Health professionals’ perspectives on information provision for patients with brain tumours and their families

A significant number of patients diagnosed with primary brain tumours report unmet information needs. Using concept mapping methodology, this study aimed to identify strategies for improving information provision, and to describe factors that health professionals understood to influence their provision of information to patients with brain tumours and their families. Concept mapping is a mixed methods approach that uses statistical methods to represent participants’ perceived relationships between elements as conceptual maps. These maps, and results of associated data collection and analyses, are used to extract concepts involved in information provision to these patients. Thirty health professionals working across a range of neuro-oncology roles and settings participated in the concept mapping process. Participants rated a care coordinator as the most important strategy for improving brain tumour care, with psychological support as a whole rated as the most important element of care. Five major themes were identified as facilitating information provision: health professionals’ communication skills, style and attitudes; patients’ needs and preferences; perceptions of patients’ need for protection and initiative; rapport and continuity between patients and health professionals; and the nature of the health care system. Overall, health professionals conceptualised information provision as ‘individualised’, dependent on these interconnected personal and environmental factors.

Postnatal depression in Central Vietnam

Postnatal depression (PND) is a significant global health issue, which not only impacts maternal wellbeing, but also infant development and family structures. Mental health disorders represent approximately 14% of global burden of disease and disability, including low and middle-income countries (LMIC), and PND has direct relevance to the Millennium Development Goals of reducing child mortality, improving maternal health, and creating global partnerships (United Nations, 2012; Guiseppe, Becker & Farmer, 2011). Emerging evidence suggests that PND in LMIC is similar to, or higher than in high-income countries (HIC), however, less than 10% of LMIC have prevalence data available (Fisher, Cabral de Mello, & Izutsu 2009; Lund et al., 2011). Whilst a small number of studies on maternal mental disorders have been published in Vietnam, only one specifically focuses on PND in a hospital-based sample. Also, community based mental health studies and information on mental health in rural areas of Vietnam is still scarce. The purpose of this study was to determine the prevalence of PND, and its associated social determinants in postnatal women in Thua Thien Hue Province, Central Vietnam. In order to identify social determinants relevant to the Central Vietnamese context, two qualitative studies and one community survey were undertaken. Associations between maternal mental health and infant health outcomes were also explored. The study was comprised of three phases. Firstly, iterative, qualitative interviews with Vietnamese health professionals (n = 17) and postpartum women (n = 15) were conducted and analysed using Kleinman's theory of explanatory models to identify narratives surrounding PND in the Vietnamese context (Kleinman, 1978). Secondly, a participatory concept mapping exercise was undertaken with two groups of health professionals (n = 12) to explore perceived risk and protective factors for postnatal mental health. Qualitative phases of the research elucidated narratives surrounding maternal mental health in the Vietnamese context such as son preference, use of traditional medicines, and the popularity of confinement practices such as having one to three months of complete rest. The qualitative research also revealed the construct of depression was not widely recognised. Rather, postpartum changes in mood were conceptualised as a loss of 'vital strength' following childbirth or 'disappointment'. Most women managed postpartum changes in mood within the family although some sought help from traditional medicine practitioners or biomedical doctors. Thirdly, a cross-sectional study of twelve randomly selected communes (six urban, six rural) in Thua Thien Hue Province was then conducted. Overall, 465 women with infants between 4 weeks and six months old participated, and 431 questionnaires were analysed. Women from urban (n = 216) and rural (n = 215) areas participated. All eligible women completed a structured interview about their health, basic demographics, and social circumstances. Maternal depression was measured using the Edinburgh Postnatal Depression Scale (EPDS) as a continuous variable. Multivariate generalised linear regression was conducted using PASW Statistics version 18.0 (2009). When using the conventional EPDS threshold for probable depression (EPDS score ~ 13) 18.1% (n = 78) of women were depressed (Gibson, McKenzie-McHarg, Shakespeare, Price & Gray, 2009). Interestingly, 20.4% of urban women (n = 44) had EPDS scores~ 13, which was a higher proportion than rural women, where 15.8% (n = 34) had EPDS scores ~ 13, although this difference was not statistically significant: t(429) = -0.689, p = 0.491. Whilst qualitative narratives identified infant gender and family composition, and traditional confinement practices as relevant to postnatal mood, these were not statistically significant in multivariate analysis. Rather, poverty, food security, being frightened of your husband or family members, experiences of intimate partner violence and breastfeeding difficulties had strong statistical associations. PND was also associated with having an infant with diarrhoea in the past two weeks, but not infant malnutrition or acute respiratory infections. This study is the first to explore maternal mental health in Central Vietnam, and provides further evidence that PND is a universally experienced phenomenon. The independent social risk factors of depressive symptoms identified such as poverty, food insecurity, experiences of violence and powerlessness, and relationship adversity points to women in a context of social suffering which is relevant throughout the world (Kleinman, Das & Lock, 1997). The culturally specific risk factors explored such as infant gender were not statistically significant when included in a multivariable model. However, they feature prominently in qualitative narratives surrounding PND in Vietnam, both in this study and previous literature. It appears that whilst infant gender may not be associated with PND per se, the reactions of close relatives to the gender of the baby can adversely affect maternal wellbeing. This study used a community based participatory research approach (CBPR) (Israel.2005). This approach encourages the knowledge produced to be used for public health interventions and workforce training in the community in which the research was conducted, and such work has commenced. These results suggest that packages of interventions for LMIC devised to address maternal mental health and infant wellbeing could be applied in Central Vietnam. Such interventions could include training lay workers to follow up postpartum women, and incorporating mental health screening and referral into primary maternal and child health care (Pate! et al., 2011; Rahman, Malik, Sikander & Roberts, 2008). Addressing the underlying social determinants of PND through poverty reduction and violence elimination programs is also recommended.

Exploring postnatal depression in Thua Thien Hue Province, Central Vietnam

Introduction Postnatal depression (PND) is an important public health issue due to its impact on maternal wellbeing, infant development, and family cohesion. The estimated prevalence of PND during the first 12 months post-partum ranges between10-20% worldwide. Whilst PND used to be considered a syndrome only occurring in western countries, there is now evidence that it occurs throughout the world, and often at higher rates in low and middleincome countries. To date, there has been little research into PND in South East Asia and only two community-based surveys in Vietnam, one in Ho Chi Minh City in 1999 and one in Hanoi and Ha Nam in 2009. This study will investigate health worker attitudes about risk and protective factors for PND among women in Thua Thien Hue province in central Vietnam. Methodology In 2009, 23 health professionals participated in qualitative exploratory research of postnatal depression in Hue. This included two focus groups with 12 health professionals who completed a concept mapping process, and in-depth interviews with another 11 health professionals. Results Many factors relating to postnatal depression were identified including socio-economic status, son preference, mother’s health, infant health, social support from family and the community, and health promoting behaviours. In-depth interviews highlighted community knowledge and attitudes surrounding PND such as traditional confinement practices and fear of experiencing stigma. Conclusion The findings of this research will be used to plan a substantial community-based quantitative survey in order to establish prevalence of PND and surrounding social determinants in central Vietnam.

The Thoughts Questionnaire (TQ) for family caregivers of people with dementia

Objectives: To develop a new measure of dysfunctional thoughts for family caregivers of people living with dementia. These thoughts can contribute to negative outcomes, but they may be modifiable. Method: A stepwise process was used to develop the Thoughts Questionnaire, commencing with item generation, concept mapping, and pilot testing in a sample of professional and nonprofessional caregivers of people with dementia (n = 18). Next, an independent sample of 35 family caregivers of people with dementia (30 female; M age = 64.30, standard deviation = 10.65) completed: (a) the Thoughts Questionnaire; (b) an existing measure of dysfunctional thoughts, the Dementia Thoughts Caregivers Questionnaire; and (c) separate validated measures of depressive symptoms, caregiver stress, and coping, respectively. Results: The level of agreement with dysfunctional thought statements from the Dementia Thoughts Caregivers Questionnaire and Thoughts Questionnaire was low. However, a small number of Thoughts Questionnaire statements were strongly endorsed by over 85% of the sample. Both dysfunctional thought measures had adequate reliability, but total scores were not significantly intercorrelated (r = .287, p = .095). Only the Thoughts Questionnaire was significantly, positively correlated with most caregiver stress measures. Thoughts Questionnaire items required a much lower reading level than the Dementia Thoughts Caregivers Questionnaire items. Discussion: This study provides preliminary data on a tool for assessing the negative role-related thoughts that family caregivers of people with dementia may experience. Given that these thoughts are implicated in depression but they may be modified, the capacity to identify dysfunctional thoughts may prove useful in caregiver support programs.

Attributes of clinical role models as described by senior veterinary students in Australia

Role models incite admiration and provide inspiration, contributing to learning as students aspire to emulate their example. The attributes of physician role models for medical trainees are well documented, but they remain largely unexplored in the context of veterinary medical training. The aim of the current study was to describe the attributes that final-year veterinary students (N=213) at the University of Queensland identified when reflecting on their clinical role models. Clinical role model descriptions provided by students were analyzed using concept-mapping software (Leximancer v. 2.25). The most frequent and highly connected concepts used by students when describing their role model(s) included clients, vet, and animal. Role models were described as good communicators who were skilled at managing relationships with clients, patients, and staff. They had exemplary knowledge, skills, and abilities, and they were methodical and conducted well-structured consultations. They were well respected and, in turn, demonstrated respect for clients, colleagues, staff, and students alike. They were also good teachers and able to tailor explanations to suit both clients and students. Findings from this study may serve to assist with faculty development and as a basis for further research in this area.

Antecedentes de la institucionalización de las organizaciones

[ES] Esta investigación es un intento de avanzar en la comprensión de por qué las organizaciones son sensibles a la institucionalización. Para ello, describimos los elementos clave que ayudan a explicar el origen del proceso corporativo de institucionalización. Además, se ha seguido una metodología de investigación cualitativa, utilizando la técnica del concept mapping , para agrupar en constructos los diferentes ítems que actúan como factores motivadores de la transformación de las organizaciones en instituciones. Metodológicamente hemos tratado de obviar la separación entre viejo y nuevo institucionalismo siguiendo a los autores que cuestionan la conveniencia de trazar una línea divisoria entre la vieja y la nueva teoría. Consideramos que el papel del CEO es esencial en el impulso del proceso de institucionalización, aunque en muchas ocasiones sus decisiones estén apoyadas o hayan pasado por el filtro de los equipos de gobierno de la organización o de los consejos de administración. Cualquier impulso que realice la organización dependerá fundamentalmente de las capacidades, las sensaciones, la formación y el modo de pensar del CEO. Los resultados refuerzan varios de los temas claves sugeridos en la literatura sobre Teoría Institucional. En particular, se establece una clasificación con los motivos que dan origen a las iniciativas institucionales, a saber: autoridad institucional; ventaja en gestión; e, implicación social. Esta clasificación es coincidente, en una gran medida, con los pilares de la institucionalización que han sido definidos en la literatura de la teoría institucional, ayudando a comprender, con mayor detalle, el origen de los procesos institucionales y los antecedentes o motivaciones que los generan y guían.

Error-driven active learning in growing radial basis function networks for early robot learning

Q. Meng and M.H. Lee, 'Error-driven active learning in growing radial basis function networks for early robot learning', 2006 IEEE International Conference on Robotics and Automation (IEEE ICRA 2006), 2984-90, Orlando, Florida, USA.

Development of hemispheric specialization for lexical pitch-accent in Japanese infants.

Infants' speech perception abilities change through the first year of life, from broad sensitivity to a wide range of speech contrasts to becoming more finely attuned to their native language. What remains unclear, however, is how this perceptual change relates to brain responses to native language contrasts in terms of the functional specialization of the left and right hemispheres. Here, to elucidate the developmental changes in functional lateralization accompanying this perceptual change, we conducted two experiments on Japanese infants using Japanese lexical pitch-accent, which changes word meanings with the pitch pattern within words. In the first behavioral experiment, using visual habituation, we confirmed that infants at both 4 and 10 months have sensitivities to the lexical pitch-accent pattern change embedded in disyllabic words. In the second experiment, near-infrared spectroscopy was used to measure cortical hemodynamic responses in the left and right hemispheres to the same lexical pitch-accent pattern changes and their pure tone counterparts. We found that brain responses to the pitch change within words differed between 4- and 10-month-old infants in terms of functional lateralization: Left hemisphere dominance for the perception of the pitch change embedded in words was seen only in the 10-month-olds. These results suggest that the perceptual change in Japanese lexical pitch-accent may be related to a shift in functional lateralization from bilateral to left hemisphere dominance.

Le design participatif au sein d’entreprises : une exploration des opportunités et limites perçues par des concepteurs de produits

La littérature contient une abondance d’information sur les approches de design impliquant les utilisateurs. Bien que les chercheurs soulèvent de nombreux avantages concernant ces approches, on en sait peu sur ce que les concepteurs des entreprises en pensent. Ce projet a pour but de connaître les perceptions des concepteurs de produits quant aux outils de design participatif puis, d’identifier les opportunités et limites qu’ils évoquent à ce sujet, et finalement, de faire des suggestions d’outils qui faciliteraient l’introduction du design participatif dans un processus de design existant. Après avoir fait un survol du domaine du design participatif et de ses outils, six cas sont étudiés au moyen d’entrevues semi-dirigées conduites auprès de concepteurs de produits. Les données sont analysées à l’aide de cartes cognitives. En ce qui concerne les outils de design participatif, les participants rencontrés perçoivent un accès direct aux besoins des utilisateurs et la possibilité de minimiser les erreurs en début de processus donc, d’éviter les modifications coûteuses qu’elles auraient entraînées. Les obstacles perçus par les concepteurs sont principalement liés à la résistance au changement, à la crainte de laisser créer ou décider les utilisateurs, ainsi qu’au manque de temps et de ressources de l’équipe. Finalement, sur la base des informations collectées, nous suggérons quatre outils de design participatif qui semblent plus intéressants : l’enquête contextuelle, les sondes, les tests de prototypes et l’approche « lead user ». Pour faire suite à ce travail, il serait intéressant d’élaborer un protocole de recherche plus exhaustif pour augmenter la portée des résultats, ou encore, d’appliquer le design participatif, dans une entreprise, afin d’explorer la satisfaction des gens quant aux produits conçus, les effets collatéraux sur les équipes impliquées, l’évolution des prototypes ou le déroulement des ateliers.

Apropiación de los derechos sexuales y reproductivos. Un estudio de las condiciones socioeconómicas en jóvenes y adolescentes residentes del barrio Las Aguas de Bogotá

Este estudio inquiere por la apropiación de los Derechos Sexuales y Reproductivos de los jóvenes y adolescentes a partir de sus condiciones socioeconómicas. En este sentido, se analiza cómo el ingreso económico, la religión, la escolaridad, entre otros, influyen en la apropiación de estos derechos al condicionar la toma de decisiones seguras y efectivas para el ejercicio de una sexualidad sana y responsable. Mediante una encuesta aplicada a 72 jóvenes y adolescentes residentes del barrio Las Aguas de Bogotá, se indagó por los conocimientos, la toma de decisiones y las valoraciones en torno al tema de sexualidad. Se concluyó que hay un amplio desconocimiento de los Derechos Sexuales y Reproductivos pero existe cierta autonomía y responsabilidad en el ejercicio de la sexualidad.

Towards a definition of a crop wild relative

Crop wild relatives are an important socio-economic resource that is currently being eroded or even extinguished through careless human activities. If the Conference of the Parties (COP) to the CBD 2010 Biodiversity Target of achieving a significant reduction in the current rate of loss is to be achieved, we must first define what crop wild relatives are and how their conservation might be prioritised. A definition of a crop wild relative is proposed and illustrated in the light of previous Gene Pool concept theory. Where crossing and genetic diversity information is unavailable, the Taxon Group concept is introduced to assist recognition of the degree of crop wild relative relatedness by using the existing taxonomic hierarchy.

Comparison of learning between Digital gallery and Hands-on Laboratory

This thesis has been done in ROM (Royal Ontario Museum) located in Toronto Canada. It focuses on learning in two parts of the museum. It tries to find out how much each part is effective in terms of learning. Studies have been done in the Digital gallery, which has been equipped with digital video projector and workstation that allows visitors to interact with the collections in 2 or 3 dimensional spaces while they are watching the presenting film. The rest of the study was in Hands-on laboratory, which allows students to examine artifacts and discuss their findings .The method was used in this research is Concept mapping .In Digital gallery, 24 schools surveys in the form of pre-post- test by help of the concept mapping method has been done. In Hands-on laboratory, 12 schools have been studied by using the combination of interviewing and written pre post-test of concept mapping.

Uma análise histórico-epistemológica do conceito de grupo

This work aims to analyze the historical and epistemological development of the Group concept related to the theory on advanced mathematical thinking proposed by Dreyfus (1991). Thus it presents pedagogical resources that enable learning and teaching of algebraic structures as well as propose greater meaning of this concept in mathematical graduation programs. This study also proposes an answer to the following question: in what way a teaching approach that is centered in the Theory of Numbers and Theory of Equations is a model for the teaching of the concept of Group? To answer this question a historical reconstruction of the development of this concept is done on relating Lagrange to Cayley. This is done considering Foucault s (2007) knowledge archeology proposal theoretically reinforced by Dreyfus (1991). An exploratory research was performed in Mathematic graduation courses in Universidade Federal do Pará (UFPA) and Universidade Federal do Rio Grande do Norte (UFRN). The research aimed to evaluate the formation of concept images of the students in two algebra courses based on a traditional teaching model. Another experience was realized in algebra at UFPA and it involved historical components (MENDES, 2001a; 2001b; 2006b), the development of multiple representations (DREYFUS, 1991) as well as the formation of concept images (VINNER, 1991). The efficiency of this approach related to the extent of learning was evaluated, aiming to acknowledge the conceptual image established in student s minds. At the end, a classification based on Dreyfus (1991) was done relating the historical periods of the historical and epistemological development of group concepts in the process of representation, generalization, synthesis, and abstraction, proposed here for the teaching of algebra in Mathematics graduation course

Developing a research agenda for promoting physical activity in Brazil through environmental and policy change

Objective. To identify the highest priorities for research on environmental and policy changes for promoting physical activity (PA) in Brazil; to uncover any gaps between researchers' and practitioners' priorities; and to consider which tools, methods, collaborative strategies, and actions could be useful to moving a research agenda forward.Methods. This was a mixed-methods study (qualitative and quantitative) conducted by Project GUIA (Guide for Useful Interventions for Activity in Brazil and Latin America) in February 2010-January 2011. A total of 240 individuals in the PA field (186 practitioners and 54 researchers) were asked to generate research ideas; 82 participants provided 266 original statements from which 52 topics emerged. Participants rated topics by "importance" and "feasibility;" a separate convenience sample of 21 individuals categorized them. Cluster analysis and multidimensional scaling were used to create concept maps and pattern matches.Results. Five distinct clusters emerged from the concept mapping, of which " effectiveness and innovation in PA interventions" was rated most important by both practitioners and researchers. Pattern matching showed a divergence between the groups, especially regarding feasibility, where there was no consensus.Conclusions. The study results provided the basis for a research agenda to advance the understanding of environmental and policy influences on PA promotion in Brazil and Latin America. These results should stimulate future research and, ultimately, contribute to the evidence-base of successful PA strategies in Latin America.

Multimedia selection: Allowing educators to act critically and independently

In Brazil, important portals like the Portal do Professor, or Teacher's Portal, from the Ministry of Education, offer multimedia products like audios, videos, games, animations, simulations and others with an accompanying teacher's guide. These guides in general suggest ways to prepare the students to use the products while offering indications on how to practice that knowledge after using the products in the classrooom. Despite this, portals with huge repositories that receive new products every week don't present to teachers a solution for a problem: How to select the appropriate products to use in the classroom and how to assess their use after teaching in order to check if the learning was meaningful? In this way, this paper discusses multimedia selection for meaningful learning while considering concept mapping and abstraction classification. The development of multimedia repositories has created both opportunities for easy access to digital content and areas of serious concerns since the misuse of products by teachers may lead to different problems.