Gender comparisons in non-acute cardiac symptom recognition and subsequent help-seeking decisions: a mixed methods study protocol

Introduction: Coronary heart disease (CHD) is one of the leading causes of death in both men and women worldwide. Despite the common misconception that CHD is a ‘man's disease’, it is now well accepted that women endure worse clinical outcomes than men following CHD-related events. A number of studies have explored whether or not gender differences exist in patients presenting with CHD, and specifically whether women delay seeking help for cardiac conditions. UK and overseas studies on help-seeking for emergency cardiac events are contradictory, yet suggest that women often delay help-seeking. In addition, no studies have looked at presumed cardiac symptoms outside an emergency situation. Given the lack of understanding in this area, an explorative qualitative study on the gender differences in help-seeking for a non-emergency cardiac events is needed. Methods and analysis: A purposive sample of 20–30 participants of different ethnic backgrounds and ages attending a rapid access chest pain clinic will be recruited to achieve saturation. Semistructured interviews focusing on help-seeking decision-making for apparent cardiac symptoms will be undertaken. Interview data will be analysed thematically using qualitative software (NVivo) to understand any similarities and differences between the way men and women construct help-seeking. Findings will also be used to inform the preliminary development of a cardiac help-seeking intentions questionnaire. Ethics and dissemination: Ethical approvals were sought and granted. Namely, the University of Westminster (sponsor) and St Georges NHS Trust REC, and the Trust Research and Development Office granted approval to host the study on the Queen Mary's Roehampton site. The study is low risk, with interviews being conducted on hospital premises during working hours. Investigators will disseminate findings via presentations and publications. Participants will receive a written summary of the key findings.

Help-seeking for 'memory loss' by older adults in India : patient, caregiver and health providers' perspectives

ABSTRACT: Background. In India, prevalence rates of dementia and prodromal amnestic Mild Cognitive Impairment (MCI) are 3.1% and 4.3% respectively. Most Indians refer to the full spectrum of cognitive disorders simply as ‘memory loss.’ Barring prevention or cure, these conditions will rise rapidly with population aging. Evidence-based policies and practices can improve the lives of affected individuals and their caregivers, but will require timely and sustained uptake. Objectives. Framed by social cognitive theories of health behavior, this study explores the knowledge, attitudes and practices concerning cognitive impairment and related service use by older adults who screen positive for MCI, their primary caregivers, and health providers. Methods. I used the Montreal Cognitive Assessment to screen for cognitive impairment in memory camps in Mumbai. To achieve sampling diversity, I used maximum variation sampling. Ten adults aged 60+ who had no significant functional impairment but screened positive for MCI and their caregivers participated in separate focus groups. Four other such dyads and six doctors/ traditional healers completed in-depth interviews. Data were translated from Hindi or Marathi to English and analyzed in Atlas.ti using Framework Analysis. Findings. Knowledge and awareness of cognitive impairment and available resources were very low. Physicians attributed the condition to disease-induced pathology while lay persons blamed brain malfunction due to normal aging. Main attitudes were that this condition is not a disease, is not serious and/or is not treatable, and that it evokes stigma toward and among impaired persons, their families and providers. Low knowledge and poor attitudes impeded help-seeking. Conclusions. Cognitive disorders of aging will take a heavy toll on private lives and public resources in developing countries. Early detection, accurate diagnosis, systematic monitoring and quality care are needed to compress the period of morbidity and promote quality of life. Key stakeholders provide essential insights into how scientific and indigenous knowledge and sociocultural attitudes affect use and provision of resources.

Predicting market direction with hidden Markov models

This paper develops the model of Bicego, Grosso, and Otranto (2008) and applies Hidden Markov Models to predict market direction. The paper draws an analogy between financial markets and speech recognition, seeking inspiration from the latter to solve common issues in quantitative investing. Whereas previous works focus mostly on very complex modifications of the original hidden markov model algorithm, the current paper provides an innovative methodology by drawing inspiration from thoroughly tested, yet simple, speech recognition methodologies. By grouping returns into sequences, Hidden Markov Models can then predict market direction the same way they are used to identify phonemes in speech recognition. The model proves highly successful in identifying market direction but fails to consistently identify whether a trend is in place. All in all, the current paper seeks to bridge the gap between speech recognition and quantitative finance and, even though the model is not fully successful, several refinements are suggested and the room for improvement is significant.

Die Bildung einer neuen Identität. Bekehrung und Berufung im Licht der göttlichen Inspiration

Das Urchristentum ist nicht nur Niederschlag objektiver sozialer Strukturen, sondern besteht in subjektiven Sinndeutungen mit Hilfe vorgegebener Muster des Verhaltens und Erlebens. Die Erforschung dieser subjektiven Seite des Urchristentums ist Aufgabe einer »Psychologie des Urchristentums«. Der vorliegende Band vereint neue psychologische Ansätze der Interpretation des frühen Christentums. Untersucht werden grundlegende Erfahrungen (Berufungserlebnisse, Diskriminierung, Leid, Tod u.a.), das religiöse Denken und Sprechen sowie das Ethos (Neid, Freude, Gewissen) der ersten Christen.

Patients' information-seeking activity is associated with treatment compliance in inflammatory bowel disease patients.

Background. Despite the chronic and relapsing nature of inflammatory bowel diseases (IBD), at least 30% to 45% of the patients are noncompliant to treatment. IBD patients often seek information about their disease. Aim. To examine the association between information-seeking activity and treatment compliance among IBD patients. To compare information sources and concerns between compliant and noncompliant patients. Methods. We used data from the Swiss IBD cohort study, and from a qualitative survey conducted to assess information sources and concerns. Crude and adjusted odds ratios (OR) for noncompliance were calculated. Differences in the proportions of information sources and concerns were compared between compliant and noncompliant patients. Results. A total of 512 patients were included. About 18% (n = 99) of patients were reported to be noncompliant to drug treatment and two-thirds (n = 353) were information seekers. The OR for noncompliance among information seekers was 2.44 (95%CI: 1.34-4.41) after adjustment for confounders and major risk factors. General practitioners were 15.2% more often consulted (p = 0.019) among compliant patients, as were books and television (+13.1%; p = 0.048), whereas no difference in proportions was observed for sources such as internet or gastroenterologists. Information on tips for disease management were 14.2% more often sought among noncompliant patients (p = 0.028). No difference was observed for concerns on research and development on IBD or therapies. Conclusion. In Switzerland, IBD patients noncompliant to treatment were more often seeking disease-related information than compliant patients. Daily management of symptoms and disease seemed to be an important concern of those patients.

Moderating effects of gender and general self-efficacy on the relationship between sensation-seeking and adolescent substance use /

This study performed a aecondvy dau analysis of information collected during the Youth Leisure Study (YLS). The purpose of this study was to examine the potential moderating influences of gender and general self-efTicacy on the relationships aoKXig sensation-seeking and various forms of substance use in adolescents. Specifically, the predictive ability of sensation seeking on five adolescents substance use outcomes (alcohol, tobacco, and marijuana use; binge drinking; and number of times drunk) was examined. Moderated hierarchical multiple regression (MHMR) analyses were used to examine the relationships among study variables. The results for this study indicate that the relationships among sensation-seeking and forms of adolescent substance use are more complex than literature suggests. Main effect relationships were found consistently for sensation-seeking and general self-efficacy with each of the outcome variables. Results for gender were not consistent across the substance use outcomes. Gender was a significant predictor for marijuana use only. The moderating effects of general self-efficacy (GSE) on the sensation-seekingsubstance use relationship were inconsistent. While no significant interactions were found for tobacco or alcohol use outcomes, GSE was found to moderate the relationship between sensation-seeking and marijuana use indicating that feelings of high general selfefficacy act as a buffer or guard against marijuana use. A consistent pattern was found among the alcohol use variables (alcohol use. binge drinking, and number of times drunk). Gender was found to moderate each of these variables indicating that higher levels of sensation seeking are more predictive of higher levels of adolescent alcohol use in males only. Implications of this study on the field of education, are discussed further, and suggestions for future research are presented.

Student Perceptions of Discretion in Discipline: Seeking Resolution and Restoration in a Punitive Culture

This study examined high school student perceptions of discretion utilized by educators in high school disciplinary proceedings. Using a sample of 6 high school students who had experienced differing levels of formal discipline, the study investigated the discretionary factors that influence an educator's decision making. The study was a generic qualitative study where the primary source of data collection was open-ended interviews to ensure the integrity of the research as a study of student voices and perceptions. Journaling was also employed to record observations and to identify researcher assumptions. The data were analyzed employing aspects of a grounded theory approach. The findings were coded to reveal 5 areas high school students identified in relation to discipline and discretion: punitive discipline versus problem resolution, effective processes, educator discretion, student discretion, and the student-educator relationship. The final discussion highlights the need for a community vision for high school discipline in order to channel discretion and to uphold students' best interests. Restorative justice is proposed as a feasible vision for high school discipline, whereby participants' responses are measured against a restorative paradigm.

Exploring Academic (Di)stress and Help-Seeking in Faculty of Education Students

This is a study of education students’ conceptions of and experiences with academic stress and help-seeking. The study explored teacher education and Master of Education students’ academic stress by examining causes of academic stress and how these stressors affect students’ academic and university experiences. Stress-related help-seeking was also a focus of this study, and was explored using inquiries regarding where participants sought stress-related support. Additionally, exploring students’ use of the Internet for stress-related information or support was a goal of this study. These research goals were pursued using a qualitative methodology that applied grounded theory design. Consequently, data were used to develop a theory that would contribute to existing literature. Specifically, participant descriptions related to causes of and responses to academic stress aligned with Maslow’s (1954) theory of human motivation and Alderfer’s (1969) E. R. G. theory, and led to theoretical contributions that took a hierarchy of student needs and motivation into consideration.

De l’anthropos : se savoir humain, entre foi et savoir

Cotutelle de thèse réalisée en littérature comparée (option épistémologie) avec l'Université de Montréal sous la direction de Terry Cochran et en philosophie avec Paris X (Nanterre) sous la direction d'Alain Milon.

Institutional Boundaries and Judicial Review - Some Thoughts on How the Court is Going About Its Business: Desperately Seeking Coherence

Cet article a précédemment été publié par la Supreme Court Law Review (Second Series).