties at Redcliffe and Caboolture Hospitals, Queensland, Australia. The groups were facilitated by the consultation liaison psychiatry nurse and author using a process-focused, whole-of-group approach to explore clinical narrative in a supportive group setting. This was a preliminary evaluation utilizing a recently-developed tool, the Clinical Supervision Evaluation Questionnaire, along with externally-facilitated focus groups. Nurses and midwives responded favourably to RPG, reporting a positive impact on clinical practice, self-awareness, and resilience. The majority of participants considered RPG had positive implications for team functioning. The focus groups identified the importance of facilitation style and the need to address aspects of workplace culture to enable group development and enhance the capacity for reflection. Evaluation of the data indicates this style of RPG can improve reflective thinking, promote team cohesion, and provide support for nurses and midwives working in clinical settings. Following on from this study, a second phase of research has commenced, providing more detailed, longitudinal evaluation across a larger, more diverse group of nurses. © 2012 The Author; International Journal of Mental Health Nursing © 2012 Australian College of Mental Health Nurses Inc.

76 FR 6652 - Proposed Collection: Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2011-02-07

... Products. OMB Number: 1535-0142. Abstract: The information from the survey will be used to improve customer... ``Conducting Focus Groups for Retail Securities Products.'' DATES: Written comments should be received on or... collection of information; (c) ways to enhance the quality, utility, and clarity of the information to be...

Two Models for Implementing Senior Mentor Programs in Academic Medical Settings

ERIC Educational Resources Information Center

Corwin, Sara J.; Bates, Tovah; Cohan, Mary; Bragg, Dawn S.; Roberts, Ellen

2007-01-01

This paper compares two models of undergraduate geriatric medical education utilizing senior mentoring programs. Descriptive, comparative multiple-case study was employed analyzing program documents, archival records, and focus group data. Themes were compared for similarities and differences between the two program models. Findings indicate that…

Preservice Teachers' Perceptions of Instant Messaging in Two Educational Contexts

ERIC Educational Resources Information Center

Doering, Aaron; Lewis, Cynthia; Veletsianos, George; Nichols-Besel, Kristen

2008-01-01

Using an activity theory framework, we investigate how preservice teachers and middle school students utilized instant messaging in educational contexts and the impact of instant messaging on the development of community among preservice teachers. Qualitative results from six focus groups and two personal interviews indicate that instant messaging…

African American's Perceptions of Psychotherapy and Psychotherapists.

ERIC Educational Resources Information Center

Thompson, Vetta L. Sanders; Akbar, Maysa D.; Bazile, Anita

The attitudes and beliefs about utilization of mental health services of 201 African Americans, 18 years and older, are explored. One hundred and thirty-four females and 66 males participated in mixed sex focus groups conducted in an urban, Midwestern city. Discussion probes addressed participant perceptions of psychotherapists and psychotherapy,…

Research Experiences of Undergraduate Students at a Comprehensive University

ERIC Educational Resources Information Center

Tan, Emily B.

2007-01-01

Narrative inquiry was utilized to allow undergraduate students involved in an undergraduate research course to narrate their experiences in their research undertakings under the guidance of their respective mentors. A total of four focus groups representing the Bachelor of Arts and Letters, Bachelor of Commerce, Bachelor of Secondary Education,…

Self-Presentation and Gender on MySpace

ERIC Educational Resources Information Center

Manago, Adriana M.; Graham, Michael B.; Greenfield, Patricia M.; Salimkhan, Goldie

2008-01-01

Within the cultural context of MySpace, this study explores the ways emerging adults experience social networking. Through focus group methodology, the role of virtual peer interaction in the development of personal, social, and gender identities was investigated. Findings suggest that college students utilize MySpace for identity exploration,…

Culturally Tailored Depression/Suicide Prevention in Latino Youth: Community Perspectives.

PubMed

Ford-Paz, Rebecca E; Reinhard, Christine; Kuebbeler, Andrea; Contreras, Richard; Sánchez, Bernadette

2015-10-01

Latino adolescents are at elevated risk for depression and suicide compared to other ethnic groups. Project goals were to gain insight from community leaders about depression risk factors particular to Latino adolescents and generate innovative suggestions to improve cultural relevance of prevention interventions. This project utilized a CBPR approach to enhance cultural relevance, acceptability, and utility of the findings and subsequent program development. Two focus groups of youth and youth-involved Latino community leaders (n = 18) yielded three overarching themes crucial to a culturally tailored depression prevention intervention: (1) utilize a multipronged and sustainable intervention approach, (2) raise awareness about depression in culturally meaningful ways, and (3) promote Latino youth's social connection and cultural enrichment activities. Findings suggest that both adaptation of existing prevention programs and development of hybrid approaches may be necessary to reduce depression/suicide disparities for Latino youth. One such hybrid program informed by community stakeholders is described.

The effects of utilizing a near-patient e-learning tool on medical student learning.

PubMed

Selzer, Rob; Tallentire, Victoria R; Foley, Fiona

2015-01-01

This study aimed to develop a near-patient, e-learning tool and explore student views on how utilization of such a tool influenced their learning. Third year medical students from Monash University in Melbourne, Australia were invited to trial a novel, near-patient, e-learning tool in two separate pilots within the ward environment. All participating students were invited to contribute to focus groups which were audio-recorded, transcribed verbatim and thematically analyzed. Four focus groups were conducted with a total of 17 participants. The emerging themes revealed influences on the students' learning both prior to and during a clinical encounter, as well as following completion of an e-learning module. The unifying concept which linked all six themes and formed the central feature of the experience was patient-centered learning. This occurred through the acquisition of contextualized knowledge and the facilitation of workplace integration. Utilization of a near-patient e-learning tool influences medical student learning in a number of complex, inter-related ways. Clinical e-learning tools are poised to become more commonplace and provide many potential benefits to student learning. However, incorporation of technology into clinical encounters requires specific skills which should form an integral part of primary medical training.

Prevalence and predictors of healthcare utilization among older people (60+): focusing on ADL dependency and risk of depression.

PubMed

Sandberg, Magnus; Kristensson, Jimmie; Midlöv, Patrik; Fagerström, Cecilia; Jakobsson, Ulf

2012-01-01

The aim of this study was to investigate healthcare utilization patterns over a six-year period among older people (60+), classified as dependent/independent in Activities of Daily Living (ADL) and/or at/not at risk of depression and to identify healthcare utilization predictors. A sample (n=1402) comprising ten age cohorts aged between 60 and 96 years was drawn from the Swedish National study on Aging and Care (SNAC). Baseline data were collected between 2001 and 2003. Number and length of hospital stays were collected for six years after baseline year. Group differences and mean changes over time were investigated. Healthcare utilization predictors were explored using multiple linear regression analysis. The results revealed that 21-24% had at least one hospital stay in the six years after baseline, 29-37% among ADL dependent subjects and 24-33% among those at risk of depression. There was a significant increase of hospital stays in all groups over time. ADL-dependent subjects and those at risk of depression had significant more hospital stays, except for those at/not at risk of depression in years 2, 4 and 5. The healthcare utilization predictors 5-6 years after baseline were mainly age, previous healthcare utilization and various symptoms and, in 1-2 and 3-4 years after baseline, age, various diagnostic groups and various physical variables. Thus healthcare utilization patterns seem to be similar for the different groups, but it is difficult to find universal predictors. This suggests that different variables should be considered, including both ADL and psychosocial variables, when trying to identify future healthcare users. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

"Is It Worth Knowing?" Focus Group Participants' Perceived Utility of Genomic Preconception Carrier Screening.

PubMed

Schneider, Jennifer L; Goddard, Katrina A B; Davis, James; Wilfond, Benjamin; Kauffman, Tia L; Reiss, Jacob A; Gilmore, Marian; Himes, Patricia; Lynch, Frances L; Leo, Michael C; McMullen, Carmit

2016-02-01

As genome sequencing technology advances, research is needed to guide decision-making about what results can or should be offered to patients in different clinical settings. We conducted three focus groups with individuals who had prior preconception genetic testing experience to explore perceived advantages and disadvantages of genome sequencing for preconception carrier screening, compared to usual care. Using a discussion guide, a trained qualitative moderator facilitated the audio-recorded focus groups. Sixteen individuals participated. Thematic analysis of transcripts started with a grounded approach and subsequently focused on participants' perceptions of the value of genetic information. Analysis uncovered two orientations toward genomic preconception carrier screening: "certain" individuals desiring all possible screening information; and "hesitant" individuals who were more cautious about its value. Participants revealed valuable information about barriers to screening: fear/anxiety about results; concerns about the method of returning results; concerns about screening necessity; and concerns about partner participation. All participants recommended offering choice to patients to enhance the value of screening and reduce barriers. Overall, two groups of likely users of genome sequencing for preconception carrier screening demonstrated different perceptions of the advantages or disadvantages of screening, suggesting tailored approaches to education, consent, and counseling may be warranted with each group.

Marketing Strategy and Implementation

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

None

This report documents the marketing campaign that has been designed for middle and high school students in New Mexico to increase interest in participation in national security careers at the National Nuclear Security Administration. This marketing campaign builds on the research that was previously conducted, as well as the focus groups that were conducted. This work is a part of the National Nuclear Security Preparedness Project (NSPP) being performed under a Department of Energy (DOE) / National Nuclear Security Administration (NNSA) grant. Outcome analysis was performed to determine appropriate marketing strategies. The analysis was based upon focus groups with middlemore » school and high school students, student interactions, and surveys completed by students to understand and gauge student interest in Science, Technology, Engineering, and Math (STEM) subjects, interest in careers at NNSA, future job considerations, and student desire to pursue post-secondary education. Further, through the focus groups, students were asked to attend a presentation on NNSA job opportunities and employee requirements. The feedback received from the students was utilized to develop the focus and components of the marketing campaign.« less

A healthcare utilization cost comparison between employees receiving a worksite mindfulness or a diet/exercise lifestyle intervention to matched controls 5 years post intervention.

PubMed

Klatt, Maryanna D; Sieck, Cynthia; Gascon, Gregg; Malarkey, William; Huerta, Timothy

2016-08-01

To compare healthcare costs and utilization among participants in a study of two active lifestyle interventions implemented in the workplace and designed to foster awareness of and attention to health with a propensity score matched control group. We retrospectively compared changes in healthcare (HC) utilization among participants in the mindfulness intervention (n=84) and the diet/exercise intervention (n=86) to a retrospectively matched control group (n=258) drawn for this study. The control group was matched from the non-participant population on age, gender, relative risk score, and HC expenditures in the 9 month preceding the study. Measures included number of primary care visits, number and cost of pharmacy prescriptions, number of hospital admissions, and overall healthcare costs tracked for 5 years after the intervention. Significantly fewer primary care visits (p<.001) for both intervention groups as compared to controls, with a non-significant trend towards lower overall HC utilization (4,300.00 actual dollar differences) and hospital admissions for the intervention groups after five years. Pharmacy costs and number of prescriptions were significantly higher for the two intervention groups compared to controls over the five years (p<0.05), yet still resulted in less HC utilization costs, potentially indicating greater self-management of care. This study provides valuable information as to the cost savings and value of providing workplace lifestyle interventions that focus on awareness of one's body and health. Health economic studies validate the scale of personal and organization health cost savings that such programs can generate. Copyright © 2016 Elsevier Ltd. All rights reserved.

Perceptions about Iranian-Kurds' ethnic-inequality in health.

PubMed

Yari, Arezoo; Nedjat, Saharnaz; Asadi-Lari, Mohsen; Majdzadeh, Reza

2017-09-12

Evidence shows ethnic-inequality is a very effective variable in the Community and individual health associated outcomes. This study focused on gaining a deeper understanding of people's perception on inequality of health in Iranian-Kurds and its determinants. The study was conducted in the three cities of Marivan, Sanandaj (capital of Kurdistan province in Iran) and Tehran (capital of the country). The study was conducted through 34 in-depth interviews and ten focus group discussions with health services users, academic graduates and health delivery service personnel. Consensus on social, mental and physical health inequality did not exist within the study participants. However, there were concerns about differences in healthcare access and utilization. Several participants believed that access to health services and socio-cultural differences of Kurds affected the healthcare utilization. Since, people perceived ethnic-inequality in healthcare access and utilization, ethnicity must be considered as a mandatory stratifier in monitoring health status and a concern during planning health interventions. People's awareness, resources management and allocation are factors requiring more consideration when choosing policy options.

The role of patient experience surveys in quality assurance and improvement: a focus group study in English general practice.

PubMed

Boiko, Olga; Campbell, John L; Elmore, Natasha; Davey, Antoinette F; Roland, Martin; Burt, Jenni

2015-12-01

Despite widespread adoption of patient feedback surveys in international health-care systems, including the English NHS, evidence of a demonstrable impact of surveys on service improvement is sparse. To explore the views of primary care practice staff regarding the utility of patient experience surveys. Qualitative focus groups. Staff from 14 English general practices. Whilst participants engaged with feedback from patient experience surveys, they routinely questioned its validity and reliability. Participants identified surveys as having a number of useful functions: for patients, as a potentially therapeutic way of getting their voice heard; for practice staff, as a way of identifying areas of improvement; and for GPs, as a source of evidence for professional development and appraisal. Areas of potential change stimulated by survey feedback included redesigning front-line services, managing patient expectations and managing the performance of GPs. Despite this, practice staff struggled to identify and action changes based on survey feedback alone. Whilst surveys may be used to endorse existing high-quality service delivery, their use in informing changes in service delivery is more challenging for practice staff. Drawing on the Utility Index framework, we identified concerns relating to reliability and validity, cost and feasibility acceptability and educational impact, which combine to limit the utility of patient survey feedback. Feedback from patient experience surveys has great potential. However, without a specific and renewed focus on how to translate feedback into action, this potential will remain incompletely realized. © 2014 The Authors Health Expectations Published by John Wiley & Sons Ltd.

Adoption of a High-Impact Innovation in a Homogeneous Population

NASA Astrophysics Data System (ADS)

Weiss, Curtis H.; Poncela-Casasnovas, Julia; Glaser, Joshua I.; Pah, Adam R.; Persell, Stephen D.; Baker, David W.; Wunderink, Richard G.; Nunes Amaral, Luís A.

2014-10-01

Adoption of innovations, whether new ideas, technologies, or products, is crucially important to knowledge societies. The landmark studies of adoption dealt with innovations having great societal impact (such as antibiotics or hybrid crops) but where determining the utility of the innovation was straightforward (such as fewer side effects or greater yield). Recent large-scale studies of adoption were conducted within heterogeneous populations and focused on products with little societal impact. Here, we focus on a case with great practical significance: adoption by small groups of highly trained individuals of innovations with large societal impact but for which it is impractical to determine the true utility of the innovation. Specifically, we study experimentally the adoption by critical care physicians of a diagnostic assay that complements current protocols for the diagnosis of life-threatening bacterial infections and for which a physician cannot estimate the true accuracy of the assay based on personal experience. We show through computational modeling of the experiment that infection-spreading models—which have been formalized as generalized contagion processes—are not consistent with the experimental data, while a model inspired by opinion models is able to reproduce the empirical data. Our modeling approach enables us to investigate the efficacy of different intervention schemes on the rate and robustness of innovation adoption in the real world. While our study is focused on critical care physicians, our findings have implications for other settings in education, research, and business, where small groups of highly qualified peers make decisions about the adoption of innovations whose utility is difficult if not impossible to gauge.

Adoption of a High-Impact Innovation in a Homogeneous Population.

PubMed

Weiss, Curtis H; Poncela-Casasnovas, Julia; Glaser, Joshua I; Pah, Adam R; Persell, Stephen D; Baker, David W; Wunderink, Richard G; Nunes Amaral, Luís A

2014-10-15

Adoption of innovations, whether new ideas, technologies, or products, is crucially important to knowledge societies. The landmark studies of adoption dealt with innovations having great societal impact (such as antibiotics or hybrid crops) but where determining the utility of the innovation was straightforward (such as fewer side effects or greater yield). Recent large-scale studies of adoption were conducted within heterogeneous populations and focused on products with little societal impact. Here, we focus on a case with great practical significance: adoption by small groups of highly trained individuals of innovations with large societal impact but for which it is impractical to determine the true utility of the innovation. Specifically, we study experimentally the adoption by critical care physicians of a diagnostic assay that complements current protocols for the diagnosis of life-threatening bacterial infections and for which a physician cannot estimate the true accuracy of the assay based on personal experience. We show through computational modeling of the experiment that infection-spreading models-which have been formalized as generalized contagion processes-are not consistent with the experimental data, while a model inspired by opinion models is able to reproduce the empirical data. Our modeling approach enables us to investigate the efficacy of different intervention schemes on the rate and robustness of innovation adoption in the real world. While our study is focused on critical care physicians, our findings have implications for other settings in education, research, and business, where small groups of highly qualified peers make decisions about the adoption of innovations whose utility is difficult if not impossible to gauge.

Adapting an evidence-based intervention for homeless women: engaging the community in shared decision-making.

PubMed

Cederbaum, Julie A; Song, Ahyoung; Hsu, Hsun-Ta; Tucker, Joan S; Wenzel, Suzanne L

2014-11-01

As interest grows in the diffusion of evidence-based interventions (EBIs), there is increasing concern about how to mitigate implementation challenges; this paper concerns adapting an EBI for homeless women. Complementing earlier focus groups with homeless women, homeless service providers (n = 32) were engaged in focus groups to assess capacity, needs, and barriers with implementation of EBIs. Deductive analyses of data led to the selection of four EBIs. Six consensus groups were then undertaken; three each with homeless women (n = 24) and homeless service providers (n = 21). The selected EBI was adapted and pretested with homeless women (n = 9) and service providers (n = 6). The structured consensus group process provided great utility and affirmed the expertise of homeless women and service providers as experts in their domain. Engaging providers in the selection process reduced the structural barriers within agencies as obstacles to diffusion.

Promoting Mental Health Help-Seeking Behavior Among First-Year College Students.

PubMed

Pace, Kristin; Silk, Kami; Nazione, Samantha; Fournier, Laura; Collins-Eaglin, Jan

2018-02-01

Awareness and utilization of mental health services on college campuses is a salient issue, particularly for first-year students as they transition into college life. The current study uses focus groups and surveys to test help-seeking messages for first-year students. In this formative research, Phase 1 focus-group participants (N = 47) discussed four message concepts related to awareness of symptoms of mental health problems and services available to students. Phase 2 participants (N = 292) viewed one of three message concepts and then completed items that measured their perceptions of the message. Focus-group results helped prioritize likely effectiveness of messages based on responses to message features and provided an understanding of mental health help-seeking perceptions among college students. The quantitative results indicate the messages have potential for increasing awareness of mental health issues, as well as promoting availability of campus resources. Implications for tailoring campaign messages to first-year students are discussed.

Using intraindividual variability to detect malingering in cognitive performance.

PubMed

Strauss, E; Hultsch, D F; Hunter, M; Slick, D J; Patry, B; Levy-Bencheton, J

1999-11-01

The utility of measures for detecting malingering was evaluated using a simulation design in which half the participants were encouraged to do their best and half were asked to feign head injury. Particular attention was focused on the utility of repeated assessment (intraindividual variability) in discriminating the groups. Participants were tested on three occasions on measures commonly used to detect malingering including a specific symptom validity test (SVT). The results indicated that multiple measures of malingering obtained in single assessment (occasion one) discriminated the groups effectively. In addition, however, intraindividual variability in performance, particularly of indicators from the SVT, provided unique information beyond level of performance. The results suggest that response inconsistency across testing sessions may be a clinically useful measure for the detection of malingering.

Formative research exploring acceptability, utilization, and promotion in order to develop a micronutrient powder (Sprinkles) intervention among Luo families in western Kenya.

PubMed

Jefferds, Maria Elena D; Ogange, Lorraine; Owuor, Mercy; Cruz, Kari; Person, Bobbie; Obure, Alfredo; Suchdev, Parminder S; Ruth, Laird J

2010-06-01

There is a lack of peer-reviewed literature describing in detail the formative research to develop Sprinkles interventions. To describe community members' reactions to and experiences using Sprinkles, with an emphasis on acceptability, utilization, and promotion. Fourteen initial focus group discussions on Sprinkles and a 25-family home study were conducted. For the home study, each child 6 to 59 months of age in the household received 30 sachets (1 per day). The initial 14 focus group discussions included mothers, grandmothers, vendors, women who purchased from vendors, and adults in the general population. Home study families were recruited from participants in the initial 14 focus group discussions who had at least one child 6 to 59 months of age. Sprinkles were highly acceptable to adults and most children; some children thought Sprinkles were sugar. Most home study families prepared and used Sprinkles correctly. All families reported positive effects, particularly increased appetite, and recommended Sprinkles; none experienced major problems. Potential barriers identified were lack of knowledge of and experience with Sprinkles, availability of Sprinkles, and cost. Promotional messages targeted to mothers, fathers, all child-care providers, and doctors focused on the positive health effects of Sprinkles. Issues related to Sprinkles preparation, use, and barriers required attention before implementation. Locally appropriate visual and written instructions were developed for dissemination. Intervention training sessions and promotions were tailored to answer frequently asked questions, increase knowledge of Sprinkles, and provide tangible evidence of health benefits. Information needs and perceptions changed quickly after use of Sprinkles. Existing levels of Sprinkles awareness and knowledge should be considered when designing interventions.

Conceptual and Contextual Contradictions: How a Group of Primary School Teachers Negotiated Professional Learning in a Multiliteracies Book Club

ERIC Educational Resources Information Center

Gardiner, Veronica; Cumming-Potvin, Wendy

2015-01-01

The need to diversify digital communications for a global twenty-first century has prompted many theorists to reimagine literacy teaching and learning. Although the new Australian curriculum acknowledges multimodality and multimodal texts, professional learning continues to privilege print-focused literacy. Utilizing a multiliteracies' and…

Information and Communication for Rural Innovation and Development: Context, Quality and Priorities in Southeast Uganda

ERIC Educational Resources Information Center

Sseguya, Haroon; Mazur, Robert; Abbott, Eric; Matsiko, Frank

2012-01-01

Purpose: To examine the status and priorities for agricultural information generation, dissemination and utilization in the context of agricultural innovation systems in southeast Uganda. Design/Methodology/Approach: Group discussions were conducted with six communities in Kamuli district, southeast Uganda. The focus was on information sources and…

Understanding the African-American Student Experience in Higher Education through a Relational Dialectics Perspective

ERIC Educational Resources Information Center

Simmons, Jake; Lowery-Hart, Russell; Wahl, Shawn T.; McBride, M. Chad

2013-01-01

In this study, we sought to understand African-American students' higher-education experiences in predominantly White universities. We utilized Baxter's relational dialectics theory to study components of focus-group discussions in order to understand the discourse and meaning-making process of participants. Our findings provide insight into the…

An Art Therapy Exploration of Immigration with Latino Families

ERIC Educational Resources Information Center

Linesch, Debra; Aceves, Hilda C.; Quezada, Paul; Trochez, Melissa; Zuniga, Elena

2012-01-01

This grounded theory study utilized art therapy techniques to explore the experiences of 8 Latino families that had immigrated to the United States. Focus group facilitators invited the parents and adolescent children in the families to share their acculturation experiences verbally and in family drawings. Emergent themes from each of three focus…

"Amor" and Social Stigma: ASD Beliefs among Immigrant Mexican Parents

ERIC Educational Resources Information Center

Cohen, Shana R.; Miguel, Jessica

2018-01-01

This study examined cultural beliefs about ASD and its causes among Mexican-heritage families. In focus group interviews, we asked 25 immigrant parents of children with ASD to identify words they associated with ASD and its causes. Participants free-listed, ranked, and justified their responses. Mixed methods analyses utilized saliency scores to…

World War II: A Technology Lesson Plan.

ERIC Educational Resources Information Center

Hagar, Suzy

1990-01-01

Presents a class activity on the history, causes, and consequences of World War II. Focuses on the development and deployment of the atomic bomb. Utilizes a Video Encyclopedia Program for historical background. Divides the class into groups that are responsible for researching and preparing a videotape on a World War II topic. (RW)

A naturalistic inquiry into the social world of whitewater kayakers

Treesearch

Jason W. Whiting; Katharine A. Pawelko

2012-01-01

This exploratory research focused on kayakers at whitewater kayaking parks; the social and recreational characteristics of this specific user group had not previously been studied from a managerial and theoretical standpoint. Twelve kayakers were interviewed at whitewater kayaking parks in Colorado and Utah. The interviewers utilized naturalistic methodology with a...

Web Analytics Reveal User Behavior: TTU Libraries' Experience with Google Analytics

ERIC Educational Resources Information Center

Barba, Ian; Cassidy, Ryan; De Leon, Esther; Williams, B. Justin

2013-01-01

Proper planning and assessment surveys of projects for academic library Web sites will not always be predictive of real world use, no matter how many responses they might receive. In this case, multiple-phase development, librarian focus groups, and patron surveys performed before implementation of such a project inaccurately overrated utility and…

Neighborhood deprivation and preterm birth among non-Hispanic black and white women in eight geographic areas in the United States

EPA Science Inventory

Disparities in preterm birth by race and ethnic group have been demonstrated in the United States. Recent research focuses on the impact of neighborhood environmental context on racial disparities in pregnancy outcomes. The authors utilized vital records birth certificate and...

Angst about Academic Writing: Graduate Students at the Brink

ERIC Educational Resources Information Center

Holmes, Barbara; Waterbury, Theresa; Baltrinic, Eric; Davis, Arielle

2018-01-01

This paper offers some insights into the anxieties graduate students bring into the classroom about academic or technical writing. In this qualitative study, a focus group of graduate students was utilized to describe the specific negative feelings, attitudes and experiences held about writing. Findings suggest that students were able to identify…

Implementing iPads in the Inclusive Classroom Setting

ERIC Educational Resources Information Center

Maich, Kimberly; Hall, Carmen

2016-01-01

This column provides practical suggestions to help guide teachers in utilizing classroom sets of iPads. Following a brief introduction to tablet technology in inclusive classrooms and the origin of these recommendations from a case study focus group, important elements of setting up classroom iPad use, from finding funding to teaching apps, are…

Focused Group Interviews as an Innovative Quanti-Qualitative Methodology (QQM): Integrating Quantitative Elements into a Qualitative Methodology

ERIC Educational Resources Information Center

Grim, Brian J.; Harmon, Alison H.; Gromis, Judy C.

2006-01-01

There is a sharp divide between quantitative and qualitative methodologies in the social sciences. We investigate an innovative way to bridge this gap that incorporates quantitative techniques into a qualitative method, the "quanti-qualitative method" (QQM). Specifically, our research utilized small survey questionnaires and experiment-like…

Getting in Touch with Paramedic Student Career Intentions

ERIC Educational Resources Information Center

O'Meara, Peter; Tourle, Vianne; Madigan, Veronica; Lighton, David

2012-01-01

Objective: This study of paramedic and nursing/paramedic students aimed to determine the initial career intentions of full-time paramedic students and to identify the key factors that influence their career choices. Design: A longitudinal study design, utilizing surveys and a focus group, was employed. Setting: The study was conducted in an…

A Mental Health Training Format for Adult Education Teachers

ERIC Educational Resources Information Center

Meek, Fiona; Specht, Jacqueline; Rodger, Susan

2017-01-01

The present study investigated the needs of adult education staff pertaining to adult students' mental health issues within a local school board. The study utilized mixed-methods design and was divided into progression of three separate studies. An initial focus group was conducted to identify the 12 participants' concerns and provide a direction…

Grandparents Raising Their Grandchildren: Tensions, Service Needs and Involvement with Child Welfare Agencies

ERIC Educational Resources Information Center

Gladstone, James W.; Brown, Ralph A.; Fitzgerald, Kerri-Ann J.

2009-01-01

This qualitative study focuses on 22 grandparents who were raising their grandchildren and involved with child welfare agencies. We explored the tensions experienced by these grandparents, ways that child welfare agencies alleviate these tensions, and factors preventing grandparents from utilizing services. Tensions were grouped into 4 categories:…

Experiences, Perceived Challenges, and Support Systems of Early College High School Students

ERIC Educational Resources Information Center

Sáenz, Karen P.; Combs, Julie P.

2015-01-01

In this qualitative study, the prior experiences, perceived challenges, and support systems of 17 Grade 12 Hispanic students at an early college high school were explored using the framework of social capital theory. Utilizing Moustakas's phenomenological design, data were collected using focus group and individuals interviews. Several themes…

Study of the Half-Day/Full-Day Kindergarten Model

ERIC Educational Resources Information Center

McInroy, Thomas R.

2012-01-01

This case study and problem analysis was an in-depth investigation of the half-day/full-day kindergarten model by utilizing interviews and focus groups to provide insight from parents, teachers, and other district personnel as to how the model has impacted the social, emotional, and academic development of the participating students. This study…

Perceptions of Yoga Therapy Embedded in Two Inpatient Rehabilitation Hospitals: Agency Perspectives

PubMed Central

Van Puymbroeck, Marieke; Miller, Kristine K.; Dickes, Lori A.; Schmid, Arlene A.

2015-01-01

Inpatient medical rehabilitation has maintained a typical medical-model focus and structure for many years. However, as integrative therapies, such as yoga therapy, emerge as treatments which can enhance the physical and mental health of its participants, it is important to determine if they can be easily implemented into the traditional rehabilitation structure and milieu. Therefore, the purpose of this study was to examine the perceptions of key agency personnel on the feasibility and utility of yoga therapy implemented in inpatient rehabilitation. This study reports the results of focus groups and an individual interview with key stakeholders (administrators and rehabilitation therapists) from two rehabilitation hospitals following the implementation of yoga therapy. Results focused on several key themes: feasibility from the therapist and administrator perspectives, challenges to implementation, and utility and benefit. Overall, the implementation and integration of yoga therapy were positive; however, some programmatic and policy and organizational considerations remain. Implications for practice and future research are provided. PMID:26491457

"...you would probably want to do it. Cause that's what made them popular": Exploring perceptions of inhalant utility among young adolescent nonusers and occasional users.

PubMed

Siegel, Jason T; Alvaro, Eusebio M; Patel, Neil; Crano, William D

2009-01-01

With an eye toward future primary prevention efforts, this study explores perceptions of inhalant utility among young adolescents in the United States. The study makes use of data gathered via nine focus groups conducted in Tucson, Arizona in 2004 (N = 47, mean age = 13.2 years). Three main themes emerged concerning the perceived utility of inhalant use: (1) Inhalant use as a means of mental escape, (2) Inhalant use as a social tool, and (3) Inhalant use as a parental relations tool. Additionally, participants discussed an interaction hypothesis regarding inhalant use and popularity. Implications for future research are suggested and limitations described.

A review of group ICA for fMRI data and ICA for joint inference of imaging, genetic, and ERP data

PubMed Central

Calhoun, Vince D.; Liu, Jingyu; Adalı, Tülay

2009-01-01

Independent component analysis (ICA) has become an increasingly utilized approach for analyzing brain imaging data. In contrast to the widely used general linear model (GLM) that requires the user to parameterize the data (e.g. the brain's response to stimuli), ICA, by relying upon a general assumption of independence, allows the user to be agnostic regarding the exact form of the response. In addition, ICA is intrinsically a multivariate approach, and hence each component provides a grouping of brain activity into regions that share the same response pattern thus providing a natural measure of functional connectivity. There are a wide variety of ICA approaches that have been proposed, in this paper we focus upon two distinct methods. The first part of this paper reviews the use of ICA for making group inferences from fMRI data. We provide an overview of current approaches for utilizing ICA to make group inferences with a focus upon the group ICA approach implemented in the GIFT software. In the next part of this paper, we provide an overview of the use of ICA to combine or fuse multimodal data. ICA has proven particularly useful for data fusion of multiple tasks or data modalities such as single nucleotide polymorphism (SNP) data or event-related potentials. As demonstrated by a number of examples in this paper, ICA is a powerful and versatile data-driven approach for studying the brain. PMID:19059344

A review of group ICA for fMRI data and ICA for joint inference of imaging, genetic, and ERP data.

PubMed

Calhoun, Vince D; Liu, Jingyu; Adali, Tülay

2009-03-01

Independent component analysis (ICA) has become an increasingly utilized approach for analyzing brain imaging data. In contrast to the widely used general linear model (GLM) that requires the user to parameterize the data (e.g. the brain's response to stimuli), ICA, by relying upon a general assumption of independence, allows the user to be agnostic regarding the exact form of the response. In addition, ICA is intrinsically a multivariate approach, and hence each component provides a grouping of brain activity into regions that share the same response pattern thus providing a natural measure of functional connectivity. There are a wide variety of ICA approaches that have been proposed, in this paper we focus upon two distinct methods. The first part of this paper reviews the use of ICA for making group inferences from fMRI data. We provide an overview of current approaches for utilizing ICA to make group inferences with a focus upon the group ICA approach implemented in the GIFT software. In the next part of this paper, we provide an overview of the use of ICA to combine or fuse multimodal data. ICA has proven particularly useful for data fusion of multiple tasks or data modalities such as single nucleotide polymorphism (SNP) data or event-related potentials. As demonstrated by a number of examples in this paper, ICA is a powerful and versatile data-driven approach for studying the brain.

Reflective practice groups for nurses: a consultation liaison psychiatry nursing initiative: part 1--The model.

PubMed

Dawber, Chris

2013-04-01

In the present study, we outline the evolution of a process-focused reflective practice group (RPG) model for nurses working in clinical settings. The groups were initiated at Redcliffe and Caboolture hospitals by the consultation liaison psychiatry nurse and author. An associated article provides an evaluation of these RPG. The literature review identifies the key themes and theories on which the model is based, and the article outlines the process and practicalities of facilitating RPG in critical care, midwifery, and oncology specialties over a 3-year period. The model proposes that the effectiveness and sustainability of RPG arises from adequate preparation and engagement with prospective participants. Group rules, based on principles of confidentially, supportiveness, and diversity, were collaboratively developed for each group. Facilitation utilized a group-as-a-whole approach to manage process and stimulate reflection. While the purpose of RPG was a reflection on interpersonal aspects of nursing, contextual workplace issues were frequently raised in groups. Acknowledgement and containment of such issues were necessary to maintain clinical focus. The literature highlights facilitator credibility and style as crucial factors in the overall success of RPG, and it is proposed that reflective practice as a process-focused model for groups succeeds when nurse facilitators are trained in group process and receive concurrent supervision. © 2012 The Author; International Journal of Mental Health Nursing © 2012 Australian College of Mental Health Nurses Inc.

The Utility of Focus Group Interviews to Capture Dietary Consumption Data in the Distant Past: Dairy Consumption in Kazakhstan Villages 50 Years Ago

PubMed Central

Schwerin, Michael; Schonfeld, Sara; Drozdovitch, Vladimir; Akimzhanov, Kuat; Aldyngurov, Daulet; Bouville, André; Land, Charles; Luckyanov, Nicholas; Mabuchi, Kiyohiko; Semenova, Yulia; Simon, Steven; Tokaeva, Alma; Zhumadilov, Zhaxybay; Potischman, Nancy

2013-01-01

From 1949 to 1962, residents of several villages in Kazakhstan Abstract: received substantial doses of radiation to the thyroid gland resulting from nuclear tests conducted at the Semipalatinsk Nuclear Test Site. The primary source of radiation was internal from an intake of radioactive iodine by consumption of contaminated dairy products. A previous research study of childhood exposure and thyroid disease in this region gathered limited data on study participants’ dairy intake at the time of the fallout for the purpose of estimating past radiation doses. Because many subjects were too young at the time of the nuclear tests to recall dietary consumption and existing sources of archival data are limited, it was necessary to interview parents and other village residents who cared for children during this time; older adults ranging in age from 75 to 90 years old. Results from 11 focus group interviews conducted in 2007 with 82 women from 4 villages in Kazakhstan yielded group-level estimates of age-, gender-, ethnicity- and village-specific dairy consumption patterns in rural Kazakhstan during the 1950s. Children typically consumed cow’s milk with limited consumption of mare, goat, and sheep milk; and consumed dairy products such as sour milk (airan), soft cottage cheese (tvorog), and fermented mare milk (koumiss) with the greatest amounts of koumiss reported at ages 15–21. The consumption patterns differed by age and between Kazakh and Russian children, which should lead to different estimates of radiation exposure to the thyroid. This study demonstrated the utility of focus groups to obtain quantitative estimates for dietary intake in the distant past. PMID:24286002

Using CBPR to Assess Client Needs at a Social Service Agency.

PubMed

Amendola, Mary Grace; Nazario, Noelia; Sanchez, Veronica

2016-01-01

Community-based participatory research (CBPR) has become an important research approach for universities to partner with social service agencies by uniting them in project design, planning, implementation, and evaluation. This study involved FOCUS, an urban social service agency, and Rutgers College of Nursing (RUCON) collaboratively conducting a needs assessment to compare the health needs of its clients and their employees' perception of their clients health needs, utilizing CBPR. Qualitative data was collected using the focus group method, field notes, photographs, and observation. The employees of FOCUS facilitated focus groups, participant recruitment, and transcribed and translated data. Three themes emerged: Health Education, Cost of Health Care, and Barriers to Health Care. This study contributes to the growing body of knowledge of integrating the CBPR approach when conducting a community needs assessment with a social service agency. The CBPR approach closely reflects the identified health needs of its clients resulting in interventions that will meet their specific health needs. © 2015 Wiley Periodicals, Inc.

Peritoneal dialysis catheter implantation by nephrologists is associated with higher rates of peritoneal dialysis utilization: a population-based study.

PubMed

Perl, Jeffrey; Pierratos, Andreas; Kandasamy, Gokulan; McCormick, Brendan B; Quinn, Robert R; Jain, Arsh K; Huang, Anjie; Paterson, J Michael; Oliver, Matthew J

2015-02-01

The likelihood of peritoneal dialysis (PD) utilization following a PD catheter insertion attempt is poorly described. We explored the risk factors for PD nonuse, focusing on the method of PD catheter implantation. This population-based retrospective cohort study employed Ontario administrative health data to identify 3886 predialysis adults who had an incident PD catheter implantation between 2002 and 2010. The impact of the method of catheter implantation including open-surgical (open, n = 1884), surgical-laparoscopic (laparoscopic, n = 1154), nephrology-percutaneous (nephrology, n = 498) and radiology-percutaneous (radiology, n = 350) on rates of PD utilization (defined as four consecutive weeks of PD) was examined. Eighty-three percent of study patients received PD. After adjustment, relative to patients with openly inserted catheters, PD utilization was greater for those with nephrology-inserted catheters [adjusted hazard ratio (aHR) 1.59, 95% confidence interval (CI) 1.29-1.95] and similar for radiology-inserted catheters [aHR 1.16, 95% CI 0.94-1.43] or laparoscopic-inserted catheters [aHR 0.97 (95% CI 0.86-1.09)]. Among PD nonusers, death occurred in 10% of the open group, 6% of the laparoscopic group, 27% of the radiology group and in fewer than 3% of the nephrology group. Sixty-nine percent received hemodialysis in the open group, 63% in the laparoscopic group, 61% in the radiology group and 88% in the nephrology group. Those remaining predialysis comprised 12% of the open group, 22% of the laparoscopic group, 11% of the radiology group and <3% of the nephrology group. Nephrology insertion resulted in lower overall rates of PD nonuse, particularly due to death or remaining predialysis. Greater use may be related to insertion timing, technique or greater commitment on the part of nephrologists to the success of PD. © The Author 2014. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved.

Low-income children's reported motivators of and barriers to healthy eating behaviors: a focus group study.

PubMed

Kaye, Lillian B; Tucker, Carolyn M; Bragg, Marie A; Estampador, Angela C

2011-01-01

Despite national attention to the childhood obesity epidemic, there are few US-based studies that directly ask children--especially children from low-income families and from multiple racial/ethnic groups--why they do or do not engage in healthy eating behaviors. The purpose of this study was to identify motivators of and barriers to healthy eating behaviors, as reported by black, Hispanic, and white children from low-income families. Six gender- and race/ethnicity-concordant focus groups were conducted with 37 children who were aged 9 to 12 years and from families with an annual household income of $40000 or less. Multiple strategies were used to employ a culturally sensitive approach to both data collection and data analysis (eg, a team of culturally diverse researchers utilized inductive qualitative analysis to analyze focus group transcripts). The motivators of and barriers to healthy eating behaviors most commonly reported across the 6 focus groups included social influence, taste, issues of availability, weight concerns, and the desire to be healthy. A variety of less commonly reported motivators and barriers were also discussed. Findings were generally similar across gender and race/ethnicity. Children in this age range can indeed identify a variety of motivators and barriers that influence their engagement in healthy eating behaviors. Interventions targeting obesity and eating behaviors should include an assessment of children's own perceived motivators of and barriers to healthy eating.

Council of International Neonatal Nurses (COINN) Global Neonatal Provider Database Initiative (CGNPD): Results From an Implementation Focus Group.

PubMed

Eklund, Wakako; Kenner, Carole

2015-12-01

The neonatal nurses are the key component of the essential workforce necessary to address the healthcare needs of the infants globally. The paucity of the data regarding the availability and training of the neonatal workforce challenges the stakeholders at the regional, national, and global levels. The lack of these data makes strategic planning for initiatives especially in low-resourced countries difficult. Up-to-date data are critically needed to describe the role neonatal nurses play in global newborn health outcomes. The purpose of the COINN Global Neonatal Provider Database Initiative (CGNPD) was to develop a workforce database by developing survey questions, conducting a focus group to determine the key reasons such a database was needed and how best to implement it, and incorporating these comments into the workforce survey and launch. Pilot testing of the draft survey instrument was done. This article reports on the findings from the focus group and the development of the survey. A qualitative design using the focus group method was used. The focus group discussions were guided by semi-structured interview questions that had been developed prior to the focus group by neonatal experts. A convenience sample of 14 members from the international delegates and project advisory members who attended the COINN 2013 in Belfast, Northern Ireland, participated. These participants represented 10 countries. Thematic analysis was conducted using verbatim transcripts of the focus group data. Four main themes emerged: (1) the invisibility of neonatal nurses, (2) benchmarking needs for quality and standards, (3) need for partnership to implement the database, and (4) setting priorities for variables needed for the most salient database. The questionnaire examined participants' perceptions of the significance of and the future utilization of the workforce database and elements that should be included in the survey. The global neonatal workforce database is needed to describe who the neonatal nurses are in each country, what they do, how they are trained, and where they work. The data from the focus group aided in the development of the workforce survey that has been pilot tested and provides critical information to guide COINN's global implementation of the database project.

Uruguayan secondary school students speak up about tobacco: results from focus group discussions in and around Montevideo.

PubMed

Peterson, Erin; Harrell, Melissa; Springer, Andrew; Medina, José; Martinez, Lucía; Perry, Cheryl; Estol, Diego

2017-07-01

This qualitative research study investigated intrapersonal, interpersonal, and environmental factors that shape young adolescent tobacco use behaviors in Uruguay. Focus groups were conducted in the summer of 2012 and fall of 2013 in four secondary schools in Montevideo, Uruguay, including two private schools and two public schools. A total of four focus groups were led in each school, composed of 4-6 students each, 16 focus groups in total. Data analysis utilized NVivo software and included deductive and inductive content analysis. Overwhelmingly, students reported that the onset of smoking occurred in the second year of secondary school. The primary intrapersonal factors that were found to be universal among respondents identified that smoking was a performance in groups, to garner attention from their peers. Students interviewed most often stated that the greatest interpersonal factors for smoking were to look older, as a rite of passage, and for group membership. Environmental factors cited most often indicate that they smoked during unsupervised time, either at night or around the short Uruguayan school day. Focus group interviews revealed that adolescents had easy access to cigarettes for purchase through small family owned grocery stores, even though laws exist preventing the sale of cigarettes to minors. Few differences were cited between strata related to cigarette use in adolescents. The differences that do exist are most apparent across gender, though there were a few observed differences when stratified by public and private school. Findings from this study indicate that key factors across ecological levels (intrapersonal, interpersonal, and environmental) should be taken into consideration when designing tobacco prevention programs for youth in Uruguay. A multiple-component approach which addresses risk factors at all of these levels, implemented in schools, may be particularly well-suited to this setting.

Test Accommodations and Equating Invariance on a Fifth-Grade Science Exam

ERIC Educational Resources Information Center

Huggins, Anne Corinne; Elbaum, Batya

2013-01-01

The purpose of this study is to utilize Score Equity Assessment (SEA) to examine measurement comparability and equity in reported scores on a statewide fifth-grade science assessment with respect to groups of students defined by disability status, English Language Learner status and use of test accommodations. Benefits of SEA include a focus on…

Age Matters, and so May Raters: Rater Differences in the Assessment of Foreign Accents

ERIC Educational Resources Information Center

Huang, Becky H.; Jun, Sun-Ah

2015-01-01

Research on the age of learning effect on second language learners' foreign accents utilizes human judgments to determine speech production outcomes. Inferences drawn from analyses of these ratings are then used to inform theories. The present study focuses on rater differences in the age of learning effect research. Three groups of raters who…

The Information Needs of Virtual Users: A Study of Second Life Libraries

ERIC Educational Resources Information Center

Chow, Anthony S.; Baity, C. Chase; Zamarripa, Marilyn; Chappell, Pam; Rachlin, David; Vinson, Curtis

2012-01-01

As virtual worlds continue to proliferate globally, libraries are faced with the question of whether to provide information services to virtual patrons. This study, utilizing a mixed-method approach of interviews, focus groups, and surveys, represents one of the largest studies of virtual libraries attempted to date. Taking a holistic perspective,…

A Comparative Case Study of Developing Leaders through a Doctoral Program: A Study of One Academic Institution

ERIC Educational Resources Information Center

Scanlon, Sheryl Lynne

2012-01-01

The purpose of this comparative case study was to determine how one academic institution could address the leadership gap facing organizations today, through a traditional, classroom doctoral program in Organizational Leadership. Data was gathered utilizing mixed methods methodology that included a survey questionnaire, focus group information,…

Educational Leaders and the Prospective Responsiveness to the Vast Drastic Educational Changes in the Abu Dhabi Emirate

ERIC Educational Resources Information Center

Al-Zyoud, Mohammad Sayel

2015-01-01

This study examines the prospective responsiveness of school leaders to the drastic educational changes currently being instituted in Abu Dhabi. The study utilizes a qualitative research approach by using a focused group interview with twenty-five teachers selected by purposive sampling from Abu Dhabi Emirate schools. The study revealed that…

Committee Effectiveness in Higher Education: The Strengths and Weaknesses of Group Decision Making

ERIC Educational Resources Information Center

Bates, Stephen B.

2014-01-01

Focusing on five models of committee effectiveness for purposes of this assessment will lend insight into the strengths and weaknesses of utilizing a structured action plan as a guide to achieving and maintaining optimum committee effectiveness in higher education. In the compilation of the strengths and weaknesses of committee decision making,…

Utilizing Peer Moderating in Online Discussions: Addressing the Controversy between Teacher Moderation and Nonmoderation

ERIC Educational Resources Information Center

Seo, Kay Kyeongju

2007-01-01

This study focused on the effects of peer moderation on meaningful interactions in online discussions. A meaningful interaction was defined as a message relating to a discussion topic, responding to a previous message, and adding substance to the discussion. A randomized-subject, posttest-only control group design was used to test the first…

Motivating Factors for Teaching and Studying Music at Two-Year Colleges: A Survey of Faculty and Students

ERIC Educational Resources Information Center

Stewart, John R.; Williams, Yolanda Y.; Vu, Kinh T.; Collins, Tracey R.; Clementson, Casey J.; Berberick, David M.

2015-01-01

The purpose of this study was to explore what motivates faculty and student involvement in this educational environment and how student participation in music coursework contributes to current musical endeavors. The research team utilized a modified explanatory sequential mixed methods design to collect survey data and focus group data from…

A Blended Approach to Reading and Writing Graphic Stories

ERIC Educational Resources Information Center

Brown, Sally

2013-01-01

This article documents the experiences of a diverse group of second grade students during a nine week unit of study focused on graphic stories. The project begins as the class is immersed in reading graphic stories designed for young readers. Images, written text, and dialog are utilized to scaffold reading comprehension and to practice fluency.…

Assistant Principals' Perceptions Regarding the Role and the Effectiveness of an Educational Leadership Program

ERIC Educational Resources Information Center

Peters, Gary B.; Gurley, D. Keith; Fifolt, Matthew; Collins, Loucrecia; McNeese, Rose

2016-01-01

In this study, faculty members of an educational leadership program, situated in a large urban university in the southeastern region of the United States, utilized focus group research to determine the perceptions of K-12 assistant principals regarding the effectiveness of an educational leadership program, and to provide recommendations for…

"Por Los Ojos De Madres": Latina Mothers' Understandings of College Readiness

ERIC Educational Resources Information Center

Cortez, Laura Jean; Martinez, Melissa Ann; Sáenz, Victor B.

2014-01-01

In this study, data from six focus groups with 30 Latina mothers in South Texas were analyzed utilizing a "funds of knowledge" approach to uncover their understandings of college readiness and their role in ensuring their children are college ready. Findings indicate that Latina mothers perceived college readiness in a holistic fashion,…

Youth as Design Partners: Age-Appropriate Websites for Middle and High School Students

ERIC Educational Resources Information Center

Chow, Anthony S.; Smith, Kathelene McCarty; Sun, Katherine

2012-01-01

This study explored the impact of using best practices identified in previous studies in designing age-appropriate websites for middle and high school youth. Utilizing a mixed-method approach, 31 middle and 22 high school youth took part in six focus groups across four states. Participants were introduced to a website specifically designed for…

"I Want to Do the Right Thing but What Is It?": White Teachers' Experiences with African American Students

ERIC Educational Resources Information Center

Henfield, Malik S.; Washington, Ahmad R.

2012-01-01

This qualitative study examines 26 White middle school teachers' perceptions of their experiences in a predominantly White middle school with a growing African American student population. Utilizing in-depth focus group interviews, teachers elaborated on their experiences with navigating racial, ethnic and cultural boundaries as they attempted to…

"I Can Actually Be a Super Sleuth": Promising Practices for Engaging Adolescent Girls in Cybersecurity Education

ERIC Educational Resources Information Center

Jethwani, Monique M.; Memon, Nasir; Seo, Won; Richer, Ariel

2017-01-01

Utilizing qualitative data gleaned from focus groups with adolescent girls participating in a cybersecurity summer program (N = 38, mean age = 16.3), this study examines the following research questions: (a) How do adolescent girls perceive the cybersecurity field?; and (b) What are the promising practices that engage girls in cybersecurity…

Income, Language, and Citizenship Status: Factors Affecting the Health Care Access and Utilization of Chinese Americans.

ERIC Educational Resources Information Center

Jang, Michael; Lee, Evelyn; Woo, Kent

1998-01-01

The effects of income, language, and citizenship on the use of health-care services by Chinese Americans is examined (N=1808). Focus groups, a telephone survey, and key informant interviews were conducted. Data analysis included an acculturation index, demographic profile, and logistical regression. Health insurance and social factors are…

[Effects of a yoga-focused prenatal program on stress, anxiety, self confidence and labor pain in pregnant women with in vitro fertilization treatment].

PubMed

Shim, Chung Sin; Lee, Young-Sook

2012-06-01

The purpose of this study was to identify the effects of a Yoga-focused prenatal program on the stress, anxiety, self confidence and labor pain of pregnant women who had in vitro fertilization (IVF) treatment. A quasi experimental study with a non-equivalent control group pretest-posttest design was used. The data collection period and meditation program were between January 9 and August 31, 2009. Forty-six women who were pregnant following IVF, and were between 12-20 weeks gestation, participated in the study (23 experimental group, 23 control group). Data were analyzed using Chi-square test, Mann-Whitney U Test, ANCOVA, and Cronbach's alpha coefficients with the SPSS 12.0 for Windows Program. Although the sample size was limited, women who participated in the program showed statistically significant improvements in stress, anxiety, labor pain, and labor confidence for women pregnant after IVF. The result indicate that this 12-week Yoga-focused educational program can be utilized for women pregnant following IVF to reduce their stress, anxiety, and labor pain, and to increase delivery confidence. It is suggested that the Yoga-focused educational program be offered to every pregnant woman.

Detecting Blood-Based Biomarkers in Metastatic Breast Cancer: A Systematic Review of Their Current Status and Clinical Utility

PubMed Central

Berghuis, A. M. Sofie; Koffijberg, Hendrik; Prakash, Jai; Terstappen, Leon W. M. M.; IJzerman, Maarten J.

2017-01-01

Reviews on circulating biomarkers in breast cancer usually focus on one single biomarker or a selective group of biomarkers. An overview summarizing the discovery and evaluation of all blood-based biomarkers in metastatic breast cancer is lacking. This systematic review aims to identify the available evidence of known blood-based biomarkers in metastatic breast cancer, regarding their clinical utility and state-of-the-art position in the validation process. The initial search yielded 1078 original studies, of which 420 were assessed for eligibility. A total of 320 studies were included in the final synthesis. A Development, Evaluation and Application Chart (DEAC) of all biomarkers was developed. Most studies focus on identifying new biomarkers and search for relations between these biomarkers and traditional molecular characteristics. Biomarkers are usually investigated in only one study (68.8%). Only 9.8% of all biomarkers was investigated in more than five studies. Circulating tumor cells, gene expression within tumor cells and the concentration of secreted proteins are the most frequently investigated biomarkers in liquid biopsies. However, there is a lack of studies focusing on identifying the clinical utility of these biomarkers, by which the additional value still seems to be limited according to the investigated evidence. PMID:28208771

Enhancement of maximum attainable ion energy in the radiation pressure acceleration regime using a guiding structure

DOE PAGES

Bulanov, S. S.; Esarey, E.; Schroeder, C. B.; ...

2015-03-13

Radiation Pressure Acceleration is a highly efficient mechanism of laser driven ion acceleration, with the laser energy almost totally transferrable to the ions in the relativistic regime. There is a fundamental limit on the maximum attainable ion energy, which is determined by the group velocity of the laser. In the case of a tightly focused laser pulses, which are utilized to get the highest intensity, another factor limiting the maximum ion energy comes into play, the transverse expansion of the target. Transverse expansion makes the target transparent for radiation, thus reducing the effectiveness of acceleration. Utilization of an external guidingmore » structure for the accelerating laser pulse may provide a way of compensating for the group velocity and transverse expansion effects.« less

“They Don’t Look at What Affects Us”: The Role of Ecodevelopmental Factors on Alcohol and Drug Use among Latinos with Physical Disabilities

PubMed Central

Cordova, David; Parra-Cardona, J. Ruben; Blow, Adrian; Johnson, Deborah J.; Prado, Guillermo; Fitzgerald, Hiram E.

2014-01-01

Objectives Latinos with disabilities disproportionately report substance use, including binge drinking and drug use. Ecodevelopmental factors, including socioeconomic patterning of poverty, social exclusion and post-colonial racism, have been shown to impact alcohol and drug use. However, this line of research remains under-developed among Latinos with disabilities. The purpose of this study was to obtain rich descriptions of the role of ecodevelopmental factors, including family and community, on alcohol and drug use among Latinos with physical disabilities. Methods We utilized a community-based participatory research design, in conjunction with an innovative methodology referred to as photovoice. Three rounds of photography and focus group interviews were conducted with a total of 17 focus groups. Reflections in each focus group interview were aloud and digitally audiotaped. A total of 28 participants 19–35 years of age (mean age= 27.65, SD= 5.48) participated in each round of photography and focus group interviews. Data analyses followed the tenets of descriptive phenomenology. Results Findings highlight ecodevelopmental family and community risk and protective factors. At the family level, participants reflected on the ways in which family functioning, including family support, communication and cohesion, can serve as risk and promotive factors for alcohol and drug use. Additionally, participants described in detail how experiences of poverty, stigma and discrimination, violence, accessibility to alcohol and drugs, accessibility for persons with disabilities, transportation, community support and cohesion, and access to health and mental health services constitute risk and promotive factors at the community level. Conclusion Findings are suggestive of how ecodevelopmental family and community factors might increase the risk for alcohol and drug use among Latinos with physical disabilities. From this qualitative research, we derive a series of testable hypotheses. For example, future studies should examine the impact of family functioning on alcohol and drug use among Latinos with physical disabilities over time. Study findings may have great utility to inform the development of preventive interventions for this at-risk group. PMID:24571535

'They don't look at what affects us': the role of ecodevelopmental factors on alcohol and drug use among Latinos with physical disabilities.

PubMed

Cordova, David; Parra-Cardona, Jose Ruben; Blow, Adrian; Johnson, Deborah J; Prado, Guillermo; Fitzgerald, Hiram E

2015-01-01

Objectives. Latinos with disabilities disproportionately report substance use, including binge drinking and drug use. Ecodevelopmental factors, including socioeconomic patterning of poverty, social exclusion, and post-colonial racism, have been shown to impact alcohol and drug use. However, this line of research remains underdeveloped among Latinos with disabilities. The purpose of this study was to obtain rich descriptions of the role of ecodevelopmental factors, including family and community, on alcohol and drug use among Latinos with physical disabilities. Methods. We utilized a community-based participatory research design, in conjunction with an innovative methodology referred to as photovoice. Three rounds of photography and focus group interviews were conducted with a total of 17 focus groups. Reflections in each focus group interview were aloud and digitally audiotaped. A total of 28 participants 19-35 years of age (mean age = 27.65, SD = 5.48) participated in each round of photography and focus group interviews. Data analyses followed the tenets of descriptive phenomenology. Results. Findings highlight ecodevelopmental family and community risk and protective factors. At the family level, participants reflected on the ways in which family functioning, including family support, communication, and cohesion, can serve as risk and promotive factors for alcohol and drug use. Additionally, participants described in detail how experiences of poverty, stigma and discrimination, violence, accessibility to alcohol and drugs, accessibility for persons with disabilities, transportation, community support and cohesion, and access to health and mental health services constitute risk and promotive factors at the community level. Conclusion. Findings are suggestive of how ecodevelopmental family and community factors might increase the risk of alcohol and drug use among Latinos with physical disabilities. From this qualitative research, we derive a series of testable hypotheses. For example, future studies should examine the impact of family functioning on alcohol and drug use among Latinos with physical disabilities over time. Study findings may have great utility to inform the development of preventive interventions for this at-risk group.

Student Use of Out-of-Class Study Groups in an Introductory Undergraduate Biology Course

PubMed Central

Rybczynski, Stephen M.; Schussler, Elisabeth E.

2011-01-01

Self-formed out-of-class study groups may benefit student learning; however, few researchers have quantified the relationship between study group use and achievement or described changes in study group usage patterns over a semester. We related study group use to performance on content exams, explored patterns of study group use, and qualitatively described student perceptions of study groups. A pre- and posttest were used to measure student content knowledge. Internet-based surveys were used to collect quantitative data on exam performance and qualitative data on study group usage trends and student perceptions of study groups. No relationship was found between gains in content knowledge and study group use. Students who participated in study groups did, however, believe they were beneficial. Four patterns of study group use were identified: students either always (14%) or never (55%) used study groups, tried but quit using them (22%), or utilized study groups only late in the semester (9%). Thematic analysis revealed preconceptions and in-class experiences influence student decisions to utilize study groups. We conclude that students require guidance in the successful use of study groups. Instructors can help students maximize study group success by making students aware of potential group composition problems, helping students choose group members who are compatible, and providing students materials on which to focus their study efforts. PMID:21364102

How Patients View Probiotics: Findings from a Multicenter Study of Patients with Inflammatory Bowel Disease and Irritable Bowel Syndrome

PubMed Central

Mercer, MaryBeth; Brinich, Margaret A.; Geller, Gail; Harrison, Krista; Highland, Janelle; James, Katherine; Marshall, Patricia; McCormick, Jennifer B.; Tilburt, Jon; Achkar, Jean-Paul; Farrell, Ruth M.; Sharp, Richard R.

2011-01-01

Background Patients with inflammatory bowel disease (IBD) and irritable bowel syndrome (IBS) have access to a growing number of probiotic products marketed to improve digestive health. It is unclear how patients make decisions about probiotics and what role they expect their gastroenterologists to play as they consider using probiotics. Understanding patients’ knowledge, attitudes and expectations of probiotics may help gastroenterologists engage patients in collaborative discussions about probiotics. Study Focus groups were conducted with patients with IBD and IBS at the Cleveland Clinic, Mayo Clinic and Johns Hopkins University. Inductive analytic methods were utilized to identify common themes and draw interpretations from focus group narratives. Results One hundred thirty-six patients participated in 22 focus groups between March and August 2009. Patients viewed probiotics as an appealing alternative to pharmaceutical drugs and understood probiotics as a more “natural,” low-risk therapeutic option. Many patients were hesitant to use them without consulting their gastroenterologists. Patients would weigh the risks and benefits of probiotics, their disease severity and satisfaction with current treatments when considering probiotic use. Conclusions Patients are interested in probiotics but have many unanswered questions about their use. Our findings suggest that patients with IBD and IBS will look to gastroenterologists and other clinicians as trustworthy advisors regarding the utility of probiotics as an alternative or supplement to pharmaceutical drugs. Gastroenterologists and other clinicians who care for patients with these diseases should be prepared to discuss the potential benefits and risks of probiotics and assist patients in making informed decisions about their use. PMID:21716123

Utilization and management of maternal and child health funds in rural Nepal.

PubMed

Morrison, Joanna; Thapa, Rita; Sen, Aman; Neupane, Rishi; Borghi, Jo; Tumbahangphe, Kirti Man; Osrin, David; Manandhar, Dharma; Costello, Anthony

2010-01-01

Maternal and neonatal mortality rates are highest in the poorest countries, and financial barriers impede access to health care. Community loan funds can increase access to cash in rural areas, thereby reducing delays in care seeking. As part of a participatory intervention in rural Nepal, community women's groups initiated and managed local funds. We explore the factors affecting utilization and management of these funds and the role of the funds in the success of the women's group intervention. We conducted a qualitative study using focus group discussions, group interviews and unstructured observations. Funds may increase access to care for members of trusted 'insider' families adjudged as able to repay loans. Sustainability and sufficiency of funds was a concern but funds increased women's independence and enabled timely care seeking. Conversely, the perceived necessity to contribute may have deterred poorer women. While funds were integral to group success and increased women's autonomy, they may not be the most effective way of supporting the poorest, as the risk pool is too small to allow for repayment default.

Standardization and streamlining of a pancreas surgery practice improves outcomes and resource utilization: A single institution's 20-year experience.

PubMed

Stauffer, John A; Onkendi, Edwin O; Wallace, Michael B; Raimondo, Massimo; Woodward, Timothy A; Lukens, Frank J; Asbun, Horacio J

2017-09-01

In the past two decades, pancreas surgery (PS) has undergone significant advances in operative techniques and with a focus on multidisciplinary high-volume practices. A review of patients undergoing PS from 3/1995-2/2015 was conducted; dividing patients into group A (1995-2005) and group B (2005-2015) for a detailed comparison. Effect of surgeon volume in group B was determined. A total of 1001 patients underwent PS (group A: 259; group B: 742). The mean age was 62.7 years and 52.8% were female. Group B patients were associated with a higher rate of pylorus preservation and minimally invasive resection and a lower rate of morbidity, pancreas fistula (PF), and delayed gastric emptying (DGE) than group A. High-volume surgeons (HVS) had lower operative blood loss (300 mL vs 600 mL), transfusion requirements, PF (14% vs 20%), DGE, surgical site infections, reoperations, and major morbidity rate (15.5 vs 39%) than low-volume surgeons. This study demonstrates improved patient outcomes and hospital resource utilization over the past 20 years. Concentration of PS to HVS results in superior results. Copyright © 2017 Elsevier Inc. All rights reserved.

Health information technology knowledge and skills needed by HIT employers.

PubMed

Fenton, S H; Gongora-Ferraez, M J; Joost, E

2012-01-01

To evaluate the health information technology (HIT) workforce knowledge and skills needed by HIT employers. Statewide face-to-face and online focus groups of identified HIT employer groups in Austin, Brownsville, College Station, Dallas, El Paso, Houston, Lubbock, San Antonio, and webinars for rural health and nursing informatics. HIT employers reported needing an HIT workforce with diverse knowledge and skills ranging from basic to advanced, while covering information technology, privacy and security, clinical practice, needs assessment, contract negotiation, and many other areas. Consistent themes were that employees needed to be able to learn on the job and must possess the ability to think critically and problem solve. Many employers wanted persons with technical skills, yet also the knowledge and understanding of healthcare operations. The HIT employer focus groups provided valuable insight into employee skills needed in this fast-growing field. Additionally, this information will be utilized to develop a statewide HIT workforce needs assessment survey.

Preschool ADHD: exploring uncertainties in diagnostic validity and utility, and treatment efficacy and safety.

PubMed

Sonuga-Barke, Edmund J S; Daley, David; Thompson, Margaret; Swanson, Jim

2003-07-01

The current scientific and clinical status of preschool attention deficit hyperactivity disorder and its management is reviewed. Recent clinical and neuropsychological research supporting the utility of the construct will be presented along with a critical analysis of diagnostic issues. The published literature on treatment efficacy (both pharmacological and nonpharmacological) will be reviewed with a special focus on the issue of the safety and side effects of psycho-stimulants. The need for early identification and preventative intervention is indicated but caution should be employed in the use of psychostimulants with this age group.

Protocol for a qualitative study exploring perspectives on the INternational CLassification of Diseases (11th revision); Using lived experience to improve mental health Diagnosis in NHS England: INCLUDE study

PubMed Central

Hackmann, Corinna; Green, Amanda; Notley, Caitlin; Perkins, Amorette; Reed, Geoffrey M; Ridler, Joseph; Wilson, Jon; Shakespeare, Tom

2017-01-01

Introduction Developed in dialogue with WHO, this research aims to incorporate lived experience and views in the refinement of the International Classification of Diseases Mental and Behavioural Disorders 11th Revision (ICD-11). The validity and clinical utility of psychiatric diagnostic systems has been questioned by both service users and clinicians, as not all aspects reflect their lived experience or are user friendly. This is critical as evidence suggests that diagnosis can impact service user experience, identity, service use and outcomes. Feedback and recommendations from service users and clinicians should help minimise the potential for unintended negative consequences and improve the accuracy, validity and clinical utility of the ICD-11. Methods and analysis The name INCLUDE reflects the value of expertise by experience as all aspects of the proposed study are co-produced. Feedback on the planned criteria for the ICD-11 will be sought through focus groups with service users and clinicians. The data from these groups will be coded and inductively analysed using a thematic analysis approach. Findings from this will be used to form the basis of co-produced recommendations for the ICD-11. Two service user focus groups will be conducted for each of these diagnoses: Personality Disorder, Bipolar I Disorder, Schizophrenia, Depressive Disorder and Generalised Anxiety Disorder. There will be four focus groups with clinicians (psychiatrists, general practitioners and clinical psychologists). Ethics and dissemination This study has received ethical approval from the Coventry and Warwickshire HRA Research Ethics Committee (16/WM/0479). The output for the project will be recommendations that reflect the views and experiences of experts by experience (service users and clinicians). The findings will be disseminated via conferences and peer-reviewed publications. As the ICD is an international tool, the aim is for the methodology to be internationally disseminated for replication by other groups. Trial registration number ClinicalTrials.gov: NCT03131505. PMID:28871029

Are two youth-focused interventions sufficient to empower youth with chronic health conditions in their transition to adult healthcare: a mixed-methods longitudinal prospective cohort study.

PubMed

Gorter, Jan Willem; Stewart, Deb; Cohen, Eyal; Hlyva, Oksana; Morrison, Andrea; Galuppi, Barb; Nguyen, Tram; Amaria, Khush; Punthakee, Zubin

2015-05-06

To assess use, utility and impact of transition interventions designed to support and empower self-management in youth with chronic health conditions during transition into adult healthcare. A 4-year mixed-method prospective cohort study. 2 academic paediatric hospitals (13 clinics) in Canada. 50 adolescents (42% male; mean age 17.9±0.9 years; 20 underlying diagnoses) with transfer to adult care planned within 1 year. The Youth KIT (an organisational tool that includes goal setting activities); an online transition mentor. Frequency of use, utility and impact of the transition interventions; goal achievement; post-transfer qualitative interviews with youth. 50 participants were enrolled during their last year of paediatric care; 36 (72%) were followed into adult care. All participants had access to the transition interventions from enrolment until the end of the study (exposure time: 12-47 months). Most youth (85%) reported using the medical/health section of the Youth KIT at least once; 20 (40%) participants engaged in chats with the mentor. The overall perceived utility of both interventions was modest; the Youth KIT received the highest ratings for 'help with goal setting': (mean (SD): 4.2 (2.3)) on a 7-point Likert scale. 45 (90%) participants set 294 transition goals. Goal achievement performance and satisfaction increased over time (p≤0.001). The qualitative evidence revealed reasons behind the variability in use and utility of the interventions, the interconnectedness of life-course and healthcare transitions, and the need for stronger partnerships between paediatric and adult healthcare systems. Participants' perceptions about the utility of the Youth KIT and the online mentor were modest. Transition supports need to be carefully tailored, timed and integrated into healthcare systems. Individualised goal setting may be an important 'active ingredient' in optimising transition supports and outcomes. Interventions that focus on youth only are insufficient for empowering self-management. 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.

Rural Veteran Access to Healthcare Services: Investigating the Role of Information and Communication Technologies in Overcoming Spatial Barriers

PubMed Central

Schooley, Benjamin L; Horan, Thomas A; Lee, Pamela W; West, Priscilla A

2010-01-01

This multimethod pilot study examined patient and practitioner perspectives on the influence of spatial barriers to healthcare access and the role of health information technology in overcoming these barriers. The study included a survey administered to patients attending a Department of Veterans Affairs (VA) health visit, and a focus group with VA care providers. Descriptive results and focus group findings are presented. Spatial distance is a significant factor for many rural veterans when seeking healthcare. For this sample of rural veterans, a range of telephone, computer, and Internet technologies may become more important for accessing care as Internet access becomes more ubiquitous and as younger veterans begin using the VA health system. The focus group highlighted the negative impact of distance, economic considerations, geographic barriers, and specific medical conditions on access to care. Lack of adequate technology infrastructure was seen as an obstacle to utilization. This study discusses the need to consider distance, travel modes, age, and information technology infrastructure and adoption when designing health information technology to care for rural patients. PMID:20697468

What HIV-Positive Young Women Want from Behavioral Interventions: A Qualitative Approach

PubMed Central

Brothers, Jennifer; Lemos, Diana

2012-01-01

Abstract Young women living with HIV in the United States face many social and psychological challenges, including involvement in health care and secondary prevention efforts. The factors that put these young women at risk for HIV acquisition initially, such as poverty, gender roles, cultural norms, and limited perceived control over sexual relationships, continue to place them at risk for both adverse mental and physical health outcomes that impact their daily lives and secondary prevention efforts. This study utilized focus groups with young HIV-positive women in order to better understand their perceived problems and pressures and to inform a developmentally appropriate secondary prevention intervention for young HIV-positive women that could be implemented in clinical care settings. Focus groups with young HIV-positive women were convened in three U.S. cities: Baltimore, Chicago, and Tampa. A total of 17 young, HIV-positive women, age range 17–24 (mean age=21), participated in the focus groups. This article describes the psychological and social challenges these young women face as well as their suggestions regarding secondary HIV prevention intervention components. PMID:22675725

Evaluating a Web-Based Health Risk Assessment With Tailored Feedback: What Does an Expert Focus Group Yield Compared to a Web-Based End-User Survey?

PubMed Central

Vosbergen, Sandra; Mahieu, Guy R; Laan, Eva K; Kraaijenhagen, Roderik A; Jaspers, Monique WM

2014-01-01

Background Increasingly, Web-based health applications are developed for the prevention and management of chronic diseases. However, their reach and utilization is often disappointing. Qualitative evaluations post-implementation can be used to inform the optimization process and ultimately enhance their adoption. In current practice, such evaluations are mainly performed with end-user surveys. However, a review approach by experts in a focus group may be easier to administer and might provide similar results. Objective The aim of this study was to assess whether industrial design engineers in a focus group would address the same issues as end users in a Web-based survey when evaluating a commercial Web-based health risk assessment (HRA) with tailored feedback. Methods Seven Dutch companies used the HRA as part of their corporate health management strategy. Employees using the HRA (N=2289) and 10 independent industrial designers were invited to participate in the study. The HRA consisted of four components: (1) an electronic health questionnaire, (2) biometric measurements, (3) laboratory evaluation, and (4) individually tailored feedback generated by decision support software. After participating in the HRA as end users, both end users and designers evaluated the program. End users completed an evaluation questionnaire that included a free-text field. Designers participated in a focus group discussion. Constructs from user satisfaction and technology acceptance theories were used to categorize and compare the remarks from both evaluations. Results We assessed and qualitatively analyzed 294 remarks of 189 end users and 337 remarks of 6 industrial designers, pertaining to 295 issues in total. Of those, 137 issues were addressed in the end-user survey and 148 issues in the designer focus group. Only 7.3% (10/137) of the issues addressed in the survey were also addressed in the focus group. End users made more remarks about the usefulness of the HRA and prior expectations that were not met. Designers made more remarks about how the information was presented to end users, quality of the feedback provided by the HRA, recommendations on the marketing and on how to create more unity in the design of the HRA, and on how to improve the HRA based on these issues. Conclusions End-user surveys should not be substituted for expert focus groups. Issues identified by end users in the survey and designers in the focus group differed considerably, and the focus group produced a lot of new issues. The issues addressed in the focus group often focused on different aspects of user satisfaction and technology acceptance than those addressed by the survey participants; when they did focus on the same aspects, then the nature of issues differed considerably in content. PMID:24384408

Evaluating a web-based health risk assessment with tailored feedback: what does an expert focus group yield compared to a web-based end-user survey?

PubMed

Vosbergen, Sandra; Mahieu, Guy R; Laan, Eva K; Kraaijenhagen, Roderik A; Jaspers, Monique Wm; Peek, Niels

2014-01-02

Increasingly, Web-based health applications are developed for the prevention and management of chronic diseases. However, their reach and utilization is often disappointing. Qualitative evaluations post-implementation can be used to inform the optimization process and ultimately enhance their adoption. In current practice, such evaluations are mainly performed with end-user surveys. However, a review approach by experts in a focus group may be easier to administer and might provide similar results. The aim of this study was to assess whether industrial design engineers in a focus group would address the same issues as end users in a Web-based survey when evaluating a commercial Web-based health risk assessment (HRA) with tailored feedback. Seven Dutch companies used the HRA as part of their corporate health management strategy. Employees using the HRA (N=2289) and 10 independent industrial designers were invited to participate in the study. The HRA consisted of four components: (1) an electronic health questionnaire, (2) biometric measurements, (3) laboratory evaluation, and (4) individually tailored feedback generated by decision support software. After participating in the HRA as end users, both end users and designers evaluated the program. End users completed an evaluation questionnaire that included a free-text field. Designers participated in a focus group discussion. Constructs from user satisfaction and technology acceptance theories were used to categorize and compare the remarks from both evaluations. We assessed and qualitatively analyzed 294 remarks of 189 end users and 337 remarks of 6 industrial designers, pertaining to 295 issues in total. Of those, 137 issues were addressed in the end-user survey and 148 issues in the designer focus group. Only 7.3% (10/137) of the issues addressed in the survey were also addressed in the focus group. End users made more remarks about the usefulness of the HRA and prior expectations that were not met. Designers made more remarks about how the information was presented to end users, quality of the feedback provided by the HRA, recommendations on the marketing and on how to create more unity in the design of the HRA, and on how to improve the HRA based on these issues. End-user surveys should not be substituted for expert focus groups. Issues identified by end users in the survey and designers in the focus group differed considerably, and the focus group produced a lot of new issues. The issues addressed in the focus group often focused on different aspects of user satisfaction and technology acceptance than those addressed by the survey participants; when they did focus on the same aspects, then the nature of issues differed considerably in content.

Inquiry-Based Instruction: How Is It Utilized, Accepted, and Assessed in Schools with National Agriscience Teacher Ambassadors?

ERIC Educational Resources Information Center

Thoron, Andrew C.; Myers, Brian E.; Abrams, Katie

2011-01-01

The agricultural education profession has established that agriculture can be taught as an integrated science and teachers are receptive to highlighting the science in agriculture. However, there is a lack of consensus and possibly even confusion on the understanding of the term "inquiry" in agricultural education. This study used focus groups to…

Sisters and Brothers, Brothers and Sisters in the Family Affected by Traumatic Brain Injury.

ERIC Educational Resources Information Center

Pieper, Betty

This report is based on a qualitative research study which utilized a nominal group process to identify major life stressors for parents of children with traumatic brain injuries (TBI). It focuses first on effects of TBI on siblings and then on effective interventions. The first section uses quotes from participating parents to identify their…

Pedagogical Praxis Surrounding the Integration of Photography, Visual Literacy, Digital Literacy, and Educational Technology into Business Education Classrooms: A Focus Group Study

ERIC Educational Resources Information Center

Schlosser, Peter Allen

2010-01-01

This paper reports on an investigation into how Marketing and Business Education Teachers utilize and integrate educational technology into curriculum through the use of photography. The ontology of this visual, technological, and language interface is explored with an eye toward visual literacy, digital literacy, and pedagogical praxis, focusing…

Social Structural Characteristics of Hispanic Recreationists on the Angeles and San Bernardino National Forests

Treesearch

Deborah S. Carr; Daniel R. Williams

1992-01-01

Much of the early work done within the realm of ethnic group participation in outdoor recreation has focused on understanding what was seen as underparticipation utilizing two possible explanations: marginality and ethnicity. Rather than characterizing these explanations as competing, it may be more fruitful to characterize them as being two parts of the larger social...

Teacher Stress Related to Student Mental Health Promotion: The Match between Perceived Demands and Competence to Help Students with Mental Health Problems

ERIC Educational Resources Information Center

Ekornes, Stine

2017-01-01

The present study highlights teacher stress related to student mental health promotion through the relationship between perceived competence, perceived responsibility and negative emotions. Data were derived from a mixed methods design, utilizing three focus group interviews (n = 15), followed by survey research (n = 771) amongst Norwegian K-12…

"There Is No Moral They Can Teach Us": Adolescents' Perspectives on School-Based Sexuality Education in a Semiurban, Southwestern District in Nigeria

ERIC Educational Resources Information Center

Aham-Chiabuotu, Chidimma B.; Aja, Godwin N.

2017-01-01

There is limited data on the implementation of Comprehensive Sexuality Education in Nigerian schools. This study explored In-School adolescents' perspectives on the implementation and utility of the Family Life and HIV/AIDS Education Curriculum, using questionnaires and focus group discussions. Findings reveal that sexuality education in schools…

The Influence of Alternative Pedagogical Methods in Postsecondary Biology Education: How Do Students Experience a Multimedia Case-Study Environment?

ERIC Educational Resources Information Center

Wolter, Bjorn Hugo Karl

2010-01-01

The purpose of this study was to better understand how an online, multimedia case study method influenced students' motivation, performance, and perceptions of science in collegiate level biology classes. It utilized a mix-methods design including data from pre- and post-test, student surveys, and focus group interviews to answer one primary…

Assistive Technology for Students with Learning Disabilities: A Glimpse of the Livescribe Pen and Its Impact on Homework Completion

ERIC Educational Resources Information Center

Harper, Kelly A.; Kurtzworth-Keen, Kristin; Marable, Michele A.

2017-01-01

This research investigated the effectiveness of an assistive technology tool, the Livescribe Pen (LSP), with an elementary student identified with dyslexia. Using interview and focus group methodologies over the span of one academic year, the study probed the perceptions of teachers, parent, and child. While the LSP was primarily utilized for…

The Identification of Reasons, Solutions, and Techniques Informing a Theory-Based Intervention Targeting Recreational Sports Participation

ERIC Educational Resources Information Center

St Quinton, Tom; Brunton, Julie A.

2018-01-01

Purpose: This study is the 3rd piece of formative research utilizing the theory of planned behavior to inform the development of a behavior change intervention. Focus groups were used to identify reasons for and solutions to previously identified key beliefs in addition to potentially effective behavior change techniques. Method: A purposive…

Assessment of the Utilization of HIV Interventions by Sex Workers in Selected Brothels in Bangladesh: An Exploratory Study

ERIC Educational Resources Information Center

Huq, Nafisa Lira; Chowdhury, Mahbub Elahi

2012-01-01

In this qualitative study of brothel-based Female Sex Workers (FSWs), the authors explored factors that influence safe sex practices of FSWs within an integrated HIV intervention. Qualitative methods, including focus group discussions (FGDs), in-depth interviews and key informant interviews were applied in four brothels in Bangladesh. Young and…

Adding Value to Large Multimedia Collections through Annotation Technologies and Tools: Serving Communities of Interest.

ERIC Educational Resources Information Center

Shabajee, Paul; Miller, Libby; Dingley, Andy

A group of research projects based at HP-Labs Bristol, the University of Bristol (England) and ARKive (a new large multimedia database project focused on the worlds biodiversity based in the United Kingdom) are working to develop a flexible model for the indexing of multimedia collections that allows users to annotate content utilizing extensible…

Determining the structure of an optimal personnel profile for a transformed commission

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

Graniere, R.J.

1998-06-01

In the classic sociological sense, an organization such as a public utility commission is a social unit consisting of specific groupings constructed and reconstructed deliberately and with forethought to achieve specific goals. These organizational groupings determined on the basis of rational divisions of labor, power, and communication are designed with the objective of placing individuals into positions where they are expected to make the largest contribution towards achieving the organization`s goals. It is reasonable then to conclude that proponents of the classical view had in mind a readily identifiable common ground among the organization`s members that the organization exploits asmore » it selects its goals. Recently, it has been argued that metaphors are an acceptable shorthand for this common ground that provides an insight into the types of personnel an organization would find most suitable for assisting its efforts to reach its goals. This report is one of a series of reports on the transformation of public utility commissions. Previous reports in the series have focused on the transformation of a commission`s culture, roles, and activities. This report focuses on the staffing dimension of the personnel mix needed to support these changes.« less

How to enhance public health service utilization in community pharmacy?: general public and health providers' perspectives.

PubMed

Saramunee, Kritsanee; Krska, Janet; Mackridge, Adam; Richards, Jacqueline; Suttajit, Siritree; Phillips-Howard, Penelope

2014-01-01

Community pharmacists (PHs) in England are increasingly providing a range of public health services. However, the general public view pharmacists as drug experts and not experts in health, and therefore, services may be underutilized. To explore experiences and views of 4 groups of participants, the general public, PHs, general practitioners (GPs), and other stakeholders (STs) on pharmacy-based public health services, and identify potential factors affecting service use. The study was undertaken in a locality of North West England. Three focus groups were conducted with the general public (n=16), grouped by socioeconomic status. Fourteen semistructured interviews were undertaken with PHs (n=9), GPs (n=2), and STs (n=3). Discussions/interviews were audio recorded, transcribed verbatim, and analyzed thematically. All 4 groups of participants agreed that community pharmacies are a good source of advice on medicines and minor ailments but were less supportive of public health services. Six factors were identified affecting utilization of pharmacy services: community pharmacy environment, pharmacist and support staff, service publicity, general public, GP services, and health care system and policies. Crucial obstacles that could inhibit service utilization are perceptions of both the general public and other health providers toward pharmacists' competencies, privacy and confidentiality in pharmacies, high dispensing workload, and inadequate financial support. Networking between local health professionals could enhance confidence in service delivery, general awareness, and thus utilization. Community pharmacy has the potential to deliver public health services, although the impact on public health may be limited. Addressing the factors identified could help to increase utilization and impact of pharmacy public health services. Copyright © 2014 Elsevier Inc. All rights reserved.

Perceived Barriers and Facilitators of Using a Web-Based Interactive Decision Aid for Colorectal Cancer Screening in Community Practice Settings: Findings From Focus Groups With Primary Care Clinicians and Medical Office Staff

PubMed Central

2013-01-01

Background Information is lacking about the capacity of those working in community practice settings to utilize health information technology for colorectal cancer screening. Objective To address this gap we asked those working in community practice settings to share their perspectives about how the implementation of a Web-based patient-led decision aid might affect patient-clinician conversations about colorectal cancer screening and the day-to-day clinical workflow. Methods Five focus groups in five community practice settings were conducted with 8 physicians, 1 physician assistant, and 18 clinic staff. Focus groups were organized using a semistructured discussion guide designed to identify factors that mediate and impede the use of a Web-based decision aid intended to clarify patient preferences for colorectal cancer screening and to trigger shared decision making during the clinical encounter. Results All physicians, the physician assistant, and 8 of the 18 clinic staff were active participants in the focus groups. Clinician and staff participants from each setting reported a belief that the Web-based patient-led decision aid could be an informative and educational tool; in all but one setting participants reported a readiness to recommend the tool to patients. The exception related to clinicians from one clinic who described a preference for patients having fewer screening choices, noting that a colonoscopy was the preferred screening modality for patients in their clinic. Perceived barriers to utilizing the Web-based decision aid included patients’ lack of Internet access or low computer literacy, and potential impediments to the clinics’ daily workflow. Expanding patients’ use of an online decision aid that is both easy to access and understand and that is utilized by patients outside of the office visit was described as a potentially efficient means for soliciting patients’ screening preferences. Participants described that a system to link the online decision aid to a computerized reminder system could promote a better understanding of patients’ screening preferences, though some expressed concern that such a system could be difficult to keep up and running. Conclusions Community practice clinicians and staff perceived the Web-based decision aid technology as promising but raised questions as to how the technology and resultant information would be integrated into their daily practice workflow. Additional research investigating how to best implement online decision aids should be conducted prior to the widespread adoption of such technology so as to maximize the benefits of the technology while minimizing workflow disruptions. PMID:24351420

Communicating Medical Needs to Non-Medical Managers

NASA Technical Reports Server (NTRS)

Bacal, Kira; Miller, Robert; Doerr, Harold

2004-01-01

Differences in communication styles and languages between groups often lead to miscommunication, confusion, and/or frustration. Engineers, computer specialists, clinicians, and managers often utilize the English language in very different ways, with different groups using the same words to represent different concepts ("complaint" is a typical example). In addition, medical issues are often perceived as "off-nominal" and not "primary mission tasks" by managers, which can cause them to assign lower priorities to medical training time and resources. Knowledge bases differ due to variations in training and skill sets, and the goals (both immediate and long-term) of the communicators may also vary, with managers being primarily concerned with overall mission objectives, while clinicians focus on individual or group health issues. Furthermore, true communication is only possible when clinicians possess a deep understanding of mission requirements as well as the ability to communicate medical requirements on a priority basis using risk assessment, added value, and cost benefit analysis. These understandable differences may contribute to difficulties in expressing concerns and ideas in an efficient manner, particularly in projects, such as the space program or many military operations, where these varied groups must collaborate, and where the final decisions must be made by fully informed mission commanders. Methods: Three scenario-based approaches were developed utilizing decision trees and problem based learning, to help define and integrate these concepts. Results: Use of these techniques by NASA and military personnel will be presented. Discussion: To enhance communication, particularly of medical needs, one must identify the concerns and motivating factors for the other groups; for example, members of management may focus on financial concerns, a desire for risk mitigation, public perceptions, mission objectives, etc. Training clinicians to frame issues in these terms may lead to better understanding of the medical concerns by other groups.

Barriers to Care-Seeking for Children’s Oral Health Among Low-Income Caregivers

PubMed Central

Kelly, Susan E.; Binkley, Catherine J.; Neace, William P.; Gale, Bruce S.

2005-01-01

Objectives. We identified psychosocial, structural, and cultural barriers to seeking dental care among nonutilizing caregivers of Medicaid-enrolled children. Methods. We used Medicaid utilization records to identify utilizing and nonutilizing African American and White caregivers of Medicaid-enrolled children in Jefferson County, Kentucky. We conducted 8 focus groups (N=76) with a stratified random sample of responding caregivers; transcripts were qualitatively analyzed. Results. Psychosocial factors associated with utilization included oral health beliefs, norms of caregiver responsibility, and positive caregiver dental experiences. Utilizing groups reported higher education; health beliefs included identifying oral health with overall health and professional preventive dental care with caregiver responsibility for children’s overall health. These beliefs may mediate shared structural barriers, including transportation, school absence policies, discriminatory treatment, and difficulty locating providers who accept Medicaid. Expectation of poor oral health among some low-income caregivers was among factors identified with nonutilization. Conclusions. Disadvantaged caregivers reported multiple barriers to accessing dental care for their children. Providers, Medicaid administrators, and schools must coordinate steps to encourage caregiver-controlled dental care, build trust, and link professional preventive dental care with caregiver responsibility for children’s overall health. PMID:16043666

Exploring precarious employment and women's health within the context of U.S. microenterprise using focus groups.

PubMed

Salt, Rebekah; Lee, Jongwon

2014-01-01

Nursing has been a leader in exploring social determinants of health within the context of U.S. microenterprise and women's health. The purpose of this study was to explore precarious employment within the context of microenterprise and women's health using focus groups with clientele from New Mexico (NM). The specific aims were to identify (1) the health concerns of low-income women who utilized resources from Women's Economic Self-Sufficiency Team (WESST), and (2) the meaning of precarious employment in low-income women's lives. Fourteen women, ranging in age from 21-65 years, who were affiliated with regional WESST sites around NM participated in focus groups and completed a demographic questionnaire. Focus group data were analyzed using content analysis. The degree of interrater agreement was determined by calculating the Cohen's kappa, percentage agreement, and prevalence-adjusted and bias-adjusted kappa (PABAK). Two broad themes emerged from these data: (1) Working for Yourself and (2) Strategies. Although the women identified concerns about participation in microenterprise, flexibility, freedom, and feeling purposeful were motivators to pursue a small business. The kappa statistics on the five transcripts revealed poor inter-rater agreement, yet PABAK, which is a more sophisticated inter-rater reliability index, indicated that inter-rater agreement between the two raters was satisfactory. Despite the challenges associated with microenterprise in the US, women found value in working for themselves. © 2014 Wiley Periodicals, Inc.

The patient perspective: utilizing focus groups to inform care coordination for high-risk medicaid populations.

PubMed

Sheff, Alex; Park, Elyse R; Neagle, Mary; Oreskovic, Nicolas M

2017-07-25

Care coordination programs for high-risk, high-cost patients are a critical component of population health management. These programs aim to improve outcomes and reduce costs and have proliferated over the last decade. Some programs, originally designed for Medicare patients, are now transitioning to also serve Medicaid populations. However, there are still gaps in the understanding of what barriers to care Medicaid patients experience, and what supports will be most effective for providing them care coordination. We conducted two focus groups (n = 13) and thematic analyses to assess the outcomes drivers and programmatic preferences of Medicaid patients enrolled in a high-risk care coordination program at a major academic medical center in Boston, MA. Two focus groups identified areas where care coordination efforts were having a positive impact, as well as areas of unmet needs among the Medicaid population. Six themes emerged from the focus groups that clustered in three groupings: In the first group (1) enrollment in an existing medical care coordination programs, and (2) provider communication largely presented as positive accounts of assistance, and good relationships with providers, though participants also pointed to areas where these efforts fell short. In the second group (3) trauma histories, (4) mental health challenges, and (5) executive function difficulties all presented challenges faced by high-risk Medicaid patients that would likely require redress through additional programmatic supports. Finally, in the third group, (6) peer-to-peer support tendencies among patients suggested an untapped resource for care coordination programs. Programs aimed at high-risk Medicaid patients will want to consider programmatic adjustments to attend to patient needs in five areas: (1) provider connection/care coordination, (2) trauma, (3) mental health, (4) executive function/paperwork and coaching support, and (5) peer-to-peer support.

Simulated ward round: reducing costs, not outcomes.

PubMed

Ford, Helen; Cleland, Jennifer; Thomas, Ian

2017-02-01

Distractions and interruptions on the ward pose substantial patient safety risks, but medical students receive little training on their management. Although there is some evidence that medical students can be taught how to manage distractions and interruptions in a simulated ward environment, the only model to date is based on individual feedback, which is resource-expensive, mitigating curricular integration. Our aim was to assess the educational utility of a cost-efficient approach to a patient safety-focused simulated ward round. Twenty-three of 55 final-year medical students took part in a cost-reduced simulated ward round. Costs were minimised by providing group rather than individualised feedback, thereby shortening the duration of each simulation and reducing the number of interruptions. The utility of the simulation was assessed via student evaluation and performance on a patient safety station of an objective structured clinical examination (OSCE). The direct costs of the simulation were more than 50 per cent lower per student compared with the original study, mostly as a result of a reduction in the time that faculty members took to give feedback. Students managed distractions better and received higher scores in the OSCE station than those who had not undergone the ward round. Group feedback was evaluated positively by most participants: 94 per cent of those who provided feedback agreed or strongly agreed that the simulation would make them a safer doctor and would improve their handling of distractions. Our aim was to assess the educational utility of a cost-efficient approach to a patient safety-focused simulated ward round DISCUSSION: The costs of a simulated ward round can be significantly reduced whilst maintaining educational utility. These findings should encourage medical schools to integrate ward simulation into curricula. © 2016 John Wiley & Sons Ltd.

Student use of Web 2.0 tools to support argumentation in a high school science classroom

NASA Astrophysics Data System (ADS)

Weible, Jennifer L.

This ethnographic study is an investigation into how two classes of chemistry students (n=35) from a low-income high school with a one-to-one laptop initiative used Web 2.0 tools to support participation in the science practice of argumentation (i.e., sensemaking, articulating understandings, and persuading an audience) during a unit on alternative energy. The science curriculum utilized the Technology-Enhanced Inquiry Tools for Science Education as a pedagogical framework (Kim, Hannafin, & Bryan, 2007). Video recordings of the classroom work, small group discussions, and focus group interviews, documents, screen shots, wiki evidence, and student produced multi-media artifacts were the data analyzed for this study. Open and focused coding techniques, counts of social tags and wiki moves, and interpretive analyses were used to find patterns in the data. The study found that the tools of social bookmarking, wiki, and persuasive multimedia artifacts supported participation in argumentation. In addition, students utilized the affordances of the technologies in multiple ways to communicate, collaborate, manage the work of others, and efficiently complete their science project. This study also found that technologically enhanced science curriculum can bridge students' everyday and scientific understandings of making meaning, articulating understandings, and persuading others of their point of view. As a result, implications from this work include a set of design principles for science inquiry learning that utilize technology. This study suggests new consideration of analytical methodology that blends wiki data analytics and video data. It also suggests that utilizing technology as a bridging strategy serves two roles within classrooms: (a) deepening students' understanding of alternative energy science content and (b) supporting students as they learn to participate in the practices of argumentation.

An integrated model for adolescent inpatient group therapy.

PubMed

Garrick, D; Ewashen, C

2001-04-01

This paper proposes an integrated group therapy model to be utilized by psychiatric and mental health nurses; one innovatively designed to meet the therapeutic needs of adolescents admitted to inpatient psychiatric programs. The writers suggest a model of group therapy primarily comprised of interpersonal approaches within a feminist perspective. The proposed group focus is on active therapeutic engagement with adolescents to further interpersonal learning and to critically examine their contextualized lived experiences. Specific client and setting factors relevant to the selection of therapeutic techniques are reviewed. Selected theoretical models of group therapy are critiqued in relation to group therapy with adolescents. This integrated model of group therapy provides a safe and therapeutic forum that enriches clients' personal and interpersonal experiences as well as promotes healthy exploration, change, and empowerment.

The New Parent Checklist: A Tool to Promote Parental Reflection.

PubMed

Keys, Elizabeth M; McNeil, Deborah A; Wallace, Donna A; Bostick, Jason; Churchill, A Jocelyn; Dodd, Maureen M

To design and establish content and face validity of an evidence-informed tool that promotes parental self-reflection during the transition to parenthood. The New Parent Checklist was developed using a three-phase sequential approach: Phase 1 a scoping review and expert consultation to develop and refine a prototype tool; Phase 2 content analysis of parent focus groups; and Phase 3 assessment of utility in a cross-sectional sample of parents completing the New Parent Checklist and a questionnaire. The initial version of the checklist was considered by experts to contain key information. Focus group participants found it useful, appropriate, and nonjudgmental, and offered suggestions to enhance readability, utility, as well as face and content validity. In the cross-sectional survey, 83% of the participants rated the New Parent Checklist as "helpful" or "very helpful" and 90% found the New Parent Checklist "very easy" to use. Open-ended survey responses included predominantly positive feedback. Notable differences existed for some items based on respondents' first language, age, and sex. Results and feedback from all three phases informed the current version, available for download online. The New Parent Checklist is a comprehensive evidence-informed self-reflective tool with promising content and face validity. Depending on parental characteristics and infant age, certain items of the New Parent Checklist have particular utility but may also require further adaptation and testing. Local resources for information and/or support are included in the tool and could be easily adapted by other regions to incorporate their own local resources.

The utility of an online diagnostic decision support system (Isabel) in general practice: a process evaluation.

PubMed

Henderson, Emily J; Rubin, Greg P

2013-05-01

To evaluate the utility of Isabel, an online diagnostic decision support system developed by Isabel Healthcare primarily for secondary medical care, in the general practice setting. Focus groups were conducted with clinicians to understand why and how they used the system. A modified online post-use survey asked practitioners about its impact on their decision-making. Normalization process theory (NPT) was used as a theoretical framework to determine whether the system could be incorporated into routine clinical practice. The system was introduced by NHS County Durham and Darlington in the UK in selected general practices as a three-month pilot. General practitioners and nurse practitioners who had access to Isabel as part of the Primary Care Trust's pilot. General practitioners' views, experiences and usage of the system. Seven general practices agreed to pilot Isabel. Two practices did not subsequently use it. The remaining five practices conducted searches on 16 patients. Post-use surveys (n = 10) indicated that Isabel had little impact on diagnostic decision-making. Focus group participants stated that, although the diagnoses produced by Isabel in general did not have an impact on their decision-making, they would find the tool useful if it were better tailored to the primary care setting. Our analysis concluded that normalization was not likely to occur in its current form. Isabel was of limited utility in this short pilot study and may need further modification for use in general practice.

Assimilation and health service utilization of Korean immigrant women.

PubMed

Son, Juyeon

2013-11-01

In this case study, I present descriptive findings with regard to immigrant incorporation and health service utilization. Using focus groups and survey of Korean immigrant women in Wisconsin, I examine whether the ways in which they adapt to the U.S. society is relevant to their health services utilization and the alternatives they seek when available health services are less than satisfactory. The findings suggest that adherence to Korean identity appears to be associated with health service utilization. This is evident in the immigrants' evaluation of the U.S. health services as compared to those of Korea, and the consideration given by these immigrants to seeking health services in Korea instead of the United States. Such concerns on the part of these immigrants have important implications for health researchers, as they highlight the significance of immigrants' transnational experiences and their sense of personal agency in the use of health care.

The Arab American Experience with Diabetes: Perceptions, Myths and Implications for Culturally-Specific Interventions

PubMed Central

Bertran, Elizabeth A; Pinelli, Nicole R; Sills, Stephen J; Jaber, Linda A

2016-01-01

Aims Culturally-specific lifestyle diabetes prevention programs require an assessment of population disease perceptions and cultural influences on health beliefs and behaviors. The primary objectives were to assess Arab Americans’ knowledge and perceptions of diabetes and their preferences for a lifestyle intervention. Methods Sixty-nine self-identified Arab or Arab Americans ≥ 30 years of age and without diabetes participated in 8 focus groups. Results Emerging themes from the data included myths about diabetes etiology, folk remedies, and social stigma. The main barrier to healthcare was lack of health insurance and/or cost of care. Intervention preferences included gender-specific exercise, group-delivered education featuring religious ideology, inclusion of the family, and utilization of community facilities. Conclusion Lifestyle interventions for Arab Americans need to address cultural preferences, diabetes myths, and folk remedies. Interventions should incorporate Arabic cultural content and gender-specific group education and exercise. Utilization of family support and religious centers will enable culturally-acceptable and cost-effective interventions. PMID:27460886

Examining Elementary Students' Development of Oral and Written Argumentation Practices Through Argument-Based Inquiry

NASA Astrophysics Data System (ADS)

Chen, Ying-Chih; Hand, Brian; Park, Soonhye

2016-05-01

Argumentation, and the production of scientific arguments are critical elements of inquiry that are necessary for helping students become scientifically literate through engaging them in constructing and critiquing ideas. This case study employed a mixed methods research design to examine the development in 5th grade students' practices of oral and written argumentation from one unit to another over 16 weeks utilizing the science writing heuristic approach. Data sources included five rounds of whole-class discussion focused on group presentations of arguments that occurred over eleven class periods; students' group writings; interviews with six target students and the teacher; and the researcher's field notes. The results revealed five salient trends in students' development of oral and written argumentative practices over time: (1) Students came to use more critique components as they participated in more rounds of whole-class discussion focused on group presentations of arguments; (2) by challenging each other's arguments, students came to focus on the coherence of the argument and the quality of evidence; (3) students came to use evidence to defend, support, and reject arguments; (4) the quality of students' writing continuously improved over time; and (5) students connected oral argument skills to written argument skills as they had opportunities to revise their writing after debating and developed awareness of the usefulness of critique from peers. Given the development in oral argumentative practices and the quality of written arguments over time, this study indicates that students' development of oral and written argumentative practices is positively related to each other. This study suggests that argumentative practices should be framed through both a social and epistemic understanding of argument-utilizing talk and writing as vehicles to create norms of these complex practices.

Plenary III-04: Media Messages and Public Perceptions of Direct-to-Consumer Genetics: Results of a Media Analysis and Focus Group Study

PubMed Central

Rahm, Alanna Kulchak; Dearing, James; Feigelson, Heather Spencer; Tracer, David; Bull, Sheana

2011-01-01

Background Information about genetics and the promise of genomic medicine is commonplace in the mass media. How the mass media themselves contribute – or not – to the persistence of this issue and its perception by the public is the topic of this presentation. The purpose of this study is to investigate the structural and individual perspectives on the issue of direct-to-consumer (DTC) genetics, and assess the degree of correspondence across these perspectives. Methods I conducted a media analysis to determine how the issue of DTC genetics has been framed in mass media stories and the salient topics related to the issue. I conducted focus groups to determine individual knowledge, attitudes and beliefs about the issue of DTC genetics. Results A final sample of 398 mass media stories of DTC genetics from Lexis-Nexis Academic archives between September 1, 2007 and September 30, 2009 were coded for salience and frames. Fourteen focus groups were conducted between October, 2009 and March, 2010 with Kaiser Permanente Colorado members and medical staff. Focus group transcripts were coded for salience and framing of the issue and compared with the media analysis results.Study results found that the issue of DTC genetics was not very important to focus group participants except as it related to the topic of breast cancer. Mass media message topics and frames showed differences over time. Focus group participants were generally negative towards the issue while the mass media was mostly positive towards DTC genetics. Focus group participants used some of the many frames to understand the issue that were utilized by the mass media to package the issue, but participants mainly framed the issue in terms of prevention and a pandora’s box, while the mass media presented the issue more in terms of progressive and discrimination frames. Conclusions The mass media appears to function as a field of power for the issue of DTC genetics with the consumers in the middle of the contests. A higher-level concept of an “informed consumer” emerged from the focus groups that appears to provide consumers a degree of power in this battlefield as well.

Impact of a personal CYP2D6 testing workshop on physician assistant student attitudes toward pharmacogenetics.

PubMed

O'Brien, Travis J; LeLacheur, Susan; Ward, Caitlin; Lee, Norman H; Callier, Shawneequa; Harralson, Arthur F

2016-03-01

We assessed the impact of personal CYP2D6 testing on physician assistant student competency in, and attitudes toward, pharmacogenetics (PGx). Buccal samples were genotyped for CYP2D6 polymorphisms. Results were discussed during a 3-h PGx workshop. PGx knowledge was assessed by pre- and post-tests. Focus groups assessed the impact of the workshop on attitudes toward the clinical utility of PGx. Both student knowledge of PGx, and its perceived clinical utility, increased immediately following the workshop. However, exposure to PGx on clinical rotations following the workshop seemed to influence student attitudes toward PGx utility. Personal CYP2D6 testing improves both knowledge and comfort with PGx. Continued exposure to PGx concepts is important for transfer of learning.

Development of a low cost integrated 15 kW A.C. solar tracking sub-array for grid connected PV power system applications

NASA Astrophysics Data System (ADS)

Stern, M.; West, R.; Fourer, G.; Whalen, W.; Van Loo, M.; Duran, G.

1997-02-01

Utility Power Group has achieved a significant reduction in the installed cost of grid-connected PV systems. The two part technical approach focused on 1) The utilization of a large area factory assembled PV panel, and 2) The integration and packaging of all sub-array power conversion and control functions within a single factory produced enclosure. Eight engineering prototype 15kW ac single axis solar tracking sub-arrays were designed, fabricated, and installed at the Sacramento Municipal Utility District's Hedge Substation site in 1996 and are being evaluated for performance and reliability. A number of design enhancements will be implemented in 1997 and demonstrated by the field deployment and operation of over twenty advanced sub-array PV power systems.

Acknowledging adult bias: a focus-group approach to utilizing beauty salons as health-education portals for inner-city adolescent girls.

PubMed

Lieberman, Alexis; Harris, Diana

2007-04-01

To assess the feasibility of using beauticians as health literacy agents and beauty salons as health-education portals for adolescent, inner-city, African American girls, the authors conducted focus groups with 25 women: salon clients, salon owners, and medical students. Facilitators to program development included (a) beautician-client relationships, (b) teens' access to health information, and (c) beauticians as information resources. Barriers included (a) adult opinions of teen behaviors, (b) teen mistrust of adults, and (c) low health literacy of beauticians. In developing a health-education program for this population, beauticians and salons may be excellent health information agents and portals if barriers including beautician poor health literacy, adolescent mistrust in adults, and adults' anti-adolescent bias are improved. Program implementation must not solely focus on teens but should also include adult salon users, with the goal of reaching the teens first through these adults and, with time and trust, reaching the teens directly.

The Complexities of Family Caregiving at Work: A Mixed-Methods Study.

PubMed

Gaugler, Joseph E; Pestka, Deborah L; Davila, Heather; Sales, Rebecca; Owen, Greg; Baumgartner, Sarah A; Shook, Rocky; Cunningham, Jane; Kenney, Maureen

2018-01-01

The current project examined the impact of caregiving and caregiving-work conflict on employees' well-being. A sequential explanatory mixed-methods design (QUAN→qual) was utilized, and a total of 880 employees from a large health-care plan employer completed an online survey. Forty-five caregivers who completed the survey also participated in one of the five focus groups held 1 to 2 months later. Employed caregivers were significantly ( p < .05) more likely to indicate poorer physical and mental health than noncaregivers; among caregivers ( n = 370), caregiving-work conflict emerged as the most significant predictor of well-being and fully mediated the empirical relationship between burden and well-being. The focus group findings complemented the quantitative results; many of the challenges employed caregivers experience stem from their ability or inability to effectively balance their employment and caregiving roles. The results suggest the need to focus on caregiving-work conflict when constructing new or translating existing evidence-based caregiver interventions.

Exploring the differences in general practitioner and health care specialist utilization according to education, occupation, income and social networks across Europe: findings from the European social survey (2014) special module on the social determinants of health.

PubMed

Fjær, Erlend L; Balaj, Mirza; Stornes, Per; Todd, Adam; McNamara, Courtney L; Eikemo, Terje A

2017-02-01

Low socioeconomic position (SEP) tends to be linked to higher use of general practitioners (GPs), while the use of health care specialists is more common in higher SEPs. Despite extensive literature in this area, previous studies have, however, only studied health care use by income or education. The aim of this study is, therefore, to examine inequalities in GP and health care specialist use by four social markers that may be linked to health care utilization (educational level, occupational status, level of financial strain and size and frequency of social networks) across 20 European countries and Israel. Logistic regression models were employed using data from the seventh round of the European Social Survey; this study focused upon people aged 25–75 years, across 21 countries. Health care utilization was measured according to self-reported use of GP or specialist care within 12 months. Analyses tested four social markers: income (financial strain), occupational status, education and social networks. We observed a cross-national tendency that countries with higher or equal probability of GP utilization by lower SEP groups had a more consistent probability of specialist use among high SEP groups. Moreover, countries with inequalities in GP use in favour of high SEP groups had comparable levels of inequalities in specialist care utilization. This was the case for three social markers (education, occupational class and social networks), while the pattern was less pronounced for income (financial strain). There are significant inequalities associated with GP and specialist health care use across Europe—with higher SEP groups more likely to use health care specialists, compared with lower SEP groups. In the context of health care specialist use, education and occupation appear to be particularly important factors. © The Author 2017. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

Barriers to Accessing Tutoring Services among Students Who Received a Mid-Semester Warning

ERIC Educational Resources Information Center

Ciscell, Galen; Foley, Leslie; Luther, Kate; Howe, Robin; Gjsedal, Taylor

2016-01-01

For this focus group study we recruited from a population of 345 university students who had been informed of their poor academic performance in at least one course, but who had not utilized peer tutoring in the semester they received the warning, in order to determine if stigma played a role in their decision not to seek help. We learned from…

Active Learning: A Small Group Histology Laboratory Exercise in a Whole Class Setting Utilizing Virtual Slides and Peer Education

ERIC Educational Resources Information Center

Bloodgood, Robert A.

2012-01-01

Histology laboratory instruction is moving away from the sole use of the traditional combination of light microscopes and glass slides in favor of virtual microscopy and virtual slides. At the same time, medical curricula are changing so as to reduce scheduled time for basic science instruction as well as focusing on student-centered learning…

Comorbidity profile and healthcare utilization in elderly patients with serious mental illnesses.

PubMed

Hendrie, Hugh C; Lindgren, Donald; Hay, Donald P; Lane, Kathleen A; Gao, Sujuan; Purnell, Christianna; Munger, Stephanie; Smith, Faye; Dickens, Jeanne; Boustani, Malaz A; Callahan, Christopher M

2013-12-01

Patients with serious mental illness are living longer. Yet, there remain few studies that focus on healthcare utilization and its relationship with comorbidities in these elderly mentally ill patients. Comparative study. Information on demographics, comorbidities, and healthcare utilization was taken from an electronic medical record system. Wishard Health Services senior care and community mental health clinics. Patients age 65 years and older-255 patients with serious mental illness (schizophrenia, major recurrent depression, and bipolar illness) attending a mental health clinic and a representative sample of 533 nondemented patients without serious mental illness attending primary care clinics. Patients having serious mental illness had significantly higher rates of medical emergency department visits (p = 0.0027) and significantly longer lengths of medical hospitalizations (p <0.0001) than did the primary care control group. The frequency of medical comorbidities such as diabetes, coronary artery disease, congestive heart failure, chronic obstructive pulmonary disease, thyroid disease, and cancer was not significantly different between the groups. Hypertension was lower in the mentally ill group (p <0.0001). Reported falls (p <0.0001), diagnoses of substance abuse (p = 0.02), and alcoholism (p = 0.0016) were higher in the seriously mentally ill. The differences in healthcare utilization between the groups remained significant after adjusting for comorbidity levels, lifestyle factors, and attending primary care. Our findings of higher rates of emergency care, longer hospitalizations, and increased frequency of falls, substance abuse, and alcoholism suggest that seriously mentally ill older adults remain a vulnerable population requiring an integrated model of healthcare. Copyright © 2013 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

Embracing technology? Using change management strategies to improve the use of continuous lateral rotation therapy.

PubMed

Cybulski, Pamela; Zantinge, Johanna; Abbott-McNeil, Deanna

2006-01-01

The purpose of this quality improvement initiative was to improve the utilization of continuous lateral rotation therapy (CLRT) in a nine-bed community hospital ICU within the context of a nurse-driven protocol. Nursing focus groups, analyzed using a strength, weakness, opportunity, threat (SWOT) approach, resulted in the implementation of four interventions over seven weeks. Change management strategies guided all aspects of the project. Results showed a modest increase in the utilization of CLRT. This initiative demonstrates that change management strategies may assist with the incorporation of technology into nursing practice by increasing empowerment and creating an attachment to and responsibility for outcomes.

Proceedings of Small Power Systems Solar Electric Workshop. Volume 2: Invited papers

NASA Technical Reports Server (NTRS)

Ferber, R. (Editor)

1978-01-01

The focus of this work shop was to present the committment to the development of solar thermal power plants for a variety of applications including utility applications. Workshop activities included panel discussions, formal presentations, small group interactive discussions, question and answer periods, and informal gatherings. Discussion on topics include: (1) solar power technology options; (2) solar thermal power programs currently underway at the DOE, JPL, Electric Power Research Institute (EPRI), and Solar Energy Research Institute (SERI); (3) power options competing with solar; (4) institutional issues; (5) environmental and siting issues; (6) financial issues; (7) energy storage; (8) site requirements for experimental solar installations, and (9) utility planning.

An evaluation of students' perceptions of a college-based programme that involves patients, carers and service users in physiotherapy education.

PubMed

Thomson, Di; Hilton, Ros

2012-03-01

There is little evidence of the integration of UK physiotherapy university education into clinical practice, and some students say that they are not adequately prepared for professional life. This was addressed by a college-based programme involving patients, carers and service users as facilitators of learning to enhance the partnership between health professionals and patients. This programme has been running for 2 years, and this paper is an evaluation of the students' perceptions of it, appraising the outcomes of their learning in order to discover the ways in which it can be enhanced, improved or changed. A grounded theory approach utilizing focus groups and semi-structured interviews was conducted. Three focus groups representing the higher educational levels 4-6 in pre-registration physiotherapy were carried out. Following the analysis of the focus groups, seven interviews reflecting the three educational levels were conducted in order to explore in greater depth the findings from the focus groups. The analysis of the focus groups and the subsequent interviews were carried out in accordance with a grounded theory framework. The students perceived the programme as a context in which to think how their learning needs could be met within a 'real' framework but on their own territory. Equally, it created feelings of anxiety at being given such an open forum that created a challenge to their communication skills. Many expressed a wish for a more explicit mentoring-learning environment. They also perceived a tension between the technical-rational demands of academia and social practice and a need to view this as a basis for critical appraisal and self-awareness. This programme appeared to be integral to the students' development as future physiotherapists. Copyright © 2011 John Wiley & Sons, Ltd.

Practicing preventive health: the underlying culture among low-income rural populations.

PubMed

Murimi, Mary W; Harpel, Tammy

2010-01-01

Health disparities on the basis of geographic location, social economic factors and education levels are well documented. However, even when health care services are available, there is no guarantee that all persons will take preventive health measures. Understanding the cultural beliefs, practices, and lifestyle choices that determine utilization of health services is an important factor in combating chronic diseases. The purpose of this study was to investigate personal, cultural, and external barriers that interfered with participating in a community-based preventive outreach program that included health screening for obesity, diabetes, heart diseases, and hypertension when cost and transportation factors were addressed. Six focus groups were conducted in a rural community of Louisiana. Focus groups were divided into 2 categories: participants and nonparticipants. Three focus groups were completed with Dubach Health Outreach Project (DUHOP) participants and 3 were completed with nonparticipants. The focus group interviews were moderated by a researcher experienced in focus group interviews; a graduate student assisted with recording and note-taking during the sessions. Four main themes associated with barriers to participation in preventive services emerged from the discussions: (1) time, (2) low priority, (3) fear of the unknown, and (4) lack of companionship or support. Health concerns, free services, enjoyment, and free food were identified as motivators for participation. The findings of this study indicated that the resulting synergy between low-income status and a lack of motivation regarding health care prevention created a complicated practice of health care procrastination, which resulted in unnecessary emergency care and disease progression. To change this practice to proactive disease prevention and self care, a concerted effort will need to be implemented by policy makers, funding agents, health care providers, and community leaders and members.

Marketing Strategy and Implementation

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

None, None

This report documents the preparation of materials for the marketing campaign that has been designed for middle and high school students in New Mexico to increase interest in participation in national security careers at the National Nuclear Security Administration. The materials and the marketing campaign build on the research that was previously completed, as well as the focus groups that were conducted. This work is a part of the National Nuclear Security Preparedness Project (NSPP). Previous research included outcome analysis to determine appropriate marketing strategies. The analysis was based upon focus groups with middle school and high school students, studentmore » interactions, and surveys completed by students to understand and gauge student interest in Science, Technology, Engineering, and Math (STEM) subjects, interest in careers at NNSA, future job considerations, and student desire to pursue post-secondary education. Further, through the focus groups, students were asked to attend a presentation on NNSA job opportunities and employee requirements. The feedback received from the students was utilized to develop the focus and components of a marketing campaign divided into DISCO (Discovering Intelligence and Security Career Opportunities) for the middle school age group and DISCO…..Your Way! for high school age groups. Both campaigns have an intertwined message that focuses on the education of students in the various national security career opportunities at NNSA using the STEM concepts and the notion that almost any career they can think of has a fit within NNSA. Further, a special emphasis has been placed on the importance of obtaining a national security clearance when working at NNSA and the steps that will need to be taken during middle school, high school, and college to be allowed this opportunity.« less

The influence of analogical reasoning instruction on the pedagogical reasoning ability of preservice elementary teachers

NASA Astrophysics Data System (ADS)

James, Mark Charles

Novice teachers with little prior knowledge of science concepts often resort to teaching science as a litany of jargon and definitions. The primary objective of this study was to establish the efficacy of analogy-based pedagogy on influencing the teaching performance of preservice elementary teachers, a group that has been identified for their particular difficulties in teaching science content. While numerous studies have focused on the efficacy of analogy-based instruction on the conceptual knowledge of learners, this was the first study to focus on the influence of analogy-based pedagogy instruction on the teaching performance of novice teachers. The study utilized a treatment/contrast group design where treatment and contrast groups were obtained from intact sections of a university course on methods of teaching science for preservice elementary education students. Preservice teachers in the treatment group were provided instruction in pedagogy that guided them in the generation of analogies to aid in the explanation phase of their learning cycle lessons. The process of generating and evaluating analogies for use in teaching was instrumental in focusing the preservice teachers' lesson planning efforts on critical attributes in target concepts, and away from misplaced concentrations on jargon and definitions. Teaching performance was primarily analyzed using coded indicants of Shulman's (1986) six stages of pedagogical reasoning ability. The primary data source was preservice teachers' work submitted for a major course assignment where the preservice teachers interviewed an elementary school student to gauge prior knowledge of Newtonian force concepts. The culmination of the semester-long assignment was the design of an individualized lesson that was presented by the preservice teachers to individual elementary school students. The results of this study strongly suggest that instruction in methods to include analogy-based pedagogy within a learning cycle lesson format can positively influence the pedagogical reasoning ability of some elementary preservice teachers. The study also provided insights into techniques that can be utilized to introduce analogy-based pedagogy to elementary preservice teachers.

The physical work environment and end-user requirements: Investigating marine engineering officers' operational demands and ship design.

PubMed

Mallam, Steven C; Lundh, Monica

2016-08-12

Physical environments influence how individuals perceive a space and behave within it. Previous research has revealed deficiencies in ship engine department work environments, and their impact on crew productivity, health and wellbeing. Connect operational task demands to pragmatic physical design and layout solutions by implementing a user-centric perspective. Three focus groups, each consisting of three marine engineers participated in this study. Focus groups were divided into two sessions: first, to investigate the end-user's operational requirements and their relationship with ship physical design and layout. Second, criteria formulated from group discussions were applied to a ship design case study. All focus group sessions were audio recorded and transcribed verbatim. The data were analyzed using Grounded Theory. Design choices made in a ships general arrangement were described to inherently influence how individuals and teams are able to function within the system. Participants detailed logistical relationships between key areas, stressing that the work environment and physical linkages must allow for flexibility of work organization and task execution. Traditional engine control paradigms do not allow effective mitigation of traditional engine department challenges. The influence of technology and modernization of ship systems can facilitate improvement of physical environments and work organization if effectively utilized.

Identifying What Matters to Hysterectomy Patients: Postsurgery Perceptions, Beliefs, and Experiences.

PubMed

Bossick, Andrew S; Sangha, Roopina; Olden, Heather; Alexander, Gwen L; Wegienka, Ganesa

2018-01-01

Hysterectomy is the most common non-obstetrical surgery for women in the United States. Few investigations comparing hysterectomy surgical approaches include patient-centered outcomes. The study was performed at Henry Ford Health System in Detroit, Michigan between February 2015 and May 2015. The data were collected through structured focus groups with 24 post-hysterectomy women in order to identify PCOs to employ in a subsequent cohort study of hysterectomy surgical approaches. One pilot focus group and five additional focus groups were held. Qualitative data analysis, using data from coded transcripts of focus groups, was used to identify themes.Eligible women, aged between 18 and 65 years and had an EMR documented Current Procedural Terminology (CPT™) code or an International Statistical Classification of Diseases and Related Health Problems - Ninth Edition (ICD-9) code of hysterectomy between December 2012 and December 2014 (N=1,381, N=307 after exclusions) were selected and recruited. A question guide was developed to investigate women's experiences and feelings about the experience prior and subsequent to their hysterectomy. Analysis utilized the Framework Method. Focus groups with women who previously had a hysterectomy revealed their pre- and post-hysterectomy perceptions. Responses grouped into topics of pre- and post-surgical experiences, and information all women should know. Responses grouped into themes of 1) decision making, 2) the procedure - surgical experience, 3) recovery, 4) advice to past self, and 5) recommendations to other women. These findings about perceptions, beliefs, and attitudes of women having undergone hysterectomy could support health care providers deliver patient-centered care. These results informed data collection for a prospective longitudinal cohort study that is now underway. The data suggest a need for increased education and empowerment in the decision making process, while expanding on information given for post-operative expectations and somatic changes that occur post-hysterectomy.

Evaluation of criteria for developing traffic safety materials for Latinos.

PubMed

Streit-Kaplan, Erica L; Miara, Christine; Formica, Scott W; Gallagher, Susan Scavo

2011-03-01

This quantitative study assessed the validity of guidelines that identified four key characteristics of culturally appropriate Spanish-language traffic safety materials: language, translation, formative evaluation, and credible source material. From a sample of 190, the authors randomly selected 12 Spanish-language educational materials for analysis by 15 experts. Hypotheses included that the experts would rate materials with more of the key characteristics as more effective (likely to affect behavioral change) and rate materials originally developed in Spanish and those that utilized formative evaluation (e.g., pilot tests, focus groups) as more culturally appropriate. Although results revealed a weak association between the number of key characteristics in a material and the rating of its effectiveness, reviewers rated materials originally created in Spanish and those utilizing formative evaluation as significantly more culturally appropriate. The findings and methodology demonstrated important implications for developers and evaluators of any health-related materials for Spanish speakers and other population groups.

Racial and Ethnic Differences in Factors Related to Work Place Violence Victimization

PubMed Central

Sabri, Bushra; St. Vil, Noelle M.; Campbell, Jacquelyn C.; Fitzgerald, Sheila; Kub, Joan; Agnew, Jacqueline

2014-01-01

Work place violence (WPV) is a significant public health concern affecting all racial or ethnic groups. This study examined whether different racial/ethnic groups differed in vulnerability to WPV exposure and utilization of resources at the workplace. This cross sectional research focused on White, Black and Asian nursing employees (N=2033) employed in four health care institutions in a Mid-Atlantic US metropolitan area. While childhood physical abuse was significantly related to risk for WPV among workers from all racial/ethnic backgrounds, intimate partner abuse was a significant factor for Asians and Whites. Blacks and Asians were found to be less likely than Whites to be knowledgeable about WPV resources or use resources to address WPV. Services to address past trauma, and education and training opportunities for new workers may reduce risk for WPV and promote resource utilization among minority workers. PMID:24658287

A brain-computer interface to support functional recovery.

PubMed

Kjaer, Troels W; Sørensen, Helge B

2013-01-01

Brain-computer interfaces (BCI) register changes in brain activity and utilize this to control computers. The most widely used method is based on registration of electrical signals from the cerebral cortex using extracranially placed electrodes also called electroencephalography (EEG). The features extracted from the EEG may, besides controlling the computer, also be fed back to the patient for instance as visual input. This facilitates a learning process. BCI allow us to utilize brain activity in the rehabilitation of patients after stroke. The activity of the cerebral cortex varies with the type of movement we imagine, and by letting the patient know the type of brain activity best associated with the intended movement the rehabilitation process may be faster and more efficient. The focus of BCI utilization in medicine has changed in recent years. While we previously focused on devices facilitating communication in the rather few patients with locked-in syndrome, much interest is now devoted to the therapeutic use of BCI in rehabilitation. For this latter group of patients, the device is not intended to be a lifelong assistive companion but rather a 'teacher' during the rehabilitation period. Copyright © 2013 S. Karger AG, Basel.

Social and Economic Costs of Food Allergies in Europe: Development of a Questionnaire to Measure Costs and Health Utility

PubMed Central

Fox, Margaret; Voordouw, Jantine; Mugford, Miranda; Cornelisse, Judith; Antonides, Gerrit; Frewer, Lynn

2009-01-01

Objectives To develop a questionnaire to measure the additional social costs of food allergies (FAs). Data Source and Study Setting People with FAs and sampled members of the general population (with and without FAs) in the Netherlands and the United Kingdom in 2006. Study Design (1) Literature review. (2) Focus group to identify key costs of FAs and seek views on the questionnaires. (3) Pilot survey to test the questionnaires in cases and controls. Data Collection Twenty-eight participants in the United Kingdom and the Netherlands with clinically or self-diagnosed FAs took part in one of five focus groups. A case–control postal survey was conducted in the United Kingdom and the Netherlands (with 125 FA cases and 62 controls). Principal Findings Methods exist to measure social costs in chronic illness, but not FAs. Focus groups found features of FAs likely to impact costs of living. Pilot results suggest higher costs of living and health care costs, and well-being in FAs. Conclusion The questionnaire is proposed for use in wider European and other comparative studies of FAs. PMID:19619251

“Good passengers and not good passengers:” Adolescent drivers’ perceptions about inattention and peer passengers

PubMed Central

Sommers, Marilyn S.

2016-01-01

Purpose The purpose of this qualitative focus group elicitation research study was to explore teen driver perceptions of peer passengers and driver inattention. Design & Methods We utilized focus groups for data collection and content analysis to analyze the data, both of which were guided by the Theory of Planned Behavior. We conducted 7 focus groups with 30 teens, ages 16–18, licensed for ≤1 year to examine attitudes, perceived behavioral control, and norms related to driving inattention and peer passengers. Results The sample was 50% male, mean age 17.39 (sd 0.52) with mean length of licensure 173.7 days (sd 109.2). Three themes emerged: 1) “Good and not good” passengers; 2) Passengers and technology as harmful and helpful; and 3) The driver is in charge. Conclusions While passengers can be a source of distraction, our participants also identified passenger behaviors that reduced risk, such as assistance with technology and guidance for directions. Practical Implications An understanding of teens’ perceptions of peer passengers can contribute to the development of effective interventions targeting teen driver inattention. Nurses are well-positioned to contribute to these teen crash prevention efforts. PMID:27496828

"Good Passengers and Not Good Passengers:" Adolescent Drivers' Perceptions About Inattention and Peer Passengers.

PubMed

McDonald, Catherine C; Sommers, Marilyn S

The purpose of this qualitative focus group elicitation research study was to explore teen driver perceptions of peer passengers and driver inattention. We utilized focus groups for data collection and content analysis to analyze the data, both of which were guided by the theory of planned behavior. We conducted 7 focus groups with 30 teens, ages 16-18, licensed for ≤1year to examine attitudes, perceived behavioral control, and norms related to driving inattention and peer passengers. The sample was 50% male, mean age 17.39 (SD 0.52) with mean length of licensure 173.7days (SD 109.2). Three themes emerged: 1) "Good and not good" passengers; 2) Passengers and technology as harmful and helpful; and 3) The driver is in charge. While passengers can be a source of distraction, our participants also identified passenger behaviors that reduced risk, such as assistance with technology and guidance for directions. An understanding of teens' perceptions of peer passengers can contribute to the development of effective interventions targeting teen driver inattention. Nurses are well-positioned to contribute to these teen crash prevention efforts. Copyright © 2016 Elsevier Inc. All rights reserved.

Role of Community Based Savings Groups (CBSGs) enhancing the utilization of community midwives in Chitral district of Pakistan.

PubMed

Noorani, Qayyum Ali; Azam, Iqbal; Shaikh, Babar T; Ranasinghe, Tharanga; Abbas, Shazia; Wali, Shakeela; Rippey, Paul; Javed, Wajiha

2013-10-11

Maternal and infant mortality rates in the district of Chitral in Pakistan are alarmingly high. One of the major reasons for this is the inability of women to access skilled care due to the high costs associated with traveling and utilizing such services. The Aga Khan Health Services, Pakistan (AKHSP) in partnership with the national and provincial Maternal, Neonatal and Child Health (MNCH) program, deployed 28 community midwives (CMWs) in remote villages of Chitral district. This program has also established Community-Based Savings Groups (CBSGs) to support and facilitate access to MNCH services, in particular those delivered by the CMWs. CBSGs are a simple yet cost-effective and sustainable means of providing basic financial services to low income, marginalized, rural populations.The link between CBSGs and utilization of MNCH services is not well understood. This study will assess the relationship between women membership of CBSGs and their utilization of MNCH services, specifically those offered by CMWs, in the community. The research question will be answered through guided interviews of women in the target population who have delivered within one month. The outcome variable will be the utilization of full continuum of skilled MNCH care (disaggregated by 1+ ANC, 1+ PNC and skilled delivery). The primary independent variable of interest will be participation in a CBSG.Focus Group Discussions (FGDs) will be conducted to generate further understanding and information about the social and financial factors that contribute to health behavior and health provider decision-making during pregnancy.Analysis will be tailored to answer how CBSGs, directly or indirectly, facilitate greater financial and/or social access to CMW services for pregnant women. Furthermore, the extent to which financial or social empowerment through a CBSG leads to greater utilization of CMW services. The role of CBSGs and their interlink with the CMWs services to be replicated in other comparable areas in Pakistan as a viable mean to increase MNCH service utilization amongst rural, low income, and marginalized communities. Findings from this research will be disseminated through community, national, and international channels consisting of policy makers and social society groups.

Health Information Technology Knowledge and Skills Needed by HIT Employers

PubMed Central

Fenton, S.H.; Gongora-Ferraez, M.J.; Joost, E.

2012-01-01

Objective To evaluate the health information technology (HIT) workforce knowledge and skills needed by HIT employers. Methods Statewide face-to-face and online focus groups of identified HIT employer groups in Austin, Brownsville, College Station, Dallas, El Paso, Houston, Lubbock, San Antonio, and webinars for rural health and nursing informatics. Results HIT employers reported needing an HIT workforce with diverse knowledge and skills ranging from basic to advanced, while covering information technology, privacy and security, clinical practice, needs assessment, contract negotiation, and many other areas. Consistent themes were that employees needed to be able to learn on the job and must possess the ability to think critically and problem solve. Many employers wanted persons with technical skills, yet also the knowledge and understanding of healthcare operations. Conclusion The HIT employer focus groups provided valuable insight into employee skills needed in this fast-growing field. Additionally, this information will be utilized to develop a statewide HIT workforce needs assessment survey. PMID:23646090

How Pregnant African-American Women View Pregnancy Weight Gain

PubMed Central

Groth, Susan W.; Morrison-Beedy, Dianne; Meng, Ying

2012-01-01

Objective To gain insight into how low-income, pregnant African-American women viewed their weight gain while pregnant and how they managed their weight during pregnancy. Design Descriptive study using three focus groups. Setting Women were recruited from urban prenatal care sites and the Special Supplemental Nutrition Program for Women, Infants and Children (WIC) services in a medium-sized urban Northeastern city. Participants Twenty-six adult, low-income, pregnant African-American women, aged 18–39; the majority were within the first 20 weeks of pregnancy. Methods Three focus groups were conducted utilizing open-ended questions related to pregnancy weight gain. Content analysis was used to analyze the verbatim transcripts. Analysis focused on meaning, intention and context. Groups were compared and contrasted at the within and between group levels to identify themes. Results Four themes were identified that provided insight into how women viewed their pregnancy weight gain and managed weight gain during pregnancy: (a) pregnancy weight gain: no matter how much means a healthy baby; (b) weight retention: it happens; (c) there is a limit: weight gain impact on appearance; and (d) watching and waiting: plans for controlling weight. Conclusion Low-income African-American women, though cognizant of the likelihood of retention of weight following pregnancy, are not focused on limiting their gestational weight gain. The cultural acceptance of a larger body size along with the belief that gaining more weight is indicative of a healthy infant present challenges for interventions to limit excessive gestational weight gain. PMID:22789036

Focus on vulnerable populations and promoting equity in health service utilization--an analysis of visitor characteristics and service utilization of the Chinese community health service.

PubMed

Dong, Xiaoxin; Liu, Ling; Cao, Shiyi; Yang, Huajie; Song, Fujian; Yang, Chen; Gong, Yanhong; Wang, Yunxia; Yin, Xiaoxu; Xu, Xing; Xie, Jun; Sun, Yi; Lu, Zuxun

2014-05-26

Community health service in China is designed to provide a convenient and affordable primary health service for the city residents, and to promote health equity. Based on data from a large national study of 35 cities across China, we examined the characteristics of the patients and the utilization of community health institutions (CHIs), and assessed the role of community health service in promoting equity in health service utilization for community residents. Multistage sampling method was applied to select 35 cities in China. Four CHIs were randomly chosen in every district of the 35 cities. A total of 88,482 visitors to the selected CHIs were investigated by using intercept survey method at the exit of the CHIs in 2008, 2009, 2010, and 2011. Descriptive analyses were used to analyze the main characteristics (gender, age, and income) of the CHI visitors, and the results were compared with that from the National Health Services Survey (NHSS, including CHIs and higher levels of hospitals). We also analyzed the service utilization and the satisfactions of the CHI visitors. The proportions of the children (2.4%) and the elderly (about 22.7%) were lower in our survey than those in NHSS (9.8% and 38.8% respectively). The proportion of the low-income group (26.4%) was apparently higher than that in NHSS (12.5%). The children group had the lowest satisfaction with the CHIs than other age groups. The satisfaction of the low-income visitors was slightly higher than that of the higher-income visitors. The utilization rate of public health services was low in CHIs. The CHIs in China appears to fulfill the public health target of uptake by vulnerable populations, and may play an important role in promoting equity in health service utilization. However, services for children and the elderly should be strengthened.

'Transitions are Scary for our Kids, and They're Scary for us': Family Member and Youth Perspectives on the Challenges of Transitioning to Adulthood with Autism.

PubMed

Cheak-Zamora, Nancy C; Teti, Michelle; First, Jennifer

2015-11-01

Adolescents with autism spectrum disorder (ASD) face many challenges as they age into adulthood. Because little is known about the perspectives of caregivers and youth during this critical transition, this study explored their social, educational, and vocational needs and experiences. Two focus groups were conducted with youth with ASD (n = 13) and two focus groups were conducted with their caregivers (n = 19), where theme analysis strategies derived from Grounded Theory were utilized to identify themes. Both groups experienced fear and anxiety about transitioning, unmet needs were also high, leaving caregivers struggling to fill gaps. Most caregivers and youth reported lacking individualized services. Caregivers faced difficulty in motivating youth and creating opportunities for education and employment. Although youth have future goals, they were unaware of steps needed to accomplish them and hesitant to talk to caregivers. Findings indicate considerable unmet needs for caregivers and youth with ASD. Perspectives of both groups should be considered when developing programmes and educating providers. © 2015 John Wiley & Sons Ltd.

Utilizing Integrative Medicine in the U.S. Army Medical Department

DTIC Science & Technology

2012-05-15

This first group can be considered ―complementary‖ to traditional Western medicine (TWM6), such as diet and herbal therapy, or mind-body medicine, in...categorized as: nutritional medicine (including dietary supplements ), botanical medicine, lifestyle medicine, mind-body medicine, manual medicine, traditional...focus on the body and the psyche‘s ability to restore themselves, aided by measures such as proper diet, healing spices, herbal therapy, meditation

The standards process: Technical committee X3B5 digital magnetic tape

NASA Technical Reports Server (NTRS)

Cheatham, Sam

1993-01-01

The definition of X3B5, where it fits in the national and international standards development process, and how it interfaces and influences the world community of standards developers are provided. Details concerning the focus of the committee, how it operates, and what the group sees as the future trends in the area of interchange standards utilizing the multifaceted, ubiquitous magnetic tape are presented.

Case Method Instruction: 25 Minutes of Discussion Can Make a Difference

DTIC Science & Technology

2007-07-01

discussion was facilitated by computer rather than an instructor. In a comparison of pretest and posttest scores, students performed better on a...that the research design utilized a within-subjects design without a control group. Thus, the pretest might have primed students to focus on the... Research Institute Jason M. Brunner and Christopher L. Vowels Kansas State University Consortium Research Fellows Program Julia M. Kim

Walking the Path Together from High School to STEM Majors and Careers: Utilizing Community Engagement and a Focus on Teaching to Increase Opportunities for URM Students

ERIC Educational Resources Information Center

Finkel, Liza

2017-01-01

Despite decades of efforts to increase the participation of women and people from underrepresented minority groups (URM) in science and math majors and careers, and despite the increasing diversification of the US population as a whole (Planty et al. in National Center for Education Statistics, Institute of Education Sciences, U.S. Department of…

APRN Usability Testing of a Tailored Computer-Mediated Health Communication Program

PubMed Central

Lin, Carolyn A.; Neafsey, Patricia J.; Anderson, Elizabeth

2010-01-01

This study tested the usability of a touch-screen enabled “Personal Education Program” (PEP) with Advanced Practice Registered Nurses (APRN). The PEP is designed to enhance medication adherence and reduce adverse self-medication behaviors in older adults with hypertension. An iterative research process was employed, which involved the use of: (1) pre-trial focus groups to guide the design of system information architecture, (2) two different cycles of think-aloud trials to test the software interface, and (3) post-trial focus groups to gather feedback on the think-aloud studies. Results from this iterative usability testing process were utilized to systematically modify and improve the three PEP prototype versions—the pilot, Prototype-1 and Prototype-2. Findings contrasting the two separate think-aloud trials showed that APRN users rated the PEP system usability, system information and system-use satisfaction at a moderately high level between trials. In addition, errors using the interface were reduced by 76 percent and the interface time was reduced by 18.5 percent between the two trials. The usability testing processes employed in this study ensured an interface design adapted to APRNs' needs and preferences to allow them to effectively utilize the computer-mediated health-communication technology in a clinical setting. PMID:19940619

The Journey of Addiction: Barriers to and Facilitators of Drug Use Cessation among Street Children and Youths in Western Kenya

PubMed Central

Embleton, Lonnie; Atwoli, Lukoye; Ayuku, David; Braitstein, Paula

2013-01-01

This mixed-methods study examined barriers to and facilitators of street children’s drug use cessation in Eldoret, Kenya utilizing a cross-sectional survey and focus group discussions with a community-based sample of street-involved children and youth. The primary objective of this study was to describe factors that may assist or impede cessation of drug use that can be utilized in developing substance use interventions for this marginalized population. In 2011, 146 children and youth ages 10–19 years, classified as either children on the street or children of the street were recruited to participate in the cross-sectional survey. Of the 146 children that participated in the survey 40 were invited to participate in focus group discussion; 30 returned voluntarily to participate in the discussions. Several themes were derived from children’s narratives that described the barriers to and facilitators of drug cessation. Specifically, our findings reveal the strength of the addiction to inhalants, the dual role that peers and family play in substance use, and how the social, cultural, and economic context influence or impede cessation. Our findings demonstrate the need to integrate community, family and peers into any intervention in addition to traditional medical and psychological models for treatment of substance use dependence. PMID:23326428

Utilization of In-Hospital Care among Foreign-Born Compared to Native Swedes 1987–1999

PubMed Central

Albin, Björn; Hjelm, Katarina; Ekberg, Jan; Elmståhl, Sölve

2012-01-01

In previous longitudinal studies of mortality and morbidity among foreign-born and native-born Swedes, increased mortality and dissimilarities in mortality pattern were found. The aim of this study is to describe, compare, and analyse the utilization of in-hospital care among deceased foreign- and Swedish-born persons during the years 1987–1999 with focus on four diagnostic categories. The study population consisted of 361,974 foreign-born persons aged 16 years and upward who were registered as living in Sweden in 1970, together with 361,974 matched Swedish controls for each person. Data from Statistics Sweden (SCB) and the National Board of Health and Welfare Centre for Epidemiology, covering the period 1970–1999, was used. Persons were selected if they were admitted to hospital during 1987–1999 and the cause of death was in one of four ICD groups. The results indicate a tendency towards less health care utilization among migrants, especially men, as regards Symptoms, signs, and ill-defined conditions and Injury and poisoning. Further studies are needed to explore the possible explanations and the pattern of other diseases to see whether migrants, and especially migrant men, are a risk group with less utilization of health care. PMID:23213496

Exploring the usefulness of comprehensive care plans for children with medical complexity (CMC): a qualitative study.

PubMed

Adams, Sherri; Cohen, Eyal; Mahant, Sanjay; Friedman, Jeremy N; Macculloch, Radha; Nicholas, David B

2013-01-19

The Medical Home model recommends that Children with Special Health Care Needs (CSHCN) receive a medical care plan, outlining the child's major medical issues and care needs to assist with care coordination. While care plans are a primary component of effective care coordination, the creation and maintenance of care plans is time, labor, and cost intensive, and the desired content of the care plan has not been studied. The purpose of this qualitative study was to understand the usefulness and desired content of comprehensive care plans by exploring the perceptions of parents and health care providers (HCPs) of children with medical complexity (CMC). This qualitative study utilized in-depth semi-structured interviews and focus groups. HCPs (n = 15) and parents (n = 15) of CMC who had all used a comprehensive care plan were recruited from a tertiary pediatric academic health sciences center. Themes were identified through grounded theory analysis of interview and focus group data. A multi-dimensional model of perceived care plan usefulness emerged. The model highlights three integral aspects of the care plan: care plan characteristics, activating factors and perceived outcomes of using a care plan. Care plans were perceived as a useful tool that centralized and focused the care of the child. Care plans were reported to flatten the hierarchical relationship between HCPs and parents, resulting in enhanced reciprocal information exchange and strengthened relationships. Participants expressed that a standardized template that is family-centered and includes content relevant to both the medical and social needs of the child is beneficial when integrated into overall care planning and delivery for CMC. Care plans are perceived to be a useful tool to both health care providers and parents of CMC. These findings inform the utility and development of a comprehensive care plan template as well as a model of how and when to best utilize care plans within family-centered models of care.

Protocol for a qualitative study exploring perspectives on the INternational CLassification of Diseases (11th revision); Using lived experience to improve mental health Diagnosis in NHS England: INCLUDE study.

PubMed

Hackmann, Corinna; Green, Amanda; Notley, Caitlin; Perkins, Amorette; Reed, Geoffrey M; Ridler, Joseph; Wilson, Jon; Shakespeare, Tom

2017-09-03

Developed in dialogue with WHO, this research aims to incorporate lived experience and views in the refinement of the International Classification of Diseases Mental and Behavioural Disorders 11th Revision (ICD-11). The validity and clinical utility of psychiatric diagnostic systems has been questioned by both service users and clinicians, as not all aspects reflect their lived experience or are user friendly. This is critical as evidence suggests that diagnosis can impact service user experience, identity, service use and outcomes. Feedback and recommendations from service users and clinicians should help minimise the potential for unintended negative consequences and improve the accuracy, validity and clinical utility of the ICD-11. The name INCLUDE reflects the value of expertise by experience as all aspects of the proposed study are co-produced. Feedback on the planned criteria for the ICD-11 will be sought through focus groups with service users and clinicians. The data from these groups will be coded and inductively analysed using a thematic analysis approach. Findings from this will be used to form the basis of co-produced recommendations for the ICD-11. Two service user focus groups will be conducted for each of these diagnoses: Personality Disorder, Bipolar I Disorder, Schizophrenia, Depressive Disorder and Generalised Anxiety Disorder. There will be four focus groups with clinicians (psychiatrists, general practitioners and clinical psychologists). This study has received ethical approval from the Coventry and Warwickshire HRA Research Ethics Committee (16/WM/0479). The output for the project will be recommendations that reflect the views and experiences of experts by experience (service users and clinicians). The findings will be disseminated via conferences and peer-reviewed publications. As the ICD is an international tool, the aim is for the methodology to be internationally disseminated for replication by other groups. ClinicalTrials.gov: NCT03131505. © 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.

Exploring rape myths, gendered norms, group processing, and the social context of rape among college women: a qualitative analysis.

PubMed

Deming, Michelle E; Covan, Eleanor Krassen; Swan, Suzanne C; Billings, Deborah L

2013-04-01

The purpose of this research is to explore the negotiation strategies of college women as they interpret ambiguous rape scenarios. In focus groups, 1st- and 4th-year college women were presented with a series of three vignettes depicting incidents that meet the legal criteria for rape yet are ambiguous due to the presence of cultural rape myths, contexts involving alcohol consumption, varying degrees of consent, and a known perpetrator. These contexts are critical in understanding how college women define rape. Key findings indicated many of these college women utilized rape myths and norms within their peer groups to interpret rape scenarios.

Faithful Remote Information Concentration Based on the Optimal Universal 1→2 Telecloning of Arbitrary Two-Qubit States

NASA Astrophysics Data System (ADS)

Peng, Jia-Yin; Lei, Hong-Xuan; Mo, Zhi-Wen

2014-05-01

The previous protocols of remote quantum information concentration were focused on the reverse process of quantum telecloning of single-qubit states. We here investigate the reverse process of optimal universal 1→2 telecloning of arbitrary two-qubit states. The aim of this telecloning is to distribute respectively the quantum information to two groups of spatially separated receivers from a group of two senders situated at two different locations. Our scheme shows that the distributed quantum information can be remotely concentrated back to a group of two different receivers with 1 of probability by utilizing maximally four-particle cluster state and four-particle GHZ state as quantum channel.

The BOS-X approach: achieving drastic cost reduction in CPV through holistic power plant level innovation

NASA Astrophysics Data System (ADS)

Plesniak, A.; Garboushian, V.

2012-10-01

In 2011, the Amonix Advanced Technology Group was awarded DOE SunShot funding in the amount of 4.5M to design a new Balance of System (BOS) architecture utilizing Amonix MegaModules™ focused on reaching the SunShot goal of 0.06-$0.08/kWhr LCOE. The project proposal presented a comprehensive re-evaluation of the cost components of a utility scale CPV plant and identified critical areas of focus where innovation is needed to achieve cost reduction. As the world's premier manufacturer and most experienced installer of CPV power plants, Amonix is uniquely qualified to lead a rethinking of BOS architecture for CPV. The presentation will focus on the structure of the BOS-X approach, which looks for the next wave of cost reduction in CPV through evaluation of non-module subsystems and the interaction between subsystems during the lifecycle of a solar power plant. Innovation around nonmodule components is minimal to date because CPV companies are just now getting enough practice through completion of large projects to create ideas and tests on how to improve baseline designs and processes. As CPV companies increase their installed capacity, they can utilize an approach similar to the methodology of BOS-X to increase the competitiveness of their product. Through partnership with DOE, this holistic approach is expected to define a path for CPV well aligned with the goals of the SunShot Initiative.

Does the choice of tariff matter?

PubMed Central

Zhao, Yue; Li, Shun-Ping; Liu, Liu; Zhang, Jiang-Lin; Chen, Gang

2017-01-01

Abstract There is an increasing trend globally to develop country-specific tariffs that can theoretically better reflect population's preferences on health states for preference-based health-related quality-of-life instruments, also known as multiattribute utility instruments. This study focused on the most recently developed 5-level version of EuroQol-5 Dimension (EQ-5D) questionnaire, 1 of the world's most well-known multiattribute utility instruments, and aimed to empirically explore the agreements and known-group validities of applying the country-specific tariff versus tariffs developed from other countries using a sample of psoriasis vulgaris patients in Mainland China. A convenience sampling framework was adopted to recruit patients diagnosed with psoriasis vulgaris from Xiangya Hospital, Central South University, China, between May 2014 and February 2015. The 5-level EuroQol-5 dimensions (EQ-5D-5L) utilities were scored by using the Chinese, Japanese, and UK tariffs. Health state utilities were compared using a range of nonparametric test. The intraclass correlation coefficients and Bland–Altman plots were used to examine the agreements among the 3 EQ-5D-5L scores. Health state utility decrements between known groups were investigated using both effect size and a regression analysis. In all, 350 patients (aged 16 years or older) were recruited. There were significant differences among the 3 national tariff sets. Overall, 3 tariffs showed excellent agreements (intraclass correlation coefficient >0.90); however, the wide limits of agreement from the Bland–Altman plots suggest that these tariffs cannot be used interchangeably. The EQ-5D-5L scores using the Chinese-specific tariff showed the best known-group validity than the other 2 tariffs in this Chinese patient sample. The evidence from this study supports the choice of the country-specific tariff to be used in Mainland China. PMID:28834893

Traditional Knowledge and Nutritive Value of Indigenous Foods in the Oraon Tribal Community of Jharkhand: An Exploratory Cross-sectional Study

PubMed Central

Ghosh-Jerath, Suparna; Singh, Archna; Kamboj, Preeti; Goldberg, Gail; Magsumbol, Melina S.

2015-01-01

Traditional knowledge and nutritional value of indigenous foods of the Oraon tribal community in Jharkhand, India was explored. Focus group discussions were conducted with adult members to identify commonly consumed indigenous foods. Taxonomic classification and quantitative estimation of nutritive value were conducted in laboratories or utilized data from Indian food composition database. More than 130 varieties of indigenous foods were identified, many of which were rich sources of micronutrients like calcium, iron, vitamin A, and folic acid. Some were reported having medicinal properties. Utilization and ease of assimilation of indigenous foods into routine diets can be leveraged to address malnutrition in tribal communities. PMID:25902000

Bringing radical behaviorism to revolutionary Brazil and back: Fred Keller's Personalized System of Instruction and Cold War engineering education.

PubMed

Akera, Atsushi

2017-09-01

This article traces the shifting epistemic commitments of Fred S. Keller and his behaviorist colleagues during their application of Skinnerian radical behaviorism to higher education pedagogy. Building on prior work by Alexandra Rutherford and her focus on the successive adaptation of Skinnerian behaviorism during its successive applications, this study utilizes sociologist of science Karin Knorr Cetina's concept of epistemic cultures to more precisely trace the changes in the epistemic commitments of a group of radical behaviorists as they shifted their focus to applied behavioral analysis. The story revolves around a self-paced system of instruction known as the Personalized System of Instruction, or PSI, which utilized behaviorist principles to accelerate learning within the classroom. Unlike Skinner's entry into education, and his focus on educational technologies, Keller developed a mastery-based approach to instruction that utilized generalized reinforcers to cultivate higher-order learning behaviors. As it happens, the story also unfolds across a rather fantastic political terrain: PSI originated in the context of Brazilian revolutionary history, but circulated widely in the U.S. amidst Cold War concerns about an engineering manpower(sic) crisis. This study also presents us with an opportunity to test Knorr Cetina's conjecture about the possible use of a focus on epistemic cultures in addressing a classic problem in the sociology of science, namely unpacking the relationship between knowledge and its social context. Ultimately, however, this study complements another historical case study in applied behavioral analysis, where a difference in outcome helps to lay out the range of possible shifts in the epistemic commitments of radical behaviorists who entered different domains of application. The case study also has some practical implications for those creating distance learning environments today, which are briefly explored in the conclusion. © 2017 Wiley Periodicals, Inc.

The Mexican American Cultural Values scales for Adolescents and Adults

PubMed Central

Knight, George P.; Gonzales, Nancy A.; Saenz, Delia S.; Bonds, Darya D.; Germán, Miguelina; Deardorff, Julianna; Roosa, Mark W.; Updegraff, Kimberly A.

2009-01-01

This research evaluates the properties of a measure of culturally linked values of Mexican Americans in early adolescence and adulthood. The items measure were derived from qualitative data provided by focus groups in which Mexican Americans’ (adolescents, mothers and fathers) perceptions of key values were discussed. The focus groups and a preliminary item refinement resulted in the fifty-item Mexican American Cultural Values Scales (identical for adolescents and adults) that includes nine value subscales. Analyses of data from two large previously published studies sampling Mexican American adolescents, mothers, and fathers provided evidence of the expected two correlated higher order factor structures, reliability, and construct validity of the subscales of the Mexican American Cultural Values Scales as indicators of values that are frequently associated with Mexican/Mexican American culture. The utility of this measure for use in longitudinal research, and in resolving some important theoretical questions regarding dual cultural adaptation, are discussed. PMID:20644653

A mobile phone based remote patient monitoring system for chronic disease management.

PubMed

Trudel, Mathieu; Cafazzo, Joseph A; Hamill, Melinda; Igharas, Walter; Tallevi, Kevin; Picton, Peter; Lam, Jack; Rossos, Peter G; Easty, Anthony C; Logan, Alexander

2007-01-01

Rising concern over the poor state of chronic disease management led to the user-informed design and development of a home tele-monitoring system. Focus groups with patients and primary care providers guided the research team towards a design that would accommodate the workflow and concerns of the healthcare providers and the low use and comfort with technology found among the patient population. The system was trialed in a before-and-after pilot study of 34 patients with diabetes and hypertension. Findings demonstrate a significant improvement in systolic and diastolic blood pressure. An RCT beginning in 2007 is being conducted to confirm these findings. It is hypothesized that this user-centred approach, utilizing focus groups, iterative design and human factors methods of evaluation, will lead to the next-generation of home tele-monitoring applications that are more intuitive, less cumbersome, and ultimately bring about greater patient compliance and better physician management.

Personal Care Participation Assessment and Resource Tool: Clinical utility for inpatient rehabilitation.

PubMed

Darzins, Susan W; Imms, Christine; Stefano, Marilyn Di; Radia-George, Camilla A

2016-10-01

Evidence supports validity of the Personal Care Participation Assessment and Resource Tool (PC-PART), but clinical utility remains unverified. This study aimed to investigate occupational therapists' perceptions about the PC-PART's clinical utility for inpatient rehabilitation. Using mixed methods, occupational therapists who had used the PC-PART as part of a research study in an inpatient rehabilitation setting completed a questionnaire ( n = 9) and participated in a focus group ( n = 6) to explore their perspectives about its clinical utility. Quantitative data were summarized and qualitative data analyzed using inductive thematic analysis. Quantitative data highlighted both positive and negative aspects of the PC-PART's clinical utility. Five themes emerged from the qualitative data: nature of information gathered; familiarity with the instrument; perceived time and effort; item phrasing, interpretation, and presentation; and external influences on clinical use. The PC-PART was perceived to support gathering of clinically useful information, helpful to intervention and discharge planning. Recommendations for improving some item phrasing, operational definitions, and instructions were identified. Although standardized assessments were valued, use in routine practice was challenging, requiring a knowledge translation strategy.

Examining the Effect of Household Wealth and Migration Status on Safe Delivery Care in Urban India, 1992–2006

PubMed Central

Singh, Prashant Kumar; Rai, Rajesh Kumar; Singh, Lucky

2012-01-01

Background Although the urban health issue has been of long-standing interest to public health researchers, majority of the studies have looked upon the urban poor and migrants as distinct subgroups. Another concern is, whether being poor and at the same time migrant leads to a double disadvantage in the utilization of maternal health services? This study aims to examine the trends and factors that affect safe delivery care utilization among the migrants and the poor in urban India. Methodology/Principal Findings Using data from the National Family Health Survey, 1992–93 and 2005–06, this study grouped the household wealth and migration status into four distinct categories poor-migrant, poor-non migrant, non poor-migrant, non poor-non migrant. Both chi-square test and binary logistic regression were performed to examine the influence of household wealth and migration status on safe delivery care utilization among women who had experienced a birth in the four years preceding the survey. Results suggest a decline in safe delivery care among poor-migrant women during 1992–2006. The present study identifies two distinct groups in terms of safe delivery care utilization in urban India – one for poor-migrant and one for non poor-non migrants. While poor-migrant women were most vulnerable, non poor-non migrant women were the highest users of safe delivery care. Conclusion This study reiterates the inequality that underlies the utilization of maternal healthcare services not only by the urban poor but also by poor-migrant women, who deserve special attention. The ongoing programmatic efforts under the National Urban Health Mission should start focusing on the poorest of the poor groups such as poor-migrant women. Importantly, there should be continuous evaluation to examine the progress among target groups within urban areas. PMID:22970324

The Arab American experience with diabetes: Perceptions, myths and implications for culturally-specific interventions.

PubMed

Bertran, Elizabeth A; Pinelli, Nicole R; Sills, Stephen J; Jaber, Linda A

2017-02-01

Culturally-specific lifestyle diabetes prevention programs require an assessment of population disease perceptions and cultural influences on health beliefs and behaviors. The primary objectives were to assess Arab Americans' knowledge and perceptions of diabetes and their preferences for a lifestyle intervention. Sixty-nine self-identified Arab or Arab Americans ≥30 years of age and without diabetes participated in 8 focus groups. Emerging themes from the data included myths about diabetes etiology, folk remedies, and social stigma. The main barrier to healthcare was lack of health insurance and/or cost of care. Intervention preferences included gender-specific exercise, group-delivered education featuring religious ideology, inclusion of the family, and utilization of community facilities. Lifestyle interventions for Arab Americans need to address cultural preferences, diabetes myths, and folk remedies. Interventions should incorporate Arabic cultural content and gender-specific group education and exercise. Utilization of family support and religious centers will enable culturally-acceptable and cost-effective interventions. Copyright © 2016 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved.

Patient-accessible tool for shared decision making in cardiovascular primary prevention: balancing longevity benefits against medication disutility.

PubMed

Fontana, Marianna; Asaria, Perviz; Moraldo, Michela; Finegold, Judith; Hassanally, Khalil; Manisty, Charlotte H; Francis, Darrel P

2014-06-17

Primary prevention guidelines focus on risk, often assuming negligible aversion to medication, yet most patients discontinue primary prevention statins within 3 years. We quantify real-world distribution of medication disutility and separately calculate the average utilities for a range of risk strata. We randomly sampled 360 members of the general public in London. Medication aversion was quantified as the gain in lifespan required by each individual to offset the inconvenience (disutility) of taking an idealized daily preventative tablet. In parallel, we constructed tables of expected gain in lifespan (utility) from initiating statin therapy for each age group, sex, and cardiovascular risk profile in the population. This allowed comparison of the widths of the distributions of medication disutility and of group-average expectation of longevity gain. Observed medication disutility ranged from 1 day to >10 years of life being required by subjects (median, 6 months; interquartile range, 1-36 months) to make daily preventative therapy worthwhile. Average expected longevity benefit from statins at ages ≥50 years ranges from 3.6 months (low-risk women) to 24.3 months (high-risk men). We can no longer assume that medication disutility is almost zero. Over one-quarter of subjects had disutility exceeding the group-average longevity gain from statins expected even for the highest-risk (ie, highest-gain) group. Future primary prevention studies might explore medication disutility in larger populations. Patients may differ more in disutility than in prospectively definable utility (which provides only group-average estimates). Consultations could be enriched by assessing disutility and exploring its reasons. © 2014 American Heart Association, Inc.

Clinical Consideration of Treatment to Ablate Uterine Fibroids with Magnetic Resonance Imaging-guided High Intensity Focused Ultrasound (MRgFUS): Sonalleve

PubMed Central

Jeong, Jae-Hyeok; Hong, Gil Pyo; Kim, Yu-Ri; Ha, Jae-Eun

2016-01-01

Objectives Magnetic resonance imaging (MRI)-guided high intensity focused ultrasound surgery (MRgFUS) is a newly emerging non-invasive technique for the treatment of uterine fibroids. The purpose of this study is to review the clinical impact of MRgFUS. Methods This study examined 157 patients. The high intensity focused ultrasound (HIFU) utilized in this study was Philips Achieva 1.5 Tesla MR (Philips Healthcare, Best, the Netherlands) and Sonalleve HIFU system. The patients were followed in post-operative Month 1, Month 3, and Month 6 to investigate any change. Then, these were further classified according to the use of uterine stimulant (oxytocin) in parallel, Funaki Type of uterine fibroid, HIFU intensity, and non-perfused volume (NPV) ratio. Results When the uterine stimulant was utilized, the HIFU intensity was measured at significantly lower levels, compared with the group not using uterine stimulant, and treatment duration was significantly. The NPV ratio was found significantly higher in the group using uterine stimulant. Concerning the correlation between Funaki Type of uterine fibroid and average sonication power, it was found that the closer to Type I, the lower the sonication power, the shorter the treatment duration, and the higher the NPV ratio significantly. Conclusions In this study, it was found that the lower the Funaki Types of uterine fibroids, and the higher the NPV ratio immediately after the operation, the larger the uterine fibroid volume decrease and SSS change were. Also, if uterine stimulant was used in parallel in treatment, treatment duration and HIFU intensity could become shorter and lower. PMID:27617244

Mega-Project Construction Management: The Corps of Engineers and Bechtel Group in Saudi Arabia

DTIC Science & Technology

1991-02-01

collaborative efforts of government and private firms; utilizing state-of-the-art technology; and, having economic , sociocultural, and environmental impacts...pushing out their traditional managerial corps of stodgy engineers and aristocrats."LA Although I don’t focus on individual personalities in this...help from Western economists the Central Planning Organization created Saudi Arabia’s first five year economic plan, which covered the years 1970 to

Digital storytelling: an innovative technological approach to nursing education.

PubMed

Price, Deborah M; Strodtman, Linda; Brough, Elizabeth; Lonn, Steven; Luo, Airong

2015-01-01

This study investigated the impact of using digital stories in promoting deeper understanding in nursing students about palliative care concepts. Students (N = 134) created a 5-minute narrated digital story utilizing VoiceThread technology that synthesized and applied knowledge that had been presented in class and course readings. Postsurvey and focus group evaluation data revealed that through the writing and sharing of digital stories, students embraced the personal and complex nature of palliative care.

"A 28-Day Program Ain't Helping the Crack Smoker" -- Perceptions of Effective Drug Abuse Prevention Interventions by North Central Florida African Americans Who Use Cocaine

ERIC Educational Resources Information Center

Brown, Emma J.; Hill, Mary Angelique; Giroux, Stacey A.

2004-01-01

Cocaine is a major problem in the rural South, but knowledge is limited regarding the impact on African American populations. Purpose: This study of 18-39-year-old black drug users assessed perceptions of contributing factors to drug use and possible interventions. The study design was qualitative-descriptive, utilizing 4 focus groups with 5 rural…

Computer technology applications in industrial and organizational psychology.

PubMed

Crespin, Timothy R; Austin, James T

2002-08-01

This article reviews computer applications developed and utilized by industrial-organizational (I-O) psychologists, both in practice and in research. A primary emphasis is on applications developed for Internet usage, because this "network of networks" changes the way I-O psychologists work. The review focuses on traditional and emerging topics in I-O psychology. The first topic involves information technology applications in measurement, defined broadly across levels of analysis (persons, groups, organizations) and domains (abilities, personality, attitudes). Discussion then focuses on individual learning at work, both in formal training and in coping with continual automation of work. A section on job analysis follows, illustrating the role of computers and the Internet in studying jobs. Shifting focus to the group level of analysis, we briefly review how information technology is being used to understand and support cooperative work. Finally, special emphasis is given to the emerging "third discipline" in I-O psychology research-computational modeling of behavioral events in organizations. Throughout this review, themes of innovation and dissemination underlie a continuum between research and practice. The review concludes by setting a framework for I-O psychology in a computerized and networked world.

Principles of effective communication with patients who have intellectual disability among primary care physicians.

PubMed

Werner, S; Yalon-Chamovitz, S; Tenne Rinde, M; Heymann, A D

2017-07-01

Examine physicians' implementation of effective communication principles with patients with intellectual disabilities (ID) and its predictors. Focus groups helped construct a quantitative questionnaire. The questionnaire (completed by 440 physicians) examined utilization of effective communication principles, attitudes toward individuals with ID, subjective knowledge and number of patients with ID. Subjective knowledge of ID and more patients with ID increased utilization of effective communication principles. Provision of knowledge that allows patients to make their own medical decisions was predicted by more patients with ID, lower attitudes that treatment of this population group is not desirable, less negative affect and greater perception that treatment of this group is part of the physician's role. Effective preparation of patients with ID for treatment was predicted by higher perception of treatment of this group as part of the physician's role, lower perception of this field as undesirable and higher perception of these individuals as unable to make their own choice. Simplification of information was predicted by a greater perception of treatment of this group as part of the physician's role and more negative affect. Greater familiarity may enhance care for these patients. Increase exposure to patients with ID within training. Copyright © 2017 Elsevier B.V. All rights reserved.

Promoting physical activity using a wearable activity tracker in college students: A cluster randomized controlled trial.

PubMed

Kim, Youngdeok; Lumpkin, Angela; Lochbaum, Marc; Stegemeier, Steven; Kitten, Karla

2018-08-01

This study examined the effects of utilizing a wearable activity tracker in a credit-based physical activity instructional program (PAIP) for promoting physical activity (PA) in college students. Fourteen PAIP courses in a large public university were randomly assigned into intervention (k = 7; n = 101) and control (k = 7; n = 86) groups. All courses focused on a core curriculum that covers basic exercise and behavioral science contents through lectures and activity sessions. A Misfit Flash activity tracker was provided to students in the intervention group. Objective PA assessments occurred at baseline, mid-, and end-of-semester during a 15-week academic semester. The control group showed a significant reduction in moderate- and vigorous-intensity PA (MVPA) minutes from baseline to the end-of-semester (P <.05), whereas the intervention group showed no changes in MVPA minutes over time. However, the intervention group also showed increased sedentary time and decreased time spent in light-intensity PA during the intervention period. Taken together, the present study found null effects of utilizing the wearable activity tracker in promoting PA in college students suggesting that intervention of primary using the wearable activity tracker as a behavior change strategy may not be effective to increase in PA in this setting.

Essential pediatric hypertension: defining the educational needs of primary care pediatricians.

PubMed

Cha, Stephen D; Chisolm, Deena J; Mahan, John D

2014-07-27

In order to better understand the educational needs regarding appropriate recognition, diagnosis and management of pediatric hypertension (HTN), we asked practicing pediatricians questions regarding their educational needs and comfort level on this topic. We conducted 4 focus group sessions that included 27 participants representing pediatric residents, adolescent medicine physicians, clinic based pediatricians and office based pediatricians. Each focus group session lasted for approximately an hour and 90 pages of total transcriptions were produced verbatim from audio recordings. Four reviewers read each transcript and themes were elucidated from these transcripts. Overall, 5 major themes related to educational needs and clinical concerns were found: utilization of resources to define blood pressure (BP), correct BP measurement method(s), co-morbidities, barriers to care, and experience level with HTN. Six minor themes were also identified: differences in BP measurement, accuracy of BP, recognition of HTN, practice pattern of care, education of families and patients, and differences in level of training. The focus group participants were also questioned on their preferences regarding educational methods (i.e. e-learning, small group sessions, self-study, large group presentations) and revealed varied teaching and learning preferences. There are multiple methods to approach education regarding pediatric HTN for primary care pediatricians based on provider preferences and multiple educational activities should be pursued to achieve best outcomes. Based on this data, the next direction will be to develop and deliver multiple educational methods and to evaluate the impact on practice patterns of care for children and adolescents with HTN.

Women's perceptions about abortion in their communities: perspectives from western Kenya.

PubMed

Marlow, Heather M; Wamugi, Sylvia; Yegon, Erick; Fetters, Tamara; Wanaswa, Leah; Msipa-Ndebele, Sinikiwe

2014-05-01

Unsafe abortion in Kenya is a leading cause of maternal morbidity and mortality. In October 2012, we sought to understand the methods married women aged 24-49 and young, unmarried women aged ≤ 20 used to induce abortion, the providers they utilized and the social, economic and cultural norms that influenced women's access to safe abortion services in Bungoma and Trans Nzoia counties in western Kenya. We conducted five focus groups with young women and five with married women in rural and urban communities in each county. We trained local facilitators to conduct the focus groups in Swahili or English. All focus groups were audiotaped, transcribed, translated, computerized, and coded for analysis. Abortion outside public health facilities was mentioned frequently. Because of the need for secrecy to avoid condemnation, uncertainty about the law, and perceived higher cost of safer abortion methods, women sought unsafe abortions from community midwives, drug sellers and/or untrained providers at lower cost. Many groups believed that abortion was safer at higher gestational ages, but that there was no such thing as a safe abortion method. Our aim was to inform the design of a community-based intervention on safe abortion for women. Barriers to seeking safe services such as high cost, perceived illegality, and fear of insults and abuse at public facilities among both age groups must be addressed. Copyright © 2014 Reproductive Health Matters. Published by Elsevier Ltd. All rights reserved.

Identifying research needs for wheelchair transfers in the built environment.

PubMed

Crytzer, Theresa Marie; Cooper, Rory; Jerome, Genevieve; Koontz, Alicia

2017-02-01

The purpose of this study is to describe the results of focus groups held during the Independent Wheelchair Transfer (IWT) Workgroup. The aims were to facilitate exchange of ideas on (1) the impact of the built environment on the wheelchair transfer process within the community (i.e. moving from wheelchair to and from other surfaces (e.g. furniture, toilet seat, bath bench, car seat) to participate in daily activities), (2) wheelchair users' needs during transfers in the built environment, and (3) future research directions. Live web-based conferencing using Adobe Connect technology (Clarix Technologies, Inc., Pittsford, NY) was utilized to conduct three focus groups composed of experts in the field of assistive technology. Investigators independently reviewed focus group meeting transcripts and used qualitative methods to identify main themes. Thirty-one experts in assistive technology and related fields participated in focus groups. Nine main themes were found including the effect of transfer skills training, space considerations in the built environment, wheelchair configuration, and the interaction between the built environment, user preferences, and transfer techniques. All groups raised issues about the transfer process in areas of the built environment with limited access, the effect of wheelchair users' transfer techniques, and user preferences during transfers. The area of independent transfers is multi-faceted and several factors require consideration when contemplating environmental changes to improve accessibility for wheelchair users. Obvious opportunity exists for research which could lead to advances in transfer technology, environments, and techniques for wheelchair users. Implications for Rehabilitation Tremendous opportunities for research collaborations in the field of assistive technology: To develop new terminology to describe wheelchair transfers. To improve the design of the built environment for wheelchair users. To investigate wheelchair transfer training techniques.

A gender-based approach to developing a healthy lifestyle and healthy weight intervention for diverse Utah women.

PubMed

Simonsen, Sara E; Digre, Kathleen B; Ralls, Brenda; Mukundente, Valentine; Davis, France A; Rickard, Sylvia; Tavake-Pasi, Fahina; Napia, Eru Ed; Aiono, Heather; Chirpich, Meghan; Stark, Louisa A; Sunada, Grant; Keen, Kassy; Johnston, Leanne; Frost, Caren J; Varner, Michael W; Alder, Stephen C

2015-08-01

Utah women from some cultural minority groups have higher overweight/obesity rates than the overall population. We utilized a gender-based mixed methods approach to learn about the underlying social, cultural and gender issues that contribute to the increased obesity risk among these women and to inform intervention development. A literature review and analysis of Utah's Behavioral Risk Factor Surveillance System data informed the development of a focus group guide. Focus groups were conducted with five groups of women: African immigrants from Burundi and Rwanda, African Americans, American Indians/Alaskan Natives, Hispanics/Latinas, and Pacific Islanders. Six common themes emerged: (1) health is multidimensional and interventions must address health in this manner; (2) limited resources and time influence health behaviors; (3) norms about healthy weight vary, with certain communities showing more preference to heavier women; (4) women and men have important but different influences on healthy lifestyle practices within households; (5) women have an influential role on the health of families; and (6) opportunities exist within each group to improve health. Seeking insights from these five groups of women helped to identify common and distinct cultural and gender themes related to obesity, which can be used to help elucidate core obesity determinants. Copyright © 2014 Elsevier Ltd. All rights reserved.

Implementation of an electronic health record-based care management system to improve tobacco treatment.

PubMed

Kruse, Gina R; Kelley, Jennifer H K; Linder, Jeffrey A; Park, Elyse R; Rigotti, Nancy A

2012-12-01

Tobacco treatment is underused in primary care. We designed a Tobacco Care Management system to increase the delivery of treatment and reduce the burden on primary care providers (PCPs). A one-click functionality added to the electronic health record (EHR) allowed PCPs to refer smokers to a centralized tobacco treatment coordinator (TTC) who called smokers, provided brief counseling, connected them to ongoing treatment and gave feedback to PCPs. To study the system's feasibility and acceptability among PCPs, and its utilization by smokers. Using a mixed methods design, we documented system utilization quantitatively from February 1, 2010 to July 31, 2011, and conducted two focus groups with PCPs in June 2011. Thirty-six PCPs and 2,894 smokers from two community health centers in Massachusetts. Quantitative: One-click referral utilization by PCPs, proportion of smokers referred and connected to treatment. Qualitative: PCPs' reasons for use, barriers to use, and experiences with feedback. Twenty-nine PCPs (81 %) used the functionality more than once, generating 466 referrals for 15 % of known smokers seen during the study. The TTC reached 260 (56 %) of the referrals and connected 135 (29 %) to additional treatment. The director of one center sent PCPs monthly feedback about their utilization compared to peers. These PCPs referred a greater proportion of their known smokers (18 % vs. 9 %, p<0.0001) and reported that monthly feedback motivated referrals. PCPs attending focus groups (n=24) appreciated the system's simplicity, access to updated resources, and time-efficient way to address smoking, and wanted more feedback about cessation outcomes. They collectively supported the system's continuation. A novel EHR-based Tobacco Care Management system was adopted by PCPs, especially those receiving performance feedback, and connected one-third of referred smokers to treatment. The model has the potential to improve the delivery and outcomes of evidence-based tobacco treatment in primary care.

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

Does the choice of tariff matter?: A comparison of EQ-5D-5L utility scores using Chinese, UK, and Japanese tariffs on patients with psoriasis vulgaris in Central South China.

PubMed

Zhao, Yue; Li, Shun-Ping; Liu, Liu; Zhang, Jiang-Lin; Chen, Gang

2017-08-01

There is an increasing trend globally to develop country-specific tariffs that can theoretically better reflect population's preferences on health states for preference-based health-related quality-of-life instruments, also known as multiattribute utility instruments. This study focused on the most recently developed 5-level version of EuroQol-5 Dimension (EQ-5D) questionnaire, 1 of the world's most well-known multiattribute utility instruments, and aimed to empirically explore the agreements and known-group validities of applying the country-specific tariff versus tariffs developed from other countries using a sample of psoriasis vulgaris patients in Mainland China.A convenience sampling framework was adopted to recruit patients diagnosed with psoriasis vulgaris from Xiangya Hospital, Central South University, China, between May 2014 and February 2015. The 5-level EuroQol-5 dimensions (EQ-5D-5L) utilities were scored by using the Chinese, Japanese, and UK tariffs. Health state utilities were compared using a range of nonparametric test. The intraclass correlation coefficients and Bland-Altman plots were used to examine the agreements among the 3 EQ-5D-5L scores. Health state utility decrements between known groups were investigated using both effect size and a regression analysis.In all, 350 patients (aged 16 years or older) were recruited. There were significant differences among the 3 national tariff sets. Overall, 3 tariffs showed excellent agreements (intraclass correlation coefficient >0.90); however, the wide limits of agreement from the Bland-Altman plots suggest that these tariffs cannot be used interchangeably. The EQ-5D-5L scores using the Chinese-specific tariff showed the best known-group validity than the other 2 tariffs in this Chinese patient sample. The evidence from this study supports the choice of the country-specific tariff to be used in Mainland China.

High school students' views of learning chemistry concepts with analogies

NASA Astrophysics Data System (ADS)

Mathews, Jeffrey A.

Analogies are often used in teaching abstract chemistry concepts, however few studies are concerned with how students actually view learning with analogies. An eight-member focus group, consisting of high school students, described the process of learning with analogies and how aware they were of their own learning. The students attended four analogy presentations and completed written responses, attended focus groups, and participated in repeated individual interview sessions throughout this eight-week, emic, phenomenological study. This study utilized an interpretive, qualitative methodology using a constant comparative, inductive analysis design. Students from a suburban high school in the southeastern United States were selected by purposeful sampling involving a concepts pre-test and an analogy presentation used to determine an eight member focus group. The focus group meetings were videotaped and emergent, semi-structured individual interviews were audio taped, transcribed and coded. Personal student journals, field notes, and a reflective journal were used to triangulate the study. Open, axial, and selective coding were used for data analysis and interpretation. Students described the process of learning with analogies as being able to visually see connections or picture mental images of familiar and unfamiliar concepts. Students pointed out the significance of investigating analogy breakdowns and described accommodation of new information as either automatic, which according to students resulted in memorization and hard learning, or quite laborious, which resulted in understanding and soft learning. Results indicated that students gave themselves more permission to ask questions and be critical of the teaching they are experiencing when their views were given merit. Implications for teachers include insight on students' views of learning and students' self-awareness.

Maternal Perceptions Related to Eating and Obesity Risk Among Low-Income African American Preschoolers.

PubMed

Porter, Lauren; Shriver, Lenka H; Ramsay, Samantha

2016-12-01

Objectives Health disparities are prevalent in the U.S., with low-income African American children suffering from high rates of obesity and related conditions. Better understanding of parental attitudes and barriers related to healthy eating and obesity risk is needed to suggest more effective intervention foci for this at-risk population. Methods African American caregivers of 3-5 year old children were recruited for focus groups and a questionnaire completion from two Head Start programs in a southeastern state of the U.S. The Social Cognitive Theory was utilized to develop a focus group guide. Focus group recordings were transcribed verbatim and analyzed using the comparative content analysis. Results Eight focus groups (all participants were mothers) yielded the following main themes: (1) general nutrition knowledge but common misconceptions about foods/beverages; (2) beliefs that meals have to include meat and starch and be home-cooked to be healthy; (3) desire to feed children better than their own parents; (4) lack of family support and child pickiness perceived as the greatest barriers to healthy eating; (5) awareness of family history of diseases; and (6) low concern about children's current diet and weight status. Over 25 % of mothers underestimated their child weight status. Conclusions Our findings highlight the importance of understanding maternal perspectives related to food, eating, and weight among low-income African American mothers of preschoolers. Nutrition educators should be aware of misconceptions and recognize that mothers might not perceive diet quality in early childhood as having strong impact on the child's future health and/or obesity risks.

The Utility of the Memorable Messages Framework as an Intermediary Evaluation Tool for Fruit and Vegetable Consumption in a Nutrition Education Program.

PubMed

Davis, LaShara A; Morgan, Susan E; Mobley, Amy R

2016-06-01

Additional strategies to evaluate the impact of community nutrition education programs on low-income individuals are needed. The objective of this qualitative study was to examine the use of the Memorable Messages Framework as an intermediary nutrition education program evaluation tool to determine what fruit and vegetable messages were reported as memorable and the characteristics of those memorable messages. A convenience sample of low-income, primarily African American adults (N = 58) who previously completed a series of community nutrition education lessons within an urban area of Indiana participated in a focus group (N = 8 focus groups). A lead moderator using a semistructured script conducted the focus groups to determine what information about fruits and vegetables was most memorable from the participants' nutrition lessons and why this information was memorable. All focus group audiotapes were transcribed verbatim and ATLAS.ti software was used to code and identify themes within the data. Participants cited quantity, variety, and the positive nutritional impact of eating fruits and vegetables as most memorable. Information given in the form of recipes was also cited as most memorable. For example, participants referred to the recipe demonstrations as not only fun but also key components of the program that helped with message retention and memorability. Key characteristics of memorable messages included personal relevance and message vividness. These findings indicated that the Memorable Messages Framework may serve as an intermediary program evaluation tool to identify what information and messages are most influential to participants in community nutrition education programs. © 2015 Society for Public Health Education.

Multifamily group treatment for veterans with traumatic brain injury: what is the value to participants?

PubMed

Straits-Troster, Kristy; Gierisch, Jennifer M; Strauss, Jennifer L; Dyck, Dennis G; Dixon, Lisa B; Norell, Diane; Perlick, Deborah A

2013-06-01

This study evaluated the feasibility, acceptability, and helpfulness of implementation of multifamily group treatment for traumatic brain injury (TBI) among veterans who sustained a TBI during the wars in Iraq and Afghanistan and their families or caregivers. Veterans and their family members who participated in an open clinical trial (August 2010-March 2011) of multifamily psychoeducation for TBI at two Veterans Affairs medical centers were invited to one of three focus groups. Participants were asked about problems experienced before and during the intervention, aspects of treatment that were helpful, and improvements that would facilitate effective implementation of multifamily group treatment for TBI. Postintervention focus group transcripts were analyzed by utilizing qualitative content analysis. Participants included eight veterans with TBI and eight family members. Five themes emerged: exploring common struggles and reducing isolation, building skills to cope with TBI and related problems, restoring relationships through communication and understanding, increasing understanding of the interconnection between TBI and posttraumatic stress disorder, and improving the multifamily group experience and increasing treatment engagement of veterans and families. Veterans and family members found multifamily group treatment for TBI highly acceptable and offered recommendations to improve and increase access to the program. The results supported the feasibility and acceptability of multifamily group treatment for TBI. Specific recommendations to improve this psychoeducational intervention and its implementation are offered.

Using mind mapping techniques for rapid qualitative data analysis in public participation processes.

PubMed

Burgess-Allen, Jilla; Owen-Smith, Vicci

2010-12-01

In a health service environment where timescales for patient participation in service design are short and resources scarce, a balance needs to be achieved between research rigour and the timeliness and utility of the findings of patient participation processes. To develop a pragmatic mind mapping approach to managing the qualitative data from patient participation processes. While this article draws on experience of using mind maps in a variety of participation processes, a single example is used to illustrate the approach. In this example mind maps were created during the course of patient participation focus groups. Two group discussions were also transcribed verbatim to allow comparison of the rapid mind mapping approach with traditional thematic analysis of qualitative data. The illustrative example formed part of a local alcohol service review which included consultation with local alcohol service users, their families and staff groups. The mind mapping approach provided a pleasing graphical format for representing the key themes raised during the focus groups. It helped stimulate and galvanize discussion and keep it on track, enhanced transparency and group ownership of the data analysis process, allowed a rapid dynamic between data collection and feedback, and was considerably faster than traditional methods for the analysis of focus groups, while resulting in similar broad themes. This study suggests that the use of a mind mapping approach to managing qualitative data can provide a pragmatic resolution of the tension between limited resources and quality in patient participation processes. © 2010 The Authors. Health Expectations © 2010 Blackwell Publishing Ltd.

Let us fight and support one another: adolescent girls and young women on contributors and solutions to HIV risk in Zambia

PubMed Central

Butts, Stefani A; Parmley, Lauren E; Alcaide, Maria L; Rodriguez, Violeta J; Kayukwa, Annette; Chitalu, Ndashi; Weiss, Stephen M; Jones, Deborah L

2017-01-01

In Zambia, adolescent girls and young women (AGYW) are disproportionately affected by human immunodeficiency virus (HIV), social, cultural and economic factors making them particularly vulnerable. This study was designed to understand the context in which AGYW are at risk and to identify perceived drivers of the epidemic and potential strategies to reduce HIV risk. Focus group discussions were conducted with AGYW in Zambian districts with the highest HIV prevalence from February through August 2016. The focus group guide addressed HIV risk factors and strategies for HIV prevention in AGYW. Focus group discussions were recorded, translated and transcribed, themes identified and responses coded. Results suggest that gender inequality undermined potentially protective factors against HIV among AGYW. Poverty and stigmatization were major barriers to accessing available HIV prevention services as well as primary risk factors for HIV infection. Sponsorship to support AGYW school attendance, programs for boys and girls to foster gender equality and financial assistance from the government of Zambia to support AGYW most in need were proposed as strategies to reduce HIV risk. Results highlight the utility of using community-based research to guide potential interventions for the affected population. Future research should explore the use of multilevel interventions to combat HIV among AGYW. PMID:29033613

Measuring the attitudes of dental students towards social accountability following dental education - Qualitative findings.

PubMed

Chen, Vivian; Foster Page, Lyndie; McMillan, John; Lyons, Karl; Gibson, Barry

2016-06-01

The term social accountability has gained increased interest in medical education, but is relatively unexplored in dentistry. The aim of this study is to explore dental students' attitudes towards social accountability. A qualitative study utilizing focus groups with University of Otago final year (5th year) Bachelor of Dental Surgery (BDS) students was carried out. A questionnaire designed to measure medical students' attitudes towards social responsibility was used as a guide. Following data collection, framework analysis was used to analyze each of the three focus groups, and repeating themes were noted. Analysis of the focus groups discovered recurring themes, such that participants believed that dentists should be accountable to society in a professional context and that they are responsible for patients who present at their clinic but that there is no professional obligation to help reduce oral health inequalities by working with populations facing inequalities. There was strong agreement that there needs to be change to the dental health care system from a structural and political level to address oral health inequalities, rather than individual dentists assuming greater responsibility. Our findings show that dental education may not be accountable to society in the sense that it is not producing graduates who believe that they have an obligation to address the priority oral health concerns of society.

Improving a Case-Control Study of Multiple Sclerosis Using Formative Research

PubMed Central

Williamson, Dhelia M.; Wagner, Laurie; Henry, Judy P.

2015-01-01

Formative research (i.e. focus groups and key informant interviews) was conducted to understand risk perceptions and identify barriers to participation in a case-control study of environmental exposures and genetic susceptibility as risk factors for multiple sclerosis (MS). Individuals with MS were recruited to participate in a focus group discussion and individual interviews. Participants were asked to review and comment on study materials and process including participation, interview, genetic testing, confidentiality, and questionnaire. A structured discussion guide was used with all participants to ensure uniformity and coverage of all predetermined topics. Participants reported an increased likelihood of participation if they were informed about the study by their neurologist and not a government agency. All participants expressed willingness to provide a blood sample for genotyping but disagreed about the setting for the blood draw (at home or in a lab). Participants were concerned that they would not receive their individual genotyping results. The study protocol and materials were revised based on comments from the focus group participants. Formative research is an under-utilized resource for researchers conducting epidemiologic studies. Even with limited resources, piloting study materials with individuals similar to the proposed study population can provide opportunities to make modifications to effectively meet the needs of participants and promote participation and retention. PMID:25741529

Children's Oncology Group's 2013 blueprint for research: behavioral science.

PubMed

Noll, Robert B; Patel, Sunita K; Embry, Leanne; Hardy, Kristina K; Pelletier, Wendy; Annett, Robert D; Patenaude, Andrea; Lown, E Anne; Sands, Stephen A; Barakat, Lamia P

2013-06-01

Behavioral science has long played a central role in pediatric oncology clinical service and research. Early work focused on symptom relief related to side effects of chemotherapy and pain management related to invasive medical procedures. As survival rates improved, the focused has shifted to examination of the psychosocial impact, during and after treatment, of pediatric cancer and its treatment on children and their families. The success of the clinical trials networks related to survivorship highlights an even more critical role in numerous domains of psychosocial research and care. Within the cooperative group setting, the field of behavioral science includes psychologists, social workers, physicians, nurses, and parent advisors. The research agenda of this group of experts needs to focus on utilization of psychometrically robust measures to evaluate the impact of treatment on children with cancer and their families during and after treatment ends. Over the next 5 years, the field of behavioral science will need to develop and implement initiatives to expand use of standardized neurocognitive and behavior batteries; increase assessment of neurocognition using technology; early identification of at-risk children/families; establish standards for evidence-based psychosocial care; and leverage linkages with the broader behavioral health pediatric oncology community to translate empirically supported research clinical trials care to practice. Copyright © 2012 Wiley Periodicals, Inc.

Factors influencing food preparation behaviours: findings from focus groups with Mexican-American mothers in southern California.

PubMed

Smith, Teresa M; Dunton, Genevieve F; Pinard, Courtney A; Yaroch, Amy L

2016-04-01

The purpose of the present study was to explore food preparation behaviours, attitudes, meal planning and shopping among Mexican-American mothers. Data were collected through four focus groups with mothers of Mexican origin/ancestry who considered themselves to be the primary food preparer. Topics included food preparation behaviours and influencers (culture, family, attitudes, barriers, meal planning and shopping). Data were analysed using a qualitative grounded theory approach. All focus groups were audio recorded, transcribed verbatim and coded for themes. Data were collected in southern California, USA in 2013. Of the sample of twenty-one Mexican-American mothers, thirteen were born outside the USA and the mean household size was five members. Participants reported that food was often prepared using traditional staples and food preparation behaviours were learned from maternal family members. Participants also suggested that health was influenced by foods eaten and how they were prepared. Salient factors influencing food preparation behaviours included culture and tradition, maternal family members' food preparation behaviours, food preparation self-efficacy and attitudes towards healthy eating. Time and busy schedules were cited as barriers. Future interventions should consider utilizing family-based approaches and teaching culturally relevant food preparation skills, especially to youth, while reinforcing more healthful dietary practices.

Caregiver Perspectives of Stigma Associated With Sickle Cell Disease in Adolescents.

PubMed

Wesley, Kimberly M; Zhao, Mimi; Carroll, Yvonne; Porter, Jerlym S

2016-01-01

Patients and families affected by various medical conditions report experiencing health-related stigma, which contributes to detrimental physical, psychological, and social outcomes. Sickle cell disease (SCD) is a genetic disorder that affects 89,000 individuals in the United States and is often associated with negative stereotypes and incorrect assumptions. The present study explored the perception of stigma as reported by caregivers of adolescents with SCD. Focus groups were conducted with 20 caregivers of patients with SCD. Focus groups were audio recorded and transcribed. The data were coded independently by two authors, and then reviewed conjointly until consensus was reached. Caregivers reported the perception of stigma in academic, medical, community, and family settings. They also reported internalized stigma including negative feelings toward having a child with SCD, feeling upset with others, and seeing negative emotions in their child due to SCD. Caregivers reported a general lack of knowledge about SCD across settings. These results demonstrated that stigma may affect individuals with SCD across multiple settings. These results also highlighted areas for intervention, with a focus on increasing communication and education toward medical providers, schools, and communities. Interventions can utilize technology, social media, and advertisement campaigns. Additionally, support groups for patients with SCD may help decrease stigma and validate patients' experiences. Copyright © 2016 Elsevier Inc. All rights reserved.

Let us fight and support one another: adolescent girls and young women on contributors and solutions to HIV risk in Zambia.

PubMed

Butts, Stefani A; Parmley, Lauren E; Alcaide, Maria L; Rodriguez, Violeta J; Kayukwa, Annette; Chitalu, Ndashi; Weiss, Stephen M; Jones, Deborah L

2017-01-01

In Zambia, adolescent girls and young women (AGYW) are disproportionately affected by human immunodeficiency virus (HIV), social, cultural and economic factors making them particularly vulnerable. This study was designed to understand the context in which AGYW are at risk and to identify perceived drivers of the epidemic and potential strategies to reduce HIV risk. Focus group discussions were conducted with AGYW in Zambian districts with the highest HIV prevalence from February through August 2016. The focus group guide addressed HIV risk factors and strategies for HIV prevention in AGYW. Focus group discussions were recorded, translated and transcribed, themes identified and responses coded. Results suggest that gender inequality undermined potentially protective factors against HIV among AGYW. Poverty and stigmatization were major barriers to accessing available HIV prevention services as well as primary risk factors for HIV infection. Sponsorship to support AGYW school attendance, programs for boys and girls to foster gender equality and financial assistance from the government of Zambia to support AGYW most in need were proposed as strategies to reduce HIV risk. Results highlight the utility of using community-based research to guide potential interventions for the affected population. Future research should explore the use of multilevel interventions to combat HIV among AGYW.

The effects of different gender groupings on middle school students' performance in science lab

NASA Astrophysics Data System (ADS)

Drab, Deborah D.

Grouping students for labs in science classes is a common practice. This mixed methods quasi-experimental action research study examines homogeneous and heterogeneous gender grouping strategies to determine what gender grouping strategy is the most effective in a coeducational science classroom setting. Sixth grade students were grouped in same-gender and mixed-gender groups, alternating each quarter. Over the course of an academic year, data were collected from four sources. The teacher-researcher observed groups working during hands-on activities to collect data on student behaviors. Students completed post-lab questionnaires and an end-of-course questionnaire about their preferences and experiences in the different grouping strategies. Student scores on written lab assignments were also utilized. Data analysis focused on four areas: active engagement, student achievement, student perceptions of success and cooperative teamwork. Findings suggest that teachers may consider grouping students of different ability levels according to different gender grouping strategies to optimize learning.

Need, Enabling, Predisposing, and Behavioral Determinants of Access to Preventative Care in Argentina: Analysis of the National Survey of Risk Factors

PubMed Central

Jahangir, Eiman; Irazola, Vilma; Rubinstein, Adolfo

2012-01-01

Introduction Health care utilization is an important step to disease management, providing opportunities for prevention and treatment. Anderson’s Health Behavior Model has defined utilization by need, predisposing, and enabling determinants. We hypothesize that need, predisposing, and enabling, highlighting behavioral factors are associated with utilization in Argentina. Methods We performed a logistic regression analysis of the 2005 and 2009 Argentinean Survey of Risk Factors, a cohort of 41,392 and 34,732 individuals, to explore the association between need, enabling, predisposing, and behavioral factors to blood pressure measurement in the last year. Results In the 2005 cohort, blood pressure measurement was associated with perception of health, insurance coverage, basic needs met, and income. Additionally, female sex, civil state, household type, older age groups, education, and alcohol use were associated with utilization. The 2009 cohort showed similar associations with only minor differences between the models. Conclusions We explored the association between utilization of clinical preventive services with need, enabling, predisposing, and behavioral factors. While predisposing and need determinants are associated with utilization, enabling factors such as insurance coverage provides an area for public intervention. These are important findings where policies should be focused to improve utilization of preventive services in Argentina. PMID:22984608

The construction of standard gamble utilities.

PubMed

van Osch, Sylvie M C; Stiggelbout, Anne M

2008-01-01

Health effects for cost-effectiveness analysis are best measured in life years, with quality of life in each life year expressed in terms of utilities. The standard gamble (SG) has been the gold standard for utility measurement. However, the biases of probability weighting, loss aversion, and scale compatibility have an inconclusive effect on SG utilities. We determined their effect on SG utilities using qualitative data to assess the reference point and the focus of attention. While thinking aloud, 45 healthy respondents provided SG utilities for six rheumatoid arthritis health states. Reference points, goals, and focuses of attention were coded. To assess the effect of scale compatibility, correlations were assessed between focus of attention and mean utility. The certain outcome served most frequently as reference point, the SG was perceived as a mixed gamble. Goals were mostly mentioned with respect to this outcome. Scale compatibility led to a significant upward bias in utilities; attention lay relatively more on the low outcome and this was positively correlated with mean utility. SG utilities should be corrected for loss aversion and probability weighting with the mixed correction formula proposed by prospect theory. Scale compatibility will likely still bias SG utilities, calling for research on a correction. Copyright (c) 2007 John Wiley & Sons, Ltd.

Older Adults Perceptions of Technology and Barriers to Interacting with Tablet Computers: A Focus Group Study.

PubMed

Vaportzis, Eleftheria; Clausen, Maria Giatsi; Gow, Alan J

2017-10-04

New technologies provide opportunities for the delivery of broad, flexible interventions with older adults. Focus groups were conducted to: (1) understand older adults' familiarity with, and barriers to, interacting with new technologies and tablets; and (2) utilize user-engagement in refining an intervention protocol. Eighteen older adults (65-76 years old; 83.3% female) who were novice tablet users participated in discussions about their perceptions of and barriers to interacting with tablets. We conducted three separate focus groups and used a generic qualitative design applying thematic analysis to analyse the data. The focus groups explored attitudes toward tablets and technology in general. We also explored the perceived advantages and disadvantages of using tablets, familiarity with, and barriers to interacting with tablets. In two of the focus groups, participants had previous computing experience (e.g., desktop), while in the other, participants had no previous computing experience. None of the participants had any previous experience with tablet computers. The themes that emerged were related to barriers (i.e., lack of instructions and guidance, lack of knowledge and confidence, health-related barriers, cost); disadvantages and concerns (i.e., too much and too complex technology, feelings of inadequacy, and comparison with younger generations, lack of social interaction and communication, negative features of tablets); advantages (i.e., positive features of tablets, accessing information, willingness to adopt technology); and skepticism about using tablets and technology in general. After brief exposure to tablets, participants emphasized the likelihood of using a tablet in the future. Our findings suggest that most of our participants were eager to adopt new technology and willing to learn using a tablet. However, they voiced apprehension about lack of, or lack of clarity in, instructions and support. Understanding older adults' perceptions of technology is important to assist with introducing it to this population and maximize the potential of technology to facilitate independent living.

Older Adults Perceptions of Technology and Barriers to Interacting with Tablet Computers: A Focus Group Study

PubMed Central

Vaportzis, Eleftheria; Giatsi Clausen, Maria; Gow, Alan J.

2017-01-01

Background: New technologies provide opportunities for the delivery of broad, flexible interventions with older adults. Focus groups were conducted to: (1) understand older adults' familiarity with, and barriers to, interacting with new technologies and tablets; and (2) utilize user-engagement in refining an intervention protocol. Methods: Eighteen older adults (65–76 years old; 83.3% female) who were novice tablet users participated in discussions about their perceptions of and barriers to interacting with tablets. We conducted three separate focus groups and used a generic qualitative design applying thematic analysis to analyse the data. The focus groups explored attitudes toward tablets and technology in general. We also explored the perceived advantages and disadvantages of using tablets, familiarity with, and barriers to interacting with tablets. In two of the focus groups, participants had previous computing experience (e.g., desktop), while in the other, participants had no previous computing experience. None of the participants had any previous experience with tablet computers. Results: The themes that emerged were related to barriers (i.e., lack of instructions and guidance, lack of knowledge and confidence, health-related barriers, cost); disadvantages and concerns (i.e., too much and too complex technology, feelings of inadequacy, and comparison with younger generations, lack of social interaction and communication, negative features of tablets); advantages (i.e., positive features of tablets, accessing information, willingness to adopt technology); and skepticism about using tablets and technology in general. After brief exposure to tablets, participants emphasized the likelihood of using a tablet in the future. Conclusions: Our findings suggest that most of our participants were eager to adopt new technology and willing to learn using a tablet. However, they voiced apprehension about lack of, or lack of clarity in, instructions and support. Understanding older adults' perceptions of technology is important to assist with introducing it to this population and maximize the potential of technology to facilitate independent living. PMID:29071004

Graphene-based platforms for cancer therapeutics

PubMed Central

Patel, Sunny C; Lee, Stephen; Lalwani, Gaurav; Suhrland, Cassandra; Chowdhury, Sayan Mullick; Sitharaman, Balaji

2016-01-01

Graphene is a multifunctional carbon nanomaterial and could be utilized to develop platform technologies for cancer therapies. Its surface can be covalently and noncovalently functionalized with anticancer drugs and functional groups that target cancer cells and tissue to improve treatment efficacies. Furthermore, its physicochemical properties can be harnessed to facilitate stimulus responsive therapeutics and drug delivery. This review article summarizes the recent literature specifically focused on development of graphene technologies to treat cancer. We will focus on advances at the interface of graphene based drug/gene delivery, photothermal/photodynamic therapy and combinations of these techniques. We also discuss the current understanding in cytocompatibility and biocompatibility issues related to graphene formulations and their implications pertinent to clinical cancer management. PMID:26769305

Graphene-based platforms for cancer therapeutics.

PubMed

Patel, Sunny C; Lee, Stephen; Lalwani, Gaurav; Suhrland, Cassandra; Chowdhury, Sayan Mullick; Sitharaman, Balaji

2016-01-01

Graphene is a multifunctional carbon nanomaterial and could be utilized to develop platform technologies for cancer therapies. Its surface can be covalently and noncovalently functionalized with anticancer drugs and functional groups that target cancer cells and tissue to improve treatment efficacies. Furthermore, its physicochemical properties can be harnessed to facilitate stimulus responsive therapeutics and drug delivery. This review article summarizes the recent literature specifically focused on development of graphene technologies to treat cancer. We will focus on advances at the interface of graphene based drug/gene delivery, photothermal/photodynamic therapy and combinations of these techniques. We also discuss the current understanding in cytocompatibility and biocompatibility issues related to graphene formulations and their implications pertinent to clinical cancer management.

Context Matters: Real-World and Utilization-Focused Evaluation Strategies to Support Change and Improvement in Child Welfare

ERIC Educational Resources Information Center

Ward, Kristin J.; Maher, Erin J.; Marcynyszyn, Lyscha A.; Ellis, Mei Ling K.; Pecora, Peter J.

2011-01-01

This article examines the importance of context in evaluative inquiry. Following guidelines from real-world and utilization-focused evaluation frameworks, four projects are described to illustrate one foundation's pragmatic approach to evaluation that values collaboration, methodological appropriateness, and utilization. The authors contend that…

Barriers to sexual reproductive health services and rights among young people in Mtwara district, Tanzania: a qualitative study

PubMed Central

Mbeba, Rita Moses; Mkuye, Martin Sem; Magembe, Grace Elias; Yotham, William Lubazi; Mellah, Alfred obeidy; Mkuwa, Serafina Baptist

2012-01-01

Background In Tanzania over 1/3 of the population is under 24 years. Nationwide 23% of teenagers have started childbearing. However, Mtwara Region has the highest percentage (25.5%) of teenagers who begin childbearing early. Mtwara District has a teenage pregnancy rate of 11% with young people utilizing sexual reproductive health services (SRHS) less frequently than adults.This study aimed at gaining insights on barriers to the utilization of SRHS in Mtwara district. Methods A qualitative study was carried out using focus group discussions, facility assessment interviews and case studies. A total of nine focus group discussions (comprising 8 to10 persons per group) were conducted among girls (10-18 years), community leaders and adults. Data was transcribed using pattern matching methods then merged into relevant themes for analysis and interpretation. Results The study revealed that a good number of health facilities do not have skilled service providers (SPs) on sexual reproductive health rights. Girls start sexual intercourse between 9 and12 years. Services sought included; education, family planning and voluntary counseling and testing. However, the services were inaccessible due to lack of privacy, confidentiality, equipments and negative attitudes from SPs. Initiation ceremonies, early marriages and gender disparities were mentioned as social-cultural barriers to SRH rights. Conclusion This study has demonstrated that factors such as lack of youth friendly services, gender disparity and unfavorable socio-cultural practices may create barriers to accessing adolescent SRHS and rights. Therefore, there is a need to integrate youth friendly services in health facilities and advocate for behavior change. PMID:23467684

Consumer attitudes and preferences for fresh market tomatoes.

PubMed

Oltman, A E; Jervis, S M; Drake, M A

2014-10-01

This study established attractive attributes and consumer desires for fresh tomatoes. Three focus groups (n = 28 participants) were conducted to explore how consumers perceived tomatoes, including how they purchased and consumed them. Subsequently, an Adaptive Choice Based Conjoint (ACBC) survey was conducted to understand consumer preferences toward traditional tomatoes. The ACBC survey with Kano questions (n = 1037 consumers in Raleigh, NC) explored the importance of color, firmness, size, skin, texture, interior, seed presence, flavor, and health benefits. The most important tomato attribute was color, then juice when sliced, followed by size, followed by seed presence, which was at parity with firmness. An attractive tomato was red, firm, medium/small sized, crisp, meaty, juicy, flavorful, and with few seeds. Deviations from these features resulted in a tomato that was rejected by consumers. Segmentations of consumers were determined by patterns in utility scores. External attributes were the main drivers of tomato liking, but different groups of tomato consumers exist with distinct preferences for juiciness, firmness, flavor, and health benefits. Conjoint analysis is a research technique that collects a large amount of data from consumers in a format designed to be reflective of a real life market setting and can be combined with qualitative insight from focus groups to gain information on consumer consumption and purchase behaviors. This study established that the most important fresh tomato attributes were color, amount of juice when sliced, and size. Distinct consumer clusters were differentiated by preference for color/appearance, juiciness and firm texture. Tomato growers can utilize the results to target attributes that drive consumer choice for fresh tomatoes. © 2014 Institute of Food Technologists®

Nowcasting Unemployment Rates with Google Searches: Evidence from the Visegrad Group Countries

PubMed Central

Pavlicek, Jaroslav; Kristoufek, Ladislav

2015-01-01

The online activity of Internet users has repeatedly been shown to provide a rich information set for various research fields. We focus on job-related searches on Google and their possible usefulness in the region of the Visegrad Group - the Czech Republic, Hungary, Poland and Slovakia. Even for rather small economies, the online searches of inhabitants can be successfully utilized for macroeconomic predictions. Specifically, we study unemployment rates and their interconnection with job-related searches. We show that Google searches enhance nowcasting models of unemployment rates for the Czech Republic and Hungary whereas for Poland and Slovakia, the results are mixed. PMID:26001083

Nowcasting unemployment rates with Google searches: evidence from the Visegrad Group countries.

PubMed

Pavlicek, Jaroslav; Kristoufek, Ladislav

2015-01-01

The online activity of Internet users has repeatedly been shown to provide a rich information set for various research fields. We focus on job-related searches on Google and their possible usefulness in the region of the Visegrad Group--the Czech Republic, Hungary, Poland and Slovakia. Even for rather small economies, the online searches of inhabitants can be successfully utilized for macroeconomic predictions. Specifically, we study unemployment rates and their interconnection with job-related searches. We show that Google searches enhance nowcasting models of unemployment rates for the Czech Republic and Hungary whereas for Poland and Slovakia, the results are mixed.

Burden on informal caregivers of elderly cancer survivors: risk versus resilience.

PubMed

Jones, Simeon B W; Whitford, Hayley S; Bond, Melissa J

2015-01-01

This study assessed psychological morbidity and resilience, including the subjective burden of 76 caregivers of elderly cancer survivors utilizing a cross-sectional questionnaire. Participants were mainly elderly female spouses, sole-caregiving > 35 hours per week; 19.1% and 23.6% reported moderate or greater anxiety and depression, respectively. A significant regression model found depression, emotion-focused coping, and greater years since diagnosis as significant predictors of subjective caregiver burden. Thus, caregiving appears a dominant role for this group and the Brief Assessment Scale for Caregivers of the Medically Ill (BASC) appears to be an efficient screening tool for psychological morbidity in this under-supported group.

Trifluoromethyl ethers – synthesis and properties of an unusual substituent

PubMed Central

Manteau, Baptiste; Vors, Jean-Pierre; Pazenok, Sergiy

2008-01-01

Summary After nitrogen, fluorine is probably the next most favorite hetero-atom for incorporation into small molecules in life science-oriented research. This review focuses on a particular fluorinated substituent, the trifluoromethoxy group, which is finding increased utility as a substituent in bioactives, but it is still perhaps the least well understood fluorine substituent in currency. The present review will give an overview of the synthesis, properties and reactivity of this important substituent. PMID:18941485

Effect of acculturation and access to care on colorectal cancer screening in low-income Latinos.

PubMed

Savas, Lara S; Vernon, Sally W; Atkinson, John S; Fernández, Maria E

2015-06-01

Latinos have lower colorectal cancer screening (CRCS) and survival rates compared to other race/ethnic groups. This cross-sectional study examines relationships between acculturation, access to and utilization of healthcare services, and CRCS in low-income Latinos. Bilingual data collectors conducted structured interviews with 544 Latino men and women (>50 years) residing in the Texas-Mexico border area. Using a hierarchical logistic regression model, we examined the relationship between lifetime history of any CRCS test and indicators of acculturation, healthcare utilization and access to care, adjusting for socio-demographic characteristics. Survey results revealed a 34% prevalence of CRCS. Participants reporting a provider recommendation for screening, regular check-ups, higher acculturation level, and health insurance had significantly increased odds of CRCS. Findings indicate CRCS intervention research in Latinos should focus on (1) increasing physicians' recommendations for screening, (2) promoting regular check-ups, (3) and increasing CRC prevention efforts on less acculturated and uninsured groups.

Understanding thread properties for red blood cell antigen assays: weak ABO blood typing.

PubMed

Nilghaz, Azadeh; Zhang, Liyuan; Li, Miaosi; Ballerini, David R; Shen, Wei

2014-12-24

"Thread-based microfluidics" research has so far focused on utilizing and manipulating the wicking properties of threads to form controllable microfluidic channels. In this study we aim to understand the separation properties of threads, which are important to their microfluidic detection applications for blood analysis. Confocal microscopy was utilized to investigate the effect of the microscale surface morphologies of fibers on the thread's separation efficiency of red blood cells. We demonstrated the remarkably different separation properties of threads made using silk and cotton fibers. Thread separation properties dominate the clarity of blood typing assays of the ABO groups and some of their weak subgroups (Ax and A3). The microfluidic thread-based analytical devices (μTADs) designed in this work were used to accurately type different blood samples, including 89 normal ABO and 6 weak A subgroups. By selecting thread with the right surface morphology, we were able to build μTADs capable of providing rapid and accurate typing of the weak blood groups with high clarity.

Undergraduate-driven interventions to increase representation in science classrooms

NASA Astrophysics Data System (ADS)

Freilich, M.; Aluthge, D.; Bryant, R. M.; Knox, B.; McAdams, J.; Plummer, A.; Schlottman, N.; Stanley, Z.; Suglia, E.; Watson-Daniels, J.

2014-12-01

Recognizing that racial, ethnic, and gender underrepresentation in science classrooms persists despite intervention programs and institutional commitments to diversity, a group of undergraduates from a variety of backgrounds and academic disciplines came together for a group independent study to (a) study the theoretical foundations of the current practice of science and of programs meant to increase diversity, (b) utilize the experiences of course participants and our peers to better understand the drivers of underrepresentation, and (c) design and implement interventions at Brown University. We will present on individual and small group projects designed by course members in collaboration with faculty. The projects emerged from an exploration of literature in history, philosophy, and sociology of science, as well as an examination of anthropological and psychological studies. We also evaluated the effectiveness of top-down and bottom-up approaches that have already been attempted in developing our projects. They focus on the specific problems faced by underrepresented minorities, women, LGBTQ+ people, and well-represented minorities. We will share experiences of faculty-student collaboration and engaged scholarship focused on representation in science and discuss student-designed interventions.

Methodology for a Community Based Stroke Preparedness Intervention: The ASPIRE Study

PubMed Central

Boden-Albala, Bernadette; Edwards, Dorothy F.; Clair, Shauna St; Wing, Jeffrey J; Fernandez, Stephen; Gibbons, Chris; Hsia, Amie W.; Morgenstern, Lewis B.; Kidwell, Chelsea S.

2014-01-01

Background and Purpose Acute stroke education has focused on stroke symptom recognition. Lack of education about stroke preparedness and appropriate actions may prevent people from seeking immediate care. Few interventions have rigorously evaluated preparedness strategies in multiethnic community settings. Methods The Acute Stroke Program of Interventions Addressing Racial and Ethnic Disparities (ASPIRE) project is a multi-level program utilizing a community engaged approach to stroke preparedness targeted to underserved black communities in the District of Columbia (DC). This intervention aimed to decrease acute stroke presentation times and increase intravenous tissue plasminogen activator (IV tPA) utilization for acute ischemic stroke. Results Phase 1 included: 1) enhancement of EMS focus on acute stroke; 2) hospital collaborations to implement and/or enrich acute stroke protocols and transition DC hospitals toward Primary Stroke Center certification; and 3) pre-intervention acute stroke patient data collection in all 7 acute care DC hospitals. A community advisory committee, focus groups, and surveys identified perceptions of barriers to emergency stroke care. Phase 2 included a pilot intervention and subsequent citywide intervention rollout. A total of 531 community interventions were conducted with over 10,256 participants reached; 3289 intervention evaluations were performed, and 19,000 preparedness bracelets and 14,000 stroke warning magnets were distributed. Phase 3 included an evaluation of EMS and hospital processes for acute stroke care and a yearlong post-intervention acute stroke data collection period to assess changes in IV tPA utilization. Conclusions We report the methods, feasibility, and pre-intervention data collection efforts of the ASPIRE intervention. PMID:24876243

Utilization-focused evaluation of a STEM enrichment program

NASA Astrophysics Data System (ADS)

Carter, Sally

The purpose of this study was to determine the impact and utilization of a STEM enrichment program (hereafter referred to as The Program). The Program consisted of two parts. First an educator resource center provided free educational materials throughout The Program’s home state. The second part of The Program was a network of education specialists who provided professional development for teachers, modeled lessons with students, and provided presentations for the general public. The problem addressed by this study was a lack of knowledge regarding the impact of The Program. The Program’s director requested a utilization-focused program evaluation to answer thirteen questions. Questions covered Program impact for five areas: overall impact on teachers, overall impact on students, overall impact of materials, overall impact of Program personnel, and overall impact on STEM education. A mixed-methods case study was designed to gather data. Quantitative data included Program archival data regarding the number of contacts and a survey distributed to teachers who had used The Program’s services on at least one occasion. Qualitative data included written comments gathered from the teacher surveys, seven teacher focus groups, and four Program personnel interviews. Data found an overall positive Program impact in all five areas. Both quantitative and qualitative data showed favorable perceptions by teachers and Program personnel. It is not known if data from this case study can be generalized to other STEM enrichment programs. Future research might include a study to determine if The Program’s model could be used to generate new STEM enrichment programs.

Resident Wellness and Social Support: Development and Cognitive Validation of a Resident Social Capital Assessment Tool.

PubMed

Kaplan, Stephen J; Seabott, Heather M; Cunningham, Erika B; Helman, James D; Calderon, Alvin; Thirlby, Richard C; Schenarts, Kimberly D

The purpose of this study is to develop and generate validity evidence for an instrument to measure social capital in residents. Mixed-methods, phased approach utilizing a modified Delphi technique, focus groups, and cognitive interviews. Four residency training institutions in Washington state between February 2016 and March 2017. General surgery, anesthesia, and internal medicine residents ranging from PGY-1 to PGY-6. The initial resident-focused instrument underwent revision via Delphi process with 6 experts; 100% expert consensus was achieved after 4 cycles. Three focus groups were conducted with 19 total residents. Focus groups identified 6 of 11 instrument items with mean quality ratings ≤4.0 on a 1-5 scale. The composite instrument rating of the draft version was 4.1 ± 0.5. After refining the instrument, cognitive interviews with the final version were completed with 22 residents. All items in the final version had quality ratings >4.0; the composite instrument rating was 4.8 ± 0.1. Social capital may be an important factor in resident wellness as residents rely upon each other and external social support to withstand fatigue, burnout, and other negative sequelae of rigorous training. This instrument for assessment of social capital in residents may provide an avenue for data collection and potentially, identification of residents at-risk for wellness degradation. Copyright © 2018 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Mars 2020 Model Based Systems Engineering Pilot

NASA Technical Reports Server (NTRS)

Dukes, Alexandra Marie

2017-01-01

The pilot study is led by the Integration Engineering group in NASA's Launch Services Program (LSP). The Integration Engineering (IE) group is responsible for managing the interfaces between the spacecraft and launch vehicle. This pilot investigates the utility of Model-Based Systems Engineering (MBSE) with respect to managing and verifying interface requirements. The main objectives of the pilot are to model several key aspects of the Mars 2020 integrated operations and interface requirements based on the design and verification artifacts from Mars Science Laboratory (MSL) and to demonstrate how MBSE could be used by LSP to gain further insight on the interface between the spacecraft and launch vehicle as well as to enhance how LSP manages the launch service. The method used to accomplish this pilot started through familiarization of SysML, MagicDraw, and the Mars 2020 and MSL systems through books, tutorials, and NASA documentation. MSL was chosen as the focus of the model since its processes and verifications translate easily to the Mars 2020 mission. The study was further focused by modeling specialized systems and processes within MSL in order to demonstrate the utility of MBSE for the rest of the mission. The systems chosen were the In-Flight Disconnect (IFD) system and the Mass Properties process. The IFD was chosen as a system of focus since it is an interface between the spacecraft and launch vehicle which can demonstrate the usefulness of MBSE from a system perspective. The Mass Properties process was chosen as a process of focus since the verifications for mass properties occur throughout the lifecycle and can demonstrate the usefulness of MBSE from a multi-discipline perspective. Several iterations of both perspectives have been modeled and evaluated. While the pilot study will continue for another 2 weeks, pros and cons of using MBSE for LSP IE have been identified. A pro of using MBSE includes an integrated view of the disciplines, requirements, and verifications leading up to launch. The model allows IE to understand the relationships between disciplines throughout test activities and verifications. Additionally, the relationships between disciplines and integration tasks are generally consistent. The model allows for the generic relationships and tasks to be captured and used throughout multiple mission models should LSP further pursue MBSE. A con of MBSE is the amount of time it takes upfront to understand MBSE and create a useful model. The upfront time it takes to create a useful model is heavily discussed in MBSE literature and is a consistent con throughout the known applications of MBSE. The need to understand SysML and the software chosen also poses the possibility of a "bottleneck" or one person being the sole MBSE user for the working group. The utility of MBSE will continue to be evaluated through the remainder of the study. In conclusion, the original objectives of the pilot study were to use artifacts from MSL to model key aspects of Mars 2020 and demonstrate how MBSE could be used by LSP to gain insight into the spacecraft and launch vehicle interfaces. Progress has been made in modeling and identifying the utility of MBSE to LSP IE and will continue to be made until the pilot study's conclusion in mid-August. The results of this study will produce initial models, modeling instructions and examples, and a summary of MBSE's utility for future use by LSP.

Health state utilities among contemporary prostate cancer patients on active surveillance.

PubMed

Loeb, Stacy; Curnyn, Caitlin; Walter, Dawn; Fagerlin, Angela; Siebert, Uwe; Mühlberger, Nick; Braithwaite, R Scott; Schwartz, Mark D; Lepor, Herbert; Sedlander, Erica

2018-04-01

Active surveillance (AS) is the most rapidly expanding management option for favorable-risk prostate cancer (PCa). Early studies suggested substantial decrements in utility (quality of life weights) from disease-related anxiety. Our objective was to determine utilities for contemporary AS patients using different instruments. We performed a systematic review of PubMed, PMC and OVID for utility measurements in modern AS patients. We then examined utilities among 37 men on AS participating in focus groups between 2015-2016 using the generic EurQol five dimensions questionnaire (EQ-5D-3L) and Patient Oriented Prostate Utility Scale (PORPUS), a PCa-specific instrument. The systematic review found previous studies with utilities for PCa treatment and historical watchful waiting populations, but none specifically in contemporary AS. In our AS population, the mean EQ-5D-3L score was 0.90±0.16 (median, 1.00; range, 0.21-1.00) and PORPUS was 0.98±0.03 (median, 0.99; range, 0.84-1.00). The Spearman correlation between the EQ-5D-3L and PORPUS was 0.87 (P<0.0001), and 38% of patients had a difference >0.1 between instruments. Most contemporary AS patients had high utility scores suggesting that they perceive themselves in good health without a major decrement in quality of life from the disease. However, some patients had substantial differences in utility measured with generic versus disease-specific instruments. Further study is warranted into the optimal instrument for utility assessment in contemporary AS patients.

The increased cost of ventral hernia recurrence: a cost analysis.

PubMed

Davila, D G; Parikh, N; Frelich, M J; Goldblatt, M I

2016-12-01

Over 300,000 ventral hernia repairs (VHRs) are performed each year in the US. We sought to assess the economic burden related to ventral hernia recurrences with a focused comparison of those with the initial open versus laparoscopic surgery. The Premier Alliance database from 2009 to 2014 was utilized to obtain patient demographics and comorbid indices, including the Charlson comorbidity index (CCI). Total hospital cost and resource expenses during index laparoscopic and open VHRs and subsequent recurrent repairs were also obtained. The sample was separated into laparoscopic and open repair groups from the initial operation. Adjusted and propensity score matched cost outcome data were then compared amongst groups. One thousand and seventy-seven patients were used for the analysis with a recurrence rate of 3.78 %. For the combined sample, costs were significantly higher during recurrent hernia repair hospitalization ($21,726 versus $19,484, p < 0.0001). However, for index laparoscopic repairs, both the adjusted total hospital cost and department level costs were similar during the index and the recurrent visit. The costs and resource utilization did not go up due to recurrence, even though these patients had greater severity during the recurrent visit (CCI score 0.92 versus 1.06; p = 0.0092). Using a matched sample, the total hospital recurrence cost was higher for the initial open group compared to laparoscopic group ($14,520 versus $12,649; p = 0.0454). Based on our analysis, need for recurrent VHR adds substantially to total hospital costs and resource utilization. Following initial laparoscopic repair, however, the total cost of recurrent repair is not significantly increased, as it is following initial open repair. When comparing the initial laparoscopic repair versus open, the cost of recurrence was higher for the prior open repair group.

Meeting the Needs of USGS's Science Application for Risk Reduction Group through Evaluation Research

NASA Astrophysics Data System (ADS)

Ritchie, L.; Campbell, N. M.; Vickery, J.; Madera, A.

2016-12-01

The U.S. Geological Survey's (USGS) Science Application for Risk Reduction (SAFRR) group aims to support innovative collaborations in hazard science by uniting a broad range of stakeholders to produce and disseminate knowledge in ways that are useful for decision-making in hazard mitigation, planning, and preparedness. Since 2013, an evaluation team at the Natural Hazards Center (NHC) has worked closely with the SAFRR group to assess these collaborations and communication efforts. In contributing to the nexus between academia and practice, or "pracademia," we use evaluation research to provide the USGS with useful feedback for crafting relevant information for practitioners and decision-makers. This presentation will highlight how the NHC team has varied our methodological and information design approaches according to the needs of each project, which in turn assist the SAFRR group in meeting the needs of practitioners and decision-makers. As the foci of our evaluation activities with SAFRR have evolved, so have our efforts to ensure that our work appropriately matches the information needs of each scenario project. We draw upon multiple projects, including evaluation work on the SAFRR Tsunami Scenario, "The First Sue Nami" tsunami awareness messaging, and their most recent project concerning a hypothetical M7 earthquake on the Hayward fault in the Bay Area (HayWired scenario). We have utilized various qualitative and quantitative methodologies—including telephone interviews, focus groups, online surveys, nonparticipant observation, and in-person survey distribution. The findings generated from these series of evaluations highlight the ways in which evaluation research can be used by researchers and academics to more appropriately address the needs of practitioners. Moreover, they contribute to knowledge enhancement surrounding disaster preparedness and risk communication, and, more generally, the limited body of knowledge about evaluation-focused disaster preparedness and risk communication. Finally, they call attention to the need to adapt evaluation findings for a variety of audiences to ensure accessibility and utility for enhancing future practice.

Dementia caregivers' responses to 2 Internet-based intervention programs.

PubMed

Marziali, Elsa; Garcia, Linda J

2011-02-01

The aim of this study was to examine the impact on dementia caregivers' experienced stress and health status of 2 Internet-based intervention programs. Ninety-one dementia caregivers were given the choice of being involved in either an Internet-based chat support group or an Internet-based video conferencing support group. Pre-post outcome measures focused on distress, health status, social support, and service utilization. In contrast to the Chat Group, the Video Group showed significantly greater improvement in mental health status. Also, for the Video Group, improvements in self-efficacy, neuroticism, and social support were associated with lower stress response to coping with the care recipient's cognitive impairment and decline in function. The results show that, of 2 Internet-based intervention programs for dementia caregivers, the video conferencing intervention program was more effective in improving mental health status and improvement in personal characteristics were associated with lower caregiver stress response.

Building an outpatient imaging center: A case study at genesis healthcare system, part 2.

PubMed

Yanci, Jim

2006-01-01

In the second of 2 parts, this article will focus on process improvement projects utilizing a case study at Genesis HealthCare System located in Zanesville, OH. Operational efficiency is a key step in developing a freestanding diagnostic imaging center. The process improvement projects began with an Expert Improvement Session (EIS) on the scheduling process. An EIS session is a facilitated meeting that can last anywhere from 3 hours to 2 days. Its intention is to take a group of people involved with the problem or operational process and work to understand current failures or breakdowns in the process. Recommendations are jointly developed to overcome any current deficiencies, and a work plan is structured to create ownership over the changes. A total of 11 EIS sessions occurred over the course of this project, covering 5 sections: Scheduling/telephone call process, Pre-registration, Verification/pre-certification, MRI throughput, CT throughput. Following is a single example of a project focused on the process improvement efforts. All of the process improvement projects utilized a quasi methodology of "DMAIC" (Define, Measure, Analyze, Improve, and Control).

The role of community mental health nurses caring for people with schizophrenia in Taiwan: a substantive grounded theory.

PubMed

Huang, Xuan-Yi; Yen, Wen-Jiuan; Liu, Shwu-Jiuan; Lin, Chouh-Jiuan

2008-03-01

The aim was to develop a practice theory that can be used to guide the direction of community nursing practice to help clients with schizophrenia and those who care for them. Substantive grounded theory was developed through use of grounded theory method of Strauss and Corbin. Two groups of participants in Taiwan were selected using theoretical sampling: one group consisted of community mental health nurses and the other group was clients with schizophrenia and those who cared for them. The number of participants in each group was determined by theoretical saturation. Semi-structured one-to-one in-depth interviews and unstructured non-participant observation were utilized for data collection. Data analysis involved three stages: open, axial and selective coding. During the process of coding and analysis, both inductive and deductive thinking were utilized and the constant comparative analysis process continued until data saturation occurred. To establish trustworthiness, the four criteria of credibility, transferability, dependability and confirmability were followed along with field trial, audit trial, member check and peer debriefing for reliability and validity. A substantive grounded theory, the role of community mental health nurses caring for people with schizophrenia in Taiwan, was developed through utilization of grounded theory method of Strauss and Corbin. In this paper, results and discussion focus on causal conditions, context, intervening conditions, consequences and phenomenon. The theory is the first to contribute knowledge about the field of mental health home visiting services in Taiwan to provide guidance for the delivery of quality care to assist people in the community with schizophrenia and their carers.

Barriers to and Facilitators of Physical Activity Program Use Among Older Adults

PubMed Central

Bethancourt, Hilary J.; Rosenberg, Dori E.; Beatty, Tara; Arterburn, David E.

2014-01-01

Objective Regular physical activity (PA) is important for maintaining long-term physical, cognitive, and emotional health. However, few older adults engage in routine PA, and even fewer take advantage of programs designed to enhance PA participation. Though most managed Medicare members have free access to the Silver Sneakers and EnhanceFitness PA programs, the vast majority of eligible seniors do not utilize these programs. The goal of this qualitative study was to better understand the barriers to and facilitators of PA and participation in PA programs among older adults. Design This was a qualitative study using focus group interviews. Setting Focus groups took place at three Group Health clinics in King County, Washington. Participants Fifty-two randomly selected Group Health Medicare members between the ages of 66 to 78 participated. Methods We conducted four focus groups with 13 participants each. Focus group discussions were audio-recorded, transcribed, and analyzed using an inductive thematic approach and a social-ecological framework. Results Men and women were nearly equally represented among the participants, and the sample was largely white (77%), well-educated (69% college graduates), and relatively physically active. Prominent barriers to PA and PA program participation were physical limitations due to health conditions or aging, lack of professional guidance, and inadequate distribution of information on available and appropriate PA options and programs. Facilitators included the motivation to maintain physical and mental health and access to affordable, convenient, and stimulating PA options. Conclusion Older adult populations may benefit from greater support and information from their providers and health care systems on how to safely and successfully improve or maintain PA levels through later adulthood. Efforts among health care systems to boost PA among older adults may need to consider patient-centered adjustments to current PA programs, as well as alternative methods for promoting overall active lifestyle choices. PMID:24415748

Cost-effectiveness of a health-social partnership transitional program for post-discharge medical patients.

PubMed

Wong, Frances Kam Yuet; Chau, June; So, Ching; Tam, Stanley Ku Fu; McGhee, Sarah

2012-12-24

Readmissions are costly and have implications for quality of care. Studies have been reported to support effects of transitional care programs in reducing hospital readmissions and enhancing clinical outcomes. However, there is a paucity of studies executing full economic evaluation to assess the cost-effectiveness of these transitional care programs. This study is therefore launched to fill this knowledge gap. Cost-effectiveness analysis was conducted alongside a randomized controlled trial that examined the effects of a Health-Social Transitional Care Management Program (HSTCMP) for medical patients discharged from an acute regional hospital in Hong Kong. The cost and health outcomes were compared between the patients receiving the HSTCMP and usual care. The total costs comprised the pre-program, program, and healthcare utilization costs. Quality of life was measured with SF-36 and transformed to utility values between 0 and 1. The readmission rates within 28 (control 10.2%, study 4.0%) and 84 days (control 19.4%, study 8.1%) were significantly higher in the control group. Utility values showed no difference between the control and study groups at baseline (p = 0.308). Utility values for the study group were significantly higher than in the control group at 28 (p < 0.001) and 84 days (p = 0.002). The study group also had a significantly higher QALYs gain (p < 0.001) over time at 28 and 84 days when compared with the control group. The intervention had an 89% chance of being cost-effective at the threshold of £20000/QALY. Previous studies on transitional care focused mainly on clinical outcomes and not too many included cost as an outcome measure. Studies examining the cost-effectiveness of the post-discharge support services are scanty. This study is the first to examine the cost-effectiveness of a transitional care program that used nurse-led services participated by volunteers. Results have shown that a health-social partnership transitional care program is cost-effective in reducing healthcare costs and attaining QALY gains. Economic evaluation helps to inform funders and guide decisions for the effective use of competing healthcare resources.

Living in a material world: Development and evaluation of a new materials science course for non-science majors

NASA Astrophysics Data System (ADS)

Brust, Gregory John

This study was designed to discover if there is a difference in the scientific attitudes and process skills between a group of students who were instructed with Living in a Material World and groups of students in non-science majors sections of introductory biology, chemistry, and geology courses at the University of Southern Mississippi (USM). Each of the four courses utilized different instructional techniques. Students' scientific attitudes were measured with the Scientific Attitudes Inventory (SAI II) and their knowledge of science process skills were measured with the Test of Integrated Process Skills (TIPS II). The Group Assessment of Logical Thinking (GALT) was also administered to determine if the cognitive levels of students are comparable. A series of four questionnaires called Qualitative Course Assessments (QCA) were also administered to students in the experimental course to evaluate subtle changes in their understanding of the nature and processes of science and attitudes towards science. Student responses to the QCA questionnaires were triangulated with results of the qualitative instruments, and students' work on the final project. Results of the GALT found a significant difference in the cognitive levels of students in the experimental course (PSC 190) and in one of the control group, the introductory biology (BSC 107). Results of the SAI II and the TIPS II found no significant difference between the experimental group and the control groups. Qualitative analyses of students' responses to selected questions from the TIPS II, selected items on the SAI II, QCA questionnaires, and Materials that Fly project reports demonstrate an improvement in the understanding of the nature and processes of science and a change to positive attitude toward science of students in the experimental group. Students indicated that hands-on, inquiry-based labs and performance assessment were the most effective methods for their learning. These results indicate that science courses for non-science majors should focus on connections to students' daily lives while utilizing an STS curriculum and inquiry-based activities. Future research could focus on long term effects of this type of course as well as the effectiveness of these teaching methods for science majors.

Blended learning networks supported by information and communication technology: an intervention for knowledge transformation within family care of older people.

PubMed

Hanson, Elizabeth; Magnusson, Lennart; Sennemark, Eva

2011-08-01

This article describes an innovative practice called Blended Learning Networks (BLNs) whose aim is to enable older people, their families, and care providers to exchange knowledge, learn together, and support each other in local development work so that care is improved for older people. BLNs were established in 31 municipalities, headed up by a local facilitator. They were supported by a national themed network consisting of virtual meetings between local facilitators and national facilitators at the Swedish National Family Care Competence Centre. An evaluation was conducted to explore the utility of the BLNs so that any improvements to the model could be instigated. Focus group interviews were conducted with members of 9 BLNs, and self-evaluation questions were discussed in 16 BLNs. Limitations are that not all BLN members participated in the evaluation, and local facilitators conducting self-evaluations were not trained in focus group dynamics. Virtual focus groups were carried out with 26 of the 31 local facilitators and with the national facilitators. Participants reported an increased understanding of caregiver issues and of each group's roles. Of particular value were the stories shared by caregivers and the potential for change locally due to the involvement of decision makers. The practice demanded considerable skills of the local facilitators. An initial education for new local facilitators was deemed necessary. BLNs is a unique practice of community communications and knowledge transfer as it creates partnerships among all key stakeholder groups that act as a catalyst for improving care for older people.

Essential pediatric hypertension: defining the educational needs of primary care pediatricians

PubMed Central

2014-01-01

Background In order to better understand the educational needs regarding appropriate recognition, diagnosis and management of pediatric hypertension (HTN), we asked practicing pediatricians questions regarding their educational needs and comfort level on this topic. Methods We conducted 4 focus group sessions that included 27 participants representing pediatric residents, adolescent medicine physicians, clinic based pediatricians and office based pediatricians. Each focus group session lasted for approximately an hour and 90 pages of total transcriptions were produced verbatim from audio recordings. Results Four reviewers read each transcript and themes were elucidated from these transcripts. Overall, 5 major themes related to educational needs and clinical concerns were found: utilization of resources to define blood pressure (BP), correct BP measurement method(s), co-morbidities, barriers to care, and experience level with HTN. Six minor themes were also identified: differences in BP measurement, accuracy of BP, recognition of HTN, practice pattern of care, education of families and patients, and differences in level of training. The focus group participants were also questioned on their preferences regarding educational methods (i.e. e-learning, small group sessions, self-study, large group presentations) and revealed varied teaching and learning preferences. Conclusions There are multiple methods to approach education regarding pediatric HTN for primary care pediatricians based on provider preferences and multiple educational activities should be pursued to achieve best outcomes. Based on this data, the next direction will be to develop and deliver multiple educational methods and to evaluate the impact on practice patterns of care for children and adolescents with HTN. PMID:25063988

A qualitative study of pharmacists' perceptions of, and recommendations for improvement of antibiotic use in Qatar.

PubMed

Black, Emily; Cartwright, Andrea; Bakharaiba, Sumaia; Al-Mekaty, Eman; Alsahan, Dima

2014-08-01

Use of antibiotics has been correlated with increasing rates of resistance. Pharmacists are ideally positioned as front line health care providers to limit indiscriminate antibiotic use and promote the safe and effective administration of these medications. The aim of this project was to assess pharmacists' opinions relating to antibiotic utilization in the community setting. Doha, Qatar. Community and primary care pharmacists were invited to participate in one of three focus groups or a semi-structured interview at Qatar University or at their site of employment. A total of 22 community and primary care pharmacists participated in this study. Interviews were facilitated using a focus group guide, were recorded, and later transcribed. Transcripts were reviewed for recurring themes and coded using Nvivo software for qualitative research. Pharmacists' perceptions. Five major themes emerged from a series of focus groups and interviews. Themes which recurred across interview groups included: misconceptions and inappropriate practices by patients and healthcare providers, currently implemented strategies, perceived barriers, ways to overcome perceived barriers, and targets for improvement of antibiotic use in Qatar. The greatest need, as identified by pharmacists in this study was increased knowledge of the general population about appropriate antibiotic use through various educational interventions. Pharmacists report a number of misconceptions and inappropriate practices relating to antibiotic use in Qatar by patients and healthcare providers. Education to improve knowledge of appropriate antibiotic use is needed. Despite recognition of these issues, barriers are preventing pharmacists from implementing strategies to improve antibiotic use in Qatar.

Integrated concurrent utilization quality review, Part one.

PubMed

Caterinicchio, R P

1987-01-01

This article is the first of a two-part series which argues for the concurrent management of the appropriateness, necessity, and quality of patient care. Intensifying scrutiny by the credentialing groups, the PROs and all third-party payors underscores the vital need to implement cost-effective information systems which integrate the departmentalized functions of patient-physician profiling, DRG case-mix analyses, length of stay monitoring, pre-admission/admission and continued stay review, discharge planning, risk management, incident reporting and quality review. In the domain of physician performance regarding admitting and practice patterns, the ability to exercise concurrent utilization-quality review means early detection and prevention of events which would otherwise result in denials of payment and/or compromised patient care. Concurrent utilization-quality review must, by definition, be managerially invasive and focused; hence, it is integral to maintaining the integrity of the services and product lines offered by the provider. In fact, if PPO status is a marketing agenda, then the institutional objectives of cost-effectiveness, productivity, value, and competitiveness can only be achieved through concurrent utilization-quality review.

Iridium catalysis: application of asymmetric reductive hydrogenation.

PubMed

Cadu, Alban; Andersson, Pher G

2013-10-28

Iridium, despite being one of the least abundant transition metals, has found several uses. N,P-ligated iridium catalysts are used to perform many highly selective reactions. These methodologies have been developed extensively over the past 15 years. More recently, the application of iridium N,P catalysts in asymmetric hydrogenation has been a focus of research to find novel applications and to expand on their current synthetic utility. The aim of this perspective is to highlight the advances made by the Andersson group.

(Networking + Integrating) * (Systems + Society). Proceedings of the Annual Canadian Conference of Information Science (12th, Toronto, Ontario, May 14-16, 1984) = (Reseaux + Integration) * (Systemes + Societe). Comptes rendus de la conference annuelle Canadienne des sciences de l'information (12th, Toronto, Ontario, 14-16 mai, 1984).

ERIC Educational Resources Information Center

Canadian Association for Information Science, Ottawa (Ontario).

Seventeen papers from the 1984 annual conference of the Canadian Association for Information Science (CAIS) are presented in four broad topic areas. The first group, which focuses on changing roles in information access, includes the keynote address by Charles Meadow, "Integrating Access to Information Utilities: Promises, Problems, and…

The impact of local immigration enforcement policies on the health of immigrant hispanics/latinos in the United States.

PubMed

Rhodes, Scott D; Mann, Lilli; Simán, Florence M; Song, Eunyoung; Alonzo, Jorge; Downs, Mario; Lawlor, Emma; Martinez, Omar; Sun, Christina J; O'Brien, Mary Claire; Reboussin, Beth A; Hall, Mark A

2015-02-01

We sought to understand how local immigration enforcement policies affect the utilization of health services among immigrant Hispanics/Latinos in North Carolina. In 2012, we analyzed vital records data to determine whether local implementation of section 287(g) of the Immigration and Nationality Act and the Secure Communities program, which authorizes local law enforcement agencies to enforce federal immigration laws, affected the prenatal care utilization of Hispanics/Latinas. We also conducted 6 focus groups and 17 interviews with Hispanic/Latino persons across North Carolina to explore the impact of immigration policies on their utilization of health services. We found no significant differences in utilization of prenatal care before and after implementation of section 287(g), but we did find that, in individual-level analysis, Hispanic/Latina mothers sought prenatal care later and had inadequate care when compared with non-Hispanic/Latina mothers. Participants reported profound mistrust of health services, avoiding health services, and sacrificing their health and the health of their family members. Fear of immigration enforcement policies is generalized across counties. Interventions are needed to increase immigrant Hispanics/Latinos' understanding of their rights and eligibility to utilize health services. Policy-level initiatives are also needed (e.g., driver's licenses) to help undocumented persons access and utilize these services.

Development of a web-based executive functioning intervention for adolescents with epilepsy: The Epilepsy Journey.

PubMed

Modi, Avani C; Schmidt, Matthew; Smith, Aimee W; Turnier, Luke; Glaser, Noah; Wade, Shari L

2017-07-01

Youth with epilepsy exhibit significant deficits in executive functioning (EF), yet there are few interventions to improve EF for adolescents. The aims of the current study were to develop an individually-tailored intervention, called Epilepsy Journey, to improve aspects of EF through an iterative, patient-centered process including focus groups and usability testing. Five adolescents and caregivers participated in focus groups. This input was used to develop ten learning modules based on subscales of the Behavioral Rating Inventory of Executive Functions and key issues that may impact EF in adolescents. Six adolescents participated in usability testing and a usability expert conducted a heuristic evaluation. Demographic information, chart reviews and measures of EF were also completed. Focus group participants and their parents reported difficulties with memory, attention, organization, monitoring, initiation, impulsivity, emotional control, sleep, awareness in schools and managing stress. They also identified successful strategies to address memory and organizational difficulties. Usability testing of the resultant Epilepsy Journey modules revealed problems with navigation and identified features that promoted usability, including progress bars and interactive modules. Program modifications were made after each usability trial resulting in a relatively brief, interactive and readily navigable program. Perceived utility was high with all but one participant. Participants rated the content as helpful and indicated they would recommend Epilepsy Journey to others. Feedback from the focus group and usability testing yielded a feasible, acceptable, relevant and user-friendly web-based intervention for adolescents with epilepsy. The Epilepsy Journey program will be further tested in an open pilot with adolescents with epilepsy and associated EF deficits. Copyright © 2017 Elsevier Inc. All rights reserved.

Development of the PedsQL™ Epilepsy Module: Focus group and cognitive interviews.

PubMed

Follansbee-Junger, Katherine W; Mann, Krista A; Guilfoyle, Shanna M; Morita, Diego A; Varni, James W; Modi, Avani C

2016-09-01

Youth with epilepsy have impaired health-related quality of life (HRQOL). Existing epilepsy-specific HRQOL measures are limited by not having parallel self- and parent-proxy versions, having a restricted age range, not being inclusive of children with developmental disabilities, or being too lengthy for use in a clinical setting. Generic HRQOL measures do not adequately capture the idiosyncrasies of epilepsy. The purpose of the present study was to develop items and content validity for the PedsQL™ Epilepsy Module. An iterative qualitative process of conducting focus group interviews with families of children with epilepsy, obtaining expert input, and conducting cognitive interviews and debriefing was utilized to develop empirically derived content for the instrument. Eleven health providers with expertise in pediatric epilepsy from across the country provided feedback on the conceptual model and content, including epileptologists, nurse practitioners, social workers, and psychologists. Ten pediatric patients (age 4-16years) with a diagnosis of epilepsy and 11 parents participated in focus groups. Thirteen pediatric patients (age 5-17years) and 17 parents participated in cognitive interviews. Focus groups, expert input, and cognitive debriefing resulted in 6 final domains including restrictions, seizure management, cognitive/executive functioning, social, sleep/fatigue, and mood/behavior. Patient self-report versions ranged from 30 to 33 items and parent proxy-report versions ranged from 26 to 33 items, with the toddler and young child versions having fewer items. Standardized qualitative methodology was employed to develop the items and content for the novel PedsQL™ Epilepsy Module. The PedsQL™ Epilepsy Module has the potential to enhance clinical decision-making in pediatric epilepsy by capturing and monitoring important patient-identified contributors to HRQOL. Copyright © 2016 Elsevier Inc. All rights reserved.

“I just start crying for no reason”: The experience of stress and depression in pregnant urban African American adolescents and their perception of yoga as a management strategy

PubMed Central

Kinser, Patricia; Masho, Saba

2015-01-01

Purpose Perinatal health disparities are of particular concern with pregnant urban African American adolescents who have high rates of stress and depression during pregnancy, higher rates of adverse pregnancy and neonatal outcomes, and many barriers to effective treatment. The purpose of this study was to explore pregnant urban African American teenagers’ experience of stress and depression and examine their perceptions of adjunctive non-pharmacologic management strategies, such as yoga. Methods This community-based qualitative study utilized non-therapeutic focus groups to allow for exploration of attitudes, concerns, beliefs and values regarding stress and depression in pregnancy and non-pharmacologic management approaches, such as mind-body therapies and other prenatal activities. Findings The sample consisted of pregnant African-American low-income adolescents (n=17) who resided in a large urban area in the United States. The themes that arose in the focus group discussions were: (1) stress and depression symptoms are pervasive in daily life; (2) participants felt a generalized sense of isolation; (3) stress/depression-management techniques should be group-based, interactive, and focused on the specific needs of teenagers; (4) yoga is an appealing stress-management technique to this population. Conclusions The findings from this study suggest that pregnant urban adolescents are highly stressed, they interpret depression-like symptoms to be signs of stress, they desire group-based, interactive activities, and they are interested in yoga classes for stress/depression management and relationship-building. It is imperative that healthcare providers and researchers focus on these needs, particularly when designing prevention and intervention strategies. PMID:25648492

A Healthcare Utilization Analysis Framework for Hot Spotting and Contextual Anomaly Detection

PubMed Central

Hu, Jianying; Wang, Fei; Sun, Jimeng; Sorrentino, Robert; Ebadollahi, Shahram

2012-01-01

Patient medical records today contain vast amount of information regarding patient conditions along with treatment and procedure records. Systematic healthcare resource utilization analysis leveraging such observational data can provide critical insights to guide resource planning and improve the quality of care delivery while reducing cost. Of particular interest to providers are hot spotting: the ability to identify in a timely manner heavy users of the systems and their patterns of utilization so that targeted intervention programs can be instituted, and anomaly detection: the ability to identify anomalous utilization cases where the patients incurred levels of utilization that are unexpected given their clinical characteristics which may require corrective actions. Past work on medical utilization pattern analysis has focused on disease specific studies. We present a framework for utilization analysis that can be easily applied to any patient population. The framework includes two main components: utilization profiling and hot spotting, where we use a vector space model to represent patient utilization profiles, and apply clustering techniques to identify utilization groups within a given population and isolate high utilizers of different types; and contextual anomaly detection for utilization, where models that map patient’s clinical characteristics to the utilization level are built in order to quantify the deviation between the expected and actual utilization levels and identify anomalies. We demonstrate the effectiveness of the framework using claims data collected from a population of 7667 diabetes patients. Our analysis demonstrates the usefulness of the proposed approaches in identifying clinically meaningful instances for both hot spotting and anomaly detection. In future work we plan to incorporate additional sources of observational data including EMRs and disease registries, and develop analytics models to leverage temporal relationships among medical encounters to provide more in-depth insights. PMID:23304306

A healthcare utilization analysis framework for hot spotting and contextual anomaly detection.

PubMed

Hu, Jianying; Wang, Fei; Sun, Jimeng; Sorrentino, Robert; Ebadollahi, Shahram

2012-01-01

Patient medical records today contain vast amount of information regarding patient conditions along with treatment and procedure records. Systematic healthcare resource utilization analysis leveraging such observational data can provide critical insights to guide resource planning and improve the quality of care delivery while reducing cost. Of particular interest to providers are hot spotting: the ability to identify in a timely manner heavy users of the systems and their patterns of utilization so that targeted intervention programs can be instituted, and anomaly detection: the ability to identify anomalous utilization cases where the patients incurred levels of utilization that are unexpected given their clinical characteristics which may require corrective actions. Past work on medical utilization pattern analysis has focused on disease specific studies. We present a framework for utilization analysis that can be easily applied to any patient population. The framework includes two main components: utilization profiling and hot spotting, where we use a vector space model to represent patient utilization profiles, and apply clustering techniques to identify utilization groups within a given population and isolate high utilizers of different types; and contextual anomaly detection for utilization, where models that map patient's clinical characteristics to the utilization level are built in order to quantify the deviation between the expected and actual utilization levels and identify anomalies. We demonstrate the effectiveness of the framework using claims data collected from a population of 7667 diabetes patients. Our analysis demonstrates the usefulness of the proposed approaches in identifying clinically meaningful instances for both hot spotting and anomaly detection. In future work we plan to incorporate additional sources of observational data including EMRs and disease registries, and develop analytics models to leverage temporal relationships among medical encounters to provide more in-depth insights.

Content analysis of neurodegenerative and mental diseases social groups.

PubMed

Martínez-Pérez, Borja; de la Torre-Díez, Isabel; Bargiela-Flórez, Beatriz; López-Coronado, Miguel; Rodrigues, Joel J P C

2015-12-01

This article aims to characterize the different types of Facebook and Twitter groups for different mental diseases, their purposes, and their functions. We focused the search on depressive disorders, dementia, and Alzheimer's and Parkinson's diseases and examined the Facebook (www.facebook.com) and Twitter (www.twitter.com) groups. We used four assessment criteria: (1) purpose, (2) type of creator, (3) telehealth content, and (4) free-text responses in surveys and interviews. We observed a total of 357 Parkinson groups, 325 dementia groups, 853 Alzheimer groups, and 1127 depression groups on Facebook and Twitter. Moreover, we analyze the responses provided by different users. The survey and interview responses showed that many people were interested in using social networks to support and help in the fight against these diseases. The results indicate that social networks are acceptable by users in terms of simplicity and utility. People use them for finding support, information, self-help, advocacy and awareness, and for collecting funds. © The Author(s) 2014.

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

Marrinan, Thomas; Leigh, Jason; Renambot, Luc

Mixed presence collaboration involves remote collaboration between multiple collocated groups. This paper presents the design and results of a user study that focused on mixed presence collaboration using large-scale tiled display walls. The research was conducted in order to compare data synchronization schemes for multi-user visualization applications. Our study compared three techniques for sharing data between display spaces with varying constraints and affordances. The results provide empirical evidence that using data sharing techniques with continuous synchronization between the sites lead to improved collaboration for a search and analysis task between remotely located groups. We have also identified aspects of synchronizedmore » sessions that result in increased remote collaborator awareness and parallel task coordination. It is believed that this research will lead to better utilization of large-scale tiled display walls for distributed group work.« less

Acoustics outreach program for the deaf

NASA Astrophysics Data System (ADS)

Vongsawad, Cameron T.; Berardi, Mark L.; Whiting, Jennifer K.; Lawler, M. Jeannette; Gee, Kent L.; Neilsen, Tracianne B.

2016-03-01

The Hear and See methodology has often been used as a means of enhancing pedagogy by focusing on the two strongest learning senses, but this naturally does not apply to deaf or hard of hearing students. Because deaf students' prior nonaural experiences with sound will vary significantly from those of students with typical hearing, different methods must be used to build understanding. However, the sensory-focused pedagogical principle can be applied in a different way for the Deaf by utilizing the senses of touch and sight, called here the ``See and Feel'' method. This presentation will provide several examples of how acoustics demonstrations have been adapted to create an outreach program for a group of junior high students from a school for the Deaf and discuss challenges encountered.

Health care reform and people with disabilities.

PubMed

Batavia, A I

1993-01-01

As a group, people with disabilities or chronic conditions experience higher-than-average health care costs and have difficulty gaining access to affordable private health insurance coverage. While the Americans with Disabilities Act will enhance access by prohibiting differential treatment without sound actuarial justification, it will not guarantee equal access for people in impairment groups with high utilization rates. Health care reform is needed to subsidize the coverage of such individuals. Such subsidization can be achieved under either a casualty insurance model, in which premiums based on expected costs are subsidized directly, or a social insurance model, in which low-cost enrollees cross-subsidize high-cost enrollees. Cost containment provisions that focus on the provider, such as global budgeting and managed competition, will adversely affect disabled people if providers do not have adequate incentives to meet these people's needs. Provisions focusing on the consumer, such as cost sharing, case management, and benefit reductions, will adversely affect disabled people if they unduly limit needed services or impose a disproportionate financial burden on disabled people.

Focusing the Sun: State Considerations for Designing Community Solar Policy

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

Cook, Jeffrey J; Shah, Monisha R

This report summarizes outcomes from the National Community Solar Partnership State Best Practices working group by identifying key differences in state policies that enable community solar and illustrating how various policy design approaches may impact the market. For the latter question, it is too early to quantify a relationship between policy design and market impacts, because most state programs have not been fully implemented. So, the authors conducted interviews with 19 subject matter experts, including project developers, regulators, and utilities to better understand how various policy design approaches may impact community solar markets. These perspectives, along with those gleaned frommore » the working group and relevant literature were synthesized to identify key considerations for policymakers designing community solar programs. Though state community solar policies vary in numerous ways, the report focuses on the following critical elements: program cap, project size cap, subscriber location requirements, subscriber eligibility requirements, low- and moderate-income stipulations, and subscriber compensation.« less

Acceptability of an e-learning program to help nursing assistants manage relationship conflict in nursing homes.

PubMed

Marziali, Elsa; Mackenzie, Corey Scott; Tchernikov, Illia

2015-02-01

Management of nursing assistants' (NAs) emotional stress from relationship conflicts with residents, families, and coworkers is rarely the focus of educational programs. Our objective was to gather feedback from NAs and their nursing supervisors (NSs) about the utility of our e-learning program for managing relationship stress. A total of 147 NAs and their NSs from 17 long-term care homes viewed the educational modules (DVD slides with voice-over), either individually or in small groups, and provided feedback using conference call focus groups. Qualitative analysis of NA feedback showed that workplace relationship conflict stress was associated with workload and the absence of a forum for discussing relationship conflicts that was not acknowledged by NSs. This accessible e-learning program provides NAs with strategies for managing stressful emotions arising from workplace relationship conflict situations and underscores the importance of supervisory support and team collaboration in coping with emotionally evoked workplace stress. © The Author(s) 2014.

Between modern and traditional values: Informal mental health help-seeking attitudes according to Israeli Arab women, primary care patients and their providers.

PubMed

Ayalon, Liat; Karkabi, Khaled; Bleichman, Igor; Fleischmann, Silvia; Goldfracht, Margalit

2015-06-01

Israeli Arab women under-utilize mental health services. The present study evaluated the use of alternative services for dealing with depression and anxiety among Israeli Arab women and primary care providers. Four focus groups with primary care patients and two focus groups with primary care providers were conducted. Constant comparisons were employed in order to identify major themes related to informal help-seeking behaviors. Three informal help-seeking behaviors were identified: (a) social support, divided into extended family and neighbors versus nuclear family and close friends; (b) religiosity, divided into inner, direct practices and beliefs versus externally mediated ones; and (c) self-help techniques, such as engagement in activities and distancing oneself from the situation. Both social support and religiosity were viewed with ambivalence by primary care patients and providers. The findings suggest that the Arab population in Israel might be lacking informal sources of support at times of mental health needs. © The Author(s) 2014.

Perceptions of Informal and Formal Coping Strategies for Intimate Partner Violence Among Gay and Bisexual Men.

PubMed

Freeland, Ryan; Goldenberg, Tamar; Stephenson, Rob

2018-03-01

The prevalence of intimate partner violence (IPV) in same-sex male relationships has been reported to be at least as prevalent as is observed in female-male relationships. Though research has focused on understanding the prevalence and antecedents of IPV in male-male relationships, there is a paucity of data describing perceptions of coping strategies adopted by gay and bisexual men who may experience IPV. Ten focus group discussions were conducted with 64 gay and bisexual men in Atlanta, Georgia, between September 2013 and November 2013. Focus groups examined perceptions of how gay and bisexual men would respond to IPV and the IPV-coping services they would utilize. Thematic analysis was conducted to identify themes that describe how gay and bisexual men perceive existing IPV services and how they would use these services, if gay and bisexual men were to experience IPV. The results indicate that men experiencing IPV in male-male relationships do not have adequate access to IPV services that are tailored to their unique needs. As a result, there is a strong reliance on informal sources of support. Services are urgently needed to meet the unique needs of men experiencing IPV in same-sex relationships.

Consumer Health Informatics Aspects of Direct-to-Consumer Personal Genomic Testing.

PubMed

Gray, Kathleen; Stephen, Remya; Terrill, Bronwyn; Wilson, Brenda; Middleton, Anna; Tytherleigh, Rigan; Turbitt, Erin; Gaff, Clara; Savard, Jacqueline; Hickerton, Chriselle; Newson, Ainsley; Metcalfe, Sylvia

2017-01-01

This paper uses consumer health informatics as a framework to explore whether and how direct-to-consumer personal genomic testing can be regarded as a form of information which assists consumers to manage their health. It presents findings from qualitative content analysis of web sites that offer testing services, and of transcripts from focus groups conducted as part a study of the Australian public's expectations of personal genomics. Content analysis showed that service offerings have some features of consumer health information but lack consistency. Focus group participants were mostly unfamiliar with the specifics of test reports and related information services. Some of their ideas about aids to knowledge were in line with the benefits described on provider web sites, but some expectations were inflated. People were ambivalent about whether these services would address consumers' health needs, interests and contexts and whether they would support consumers' health self-management decisions and outcomes. There is scope for consumer health informatics approaches to refine the usage and the utility of direct-to-consumer personal genomic testing. Further research may focus on how uptake is affected by consumers' health literacy or by services' engagement with consumers about what they really want.

Daughter-initiated health advice to mothers: perceptions of African–American and Latina daughters

PubMed Central

Mosavel, M.; Thomas, T.

2009-01-01

The prevailing paradigm of health exchange within the family is for health advice to flow from parent to child. Consistent with this pattern of exchange, most research has focused on the one-directional influence of the parent on the child and there is thus an absence of literature that explores the ability of adolescents to influence their parents’ health behaviors. This qualitative study addressed this gap by exploring the feasibility of daughters providing health advice to their mothers. Twelve focus groups were conducted with 78 African–American and Latina daughters between the ages of 12 and 17 from low-income neighborhoods in a Mid-Western city in the United States. This study utilized a grounded theory approach to examine the focus group data. The findings indicate that many daughters report that they are already giving their mothers a wide spectrum of advice, including health advice. Differences were found in the reported willingness of African–American daughters when compared to Latina daughters to provide their mothers with specific cancer advice. These data suggest that some of these daughters have the potential to be valuable health education conveyers in the family. PMID:19339373

Multiple Comorbidities and Interest in Research Participation Among Clients of a Nonprofit Food Distribution Site.

PubMed

Higashi, Robin T; Craddock Lee, Simon J; Leonard, Tammy; Cuate, Erica L; Cole, Jay; Pruitt, Sandi L

2015-10-01

Persons accessing food from nonprofit distribution sites face numerous challenges and typically have significant unmet health needs. However, given limited and intermittent healthcare system engagement, this vulnerable population is underrepresented in clinical research. We sought to better understand the health needs of a nonclinical population to inform future research and interventions. Focus groups were conducted in English (n = 4) and Spanish (n = 4) with clients of Crossroads Community Services (CCS), the largest distributor of North Texas Food Bank. Discussions probed participants' health status, healthcare utilization, understanding and utilization of mammography, and attitudes toward participation in research. Participants included 42 CCS clients, primarily Hispanic or African American women. Participants reported multiple comorbid conditions among household members, yet utilization of health services was often limited by cost. The majority expressed interest in participating in research to communicate their health concerns and obtain emotional support. CCS clients represent a high-need, under-reached population willing to engage in health-related research that affords them opportunity to connect with peers in group settings and obtain information to improve management of daily life challenges. The Community Assistance Research (CARe) Initiative, a community-academic collaboration, establishes a much-needed opportunity for ongoing clinical research and intervention among this underserved population. © 2015 Wiley Periodicals, Inc.

Multiple Comorbidities and Interest in Research Participation Among Clients of a Nonprofit Food Distribution Site

PubMed Central

Higashi, Robin T.; Craddock Lee, Simon J.; Leonard, Tammy; Cuate, Erica L.; Cole, Jay

2015-01-01

Abstract Background Persons accessing food from nonprofit distribution sites face numerous challenges and typically have significant unmet health needs. However, given limited and intermittent healthcare system engagement, this vulnerable population is underrepresented in clinical research. We sought to better understand the health needs of a nonclinical population to inform future research and interventions. Methods : Focus groups were conducted in English (n = 4) and Spanish (n = 4) with clients of Crossroads Community Services (CCS), the largest distributor of North Texas Food Bank. Discussions probed participants’ health status, healthcare utilization, understanding and utilization of mammography, and attitudes toward participation in research. Results Participants included 42 CCS clients, primarily Hispanic or African American women. Participants reported multiple comorbid conditions among household members, yet utilization of health services was often limited by cost. The majority expressed interest in participating in research to communicate their health concerns and obtain emotional support. Conclusion CCS clients represent a high‐need, under‐reached population willing to engage in health‐related research that affords them opportunity to connect with peers in group settings and obtain information to improve management of daily life challenges. The Community Assistance Research (CARe) Initiative, a community–academic collaboration, establishes a much‐needed opportunity for ongoing clinical research and intervention among this underserved population. PMID:26277918

1990 Fuel oil utilization workshop

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

McDonald, B.L.; Lange, H.B.; Miller, M.N.

1992-01-01

Following a 1983 EPRI-sponsored workshop on utility boiler problems (EPRI report AP-3753), the Institute has responded to the need for better information on fuel utilization by sponsoring annual utility-focused workshops. This workshop is the sixth in a series of annual events designed to address this need. The objective was to provide utility personnel with an opportunity to exchange information on residual oil use in fossil steam plants. Participants at the 1990 workshop, held in Arlington, Virginia, October 31-November 1, 1990, included 37 representatives from 19 electric utilities, including representatives from Mexico, Canada, and Spain, as well as the Institute demore » Investigaciones Electricas in Mexico. The workshop comprised formal presentations followed by question-and-answer sessions and three 2-hour discussion group sessions. Topics included a water/oil emulsion test summary, a NO{sub x} reduction program, particulate and unburned carbon emissions reductions from oil-fired boilers using combustion promoters, a utility perspective on oil spills, and size distribution and opacity of particulate matter emissions from combustion of residual fuel oils. In addition, participants discussed the development of a coke formation index, instability and compatibility of residual fuel oils, the clean combustion of heavy liquid fuels, toxic air emissions from the combustion of residual fuel oils, H{sub 2}S release from residual fuel oils, and increased reliability of superheater and reheater tubes and headers by optimization of steam-side and gas-side temperatures.« less

Strategic Communication and its Utility in Ecosystem Service ...

EPA Pesticide Factsheets

The field of Strategic Communication involves a focused effort to identify, develop, and present multiple types of communication media on a given subject. A Strategic Communication program recognizes the limitations of the most common communication models (primarily “one size fits all” and “presenting everything and letting the audience decide what is important”) and specifically focuses on building a communication framework that is composed of three interlinked pillars: message – Identifying the right content for a given audience and a vehicle; audience – Identify the right target group for a given message and vehicle; vehicle – Identifying the right types of media for a given message and audience. In addition to serving as an organizational framework, the physical structure of a Strategic Communication plan also can serve as a way to show an audience where they, the message, and vehicle fit into the larger picture (i.e., “you are here”). This presentation will explore the process of designing a Strategic Communication plan and examine some examples of its utility in the field of ecosystem services science. Ideally, a strategic communication matrix can be utilized to identify and access the materials of interest for any given activity (i.e., avoids the need to recreate materials or use the wrong materials for the wrong audience). Challenges in implementation will also be explored. Abstract for ACES conference

Group refractive index reconstruction with broadband interferometric confocal microscopy

PubMed Central

Marks, Daniel L.; Schlachter, Simon C.; Zysk, Adam M.; Boppart, Stephen A.

2010-01-01

We propose a novel method of measuring the group refractive index of biological tissues at the micrometer scale. The technique utilizes a broadband confocal microscope embedded into a Mach–Zehnder interferometer, with which spectral interferograms are measured as the sample is translated through the focus of the beam. The method does not require phase unwrapping and is insensitive to vibrations in the sample and reference arms. High measurement stability is achieved because a single spectral interferogram contains all the information necessary to compute the optical path delay of the beam transmitted through the sample. Included are a physical framework defining the forward problem, linear solutions to the inverse problem, and simulated images of biologically relevant phantoms. PMID:18451922

Increasing Efficiency in Evaluation of Chronic Cough: A Multidisciplinary, Collaborative Approach.

PubMed

Patton, Cynthia M; Lim, Kaiser G; Ramlow, Luke W; White, Kathleen M

2015-01-01

Chronic cough is the most common reason for medical office visits in the United States. The typical patient has coughed more than 8 years and seen many specialists. This quality improvement project is an ambulatory clinic redesign to deliver efficient, patient-centered care with interspecialty collaboration. Methodology included the Institute for Healthcare Improvement collaborative model focused on Lean/Six Sigma and ADKAR (Awareness, Desire, Knowledge, Ability, Reinforcement) Change Management. Interventions targeted education to referring providers, implementation of software changes, building a collaborative interdepartmental scheduling decision tree, and an interclinic dashboard enhancing communication and decision support. Outcome measures compare group resource utilization, evidenced by the total number of specialist referrals for same indication of chronic cough (International Classification of Diseases, Ninth Revision: 786.2), and length of time to complete evaluation. A retrospective review of 165 medical records yielded 2 groups, "current care" (n = 67) and "intervention" (n = 68). The number of specialist referrals per patient was reduced in the intervention group (M = 1.22, SD = 0.48) compared with the current care group (M = 3.33, SD = 1.02). Length of itinerary was reduced in the intervention group (M = 11.90, SD = 12.13, GM = 6.82) compared with the current care group (M = 126.93, SD = 158.13, GM = 54.8). Multidisciplinary collaboration, communication, coordinating diagnosis, and management of multifactorial conditions, such as chronic cough, are associated with lower costs and decreased utilization of health care resources.

Lung Focused Resuscitation at a Specialized Donor Care Facility Improves Lung Procurement Rates.

PubMed

Chang, Stephanie H; Kreisel, Daniel; Marklin, Gary F; Cook, Lindsey; Hachem, Ramsey; Kozower, Benjamin D; Balsara, Keki R; Bell, Jennifer M; Frederiksen, Christine; Meyers, Bryan F; Patterson, G Alexander; Puri, Varun

2018-05-01

Lung procurement for transplantation occurs in approximately 20% of brain dead donors and is a major impediment to wider application of lung transplantation. We investigated the effect of lung protective management at a specialized donor care facility on lung procurement rates from brain dead donors. Our local organ procurement organization instituted a protocol of lung protective management at a freestanding specialized donor care facility in 2008. Brain dead donors from 2001 to 2007 (early period) were compared with those from 2009 to 2016 (current period) for lung procurement rates and other solid-organ procurement rates using a prospectively maintained database. An overall increase occurred in the number of brain dead donors during the study period (early group, 791; late group, 1,333; p < 0.0001). The lung procurement rate (lung donors/all brain dead donors) improved markedly after the introduction of lung protective management (early group, 157 of 791 [19.8%]; current group, 452 of 1,333 [33.9%]; p < 0.0001). The overall organ procurement rate (total number of organs procured/donor) also increased during the study period (early group, 3.5 organs/donor; current group, 3.8 organs/donor; p = 0.006). Lung protective management in brain dead donors at a specialized donor care facility is associated with higher lung utilization rates compared with conventional management. This strategy does not adversely affect the utilization of other organs in a multiorgan donor. Copyright © 2018 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

Preference-based Glaucoma-specific Health-related Quality of Life Instrument: Development of the Health Utility for Glaucoma.

PubMed

Muratov, Sergei; Podbielski, Dominik W; Kennedy, Kevin; Jack, Susan M; Pemberton, Julia; Ahmed, Iqbal Ike K; Baltaziak, Monika; Xie, Feng

2018-05-12

To develop a descriptive system for a glaucoma-specific preference-based health-related quality of life (HRQoL) instrument: the Health Utility for Glaucoma (HUG-5). The descriptive system was developed in two stages: item identification and item selection. A systematic literature review of HRQoL assessment of glaucoma was conducted using a comprehensive search strategy. Purposeful sampling was used to recruit patients with different clinical characteristics. Relevant items were presented to glaucoma patients through face-to-face, semi-structured interviews. Framework methodology was applied to analyze interview content. The recurring themes identified through an iterative content analysis represented topics of most importance and relevance to patients. These themes formed the domains of the HUG-5 descriptive system. Three versions of the descriptive system, differing in explanatory detail, were pilot tested using a focus group. The literature review identified 19 articles which contained 266 items. These items were included for the full text review and were used to develop an interview guide. From twelve patient interviews, 22 themes were identified and grouped into five domains that informed the five questions of the descriptive system. The HUG-5 measures visual discomfort, mobility, daily life activities, emotional well-being, and social activities. Each question has five response levels that range from "no problem" to "severe problem". The focus group comprised of seven additional patients unanimously preferred the version that contained detailed, specific examples to support each question. A 5-domain descriptive system of a glaucoma-specific preference-based instrument, the HUG-5, was developed and remains to be evaluated for validity and reliability in the glaucoma patient population.

Qualitative Assessment of Learning Strategies among Medical Students Using Focus Group Discussions and In-depth Interviews.

PubMed

Joshi, Anuradha Sujai; Ganjiwale, Jaishree Deepak; Varma, Jagdish; Singh, Praveen; Modi, Jyoti Nath; Singh, Tejinder

2017-12-01

Globally, students with top academic performance and high intellectual capacity usually opt to study medicine. However, once students get enrolled, their academic performance varies widely. Such variations appear to be determined by various factors, one of them being types of learning strategies adopted by students. The learning strategies utilized by the students with better academic performance are likely to be more effective learning strategies. The objective is to identify effective learning strategies used by medical students. This study was carried out among the MBBS students of Final Professional Part I. Students were categorized into three groups namely: high, average, and low rankers based on overall academic performance in second Professional University examination. First, a questionnaire consisting of closed- and open-ended questions was administered to students, to find their learning strategies. Subsequently, focus group discussion and in-depth interviews were conducted for high- and low-rankers. Discussions were audio-recorded, transcribed, and analyzed. Key statements were highlighted, collated, and categorized into general themes and sub-themes. Evident themes which emerged as effective strategies were hard work in the form of regularity of studies, meticulous preparation of notes, constructive use of time, utilization of e-learning, learning styles and deep learning approach and regular ward visits. Intrinsic motivation, family support, balancing physical activities and studies, guidance by seniors, teachers, dealing with nonacademic issues such as language barriers and stress were also identified as important strategies. Disseminating effective learning strategies in a systematic manner may be helpful to students in achieving better academic outcomes. Furthermore, educationists need to modulate their teaching strategies based on students' feedback.

Perceptions of users and providers on barriers to utilizing skilled birth care in mid- and far-western Nepal: a qualitative study.

PubMed

Onta, Sharad; Choulagai, Bishnu; Shrestha, Binjwala; Subedi, Narayan; Bhandari, Gajananda P; Krettek, Alexandra

2014-01-01

Although skilled birth care contributes significantly to the prevention of maternal and newborn morbidity and mortality, utilization of such care is poor in mid- and far-western Nepal. This study explored the perceptions of service users and providers regarding barriers to skilled birth care. We conducted 24 focus group discussions, 12 each with service users and service providers from different health institutions in mid- and far-western Nepal. All discussions examined the perceptions and experiences of service users and providers regarding barriers to skilled birth care and explored possible solutions to overcoming such barriers. Our results determined that major barriers to skilled birth care include inadequate knowledge of the importance of services offered by skilled birth attendants (SBAs), distance to health facilities, unavailability of transport services, and poor availability of SBAs. Other barriers included poor infrastructure, meager services, inadequate information about services/facilities, cultural practices and beliefs, and low prioritization of birth care. Moreover, the tradition of isolating women during and after childbirth decreased the likelihood that women would utilize delivery care services at health facilities. Service users and providers perceived inadequate availability and accessibility of skilled birth care in remote areas of Nepal, and overall utilization of these services was poor. Therefore, training and recruiting locally available health workers, helping community groups establish transport mechanisms, upgrading physical facilities and services at health institutions, and increasing community awareness of the importance of skilled birth care will help bridge these gaps.

Ultracompact Pseudowedge Plasmonic Lasers and Laser Arrays.

PubMed

Chou, Yu-Hsun; Hong, Kuo-Bin; Chang, Chun-Tse; Chang, Tsu-Chi; Huang, Zhen-Ting; Cheng, Pi-Ju; Yang, Jhen-Hong; Lin, Meng-Hsien; Lin, Tzy-Rong; Chen, Kuo-Ping; Gwo, Shangjr; Lu, Tien-Chang

2018-02-14

Concentrating light at the deep subwavelength scale by utilizing plasmonic effects has been reported in various optoelectronic devices with intriguing phenomena and functionality. Plasmonic waveguides with a planar structure exhibit a two-dimensional degree of freedom for the surface plasmon; the degree of freedom can be further reduced by utilizing metallic nanostructures or nanoparticles for surface plasmon resonance. Reduction leads to different lightwave confinement capabilities, which can be utilized to construct plasmonic nanolaser cavities. However, most theoretical and experimental research efforts have focused on planar surface plasmon polariton (SPP) nanolasers. In this study, we combined nanometallic structures intersecting with ZnO nanowires and realized the first laser emission based on pseudowedge SPP waveguides. Relative to current plasmonic nanolasers, the pseudowedge plasmonic lasers reported in our study exhibit extremely small mode volumes, high group indices, high spontaneous emission factors, and high Purell factors beneficial for the strong interaction between light and matter. Furthermore, we demonstrated that compact plasmonic laser arrays can be constructed, which could benefit integrated plasmonic circuits.

The group II intron maturase: a reverse transcriptase and splicing factor go hand in hand.

PubMed

Zhao, Chen; Pyle, Anna Marie

2017-12-01

The splicing of group II introns in vivo requires the assistance of a multifunctional intron encoded protein (IEP, or maturase). Each IEP is also a reverse-transcriptase enzyme that enables group II introns to behave as mobile genetic elements. During splicing or retro-transposition, each group II intron forms a tight, specific complex with its own encoded IEP, resulting in a highly reactive holoenzyme. This review focuses on the structural basis for IEP function, as revealed by recent crystal structures of an IEP reverse transcriptase domain and cryo-EM structures of an IEP-intron complex. These structures explain how the same IEP scaffold is utilized for intron recognition, splicing and reverse transcription, while providing a physical basis for understanding the evolutionary transformation of the IEP into the eukaryotic splicing factor Prp8. Copyright © 2017 Elsevier Ltd. All rights reserved.

The effects of an early intervention music curriculum on prereading/writing.

PubMed

Register, D

2001-01-01

This study evaluated the effects of music sessions using a curriculum designed to enhance the prereading and writing skills of 25 children aged 4 to 5 years who were enrolled in Early Intervention and Exceptional Student Education programs. This study was a replication of the work of Standley and Hughes (1997) and utilized a larger sample size (n = 50) in order to evaluate the efficacy of a music curriculum designed specifically to teach prereading and writing skills versus one that focuses on all developmental areas. Both the experimental (n = 25) and control (n = 25) groups received two 30-minute sessions each week for an entire school year for a minimum of 60 sessions per group. The differentiating factors between the two groups were the structure and components of the musical activities. The fall sessions for the experimental group were focused primarily on writing skills while the spring sessions taught reading/book concepts. Music sessions for the control group were based purely on the thematic material, as determined by the classroom teacher with purposeful exclusion of all preliteracy concepts. All participants were pretested at the beginning of the school year and posttested before the school year ended. Overall, results demonstrated that music sessions significantly enhanced both groups' abilities to learn prewriting and print concepts. However, the experimental group showed significantly higher results on the logo identification posttest and the word recognition test. Implications for curriculum design and academic and social applications of music in Early Intervention programs are discussed.

Implementation of a Flipped Classroom for Nuclear Medicine Physician CME.

PubMed

Komarraju, Aparna; Bartel, Twyla B; Dickinson, Lisa A; Grant, Frederick D; Yarbrough, Tracy L

2018-06-21

Increasingly, emerging technologies are expanding instructional possibilities, with new methods being adopted to improve knowledge acquisition and retention. Within medical education, many new techniques have been employed in the undergraduate setting, with less utilization thus far in the continuing medical education (CME) sphere. This paper discusses the use of a new method for CME-the "flipped classroom," widely used in undergraduate medical education. This method engages learners by providing content before the live ("in class") session that aids in preparation and fosters in-class engagement. A flipped classroom method was employed using an online image-rich case-based module and quiz prior to a live CME session at a national nuclear medicine meeting. The preparatory material provided a springboard for in-depth discussion at the live session-a case-based activity utilizing audience response technology. Study participants completed a survey regarding their initial experience with this new instructional method. In addition, focus group interviews were conducted with session attendees who had or had not completed the presession material; transcripts were qualitatively analyzed. Quantitative survey data (completed by two-thirds of the session attendees) suggested that the flipped method was highly valuable and met attendee educational objectives. Analysis of focus group data yielded six themes broadly related to two categories-benefits of the flipped method for CME and programmatic considerations for successfully implementing the flipped method in CME. Data from this study have proven encouraging and support further investigations around the incorporation of this innovative teaching method into CME for nuclear imaging specialists.

Enhancing decision making about participation in cancer clinical trials: development of a question prompt list

PubMed Central

Brown, Richard F.; Shuk, Elyse; Leighl, Natasha; Butow, Phyllis; Ostroff, Jamie; Edgerson, Shawna; Tattersall, Martin

2016-01-01

Purpose Slow accrual to cancer clinical trials impedes the progress of effective new cancer treatments. Poor physician–patient communication has been identified as a key contributor to low trial accrual. Question prompt lists (QPLs) have demonstrated a significant promise in facilitating communication in general, surgical, and palliative oncology settings. These simple patient interventions have not been tested in the oncology clinical trial setting. We aimed to develop a targeted QPL for clinical trials (QPL-CT). Method Lung, breast, and prostate cancer patients who either had (trial experienced) or had not (trial naive) participated in a clinical trial were invited to join focus groups to help develop and explore the acceptability of a QPL-CT. Focus groups were audio-recorded and transcribed. A research team, including a qualitative data expert, analyzed these data to explore patients’ decision-making processes and views about the utility of the QPL-CT prompt to aid in trial decision making. Results Decision making was influenced by the outcome of patients’ comparative assessment of perceived risks versus benefits of a trial, and the level of trust patients had in their doctors’ recommendation about the trial. Severity of a patient’s disease influenced trial decision making only for trial-naive patients. Conclusion Although patients were likely to prefer a paternalistic decision-making style, they expressed valuation of the QPL as an aid to decision making. QPL-CT utility extended beyond the actual consultation to include roles both before and after the clinical trial discussion. PMID:20593202

The impact of digital media on health: children's perspectives.

PubMed

Smahel, David; Wright, Michelle F; Cernikova, Martina

2015-02-01

Previous research has mainly focused on the effects of excessive digital media use or overuse on the health of children, primarily utilizing quantitative designs. More research should be conducted on general populations of children, rather than focusing exclusively on excessive technology users. This qualitative study describes technology's impact on physical and mental health from children's perspectives. Focus groups and interviews were conducted with children between the ages of 9 and 16 in 9 European countries (N = 368). During focus groups and interviews, researchers asked what children perceive as being potentially negative or problematic while using the internet and technology. In this study, children reported several physical and mental health problems without indicating internet addiction or overuse. Physical health symptoms included eye problems, headaches, not eating, and tiredness. For mental health symptoms, children reported cognitive salience of online events, aggression, and sleeping problems. Sometimes they reported these problems within 30 min of technology usage. This suggests that even shorter time usage can cause self-reported health problems for some children. Qualitative methodology helps to understand what children's perspectives are concerning the impact of digital media on health. We recommend future studies focused on average technology users and low technology users to determine whether average levels of technology usage relate to health problems of children. Parents and teachers should also be informed about the possible physical and mental health issues associated with children's average usage of technology.

Clinical outcomes and cost-effectiveness of brief guided parent-delivered cognitive behavioural therapy and solution-focused brief therapy for treatment of childhood anxiety disorders: a randomised controlled trial.

PubMed

Creswell, Cathy; Violato, Mara; Fairbanks, Hannah; White, Elizabeth; Parkinson, Monika; Abitabile, Gemma; Leidi, Alessandro; Cooper, Peter J

2017-07-01

Half of all lifetime anxiety disorders emerge before age 12 years; however, access to evidence-based psychological therapies for affected children is poor. We aimed to compare the clinical outcomes and cost-effectiveness of two brief psychological treatments for children with anxiety referred to routine child mental health settings. We hypothesised that brief guided parent-delivered cognitive behavioural therapy (CBT) would be associated with better clinical outcomes than solution-focused brief therapy and would be cost-effective. We did this randomised controlled trial at four National Health Service primary child and mental health services in Oxfordshire, UK. Children aged 5-12 years referred for anxiety difficulties were randomly allocated (1:1), via a secure online minimisation tool, to receive brief guided parent-delivered CBT or solution-focused brief therapy, with minimisation for age, sex, anxiety severity, and level of parental anxiety. The allocation sequence was not accessible to the researcher enrolling participants or to study assessors. Research staff who obtained outcome measurements were masked to group allocation and clinical staff who delivered the intervention did not measure outcomes. The primary outcome was recovery, on the basis of Clinical Global Impressions of Improvement (CGI-I). Parents recorded patient-level resource use. Quality-adjusted life-years (QALYs) for use in cost-utility analysis were derived from the Child Health Utility 9D. Assessments were done at baseline (before randomisation), after treatment (primary endpoint), and 6 months after treatment completion. We did analysis by intention to treat. This trial is registered with the ISCRTN registry, number ISRCTN07627865. Between March 23, 2012, and March 31, 2014, we randomly assigned 136 patients to receive brief guided parent-delivered CBT (n=68) or solution-focused brief therapy (n=68). At the primary endpoint assessment (June, 2012, to September, 2014), 40 (59%) children in the brief guided parent-delivered CBT group versus 47 (69%) children in the solution-focused brief therapy group had an improvement of much or very much in CGI-I score, with no significant differences between groups in either clinical (CGI-I: relative risk 1·01, 95% CI 0·86-1·19; p=0·95) or economic (QALY: mean difference 0·006, -0·009 to 0·02; p=0·42) outcome measures. However, brief guided parent-delivered CBT was associated with lower costs (mean difference -£448; 95% CI -934 to 37; p=0·070) and, taking into account sampling uncertainty, was likely to represent a cost-effective use of resources compared with solution-focused brief therapy. No treatment-related or trial-related adverse events were reported in either group. Our findings show no evidence of clinical superiority of brief guided parent-delivered CBT. However, guided parent-delivered CBT is likely to be a cost-effective alternative to solution-focused brief therapy and might be considered as a first-line treatment for children with anxiety problems. National Institute for Health Research. Copyright © 2017 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license. Published by Elsevier Ltd.. All rights reserved.

Analysis of changes in the association of income and the utilization of curative health services in Mexico between 2000 and 2006

PubMed Central

2011-01-01

Background A common characteristic of health systems in most developing countries is unequal access to health services. As a result, members of the poorest population groups often do not receive formal attention for health services, because they cannot afford it. In 2001 in Mexico, to address income-related differences in the use of health services, the government launched a major healthcare reform, which includes a health insurance program called Seguro Popular, aimed at improving healthcare access among poor, uninsured residents. This paper analyzes the before and after changes in the demand for curative ambulatory health services focusing on the association of income-related characteristics and the utilization of formal healthcare providers vs. no healthcare service utilization. Methods By using two nationally representative health surveys (ENSA-2000 and ENSANUT-2006), we modeled an individual's decision when experiencing an illness to use services provided by the (1) Ministry of Health (MoH), (2) social security, (3) private entities, or (4) to not use formal services (no healthcare service utilization). Results Poorer individuals were more likely in 2006 than in 2000 to respond to an illness by using formal healthcare providers. Trends in provider selection differed, however. The probability of using public services from the MoH increased among the poorest population, while the findings indicated an increase in utilization of private health services among members of low- and middle-income groups. No significant change was seen among formal workers -covered by social security services-, regardless of socioeconomic status. Conclusions Overall, for 2006 the Mexican population appears less differentiated in using healthcare across economic groups than in 2000. This may be related, in part, to the implementation of Seguro Popular, which seems to be stimulating healthcare demand among the poorest and previously uninsured segment of the population. Still, public health authorities need to address the remaining income-related healthcare utilization differences, the differences in quality between public and private health services, and the general perception that MoH facilities offer inferior services. PMID:21978183

Analysis of changes in the association of income and the utilization of curative health services in Mexico between 2000 and 2006.

PubMed

Danese-Dlsantos, Laura G; Sosa-Rubí, Sandra G; Valencia-Mendoza, Atanacio

2011-10-07

A common characteristic of health systems in most developing countries is unequal access to health services. As a result, members of the poorest population groups often do not receive formal attention for health services, because they cannot afford it. In 2001 in Mexico, to address income-related differences in the use of health services, the government launched a major healthcare reform, which includes a health insurance program called Seguro Popular, aimed at improving healthcare access among poor, uninsured residents. This paper analyzes the before and after changes in the demand for curative ambulatory health services focusing on the association of income-related characteristics and the utilization of formal healthcare providers vs. no healthcare service utilization. By using two nationally representative health surveys (ENSA-2000 and ENSANUT-2006), we modeled an individual's decision when experiencing an illness to use services provided by the (1) Ministry of Health (MoH), (2) social security, (3) private entities, or (4) to not use formal services (no healthcare service utilization). Poorer individuals were more likely in 2006 than in 2000 to respond to an illness by using formal healthcare providers. Trends in provider selection differed, however. The probability of using public services from the MoH increased among the poorest population, while the findings indicated an increase in utilization of private health services among members of low- and middle-income groups. No significant change was seen among formal workers -covered by social security services-, regardless of socioeconomic status. Overall, for 2006 the Mexican population appears less differentiated in using healthcare across economic groups than in 2000. This may be related, in part, to the implementation of Seguro Popular, which seems to be stimulating healthcare demand among the poorest and previously uninsured segment of the population. Still, public health authorities need to address the remaining income-related healthcare utilization differences, the differences in quality between public and private health services, and the general perception that MoH facilities offer inferior services.

Real-time optimized biofeedback utilizing sport techniques (ROBUST): a study protocol for a randomized controlled trial.

PubMed

Taylor, Jeffrey B; Nguyen, Anh-Dung; Paterno, Mark V; Huang, Bin; Ford, Kevin R

2017-02-07

Anterior cruciate ligament (ACL) injuries in female athletes lead to a variety of short- and long-term physical, financial, and psychosocial ramifications. While dedicated injury prevention training programs have shown promise, ACL injury rates remain high as implementation has not become widespread. Conventional prevention programs use a combination of resistance, plyometric, balance and agility training to improve high-risk biomechanics and reduce the risk of injury. While many of these programs focus on reducing knee abduction load and posture during dynamic activity, targeting hip extensor strength and utilization may be more efficacious, as it is theorized to be an underlying mechanism of injury in adolescent female athletes. Biofeedback training may complement traditional preventive training, but has not been widely studied in connection with ACL injuries. We hypothesize that biofeedback may be needed to maximize the effectiveness of neuromuscular prophylactic interventions, and that hip-focused biofeedback will improve lower extremity biomechanics to a larger extent than knee-focused biofeedback during dynamic sport-specific tasks and long-term movement strategies. This is an assessor-blind, randomized control trial of 150 adolescent competitive female (9-19 years) soccer players. Each participant receives 3x/week neuromuscular preventive training and 1x/week biofeedback, the mode depending on their randomization to one of 3 biofeedback groups (hip-focused, knee-focused, sham). The primary aim is to assess the impact of biofeedback training on knee abduction moments (the primary biomechanical predictor of future ACL injury) during double-leg landings, single-leg landings, and unplanned cutting. Testing will occur immediately before the training intervention, immediately after the training intervention, and 6 months after the training intervention to assess the long-term retention of modified biomechanics. Secondary aims will assess performance changes, including hip and core strength, power, and agility, and the extent to which maturation effects biofeedback efficacy. The results of the Real-time Optimized Biofeedback Utilizing Sport Techniques (ROBUST) trial will help complement current preventive training and may lead to clinician-friendly methods of biofeedback to incorporate into widespread training practices. Date of publication in ClinicalTrials.gov: 20/04/2016. ClinicalTrials.gov Identifier: NCT02754700 .

Group education sessions for women veterans who experienced sexual violence: Qualitative findings.

PubMed

Dognin, Joanna; Sedlander, Erica; Jay, Melanie; Ades, Veronica

2017-09-01

The impact of sexual violence (SV) on mental health, self-care, and interpersonal relationships is profound and poses special challenges to health care delivery. Reproductive health care merits special attention because the care required may be linked to reminders of past abuse. We explored facilitators and barriers affecting the use of reproductive health services among women veterans with a history of SV. Between June and September 2015, we conducted 2 focus groups and 3 general education sessions with 27 female veterans with a history of SV at 1 medical center. We analyzed transcripts according to applied thematic analysis and used Nvivo software for data management and retrieval. Three main themes emerged from the focus groups and education sessions. (a) expressed a desire for greater agency in relation to the control they have over their bodies and medical care; (b) described how posttraumatic stress symptoms are retriggered during medical care; and (c) expressed needs for additional education, peer and provider support within the medical system. For women with a history of SV, multiple individual and systemic barriers complicate how they utilize reproductive health services. Group education sessions were an effective mode of support, information and connection to other women within the Veterans Health Administration. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Views of Somali women and men on the use of faith-based messages promoting breast and cervical cancer screening for Somali women: a focus-group study.

PubMed

Pratt, Rebekah; Mohamed, Sharif; Dirie, Wali; Ahmed, Nimo; VanKeulen, Michael; Ahmed, Huda; Raymond, Nancy; Okuyemi, Kola

2017-03-20

Screening rates for breast and cervical cancer for Muslim women in the United States are low, particularly for first-generation immigrants. Interpretations of the Muslim faith represent some of the barriers for breast and cervical cancer screening. Working to understand how faith influences breast and cervical screening for Somali women, and working with the community to identify and utilize faith-based assets for promoting screening, may lead to life-saving changes in screening behaviors. We partnered with an Imam to develop faith-based messages addressing the concerns of modesty and predetermination and promoting cancer testing and screening. A total of five focus groups were convened, with 34 Somali women (three groups) and 20 Somali men (two groups). Each focus group first discussed participant views of breast and cervical cancer screening in general and then viewed and discussed video clips of the Imam delivering the faith-based messages. Both Somali women and men had an overwhelmingly positive response to the faith-based messages promoting breast and cervical cancer screening. The faith-based messages appeared to reinforce the views of those who were already inclined to see screening positively, with participants describing increased confidence to engage in screening. For those who had reservations about screening, there was feedback that the faith-based messages had meaningfully influenced their views. Somali immigrant women and men found faith-based messages addressing topics of predestination and modesty and encouraging the use of screening and treatment to be both acceptable and influential. Faith can play an important role as an asset to promote breast and cervical cancer screening, and there may be substantial benefits to adding faith-based messaging to other interventions that focus on improving screening uptake. This may help to address health disparities for Somali women in this area.

Comparing Mobile Health Strategies to Improve Medication Adherence for Veterans With Coronary Heart Disease (Mobile4Meds): Protocol for a Mixed-Methods Study.

PubMed

Park, Linda G; Collins, Eileen G; Shim, Janet K; Whooley, Mary A

2017-07-18

Adherence to antiplatelet medications is critical to prevent life threatening complications (ie, stent thrombosis) after percutaneous coronary interventions (PCIs), yet rates of nonadherence range from 21-57% by 12 months. Mobile interventions delivered via text messaging or mobile apps represent a practical and inexpensive strategy to promote behavior change and enhance medication adherence. The Mobile4Meds study seeks to determine whether text messaging or a mobile app, compared with an educational website control provided to all Veterans, can improve adherence to antiplatelet therapy among patients following acute coronary syndrome (ACS) or PCI. The three aims of the study are to: (1) determine preferences for content and frequency of text messaging to promote medication adherence through focus groups; (2) identify the most patient-centered app that promotes adherence, through a content analysis of all commercially available apps for medication adherence and focus groups centered on usability; and (3) compare adherence to antiplatelet medications in Veterans after ACS/PCI via a randomized clinical trial (RCT). We will utilize a mixed-methods design that uses focus groups to achieve the first and second aims (N=32). Patients will be followed for 12 months after being randomly assigned to one of three arms: (1) customized text messaging, (2) mobile app, or (3) website-control groups (N=225). Medication adherence will be measured with electronic monitoring devices, pharmacy records, and self-reports. Enrollment for the focus groups is currently in progress. We expect to enroll patients for the RCT in the beginning of 2018. Determining the efficacy of mobile technology using a Veteran-designed protocol to promote medication adherence will have a significant impact on Veteran health and public health, particularly for individuals with chronic diseases that require strict medication adherence. ClinicalTrials.gov NCT03022669. ©Linda G Park, Eileen G Collins, Janet K Shim, Mary A Whooley. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 18.07.2017.

Income Disparities in the Use of Health Screening Services Among University Students in Korea: A Cross-Sectional Study of 2479 Participants in a University.

PubMed

Lee, Su Hyun; Joh, Hee-Kyung; Kim, Soojin; Oh, Seung-Won; Lee, Cheol Min; Kwon, Hyuktae

2016-05-01

Public health insurance coverage for preventive care in young adults is incomplete in Korea. Few studies have focused on young adults' socioeconomic disparities in preventive care utilization. We aimed to explore household income disparities in the use of different types of health screening services among university students in Korea.This cross-sectional study used a web-based self-administered survey of students at a university in Korea from January to February 2013. To examine the associations between household income levels and health screening service use within the past 2 years, odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using logistic regression with adjustment for various covariables.Of 2479 participants, 45.5% reported using health screening services within 2 years (university-provided screening 32.9%, private sector screening 16.7%, and both 4.1%). Household income levels were not significantly associated with overall rates of health screening service use with a multivariable-adjusted OR (95% CI) in the lowest versus highest income group of 1.12 (0.87-1.45, Ptrend = 0.35). However, we found significantly different associations in specific types of utilized screening services by household income levels. The multivariable-adjusted OR (95% CI) of university-provided health screening service use in the lowest versus highest income level was 1.74 (1.30-2.34; Ptrend < 0.001), whereas the multivariable-adjusted OR (95% CI) of private sector service use in the lowest versus highest income level was 0.45 (0.31-0.66; Ptrend < 0.001).This study demonstrated significant disparities in the types of utilized health screening services by income groups among university students in Korea, although overall rates of health screening service use were similar across income levels. Low-income students were more likely to use university-provided health screening services, and less likely to use private sector screening services. To ensure appropriate preventive care delivery for young adults and to address disparities in disadvantaged groups, the expansion of medical insurance coverage for preventive health care, establishment of a usual source of care, focusing on vulnerable groups, and the development of evidence-based standardized health screening guidelines for young adults are needed.

Income Disparities in the Use of Health Screening Services Among University Students in Korea

PubMed Central

Lee, Su Hyun; Joh, Hee-Kyung; Kim, Soojin; Oh, Seung-Won; Lee, Cheol Min; Kwon, Hyuktae

2016-01-01

Abstract Public health insurance coverage for preventive care in young adults is incomplete in Korea. Few studies have focused on young adults’ socioeconomic disparities in preventive care utilization. We aimed to explore household income disparities in the use of different types of health screening services among university students in Korea. This cross-sectional study used a web-based self-administered survey of students at a university in Korea from January to February 2013. To examine the associations between household income levels and health screening service use within the past 2 years, odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using logistic regression with adjustment for various covariables. Of 2479 participants, 45.5% reported using health screening services within 2 years (university-provided screening 32.9%, private sector screening 16.7%, and both 4.1%). Household income levels were not significantly associated with overall rates of health screening service use with a multivariable-adjusted OR (95% CI) in the lowest versus highest income group of 1.12 (0.87–1.45, Ptrend = 0.35). However, we found significantly different associations in specific types of utilized screening services by household income levels. The multivariable-adjusted OR (95% CI) of university-provided health screening service use in the lowest versus highest income level was 1.74 (1.30–2.34; Ptrend < 0.001), whereas the multivariable-adjusted OR (95% CI) of private sector service use in the lowest versus highest income level was 0.45 (0.31–0.66; Ptrend < 0.001). This study demonstrated significant disparities in the types of utilized health screening services by income groups among university students in Korea, although overall rates of health screening service use were similar across income levels. Low-income students were more likely to use university-provided health screening services, and less likely to use private sector screening services. To ensure appropriate preventive care delivery for young adults and to address disparities in disadvantaged groups, the expansion of medical insurance coverage for preventive health care, establishment of a usual source of care, focusing on vulnerable groups, and the development of evidence-based standardized health screening guidelines for young adults are needed. PMID:27196475

Preventing sight loss in older people. A qualitative study exploring barriers to the uptake of regular sight tests of older people living in socially deprived communities in South Wales.

PubMed

Biddyr, S; Jones, A

2015-02-01

This paper describes research findings that try to understand some of the reasons that prevent older people in deprived communities in South Wales from accessing NHS funded sight tests and leads to a discussion of suitable interventions that seek to improve access to primary eye care services and prevent avoidable sight loss. Data were collected from eight focus groups (n = 63) of mixed gender and ages (60-80+ years), of white origin living in deprived communities in South Wales. Individuals were recruited for the focus groups by extensively publicizing the project, with a range of health and older people's community services and groups such as sheltered housing complexes, stroke support groups and coffee morning groups. The study included people who attended optometry services and people not engaged with services. A purposive sampling technique summarizes the sampling approach taken, an approach which the team utilized to recruit 'information rich' cases, namely individuals, groups and organizations that provided the greatest insight into the research question. Focus groups were recorded and transcribed verbatim. Data underwent thematic content analysis and subsequent interpretations were corroborated by expert advisors and a project steering group. Cost was perceived as a significant barrier to accessing sight tests, particularly in relation to purchasing glasses. Other barriers included the perceived pressure to buy glasses associated with visits to the optometrists; poor understanding of the purpose of a sight test in a health prevention context and acceptance of deteriorating sight loss due to the ageing process. Areas of improvement for the delivery of preventative eye health services to older people are identified, as are areas for reflection on the part of those who work within the eye health industry. Copyright © 2014 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Factors Affecting Utilization of Family Planning Services in a Post-Conflict Setting, South Sudan: A Qualitative Study

PubMed Central

Ahmed, Waled Amen Mohammed; Shokai, Sara Boutros; Abduelkhair, Insaf Hassan; Boshra, Amira Yahia

2015-01-01

This study aims to explore and examine the conjectures surrounding the utilization of family planning services among currently married couples of childbearing age in Renk County. This study has adopted a qualitative method to collect data on factors affecting the utilization of family planning services through focus group discussions and in-depth interviews, in rural and urban areas of Renk County. It targeted married women, men as well as unmarried men and women. The researchers conducted nine focus group discussions and nine interviews at both Jelhak (rural setting) and Renk (urban setting). The results suggested that the people of Renk County prefer to have large families and therefore choose not to use family planning methods. The data collected was analyzed by means of thematic analysis. This included the construction of a thematic framework, coding, editing and categorization of available data as well as the creation of sub-themes. The result also suggested that perception is a main factor that affects utilization of family planning services with a majority of the people in Renk and Jelhak preferring to have many children in order to increase the family size for some reasons. These are linked to religion, social stigma and taboo that are attached to childless people or users of family planning methods for birth control purposes. The responses revealed some variation in perception between rural (Jelhak) and urban (Renk) areas. Respondents from Renk area reported that some people use family planning services for economic reasons that involve alleviation of financial difficulties and provision of better education when the family size is small. On the other hand, rural people from Jelhak perceive family planning to be socially un-acceptable. Furthermore, men and women of Jelhak reported that after each birth of a child, married couples avoid sexual relationship for a period of two years as means of family planning. Women of both Urban and Rural settings reported intentions to use conventional methods of family planning without the knowledge of their spouses. PMID:29546129

Factors Affecting Utilization of Family Planning Services in a Post-Conflict Setting, South Sudan: A Qualitative Study.

PubMed

Ahmed, Waled Amen Mohammed; Shokai, Sara Boutros; Abduelkhair, Insaf Hassan; Boshra, Amira Yahia

2015-01-01

This study aims to explore and examine the conjectures surrounding the utilization of family planning services among currently married couples of childbearing age in Renk County. This study has adopted a qualitative method to collect data on factors affecting the utilization of family planning services through focus group discussions and in-depth interviews, in rural and urban areas of Renk County. It targeted married women, men as well as unmarried men and women. The researchers conducted nine focus group discussions and nine interviews at both Jelhak (rural setting) and Renk (urban setting). The results suggested that the people of Renk County prefer to have large families and therefore choose not to use family planning methods. The data collected was analyzed by means of thematic analysis. This included the construction of a thematic framework, coding, editing and categorization of available data as well as the creation of sub-themes. The result also suggested that perception is a main factor that affects utilization of family planning services with a majority of the people in Renk and Jelhak preferring to have many children in order to increase the family size for some reasons. These are linked to religion, social stigma and taboo that are attached to childless people or users of family planning methods for birth control purposes. The responses revealed some variation in perception between rural (Jelhak) and urban (Renk) areas. Respondents from Renk area reported that some people use family planning services for economic reasons that involve alleviation of financial difficulties and provision of better education when the family size is small. On the other hand, rural people from Jelhak perceive family planning to be socially un-acceptable. Furthermore, men and women of Jelhak reported that after each birth of a child, married couples avoid sexual relationship for a period of two years as means of family planning. Women of both Urban and Rural settings reported intentions to use conventional methods of family planning without the knowledge of their spouses.

The development and evaluation of a five-language multi-perspective standardised measure: clinical decision-making involvement and satisfaction (CDIS)

PubMed Central

2014-01-01

Background The aim of this study was to develop and evaluate a brief quantitative five-language measure of involvement and satisfaction in clinical decision-making (CDIS) – with versions for patients (CDIS-P) and staff (CDIS-S) – for use in mental health services. Methods An English CDIS was developed by reviewing existing measures, focus groups, semistructured interviews and piloting. Translations into Danish, German, Hungarian and Italian followed the International Society for Pharmacoeconomics and Outcomes Research (ISPOR) Task Force principles of good practice for translation and cultural adaptation. Psychometricevaluation involved testing the measure in secondary mental health services in Aalborg, Debrecen, London, Naples, Ulm and Zurich. Results After appraising 14 measures, the Control Preference Scale and Satisfaction With Decision-making English-language scales were modified and evaluated in interviews (n = 9), focus groups (n = 22) and piloting (n = 16). Translations were validated through focus groups (n = 38) and piloting (n = 61). A total of 443 service users and 403 paired staff completed CDIS. The Satisfaction sub-scale had internal consistency of 0.89 (0.86-0.89 after item-level deletion) for staff and 0.90 (0.87-0.90) for service users, both continuous and categorical (utility) versions were associated with symptomatology and both staff-rated and service userrated therapeutic alliance (showing convergent validity), and not with social disability (showing divergent validity), and satisfaction predicted staff-rated (OR 2.43, 95%CI 1.54- 3.83 continuous, OR 5.77, 95%CI 1.90-17.53 utility) and service user-rated (OR 2.21, 95%CI 1.51-3.23 continuous, OR 3.13, 95%CI 1.10-8.94 utility) decision implementation two months later. The Involvement sub-scale had appropriate distribution and no floor or ceiling effects, was associated with stage of recovery, functioning and quality of life (staff only) (showing convergent validity), and not with symptomatology or social disability (showing divergent validity), and staff-rated passive involvement by the service user predicted implementation (OR 3.55, 95%CI 1.53-8.24). Relationships remained after adjusting for clustering by staff. Conclusions CDIS demonstrates adequate internal consistency, no evidence of item redundancy, appropriate distribution, and face, content, convergent, divergent and predictive validity. It can be recommended for research and clinical use. CDIS-P and CDIS-S in all 3 five languages can be downloaded at http://www.cedar-net.eu/instruments. Trial registration ISRCTN75841675. PMID:25066212

The Basic Shelf Experience: a comprehensive evaluation.

PubMed

Dewolfe, Judith A; Greaves, Gaye

2003-01-01

The Basic Shelf Experience is a program designed to assist people living on limited incomes to make better use of their food resources. The purpose of this research was to learn if the Basic Shelf Experience program helps such people to 1. utilize food resources more effectively and 2. cope, through group support, with poverty-associated stressors that influence food security. Both quantitative and qualitative methods were used to evaluate the program objectives. Participants completed a questionnaire at the beginning and end of the six-week program. The questionnaire asked about their food access, food security, and feelings about themselves. Participants returned for a focus group discussion and completed the questionnaire again three months after the program ended. The focus group was designed to elicit information about perceived changes, if any, attributed to the program. Forty-two people completed the questionnaires pre-program and 20 post-program; 17 participated in the three-month follow-up session. While results from quantitative data analysis indicate that program objectives were not met, qualitative data provide evidence that the program did achieve its stated objectives. Our results suggest such programs as the Basic Shelf Experience can assist people living on limited incomes to achieve food security.

Nonequilibrium statistical mechanics Brussels-Austin style

NASA Astrophysics Data System (ADS)

Bishop, Robert C.

The fundamental problem on which Ilya Prigogine and the Brussels-Austin Group have focused can be stated briefly as follows. Our observations indicate that there is an arrow of time in our experience of the world (e.g., decay of unstable radioactive atoms like uranium, or the mixing of cream in coffee). Most of the fundamental equations of physics are time reversible, however, presenting an apparent conflict between our theoretical descriptions and experimental observations. Many have thought that the observed arrow of time was either an artifact of our observations or due to very special initial conditions. An alternative approach, followed by the Brussels-Austin Group, is to consider the observed direction of time to be a basic physical phenomenon due to the dynamics of physical systems. This essay focuses mainly on recent developments in the Brussels-Austin Group after the mid-1980s. The fundamental concerns are the same as in their earlier approaches (subdynamics, similarity transformations), but the contemporary approach utilizes rigged Hilbert space (whereas the older approaches used Hilbert space). While the emphasis on nonequilibrium statistical mechanics remains the same, their more recent approach addresses the physical features of large Poincaré systems, nonlinear dynamics and the mathematical tools necessary to analyze them.

Feedback data sources that inform physician self-assessment.

PubMed

Lockyer, Jocelyn; Armson, Heather; Chesluk, Benjamin; Dornan, Timothy; Holmboe, Eric; Loney, Elaine; Mann, Karen; Sargeant, Joan

2011-01-01

Self-assessment is a process of interpreting data about one's performance and comparing it to explicit or implicit standards. To examine the external data sources physicians used to monitor themselves. Focus groups were conducted with physicians who participated in three practice improvement activities: a multisource feedback program; a program providing patient and chart audit data; and practice-based learning groups. We used grounded theory strategies to understand the external sources that stimulated self-assessment and how they worked. Data from seven focus groups (49 physicians) were analyzed. Physicians used information from structured programs, other educational activities, professional colleagues, and patients. Data were of varying quality, often from non-formal sources with implicit (not explicit) standards. Mandatory programs elicited variable responses, whereas data and activities the physicians selected themselves were more likely to be accepted. Physicians used the information to create a reference point against which they could weigh their performance using it variably depending on their personal interpretation of its accuracy, application, and utility. Physicians use and interpret data and standards of varying quality to inform self-assessment. Physicians may benefit from regular and routine feedback and guidance on how to seek out data for self-assessment.

Impact of decentralization on health services in Uganda: a look at facility utilization, prescribing and availability of essential drugs.

PubMed

Anokbonggo, W W; Ogwal-Okeng, J W; Obua, C; Aupont, O; Ross-Degnan, D

2004-02-01

Uganda began implementation of a structural adjustment programme (SAP) in July 1994 in order to improve social services. The decentralization of health services administration to district level was intended to improve the quality of health services and pharmaceutical supplies in the hospitals, with resultant increase in the level of utilization of health facilities. This study evaluated the impact of the decentralization policy on health facility utilization; availability of essential drugs, and prescribing patterns for acute respiratory infections (ARI), diarrhoea, and malaria in two district hospitals in Uganda. Mixed method evaluation design, involving both quantitative and qualitative methods. Time series analyses of data from utilization, pharmacy stock, and prescription records before and after the policy change. Key informant interviews and focus group discussions to obtain information on perceptions and attitude of stakeholders on the process of the policy implementation. STUDY SETTING AND POPULATION: The study was conducted in two district hospitals in northern Uganda. A total of seven years of utilization and pharmacy stock data including 5040 patient records from the hospitals were analysed retrospectively. In-depth interviews were conducted among 11 politicians from each district; 100 open-ended questionnaires were administered to patients in each hospital; 86 health care workers were interviewed using semi-structured questionnaires; and focus group discussions were conducted with 23 health care providers. Facility utilization was evaluated by average monthly attendance in the outpatient department and paediatric ward admissions. Availability was assessed as average number of drugs per month. Prescribing indicator outcomes included: for malaria, percent chloroquine tablets and percent chloroquine injection; for ARI, percent receiving antibiotics or injections; for diarrhoea, use of oral rehydration salts (ORS), antidiarrhoeal mixtures, and antibiotics. The average number of drugs prescribed assessed polypharmacy. There was a general increase in patient attendance in both hospitals, although the initial increase later declined in Apac. Drug availability was erratic and not always adequate. The situation was better in Lira where funding for drug procurement was more accessible. Prescribing patterns varied, with improvement in some indicators, while others showed no change or even worsened. The decentralization policy led to increased utilization of health facilities. The perception was that the policy was good because it "empowered the community in terms of creating a sense of responsibility in the stakeholders, and a sense of ownership that facilitated sustainability" of public institutions. In spite of the views expressed by the stakeholders, the policy failed to improve drug shortages, inefficient utilization of resources, and low morale among hospital staff. Staff should be re-trained and better remunerated in order to cope with the implementation of the policy. Local politicians should clearly understand their roles and responsibility under the new policy. Efficient utilization of funds at all levels of the district administrative structures should be ensured.

Immigration and HIV/AIDS in the New York Metropolitan Area.

PubMed

Shedlin, Michele G; Drucker, Ernest; Decena, Carlos U; Hoffman, Susie; Bhattacharya, Gauri; Beckford, Sharlene; Barreras, Ricardo

2006-01-01

Because the HIV pandemic undergoes continual change in its locations and affected populations, it is crucial to study HIV risk behaviors among mobile and immigrant groups within and across borders. The impact of cross-cultural migrations and the importance of studying that impact in terms of demographic characteristics as well as cultural and environmental factors has not received adequate attention in public health research. This collaborative analysis utilizes data from three studies of immigrant groups in New York to describe and compare these factors that provide the context for risk and prevention of HIVAIDS and other health challenges. Data discussed were obtained utilizing multi-method approaches to identify and describe HIV risks among both new and more established immigrant populations within the urban settings of North America, with NYC as a central focus. Demographic and epidemiological data situate the analysis within the larger contexts of US migration and the HIV/AIDS epidemic in NYC. The authors identify risk and protective factors embedded to varying degrees in immigrants' multiple cultures and sub-cultures. The three populations studied include: 1) new Hispanic immigrants from the Dominican Republic, Mexico and Central America; 2) West Indian (Caribbean) immigrants from Jamaica, Trinidad/Tobago and other anglophone Caribbean nations; and 3) South Asian immigrants from India (Indian Americans). The paper seeks differences and commonalities, focusing on the social, attitudinal and behavioral factors that contribute to increased HIV/AIDS vulnerability among these populations. The data presented also identify some of the attitudes and behaviors of individuals and groups, as well as other facilitators and obstacles to transmission for immigrants as they adapt to new environments. Topics addressed include factors affecting HIV/AIDS vulnerability of immigrant groups, goals and expectations, health and mental heath issues, gender role change, sexual risk, alcohol and other drug use, perception of HIV/AIDS risk and implications for prevention.

Longitudinal changes in microstructural white matter metrics in Alzheimer's disease.

PubMed

Mayo, Chantel D; Mazerolle, Erin L; Ritchie, Lesley; Fisk, John D; Gawryluk, Jodie R

2017-01-01

Alzheimer's disease (AD) is a progressive neurodegenerative disorder. Current avenues of AD research focus on pre-symptomatic biomarkers that will assist with early diagnosis of AD. The majority of magnetic resonance imaging (MRI) based biomarker research to date has focused on neuronal loss in grey matter and there is a paucity of research on white matter. Longitudinal DTI data from the Alzheimer's Disease Neuroimaging Initiative 2 database were used to examine 1) the within-group microstructural white matter changes in individuals with AD and healthy controls at baseline and year one; and 2) the between-group microstructural differences in individuals with AD and healthy controls at both time points. 1) Within-group: longitudinal Tract-Based Spatial Statistics revealed that individuals with AD and healthy controls both had widespread reduced fractional anisotropy (FA) and increased mean diffusivity (MD) with changes in the hippocampal cingulum exclusive to the AD group. 2) Between-group: relative to healthy controls, individuals with AD had lower FA and higher MD in the hippocampal cingulum, as well as the corpus callosum, internal and external capsule; corona radiata; posterior thalamic radiation; superior and inferior longitudinal fasciculus; fronto-occipital fasciculus; cingulate gyri; fornix; uncinate fasciculus; and tapetum. The current results indicate that sensitivity to white matter microstructure is a promising avenue for AD biomarker research. Additional longitudinal studies on both white and grey matter are warranted to further evaluate potential clinical utility.

Lives in isolation: stories and struggles of low-income African American women with panic disorder.

PubMed

Johnson, Michael; Mills, Terry L; Deleon, Jessica M; Hartzema, Abraham G; Haddad, Judella

2009-01-01

Research evidence points to the existence of racial-ethnic disparities in both access to and quality of mental health services for African Americans with panic disorder. Current panic disorder evaluation and treatment paradigms are not responsive to the needs of many African Americans. The primary individual, social, and health-care system factors that limit African Americans' access to care and response to treatment are not well understood. Low-income African American women with panic disorder participated in a series of focus-group sessions designed to elicit (1) their perspectives regarding access and treatment barriers and (2) their recommendations for designing a culturally consistent panic treatment program. Fear of confiding to others about panic symptoms, fear of social stigma, and lack of information about panic disorder were major individual barriers. Within their social networks, stigmatizing attitudes toward mental illness and the mentally ill, discouragement about the use of psychiatric medication, and perceptions that symptoms were the result of personal or spiritual weakness had all interfered with the participants' treatment seeking efforts and contributed to a common experience of severe social isolation. None of the focus-group members had developed fully effective therapeutic relationships with either medical or mental health providers. They described an unmet need for more interactive and culturally authentic relationships with treatment providers. Although the focus-group sessions were not intended to be therapeutic, the women reported that participation in the meetings had been an emotionally powerful and beneficial experience. They expressed a strong preference for the utilization of female-only, panic disorder peer-support groups as an initial step in the treatment/recovery process. Peer-support groups for low-income African American women with panic disorder could address many of the identified access and treatment barriers.

Integrated Cognitive Behavioral Therapy Versus Cognitive Processing Therapy for Adults With Depression, Substance Use Disorder, and Trauma.

PubMed

Haller, Moira; Norman, Sonya B; Cummins, Kevin; Trim, Ryan S; Xu, Xiaomin; Cui, Ruifeng; Allard, Carolyn B; Brown, Sandra A; Tate, Susan R

2016-03-01

The comorbidity of substance use disorder (SUD), depression, and PTSD is common among veterans. Prior research has shown that among veterans with SUD and depression, those with PTSD did not maintain cognitive-behavioral treatment gains as well as those without PTSD. Thus, the current study was designed to evaluate whether adding trauma-focused treatment following an initial group-based integrated cognitive behavioral treatment (ICBT) for SUD and depression improved treatment outcomes. Participants were 123 veterans (89% male) recruited from the VA San Diego Healthcare System. All participants received ICBT in twice weekly, group-delivered sessions for 12 weeks (Phase 1). Participants were then randomized to receive 12 sessions of individual follow-up sessions (Phase 2) utilizing either ICBT or cognitive processing therapy that was modified to integrate SUD treatment (CPT-M). Results indicated that PTSD and depression symptoms slightly improved at the end of Phase 1 group ICBT and further improved through Phase 2 individual treatment (except for participants without PTSD who received CPT-M), with treatment gains maintained one year later. Substance use significantly improved at the end of Phase 1 group ICBT and these improvements were maintained through Phase 2 and the one year follow-up. Participants in the trauma-focused Phase 2 treatment (CPT-M) exhibited similar levels of symptom reduction and maintenance of treatment gains as those in the non-trauma-focused Phase 2 treatment (ICBT). However, there was a slight advantage for Phase 2 CPT-M over Phase 2 ICBT with respect to heavy drinking outcomes for individuals with PTSD. Overall, the combination of group ICBT followed by either CPT-M or ICBT individual therapy appears to be effective for veterans with depression, SUD, and trauma history. Copyright © 2015. Published by Elsevier Inc.

Identifying and Understanding the Gaps in Care Experienced by Adolescent and Young Adult Cancer Patients at the University of Iowa Hospitals and Clinics.

PubMed

Mobley, Erin M; Foster, Kristin J; Terry, William W

2018-06-20

In an effort to counteract the differences in improvement in survival rates of adolescents and young adults (AYA), compared to other age groups with cancer, the University of Iowa Hospitals and Clinics established an AYA cancer program. This study was conducted to gather feedback from AYAs in an effort to generate actionable data for program development. The target population included patients aged 13-31 treated for malignancy in one of the following disease sites: central nervous system, leukemia, lymphoma, neuroendocrine, sarcoma, and thyroid. A series of four focus groups was held to identify and describe gaps in care and provide suggestions for program development. A convergent parallel mixed-methods design was used. Qualitative data were derived from focus group discussion and free-response survey questions, while quantitative data were derived from objective survey questions and electronic medical record data. Across the four focus groups, 24 different AYAs participated, ranging from 8 to 19 individuals per session. Topics discussed included the following: communication, treatment experience, and overall AYA program; finances, work and school, and late effects; relationships, emotions, and spirituality; and body image, infertility, sexuality, risky behavior, and suicide. The results of the analyses corroborated what makes AYAs different from other age groups. The primary theme identified was the unique relationships of AYAs, which can be thought of along a continuum. Information obtained from these analyses has been used to inform specific projects within the development of the AYA program to address patient-identified gaps. For AYAs, the importance of relationships along a continuum should be considered when developing an AYA program, in addition to potential policy or health service research utilization in the future.

Burnout and use of HIV services among health care workers in Lusaka District, Zambia: a cross-sectional study

PubMed Central

Kruse, Gina R; Chapula, Bushimbwa Tambatamba; Ikeda, Scott; Nkhoma, Mavis; Quiterio, Nicole; Pankratz, Debra; Mataka, Kaluba; Chi, Benjamin H; Bond, Virginia; Reid, Stewart E

2009-01-01

Background Well-documented shortages of health care workers in sub-Saharan Africa are exacerbated by the increased human resource demands of rapidly expanding HIV care and treatment programmes. The successful continuation of existing programmes is threatened by health care worker burnout and HIV-related illness. Methods From March to June 2007, we studied occupational burnout and utilization of HIV services among health providers in the Lusaka public health sector. Providers from 13 public clinics were given a 36-item, self-administered questionnaire and invited for focus group discussions and key-informant interviews. Results Some 483 active clinical staff completed the questionnaire (84% response rate), 50 staff participated in six focus groups, and four individuals gave interviews. Focus group participants described burnout as feeling overworked, stressed and tired. In the survey, 51% reported occupational burnout. Risk factors were having another job (RR 1.4 95% CI 1.2–1.6) and knowing a co-worker who left in the last year (RR 1.6 95% CI 1.3–2.2). Reasons for co-worker attrition included: better pay (40%), feeling overworked or stressed (21%), moving away (16%), death (8%) and illness (5%). When asked about HIV testing, 370 of 456 (81%) reported having tested; 240 (50%) tested in the last year. In contrast, discussion groups perceived low testing rates. Both discussion groups and survey respondents identified confidentiality as the prime reason for not undergoing HIV testing. Conclusion In Lusaka primary care clinics, overwork, illness and death were common reasons for attrition. Programmes to improve access, acceptability and confidentiality of health care services for clinical providers and to reduce workplace stress could substantially affect workforce stability. PMID:19594917

Narrative therapy with an emotional approach for people with depression: Improved symptom and cognitive-emotional outcomes.

PubMed

Seo, M; Kang, H S; Lee, Y J; Chae, S M

2015-08-01

Narrative therapy is a useful approach in the treatment of depression that allows that person to 're-author' his/her life stories by focusing on positive interpretations, and such focus on positive emotions is a crucial component of treatment for depression. This paper evaluates narrative therapy with an emotional approach (NTEA) as a therapeutic modality that could be used by nurses for persons with depression. A nurse-administered NTEA intervention for people with depression appears effective in increasing cognitive-emotional outcomes, such as hope, positive emotions and decreasing symptoms of depression. Thus, NTEA can be a useful nursing intervention strategy for people with depression. Narrative therapy, which allows a person to 're-author' his/her life stories by focusing on positive interpretations, and emotion-focused therapy, which enables the person to realize his/her emotions, are useful approaches in the treatment of depression. Narrative therapy with an emotional approach (NTEA) aims to create new positive life narratives that focus on alternative stories instead of negative stories. The purpose of this study was to evaluate the effects of the NTEA programme on people with depression utilizing a quasi-experimental design. A total of 50 patients (experimental 24, control 26) participated in the study. The experimental group completed eight sessions of the NTEA programme. The effects of the programme were measured using a self-awareness scale, the Nowotny Hope Scale, the Positive Affect and Negative Affect Scale, and the Center for Epidemiological Studies-Depression Scale. The two groups were homogeneous. There were significant differences in hope, positive and negative emotions, and depression between the experimental and control group. The results established that NTEA can be a useful nursing intervention strategy for people with depression by focusing on positive experiences and by helping depressed patients develop a positive identity through authoring affirmative life stories. © 2015 John Wiley & Sons Ltd.

The Impact of Local Immigration Enforcement Policies on the Health of Immigrant Hispanics/Latinos in the United States

PubMed Central

Mann, Lilli; Simán, Florence M.; Song, Eunyoung; Alonzo, Jorge; Downs, Mario; Lawlor, Emma; Martinez, Omar; Sun, Christina J.; O’Brien, Mary Claire; Reboussin, Beth A.; Hall, Mark A.

2015-01-01

Objectives. We sought to understand how local immigration enforcement policies affect the utilization of health services among immigrant Hispanics/Latinos in North Carolina. Methods. In 2012, we analyzed vital records data to determine whether local implementation of section 287(g) of the Immigration and Nationality Act and the Secure Communities program, which authorizes local law enforcement agencies to enforce federal immigration laws, affected the prenatal care utilization of Hispanics/Latinas. We also conducted 6 focus groups and 17 interviews with Hispanic/Latino persons across North Carolina to explore the impact of immigration policies on their utilization of health services. Results. We found no significant differences in utilization of prenatal care before and after implementation of section 287(g), but we did find that, in individual-level analysis, Hispanic/Latina mothers sought prenatal care later and had inadequate care when compared with non-Hispanic/Latina mothers. Participants reported profound mistrust of health services, avoiding health services, and sacrificing their health and the health of their family members. Conclusions. Fear of immigration enforcement policies is generalized across counties. Interventions are needed to increase immigrant Hispanics/Latinos’ understanding of their rights and eligibility to utilize health services. Policy-level initiatives are also needed (e.g., driver’s licenses) to help undocumented persons access and utilize these services. PMID:25521886

IDENTIFYING SEXUAL HEALTH PROTECTIVE FACTORS AMONG NORTHERN PLAINS AMERICAN INDIAN YOUTH: AN ECOLOGICAL APPROACH UTILIZING MULTIPLE PERSPECTIVES

PubMed Central

Griese, Emily R.; Kenyon, DenYelle Baete; McMahon, Tracey R.

2017-01-01

This study examined aspects of the sociocultural context in which American Indian (AI) teen pregnancy occurs, focusing specifically on protective factors for Northern Plains AI youth. Principles of community-based participatory research guided the qualitative data collection from 185 community members (focus groups with AI youth, youth parents, and elders; interviews with health care providers and school personnel) from a reservation and an urban community. Results indicated three protective systems impacted the sexual health and behaviors of AI youth: school, family, and enculturation. These findings provide a better understanding of how specific protective factors within these systems may buffer AI youth from involvement in risky sexual behaviors and work to inform culturally relevant prevention and intervention efforts. PMID:27536896

A Systematic Literature Mapping of Risk Analysis of Big Data in Cloud Computing Environment

NASA Astrophysics Data System (ADS)

Bee Yusof Ali, Hazirah; Marziana Abdullah, Lili; Kartiwi, Mira; Nordin, Azlin; Salleh, Norsaremah; Sham Awang Abu Bakar, Normi

2018-05-01

This paper investigates previous literature that focusses on the three elements: risk assessment, big data and cloud. We use a systematic literature mapping method to search for journals and proceedings. The systematic literature mapping process is utilized to get a properly screened and focused literature. With the help of inclusion and exclusion criteria, the search of literature is further narrowed. Classification helps us in grouping the literature into categories. At the end of the mapping, gaps can be seen. The gap is where our focus should be in analysing risk of big data in cloud computing environment. Thus, a framework of how to assess the risk of security, privacy and trust associated with big data and cloud computing environment is highly needed.

Remote sensing information for fire management and fire effects assessment

NASA Astrophysics Data System (ADS)

Chuvieco, Emilio; Kasischke, Eric S.

2007-03-01

Over the past decade, much research has been carried out on the utilization of advanced geospatial technologies (remote sensing and geographic information systems) in the fire science and fire management disciplines. Recent advances in these technologies were the focus of a workshop sponsored by the EARSEL special interest group (SIG) on forest fires (FF-SIG) and the Global Observation of Forest and Land Cover Dynamics (GOFC-GOLD) fire implementation team. Here we summarize the framework and the key findings of papers submitted from this meeting and presented in this special section. These papers focus on the latest advances for near real-time monitoring of active fires, prediction of fire hazards and danger, monitoring of fuel moisture, mapping of fuel types, and postfire assessment of the impacts from fires.

Sit Still and Pay Attention! Trunk Movement and Attentional Resources in Infants with Typical and Delayed Development.

PubMed

Berger, Sarah E; Harbourne, Regina T; Guallpa Lliguichuzhca, Carmen L

2018-02-21

(1) examine infant movement during an early posture (sitting) utilizing a novel video assessment technique; and (2) document the differences between infants with typical development (TD), premature infants with motor delay, and infants with cerebral palsy (CP) during focused and nonfocused attention (NFA). Infants were tested when they began to sit independently. We utilized Eulerian Video Magnification (EVM) to accentuate small trunk and pelvic movements for visual coding from video taken during a natural play task with and without focused attention (FA). Trunk/pelvic movement varied as a function of both motor skill and attention. Infants with TD and CP made fewer trunk movements during periods of FA than NFA. Preterm infants exhibited more trunk/pelvic movement than the other groups and their movement did not differ based on attention type. The EVM technique allowed for replicable coding of real-time "hidden" motor adjustments from video. The capacity to minimize extraneous movements in infants, or "sitting still" may allow greater attention to the task at hand, similar to older children and adults. Premature infants' excessive trunk/pelvic movement that did not adapt to task requirements could, in the long term, impact tasks requiring attentional resources.

Developing an evidence-based public health informatics course.

PubMed

Yu, Xinyu; Xie, Yue; Pan, Xuequn; Mayfield-Johnson, Susan; Whipple, Jessica; Azadbakht, Elena

2015-10-01

This study assessed the need to develop a public health informatics (PHI) introductory course and determine contents of such a course. Community assessments employing focus group interviews and an online survey were utilized to determine course need and content. Results revealed a need to provide PHI training to graduate public health students and suggested broad course content requirements. Results indicated lack of awareness of libraries and librarians as sources of public health information. A graduate PHI course was developed and delivered. Additionally, implementation of a subject guide increased the library's profile.

Functional Modification of Thioether Groups in Peptides, Polypeptides, and Proteins.

PubMed

Deming, Timothy J

2017-03-15

Recent developments in the modification of methionine and other thioether-containing residues in peptides, polypeptides, and proteins are reviewed. Properties and potential applications of the resulting functionalized products are also discussed. While much of this work is focused on natural Met residues, modifications at other side-chain residues have also emerged as new thioether-containing amino acids have been incorporated into peptidic materials. Functional modification of thioether-containing amino acids has many advantages and is a complementary methodology to the widely utilized methods for modification at cysteine residues.

Proceedings: pellet fuels conference

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

Not Available

1995-12-31

The conference brought together professionals from the process- engineered-fuels (PEF), utility, paper, plastics, and boiler industries. Although the last two decades have produced technical breakthroughs, efforts to advance PEF must now focus on increasing commercial breakthroughs. Successful commercialization will depend on increasing supplier, consumer, and regulator confidence and support by demonstrating the performance and value of PEF products. Speakers provided updates on how PEF technology is evolving with respect to technical, economic, and regulatory challenges. Actions critical toward full commercialization of PEF were then considered. Discussion groups addressed materials sourcing, fuel processing and transportation, combustion, and ash handling.

Perceived barriers to utilization of maternal health services in rural Cambodia.

PubMed

Matsuoka, Sadatoshi; Aiga, Hirotsugu; Rasmey, Lon Chan; Rathavy, Tung; Okitsu, Akiko

2010-05-01

The aim of this study was to identify the underlying causes of Cambodian women's non-use of maternal health services provided by skilled birth attendants. A qualitative study of 66 reproductive-age women was conducted in Kampong Cham Province, Cambodia. Data were collected through 30 semi-structured interviews and 6 focus groups. We identified 5 barriers to the utilization of maternal health services: (i) financial barriers; (ii) physical barriers; (iii) cognitive barriers; (iv) organizational barriers; and (v) psychological and socio-cultural barriers. The Cambodian Ministry of Health and its development partners should take these barriers into account when promoting the use of maternal health services. These barriers should be addressed proactively. A successful approach to increasing use of maternal health services should involve changes to both service programs and public education. Copyright (c) 2009 Elsevier Ireland Ltd. All rights reserved.

Post-apartheid challenges: household access and use of health care in South Africa.

PubMed

Gilson, Lucy; McIntyre, Di

2007-01-01

Since 1994 the South African government has placed equity at the heart of its health policy goals. However, there has as yet been surprisingly little assessment of the success of policies in reducing inequity. This article provides insights on these issues by applying the Affordability Ladder conceptual framework in synthesizing evidence drawn from a series of household surveys and studies undertaken between 1992 and 2003. These data suggest that, despite policy efforts, inequities in access and utilization between socioeconomic groups remain. Underlying challenges include worsening community perceptions of the quality of publicly provided care and the influence of insurance status on utilization patterns. Further and more detailed evaluation of household-level policy impacts requires both improvements in the quality of South African survey data, particularly in enhancing consistency in survey design over time, and more detailed, focused studies.

Three-dimensional patterning in polymer optical waveguides using focused ion beam milling

NASA Astrophysics Data System (ADS)

Kruse, Kevin; Burrell, Derek; Middlebrook, Christopher

2016-07-01

Waveguide (WG) photonic-bridge taper modules are designed for symmetric planar coupling between silicon WGs and single-mode fibers (SMFs) to minimize photonic chip and packaging footprint requirements with improving broadband functionality. Micromachined fabrication and evaluation of polymer WG tapers utilizing high-resolution focused ion beam (FIB) milling is performed and presented. Polymer etch rates utilizing the FIB and optimal methods for milling polymer tapers are identified for three-dimensional patterning. Polymer WG tapers with low sidewall roughness are manufactured utilizing FIB milling and optically tested for fabrication loss. FIB platforms utilize a focused beam of ions (Ga+) to etch submicron patterns into substrates. Fabricating low-loss polymer WG taper prototypes with the FIB before moving on to mass-production techniques provides theoretical understanding of the polymer taper and its feasibility for connectorization devices between silicon WGs and SMFs.

Utilizing Natural Cognitive Tendencies to Enhance Agricultural Education Programs

ERIC Educational Resources Information Center

Lamm, Alexa J.; Rhodes, Emily B.; Irani, Tracy A.; Roberts, T. Grady; Snyder, Lori J. Unruh; Brendemuhl, Joel

2011-01-01

The influences of cognitive styles have been the focus of research on problems in education for quite some time (Witkin, Moore, Goodenough, & Cox, 1977). In fact, agricultural educators are rapidly increasing the amount of research and education focused on understanding and utilizing cognitive function in an attempt to improve educational…

Developing objectives with multiple stakeholders: adaptive management of horseshoe crabs and Red Knots in the Delaware Bay

USGS Publications Warehouse

McGowan, Conor P.; Lyons, James E.; Smith, David

2015-01-01

Structured decision making (SDM) is an increasingly utilized approach and set of tools for addressing complex decisions in environmental management. SDM is a value-focused thinking approach that places paramount importance on first establishing clear management objectives that reflect core values of stakeholders. To be useful for management, objectives must be transparently stated in unambiguous and measurable terms. We used these concepts to develop consensus objectives for the multiple stakeholders of horseshoe crab harvest in Delaware Bay. Participating stakeholders first agreed on a qualitative statement of fundamental objectives, and then worked to convert those objectives to specific and measurable quantities, so that management decisions could be assessed. We used a constraint-based approach where the conservation objectives for Red Knots, a species of migratory shorebird that relies on horseshoe crab eggs as a food resource during migration, constrained the utility of crab harvest. Developing utility functions to effectively reflect the management objectives allowed us to incorporate stakeholder risk aversion even though different stakeholder groups were averse to different or competing risks. While measurable objectives and quantitative utility functions seem scientific, developing these objectives was fundamentally driven by the values of the participating stakeholders.

Developing Objectives with Multiple Stakeholders: Adaptive Management of Horseshoe Crabs and Red Knots in the Delaware Bay

NASA Astrophysics Data System (ADS)

McGowan, Conor P.; Lyons, James E.; Smith, David R.

2015-04-01

Structured decision making (SDM) is an increasingly utilized approach and set of tools for addressing complex decisions in environmental management. SDM is a value-focused thinking approach that places paramount importance on first establishing clear management objectives that reflect core values of stakeholders. To be useful for management, objectives must be transparently stated in unambiguous and measurable terms. We used these concepts to develop consensus objectives for the multiple stakeholders of horseshoe crab harvest in Delaware Bay. Participating stakeholders first agreed on a qualitative statement of fundamental objectives, and then worked to convert those objectives to specific and measurable quantities, so that management decisions could be assessed. We used a constraint-based approach where the conservation objectives for Red Knots, a species of migratory shorebird that relies on horseshoe crab eggs as a food resource during migration, constrained the utility of crab harvest. Developing utility functions to effectively reflect the management objectives allowed us to incorporate stakeholder risk aversion even though different stakeholder groups were averse to different or competing risks. While measurable objectives and quantitative utility functions seem scientific, developing these objectives was fundamentally driven by the values of the participating stakeholders.

Levers supporting tariff growth for water services: evidence from a contingent valuation analysis.

PubMed

Guerrini, Andrea; Vigolo, Vania; Romano, Giulia; Testa, Federico

2018-02-01

The backwardness of the water utilities sector necessitates urgent investment in infrastructure to improve water quality and efficiency in water supply networks. A policy of tariff growth represents the main source to sustain such investments. Therefore, customer engagement in the form of willingness to pay (WTP) is highly desirable by water utilities to obtain social legitimization and support. This study examines the determinants of consumers' WTP for improvement programs for three drinking water issues: quality of water sources, renewal of water mains, and building of new wastewater treatment plants. The study is based on a survey conducted among a sample of 587 customers of a water utility located in the province of Verona in the north of Italy. The contingence valuation method is used to measure WTP. Specifically, an ordinal logistic regression model yields the following significant determinants of WTP: quality of water and services provided, preference for privatization of the water utility, sustainable consumption of water, and some socio-demographic variables. The findings provide interesting insights into the drivers of WTP as well as managerial recommendations for water utilities. In particular, the findings show that water utilities need to improve service and water quality to increase customers' acceptance of tariff growth. In addition, utilities should invest in customer education and communication activities focusing on specific age groups (e.g., older customers) to enhance their WTP. Finally, communication strategies should reinforce the possible role of liberalization and privatization in supporting infrastructure investments. Copyright © 2017 Elsevier Ltd. All rights reserved.

Phylotype Dynamics of Bacterial P Utilization Genes in Microbialites and Bacterioplankton of a Monomictic Endorheic Lake.

PubMed

Valdespino-Castillo, Patricia M; Alcántara-Hernández, Rocío J; Merino-Ibarra, Martín; Alcocer, Javier; Macek, Miroslav; Moreno-Guillén, Octavio A; Falcón, Luisa I

2017-02-01

Microbes can modulate ecosystem function since they harbor a vast genetic potential for biogeochemical cycling. The spatial and temporal dynamics of this genetic diversity should be acknowledged to establish a link between ecosystem function and community structure. In this study, we analyzed the genetic diversity of bacterial phosphorus utilization genes in two microbial assemblages, microbialites and bacterioplankton of Lake Alchichica, a semiclosed (i.e., endorheic) system with marked seasonality that varies in nutrient conditions, temperature, dissolved oxygen, and water column stability. We focused on dissolved organic phosphorus (DOP) utilization gene dynamics during contrasting mixing and stratification periods. Bacterial alkaline phosphatases (phoX and phoD) and alkaline beta-propeller phytases (bpp) were surveyed. DOP utilization genes showed different dynamics evidenced by a marked change within an intra-annual period and a differential circadian pattern of expression. Although Lake Alchichica is a semiclosed system, this dynamic turnover of phylotypes (from lake circulation to stratification) points to a different potential of DOP utilization by the microbial communities within periods. DOP utilization gene dynamics was different among genetic markers and among assemblages (microbialite vs. bacterioplankton). As estimated by the system's P mass balance, P inputs and outputs were similar in magnitude (difference was <10 %). A theoretical estimation of water column P monoesters was used to calculate the potential P fraction that can be remineralized on an annual basis. Overall, bacterial groups including Proteobacteria (Alpha and Gamma) and Bacteroidetes seem to be key participants in DOP utilization responses.

Micro enterprise initiative in water sector and poverty reduction .

PubMed

Jose, T K

2003-01-01

The author reports on the Kerala model for water sector development, broadly adopted as a role model for poverty reduction and build up of social capital. It is a community based organisation with its focus on facilitating a stable income to the poor, and composed of a People's Plan Campaign, the Kudumbashree (women-based poverty eradication programme), with grassroot level neighbourhood groups, federated into an area development society. It promotes savings and credit channelling, capacity building and entrepreneurship development. Activities include awareness raising on water conservation and hygiene, utilization of student power, promotion of small, cheap and low technology projects that people can understand and undertake (small reservoirs, tanks, rainwater harvesting structures, water meters), as well as microenterprises, and training of women-based repair groups.

Low-cost composited accelerants for anaerobic digestion of dairy manure: Focusing on methane yield, digestate utilization and energy evaluation.

PubMed

Zhang, Chen; Yun, Sining; Li, Xue; Wang, Ziqi; Xu, Hongfei; Du, Tingting

2018-05-11

To improve the methane yield and digestate utilization of anaerobic digestion (AD), low-cost composited accelerants consisting of urea (0.2-0.5%), bentonite (0.5-0.8%), active carbon (0.6-0.9%), and plant ash (0.01-0.3%) were designed and tested in batch experiments. Total biogas yield (485.7-681.9 mL/g VS) and methane content (63.0-66.6%) were remarkably enhanced in AD systems by adding accelerants compared to those of control group (361.9 mL/g VS, 59.4%). Composited accelerant addition led to the highest methane yield (454.1 mL/g VS), more than double that of control group. The TS, VS, and CODt removal rates (29.7-55.3%, 50.9-63.0%, and 46.8-69.1%) for AD with accelerants were much higher than control group (26.2%, 37.1%, and 39.6%). The improved digestate stability and enhanced fertilizer nutrient content (4.95-5.66%) confirmed that the digestate of AD systems with composited accelerants could safely serve as a potential component of bioorganic fertilizer. These findings open innovative avenues in composited accelerant development and application. Copyright © 2018 Elsevier Ltd. All rights reserved.

Professional online community membership and participation among healthcare providers: An extension to nurse practitioners and physician assistants.

PubMed

Betts, Kevin R; O'Donoghue, Amie C; Aikin, Kathryn J; Kelly, Bridget J; Boudewyns, Vanessa

2016-12-01

Professional online communities allow healthcare providers to exchange ideas with their colleagues about best practices for patient care. Research on this topic has focused almost exclusively on primary care physicians and specialists, to the exclusion of advanced practice providers such as nurse practitioners and physician assistants. We expand this literature by examining membership and participation on these websites among each of these provider groups. Participants (N = 2008; approximately 500 per provider group) responded to an Internet-based survey in which they were asked if they use professional online communities to dialogue with colleagues and if so, what their motivation is for doing so. Nearly half of the participants in our sample reported utilizing professional online communities. Select differences were observed between provider groups, but overall, similar patterns emerged in their membership and participation on these websites. Nurse practitioners and physician assistants utilize professional online communities in similar proportion to primary care physicians and specialists. Providers should be cognizant of the impact this use may have for both themselves and their patients. Researchers are urged to take into account the various professional roles within the healthcare community while developing research on this topic. ©2016 American Association of Nurse Practitioners.

A qualitative examination of health and health care utilization after the September 11th terror attacks among World Trade Center Health Registry enrollees.

PubMed

Welch, Alice E; Caramanica, Kimberly; Debchoudhury, Indira; Pulizzi, Allison; Farfel, Mark R; Stellman, Steven D; Cone, James E

2012-08-31

Many individuals who have 9/11-related physical and mental health symptoms do not use or are unaware of 9/11-related health care services despite extensive education and outreach efforts by the World Trade Center (WTC) Health Registry (the Registry) and various other organizations. This study sought to evaluate Registry enrollees' perceptions of the relationship between physical and mental health outcomes and 9/11, as well as utilization of and barriers to 9/11-related health care services. Six focus groups were conducted in January 2010 with diverse subgroups of enrollees, who were likely eligible for 9/11-related treatment services. The 48 participants were of differing race/ethnicities, ages, and boroughs of residence. Qualitative analysis of focus group transcripts was conducted using open coding and the identification of recurring themes. Participants described a variety of physical and mental symptoms and conditions, yet their knowledge and utilization of 9/11 health care services were low. Participants highlighted numerous barriers to accessing 9/11 services, including programmatic barriers (lack of program visibility and accessibility), personal barriers such as stigmatization and unfamiliarity with 9/11-related health problems and services, and a lack of referrals from their primary care providers. Moreover, many participants were reluctant to connect their symptoms to the events of 9/11 due to lack of knowledge, the amount of time that had elapsed since 9/11, and the attribution of current health symptoms to the aging process. Knowledge of the barriers to 9/11-related health care has led to improvements in the Registry's ability to refer eligible enrollees to appropriate treatment programs. These findings highlight areas for consideration in the implementation of the new federal WTC Health Program, now funded under the James Zadroga 9/11 Health and Compensation Act (PL 111-347), which includes provisions for outreach and education.

Framing a future for soil science education.

NASA Astrophysics Data System (ADS)

Field, Damien

2017-04-01

The emerging concept of Global Soil Security highlights the need to have a renewed education framework that addresses the needs of those who want to; 1) know soil, 2) know of soil, and/or 3) be aware of soil. Those who know soil are soil science discipline experts and are concerned with soil as an object of study. With their discipline expertise focusing on what soil's are capable of they would be brokers of soil knowledge to those who know of soil. The connection with soil by the those in the second group focuses on the soil's utility and are responsible for managing the functionality and condition of the soil, the obvious example are farmers and agronomists. Reconnecting society with soil illustrates those who are members of the third group, i.e. those who are aware of soil. This is predicated on concepts of 'care' and is founded in the notion of beauty and utility. The utility is concerned with soil providing good Quality, clean food, or a source of pharmaceuticals. Soil also provides a place for recreation and those aware of soil know who this contributes to human health. The teaching-research-industry-learning (TRIL) nexus has been used to develop a framework for the learning and teaching of soil science applicable to a range of recipients, particularly campus-based students and practicing farm advisors. Consultation with academics, industry and professionals, by means of online (Delphi Study) and face-to-face forums, developed a heavily content-rich core body of knowledge (CBoK) relevant to industry, satisfying those who; know, and know of soil. Integrating the multidisciplinary approach in soil science teaching is a future aspiration, and will enable the development of curriculum that incorporates those who 'care' for soil. In the interim the application of the TRIL model allows the development of a learning framework more suited to real word needs. The development of a learning framework able to meet industry needs includes authentic complex scenarios that will also benefit student learning.

Building a business case for colorectal surgery quality improvement.

PubMed

Lee, Ken K H; Berenholtz, Sean M; Hobson, Deborah B; Demski, Renee J; Yang, Ting; Wick, Elizabeth C

2013-11-01

Improving surgical quality is a priority, but building a business case for the efforts could be challenging. Bridging the gap between the clinicians and hospital leaders is the first step to align quality and financial priorities within health care. The aim of this study was to evaluate the financial impact of the surgical comprehensive unit-based safety program on colorectal surgery procedures. This a retrospective cohort study. This study was conducted at a university-based tertiary care hospital. All patients undergoing colectomy or proctectomy between July 2010 and June 2012 were included. A comprehensive unit-based safety program focused on colorectal surgical site infection reduction was implemented. Three surgeons participated in the program in year 1, and 5 surgeons participated in year 2. Patients were categorized as participating or nonparticipating based on the surgeon who performed the procedure. Resource utilization and cost were the main outcome measures. During the 2 years, there were 626 patients who met the selection criteria. Participating surgeons operated on 444 patients (70.9%), and the nonparticipating surgeons operated on 182 patients (29.1%). After adjusting for covariates, the variable direct cost was significantly lower for the participating surgeons in laboratory work by $191 (p = 0.009), operating room utilization by $149 (p = 0.05), and supplies by $615 (p = 0.003). The surgical site infection rates, need for an intensive care unit stay, and length of stay were not significantly different between the 2 groups. The multiple biases related to surgeon self-selection for program participation and surgeon training and clinical skills were not addressed in this study owing to the limitations in sample size and data collection. A comprehensive unit-based safety program implementation, including dedicated frontline providers who focused on the standardization of protocols, was able to reduce the variation in resource utilization and costs in comparison with a control group.

Examining the Personal Nature of the K-14 Engineering Pipeline for Young Women

NASA Astrophysics Data System (ADS)

Gurski, Jennifer Sue

This mixed-methods study examined young women's perceptions of their K-14 STEM pipeline experiences and their resulting choice to enter and persist in an engineering major. Despite the increase of women in the STEM workforce, women remain underrepresented among engineering majors (Beasley & Fischer, 2012; Heilbronner, 2012; Neihart & Teo, 2013). Few studies exist that utilize a retrospective approach to understand how the culmination of young women's K-14 experiences have influenced their formation of individually held perceptions that lead to engineering persistence. It is this study's aim to utilize a mixed-methods approach to answer the following research question: How do young women's perceptions of their K-14 STEM experiences influence their decision to enroll and persist in an engineering major? These perceptions are explored through an ethnographic approach focusing on young women enrolled in engineering programs during their junior and senior years of study at a small private liberal arts university with eight engineering majors. The mixed-methods approach follows a sequential design method (Creswell, 2013) and utilizes questions in a quantitative Likert-type survey from the Academic Pathways for People Learning Engineering (APPLES) survey (Eris, Chachra, Chen, Sheppard, & Ludlow, 2010) and the Motivated Strategy Learning Questionnaire (MSLQ) (Pintrich, Smith, Garcia, & McKeachie, 1991). The quantitative study results will lead to the development of open-ended, structured questions for conducting a qualitative focus group. Anonymity of all participants is maintained. Keywords: STEM, young women, perceptions, pipeline, intervention, underrepresentation, engineering, persistence, retrospective, self-efficacy.

Development of geothermal energy in the Gulf Coast: socio-economic, demographic, and political considerations

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

Letlow, K.; Lopreato, S.C.; Meriwether, M.

The institutional aspect of the study attempts to identify possible effects of geothermal research, development, and utilization on the area and its inhabitants in three chapters. Chapters I and II address key socio-economic and demographic variables. The initial chapter provides an overview of the area where the resource is located. Major data are presented that can be used to establish a baseline description of the region for comparison over time and to delineate crucial area for future study with regard to geothermal development. The chapter highlights some of the variables that reflect the cultural nature of the Gulf Coast, itsmore » social characteristics, labor force, and service in an attempt to delineate possible problems with and barriers to the development of geothermal energy in the region. The following chapter focuses on the local impacts of geothermal wells and power-generating facilities using data on such variables as size and nature of construction and operating crews. Data are summarized for the areas studied. A flow chart is utilized to describe research that is needed in order to exploit the resource as quickly and effectively as possible. Areas of interface among various parts of the research that will include exchange of data between the social-cultural group and the institutional, legal, environmental, and resource utilization groups are identified. (MCW)« less

Hacking Hackathons: Preparing the next generation for the multidisciplinary world of healthcare technology.

PubMed

Lyndon, Mataroria P; Cassidy, Michael P; Celi, Leo Anthony; Hendrik, Luk; Kim, Yoon Jeon; Gomez, Nicholas; Baum, Nathaniel; Bulgarelli, Lucas; Paik, Kenneth E; Dagan, Alon

2018-04-01

Machine learning in healthcare, and innovative healthcare technology in general, require complex interactions within multidisciplinary teams. Healthcare hackathons are being increasingly used as a model for cross-disciplinary collaboration and learning. The aim of this study is to explore high school student learning experiences during a healthcare hackathon. By optimizing their learning experiences, we hope to prepare a future workforce that can bridge technical and health fields and work seamlessly across disciplines. A qualitative exploratory study utilizing focus group interviews was conducted. Eight high school students from the hackathon were invited to participate in this study through convenience sampling Participating students (n = 8) were allocated into three focus groups. Semi structured interviews were completed, and transcripts evaluated using inductive thematic analysis. Through the structured analysis of focus group transcripts three major themes emerged from the data: (1) Collaboration, (2) Transferable knowledge and skills, and (3) Expectations about hackathons. These themes highlight strengths and potential barriers when bringing this multidisciplinary approach to high school students and the healthcare community. This study found that students were empowered by the interdisciplinary experience during a hackathon and felt that the knowledge and skills gained could be applied in real world settings. However, addressing student expectations of hackathons prior to the event is an area for improvement. These findings have implications for future hackathons and can spur further research into using the hackathon model as an educational experience for learners of all ages. Copyright © 2018 Elsevier B.V. All rights reserved.

Perceptions of users and providers on barriers to utilizing skilled birth care in mid- and far-western Nepal: a qualitative study

PubMed Central

Onta, Sharad; Choulagai, Bishnu; Shrestha, Binjwala; Subedi, Narayan; Bhandari, Gajananda P.; Krettek, Alexandra

2014-01-01

Background Although skilled birth care contributes significantly to the prevention of maternal and newborn morbidity and mortality, utilization of such care is poor in mid- and far-western Nepal. This study explored the perceptions of service users and providers regarding barriers to skilled birth care. Design We conducted 24 focus group discussions, 12 each with service users and service providers from different health institutions in mid- and far-western Nepal. All discussions examined the perceptions and experiences of service users and providers regarding barriers to skilled birth care and explored possible solutions to overcoming such barriers. Results Our results determined that major barriers to skilled birth care include inadequate knowledge of the importance of services offered by skilled birth attendants (SBAs), distance to health facilities, unavailability of transport services, and poor availability of SBAs. Other barriers included poor infrastructure, meager services, inadequate information about services/facilities, cultural practices and beliefs, and low prioritization of birth care. Moreover, the tradition of isolating women during and after childbirth decreased the likelihood that women would utilize delivery care services at health facilities. Conclusions Service users and providers perceived inadequate availability and accessibility of skilled birth care in remote areas of Nepal, and overall utilization of these services was poor. Therefore, training and recruiting locally available health workers, helping community groups establish transport mechanisms, upgrading physical facilities and services at health institutions, and increasing community awareness of the importance of skilled birth care will help bridge these gaps. PMID:25119066

Attention and material-specific memory in children with lateralized epilepsy.

PubMed

Engle, Jennifer A; Smith, Mary Lou

2010-01-01

Epilepsy is frequently associated with attention and memory problems. In adults, lateralization of seizure focus impacts the type of memory affected (left-sided lesions primarily impact verbal memory, while right-sided lesions primarily impact visual memory), but the relationship between seizure focus and the nature of the memory impairment is less clear in children. The current study examines the correlation between parent-reported attention problems and material-specific memory (verbal or visual-spatial) in 65 children (ages 6-16) with medically intractable lateralized epilepsy. There were no significant differences in attention and memory between those with left-lateralized epilepsy (n=25) and those with right-lateralized epilepsy (n=40). However, in the left-lateralized group attention problems were significantly negatively correlated only with delayed visual memory (r=-.450, p<.05), while the right-lateralized group demonstrated the opposite pattern (attention problems significantly negatively correlated with delayed verbal memory; r=-.331, p<.05). These findings suggest that lateralization of seizure focus may in fact impact children's memory in a material-specific manner, while problems with attention may impact memory more globally. Therefore, interventions designed to improve attention in children with epilepsy may have utility in improving certain aspects of memory, but further suggest that in children with lateralized epilepsy, material-specific memory deficits may not resolve with such interventions.

Development of multimedia informational tools for breast cancer patients with low levels of health literacy.

PubMed

Hart, Tae L; Blacker, Susan; Panjwani, Aliza; Torbit, Lindsey; Evans, Michael

2015-03-01

To create informational tools for breast cancer patients with low levels of health literacy. Tools were developed through a three-stage process. (1) Focus groups were conducted with breast cancer survivors and interviews were held with health educators to determine content, source of information, format and medium of the tools. (2) Based on this feedback, a suite of tools was developed. (3) Focus groups were reconvened and health educators re-interviewed to obtain feedback and determine satisfaction. We developed a suite of five informational tools using low health literacy principles, which focused on learning about breast cancer resources and learning about the members of one's healthcare team, understanding the "journey" or trajectory of care beginning at diagnosis, hearing from other breast cancer patients about their own journey, and becoming informed about what to expect pre-and post-surgery for breast cancer. The final products were rated highly by breast cancer survivors. The developed materials, designed for patients who read below an 8th grade level, reflect the informational needs reported by breast cancer patients. Healthcare providers must consider utilizing design principles and theories of adult learning appropriate for those with low health literacy. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Investigation of Knowledge and Perception of Tuberculosis Among Hispanics in Utah County, Utah.

PubMed

Boulter, Tyler; Moran, Solanda; Moxley, Victor; Cole, Eugene C

2017-02-01

This study aimed to assess extent of knowledge and perceptions of TB within the growing Hispanic community of Utah County, Utah, and the need for focused community educational intervention within that demographic. A mixed-method approach was used and included a survey of 166 adult males and females, and two focus groups with Hispanic women. TB was better known for its ability to kill (92.8 %) than for being contagious (64.5 %); while most knew that TB mainly affects the lungs (77.7 %) and is spread through coughing (75.3 %). Few believed that overcrowded living conditions were a risk factor for TB (30.1 %). Many believed that TB could be cured with medicine (75.3 %). And 65.7 % reported they had been tested for TB, and 7 % had been told by a doctor they had TB. Focus group data showed while most had knowledge of major TB symptoms, some had key misperceptions about disease transmission, testing, TB vaccine, and various protective factors. Enhanced education and dissemination of information on TB, to include an emphasis on symptoms, testing, and treatment within this demographic is recommended. A culturally-appropriate intervention should utilize a participatory approach, to include the local health department in partnership with various Hispanic community-based organizations.

The Effects of Gender and Type of Inquiry Curriculum on Sixth Grade Students' Science Process Skills and Epistemological Beliefs in Science

NASA Astrophysics Data System (ADS)

Zaleta, Kristy L.

The purpose of this study was to investigate the impact of gender and type of inquiry curriculum (open or structured) on science process skills and epistemological beliefs in science of sixth grade students. The current study took place in an urban northeastern middle school. The researcher utilized a sample of convenience comprised of 303 sixth grade students taught by four science teachers on separate teams. The study employed mixed methods with a quasi-experimental design, pretest-posttest comparison group with 17 intact classrooms of students. Students' science process skills and epistemological beliefs in science (source, certainty, development, and justification) were measured before and after the intervention, which exposed different groups of students to different types of inquiry (structured or open). Differences between comparison and treatment groups and between male and female students were analyzed after the intervention, on science process skills, using a two-way analysis of covariance (ANCOVA), and, on epistemological beliefs in science, using a two-way multivariate analysis of covariance (MANCOVA). Responses from two focus groups of open inquiry students were cycle coded and examined for themes and patterns. Quantitative measurements indicated that girls scored significantly higher on science process skills than boys, regardless of type of inquiry instruction. Neither gender nor type of inquiry instruction predicted students' epistemological beliefs in science after accounting for students' pretest scores. The dimension Development accounted for 10.6% of the variance in students' science process skills. Qualitative results indicated that students with sophisticated epistemological beliefs expressed engagement with the open-inquiry curriculum. Students in both the sophisticated and naive beliefs groups identified challenges with the curriculum and improvement in learning as major themes. The types of challenges identified differed between the groups: sophisticated beliefs group students focused on their insecurity of not knowing how to complete the activities correctly, and naive beliefs group students focused on the amount of work and how long it took them to complete it. The description of the improvement in learning was at a basic level for the naive beliefs group and at a more complex level for the sophisticated beliefs group. Implications for researchers and educators are discussed.

[Ophthalmologic healthcare utilization of people in need of long-term care : Analyses of health insurance data of the AOK Baden-Württemberg].

PubMed

Schuster, Alexander K; Pick, Julia; Saalmann, Frauke; Pfeiffer, Norbert

2018-04-10

Eye diseases causing visual impairment increase with age. Thus, seeking eye care has a higher probability in older people. In this study, the rate of utilization of outpatient eye care services in Germany was analyzed. The analyses focused on older persons and persons in need of either home-based or facility-based long-term care. A descriptive secondary data analysis of health insurance data of the AOK Baden-Württemberg from 2016 was conducted. The study population comprised all insured persons on 1 January 2016. The cohort of older persons (60 years+) was further stratified by the type of care (home-based/facility-based) and the level of care (0-3). The utilization of outpatient eye care services was defined by the reimbursement for an ophthalmologist's provision of service. While 39.3% of the study population 60+ years old sought eye care, the utilization rate was lower among people in need of home-based (33.0%) and facility-based care (19.3%). The utilization rates showed comparable age-dependent patterns, except for persons in need of facility-based care where rates were similar for all age groups. Utilization rates were negatively associated with increasing care levels. Only people with care level 0 showed lower utilization rates than people with care level 1. Utilization rates of eye healthcare services among older persons are considerably influenced by the need of long-term care, by the form of care as well as by the level of care.

Barriers and Opportunities: A Community-Based Participatory Research Study of Health Beliefs Related to Diabetes in a US Marshallese Community

PubMed Central

Hallgren, Emily Ann; McElfish, Pearl Anna; Rubon-Chutaro, Jellesen

2015-01-01

Purpose The purpose of this study was to investigate the beliefs and perceptions related to type 2 diabetes (diabetes) that influence diabetes self-management behaviors for Marshallese in the U.S. Utilizing the Health Belief Model as a theoretical framework, researchers seek to better understand the underlying beliefs that motivate or impede diabetes self-management behaviors. Methods The community-based participatory research (CBPR) collaborative engaged in 14 months of preliminary fieldwork and conducted two tiers of focus groups for this project as part of our long-term commitment to reducing health inequalities in the Marshallese community. The CBPR team conducted an initial round of two exploratory focus groups (n=15). Based on the knowledge gained, researchers held a second round of focus groups (n=13) focused on health beliefs regarding diabetes. All participants were Marshallese, aged 18 and older, and included men and women. Participants either had a diagnosis of diabetes or were a caretaker of someone with diabetes. Results The findings elucidate the structural and non-structural barriers to successful diabetes self-management for Marshallese in the US. Barriers include: eating differently than the rest of the family, social stigma of diabetes, transportation, cost, lack of access to healthcare, as well as cultural and language barriers. Conclusions While there are significant barriers to improving diabetes self-management, there are also areas of opportunity including family and peer reinforcement to encourage proper diabetes management behaviors and a growing community desire to lift the stigma of diabetes. The CBPR team offers recommendations to make diabetes management interventions more culturally appropriate and effective for the Marshallese population. PMID:25398722

Communication skills training in orthopaedics.

PubMed

Lundine, Kristopher; Buckley, Richard; Hutchison, Carol; Lockyer, Jocelyn

2008-06-01

Communication skills play a key role in many aspects of both medical education and clinical patient care. The objectives of this study were to identify the key components of communication skills from the perspectives of both orthopaedic residents and their program directors and to understand how these skills are currently taught. This study utilized a mixed methods design. Quantitative data were collected with use of a thirty-item questionnaire distributed to all Canadian orthopaedic residents. Qualitative data were collected through focus groups with orthopaedic residents and semistructured interviews with orthopaedic program directors. One hundred and nineteen (37%) of 325 questionnaires were completed, twelve residents participated in two focus groups, and nine of sixteen program directors from across the country were interviewed. Both program directors and residents identified communication skills as being the accurate and appropriate use of language (i.e., content skills), not how the communication was presented (i.e., process skills). Perceived barriers to effective communication included time constraints and the need to adapt to the many personalities and types of people encountered daily in the hospital. Residents rarely have explicit training in communication skills. They rely on communication training implicitly taught through observation of their preceptors and clinical experience interacting with patients, peers, and other health-care professionals. Orthopaedic residents and program directors focus on content and flexibility within communication skills as well as on the importance of being concise. They value the development of communication skills in the clinical environment through experiential learning and role modeling. Education should focus on developing residents' process skills in communication. Care should be taken to avoid large-group didactic teaching sessions, which are perceived as ineffective.

Using of Group-Modeling in Predesign Phase of New Healthcare Environments: Stakeholders Experiences.

PubMed

Elf, Marie; Eldh, Ann Catrine; Malmqvist, Inga; Öhrn, Kerstin; von Koch, Lena

2016-01-01

Current research shows a relationship between healthcare architecture and patient-related outcomes. The planning and designing of new healthcare environments is a complex process. The needs of the various end users of the environment must be considered, including the patients, the patients' significant others, and the staff. The aim of this study was to explore the experiences of healthcare professionals participating in group modeling utilizing system dynamics in the predesign phase of new healthcare environments. We engaged healthcare professionals in a series of workshops using system dynamics to discuss the planning of healthcare environments in the beginning of a construction and then interviewed them about their experience. An explorative and qualitative design was used to describe participants' experiences of participating in the group-modeling projects. Participants (N = 20) were recruited from a larger intervention study using group modeling and system dynamics in planning and designing projects. The interviews were analyzed by qualitative content analysis. Two themes were formed, representing the experiences in the group-modeling process: "Participation in the group modeling generated knowledge and was empowering" and "Participation in the group modeling differed from what was expected and required the dedication of time and skills." The method can support participants in design teams to focus more on their healthcare organization, their care activities, and their aims rather than focusing on detailed layout solutions. This clarification is important when decisions about the design are discussed and prepared and will most likely lead to greater readiness for future building process. © The Author(s) 2015.

Alternative Fuels Data Center: State Alternative Fuel and Advanced Vehicle

Science.gov Websites

2016, the number of new state-level legislative, executive, private, and utility activities related to , new utility and private incentives focused almost entirely on electricity. In previous years, natural gas was also a strong focus area for states. In 2016, however, the volume of new state incentives

Community College Dual Enrollment Faculty Orientation: A Utilization-Focused Approach

ERIC Educational Resources Information Center

Charlier, Hara D.; Duggan, Molly H.

2010-01-01

The current climate of accountability demands that institutions engage in data-driven program evaluation. In order to promote quality dual enrollment (DE) programs, institutions must support the adjunct faculty teaching college courses in high schools. This study uses Patton's utilization-focused model (1997) to conduct a formative evaluation of a…

New Approaches to Assessment in Science and Mathematics.

ERIC Educational Resources Information Center

Crow, Tracy, Ed.

1997-01-01

This issue of ENC Focus serves as a guide to 29 instructional materials that utilize some form of alternative assessment. These materials focus on mathematics, science, and integrated topics. The products included utilize one or more of the following means of student assessment: (1) portfolios; (2) journals; (3) interviews; (4) surveys; (5)…

Utilization of Ambulatory Mental Health Services.

ERIC Educational Resources Information Center

Williams, Stephen J.; Richardson, Mary

1980-01-01

Studied the use of mental health services by enrolled populations, in order to establish a model or predictor of utilization. Primary focus of utilization data has been patient characteristics; organizational variables, such as plan design and benefit packages, are also shown to affect utilization. (LAB)

75 FR 35458 - National Drinking Water Advisory Council's Climate Ready Water Utilities Working Group Meeting...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-22

... supportive environment in which a utility can take steps to be climate ready. In this meeting, the Working... Ready Water Utilities Working Group Meeting Announcement AGENCY: Environmental Protection Agency (EPA... fourth in-person meeting of the Climate Ready Water Utilities (CRWU) Working Group of the National...

School climate for transgender youth: a mixed method investigation of student experiences and school responses.

PubMed

McGuire, Jenifer K; Anderson, Charles R; Toomey, Russell B; Russell, Stephen T

2010-10-01

Transgender youth experience negative school environments and may not benefit directly from interventions defined to support Lesbian, Gay and Bisexual (LGB) youth. This study utilized a multi-method approach to consider the issues that transgender students encounter in school environments. Using data from two studies, survey data (total n = 2260, 68 transgender youth) from study 1 and focus groups (n = 35) from study 2, we examine transgender youth's experience of school harassment, school strategies implemented to reduce harassment, the protective role of supportive school personnel, and individual responses to harassment, including dropping out and changing schools. In both studies, we found that school harassment due to transgender identity was pervasive, and this harassment was negatively associated with feelings of safety. When schools took action to reduce harassment, students reported greater connections to school personnel. Those connections were associated with greater feelings of safety. The indirect effects of school strategies to reduce harassment on feelings of safety through connection to adults were also significant. Focus group data illuminate specific processes schools can engage in to benefit youth, and how the youth experience those interventions.

Development and Application of a Stepwise Assessment Process for Rational Redesign of Sequential Skills-Based Courses.

PubMed

Gallimore, Casey E; Porter, Andrea L; Barnett, Susanne G

2016-10-25

Objective. To develop and apply a stepwise process to assess achievement of course learning objectives related to advanced pharmacy practice experiences (APPEs) preparedness and inform redesign of sequential skills-based courses. Design. Four steps comprised the assessment and redesign process: (1) identify skills critical for APPE preparedness; (2) utilize focus groups and course evaluations to determine student competence in skill performance; (3) apply course mapping to identify course deficits contributing to suboptimal skill performance; and (4) initiate course redesign to target exposed deficits. Assessment. Focus group participants perceived students were least prepared for skills within the Accreditation Council for Pharmacy Education's pre-APPE core domains of Identification and Assessment of Drug-related Problems and General Communication Abilities. Course mapping identified gaps in instruction, performance, and assessment of skills within aforementioned domains. Conclusions. A stepwise process that identified strengths and weaknesses of a course, was used to facilitate structured course redesign. Strengths of the process included input and corroboration from both preceptors and students. Limitations included feedback from a small number of pharmacy preceptors and increased workload on course coordinators.

The Identification of Reasons, Solutions, and Techniques Informing a Theory-Based Intervention Targeting Recreational Sports Participation.

PubMed

St Quinton, Tom; Brunton, Julie A

2018-06-01

This study is the 3rd piece of formative research utilizing the theory of planned behavior to inform the development of a behavior change intervention. Focus groups were used to identify reasons for and solutions to previously identified key beliefs in addition to potentially effective behavior change techniques. A purposive sample of 22 first-year undergraduate students (n = 8 men; M age  = 19.8 years, SD = 1.3 years) attending a university in the North of England was used. Focus groups were audio-recorded; recordings were transcribed verbatim, analyzed thematically, and coded for recurrent themes. The data revealed 14 reasons regarding enjoyment, 11 reasons for friends' approval, 11 reasons for friends' own participation, 14 reasons for the approval of family members, and 10 solutions to time constraints. Twelve distinct techniques were suggested to attend to these reasons and solutions. This qualitative research will be used to inform the development of a theory-based intervention to increase students' participation in university recreational sports.

Identification of resilient individuals and those at risk for performance deficits under stress.

PubMed

Winslow, Brent D; Carroll, Meredith B; Martin, Jonathan W; Surpris, Glenn; Chadderdon, George L

2015-01-01

Human task performance is affected by exposure to physiological and psychological stress. The ability to measure the physiological response to stressors and correlate that to task performance could be used to identify resilient individuals or those at risk for stress-related performance decrements. Accomplishing this prior to performance under severe stress or the development of clinical stress disorders could facilitate focused preparation such as tailoring training to individual needs. Here we measure the effects of stress on physiological response and performance through behavior, physiological sensors, and subjective ratings, and identify which individuals are at risk for stress-related performance decrements. Participants performed military-relevant training tasks under stress in a virtual environment, with autonomic and hypothalamic-pituitary-adrenal axis (HPA) reactivity analyzed. Self-reported stress, as well as physiological indices of stress, increased in the group pre-exposed to socioevaluative stress. Stress response was effectively captured via electrodermal and cardiovascular measures of heart rate and skin conductance level. A resilience classification algorithm was developed based upon physiological reactivity, which correlated with baseline unstressed physiological and self-reported stress values. Outliers were identified in the experimental group that had a significant mismatch between self-reported stress and salivary cortisol. Baseline stress measurements were predictive of individual resilience to stress, including the impact stress had on physiological reactivity and performance. Such an approach may have utility in identifying individuals at risk for problems performing under severe stress. Continuing work has focused on adapting this method for military personnel, and assessing the utility of various coping and decision-making strategies on performance and physiological stress.

Identification of resilient individuals and those at risk for performance deficits under stress

PubMed Central

Winslow, Brent D.; Carroll, Meredith B.; Martin, Jonathan W.; Surpris, Glenn; Chadderdon, George L.

2015-01-01

Human task performance is affected by exposure to physiological and psychological stress. The ability to measure the physiological response to stressors and correlate that to task performance could be used to identify resilient individuals or those at risk for stress-related performance decrements. Accomplishing this prior to performance under severe stress or the development of clinical stress disorders could facilitate focused preparation such as tailoring training to individual needs. Here we measure the effects of stress on physiological response and performance through behavior, physiological sensors, and subjective ratings, and identify which individuals are at risk for stress-related performance decrements. Participants performed military-relevant training tasks under stress in a virtual environment, with autonomic and hypothalamic-pituitary-adrenal axis (HPA) reactivity analyzed. Self-reported stress, as well as physiological indices of stress, increased in the group pre-exposed to socioevaluative stress. Stress response was effectively captured via electrodermal and cardiovascular measures of heart rate and skin conductance level. A resilience classification algorithm was developed based upon physiological reactivity, which correlated with baseline unstressed physiological and self-reported stress values. Outliers were identified in the experimental group that had a significant mismatch between self-reported stress and salivary cortisol. Baseline stress measurements were predictive of individual resilience to stress, including the impact stress had on physiological reactivity and performance. Such an approach may have utility in identifying individuals at risk for problems performing under severe stress. Continuing work has focused on adapting this method for military personnel, and assessing the utility of various coping and decision-making strategies on performance and physiological stress. PMID:26441503

[Prioritization and Consentation of Criteria for the Appraisal, Funding and Evaluation of Projects from the German Innovationsfonds: A multi-perspective Delphi study].

PubMed

Schmitt, J; Petzold, T; Nellessen-Martens, G; Pfaff, H

2015-09-01

The German Innovationsfonds provides the chance for evidence-based developments of the German healthcare system. Prioritization of recommendations for an effective, efficient, fair, transparent, and sustainable granting of funds through a transparent, evidence-driven consensus-process involving all relevant stakeholder groups. Representatives from health and research policy, payers, patient representatives, healthcare providers, and scientists were invited to nominate participants for an electronic 3 round iterative Delphi-study to prioritize the thematic focus, requirements concerning study methods, the team of applicants, evaluation, utilization of study results, and for the selection of reviewers. Criteria considered as relevant by at least 60% of the panel (consensus definition) in the first 2 Delphi rounds were rated as facultative, preferable, or obligatory criteria for project funding. Data were analyzed descriptively. ( Datenbank Versorgungsforschung Deutschland VfD_15_003561). All invited stakeholder groups except payers participated. 34 (85%) of 40 nominated representatives participated in the Delphi-study. A total of 64 criteria were consented as relevant for project review and funding concerning the thematic focus (n=28), methodological requirements (n=13), requirements for applicants (n=4), for the evaluation (n=4), utilization (n=6), and selection of peer reviewers (n=9). It is the collective responsibility of all stakeholders to spend the designated funds as efficient and sustainable as possible. The consented recommendations shall serve decision makers as a resource for the granting of funds and the evaluation of the Innovationsfonds. © Georg Thieme Verlag KG Stuttgart · New York.

Qualitative investigation of barriers to accessing care by people who inject drugs in Saskatoon, Canada: perspectives of service providers

PubMed Central

2013-01-01

Background People who inject drugs (PWID) often encounter barriers when attempting to access health care and social services. In our previous study conducted to identify barriers to accessing care from the perspective of PWIDs in Saskatoon, Canada: poverty, lack of personal support, discrimination, and poor knowledge and coordination of service providers among other key barriers were identified. The purpose of the present investigation was to explore what service providers perceive to be the greatest barriers for PWIDs to receive optimal care. This study is an exploratory investigation with a purpose to enrich the literature and to guide community action. Methods Data were collected through focus groups with service providers in Saskatoon. Four focus groups were held with a total of 27 service providers. Data were transcribed and qualitative analysis was performed. As a result, concepts were identified and combined into major themes. Results Four barriers to care were identified by service providers: inefficient use of resources, stigma and discrimination, inadequate education and the unique and demanding nature of PWIDs. Participants also identified many successful services. Conclusion The results from this investigation suggest poor utilization of resources, lack of continuing education of health care providers on addictions and coping skills with such demanding population, and social stigma and disparity. We recommend improvements in resource utilization through, for example, case management. In addition, sensitivity training and more comprehensive service centers designed to meet PWID’s complex needs may improve care. However, community-wide commitment to addressing injection drug issues will also be required for lasting solutions. PMID:24079946

The two voices of Alzheimer's: attitudes toward brain health by diagnosed individuals and support persons.

PubMed

Beard, Renée L; Fetterman, David J; Wu, Bei; Bryant, Lucinda

2009-06-01

Most individuals with Alzheimer's are cared for in their homes by unpaid family members. Research on caregiving focuses disproportionally on costs of care, service utilization, and negative psychosocial outcomes. Few narrative accounts of Alzheimer's exist; those that do suffer similar pejorative framings and narrow foci. No studies that we are aware of examine the health beliefs of diagnosed individuals and support persons, or their attitudes about brain health. This research reports perceptions of "aging well" held by those most intimately acquainted with Alzheimer's. Diagnosed individuals and their support persons (N = 85) were enrolled into 14 focus groups. Grounded theory methods were used to collect, code, and analyze textual interview data into overarching themes. Respondents found physical and mental health, social activity, independence, and happiness integral to aging well. An acceptance of various limitations was also deemed crucial. Support persons placed more emphasis on lifestyle factors and memory loss as potential obstacles. Diagnosed respondents defined memory loss in less medicalized terms, whereas support persons labeled it Alzheimer's and negatively characterized those affected. Both groups warned against discussing "prevention" of dementia: Diagnosed individuals noted the implication of "aging poorly" and support persons cautioned against blaming diagnosed individuals. These findings can be used to encourage positive health beliefs and behaviors tailored to the needs of diagnosed seniors and their families, to help practitioners and researchers identify and become sensitive to differences between and among older adults, and to further advance the utility of narrative accounts for informing health interventions and education efforts.

A national survey to define a new core curriculum to prepare physicians for managed care practice.

PubMed

Meyer, G S; Potter, A; Gary, N

1997-08-01

All levels of medical education will require modification to address the challenges in health care practice brought about by managed care. Because preparation for practice in a managed care environment has received insufficient attention, and because the need for change is so great, in 1995 the authors sought information from a variety of sources to serve as a basis for identifying the core curricular components and the staging of these components in the medical education process. This research effort consisted of a survey of 125 U.S. medical school curriculum deans (or equivalent school representatives); four focus groups of managed care practitioners, administrators, educators, and residents; and a survey of a national sample of physicians and medical directors. Findings indicate that almost all the 91 responding school representatives recognized the importance of revising their curricula to meet the managed care challenge and that the majority either had or were developing programs to train students for practice in managed care environments. The focus groups identified a core set of competencies for managed care practice, although numbers differed on whether the classroom or a managed care setting was the best place to teach the components of a new curriculum. Although medical directors and staff physicians differed with respect to the relative levels of importance of these competencies, the findings suggest that before medical school, training should focus on communication and interpersonal skills, information systems, and customer relations; during medical school, on clinical epidemiology, quality assurance, risk management, and decision analysis; during residency, on utilization management, managed care essentials, and multidisciplinary team building; and after residency, on a review of customer relations, communication skills, and utilization management. The authors conclude that a core curriculum and its sequencing can be identified, that the majority of curricular components exist but in s some cases needed to be modified to more clearly relate to managed care practice, and that their findings may provide a useful starting point for making decisions about curricular reform.

Patients’ perceived value of pharmacy quality measures: a mixed-methods study

PubMed Central

Shiyanbola, Olayinka O; Mort, Jane R

2015-01-01

Objective To describe patients’ perceived value and use of quality measures in evaluating and choosing community pharmacies. Design Focus group methodology was combined with a survey tool. During the focus groups, participants assessed the value of the Pharmacy Quality Alliance's quality measures in evaluating and choosing a pharmacy. Also, participants completed questionnaires rating their perceived value of quality measures in evaluating a pharmacy (1 being low value and 5 being high) or choosing a pharmacy (yes/no). Thematic analysis and descriptive statistics were used to analyse the focus groups and surveys, respectively. Setting Semistructured focus groups were conducted in a private meeting space of an urban and a rural area of a Mid-western State in the USA. Participants Thirty-four adults who filled prescription medications in community pharmacies for a chronic illness were recruited in community pharmacies, senior centres and public libraries. Results While comments indicated that all measures were important, medication safety measures (eg, drug-drug interactions) were valued more highly than others. Rating of quality measure utility in evaluating a pharmacy ranged from a mean of 4.88 (‘drug-drug interactions’) to a mean of 4.0 (‘absence of controller therapy for patients with asthma’). Patients were hesitant to use quality information in choosing a pharmacy (depending on the participant's location) but might consider if moving to a new area or having had a negative pharmacy experience. Use of select quality measures to choose a pharmacy ranged from 97.1% of participants using ‘drug-drug interactions’ (medication safety measure) to 55.9% using ‘absence of controller therapy for patients with asthma’. Conclusions The study participants valued quality measures in evaluating and selecting a community pharmacy, with medication safety measures valued highest. The participants reported that the quality measures would not typically cause a switch in pharmacy but might influence their selection in certain situations. PMID:25600253

Making electronic mail accessible: perspectives of people with acquired cognitive impairments, caregivers and professionals.

PubMed

Todis, B; Sohlberg, M M; Hood, D; Fickas, S

2005-06-01

The primary objective of this study was to better understand the technology needs, barriers and strategies of individuals with acquired cognitive impairments (ACI) in order to design and modify technologies with potential for alleviating the diminished independence and social isolation common in this population. The authors hypothesized that (1) higher rates of computer use would be reported by younger, more highly educated individuals with ACI, those with less severe injuries and those with previous computer experience; (2) A low percentage of survey respondents would own their own computers; and (3) People with ACI would experience social isolation and report low frequency of connecting with important people who live far away. A total of 133 individuals with ACI, professionals and care providers completed the survey. To gain more specific information, seven focus groups were conducted with 66 individuals with ACI and 20 care providers. Finally, 10 current email users participated in structured conversations, detailing their strategies for using email. The survey revealed that 80% of subjects with ACI reported owning a computer. Age and education were not predictors of computer use, but individuals whose ACI was the result of more severe injuries were less likely to use computers. As expected, respondents reported that maintaining contact with distant loved ones is problematic. The focus groups and conversations provided more detail about the communication needs of the population and the relative advantages and disadvantages of email compared with telephone and mail. Participants also identified barriers to email use they had encountered or feared they would encounter when using email. A number of accommodations to overcome these barriers were suggested. The results of the survey, focus groups and conversations confirmed the utility of email and other technologies for people with ACI and the need to make these technologies more accessible. The results and suggestions provided by the focus groups and interviews are being used in the design of Think and Link, an email interface for use by individuals with ACI.

Thought Spot: Co-Creating Mental Health Solutions with Post-Secondary Students.

PubMed

Wiljer, David; Johnson, Andrew; McDiarmid, Erica; Abi-Jaoude, Alexxa; Ferguson, Genevieve; Hollenberg, Elisa; van Heerwaarden, Nicole; Tripp, Tim; Law, Marcus

2017-01-01

It is difficult for the nearly 20% of Canadian 15- to 24-year olds reporting symptoms to seek the help they need within the current mental health system. Web-based and mobile health interventions are promising tools for reaching this group; having the capacity to reduce access-to-service barriers and engage youth in promoting their mental well-being. A three-phased, iterative, co-creation developmental approach was used to develop Thought Spot, a platform to better enable post-secondary students to seek mental health support. Co-creation activities included student development teams, hosting a hackathon, conducting focus groups and evidence-based workshops and student advisory groups. Evaluation results highlighted the need for greater role clarity and strategies for sustainable engagement in the co-creation process. Lessons learned are informing the project optimization phase and will be utilized to inform the design and implementation of an RCT, assessing impact on help seeking behaviour.

Physical activity: exploring views of older Russian-speaking slavic immigrants.

PubMed

Purath, Janet; Van Son, Catherine; Corbett, Cynthia F

2011-01-01

Many of the 1.3 million Russian-speaking immigrants in the US have chronic conditions such as cardiovascular disease, diabetes, obesity, and depression. They engage in physical activity less often than other groups, and little is known about their views of physical activity. This qualitative study explored physical activity attitudes, beliefs, motivators, and barriers among older Russian-speaking immigrants. In four focus group interviews, 23 participants discussed physical activity. "Movement is life" was a theme throughout all interviews. Walking was the most frequently mentioned activity. Increased energy and decreased pain were described as health benefits. Motivators for physical activity were maintaining function, improved health, and the support of God and family. Barriers included poor health and environmental safety concerns. Participants suggested community walking groups and church-supported programs as useful methods to promote physical activity. Future research includes developing culturally appropriate interventions that utilize physical activity to prevent and manage chronic illness with ethnic minority older adults.

An Integrative Professional Theory and Practice Paper: Personal Reflections from the Journey through Clinical Pastoral Education.

PubMed

McLean, Gillian

2015-12-01

CPE is an experience-based approach to learning spiritual care which combines clinical care with qualified supervision, in-class education and group reflection (CASC--http://www.spiritualcare.ca/). Through didactic seminars, group presentations and personal reading there is opportunity for the student to acquire, apply and integrate relevant theoretical information into their practice. Written for my CPE Specialist application, this paper describes how, through the course of advanced CPE education, I learn to utilize and integrate theory into my clinical work. Beginning with three strands--authenticity, listening and storytelling--I then discuss how the behavioural sciences and theology inform my practice. Focusing on empathy, I speak of the application of disclosure, the use of counter-transference as a diagnostic tool, and the place of therapeutic termination. Group theory, family systems theory, theological reflection, liturgical ministry, and multi-faith practices are considered. © The Author(s) 2015.

Ability of crime, demographic and business data to forecast areas of increased violence.

PubMed

Bowen, Daniel A; Mercer Kollar, Laura M; Wu, Daniel T; Fraser, David A; Flood, Charles E; Moore, Jasmine C; Mays, Elizabeth W; Sumner, Steven A

2018-05-24

Identifying geographic areas and time periods of increased violence is of considerable importance in prevention planning. This study compared the performance of multiple data sources to prospectively forecast areas of increased interpersonal violence. We used 2011-2014 data from a large metropolitan county on interpersonal violence (homicide, assault, rape and robbery) and forecasted violence at the level of census block-groups and over a one-month moving time window. Inputs to a Random Forest model included historical crime records from the police department, demographic data from the US Census Bureau, and administrative data on licensed businesses. Among 279 block groups, a model utilizing all data sources was found to prospectively improve the identification of the top 5% most violent block-group months (positive predictive value = 52.1%; negative predictive value = 97.5%; sensitivity = 43.4%; specificity = 98.2%). Predictive modelling with simple inputs can help communities more efficiently focus violence prevention resources geographically.

Strategies to increase breast and cervical cancer screening among Hawaiian, Pacific Islander, and Filipina women in Hawai’i

PubMed Central

Aitaoto, Nia; Tsark, JoAnn U.; Wong, Danette Tomiyasu; Yamashita, Barbara A.; Braun, Kathryn L.

2016-01-01

The Hawai’i Breast and Cervical Cancer Control Program (BCCCP) offers free mammograms and Pap smears to women who are uninsured or underinsured through a statewide provider network. Native Hawaiians, Pacific Islanders and Filipinas are priority populations for this program, and BCCCP providers are required through contract with the Hawaii Department of Health to utilize half of their allotted mammograms and Pap smears for eligible women from these groups. To identify strategies for increasing use by these groups of mammography and Pap smear screening services through BCCCP, we held focus groups with women who could potentially use BCCCP services, and we conducted key informant interviews with 9 of Hawai’i’s 11 BCCCP providers and 9 non-BCCCP outreach workers serving these populations. Findings led to recommendations for promoting awareness of BCCCP and enhancing outreach to Native Hawaiian, Pacific Islander and Filipina communities in Hawai’i. PMID:19842363

Muscular control of a learned movement: the speed control system hypothesis.

PubMed

Enoka, R M

1983-01-01

The "speed control system" hypothesis, which represents an attempt to identify an invariant characteristic of learned movements, postulates that movements of variable extent are controlled by regulating the intensity of muscle contractions such that the contraction duration remains constant. The contingency set originally utilized to develop this hypothesis was expanded by examining a movement that was multidirectional and multiarticular, and executed by large muscle groups generating near maximum torques. The investigation focused on the techniques utilized by weightlifters to control lower extremity displacement during the initial phase of the double knee bend execution of the "clean" in Olympic weightlifting. The combination of the quantified muscle activity and the angular velocity, both about the knee joint, revealed a sequence of shortening-lengthening muscle contractions throughout the movement. The first two periods of net muscular activity, one extensor and the other flexor, were utilized to examine the movement for invariant characteristics. As predicted by the speed control system hypothesis, the duration of the first period of net muscle torque activity (extensor) did not vary significantly, for either group of subjects, over the relative loads examined. The duration of the second period of activity (resultant flexor muscle torque), however, was not constant across loads, and further, the direction of the change depended upon the level of expertise. The more capable lifters tended to increase the duration of the resultant flexor involvement while the less skilled athletes utilized the reverse strategy when the load was increased. Conversely, the intensity of the muscle activity for both groups of subjects and both the extensor and flexor periods covaried with load, as predicted by the hypothesis. The speed control system hypothesis, therefore, provided an appropriate explanation for the first component of the movement, the period of extensor dominated (shortening contraction) muscle torque, but was inappropriate for the subsequent interval, a resultant flexor (largely lengthening contraction) muscle torque.

Empirically Supported Interventions for Sexual and Gender Minority Youth.

PubMed

Austin, Ashley; Craig, Shelley L

2015-01-01

When empirically supported treatments (ESTs) are effectively adapted for use with minority populations, they may be more efficacious. As such, there is a need to adapt existing ESTs for use with diverse sexual and gender minority youth (SGMY). The unique bias-based challenges faced by SGMY require the integration of affirmative practices into ESTs to effectively address the specific needs of this underserved group of youth. The primary purpose of the authors in this article is to present a clearly articulated stakeholder driven model for developing an affirmative adapted version of cognitive behavioral therapy (CBT) for use with diverse SGMY. The authors' approach to adaptation follows the "adapt and evaluate" framework for enhancing cultural congruence of interventions for minority groups. A community based participatory research approach, consistent with a stakeholder driven process, is utilized to develop the intervention from the ground up through the voices of the target community. Researchers conducted 3 focus groups with culturally diverse SGMY to explore salient aspects of youths' cultural and SGM identities in order to inform the intervention and ensure its applicability to a wide range of SGMY. Focus group data is analyzed and integrated into an existing group-based CBT intervention. The following themes emerge as critical to affirmative work with diverse SGMY: (1) the interplay between cultural norms, gender norms, sexual orientation, and gender identity; (2) the complex role of religious community within the lives of SGMY; and (3) consideration of extended family and cultural community as youth navigate their SGM identities.

Out-of-pocket drug costs and drug utilization patterns of postmenopausal Medicare beneficiaries with osteoporosis.

PubMed

Conwell, Leslie Jackson; Esposito, Dominick; Garavaglia, Susan; Meadows, Eric S; Colby, Margaret; Herrera, Vivian; Goldfarb, Seth; Ball, Daniel; Marciniak, Martin

2011-08-01

The Medicare Part D coverage gap has been associated with lower adherence and drug utilization and higher discontinuation. Because osteoporosis has a relatively high prevalence among Medicare-eligible postmenopausal women, we examined changes in utilization of osteoporosis medications during this coverage gap. The purpose of this study was to investigate changes in out-of-pocket (OOP) drug costs and utilization associated with the Medicare Part D coverage gap among postmenopausal beneficiaries with osteoporosis. This retrospective analysis of 2007 pharmacy claims focuses on postmenopausal female Medicare beneficiaries enrolled in full-, partial-, or no-gap exposure standard or Medicare Advantage prescription drug plans (PDPs), retiree drug subsidy (RDS) plans, or the low-income subsidy program. We compared beneficiaries with osteoporosis who were taking teriparatide (Eli Lilly and Company, Indianapolis, Indiana) (n = 5657) with matched samples of beneficiaries who were taking nonteriparatide osteoporosis medications (NTO; n = 16,971) or who had other chronic conditions (OCC; n = 16,971). We measured average monthly prescription drug fills and OOP costs, medication discontinuation, and skipping. More than half the sample reached the coverage gap; OOP costs then rose for teriparatide users enrolled in partial- or full-gap exposure plans (increase of 121% and 186%; $300 and $349) but fell for those in no-gap exposure PDPs or RDS plans (decrease of 49% and 30%; $131 and $40). OOP costs for beneficiaries in partial- or full-gap exposure PDPs increased >120% (increase of $144 and $176) in the NTO group and nearly doubled for the OCC group (increase of $124 and $151); these OOP costs were substantially lower than those for teriparatide users. Both teriparatide users and NTO group members discontinued or skipped medications more often than persons in the OCC group, regardless of plan or benefit design. Medication discontinuation and OOP costs among beneficiaries with osteoporosis were highest for those enrolled in Part D plans with a coverage gap. Providers should be aware of potential cost-related nonadherence among Medicare beneficiaries taking osteoporosis medications. Copyright © 2011 Elsevier HS Journals, Inc. All rights reserved.

Preoperative pain neuroscience education for lumbar radiculopathy: a multicenter randomized controlled trial with 1-year follow-up.

PubMed

Louw, Adriaan; Diener, Ina; Landers, Merrill R; Puentedura, Emilio J

2014-08-15

Multicenter, randomized, controlled trial on preoperative pain neuroscience education (NE) for lumbar radiculopathy. To determine if the addition of NE to usual preoperative education would result in superior outcomes with regard to pain, function, surgical experience, and health care utilization postsurgery. One in 4 patients after lumbar surgery (LS) for radiculopathy experience persistent pain and disability, which is nonresponsive to perioperative treatments. NE focusing on the neurophysiology of pain has been shown to decrease pain and disability in populations with chronic low back pain. Eligible patients scheduled for LS for radiculopathy were randomized to receive either preoperative usual care (UC) or a combination of UC plus 1 session of NE delivered by a physical therapist (verbal one-on-one format) and a NE booklet. Sixty-seven patients completed the following outcomes prior to LS (baseline), and 1, 3, 6, and 12 months after LS: low back pain (numeric rating scale), leg pain (numeric rating scale), function (Oswestry Disability Index), various beliefs and experiences related to LS (10-item survey with Likert scale responses), and postoperative utilization of health care (utilization of health care questionnaire). At 1-year follow-up, there were no statistical differences between the experimental and control groups with regard to primary outcome measure of low back pain (P = 0.183), leg pain (P = 0.075), and function (P = 0.365). In a majority of the categories regarding surgical experience, the NE group scored significantly better: better prepared for LS (P = 0.001); preoperative session preparing them for LS (P < 0.001) and LS meeting their expectations (P = 0.021). Health care utilization post-LS also favored the NE group (P = 0.007) resulting in 45% less health care expenditure compared with the control group in the 1-year follow-up period. NE resulted in significant behavior change. Despite a similar pain and functional trajectory during the 1-year trial, patients with LS who received NE viewed their surgical experience more favorably and used less health care facility in the form of medical tests and treatments. 2.

Religion and suicide: Buddhism, Native American and African religions, Atheism, and Agnosticism.

PubMed

Lizardi, D; Gearing, R E

2010-09-01

Research has repeatedly demonstrated that religiosity can potentially serve as a protective factor against suicidal behavior. A clear understanding of the influence of religion on suicidality is required to more fully assess for the risk of suicide. The databases PsycINFO and MEDLINE were used to search peer-reviewed journals prior to 2008 focusing on religion and suicide. Articles focusing on suicidality across Buddhism, Native American and African religions, as well as on the relationship among Atheism, Agnosticism, and suicide were utilized for this review. Practice recommendations are offered for conducting accurate assessment of religiosity as it relates to suicidality in these populations. Given the influence of religious beliefs on suicide, it is important to examine each major religious group for its unique conceptualization and position on suicide to accurately identify a client's suicide risk.

Task 1.13 -- Data collection and database development for clean coal technology by-product characteristics and management practices. Semi-annual report, July 1--December 31, 1996

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

Pflughoeft-Hassett, D.F.

1997-08-01

Information from DOE projects and commercial endeavors in fluidized-bed combustion and coal gasification is the focus of this task by the Energy and Environmental Research Center. The primary goal of this task is to provide an easily accessible compilation of characterization information on CCT (Clean Coal Technology) by-products to government agencies and industry to facilitate sound regulatory and management decisions. Supporting objectives are (1) to fully utilize information from previous DOE projects, (2) to coordinate with industry and other research groups, (3) to focus on by-products from pressurized fluidized-bed combustion (PFBC) and gasification, and (4) to provide information relevant tomore » the EPA evaluation criteria for the Phase 2 decision.« less

Anatomy by whole body dissection: a focus group study of students' learning experience.

PubMed

Burgess, Annette; Ramsey-Stewart, George

2015-01-01

The social construction of knowledge within medical education is essential for learning. Students' interactions within groups and associated learning artifacts can meaningfully impact learning. Situated cognition theory poses that knowledge, thinking, and learning are located in experience. In recent years, there has been a reported decline in time spent on anatomy by whole body dissection (AWBD) within medical programs. However, teaching by surgeons in AWBD provides unique opportunities for students, promoting a deeper engagement in learning. In this study, we apply situated cognition theory as a conceptual framework to explore students' perceptions of their learning experience within the 2014 iteration of an 8-week elective AWBD course. At the end of the course, all students (n=24) were invited to attend one of three focus groups. Framework analysis was used to code and categorize data into themes. In total, 20/24 (83%) students participated in focus groups. Utilizing situated cognition theory as a conceptual framework, we illustrate students' learning experiences within the AWBD course. Students highlighted opportunities to create and reinforce their own knowledge through active participation in authentic dissection tasks; guidance and clinical context provided by surgeons as supervisors; and the provision of an inclusive learning community. Situated cognition theory offers a valuable lens through which to view students' learning experience in the anatomy dissection course. By doing so, the importance of providing clinical relevance to medical teaching is highlighted. Additionally, the value of having surgeons teach AWBD and the experience they share is illustrated. The team learning course design, with varying teaching methods and frequent assessments, prompting student-student and student-teacher interaction, was also beneficial for student learning.

The clinical and cultural factors in classifying low back pain patients within Greece: a qualitative exploration of Greek health professionals.

PubMed

Billis, Evdokia V; McCarthy, Christopher J; Stathopoulos, Ioannis; Kapreli, Eleni; Pantzou, Paulina; Oldham, Jacqueline A

2007-06-01

Identifying homogenous subgroups of low back pain (LBP) patients is considered a priority in musculoskeletal rehabilitation and is believed to enhance clinical outcomes. In order to achieve this, the specific features of each subgroup need to be identified. The aim of this study was to develop a list of clinical and cultural features that are included in the assessment of LBP patients in Greece, among health professionals. This 'list' will be, utilized in a clinical study for developing LBP subgroups. Three focus groups were conducted, each one comprising health professionals with homogenous characteristics and all coordinated by a single moderator. There were: 11 physiotherapists (PTs) with clinical experience in LBP patients, seven PTs specialized in LBP management, and five doctors with a particular spinal interest. The focus of discussions was to develop a list of clinical and cultural features that were important in the examination of LBP. Content analysis was performed by two researchers. Clinicians and postgraduates developed five categories within the History (Present Symptoms, History of Symptoms, Function, Psychosocial, Medical History) and six categories within the Physical Examination (Observation, Neurological Examination, Active and Passive Movements, Muscle Features and Palpation). The doctors identified four categories in History (Symptomatology, Function, Psychosocial, Medical History) and an additional in Physical Examination (Special Tests). All groups identified three cultural categories; Attitudes of Health Professionals, Patients' Attitudes and Health System influences. An extensive Greek 'list' of clinical and cultural features was developed from the groups' analysis. Although similarities existed in most categories, there were several differences across the three focus groups which will be discussed.

Examining the Relationship between Comparative and Self-Focused Academic Data Visualizations in At-Risk College Students' Academic Motivation

ERIC Educational Resources Information Center

Aguilar, Stephen J.

2018-01-01

This qualitative study focuses on capturing students' understanding two visualizations often utilized by learning analytics-based educational technologies: bar graphs, and line graphs. It is framed by Achievement Goal Theory--a prominent theory of students' academic motivation--and utilizes interviews (n = 60) to investigate how students at risk…

Utilization Measurement: Focusing on the "U" in "D & U." Special Report.

ERIC Educational Resources Information Center

Southwest Educational Development Lab., Austin, TX.

One of a series of booklets on disability research, this paper is intended as an introduction to the role of evaluation in the utilization process. Its purpose is to help disability researchers grasp the importance of incorporating a focus on assessing use into plans for disseminating research outcomes. The paper begins by examining basic…

75 FR 1380 - National Drinking Water Advisory Council's Climate Ready Water Utilities Working Group Meeting...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-01-11

... Ready Water Utilities Working Group Meeting Announcement AGENCY: Environmental Protection Agency. ACTION... meeting of the Climate Ready Water Utilities (CRWU) Working Group of the National Drinking Water Advisory Council (NDWAC). The purpose of this meeting is for the Working Group to discuss the attributes and...

75 FR 20352 - National Drinking Water Advisory Council's Climate Ready Water Utilities Working Group Meeting...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-19

... Ready Water Utilities Working Group Meeting Announcement AGENCY: Environmental Protection Agency. ACTION...-person meeting of the Climate Ready Water Utilities (CRWU) Working Group of the National Drinking Water Advisory Council (NDWAC). The purpose of this meeting is for the Working Group to discuss key findings, the...

Exploring the psychological and somatic impact of identity theft.

PubMed

Sharp, Tracy; Shreve-Neiger, Andrea; Fremouw, William; Kane, John; Hutton, Shawn

2004-01-01

Identity theft is a new and growing form of white-collar crime. This exploratory study examined the psychological and somatic impact of identity theft and coping methods utilized by victims. Thirty-seven victims of identity theft participated in regional victim focus groups. Participants completed a victim impact questionnaire designed by the authors and the Brief Symptom Inventory-18 (BSI-18). The majority of participants expressed an increase in maladaptive psychological and somatic symptoms post victimization. Results on the BSI indicated that identity theft victims with unresolved cases, in contrast to those with resolved cases, were more likely to have clinically elevated scores when compared with a normative sample. Relatively similar coping mechanisms were utilized across victims. The results from this study suggest that victims of identity theft do have increased psychological and physical distress, and for those whose cases remain unresolved, distress is maintained over time.

Recruitment and retention in an SMS-based health education program: Lessons learned from Text2BHealthy.

PubMed

Speirs, Katherine E; Grutzmacher, Stephanie K; Munger, Ashley L; Messina, Lauren A

2016-09-01

While text messages or short messaging service programs are increasingly utilized for delivering health education, few studies have explored the unique challenges of recruiting and retaining participants in such programs. This study utilizes survey and focus group data from Text2BHealthy, a short messaging service-based nutrition and physical activity promotion program, to examine barriers to enrollment and facilitators of retention among parents of elementary school students. Results show that participants were hard to reach with recruitment materials, had difficulty with self-enrollment, and were apprehensive about program costs. However, 89-90 percent of participants were retained. Results suggest that providing manual enrollment options, alternative program delivery methods (e.g. email messages), and opportunities to reenroll may facilitate participation in short messaging service-based health education and promotion programs. © The Author(s) 2015.

Exploring the contexts of urban science classrooms. Part 1: Investigating corporate and communal practices

NASA Astrophysics Data System (ADS)

Emdin, Christopher

2007-04-01

In this paper, I discuss the existence of varying ideologies and perspectives within urban science classrooms and uncover the importance of focusing on student and teacher practices as a means to bridge these disconnections. Specifically, I describe the existence of corporate and communal ideologies and the dynamics that create the misalignment between groups that hold allegiances to these varying belief systems. Utilizing three allied theoretical frames, this paper provides a multi layered and timely analysis of the teaching of science in an urban high school in New York City. I conjoin Bourdieu's sociocultural theory, an analysis of social life through the use of the structure|agency dialectic, and a theorizing of corporate and communal practice to embark on a journey into how African American and Latino/a students' ways of knowing and being can be utilized to meet the goal of improving their success in science.

[Transnational health service utilization by Mexican immigrants in the United States].

PubMed

González-Vázquez, Tonatiuh Tomás; Torres-Robles, Cristian Armando; Pelcastre-Villafuerte, Blanca Estela

2013-01-01

Document the transnational utilization of health resources and services by Mexican immigrants in the United States. Between December 2009-February 2011, Interviews and focus groups were conducted in California and four states of México. Data were collected from 135 individuals, including return migrants, allopathic physicians and traditional healers. Faced with obstacles to accessing US health care and some health services within the Mexican system, many immigrants within the US make use of Mexican health resources and services, either from a distance or during visits to Mexico. These resources and services include allopathic medicine, traditional medicine, and home remedies and medicines. The legal status of immigrants and their access to health insurance in the US are related to whether their transnational use of Mexican health resources and services is formal or informal; immigrants who are undocumented and without health insurance are the most vulnerable.

Assessing the Feasibility of Smartphone Apps for HIV-Care Research with MSM and Transgender Individuals in Mpumalanga, South Africa.

PubMed

Daniels, Joseph; Lane, Tim; Struthers, Helen; Maleke, Kabelo; Moges, Winta; McIntyre, James; Coates, Thomas

There is an urgent need to develop the HIV treatment cascade for men who have sex with men (MSM) and transgender individuals in rural Mpumalanga, South Africa. Mhealth tools such as smartphone applications have the potential to support HIV self-care behaviors. We conducted an exploratory study with HIV-positive community leaders to understand their current uses of cell phones and smartphones and to assess their interest in an HIV research study that utilized a smartphone application for HIV care support. A total of 18 community leaders were recruited to complete a questionnaire and focus group. We found that a large proportion of participants had smartphone access and were interested in a research study that utilized a smartphone application with secure access measures. We conclude that smartphone applications for HIV care research are feasible based on access and interest by MSM and transgender individuals in this rural setting.

Health behaviors, service utilization, and access to care among older mothers of color who have children with developmental disabilities.

PubMed

Magaña, Sandy; Smith, Matthew J

2008-08-01

This study examined health behaviors, utilization, and access to care among older Latina and Black American mothers who co-reside with a child with developmental disabilities. Using data from the National Health Interview Survey National Center for Health Statistics (2005a), we compared Latina and Black American caregivers to similar women who did not have caregiving responsibilities. Findings showed that Latina caregivers were more likely to smoke and have insurance; Black American caregivers were less likely to be able to afford medication and mental health care; and both groups were less likely to have seen a doctor in the past year than their noncaregiving counterparts. Findings suggest that service providers should consider developing programs that focus on health for caregivers of color. Furthermore, results suggest that providers should take into account differing trends across ethnicities when designing programs.

Financial analysis of biogas utilization : input cattle, pig feces and coffee waste in Karo, Indonesia

NASA Astrophysics Data System (ADS)

Ginting, N.; Zuhri, F.; Hasnudi; Mirwandhono, E.; Sembiring, I.; Daulay, A. H.

2018-02-01

The community's need for renewable energy was very urgent. In addition, efforts to preserve the environment from waste caused biogas technology feasible to apply. This study aims to provide biogas technology with minimal cost and utilize agricultural waste that were coffee and livestock waste. The study was conducted from July to October 2016. The theoretical and empirical methods used in this study were included data from officials resources, field survey on 16 biogas locations, focus group discussion and interview with stake holders. Data were tabulated by Excel Program which then were analysed by SAS. Parameters were included Production Cost, Production Result, Profit Loss Analysis, Revenue Cost Ratio (R/C Ratio), Return On Investment (ROI), Net B/C, and IRR. The result of this research showed that the application of bioplastic gas with cow dung and coffee waste as bioplasticgas input cause the best results.

Promoting public health messages: Should we move beyond fear-evoking appeals in road safety?

PubMed

Lewis, Ioni M; Watson, Barry; White, Katherine M; Tay, Richard

2007-01-01

Road traffic injury is one of the most significant global public health issues of the 21st century. The extent to which negative, fear-evoking messages represent effective persuasive strategies remains a contentious public and empirical issue. Nevertheless, negative, fear-based appeals represent a frequently used approach in Australasian road safety advertising. The authors conducted a series of focus groups with 16 licensed drivers to explore the potential utility of appeals to emotions other than fear. More specifically, they sought to explore the utility of positive emotional appeals, such as those incorporating humor. The themes emerging from the qualitative analysis suggested that both emotion and the provision of strategies are key components contributing to the overall persuasiveness of a road safety advertisement. Overall, it appears there is support for researchers and health advertising practitioners to provide further attention to the role that positive emotional appeals might play in future campaigns.

Negative Affect Instability among Individuals with Comorbid Borderline Personality Disorder and Posttraumatic Stress Disorder

PubMed Central

Scheiderer, Emily M.; Wang, Ting; Tomko, Rachel L.; Wood, Phillip K.; Trull, Timothy J.

2015-01-01

Ecological momentary assessment (EMA; Stone & Shiffman, 1994) was utilized to examine affective instability (AI) in the daily lives of outpatients with borderline personality disorder (BPD; n=78) with and without posttraumatic stress disorder (PTSD). A psychiatric control group (n=50) composed of outpatients with major depressive disorder/dysthymia (MDD/DYS) was employed to compare across subgroups: BPD-only, BPD+PTSD, MDD/DYS-only, and MDD/DYS+PTSD. Compared to the BPD-only group, the BPD+PTSD group had significantly greater instability of fear and sadness, but did not significantly differ in instability of hostility or aggregate negative affect. This pattern of elevated instability of fear and sadness was not present—and, in fact, was reversed—in the MDD/DYS group. Results emphasize the importance of examining AI within the context of specific comorbidities and affect types. Treatment and research addressing AI in the context of BPD-PTSD comorbidity may benefit from a focus on fear and sadness as separate from hostility or general negative affect. PMID:26904388

A group-level approach to analyzing participative ergonomics (PE) effectiveness: The relationship between PE dimensions and employee exposure to injuries.

PubMed

Morag, Ido; Luria, Gil

2018-04-01

Most studies concerned with participative ergonomic (PE) interventions, focus on organizational rather than group level analysis. By implementing an intervention at a manufacturing plant, the current study, utilizing advanced information systems, measured the effect of line-supervisor leadership on employee exposure to risks. The study evaluated which PE dimensions (i.e., extent of workforce involvement, diversity of reporter role types and scope of analysis) are related to such exposure at the group level. The data for the study was extracted from two separate computerized systems (workforce medical records of 791 employees and an intranet reporting system) during a two-year period. While the results did not confirm the effect of line-supervisor leadership on subordinates' exposure to risks, they did demonstrate relationships between PE dimensions and the employees' exposure to risks. The results support the suggested level of analysis and demonstrate that group-based analysis facilitates the assimilation of preventive interventions. Copyright © 2017 Elsevier Ltd. All rights reserved.

Using spiritually modified cognitive-behavioral therapy in substance dependence treatment: therapists' and clients' perceptions of the presumed benefits and limitations.

PubMed

Hodge, David R; Lietz, Cynthia A

2014-11-01

Cognitive-behavioral therapy (CBT) that has been modified to incorporate clients' spiritual beliefs and practices has been used to treat a variety of problems. This study examines the utility of this modality with the treatment of alcohol dependence and other forms of substance abuse. Toward this end, six focus groups (three therapist groups and three client groups) were conducted to identify the presumed benefits and limitations of using spiritually modified CBT in substance dependence treatment. In terms of benefits, spiritually modified CBT was perceived to enhance outcomes through operationalizing horizontal and vertical sources of social support, divine coping resources, and spiritual motivation. Potential challenges include the risk of therapists inadvertently imposing their own beliefs during the modification process and the possibility of offending clients when conflicts in belief systems emerge, particularly in group setting. The article concludes by providing suggestions for incorporating spiritually modified CBT into treatment and develops a number of illustrative examples of spiritually modified CBT self-statements.

t4 Workshop Report

PubMed Central

Silbergeld, Ellen K.; Contreras, Elizabeth Q.; Hartung, Thomas; Hirsch, Cordula; Hogberg, Helena; Jachak, Ashish C.; Jordan, William; Landsiedel, Robert; Morris, Jeffery; Patri, Anil; Pounds, Joel G.; de Vizcaya Ruiz, Andrea; Shvedova, Anna; Tanguay, Robert; Tatarazako, Norihasa; van Vliet, Erwin; Walker, Nigel J.; Wiesner, Mark; Wilcox, Neil; Zurlo, Joanne

2014-01-01

Summary In October 2010, a group of experts met as part of the transatlantic think tank for toxicology (t4) to exchange ideas about the current status and future of safety testing of nanomaterials. At present, there is no widely accepted path forward to assure appropriate and effective hazard identification for engineered nanomaterials. The group discussed needs for characterization of nanomaterials and identified testing protocols that incorporate the use of innovative alternative whole models such as zebrafish or C. elegans, as well as in vitro or alternative methods to examine specific functional pathways and modes of action. The group proposed elements of a potential testing scheme for nanomaterials that works towards an integrated testing strategy, incorporating the goals of the NRC report Toxicity Testing in the 21st Century: A Vision and a Strategy by focusing on pathways of toxic response, and utilizing an evidence-based strategy for developing the knowledge base for safety assessment. Finally, the group recommended that a reliable, open, curated database be developed that interfaces with existing databases to enable sharing of information. PMID:21993959

Shared perceptions: morality is embedded in social contexts.

PubMed

Carnes, Nate C; Lickel, Brian; Janoff-Bulman, Ronnie

2015-03-01

Morality helps make social life possible, but social life is embedded in many social contexts. Research on morality has generally neglected this and instead has emphasized people's general beliefs. We therefore investigated the extent to which different moral principles are perceived as embedded in social contexts. We conducted two studies investigating how diverse social contexts influence beliefs about the operative moral principles in distinct group types. Study 1 examined these perceptions using a within-subjects design, whereas Study 2 utilized a between-subjects design. We found a high degree of consensus among raters concerning the operative moral principles in groups, and each group type was characterized by a qualitatively distinct pattern of applicable moral principles. Political orientation, a focus of past research on morality, had a small influence on beliefs about operative moral principles. The implications of these findings for our understanding of morality and its functional role in groups are discussed. © 2015 by the Society for Personality and Social Psychology, Inc.

Promoting advance directives among African Americans: a faith-based model.

PubMed

Bullock, Karen

2006-02-01

Studies show that African Americans are less likely than other ethnic groups to complete advance directives. However, what influences African Americans' decisions to complete or not complete advance directives is unclear. Using a faith-based promotion model, 102 African Americans aged 55 years or older were recruited from local churches and community-based agencies to participate in a pilot study to promote advance care planning. Focus groups were used to collect data on participants' preferences for care, desire to make personal choices, values and attitudes, beliefs about death and dying, and advance directives. A standardized interview was used in the focus groups, and the data were organized and analyzed using NUDIST 4 software (QRS Software, Victoria, Australia). Three fourths of the participants refused to complete advance directives. The following factors influenced the participants' decisions about end-of-life care and completion of an advance directive: spirituality; view of suffering, death, and dying; social support networks; barriers to utilization; and mistrust of the health care system. The dissemination of information apprises individuals of their right to self-determine about their care, but educational efforts may not produce a significant change in behavior toward completion of advance care planning. Thus, ongoing efforts are needed to improve the trust that African Americans have in medical and health care providers.

Are mHealth Interventions to Improve Child Restraint System Installation of Value? A Mixed Methods Study of Parents

PubMed Central

Fleisher, Linda; Erkoboni, Danielle; Halkyard, Katherine; Sykes, Emily; Norris, Marisol S.; Walker, Lorrie; Winston, Flaura

2017-01-01

Childhood death from vehicle crashes and the delivery of information about proper child restraint systems (CRS) use continues to be a critical public health issue. Safe Seat, a sequential, mixed-methods study identified gaps in parental knowledge about and perceived challenges in the use of appropriate CRS and insights into the preferences of various technological approaches to deliver CRS education. Focus groups (eight groups with 21 participants) and a quantitative national survey (N = 1251) using MTurk were conducted. Although there were differences in the age, racial/ethnic background, and educational level between the focus group participants and the national sample, there was a great deal of consistency in the need for more timely and personalized information about CRS. The majority of parents did not utilize car seat check professionals although they expressed interest in and lack of knowledge about how to access these resources. Although there was some interest in an app that would be personalized and able to push just-in-time content (e.g., new guidelines, location and times of car seat checks), content that has sporadic relevance (e.g., initial installation) seemed more appropriate for a website. Stakeholder input is critical to guide the development and delivery of acceptable and useful child safety education. PMID:28954429

A Virtual Mental Health Clinic for University Students: A Qualitative Study of End-User Service Needs and Priorities

PubMed Central

Gulliver, Amelia; Chan, Jade KY; Bennett, Kylie; Griffiths, Kathleen M

2015-01-01

Background Help seeking for mental health problems among university students is low, and Internet-based interventions such as virtual clinics have the potential to provide private, streamlined, and high quality care to this vulnerable group. Objective The objective of this study was to conduct focus groups with university students to obtain input on potential functions and features of a university-specific virtual clinic for mental health. Methods Participants were 19 undergraduate students from an Australian university between 19 and 24 years of age. Focus group discussion was structured by questions that addressed the following topics: (1) the utility and acceptability of a virtual mental health clinic for students, and (2) potential features of a virtual mental health clinic. Results Participants viewed the concept of a virtual clinic for university students favorably, despite expressing concerns about privacy of personal information. Participants expressed a desire to connect with professionals through the virtual clinic, for the clinic to provide information tailored to issues faced by students, and for the clinic to enable peer-to-peer interaction. Conclusions Overall, results of the study suggest the potential for virtual clinics to play a positive role in providing students with access to mental health support. PMID:26543908

Are mHealth Interventions to Improve Child Restraint System Installation of Value? A Mixed Methods Study of Parents.

PubMed

Fleisher, Linda; Erkoboni, Danielle; Halkyard, Katherine; Sykes, Emily; Norris, Marisol S; Walker, Lorrie; Winston, Flaura

2017-09-26

Childhood death from vehicle crashes and the delivery of information about proper child restraint systems (CRS) use continues to be a critical public health issue. Safe Seat, a sequential, mixed-methods study identified gaps in parental knowledge about and perceived challenges in the use of appropriate CRS and insights into the preferences of various technological approaches to deliver CRS education. Focus groups (eight groups with 21 participants) and a quantitative national survey (N = 1251) using MTurk were conducted. Although there were differences in the age, racial/ethnic background, and educational level between the focus group participants and the national sample, there was a great deal of consistency in the need for more timely and personalized information about CRS. The majority of parents did not utilize car seat check professionals although they expressed interest in and lack of knowledge about how to access these resources. Although there was some interest in an app that would be personalized and able to push just-in-time content (e.g., new guidelines, location and times of car seat checks), content that has sporadic relevance (e.g., initial installation) seemed more appropriate for a website. Stakeholder input is critical to guide the development and delivery of acceptable and useful child safety education.

Systematic Transcreation of Self-Help Smoking Cessation Materials for Hispanic/Latino Smokers: Improving Cultural Relevance and Acceptability.

PubMed

Piñeiro, Bárbara; Díaz, Diana R; Monsalve, Luis M; Martínez, Úrsula; Meade, Cathy D; Meltzer, Lauren R; Brandon, Karen O; Unrod, Marina; Brandon, Thomas H; Simmons, Vani N

2018-01-01

Smoking-related illnesses are the leading causes of death among Hispanics/Latinos. Yet, there are few smoking cessation interventions targeted for this population. The goal of this study was to "transcreate" an existing, previously validated, English language self-help smoking cessation intervention, titled Forever Free ® : Stop Smoking for Good, for Spanish-speaking smokers. Rather than simply translating the materials, our transcreation process involved culturally adapting the intervention to enhance acceptability and receptivity of the information. We utilized a multiphase qualitative approach (focus groups and learner verification interviews) to develop a linguistically and culturally relevant intervention for the diverse sub-ethnic groups of Hispanic/Latino smokers. Focus group findings indicated a need to underscore several additional cultural characteristics and themes such as the need to address familism and unique stressors faced by immigrants and to provide information regarding nicotine replacement therapy. Learner verification findings indicated a need to further emphasize financial and social benefits of quitting smoking and to discuss how family and friends can support the quit attempt. These steps led to the development of a Spanish-language smoking cessation intervention titled, Libre del cigarillo, por mi familia y por mí: Guía para dejar de fumar, that is currently being tested in a national randomized controlled trial.

Listening to the Patient: Women Veterans' Insights About Health Care Needs, Access, and Quality in Rural Areas.

PubMed

Brooks, Elizabeth; Dailey, Nancy K; Bair, Byron D; Shore, Jay H

2016-09-01

Many work to ensure that women veterans receive appropriate and timely health care, yet the needs of those living in rural areas are often ignored. This is a critical oversight given the multitude of reports documenting rural access problems and health disparities. Lacking this, we are unable to plan for and evaluate appropriate care for this specific group. In this project, we spoke with rural women veterans to document service needs and quality of care from their perspective. Rural women veterans' views about health care access and quality were ascertained in a series of five, semistructured focus groups (n = 35) and completion of a demographic questionnaire. Content analysis documented focus-group themes. Participants said that local dental, mental health, and gender-specific care options were needed, as well as alternative healing options. Community-based support for women veterans and interaction with female peers were absent. Participants' support for telehealth was mixed, as were requests for gender-specific care. Personal experiences in the military impacted participants' current service utilization. Action by both Veterans Affairs and the local community is vital to improving the health of women veterans. Service planning should consider additional Veterans Affairs contracts, mobile health vans, peer support, and enhanced outreach. Reprint & Copyright © 2016 Association of Military Surgeons of the U.S.

Qualitative exploration of barriers and facilitators of dental service utilization of pregnant women: A triangulation approach.

PubMed

Bahramian, Hoda; Mohebbi, Simin Z; Khami, Mohammad Reza; Quinonez, Rocio Beatriz

2018-05-10

Pregnant women are vulnerable to a wide range of oral health conditions that could be harmful to their own health and future child. Despite the usefulness of regular dental service utilization in prevention and early detection of oral diseases, it is notably low among pregnant women. In this qualitative study, we aimed to explore barriers and facilitators influencing pregnant women's dental service utilization. Using a triangulation approach, we included pregnant women (n = 22) from two public health centers, midwives (n = 8) and dentists (n = 12) from 12 other public centers in Tehran (Iran). Data was gathered through face-to-face semi-structured interviewing and focus group discussion methods. The analysis of qualitative data was performed using conventional content analysis with MAXQDA10 software. Reported barriers of dental service utilization among pregnant women were categorized under emerging themes: Lack of knowledge and misbelief, cost of dental care, physiological changes, fear and other psychological conditions, time constraint, dentists' unwillingness to accept pregnant women treatment, cultural taboos and lack of interprofessional collaboration. Solutions proposed by dentists, midwives and pregnant women to improve dental care utilization during pregnancy were categorized under three themes: Provision of knowledge, financial support and establishing supportive policies. Understanding perceived barriers of dental service utilization during pregnancy can serve as baseline information for planning and formulating appropriate oral health education, financial support, and legislations tailored for lower income pregnant women, midwives and dentists in countries with developing oral health care system.

The Electronic Health Literacy and Utilization of Technology for Health in a Remote Hawaiian Community: Lana‘i

PubMed Central

Humphry, Joseph

2018-01-01

The Lana‘i Community Health Center (LCHC) like other health care organizations, is striving to implement technology-enabled care (TEC) in the clinical setting. TEC includes such technological innovations as patient portals, mobile phone applications, wearable health sensors, and telehealth. This study examines the utilization of communication technology by members of the Lana‘i community and LCHC staff and board members in the home and in their daily lives and evaluates the community's electronic health literacy. Quantitative surveys and qualitative focus groups were utilized. These revealed that members of the Lana‘i community and LCHC staff and board members regularly utilize technology, in the form of smart cell phones, WiFi, and internet texting. This community has integrated technology into their daily lives, even though they live on an isolated island with 3,102 people; however, despite this integration, the electronic health literacy of this population appears insufficient for proper understanding and utilization of TEC, limiting the potential of patient portals or remote monitoring of patient generated data for chronic disease prevention and management without additional education and mentoring. It is therefore in the best interest of the LCHC and other health organizations wishing to implement TEC in a rural community such as Lana‘i to include a strong educational component with use of TEC, and perhaps establish a mentor/partnership program for the highly-challenged patient. PMID:29541550

The Electronic Health Literacy and Utilization of Technology for Health in a Remote Hawaiian Community: Lana'i.

PubMed

Witten, Nash Ak; Humphry, Joseph

2018-03-01

The Lana'i Community Health Center (LCHC) like other health care organizations, is striving to implement technology-enabled care (TEC) in the clinical setting. TEC includes such technological innovations as patient portals, mobile phone applications, wearable health sensors, and telehealth. This study examines the utilization of communication technology by members of the Lana'i community and LCHC staff and board members in the home and in their daily lives and evaluates the community's electronic health literacy. Quantitative surveys and qualitative focus groups were utilized. These revealed that members of the Lana'i community and LCHC staff and board members regularly utilize technology, in the form of smart cell phones, WiFi, and internet texting. This community has integrated technology into their daily lives, even though they live on an isolated island with 3,102 people; however, despite this integration, the electronic health literacy of this population appears insufficient for proper understanding and utilization of TEC, limiting the potential of patient portals or remote monitoring of patient generated data for chronic disease prevention and management without additional education and mentoring. It is therefore in the best interest of the LCHC and other health organizations wishing to implement TEC in a rural community such as Lana'i to include a strong educational component with use of TEC, and perhaps establish a mentor/partnership program for the highly-challenged patient.

Towards 90-90-90 Target: Factors Influencing Availability, Access, and Utilization of HIV Services—A Qualitative Study in 19 Ugandan Districts

PubMed Central

Tumwebaze, Flora; Akakimpa, Denis; Kityo, Cissy; Mugyenyi, Peter; Abongomera, George

2018-01-01

Background UNAIDS has set a new target 90-90-90 by 2020. To achieve this target, current programs need to address challenges that limit access, availability, and utilization of HIV testing and treatment services. Therefore, the aim of this study was to identify the barriers that influence access, availability, and utilization of HIV services in rural Uganda within the setting of a large donor funded program. Methods We conducted key informant interviews with stakeholders at the district level, staff of existing HIV/AIDS projects, and health facilities in 19 districts. Data were also collected from focus group discussions comprised of clients presenting for HIV care and treatment. Data were transcribed and analyzed using content analysis. Results. Barriers identified were as follows: (1) drug shortages including antiretroviral drugs at health facilities. Some patients were afraid to start ART because of worrying about shortages; (2) distance and (3) staffing shortages; (4) stigma persistence; (5) lack of social and economic support initiatives that enhance retention in treatment. Conclusions In conclusion, our study has identified several factors that influence access, availability, and utilization of HIV services. Programs need to address drug and staff shortages, HIV stigma, and long distances to health facilities to broaden access and utilization in order to realize the UNAIDS target. PMID:29750175

Estimating phylogenetic relationships despite discordant gene trees across loci: the species tree of a diverse species group of feather mites (Acari: Proctophyllodidae).

PubMed

Knowles, Lacey L; Klimov, Pavel B

2011-11-01

With the increased availability of multilocus sequence data, the lack of concordance of gene trees estimated for independent loci has focused attention on both the biological processes producing the discord and the methodologies used to estimate phylogenetic relationships. What has emerged is a suite of new analytical tools for phylogenetic inference--species tree approaches. In contrast to traditional phylogenetic methods that are stymied by the idiosyncrasies of gene trees, approaches for estimating species trees explicitly take into account the cause of discord among loci and, in the process, provides a direct estimate of phylogenetic history (i.e. the history of species divergence, not divergence of specific loci). We illustrate the utility of species tree estimates with an analysis of a diverse group of feather mites, the pinnatus species group (genus Proctophyllodes). Discord among four sequenced nuclear loci is consistent with theoretical expectations, given the short time separating speciation events (as evident by short internodes relative to terminal branch lengths in the trees). Nevertheless, many of the relationships are well resolved in a Bayesian estimate of the species tree; the analysis also highlights ambiguous aspects of the phylogeny that require additional loci. The broad utility of species tree approaches is discussed, and specifically, their application to groups with high speciation rates--a history of diversification with particular prevalence in host/parasite systems where species interactions can drive rapid diversification.

The integrated supplier: key to cost management and multi-franchise capitation contracting.

PubMed

Schuweiler, R C

1996-05-01

Capitation...most healthcare providers do not work under it, comprehend it, or even want it, yet supply capitation contracting seminars are popping up everywhere creating the feeling that the bandwagon is leaving, and it might be time to get on board. Not true. Supply capitation is not for all organizations. Capitation contracting is not easy and there are not many successful models to help the uninitiated. If a panacea is sought for reducing supply costs, capitation is only one component of a systematic strategy to reduce materiel costs. This article suggests a direction using the Group Health Materiel Management (Group Health Cooperative of Puget Sound, WA) experience as a point of reference. It advocates a systematic approach that focuses on expense reduction in: cost of goods, holding cost of inventory, labor cost associated with all materiel processes, distribution cost (transportation and par stock pick, pack, and replenishment), product utilization, variation in product standards, and waste stream byproducts. At Group Health (GH) these issues are primarily addressed through the use of: information systems, supplier certification/selection processes, group purchasing compliance, supply channel management, supply capitation contracting programs, standardization, and utilization management. Because of managed care organizational structure, Group Health Cooperative supply capitation contracting, as performed at GH, is discussed not as a quick fix solution but in the spirit of sharing our experience with others who may be considering it as a cost savings tactic in the context of a broad-based materiel management strategy. This article highlights the experiences of GH beginning with materiel management's business process assumptions toward multiple-franchise supply capitation.

The mental health relevance of idioms of distress. Anger and perceptions of injustice among New York Puerto Ricans.

PubMed

Rogler, L H; Cortes, D E; Malgady, R G

1994-06-01

Cultural sensitivity in mental health research is enhanced by examining the collective perceptions of members of ethnic groups about their own idiomatic expressions of distress. Such an examination was conducted with Puerto Ricans living in New York City, beginning with focus group discussions. Their prevailing idioms of distress, based upon themes of anger and injustice, were correlated widely with professionally developed measures of anxiety, depression, and somatization and with utilization of professional mental health care. By examining the relationship between idioms of distress, saliently volunteered by members of the ethnic ingroup, on the one hand, and professional care and assessments of mental health, on the other, we increase our culturally based understanding of mental health in the community.

Lowering nursing injuries using post offer pre-employment testing.

PubMed

Faris, Jason

2008-01-01

Nursing injuries are alarmingly high in the healthcare system. The rate of injuries adds to the shortage of nurses that are already employed. Preventing nursing injuries has focused on utilizing patient handling equipment. This project used post offer pre employment testing to attempt to control the injuries of nurses in a healthcare facility. Injuries were significantly lower in the employment pool that was tested when compared the nursing staff that had not been tested. Five injuries were reported in the tested group, resulting in $1,778 spent on the injuries, whereas the non-tested group had 54 injuries totaling $26,208. The total return on investment by this program was $4,541,059. Post Offer Pre employment testing can be a cost effective way to decrease the amount of injuries with nursing staff.

STARS experiential group intervention: a complex trauma treatment approach for survivors of human trafficking.

PubMed

Hopper, Elizabeth K; Azar, Naomi; Bhattacharyya, Sriya; Malebranche, Dominique A; Brennan, Kelsey E

2018-01-01

This is the abstract that was submitted online with the paper: Despite the fact that many survivors of human trafficking have experienced complex trauma, there are no established interventions designed to specifically address these impacts. Leaders in the field of complex trauma have advocated for the need for somatic approaches to intervention. This paper presents STARS Experiential Group treatment, the first structured bodybased group intervention that has been designed to address complex trauma in survivors of human trafficking. Three pilot groups were run in residential settings with adolescent and adult survivors of sex trafficking. Two adaptations were utilized, with one focusing on application of expressive arts modalities and the other incorporating theater games. Qualitative results, using thematic analysis, identified several themes related to challenges and potential benefits of these groups. Potential benefits of the STARS groups were found in the areas of Interpersonal Relationships, Regulation, and Self/ Identity, with fourteen sub-themes further describing positive impacts. Challenges within these areas are explored, to inform the development of group interventions for trafficking survivors. The results of this paper suggest that experiential, somatically-oriented group treatment shows promise as an important element of holistic intervention with trafficking survivors.

Utility of the ImPACT test with deaf adolescents.

PubMed

Reesman, Jennifer; Pineda, Jill; Carver, Jenny; Brice, Patrick J; Zabel, T Andrew; Schatz, Philip

2016-02-01

The goals of the study included empirical examination of the utility of the Immediate and Post-Concussion Assessment and Cognitive Testing (ImPACT) test with adolescents who are deaf or hard-of-hearing and to investigate patterns of performance at baseline that may arise in the assessment of this population. Baseline assessment of student-athletes has been conducted on a widespread scale with focus on performance of typically developing student-athletes and some clinical groups, though to date no studies have examined adolescents who are deaf or hard-of-hearing. Retrospective and de-identified ImPACT baseline test used with deaf and hard-of-hearing high-school student-athletes (N = 143; 66% male, mean age = 16.11) was examined. Review indicated significant differences in some composite scores between the deaf and hard-of-hearing group and hearing normative comparisons. A possible marker of task misunderstanding was identified to occur more frequently within the deaf and hard-of-hearing sample (13% in deaf sample vs. .31% in hearing sample). Results may provide support for the consideration and use of additional measures to ensure comprehension of task demands when considering this tool for use with deaf and hard-of-hearing adolescents.

Life, the universe, and everything: an education outreach proposal to build a traveling astrobiology exhibit.

PubMed

Barge, Laura M; Pulschen, André A; Emygdio, Ana Paula Mendes; Congreve, Curtis; Kishimoto, Darío E; Bendia, Amanda G; de Morais M Teles, Antonio; DeMarines, Julia; Stoupin, Daniel

2013-03-01

Astrobiology is a transdisciplinary field with extraordinary potential for the scientific community. As such, it is important to educate the community at large about the growing importance of this field to increase awareness and scientific content learning and expose potential future scientists. To this end, we propose the creation of a traveling museum exhibit that focuses exclusively on astrobiology and utilizes modern museum exhibit technology and design. This exhibit (the "Astrobiology Road Show"), organized and evaluated by an international group of astrobiology students and postdocs, is planned to tour throughout the Americas.

Glioblastoma: background, standard treatment paradigms, and supportive care considerations.

PubMed

Ellor, Susan V; Pagano-Young, Teri Ann; Avgeropoulos, Nicholas G

2014-01-01

Glioblastoma is a brain tumor condition marked by rapid neurological and clinical demise, resulting in disproportionate disability for those affected. Caring for this group of patients is complex, intense, multidisciplinary in nature, and fraught with the need for expensive treatments, surveillance imaging, physician follow-up, and rehabilitative, psychological, and social support interventions. Few of these patients return to the workforce for any meaningful time frame, and because of the enormity of the financial burden that patients, their caregivers, and society face, utilization reviews become the focus of ethical scrutiny. © 2014 American Society of Law, Medicine & Ethics, Inc.

Effect of Social Media in a mHealth Application.

PubMed

Tufte, Trond; Babic, Ankica

2017-01-01

In this project the potential of social media has been reviewed in terms how it can promote a healthy lifestyle utilized in an app. A mHealth app for smartphones has been developed using Design Science methodology, where various features from social media have been implemented with the goal of increasing physical activity. The application has been evaluated extensively in order to meet usability requirements. In addition, a focus group has contributed towards the application's potential to increase physical. The data collected is suggesting that social features have a positive impact on promoting physical activity.

Terminate Lung Cancer (TLC) Study - A mixed-methods population approach to increase lung cancer screening awareness and low-dose computed tomography in Eastern Kentucky

PubMed Central

Cardarelli, Roberto; Reese, David; Roper, Karen L.; Cardarelli, Kathryn; Feltner, Frances J.; Studts, Jamie L.; Knight, Jennifer R.; Armstrong, Debra; Weaver, Anthony; Shaffer, Dana

2017-01-01

For low dose CT lung cancer screening to be effective in curbing disease mortality, efforts are needed to overcome barriers to awareness and facilitate uptake of the current evidence-based screening guidelines. A sequential mixed-methods approach was employed to design a screening campaign utilizing messages developed from community focus groups, followed by implementation of the outreach campaign intervention in two high-risk Kentucky regions. This study reports on rates of awareness and screening in intervention regions, as compared to a control region. PMID:27866066

Characterization of human cervical remodeling throughout pregnancy using in vivo Raman spectroscopy

NASA Astrophysics Data System (ADS)

O'Brien, Christine M.; Vargis, Elizabeth; Slaughter, Chris; Rudin, Amy P.; Herington, Jennifer L.; Bennett, Kelly A.; Reese, Jeff; Mahadevan-Jansen, Anita

2015-02-01

Globally, fifteen million babies are born preterm each year, affecting 1 in 8 pregnancies in the US alone. Cervical remodeling includes a biochemical cascade of changes that ultimately result in the thinning and dilation of the cervix for passage of a fetus. This process is poorly understood and is the focus of this study. Our group is utilizing Raman spectroscopy to evaluate biochemical changes occurring in the human cervix throughout pregnancy. This technique has high molecular specificity and can be performed in vivo, with the potential to unveil new molecular dynamics essential for cervical remodeling.

Case manager-reported utilization of support group, substance use and mental health services among HIV-positive women in New York City.

PubMed

Kupprat, Sandra A; Dayton, Alex; Guschlbauer, Andrea; Halkitis, Perry N

2009-07-01

A retrospective, longitudinal analysis of case management and medical charts was used to evaluate utilization of support group, mental health, and substance abuse treatment services among HIV-positive women in New York City. Analyses of 4134 case management and supportive service transactions revealed that 70% utilized support groups over the two-year study period. In contrast, only 35% utilized mental health services (therapy) and of those identified as using substances, only 48% utilized substance abuse treatment services. Considering the high prevalence of mental illness (63%, n=29) and substance use (54%, n=25) in the sample, the low utilization rates highlight unmet needs for service. Significant differences were found in utilization of mental health and substance abuse treatment services, with those who received services at a medical model agency (integrated care) being more likely to receive both types of treatment. In contrast, participants attending support groups in non-medical model agencies (77.8%, n=7) were significantly more likely to be retained in group (i.e., attend 11 or more sessions) than those at medical model agencies (39.1%, n=9). Based on the higher utilization rates of support groups among seropositive women, perhaps these groups could be a vehicle for establishing rapport between mental health professionals and group members to bridge the utilization gap and reduce the stigma associated with therapy and substance abuse treatment services. These findings both taut the success and highlight weaknesses regarding accessing mental health and substance abuse care, and support group retention. Sharing of information regarding recruitment and retention efforts between agencies of different modalities would be beneficial and also could identify service niches that capitalize on their subsequent strengths.

Qualitative assessment of attitudes and knowledge on preterm birth in Malawi and within country framework of care

PubMed Central

2014-01-01

Background The overarching goal of this study was to qualitatively assess baseline knowledge and perceptions regarding preterm birth (PTB) and oral health in an at-risk, low resource setting surrounding Lilongwe, Malawi. The aims were to determine what is understood regarding normal length of gestation and how gestational age is estimated, to identify common language for preterm birth, and to assess what is understood as options for PTB management. As prior qualitative research had largely focused on patient or client-based focused groups, we primarily focused on groups comprised of community health workers (CHWs) and providers. Methods A qualitative study using focus-group discussions, incidence narrative, and informant interviews amongst voluntary participants. Six focus groups were comprised of CHWs, patient couples, midwives, and clinical officers (n = 33) at two rural health centers referring to Kamuzu Central Hospital. Semi-structured questions facilitated discussion of PTB and oral health (inclusive of periodontal disease), including definitions, perception, causation, management, and accepted interventions. Results Every participant knew of women who had experienced “a baby born too soon”, or preterm birth. All participants recognized both an etiology conceptualization and disease framework for preterm birth, distinguished PTB from miscarriage and macerated stillbirth, and articulated a willingness to engage in studies aimed at prevention or management. Identified gaps included: (1) discordance in the definition of PTB (i.e., 28–34 weeks or less than the 8th month, but with a corresponding fetal weight ranging 500 to 2300 grams); (2) utility and regional availability of antenatal steroids for prevention of preterm infant morbidity and mortality; (3) need for antenatal referral for at-risk women, or with symptoms of preterm birth. There was no evident preference for route of progesterone for the prevention of recurrent PTB. Conclusions Qualitative research was useful in (1) identifying gaps in knowledge in urban and rural Malawi, and (2) informing the development of educational materials and implementation of programs or trials ultimately aimed at reducing PTB. As a result of this qualitative work, implementation planning was focused on the gaps in knowledge, dissemination of knowledge (to both patients and providers), and practical solutions to barriers in known efficacious therapies. PMID:24690288

Risk, reassurance and routine: a qualitative study of narrative understandings of the potential for HIV self-testing among men who have sex with men in England.

PubMed

Witzel, T Charles; Weatherburn, Peter; Rodger, Alison J; Bourne, Adam H; Burns, Fiona M

2017-05-22

HIV testing has seen a rapid evolution over the last decade with multiple modalities now in use globally. In recent years HIV self-testing (HIVST) has been legalised in the UK paving the way for further expansion of testing. Interventions are delivered in particular social contexts which shape uptake. It is therefore important to understand how novel interventions are likely to be received by their intended users. This study aims to understand how HIVST compliments existing testing strategies considered or adopted by men who have sex with men (MSM). We do this by analysing normative discourses surrounding HIV testing and their perceptions of HIVST's potential future roles. Six focus group discussions (FGDs) were conducted with 47 MSM in London, Manchester and Plymouth. One focus group included only MSM who reported higher risk behaviours and one with those who had never tested for HIV. Data were analysed through a thematic framework analysis. Three main narratives for testing for HIV were identified: (i) testing in response to a specific risk event; (ii) as reassurance when there was a small amount of doubt or anxiety related to HIV; and (iii) in response to social norms perpetuated through peers, HIV community groups and the medical establishment to test regularly for HIV. HIVST had limited utility for men when testing in response to specific risk events except in the case of significant structural barriers to other testing opportunities. HIVST was considered to have utility when seeking reassurance, and was thought to be very useful when testing to satisfy the needs and expectations of others around regular testing. There was some ambivalence about the incursion of a clinical intervention into the home. HIVST following risk events will likely be limited to those for whom existing service provision is insufficient to meet immediate needs based on structural or personal barriers to testing. Obligations of biological citizenship are central to MSM's understanding of the utility of HIVST. In the context of discourses of biocitizenship, men perceive HIVST to have dual roles: firstly as a tool to manage (mild) anxiety around one's HIV status based on an acknowledgment of HIV vulnerability arising from being homosexually active. Secondly, HIVST is useful in complying with social norms and meeting the perceived demands of biomedicine.

Astronomy4Kids: Utilizing online video forums to teach basic planetary concepts to children (pre-K to 2nd-grade)

NASA Astrophysics Data System (ADS)

Pearson, Richard L.

2016-10-01

We have developed Astronomy4Kids to help cultivate the next generation of scientists by using technology to reach every interested child in both formal and informal learning environments. This online video series fills the void of effective STEM education tools for children under the age of 8. Our first collection of videos discuss many planetary topics, including the following: planet and moon formation theories, solar and lunar eclipses, and the seasonal effect of the Earth's tilt. As education and outreach become a larger focus of groups such as AAS and NASA, it is imperative to include programs such as Astronomy4Kids to extend these initiatives to younger age groups.Traditionally, this age group has been viewed as too young to be introduced to physics and astronomy concepts. However, child development research is consistently demonstrating the amazing plasticity of a young child's mind: the younger one is introduced to a complex concept, the easier it is to grasp later on. Following the philosophies of Fred Rogers, we present children with a real, relatable, instructor allowing them to focus on the concepts being presented.The format of Astronomy4Kids includes short instruction video clips that usually include a hands-on activity that is easily reproduced at home or in the classroom. This permits flexibility in how the video series is utilized. Within formal classroom or after-school situations, teachers and instructors can lead the discussion and activity with help from the video and supplemental materials (e.g. worksheets, concept outlines, etc.). Informal environments permit the viewer to complete the tasks on their own or simply enjoy the presentation. The video series can be found on YouTube (under "Astronomy 4 Kids") or Facebook (at www.facebook.com/astronomy4kids); we have also expanded to Instagram (www.instragram.com/astronomy4kids) and Pinterest (www.pinterest.com/astronomy4kids).

Large animal and primate models of spinal cord injury for the testing of novel therapies.

PubMed

Kwon, Brian K; Streijger, Femke; Hill, Caitlin E; Anderson, Aileen J; Bacon, Mark; Beattie, Michael S; Blesch, Armin; Bradbury, Elizabeth J; Brown, Arthur; Bresnahan, Jacqueline C; Case, Casey C; Colburn, Raymond W; David, Samuel; Fawcett, James W; Ferguson, Adam R; Fischer, Itzhak; Floyd, Candace L; Gensel, John C; Houle, John D; Jakeman, Lyn B; Jeffery, Nick D; Jones, Linda Ann Truett; Kleitman, Naomi; Kocsis, Jeffery; Lu, Paul; Magnuson, David S K; Marsala, Martin; Moore, Simon W; Mothe, Andrea J; Oudega, Martin; Plant, Giles W; Rabchevsky, Alexander Sasha; Schwab, Jan M; Silver, Jerry; Steward, Oswald; Xu, Xiao-Ming; Guest, James D; Tetzlaff, Wolfram

2015-07-01

Large animal and primate models of spinal cord injury (SCI) are being increasingly utilized for the testing of novel therapies. While these represent intermediary animal species between rodents and humans and offer the opportunity to pose unique research questions prior to clinical trials, the role that such large animal and primate models should play in the translational pipeline is unclear. In this initiative we engaged members of the SCI research community in a questionnaire and round-table focus group discussion around the use of such models. Forty-one SCI researchers from academia, industry, and granting agencies were asked to complete a questionnaire about their opinion regarding the use of large animal and primate models in the context of testing novel therapeutics. The questions centered around how large animal and primate models of SCI would be best utilized in the spectrum of preclinical testing, and how much testing in rodent models was warranted before employing these models. Further questions were posed at a focus group meeting attended by the respondents. The group generally felt that large animal and primate models of SCI serve a potentially useful role in the translational pipeline for novel therapies, and that the rational use of these models would depend on the type of therapy and specific research question being addressed. While testing within these models should not be mandatory, the detection of beneficial effects using these models lends additional support for translating a therapy to humans. These models provides an opportunity to evaluate and refine surgical procedures prior to use in humans, and safety and bio-distribution in a spinal cord more similar in size and anatomy to that of humans. Our results reveal that while many feel that these models are valuable in the testing of novel therapies, important questions remain unanswered about how they should be used and how data derived from them should be interpreted. Copyright © 2015 Elsevier Inc. All rights reserved.

The nature of undergraduates' conceptual understanding of oxygen transport and utilization in humans: Can cardiopulmonary simulation software enhance learning of propositional knowledge and/or diagnose alternative conceptions in novices and intermediates?

NASA Astrophysics Data System (ADS)

Wissing, Dennis Robert

The purpose of the this research was to explore undergraduates' conceptual development for oxygen transport and utilization, as a component of a cardiopulmonary physiology and advanced respiratory care course in the allied health program. This exploration focused on the student's development of knowledge and the presence of alternative conceptions, prior to, during, and after completing cardiopulmonary physiology and advanced respiratory care courses. Using the simulation program, SimBioSysTM (Samsel, 1994), student-participants completed a series of laboratory exercises focusing on cardiopulmonary disease states. This study examined data gathered from: (1) a novice group receiving the simulation program prior to instruction, (2) a novice group that experienced the simulation program following course completion in cardiopulmonary physiology, and (3) an intermediate group who experienced the simulation program following completion of formal education in Respiratory Care. This research was based on the theory of Human Constructivism as described by Mintzes, Wandersee, and Novak (1997). Data-gathering techniques were based on theories supported by Novak (1984), Wandersee (1997), and Chi (1997). Data were generated by exams, interviews, verbal analysis (Chi, 1997), and concept mapping. Results suggest that simulation may be an effective instructional method for assessing conceptual development and diagnosing alternative conceptions in undergraduates enrolled in a cardiopulmonary science program. Use of simulation in conjunction with clinical interview and concept mapping may assist in verifying gaps in learning and conceptual knowledge. This study found only limited evidence to support the use of computer simulation prior to lecture to augment learning. However, it was demonstrated that students' prelecture experience with the computer simulation helped the instructor assess what the learner knew so he or she could be taught accordingly. In addition, use of computer simulation after formal instruction was shown to be useful in aiding students identified by the instructor as needing remediation.

Full-Range Public Health Leadership, Part 2: Qualitative Analysis and Synthesis.

PubMed

Carlton, Erik L; Holsinger, James W; Riddell, Martha C; Bush, Heather

2015-01-01

Public health leadership is an important topic in the era of U.S. health reform, population health innovation, and health system transformation. This study utilized the full-range leadership model in order to examine the public health leadership. We sought to understand local public health leadership from the perspective of local health department leaders and those who work with and for them. Public health leadership was explored through interviews and focus groups with directors (n = 4) and staff (n = 33) from local health departments. Qualitative analytic methods included reflexive journals, code-recode procedures, and member checking, with analysis facilitated by Atlas.ti v.6.0. Qualitative results supported and expanded upon previously reported quantitative findings. Leading by example and providing individual consideration to followers were found to be more important than other leader factors, such as intellectual stimulation, inspirational motivation, or idealized attributes of leaders. Having a clear and competent vision of public health, being able to work collaboratively with other community agencies, and addressing the current challenges to public health with creativity and innovation were also important findings. Idealized leadership behaviors and individual consideration should be the focus of student and professional development. Models that incorporate contextual considerations, such as the situational leadership model, could be utilized to ensure that optimal individual consideration is given to followers.

Walt Disney World`s utility efficiency awards and environmental circles of excellence

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

Allen, P.J.; Kivler, W.B.

1996-05-01

This paper describes an innovative approach to energy conservation that has been started at WALT DISNEY WORLD. The program that was established was designed to heighten the awareness of energy usage in our Management and Cast Members, establish a method for recognizing and rewarding positive energy conservation efforts and, most importantly, keeping the effort simple and fun. Two programs work together to meet this goal: Utility Efficiency Awards and the Environmental Circles of Excellence. The Utility Efficiency Awards are given to the top areas that have demonstrated a reduction in utility consumption relative to the same period in prior years.more » More importantly, a report is generated that shows a best-to-worst ranking. Relying on the idea that {open_quotes}nobody wants to be on the bottom of the list{close_quotes}, conservation is enhanced by focusing attention on improving efficiency. To encourage direct cast member involvement in our environmental program, the Environmental Circles of Excellence were created. These groups, made up of hourly and salaried cast members, discuss their location`s environmental commitments, set goals and implement programs. This paper describes these initiatives in detail and presents some initial results that have heightened the awareness of energy conservation at WALT DISNEY WORLD.« less

The evolution of utility functions and psychological altruism.

PubMed

Clavien, Christine; Chapuisat, Michel

2016-04-01

Numerous studies show that humans tend to be more cooperative than expected given the assumption that they are rational maximizers of personal gain. As a result, theoreticians have proposed elaborated formal representations of human decision-making, in which utility functions including "altruistic" or "moral" preferences replace the purely self-oriented "Homo economicus" function. Here we review mathematical approaches that provide insights into the mathematical stability of alternative utility functions. Candidate utility functions may be evaluated with help of game theory, classical modeling of social evolution that focuses on behavioral strategies, and modeling of social evolution that focuses directly on utility functions. We present the advantages of the latter form of investigation and discuss one surprisingly precise result: "Homo economicus" as well as "altruistic" utility functions are less stable than a function containing a preference for the common welfare that is only expressed in social contexts composed of individuals with similar preferences. We discuss the contribution of mathematical models to our understanding of human other-oriented behavior, with a focus on the classical debate over psychological altruism. We conclude that human can be psychologically altruistic, but that psychological altruism evolved because it was generally expressed towards individuals that contributed to the actor's fitness, such as own children, romantic partners and long term reciprocators. Copyright © 2015 Elsevier Ltd. All rights reserved.

Cross-cultural acceptability and utility of the strengths and difficulties questionnaire: views of families.

PubMed

Kersten, Paula; Dudley, Margaret; Nayar, Shoba; Elder, Hinemoa; Robertson, Heather; Tauroa, Robyn; McPherson, Kathryn M

2016-10-12

Screening children for behavioural difficulties requires the use of a tool that is culturally valid. We explored the cross-cultural acceptability and utility of the Strengths and Difficulties Questionnaire for pre-school children (aged 3-5) as perceived by families in New Zealand. A qualitative interpretive descriptive study (focus groups and interviews) in which 65 participants from five key ethnic groups (New Zealand European, Māori, Pacific, Asian and other immigrant parents) took part. Thematic analysis using an inductive approach, in which the themes identified are strongly linked to the data, was employed. Many parents reported they were unclear about the purpose of the tool, affecting its perceived value. Participants reported not understanding the context in which they should consider the questions and had difficulty understanding some questions and response options. Māori parents generally did not support the questionnaire based approach, preferring face to face interaction. Parents from Māori, Pacific Island, Asian, and new immigrant groups reported the tool lacked explicit consideration of children in their cultural context. Parents discussed the importance of timing and multiple perspectives when interpreting scores from the tool. In summary, this study posed a number of challenges to the use of the Strengths and Difficulties Questionnaire in New Zealand. Further work is required to develop a tool that is culturally appropriate with good content validity.

Practical Tips and Techniques on the Process of Transdisciplinary Sea Level Rise Research

NASA Astrophysics Data System (ADS)

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

2015-12-01

There is increasing awareness of the need for transdisciplinary science to address complex climate change issues, yet practical guidance is lacking. This presentation describes the iterative planning, implementation, and evaluation process of an ongoing transdisciplinary sea level rise (SLR) research project. Observations, reflections, and recommendations from firsthand experience are shared, illustrated with examples, and placed within a transdisciplinary research framework. The NOAA-sponsored project, Ecological Effects of Sea Level Rise in the Northern Gulf of Mexico (EESLR-NGOM) is a six-year regional study involving a team of biology, ecology, civil/coastal engineering, and communication scholars working with government agency personnel and industry professionals; supervising students and post-doctoral researchers; and engaging a group of non-academic stakeholders (i.e., coastal resource managers). EESLR-NGOM's focus is on detailed assessment and process-based modeling to project SLR impacts on northern Gulf of Mexico coastal wetland habitats and flood plains. This presentation highlights collaboration, communication, and project management considerations, and explains knowledge co-production from a dynamic combination of natural and social scientific methods (secondary data analysis, computer modeling, field observations, field and laboratory experiments, focus group interviews, surveys) and interrelated stakeholder engagement mechanisms (advisory committee, project flow chart, workshops, focus groups, webinars) infused throughout the EESLR-NGOM project to improve accessibility and utility of the scientific results and products. Attention is also given to project evaluation including monitoring, multiple quantitative and qualitative measures, and recognition of challenges and limitations. This presentation should generate productive dialogue and direction for similar endeavors to find transformative solutions to pressing problems of climate change.

How patients view probiotics: findings from a multicenter study of patients with inflammatory bowel disease and irritable bowel syndrome.

PubMed

Mercer, MaryBeth; Brinich, Margaret A; Geller, Gail; Harrison, Krista; Highland, Janelle; James, Katherine; Marshall, Patricia; McCormick, Jennifer B; Tilburt, Jon; Achkar, Jean-Paul; Farrell, Ruth M; Sharp, Richard R

2012-02-01

Patients with inflammatory bowel disease (IBD) and irritable bowel syndrome (IBS) have access to a growing number of probiotic products marketed to improve digestive health. It is unclear how patients make decisions about probiotics and what role they expect their gastroenterologists to play as they consider using probiotics. Understanding patients' knowledge, attitudes and expectations of probiotics may help gastroenterologists engage patients in collaborative discussions about probiotics. Focus groups were conducted with patients with IBD and IBS at the Cleveland Clinic, Mayo Clinic, and Johns Hopkins University. Inductive analytic methods were used to identify common themes and draw interpretations from focus group narratives. One hundred thirty-six patients participated in 22 focus groups between March and August 2009. Patients viewed probiotics as an appealing alternative to pharmaceutical drugs and understood probiotics as a more "natural," low-risk therapeutic option. Many patients were hesitant to use them without consulting their gastroenterologists. Patients would weigh the risks and benefits of probiotics, their disease severity and satisfaction with current treatments when considering probiotic use. Patients are interested in probiotics but have many unanswered questions about their use. Our findings suggest that patients with IBD and IBS will look to gastroenterologists and other clinicians as trustworthy advisors regarding the utility of probiotics as an alternative or supplement to pharmaceutical drugs. Gastroenterologists and other clinicians who care for patients with these diseases should be prepared to discuss the potential benefits and risks of probiotics and assist patients in making informed decisions about their use.

Child protective services utilization of child abuse pediatricians: A mixed methods study.

PubMed

Girardet, Rebecca; Bolton, Kelly; Hashmi, Syed; Sedlock, Emily; Khatri, Rachna; Lahoti, Nina; Lukefahr, James

2018-02-01

Several children's hospitals and medical schools across Texas have child abuse pediatricians (CAPs) who work closely with child protection workers to help ensure accurate assessments of the likelihood of maltreatment in cases of suspected abuse and neglect. Since the state does not mandate which cases should be referred to a CAP center, we were interested in studying factors that may influence workers' decisions to consult a CAP. We used a mixed methods study design consisting of a focus group followed by a survey. The focus group identified multiple factors that impact workers' decision-making, including several that involve medical providers. Responses from 436 completed surveys were compared to employees' number of years of employment and to the state region in which they worked. Focus group findings and survey responses revealed frustration among many workers when dealing with medical providers, and moderate levels of confidence in workers' abilities to make accurate determinations in cases involving medical information. Workers were more likely to refer cases involving serious physical injury than other types of cases. Among workers who reported prior interactions with a CAP, experiences and attitudes regarding CAPs were typically positive. The survey also revealed significant variability in referral practices by state region. Our results suggest that standard guidelines regarding CAP referrals may help workers who deal with cases involving medical information. Future research and quality improvement efforts to improve transfers of information and to better understand the qualities that CPS workers appreciate in CAP teams should improve CAP-CPS coordination. Copyright © 2017 Elsevier Ltd. All rights reserved.

Qualitative Application of the Theory of Planned Behavior to Understand Beverage Behaviors among Adults

PubMed Central

Krzeski, Erin; Harden, Samantha; Cook, Emily; Allen, Kacie; Estabrooks, Paul A.

2012-01-01

Despite strong scientific data indicating associations among sugar-sweetened beverages (SSB) and numerous adverse health outcomes, little is known about culturally specific beliefs and potential individual-level behavioral strategies to reduce SSB intake. The primary objective of this formative study targeting adults residing in rural southwest Virginia was to apply the Theory of Planned Behavior (TPB) to investigate culturally specific attitudes, subjective norms and perceived behavioral control constructs related to the consumption of SSB, water, and artificially sweetened beverages. Using a homogenous sampling strategy, eight focus groups were conducted with 54 adult participants who exceeded recommendations of <1 cup of SSB/day. An experienced moderator and co-moderator utilized a semi-structured script, grounded in the TPB, to execute the focus group. All focus groups were audio taped and transcribed verbatim. Three researchers independently coded meaning units (MU) to the major themes and subsequently met to gain consensus in coding. Important beverage specific themes emerged for attitudes, subjective norms, perceived behavioral control, and intentions. Across all beverages, the most notable themes included taste (n= 161 MU), availability/convenience (n= 95 MU), habit/addiction (n=57 MU), and cost (n= 28 MU). Health consequences associated with beverages and water quality issues also surfaced, as well as normative beliefs including the influence of doctors and peers. The identified themes and sub-themes provides critical insight into understanding culturally-relevant context and beliefs associated with beverage behaviors and helps inform the development and evaluation of future intervention efforts targeting SSB consumption in the health disparate region of southwest Virginia. PMID:23102176

Determinants of hospital nurse intention to remain employed: broadening our understanding

PubMed Central

Tourangeau, Ann E; Cummings, Greta; Cranley, Lisa A; Ferron, Era Mae; Harvey, Sarah

2010-01-01

Title Determinants of hospital nurse intention to remain employed: broadening ourunderstanding. Aim This paper is a report of a study to identify nurse reported determinants of intention to remain employed and to develop a model explaining determinants of hospital nurse intention to remain employed. Background A worsening shortage of nurses globally suggests that efforts must be made to promote retention of nurses. However, effective retention promotion strategies depend on understanding the factors influencing nurse retention. Methods A descriptive study using focus group methodology was implemented. Thirteen focus groups including 78 nurses were carried out in two Canadian provinces in 2007. Thematic analysis strategies were incorporated to analyse the data. Findings Eight thematic categories reflecting factors nurses described as influencing their intentions to remain employed emerged from focus groups: (1) relationships with co-workers, (2) condition of the work environment, (3) relationship with and support from one’s manager, (4) work rewards, (5) organizational support and practices, (6) physical and psychological responses to work, (7) patient relationships and other job content, and (8) external factors. A model of determinants of hospital nurse intention to remain employed is hypothesized. Conclusion Findings were both similar to and different from previous research. The overriding concept of job satisfaction was not found. Rather, nurse assessments of satisfaction within eight thematic categories were found to influence intentions to remain employed. Further testing of the hypothesized model is required to determine its global utility. Understanding determinants of intention to remain employed can lead to development of strategies that strengthen nurse retention. Incorporation of this knowledge in nurse education programmes is essential. PMID:20423434

Can sensory attention focused exercise facilitate the utilization of proprioception for improved balance control in PD?

PubMed

Lefaivre, Shannon C; Almeida, Quincy J

2015-02-01

Impaired sensory processing in Parkinson's disease (PD) has been argued to contribute to balance deficits. Exercises aimed at improving sensory feedback and body awareness have the potential to ameliorate balance deficits in PD. Recently, PD SAFEx™, a sensory and attention focused rehabilitation program, has been shown to improve motor deficits in PD, although balance control has never been evaluated. The objective of this study was to measure the effects of PD SAFEx™ on balance control in PD. Twenty-one participants with mild to moderate idiopathic PD completed 12 weeks of PD SAFEx™ training (three times/week) in a group setting. Prior to training, participants completed a pre-assessment evaluating balance in accordance with an objective, computerized test of balance (modified clinical test of sensory integration and balance (m-CTSIB) and postural stability testing (PST)) protocols. The m-CTSIB was our primary outcome measure, which allowed assessment of balance in both eyes open and closed conditions, thus enabling evaluation of specific sensory contributions to balance improvement. At post-test, a significant interaction between time of assessment and vision condition (p=.014) demonstrated that all participants significantly improved balance control, specifically when eyes were closed. Balance control did not change from pre to post with eyes open. These results provide evidence that PD SAFEx™ is effective at improving the ability to utilize proprioceptive information, resulting in improved balance control in the absence of vision. Enhancing the ability to utilize proprioception for individuals with PD is an important intermediary to improving balance deficits. Copyright © 2015. Published by Elsevier B.V.

Transitioning mental health & psychosocial support: from short-term emergency to sustainable post-disaster development. Humanitarian Action Summit 2011.

PubMed

Patel, P P; Russell, J; Allden, K; Betancourt, T S; Bolton, P; Galappatti, A; Hijazi, Z; Johnson, K; Jones, L; Kadis, L; Leary, K; Weissbecker, I; Nakku, J

2011-12-01

The Working Group (WG) on Mental Health and Psychosocial Support participated in its second Humanitarian Action Summit in 2011. This year, the WG chose to focus on a new goal: reviewing practice related to transitioning mental health and psychosocial support programs from the emergency phase to long-term development. The Working Group's findings draw on a review of relevant literature as well as case examples. The objective of the Working Group was to identify factors that promote or hinder the long term sustainability of emergency mental health and psychosocial interventions in crisis and conflict, and to provide recommendations for transitioning such programs from relief to development. The Working Group (WG) conducted a review of relevant literature and collected case examples based on experiences and observations of working group members in implementing mental and psychosocial programming in the field. The WG focused on reviewing literature on mental health and psychosocial programs and interventions that were established in conflict, disaster, protracted crisis settings, or transition from acute phase to development phase. The WG utilized case examples from programs in Lebanon, the Gaza Strip, Sierra Leone, Aceh (Indonesia), Sri Lanka, and New Orleans (United States). The WG identified five key thematic areas that should be addressed in order to successfully transition lasting and effective mental health and psychosocial programs from emergency settings to the development phase. The five areas identified were as follows: Government and Policy, Human Resources and Training, Programming and Services, Research and Monitoring, and Finance. The group identified several recommendations for each thematic area, which were generated from key lessons learned by working group members through implementing mental health and psychosocial support programs in a variety of settings, some successfully sustained and some that were not.

Molecular and Morphological Inference of Three Cryptic Species within the Merodon aureus Species Group (Diptera: Syrphidae).

PubMed

Šašić, Ljiljana; Ačanski, Jelena; Vujić, Ante; Ståhls, Gunilla; Radenković, Snežana; Milić, Dubravka; Obreht Vidaković, Dragana; Đan, Mihajla

2016-01-01

The Merodon aureus species group (Diptera: Syrphidae: Eristalinae) comprises a number of different sub-groups and species complexes. In this study we focus on resolving the taxonomic status of the entity previously identified as M. cinereus B, here identified as M. atratus species complex. We used an integrative approach based on morphological descriptions, combined with supporting characters that were obtained from molecular analyses of the mitochondrial cytochrome c oxidase I gene as well as from geometric morphometry of wing and surstylus shapes and environmental niche comparisons. All applied data and methods distinguished and supported three morphologically cryptic species: M. atratus stat. nov., M. virgatus sp. nov. and M. balkanicus sp. nov., which constitute the M. atratus species complex. We present an identification key for the sub-groups and species complexes of the M. aureus species group occurring in Europe, describe the taxa and discuss the utility of the applied methods for species delimitation. The estimated divergence times for the species splits of these taxa coincide with the Pleistocene Günz-Mindel interglaciation and the Great interglaciation (between the Ris and Mindel glacial periods).

Decomposing Kenyan socio-economic inequalities in skilled birth attendance and measles immunization

PubMed Central

2013-01-01

Introduction Skilled birth attendance (SBA) and measles immunization reflect two aspects of a health system. In Kenya, their national coverage gaps are substantial but could be largely improved if the total population had the same coverage as the wealthiest quintile. A decomposition analysis allows identifying the factors that influence these wealth-related inequalities in order to develop appropriate policy responses. The main objective of the study was to decompose wealth-related inequalities in SBA and measles immunization into their contributing factors. Methods Data from the Kenyan Demographic and Health Survey 2008/09 were used. The study investigated the effects of socio-economic determinants on [1] coverage and [2] wealth-related inequalities of SBA utilization and measles immunization. Techniques used were multivariate logistic regression and decomposition of the concentration index (C). Results SBA utilization and measles immunization coverage differed according to household wealth, parent’s education, skilled antenatal care visits, birth order and father’s occupation. SBA utilization further differed across provinces and ethnic groups. The overall C for SBA was 0.14 and was mostly explained by wealth (40%), parent’s education (28%), antenatal care (9%), and province (6%). The overall C for measles immunization was 0.08 and was mostly explained by wealth (60%), birth order (33%), and parent’s education (28%). Rural residence (−19%) reduced this inequality. Conclusion Both health care indicators require a broad strengthening of health systems with a special focus on disadvantaged sub-groups. PMID:23294938

Focus groups: a useful tool for curriculum evaluation.

PubMed

Frasier, P Y; Slatt, L; Kowlowitz, V; Kollisch, D O; Mintzer, M

1997-01-01

Focus group interviews have been used extensively in health services program planning, health education, and curriculum planning. However, with the exception of a few reports describing the use of focus groups for a basic science course evaluation and a clerkship's impact on medical students, the potential of focus groups as a tool for curriculum evaluation has not been explored. Focus groups are a valid stand-alone evaluation process, but they are most often used in combination with other quantitative and qualitative methods. Focus groups rely heavily on group interaction, combining elements of individual interviews and participant observation. This article compares the focus group interview with both quantitative and qualitative methods; discusses when to use focus group interviews; outlines a protocol for conducting focus groups, including a comparison of various styles of qualitative data analysis; and offers a case study, in which focus groups evaluated the effectiveness of a pilot preclinical curriculum.

Adaptive livelihood strategies for coping with water scarcity in the drylands of central Tanzania

NASA Astrophysics Data System (ADS)

Liwenga, Emma T.

In this paper, it is argued that local knowledge for adapting to water scarcity is important for integrated resource management by taking into consideration both the natural and social constraints in a particular setting based on accumulated experience. The paper examines the relevance of local knowledge in sustaining agricultural production in the semiarid areas of central Tanzania. The paper specifically focuses on how water scarcity, as the major limiting factor, is addressed in the study area using local knowledge to sustain livelihoods of its people. The study was conducted in four villages; Mzula, Ilolo, Chanhumba and Ngahelezi, situation in Mvumi Division in Dodoma Region. The study mainly employed qualitative data collection techniques. Participatory methods provided a means of exploring perceptions and gaining deeper insights regarding natural resource utilization in terms of problems and opportunities. The main data sources drawn upon in this study were documentation, group interviews and field observations. Group interviews involved discussions with a group of 6-12 people selected on the basis of gender, age and socio-economic groups. Data analysis entailed structural and content analysis within the adaptive livelihood framework in relation to management of water scarcity using local knowledge. The findings confirm that rainfall is the main limiting factor for agricultural activities in the drylands of Central Tanzania. As such, local communities have developed, through time, indigenous knowledge to cope with such environments utilizing seasonality and diversity of landscapes. Use of this local knowledge is therefore effective in managing water scarcity by ensuring a continuous production of crops throughout the year. This practice implies increased food availability and accessibility through sales of such agricultural products. Local innovations for water management, such as cultivation in sandy rivers, appear to be very important means of accessing water in these dryland areas. It can therefore be concluded that utilization of local knowledge has wide impact on integrated water resource management. These implications are important considerations for development of adaptive water system innovations at community level.

[Clinical study using activity-based costing to assess cost-effectiveness of a wound management system utilizing modern dressings in comparison with traditional wound care].

PubMed

Ohura, Takehiko; Sanada, Hiromi; Mino, Yoshio

2004-01-01

In recent years, the concept of cost-effectiveness, including medical delivery and health service fee systems, has become widespread in Japanese health care. In the field of pressure ulcer management, the recent introduction of penalty subtraction in the care fee system emphasizes the need for prevention and cost-effective care of pressure ulcer. Previous cost-effectiveness research on pressure ulcer management tended to focus only on "hardware" costs such as those for pharmaceuticals and medical supplies, while neglecting other cost aspects, particularly those involving the cost of labor. Thus, cost-effectiveness in pressure ulcer care has not yet been fully established. To provide true cost effectiveness data, a comparative prospective study was initiated in patients with stage II and III pressure ulcers. Considering the potential impact of the pressure reduction mattress on clinical outcome, in particular, the same type of pressure reduction mattresses are utilized in all the cases in the study. The cost analysis method used was Activity-Based Costing, which measures material and labor cost aspects on a daily basis. A reduction in the Pressure Sore Status Tool (PSST) score was used to measure clinical effectiveness. Patients were divided into three groups based on the treatment method and on the use of a consistent algorithm of wound care: 1. MC/A group, modern dressings with a treatment algorithm (control cohort). 2. TC/A group, traditional care (ointment and gauze) with a treatment algorithm. 3. TC/NA group, traditional care (ointment and gauze) without a treatment algorithm. The results revealed that MC/A is more cost-effective than both TC/A and TC/NA. This suggests that appropriate utilization of modern dressing materials and a pressure ulcer care algorithm would contribute to reducing health care costs, improved clinical results, and, ultimately, greater cost-effectiveness.

Effects of selection for cooperation and attention in dogs.

PubMed

Gácsi, Márta; McGreevy, Paul; Kara, Edina; Miklósi, Adám

2009-07-24

It has been suggested that the functional similarities in the socio-cognitive behaviour of dogs and humans emerged as a consequence of comparable environmental selection pressures. Here we use a novel approach to account for the facilitating effect of domestication in dogs and reveal that selection for two factors under genetic influence (visual cooperation and focused attention) may have led independently to increased comprehension of human communicational cues. In Study 1, we observed the performance of three groups of dogs in utilizing the human pointing gesture in a two-way object choice test. We compared breeds selected to work while visually separated from human partners (N = 30, 21 breeds, clustered as independent worker group), with those selected to work in close cooperation and continuous visual contact with human partners (N = 30, 22 breeds, clustered as cooperative worker group), and with a group of mongrels (N = 30).Secondly, it has been reported that, in dogs, selective breeding to produce an abnormal shortening of the skull is associated with a more pronounced area centralis (location of greatest visual acuity). In Study 2, breeds with high cephalic index and more frontally placed eyes (brachycephalic breeds, N = 25, 14 breeds) were compared with breeds with low cephalic index and laterally placed eyes (dolichocephalic breeds, N = 25, 14 breeds). In Study 1, cooperative workers were significantly more successful in utilizing the human pointing gesture than both the independent workers and the mongrels.In study 2, we found that brachycephalic dogs performed significantly better than dolichocephalic breeds. After controlling for environmental factors, we have provided evidence that at least two independent phenotypic traits with certain genetic variability affect the ability of dogs to rely on human visual cues. This finding should caution researchers against making simple generalizations about the effects of domestication and on dog-wolf differences in the utilization of human visual signals.

Women’s Knowledge, Views, and Experiences Regarding Alcohol Use and Pregnancy: Opportunities to Improve Health Messages

PubMed Central

Elek, Elvira; Harris, Shelly L.; Squire, Claudia M.; Margolis, Marjorie; Weber, Mary Kate; Dang, Elizabeth Parra; Mitchell, Betsy

2017-01-01

Background Women continue to drink alcohol during pregnancy despite Surgeon Generals’ Advisory statements and educational efforts about the dangers. Purpose This focus group research study examined women’s knowledge and beliefs about alcohol consumption and its risks during pregnancy along with related perceptions of social influences and information sources in order to inform future messaging. Methods The study included 20 focus groups of 149 reproductive-age women segmented by age, pregnancy status, and race/ethnicity. Results and Discussion Women acknowledged the risks and consequences of drinking alcohol during pregnancy, but many held common misconceptions. Some women continued to drink during pregnancy or expressed intent to continue drinking until pregnancy confirmation. Findings indicated that women’s partners, families, and friends influence women’s decisions to drink or abstain from alcohol. In addition, health care providers and the Internet act as important sources of health information for women but sometimes do not adequately educate them about the risks of alcohol use and pregnancy. Translation to Health Education Practice Considerations for messaging and educational materials related to alcohol use and pregnancy include providing clear and consistent messaging (especially from health professionals), focusing on social support strategies, and utilizing electronic media. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention. PMID:28261370

What new mothers need to know: perspectives from women and providers in Georgia.

PubMed

Gazmararian, Julie A; Dalmida, Safiya George; Merino, Yesenia; Blake, Sarah; Thompson, Winifred; Gaydos, Laura

2014-05-01

Identifying the educational and resource needs of new mothers is of paramount importance in developing programs to improve maternal and child health outcomes. The primary purpose of this study was to explore the educational needs of new mothers and identify opportunities to enhance healthcare providers' current educational efforts. A two-part methodology was utilized to qualitatively explore the topic of parenting information needs for new mothers in Georgia. Data collection included information from 11 focus groups with 92 first-time, new mothers and 20 interviews with healthcare providers who serve new mothers. Discussions with both new mothers and providers clearly indicated that new mothers face a significant informational deficit, especially regarding very basic, daily infant care information and health literacy challenges. Educational materials already exist; however, mothers report difficulty accessing and understanding this information. For this reason, both the mothers and the providers stressed a focus on developing programs or interventions that allow in-person education and/or alternative modalities to access information, as opposed to development of new written materials solely. Information from the focus group and interviews provided important insight regarding what improvements need to be made to help new mothers and their families during the early stages of parenthood. By improving the education of new mothers and their families, it is proposed that maternal and infant health status could be improved.

Optimizing psychosocial support during office-based buprenorphine treatment in primary care: patients’ experiences and preferences

PubMed Central

Fox, Aaron D.; Masyukova, Mariya; Cunningham, Chinazo O.

2015-01-01

Background Buprenorphine maintenance treatment is effective and has been successfully integrated into HIV and primary care settings. However, one key barrier to providers prescribing buprenorphine is their perception that they are unable to provide adequate counseling or psychosocial support to patients with opioid addiction. This qualitative study investigated supportive elements of office-based buprenorphine treatment that patients perceived to be most valuable. Methods We conducted five focus groups with 33 buprenorphine treatment-experienced participants. Focus groups were audio-recorded and transcribed. Iterative readings of transcripts and grounded theory analysis revealed common themes. Results Overall, participants perceived that buprenorphine treatment helped them to achieve their treatment goals and valued the flexibility, accessibility, and privacy of treatment. Participants identified interpersonal and structural elements of buprenorphine treatment that provided psychosocial support. Participants desired good physician-patient relationships, but also valued care delivery models that were patient-centered, created a safe place for self-disclosure, and utilized coordinated team-based care. Conclusions Participants derived psychosocial support from their prescribing physician, but were also open to collaborative or team-based models of care, as long as they were voluntary and confidential. Buprenorphine prescribing physicians without access to referral options for psychosocial counseling could focus on maintaining non-judgmental attitudes and shared decision making during patient encounters. Adding structure and psychosocial support to buprenorphine treatment through coordinated team-based care also seems to have great promise. PMID:26566712

The relationship between health literacy with health status and healthcare utilization in 18-64 years old people in Isfahan.

PubMed

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

2014-01-01

Today, much attention has been paid to the patient role as the central factor in the management of their own health. It is focused on the issue that the patient has a more critical role compared with the health-care provider in controlling the patient own health. defines health literacy as the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions. The objective of this study was to determine health literacy, health status, healthcare utilization and the relationship between them in 18 - 64 years old people in Isfahan. This study was a descriptive analytical survey, which was conducted on 300 subjects of 18-64 years old in Isfahan with Multi-stage sampling method proportional to selected sample size. For collecting the data, questionnaire adapted from CHAP (Consumer Assessment of Healthcare Providers and Systems) health literacy questionnaire was used. Health status was measured based on an assessment of the physical and mental health over the past 6 months by 5° Likert scale. Data analysis was performed by using SPSS 18, descriptive statistics, Chi-square test and multivariate analysis of variance. There was no significant correlation between health literacy, health status and healthcare utilization. Utilization was less in the urban area No. 6 of the city. In the bachelor's degree group, the health status was lower than the other groups in these cases: Older ages, married, women, large family size, undergraduates, and urban area No. 14. Due to the average prevalence of health literacy in 18-64 years old individuals in Isfahan and low- healthcare utilization, the followings are recommended: Necessity of more attention to the issue of health literacy, improving the physician-patient relationship and community awareness, whether through health promotion programs or media for the optimum use of available resources.

Compact reflective imaging spectrometer utilizing immersed gratings

DOEpatents

Chrisp, Michael P [Danville, CA

2006-05-09

A compact imaging spectrometer comprising an entrance slit for directing light, a first mirror that receives said light and reflects said light, an immersive diffraction grating that diffracts said light, a second mirror that focuses said light, and a detector array that receives said focused light. The compact imaging spectrometer can be utilized for remote sensing imaging spectrometers where size and weight are of primary importance.

Focus group discussion in built environment qualitative research practice

NASA Astrophysics Data System (ADS)

Omar, D.

2018-02-01

Focus groups discussion is a useful way in built environment for qualitative research practice. Drawing upon recent reviews of focus group discussion and examples of how focus group discussions have been used by researchers and educators, this paper provides what actually happens in focus group discussion as practiced. There is difference between group of people and topic of interest. This article examines the focus group discussions as practiced in built environment. Thus, there is broad form of focus group discussions as practiced in built environment and the applications are varied.

Community Engagement in Liberia: Routine Immunization Post-Ebola.

PubMed

Bedford, Juliet; Chitnis, Ketan; Webber, Nance; Dixon, Phil; Limwame, Ken; Elessawi, Rania; Obregon, Rafael

2017-01-01

A national integrated polio, measles, and deworming campaign was implemented across Liberia May 8-14, 2015. The community engagement and social mobilization component of the campaign was based on structures that had been invested in during the Ebola response. This article provides an overview of the community engagement and social mobilization activities that were conducted and reports the key findings of a rapid qualitative assessment conducted immediately after the campaign that focused on community perceptions of routine immunization in the post-Ebola context. Focus group discussions and interviews were conducted across four counties in Liberia (Montserrado, Nimba, Bong, and Margibi). Thematic analysis identified the barriers preventing and drivers leading to the utilization of routine immunization. Community members also made recommendations and forwarded community-based solutions to encourage engagement with future health interventions, including uptake in vaccination campaigns. These should be incorporated in the development and implementation of future interventions and programs.

Tacit Knowledge of Caring and Embodied Selfhood

PubMed Central

Kontos, Pia C.; Naglie, Gary

2013-01-01

The tacit knowledge paradigm is gaining recognition as an important source of knowledge that informs clinical decision-making. However, it is limited by an exclusive focus on knowledge acquired through clinical practice, and a consequent neglect of the primordial and socio-cultural significance of embodied selfhood, precisely what provides the foundational structure of tacit knowledge of caring and facilitates its manifestation. Drawing on findings from a qualitative study of forty-three dementia care practitioners in Ontario, Canada that utilized research-based drama and focus group methodology, we argue that embodied selfhood is fundamental to tacit knowledge of caring. Results are analyzed drawing upon the theoretical precepts of embodied selfhood that are rooted in Merleau-Ponty’s (1962) reconceptualization of perception and Bourdieu’s (1977, 1990) notion of habitus. We conclude with a call for further exploration of the body as a site of the production of tacit knowledge. PMID:19392935

Bringing nursing science to the classroom: a collaborative project.

PubMed

Reams, Susan; Bashford, Carol

2009-01-01

This project resulted as a collaborative effort on the part of a public school system and nursing faculty. The fifth grade student population utilized in this study focused on the skeletal, muscular, digestive, circulatory, respiratory, and nervous systems as part of their school system's existing science and health curriculum. The intent of the study was to evaluate the impact on student learning outcomes as a result of nursing-focused, science-based, hands-on experiential activities provided by nursing faculty in the public school setting. An assessment tool was created for pretesting and posttesting to evaluate learning outcomes resulting from the intervention. Over a two day period, six classes consisting of 25 to 30 students each were divided into three equal small groups and rotated among three interactive stations. Students explored the normal function of the digestive system, heart, lungs, and skin. Improvement in learning using the pretest and posttest assessment tools were documented.

Religious Beliefs and Cancer Screening Behaviors among Catholic Latinos: Implications for Faith-based Interventions

PubMed Central

Allen, Jennifer D.; Leyva, Bryan; Torres, María Idalí; Ospino, Hosffman; Tom, Laura; Rustan, Sarah; Bartholomew, Amanda

2014-01-01

Although most U.S. Latinos identify as Catholic, few studies have focused on the influence of this religious tradition on health beliefs among this population. This study explores the role of Catholic religious teachings, practices, and ministry on cancer screening knowledge, attitudes and behaviors among Latinos. Eight focus groups were conducted with 67 Catholic Latino parishioners in Massachusetts. Qualitative analysis provided evidence of strong reliance on faith, God, and parish leaders for health concerns. Parishes were described as vital sources of health and social support, playing a central role in the community's health. Participants emphasized that their religious beliefs promote positive health behaviors and health care utilization, including the use of cancer screening services. In addition, they expressed willingness to participate in cancer education programs located at their parishes and provided practical recommendations for implementing health programs in parishes. Implications for culturally appropriate health communication and faith-based interventions are discussed. PMID:24858865

Qualitative methods to ensure acceptability of behavioral and social interventions to the target population

PubMed Central

Ayala, Guadalupe X.; Elder, John P.

2013-01-01

This paper introduces qualitative methods for assessing the acceptability of an intervention. Acceptability refers to determining how well an intervention will be received by the target population and the extent to which the new intervention or its components might meet the needs of the target population and organizational setting. In this paper, we focus on two common qualitative methods for conducting acceptability research and their advantages and disadvantages: focus groups and interviews. We provide examples from our own research and other studies to demonstrate the use of these methods for conducting acceptability research and how one might adapt this approach for oral health research. Finally, we present emerging methods for conducting acceptability research, including the use of community-based participatory research, as well as the utility of conducting acceptability research for assessing the appropriateness of measures in intervention research. PMID:21656958

Adults and children prefer a plate food guide relative to a pyramid.

PubMed

Talati, Zenobia; Pettigrew, Simone; Moore, Sarah; Pratt, Iain S

2017-01-01

This study explored attitudes toward two food guides currently being widely used in Australia: the Healthy Eating Pyramid and the Australian Guide to Healthy Eating Plate. Ten focus groups were conducted with adults (aged 18+ years) and children (aged 10-17 years) across various locations in Perth, Western Australia. The discussions focused on liked and disliked aspects of each food guide and the implications for participants' perceptions of their relative usefulness. When asked to state their preference, a large majority of participants nominated the plate as their preferred nutrition guide. The style of presentation used for the plate was reportedly clearer and more aesthetically pleasing. The plate was also perceived to be more complex while the pyramid was considered by adults to be more child-friendly. This study provides information on consumers' reactions to different food guides and the implications for perceived relevance and utility.

Comorbidities and Chronic Obstructive Pulmonary Disease: Prevalence, Influence on Outcomes, and Management

PubMed Central

Putcha, Nirupama; Drummond, M. Bradley; Wise, Robert A.; Hansel, Nadia N.

2016-01-01

Comorbidities impact a large proportion of patients with chronic obstructive pulmonary disease (COPD), with over 80% of patients with COPD estimated to have at least one comorbid chronic condition. Guidelines for the treatment of COPD are just now incorporating comorbidities to their management recommendations of COPD, and it is becoming increasingly clear that multimorbidity as well as specific comorbidities have strong associations with mortality and clinical outcomes in COPD, including dyspnea, exercise capacity, quality of life, healthcare utilization, and exacerbation risk. Appropriately, there has been an increased focus upon describing the burden of comorbidity in the COPD population and incorporating this information into existing efforts to better understand the clinical and phenotypic heterogeneity of this group. In this article, we summarize existing knowledge about comorbidity burden and specific comorbidities in COPD, focusing on prevalence estimates, association with outcomes, and existing knowledge about treatment strategies. PMID:26238643

Factors Supporting the Employment of Young Adult Peer Providers: Perspectives of Peers and Supervisors.

PubMed

Delman, Jonathan; Klodnick, Vanessa V

2017-10-01

Peer providers are a promising practice for transition-age youth community mental health treatment engagement and support, yet little is known about the experience of being a young adult peer provider or what helps to make an individual in this role successful. Utilizing a capital theory lens, this study uses data from focus groups (two with young adult peer providers and two with their supervisors) to examine facilitators of young adult peer provider success in community mental health treatment settings. Eight factors were identified as critical to young adult peer provider on-the-job success: persistence, job confidence, resilience, job training, skilled communications with colleagues, regular and individualized supervision, support from colleagues, and family support. Findings suggest that young adult peer providers may benefit immensely from an agency level focus on fostering social organizational capital as well as more individualized efforts to increase cultural, social, and psychological capital through training and supervision.

Laser-assisted solar cell metallization processing

NASA Technical Reports Server (NTRS)

Dutta, S.

1984-01-01

Laser-assisted processing techniques utilized to produce the fine line, thin metal grid structures that are required to fabricate high efficiency solar cells are examined. Two basic techniques for metal deposition are investigated; (1) photochemical decomposition of liquid or gas phase organometallic compounds utilizing either a focused, CW ultraviolet laser (System 1) or a mask and ultraviolet flood illumination, such as that provided by a repetitively pulsed, defocused excimer laser (System 2), for pattern definition, and (2) thermal deposition of metals from organometallic solutions or vapors utilizing a focused, CW laser beam as a local heat source to draw the metallization pattern.

Developing an Acceptability Assessment of Preventive Dental Treatments

PubMed Central

Hyde, Susan; Gansky, Stuart A.; Gonzalez-Vargas, Maria J.; Husting, Sheila R.; Cheng, Nancy F.; Millstein, Susan G.; Adams, Sally H.

2012-01-01

Objectives Early childhood caries (ECC) is very prevalent among young Hispanic children. ECC is amenable to a variety of preventive procedures, yet many Hispanic families underutilize dental services. Acceptability research may assist in health care planning and resource allocation by identifying patient preferences among efficacious treatments with the goal of improving their utilization. The purposes of this study were (a) to develop a culturally competent acceptability assessment instrument, directed toward the caregivers of young Hispanic children, for five preventive dental treatments for ECC and (b) to test the instrument's reliability and validity. Methods An instrument of five standard treatments known to prevent ECC was developed, translated, reviewed by focus groups, and pilot tested, then tested for reliability. The instrument included illustrated cards, brief video clips, and samples of the treatments and was culturally appropriate for low-income Hispanic caregivers. In addition to determining the acceptability of the five treatments individually, the treatments were also presented as paired comparisons. Results Focus groups and debriefing interviews following the pilot tests established that the instrument has good face validity. The illustrated cards, product samples, and video demonstrations of the five treatments resulted in an instrument possessing good content validity. The instrument has good to excellent test–retest reliability, with identical time 1–time 2 responses for each of the five treatments 92 percent of the time (range 87 to 97 percent), and the same treatment of the paired comparisons preferred 75 percent of the time (range 61 to 90 percent). Conclusions The acceptability instrument described is reliable and valid and may be useful in program planning efforts to identify and increase the utilization of preferred ECC preventive treatments for target populations. PMID:18662256

Information and communication technologies in primary healthcare facilities in Egypt.

PubMed

Farahat, Taghreed M; Hegazy, Nagwa N; Mowafy, Maha

2018-01-01

The health sector has always relied on technologies. According to World Health Organization, they form the backbone of the services to prevent, diagnose, and treat illness and disease. It is increasingly viewed as the most promising tool for improving the overall quality, safety and efficiency of the health delivery system. Aim of the study This was to assess the current situation of information and communication technologies (ICTs) in primary healthcare in the terms of describing and classifying the existing work, identify gaps and exploring the personal experiences and the challenges of ICTs application in the primary healthcare. Subjects and methods A mixed research method in the form of sequential explanatory design was applied. In the quantitative phase a cross-sectional study was conducted among 172 family physicians using a predesigned questionnaire. Followed by qualitative data collection among 35 participants through focused group discussions. Nearly half of the physicians have ICTs in their work and they were trained on it. None of them developed a community-based research using ICTs technology. Training on ICTs showed a statistically significant difference regarding the availability and the type of ICTs present in the workplace (P<0.05). Focused group discussion revealed that the majority of the participants believe that there is poor commitment of policymaker toward ICTs utilization in the primary care. Nearly 97% thinks that there is insufficient budget allocated for ICTs utilization in the workplace. Almost 88% of the participants demanded more incentives for ICTs users than non-user at the workplace. ICTs resources are underutilized by health information professionals. Lack of funds, risk of instability of the electric supply and lack of incentives for ICTs users were the most common barriers to ICTs implementation thus a steady steps toward budget allocation and continuous training is needed.

Developing an acceptability assessment of preventive dental treatments.

PubMed

Hyde, Susan; Gansky, Stuart A; Gonzalez-Vargas, Maria J; Husting, Sheila R; Cheng, Nancy F; Millstein, Susan G; Adams, Sally H

2009-01-01

Early childhood caries (ECC) is very prevalent among young Hispanic children. ECC is amenable to a variety of preventive procedures, yet many Hispanic families underutilize dental services. Acceptability research may assist in health care planning and resource allocation by identifying patient preferences among efficacious treatments with the goal of improving their utilization. The purposes of this study were (a) to develop a culturally competent acceptability assessment instrument, directed toward the caregivers of young Hispanic children, for five preventive dental treatments for ECC and (b) to test the instrument's reliability and validity. An instrument of five standard treatments known to prevent ECC was developed, translated, reviewed by focus groups, and pilot tested, then tested for reliability The instrument included illustrated cards, brief video clips, and samples of the treatments and was culturally appropriate for low-income Hispanic caregivers. In addition to determining the acceptability of the five treatments individually, the treatments were also presented as paired comparisons. Focus groups and debriefing interviews following the pilot tests established that the instrument has good face validity. The illustrated cards, product samples, and video demonstrations of the five treatments resulted in an instrument possessing good content validity. The instrument has good to excellent test-retest reliability, with identical time 1-time 2 responses for each of the five treatments 92 percent of the time (range 87 to 97 percent), and the same treatment of the paired comparisons preferred 75 percent of the time (range 61 to 90 percent). The acceptability instrument described is reliable and valid and may be useful in program planning efforts to identify and increase the utilization of preferred ECC preventive treatments for target populations.

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

PubMed

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

2015-11-01

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

A retrospective case-control analysis of the outpatient expenditures for western medicine and dental treatment modalities in CKD patients in Taiwan.

PubMed

Huang, Ren-Yeong; Lin, Yuh-Feng; Kao, Sen-Yeong; Shieh, Yi-Shing; Chen, Jin-Shuen

2014-01-01

To determine if expenditures for dentistry (DENT) correlate with severity of chronic kidney disease (CKD). A total of 10,457 subjects were enrolled from January 2008 to December 2010, divided into three groups: healthy control (HC) group (n = 1,438), high risk (HR) group (n = 3,392), and CKD group (n = 5,627). Five stages were further categorized for the CKD group. OPD utilization and expenditures for western medicine (WM), DENT, and TCM (traditional Chinese medicine) were analyzed retrospectively (2000-2008) using Taiwan's National Health Insurance Research Database. Three major areas were analyzed among groups CKD, HR and HC in this study: 1) demographic data and medical history; 2) utilization (visits/person/year) and expenditures (9-year cumulative expenditure, expenditure/person/year) for OPD services in WM, DENT, and TCM; and 3) utilization and expenditures for dental OPD services, particularly in dental filling, root canal and periodontal therapy. OPD utilization and expenditures of WM increased significantly for the CKD group compared with the HR and HC groups, and increased steadily along with the severity of CKD stages. However, overall DENT and TCM utilization and expenditures did not increase for the CKD group. In comparison among different CKD stages, the average expenditures and utilization for DENT including restorative filling and periodontal therapy, but not root canal therapy, showed significant decreases according to severity of CKD stage, indicating less DENT OPD utilization with progression of CKD. Patients with advanced CKD used DENT OPD service less frequently. However, the connection between CKD and DENT service utilization requires further study.

Evaluation of a Multimedia Intervention for Children and Families Facing Multiple Military Deployments.

PubMed

Flittner O'Grady, Allison; Thomaseo Burton, E; Chawla, Neelu; Topp, David; MacDermid Wadsworth, Shelley

2016-02-01

Repeated military deployments have been a common experience for many military families in the past 15 years. While there has been an increase in research and intervention focused on the effects on families of military deployments, much of this work has not focused specifically on the particular needs of young children. Talk, Listen, Connect: Multiple Deployments (TLC-II MD), a multimedia kit designed for home use, is among the first interventions directed toward young children. Created by Sesame Workshop and using popular Sesame Street characters, TLC-II MD was designed to support and equip families with young children with skills to address challenges associated with multiple deployments. This study utilized a randomized experimental design to evaluate the impact of TLC-II MD relative to a control condition using a Sesame Workshop multimedia kit not tailored to military families. Parents in both groups reported that children enjoyed the video overall and watched it repeatedly. Also in both groups, caregivers' depressive symptoms and children's aggressive behaviors declined significantly over time. Caregivers in the test group reported significantly larger increases in comfort discussing the deployment with their child and stronger perceptions that the DVD helped children to cope. Thus, the resilience-oriented materials were helpful to both groups, but those tailored to military families were significantly more likely to be perceived as helpful. Findings offer evidence regarding the ability of multimedia self-administered interventions to assist military families.

Factors influencing the adoption and implementation of teledentistry in the UK, with a focus on orthodontics.

PubMed

Patel, Reena N; Antonarakis, Gregory S

2013-10-01

Utilizing Rogers' diffusion of innovation theory, this study aims to develop a better understanding of the challenges faced in teledental projects, and outline the factors that impact upon the adoption and implementation of teledental projects, with a focus on orthodontics, thus attempting to provide an explanation for the low uptake in the UK, as well as to suggest factors to encourage success. A literature search was carried out to obtain information concerning teledentistry (and telemedicine) from both primary and secondary research sources. Using the relevant information obtained, Rogers' diffusion of innovation theory was used as a framework, which was subsequently applied to the key stakeholder groups of a healthcare organization. The model describes five characteristics of an innovation: relative advantage, compatibility, complexity, trialability and observability. These attributes are discussed in the context of key stakeholder groups within a healthcare organization: clinicians, patients, hospital managers, and healthcare decision-makers and funders. Each stakeholder group is motivated by different values and experiences, which in turn influence their decision to adopt a new technology. Implementing teledental applications necessitates full comprehension and consideration of the healthcare environment and also a commitment to completely integrate teledentistry within that environment. This is a process that demands strategic alignment with clinical and organizational goals, clinical engagement and strong political support. The challenges within each stakeholder group must be specifically targeted. © 2012 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.