Medical Students' views of a career in Geriatric Medicine; Multi-Centre Qualitative Analysis

Medical students frequently have negative preconceptions of a career in Geriatric Medicine. In ta qualitative analysis of the free text from 789 response from Medical students in Scotland and Northern Ireland, we show that clinical attachment seffectively challenge negative student views and more positive statements about future careers in Geriatric Medicine emerged at the end of the attachment.

Factors influencing European consumer uptake of personalised nutrition. Results of a qualitative analysis.

The aim of this research was to explore consumer perceptions of personalised nutrition and to compare these across three different levels of "medicalization": lifestyle assessment (no blood sampling); phenotypic assessment (blood sampling); genomic assessment (blood and buccal sampling). The protocol was developed from two pilot focus groups conducted in the UK. Two focus groups (one comprising only "older" individuals between 30 and 60 years old, the other of adults 18-65 yrs of age) were run in the UK, Spain, the Netherlands, Poland, Portugal, Ireland, Greece and Germany (N = 16). The analysis (guided using grounded theory) suggested that personalised nutrition was perceived in terms of benefit to health and fitness and that convenience was an important driver of uptake. Negative attitudes were associated with internet delivery but not with personalised nutrition per se. Barriers to uptake were linked to broader technological issues associated with data protection, trust in regulator and service providers. Services that required a fee were expected to be of better quality and more secure. An efficacious, transparent and trustworthy regulatory framework for personalised nutrition is required to alleviate consumer concern. In addition, developing trust in service providers is important if such services to be successful. (C) 2013 Elsevier Ltd. All rights reserved.

Oral rehabilitation for partially dentate elders: a qualitative analysis

Aims: This study aimed to gain insight into patient’s perceptions of natural tooth loss and explored their experiences of oral rehabilitation according to a functionally orientated approach (SDA) and Removable Partial Dentures (RPD).
Study Design: For this qualitative study, a purposive sample of 15 partially dentate older patients
were recruited from Cork Dental School and Hospital. These patients had previously participated in a randomised controlled clinical trial (RCT) where they were provided with either SDA treatment using adhesive bridgework or provided with Cobalt Chromium framework RPDs. In- depth interviews were undertaken and thematic analysis was utilised to interpret the data.
Results: The findings of this study indicated strong satisfaction with SDA treatment. Patients referred to the ease in which they adapted to the adhesive prostheses as they were “lightweight”, “neat” and “fixed”. Irrespective of treatment option, patients indicated that they felt
their new prostheses were durable and an improvement on previous treatments. Most patients indicated that, previous to the RCT, they had not attended a general dentist for a number of years and only then for acute issues. They had concerns that treatment which was provided to them as part of the RCT would not be available to them in primary care. Interestingly, although they do not want their condition to dis-improve, if their prostheses failed they stated that they would not seek alternative treatment but would revert back
to adopting previous coping mechanisms.
Conclusion: This study illustrates that partially dentate older patients were very satisfied with oral rehabilitation according to a functionally orientated approach. Unfortunately they did not believe that this treatment would currently be made available to them in a primary care setting.

Sex Offending and Situational Motivation: Findings from a Qualitative Analysis of Desistance from Sexual Offending

Sex offending is typically understood from a pathology perspective with the origin of the behavior thought to be within the offending individual. Such a perspective may not be beneficial for those seeking to desist from sexual offending and reintegrate into mainstream society. A thematic analysis of 32 self-narratives of men convicted of sexual offences against children suggests that such individuals typically explain their pasts utilizing a script consistent with routine activity theory, emphasizing the role of circumstantial changes in both the onset of and desistance from sexual offending. It is argued that the self-framing of serious offending in this way might be understood as a form of ‘shame management’, a protective cognition that enables desistance by shielding individuals from internalizing stigma for past violence.

"The Heart of Irish-Language Proverbs": A Linguo-Stylistic Analysis of Explicit Metaphor

Metaphor has featured frequently in attempts to define the proverb (see Taylor 1931, Whiting 1932, Mieder 1985, 1996), and since the advent of modern paremiological scholarship, it has been identified as one of the most salient markers of ‘proverbiality’ (Arora 1984) across a broad spectrum of world languages. Significant language-specific analyses, such as Klimenko (1946), Silverman-Weinreich (1981), and Arora (1984) have provided valuable qualitative information on the form and function of metaphor in Russian, Yiddish, and Spanish proverbs respectively. Unfortunately, no academic scholarship has engaged with the subject of metaphor in Irish proverbs. This study builds on international paremiological research on metaphor and provides for the first time a comprehensive quantitative and qualitative analysis of the form, frequency, and nature of linguistic metaphors in Irish proverbs (1856-1952). Moreover, from the perspective of paremiology, it presents a methodological template and result-set that can be applied cross-linguistically to compare metaphor in the proverbs of other languages.

Waste Management and Sustainability during the Design Phase of a Construction Project: A Qualitative Review

Waste management and sustainability are two core underlying philosophies that the construction sector must acknowledge and implement; however, this can prove difficult and time consuming. To this end, the aim of this paper is to examine waste management strategies and the possible benefits, advantages and disadvantages to their introduction and use, while also to examine any inter-relationship with sustainability, particularly at the design stage. The purpose of this paper is to gather, examine and review published works and investigate factors which influence economic decisions at the design phase of a construction project. In addressing this aim, a three tiered sequential research approach is adopted; in-depth literature review, interviews/focus groups and qualitative analysis. The resulting data is analyzed, discussed, with potential conclusions identified; paying particular attention to implications for practice within architectural firms. This research is of importance, particularly to the architectural sector, as it can add to the industry’s understanding of the design process, while also considering the application and integration of waste management into the design procedure. Results indicate that the researched topic had many advantages but also had inherent disadvantages. It was found that the potential advantages outweighed disadvantages, but uptake within industry was still slow and that better promotion and their benefits to; sustainability, the environment, society and the industry were required.

A systematic review and meta-analysis of the survival of feldspathic porcelain veneers over 5 and 10 years

PURPOSE: This systematic review reports on the survival of feldspathic porcelain veneers.

MATERIALS AND METHODS: The Cochrane Library, MEDLINE (OVID), Embase, Web of Knowledge, selected journals, clinical trials registers, and conference proceedings were searched independently by two reviewers. Academic colleagues were also contacted to identify relevant research. Inclusion criteria were human cohort studies (prospective and retrospective) and controlled trials assessing outcomes of feldspathic porcelain veneers in more than 15 patients and with at least some of the veneers in situ for 5 years. Of 4,294 articles identified, 116 studies underwent full-text screenings and 69 were further reviewed for eligibility. Of these, 11 were included in the qualitative analysis and 6 (5 cohorts) were included in meta-analyses. Estimated cumulative survival and standard error for each study were assessed and used for meta-, sensitivity, and post hoc analyses. The I2 statistic and the Cochran Q test and its associated P value were used to evaluate statistical heterogeneity, with a random-effects meta-analysis used when the P value for heterogeneity was less than .1. Galbraith, forest, and funnel plots explored heterogeneity, publication patterns, and small study biases.

RESULTS: The estimated cumulative survival for feldspathic porcelain veneers was 95.7% (95% confidence interval [CI]: 92.9% to 98.4%) at 5 years and ranged from 64% to 95% at 10 years across three studies. A post hoc meta-analysis indicated that the 10-year best estimate may approach 95.6% (95% CI: 93.8% to 97.5%). High levels of statistical heterogeneity were found.

CONCLUSIONS: When bonded to enamel substrate, feldspathic porcelain veneers have a very high 10-year survival rate that may approach 95%. Clinical heterogeneity is associated with differences in reported survival rates. Use of clinically relevant survival definitions and careful reporting of tooth characteristics, censorship, clustering, and precise results in future research would improve metaanalytic estimates and aid treatment decisions.

The validity of the MacNew Quality of Life Questionnaire in heart disease.

Background A previous review suggested that the MacNew Quality of Life Questionnaire was the most appropriate disease-specific measure of health-related quality of life among people with ischaemic heart disease. However, there is ambiguity about the allocation of items to the three factors underlying the MacNew and the factor structure has not been confirmed previously among the people in the UK. Methods The MacNew Questionnaire and the SF-36 were administered to 117 newly admitted patients to a tertiary referral centre in Northern Ireland. All patients had been diagnosed with ischaemic heart disease. Results A confirmatory factor analysis was conducted on the factor structure of the MacNew and the model was found to be an inadequate fit of the data. A quantitative and qualitative analysis of the items suggested that a five factor solution was more appropriate and this was validated by confirmatory factor analysis. This new structure also displayed strong evidence of concurrent validity when compared to the SF-36. Conclusion We recommend that researchers should submit scores obtained from items on the MacNew to secondary analyses after being grouped according to the factor structure proposed in this paper, in order to explore further the most appropriate grouping of items.