Unwanted sexual experiences among adolescents: shedding light on the gray zone between consensual and non-consensual sex.

This study aimed at exploring adolescents' perceptions of unwanted sexual experiences (USE) in order to set up definitions, categories, and boundaries on the continuum between consensual and non-consensual sex. METHODS: We conducted a qualitative thematic analysis of four focus group discussions gathering a total of 29 male and female adolescents aged 16-20 years. RESULTS: Analysis of participants' discourse revealed three main characteristics that define USE, namely, regret, as most situations discussed were said to be acceptable or not in terms of whether there were regrets after the fact; misperception of sexual intent; and lack of communication between partners. CONCLUSIONS: Our findings revealed that health professionals should be aware of the subtle aspects identifying USE when screening for situations that can have adverse psychological consequences. Where prevention is concerned, it appears important to address these aspects of USE in sex education classes.

Nursing Actions in practicing inpatient advocacy in a Burn Unit

OBJECTIVEUnderstanding nursing actions in the practice of inpatient advocacy in a burn unit.METHODA single and descriptive case study, carried out with nurses working in a referral burn center in southern Brazil. Data were collected through focus group technique, between February and March 2014, in three meetings. Data was analysed through discursive textual analysis.RESULTSThree emerging categories were identified, namely: (1) instructing the patient; (2) protecting the patient; and (3) ensuring the quality of care.CONCLUSIONSThis study identified that the nurses investigated exercised patient advocacy and that the recognition of their actions is an advance for the profession, contributing to the autonomy of nurses and the effectiveness of patients' rights and social justice.

Mothers' perceptions of care practices for children who underwent heart transplantation

Abstract OBJECTIVE To learn mothers' perceptions of the main care practices that are to be administered after their children's heart transplantation, as well as the main difficulties they experience. METHOD A descriptive qualitative study conducted in March and April 2014, using the focus group technique for data gathering. Participants were 12 mothers who were monitoring their children in a hospital that is a reference for treating cardiopulmonary diseases. Speeches were recorded, transcribed, and organized around the care practices that the mothers performed after the children's heart transplantations, the mothers' main difficulties, their perceptions of their children's quality of life, and the use of educational materials to disseminate post-transplantation care practices. For data analysis, we used the content analysis technique. RESULTS The following were clarified: the schedule of immunosuppressive medication; food, environmental, and bodily and oral hygiene; the use of surgical masks; and keeping the children away from crowds. CONCLUSION The study contributed to the situational diagnosis of the care administered by the mothers of transplanted children.

Reliability of the image evaluation system PGMI

Purpose: Many countries used the PGMI (P=perfect, G=good, M=moderate, I=inadequate) classification system for assessing the quality of mammograms. Limits inherent to the subjectivity of this classification have been shown. Prior to introducing this system in Switzerland, we wanted to better understand the origin of this subjectivity in order to minimize it. Our study aimed at identifying the main determinants of the variability of the PGMI system and which criteria are the most subjected to subjectivity. Methods and Materials: A focus group composed of 2 experienced radiographers and 2 radiologists specified each PGMI criterion. Ten raters (6 radiographers and 4 radiologists) evaluated twice a panel of 40 randomly selected mammograms (20 analogic and 20 digital) according to these specified PGMI criteria. The PGMI classification was assessed and the intra- and inter-rater reliability was tested for each professional group (radiographer vs radiologist), image technology (analogic vs digital) and PGMI criterion. Results: Some 3,200 images were assessed. The intra-rater reliability appears to be weak, particularly in respect to inter-rater variability. Subjectivity appears to be largely independent of the professional group and image technology. Aspects of the PGMI classification criteria most subjected to variability were identified. Conclusion: Post-test discussions enabled to specify more precisely some criteria. This should reduce subjectivity when applying the PGMI classification system. A concomitant, important effort in training radiographers is also necessary.

Understanding informal payments in health care: motivation of health workers in Tanzania

BACKGROUND: There is growing evidence that informal payments for health care are fairly common in many low- and middle-income countries. Informal payments are reported to have a negative consequence on equity and quality of care; it has been suggested, however, that they may contribute to health worker motivation and retention. Given the significance of motivation and retention issues in human resources for health, a better understanding of the relationships between the two phenomena is needed. This study attempts to assess whether and in what ways informal payments occur in Kibaha, Tanzania. Moreover, it aims to assess how informal earnings might help boost health worker motivation and retention. METHODS: Nine focus groups were conducted in three health facilities of different levels in the health system. In total, 64 health workers participated in the focus group discussions (81% female, 19% male) and where possible, focus groups were divided by cadre. All data were processed and analysed by means of the NVivo software package. RESULTS: The use of informal payments in the study area was confirmed by this study. Furthermore, a negative relationship between informal payments and job satisfaction and better motivation is suggested. Participants mentioned that they felt enslaved by patients as a result of being bribed and this resulted in loss of self-esteem. Furthermore, fear of detection was a main demotivating factor. These factors seem to counterbalance the positive effect of financial incentives. Moreover, informal payments were not found to be related to retention of health workers in the public health system. Other factors such as job security seemed to be more relevant for retention. CONCLUSION: This study suggests that the practice of informal payments contributes to the general demotivation of health workers and negatively affects access to health care services and quality of the health system. Policy action is needed that not only provides better financial incentives for individuals but also tackles an environment in which corruption is endemic.

Acceptance of inflammatory bowel disease treatment recommendations based on appropriateness ratings : do practicing gastroenterologists agree with experts?

BACKGROUND: Appropriateness criteria for the treatment of Crohn's disease (CD) and ulcerative colitis (UC) have been developed by experts' panels. Little is known about the acceptance of such recommendations by care providers. The aim was to explore how treatment decisions of practicing gastroenterologists differ from experts using a vignette case study and a focus group. METHODS: Seventeen clinical vignettes were drawn from clinical indications evaluated by the expert panel. A vignette case questionnaire asking for treatment options in 9-10 clinical situations was submitted to 26 practicing gastroenterologists. For each vignette case, practitioners' answers on treatments deemed appropriate were compared to panel decisions. Qualitative analysis was made based on focus group discussion to explore acceptance and divergence reasons. RESULTS: 239 clinical vignettes were completed, 98 for CD and 141 for UC. Divergence between proposed treatments and results from panels was more frequent for CD (34%) than for UC (27%). Among UC clinical vignettes, the main divergences with the panel were linked to 5-ASA failure assessment and to situations where stopping treatment was the main decision. For CD, the care provider propositions diverged with the panel in mild-to-moderate active disease, where practitioners were more prone to an accelerated step up than the panel's recommendations. CONCLUSIONS: In about one third of vignettes cases, IBD treatment propositions made by practicing gastroenterologists diverged as compared to expert recommendations. Practicing gastroenterologists may experience difficulties in applying recommendations in daily practice.

Mentally Ill Offenders in Community-Based Corrections, Research in Brief, Iowa Department of Corrections, April 2008

A survey of offenders supervised by the eight district departments of correctional services. This report was commissioned by the Iowa Department of Corrections Focus Group on Mental Health in Community-Based Corrections.

Screening for post-traumatic stress disorder (PTSD) in a psychiatric emergency setting

Background and Objectives: (i) to assess the prevalence of PTSD in a psychiatric emergency setting by means of a diagnostic instrument and to compare it with PTSD-prevalence of a clinically evaluated, historical sample; and (ii) to assess psychiatric residents' perception of the systematic use of this diagnostic instrument. Methods: A consecutive sample of patients (N = 403) evaluated for a psychiatric emergency was assessed with the module J (PTSD) of the MINI, the historical sample (N = 350), assessed by chart review, consisted of consecutive patients of the same setting evaluated one year prior to the study period. Residents' perceptions were assessed by means of a focus group. Results: While in only 0.57% of the historical sample (N = 350) a diagnosis of PTSD was recorded, 20.3% (N = 64) of the patients assessed with the diagnostic instrument (N = 316) qualified for a diagnosis of PTSD. Higher prevalence rates were observed in refugees and those without legal residency status (50%); patients from countries with a recent history of war (47.1%); those with four (44.4%) or three psychiatric co-morbidities (35.3%); migrants (29.8%) and patients without professional income (25%). Residents felt that the systematic use of the tool was not adequate in the psychiatric emergency setting for various reasons (e.g.: not suitable for a first or single consultation, negative impact on the clinical evaluation). Conclusions: The study confirms that PTSD is underdiagnosed in the psychiatric emergency setting. To improve the situation, targeted screening or educational and institutional strategies are needed.

The influence of work context on demand for master's studies: a comparative analysisi between Brasil and Spain

The communication presents the results of an investigation of exploratory and comparative character which objective is to analyze the influence of the actual labour situation into the demand of official master studies in the field of education. The study has been developed in two countries with a very different labour situation: Brasil, country of economic expansion and Spain, in recession due to the actual economic crisis. In that sense, the study provides data for deep thinking about the influence of the constriction or expansion of employment on the behaviour and demand of the students who access master studies and on how the previous formative and labour trajectory affects their expectations, demands and future projects. The working methodology is qualitative and the strategy for data collection the “focus group”. As a first approach, two groups of discussion have been formed with master students. A first one with students from Universidad de Barcelona- España and another one with members of Universidade do Vale do Itajaí- Brasil. Then, we constituted a mixed group of discussion in order to analyze differences and similarities.

An Optimum Allocation Approach to Closing or Relocating Highway Maintenance Garages in Iowa, 1981

Highway maintenance engineers and administrators are often confronted with a number of problems related to highway maintenance work programs. One of these problems is concerned with determining the optimum number and locations of highway maintenance garages in a given area. Serious decline in highway revenues and a high inflation rate have made it necessary to examine existing maintenance practices and to allocate reduced financial resources more effectively and efficiently. Searching for and providing of reasonable solutions to these problems is the focus of this research project. The methodology used is to identify and modify for use (if necessary) those models which have already been developed. Models which could give optimum number and locations of highway maintenance garages were found to be too theoretical and/or practically infeasible. Consequently, research focus was shifted from these models to other models that could compare alternatives and select the best among these alternatives. Three such models -- the Alabama model, California model, and Louisiana model, were identified and studied.

The influence of work context on demand for master's studies: a comparative analysisi between Brasil and Spain

The communication presents the results of an investigation of exploratory and comparative character which objective is to analyze the influence of the actual labour situation into the demand of official master studies in the field of education. The study has been developed in two countries with a very different labour situation: Brasil, country of economic expansion and Spain, in recession due to the actual economic crisis. In that sense, the study provides data for deep thinking about the influence of the constriction or expansion of employment on the behaviour and demand of the students who access master studies and on how the previous formative and labour trajectory affects their expectations, demands and future projects. The working methodology is qualitative and the strategy for data collection the “focus group”. As a first approach, two groups of discussion have been formed with master students. A first one with students from Universidad de Barcelona- España and another one with members of Universidade do Vale do Itajaí- Brasil. Then, we constituted a mixed group of discussion in order to analyze differences and similarities.

Cellular source and mechanisms of high transcriptome complexity in the Mammalian testis.

Understanding the extent of genomic transcription and its functional relevance is a central goal in genomics research. However, detailed genome-wide investigations of transcriptome complexity in major mammalian organs have been scarce. Here, using extensive RNA-seq data, we show that transcription of the genome is substantially more widespread in the testis than in other organs across representative mammals. Furthermore, we reveal that meiotic spermatocytes and especially postmeiotic round spermatids have remarkably diverse transcriptomes, which explains the high transcriptome complexity of the testis as a whole. The widespread transcriptional activity in spermatocytes and spermatids encompasses protein-coding and long noncoding RNA genes but also poorly conserves intergenic sequences, suggesting that it may not be of immediate functional relevance. Rather, our analyses of genome-wide epigenetic data suggest that this prevalent transcription, which most likely promoted the birth of new genes during evolution, is facilitated by an overall permissive chromatin in these germ cells that results from extensive chromatin remodeling.

Estudi sobre la utilitat d'una intervenció de pacient expert en pacients amb lesions per cremades

Les lesions per cremades comporten conseqüències a nivell físic, psicològic i social. Les intervencions psicosocials per aquests pacients estan valorades de forma positiva però manquen estudis fets a l’Estat Espanyol. Les intervencions de pacient expert estan donant resultats positius en moltes patologies cròniques però no n’existeix cap per aquest tipus de lesions cròniques. L’objectiu d’aquest estudi és comprendre la utilitat d’una intervenció de pacient expert a pacients d’entre 18 i 30 anys que han patit lesions per cremades recentment. Es realitzaran 9 sessions de pacient expert des de la perspectiva bio-psicosocial. El grup focal serà un grup de 8-10 pacients de 18 a 30 anys amb un mínim del 15% de superfície corporal cremada de grau 2n profund o 3r, residents a Barcelona o rodalies. Les dades s’analitzaran per mètode mixt amb enfocament dominant qualitatiu. La recollida de dades s’obtindrà d’entrevistes, testos i anotacions realitzades prèvia a la primera sessió, al finalitzar les 9 sessions i als 6 mesos de la última sessió. Les limitacions de l’estudi són: el risc de pèrdua dels membres del grup focal a causa del retorn a la vida laboral i l’heterogeneïtat del grup en la fase d’acceptació, principis i valors personals que podrien desviar els resultats.

Acolliment lingüístic en dones nouvingudes

La immigració és una característica de la societat actual, moltes persones marxen del seu país amb l’objectiu de millorar la seva qualitat de vida. Els governs han desenvolupat accions per facilitar la inserció de la persona en el país d’acollida. Un fet que facilita la inserció és la llengua, aquesta és la clau per poder participar en el nou context. A més fomenta la cohesió perquè és l’instrument de relació amb altres persones. Per aquesta raó una de les accions del govern de Catalunya és l’acolliment lingüístic. La immigració és un tema molt ampli, la investigació es centrarà en les dones immigrants analitzant una entitat civil de Vic que ofereix acolliment lingüístic en dones.

Research into the information referents of deaf signers

La sociedad de la información está ampliando los referentes informativos de las personas sordas signantes (usuarias de una lengua de signos). Con el objetivo de explorar las vías más utilizadas para acceder a la actualidad periodística por parte del colectivo mencionado, este artículo resume una investigación cuantitativa realizada con una encuesta a 138 personas Sordas: 69 en España y 69 en EE.UU. El trabajo se complementa cualitativamente con un focus group en la Gallaudet University de Washington, en American Sign Language (ASL), y con la observación de tres conferencias-magazines en Barcelona, para participantes sordos, en Lengua de Signos Catalana (LSC).