Fattening foods - perceptions and misconceptions: a qualitative and quantitative exploration

Describes adults' perceptions and beliefs about foods that are considered "fattening". Use of qualitative and quantitative methods to determine the prevalence of the perceptions among adults; Range of factors that are considered when judging foods as "fattening"; Limitations in the public's understandings of "fattening foods" which are inconsistent with dietary recommendations.

Methods for exploring implementation variation and local context within a cluster tandomised community intervention trial

Insignificant or modest findings in intervention trials may be attributable to poorly designed or theorised interventions, poorly implemented interventions, or inadequate evaluation methods. The pre-existing context may also account for the effects observed. A combination of qualitative and quantitative methods is outlined that will permit the determination of how context level factors might modify intervention effectiveness, within a cluster randomised community intervention trial to promote the health of mothers with new babies. The methods include written and oral narratives, key informant interviews, impact logs, and inter-organisational network analyses. Context level factors, which may affect intervention uptake, success, and sustainability are the density of inter-organisational ties within communities at the start of the intervention, the centrality of the primary care agencies expected to take a lead with the intervention, the extent of context-level adaptation of the intervention, and the amount of local resources contributed by the participating agencies. Investigation of how intervention effects are modified by context is a new methodological frontier in community intervention trial research.

Mixed methods : a research design for management doctoral dissertations

Purpose – This paper seeks to examine two management doctoral research projects to highlight the advantages in mixed methods as the primary research design.
Design/methodology/approach – This paper summarises the methods of data collection and analysis which were used by two doctoral students in their management research. The researchers used mixed methods approaches (quantitative and qualitative) to explore different areas of management.
Findings – The paper supports the view that triangulation of research methods strengthens the findings and inferences made for understanding social phenomena in more depth, compared to using a single method.
Research limitations/implications – The paper relies excessively on two doctoral research projects which utilise sequential mixed methods. Therefore, arguments made in the paper are specific because other doctoral projects that have used different methods from those employed in the two projects were not considered.
Practical implications – Early researchers, in particular students commencing doctorate studies, should apply mixed methods research because it develops skills in the two most dominant data collection methods used in management research. This paper is a practical guide on how this could be done effectively.
Originality/value – The paper is drawn from two unique doctoral research projects. The paper’s originality and value is in providing experiences and practical insights on how mixed methods research is undertaken.

Qualitative methods in early-phase drug trials : data and methods from a trial of N-acetylcysteine in schizophrenia

Objective: The pharmacokinetic profile of a drug often gives little indication of its potential therapeutic application, with many therapeutic uses of drugs being discovered serendipitously while being studied for different indications. As hypothesis-driven, quantitative research methodology is exclusively used in early-phase trials, unexpected but important phenomena may escape detection. In this context, this study aimed to examine the potential for integrating qualitative research methods with quantitative methods in early-phase drug trials. To our knowledge, this mixed methodology has not previously been applied to blinded psychopharmacologic trials.

Method: We undertook qualitative data analysis of clinical observations on the dataset of a randomized, double-blind, placebo-controlled trial of N-acetylcysteine (NAC) in patients with DSM-IV-TR–diagnosed schizophrenia (N = 140). Textual data on all participants, deliberately collected for this purpose, were coded using NVivo 2, and emergent themes were analyzed in a blinded manner in the NAC and placebo groups. The trial was conducted from November 2002 to July 2005.

Results: The principal findings of the published trial could be replicated using a qualitative methodology. In addition, significant differences between NAC- and placebo-treated participants emerged for positive and affective symptoms, which had not been captured by the rating scales utilized in the quantitative trial. Qualitative data in this study subsequently led to a positive trial of NAC in bipolar disorder.

Conclusions: The use of qualitative methods may yield broader data and has the potential to complement traditional quantitative methods and detect unexpected efficacy and safety signals, thereby maximizing the findings of early-phase clinical trial research.

Life quality and wealth : a qualitative and quantitative comparison of affluent and poor people

It is well-documented that auent people, on average, have higher subjective wellbeing (SWB) than do poor people. is phenomenon has been explained using SWB homeostasis theory. However, a more precise understanding of the dierences in personal experience that lead to homeostatic failure remains to be documented. We sought such understanding through qualitative interviews and a quantitative examination of SWB domains. Twenty auent people and 20 people dependent on social welfare completed an interview and the Personal Wellbeing Index. As expected, the two groups diered signicantly in SWB. Moreover, the poor group reported a preponderance of negative life experiences while the auent group concentrated on the positive events in their lives. Most telling was the nding that both the qualitative and quantitative methods identied the area of ‘relationships’ as representing the greatest degree of divergence between the two groups. is life domain is especially relevant in the maintenance of normative levels of SWB.

The use of mixed methods in drug discovery: integrating qualitative methods into clinical trials

Contemporary methods in clinical trials are pivoted around hypothesis confirmation, not generation. This is a problem for new drug discovery, since the pharmacokinetic or receptor profile of most novel agents do not link to pathophysiology, which is very poorly understood. Therefore, it is difficult to impute the therapeutic potential of a candidate agent. Most psychotropic agents were discovered serendipitously, either through careful clinical observation or by researchers finding unexpected associations in datasets. Methods that increase the ability to detect latent signals in data are needed. These include mixed methods that incorporate qualitative methods into randomized controlled trials.

This chapter proposes a methodology for the integration of mixed methods in clinical trials, fusing qualitative and quantitative methods, and presents an exemplar using this approach.

Mixed methods show potential for signal detection, hypothesis generation, and associations that may be otherwise undetected in traditional clinical trials.

Estimating population size of the black-eared miner, with an assessment of landscape-scale habitat requirements

The decline of the Black-eared Miner Manorina melanotis has been caused primarily by habitat degradation and vegetation clearance. To better direct conservation actions for this species there was a need to assess habitat requirements on a regional-scale and to estimate the population size using quantitative methods. We used vegetation mapping and the current distribution of the Black-eared Miner to determine regional-scale habitat requirements. These findings were combined with the results of distance sampling to provide population estimates. The species is restricted to large tracts of intact mallee in the Murray Mallee of southeastern Australia that have not been burnt for at least 45 years. The density· of Black-eared Miners is highest in areas that are dominated by mallee- Triodia associations and have not been intensively grazed. The Bookmark Biosphere Reserve supports an estimated 501 (270-927, 95% CI) colonies, containing 3758 (2026-6954) phenotypically pure Black-eared Miners, 2255 (1 215-4170) hybrids and small numbers of Yellow-throated Miners Manorina flavigula. However, the effective population size is considerably smaller (390 Black-eared Miners '(21 0-726) and 234 hybrids (126-433)), due to a skewed adult sex ratio (1 female: 1.81 males) and complex social organization. A smaller population also persists in the Murray Sunset National Park containing 53 (32-85) Black-eared Miner/hybrid colonies. Both populations face a high risk of extinction from large-scale wildfire. The endangered status of the species under IUCN criteria remains warranted.

Pathways to health through Australian woodlands and forests: `Sign-posts` from recent research and practice

Health is inherently 'ecological' and the natural environment plays a crucial role in human health and well-being. Yet we do not necessarily design, manage or market such areas in ways that acknowledge this link. This paper draws on recent research by a Deakin University team exploring the links between use of and involvement in the maintenance of forests/woodlands, and health and well-being outcomes. Qualitative and quantitative methods have been used to collect data from forest/woodland users and tram volunteers contributing to management and maintenance of such areas, concerning their perceptions of the impacts of the experience
on their health and well-being. In two of the projects, samples of 'users' and 'volunteers' were compared with samples 'non-users' and 'non-volunteers'. Several of the studies included the use of scales of self-rated health, social cohesion, and frequency of use of medical services.The studies have identified a range of perceived physical, mental and social health benefits resulting from use of and/or engagement with forests/woodlands. Study findings have implications for design, management and marketing of such areas, since they identity factors influencing use of and engagement with such areas, and have the potential to promote more widespread recognition of the value of such areas and more commitment to them by individuals, communities and governments. The challenge for us is to build on this research base to more clearly Signpost the mutually beneficial links between forest and woodland ecosystems and human health and well-being, creating new and better pathways to a healthy future.

Stigmatization of AIDS patients : disentangling Thai nursing students' attitudes towards HIV/AIDS, drug use and commercial sex

This paper analyzes the interrelationships between the stigma of HIV/AIDS stigma and the co-stigmas of commercial sex (CS) and injecting drug use (IDU). Students of a Bangkok nursing college (N = 144) were presented with vignettes describing a person varying in the disease diagnoses (AIDS, leukemia, no disease) and co-characteristics (IDU, CS, blood transfusion, no co-characteristic). For each vignette, participants completed a social distance measure assessing their attitudes towards the hypothetical person portrayed. Multivariate analyses showed strong interactions between the stigmas of AIDS and IDU but not between AIDS and CS. Although AIDS was shown to be stigmatizing in and of itself, it was significantly less stigmatizing than IDU. The findings highlight the need to consider the non-disease-related stigmas associated with HIV as well as the actual stigma of HIV/AIDS in treatment and care settings. Methodological strengths and limitations were evaluated and implications for future research discussed.

Drop out from behavioral management training programs for ADHD: a prospective study

To investigate dropout from parenting programs for disruptive behavior disorders, we followed 18 clients prospectively from the beginning of a manualized treatment program to three month follow-up. Using qualitative and quantitative methods, we then compared those who dropped out of the program with those who completed it. We found that in general, those participants who dropped out of the program were parents of children with more disturbed behavior, who perceived their children to be more difficult than others, and who experienced more subjective parenting stress. Those who dropped out were also not convinced that the strategies proposed in the program to help manage their children were useful. On the other hand, those who completed the program reported a determination to persevere with the strategies which they saw as assisting them to re-establish positive relationships with their adolescent children. The findings are discussed in the context of how manualized programs might be modified to increase retention.

Data quality issues in practice and theory : a cross-cultural example

Practical considerations and traditions play a substantial role in data collection exercises, often limiting the focus of study to either qualitative or quantitative issues. An industry with a particularly strong quantitative emphasis is the insurance and reinsurance industry, where actuarial decisions are based on detailed and exacting numerical analysis of data that are assumed to be reliable and valid. However, the qualitative investigation of the quality of data in one reinsurance setting reported in this paper shows that where the meanings of the questions asked and of the answers provided are subject to interpretation, the quality of data collected for entry to databases can be poor. While this can be exacerbated in cross-cultural contexts, it is also generally true. Due to the constrained nature of insurance practice, the existence of a range of techniques combining qualitative and quantitative methods is somewhat academic. Therefore, because researchers have the latitude to investigate both qualitative and quantitative factors in the industrial context, a call is made for researchers and industry to work more closely together.

Tests of measurement invariance failed to support the application of the "then-test"

Objective
The use of then-test (retrospective pre-test) scores has frequently been proposed as a solution to potential confounding of change scores because of response shift, as it is assumed that then-test and post-test responses are provided from the same perspective. However, this assumption has not been formally tested using robust quantitative methods. The aim of this study was to compare the psychometric performance of then-test/post-test with traditional pre-test/post-test data and assessing whether the resulting data structures support the application of the then-test for evaluations of chronic disease self-management interventions.

Study Design and Setting
Pre-test, post-test, and then-test data were collected from 314 participants of self-management courses using the Health Education Impact Questionnaire (heiQ). The derived change scores (pre-test/post-test; then-test/post-test) were examined for their psychometric performance using tests of measurement invariance.

Results
Few questionnaire items were noninvariant across pre-test/post-test, with four items identified and requiring removal to enable an unbiased comparison of factor means. In contrast, 12 items were identified and required removal in then-test/post-test data to avoid biased change score estimates.

Conclusion
Traditional pre-test/post-test data appear to be robust with little indication of response shift. In contrast, the weaker psychometric performance of then-test/post-test data suggests psychometric flaws that may be the result of implicit theory of change, social desirability, and recall bias.

Healthy markets - healthy people/ : reforming health care in Cambodia

Health care reform has been described as a global epidemic. This thesis deals with nature and experience of health care reform in developing countries. Increasing privatisation, economic transition, and structural adjustment have provided the context for health system changes. Different approaches to reform have been developed by international organisations such as the World Bank, WHO and UNICEF. What has driven national health care reforms? Are such policies really appropriate to developing countries? Has a consensus now emerged in relation to international health policy? Has a new health care ‘model’ appeared? The study of health care reform in Cambodia is a timely opportunity to investigate the implementation of health care reform under extreme conditions. These conditions include a legacy of genocide, long-term conflict, political isolation, and economic transition. This case study uses both qualitative and quantitative methods and multiple sources of data to analyse the reform program. The study reinforces the conclusion that, under conditions of extreme poverty, market based reforms are likely to have limited positive impact. Rather, understanding the cultural conditions that determine demand, delivering health care of a satisfactory quality, providing appropriate incentives for health practitioners, and supporting services with adequate public funding are the prerequisites for improved service delivery and utilisation. Cambodia's strategy of integrated district health service development and universal population coverage may provide an instructive example of reform. Emerging policy issues identified by this case study include the fundamental role of equity in service provision, the influence of the social determinants of health and illness and interest in the appropriate use of evidence in international health policy-making.

Roadian – Wordian (Guadalupian, Middle Permian) global palaeobiogeography of brachiopods

A database of 4471 Roadian–Wordian (Guadalupian, Middle Permian) occurrences of 381 brachiopod genera in 44 different operational geographical units (stations) was analyzed by both Q-mode and R-mode quantitative methods. Four distinct brachiopod biogeographical realms and nine provinces, and 11 brachiopod associations are recognized. The Boreal Realm in the Northern Hemisphere includes the Verkolyman Province in the northern and northeastern Siberian Platform and the eastern European Province in the Ural seaway between the European and Siberian platforms. Both provinces are characterized by containing typical Boreal cold-water brachiopod associations. The Gondwanan Realm in the south also includes two provinces. The Austrazean Province in eastern Australia and New Zealand is probably the most stable province throughout the Permian and characterized by typical Gondwanan brachiopod associations. The Westralian Province centered in Western Australia is also characterized by typical Gondwanan brachiopods, but also demonstrates biogeographical links with the Tethyan stations. The Palaeoequatorial Realm located mainly in the palaeotropical zone contains highly diverse and abundant brachiopod faunas. Two regions/subrealms and four provinces are recognized within this realm. The North America Subrealm contains a distinct Grandian Province characterized by many endemic brachiopod genera and a few coldwater genera. East-central Alaska and Yukon Territory may constitute another brachiopod province. All the stations in the Tethyan Ocean (both Palaeotethys and Neotethys) constitute a distinct Asian–Tethyan Region/ Subrealm and incorporate three different provinces. The Cathaysian Province is comprised of the stations in South China and its surrounding terranes/blocks and a few stations in the northern and western margin of the Palaeotethys. Two transitional provinces (Sino–Mongolian–Japanese Province and Cimmerian Province) in the northern and southern temperate zones are also recognizable. The brachiopod fauna from the Mino Belt in Japan is well distinguished from those from other regions, and is hence assigned to the palaeoceanic Panthalassan Realm. Principal coordinates analysis and minimum spanning tree analysis suggest that a latitude-related thermal gradient was the major control for the palaeobiogeography of Roadian–Wordian global brachiopod faunas and for the latitudinal of pattern of decreasing brachiopod generic diversities from the equator to the poles. In addition, geographic separation and oceanic currents may also have played some role in the spatial distribution of brachiopods during Roadian–Wordian times.