743 resultados para Patient Experiences in ED


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Within development communication, gaps remain in theory and practice: communication innovations are taking place which either do not incorporate theory or fail to challenge the assumptions of development communication and HIV/AIDS theory. This can lead to the implementation of unsuccessful interventions that lack theoretical frameworks or to uninformed practice, making it difficult to replicate. Further, research has demonstrated that Entertainment Education (EE) interventions have a measurable impact on behaviour in areas such as HIV/AIDS prevention. Given the transitions in EE practice and evidence of its impact, EE theory and practice can contribute insight into these challenges. A pilot study investigated these dilemmas within the context of the monitoring and evaluation of development communication. Framing this discussion is the concept of South-North dialogue, using comparative analysis of EE interventions to distil lessons through contrasting experiences in two diverse settings. It holds as a principle that lessons from the experience of EE in the Southern context can inform lessons for the North. Further, comparison of the case studies can generate insights for the broader development communication field. We present four case studies, informed by key informant interviews, of EE interventions in the UK and South Africa. We address how communication is defined in planning, implementation and evaluation, highlighting how it often misses the importance of 'listening'. The case studies show that HIV/AIDS communication, and development communication more broadly, has not internalised ideas of evaluation and listening in communication. Successes in the case studies can be partially attributed to responsiveness and context-specificity rather than following rigid planning templates, such as those found in some development communication literature. This indicates the importance of flexibility and responsiveness to context for both development communication and HIV/AIDS communication.

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International students are important economically and culturally, bringing diversity and an international perspective enriching learning experiences in classrooms. With the global transformations eLearning has become an important element of students’ higher education experience in developed countries. Although students of developed countries have digital exposure at an early age, many students from developing countries, on the journey of becoming international students, are inadequately prepared for eLearning. The lack of digital skills, prior experience, cultural differences and language barriers together with the drastic changes in learning environments require international students to not only adapt to the host environment but also to negotiate technology for learning. The scarcity of research exploring the eLearning experiences of international students from developing countries and the benefits of this understanding is discussed in an effort to promote research in this area.

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The book describes a wide variety of students’ experiences in their practical year prior to entering University to study BSc Agriculture. Until comparatively recently it was the normal requirement for all such students, whether or not they already had home farming experience, to gain a full year’s experience of practical agriculture – and to write a report thereon. This record of 41 students’ reports of the pre-entry year begins with Paul’s own experience in the early 1950s before 41 reports from 30 or more years ago. The essays provide compelling and fascinating stories, well-articulated with clear acknowledgement for most part of the humanity and the warmth with which each student was treated by farmers and farm workers alike, despite the difference in both age and experience (considerable!). [This summary is an extract from the full overview which is archived here together with the book.]

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In this paper we explore the importance of emotionally inter-dependent relationships to the functioning of embodied social capital and habitus. Drawing upon the experiences of young people with socio-emotional differences, we demonstrate how emotionally inter-dependent and relatively nurturing relationships are integral to the acquisition of social capital and to the co-construction and embodiment of habitus. The young people presented in this paper often had difficulties in forging social relationships and in acquiring symbolic and cultural capital in school spaces. However, we outline how these young people (re)produce and embody alternative kinds of habitus, based on emotionally reciprocal relationships forged through formal and informal leisure activities and familial and fraternal social relationships. These alternative forms of habitus provide sites of subjection, scope for acquiring social and cultural capital and a positive sense of identity in the face of problematic relations and experiences in school spaces.

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Attention Deficit Hyperactivity Disorder (ADHD) and Autism Spectrum Disorder (ASD) are often comorbid and share cognitive abnormalities in temporal foresight. A key question is whether shared cognitive phenotypes are based on common or different underlying pathophysiologies and whether comorbid patients have additive neurofunctional deficits, resemble one of the disorders or have a different pathophysiology. We compared age- and IQ-matched boys with non-comorbid ADHD (18), non-comorbid ASD (15), comorbid ADHD and ASD (13) and healthy controls (18) using functional magnetic resonance imaging (fMRI) during a temporal discounting task. Only the ASD and the comorbid groups discounted delayed rewards more steeply. The fMRI data showed both shared and disorder-specific abnormalities in the three groups relative to controls in their brain-behaviour associations. The comorbid group showed both unique and more severe brain-discounting associations than controls and the non-comorbid patient groups in temporal discounting areas of ventromedial and lateral prefrontal cortex, ventral striatum and anterior cingulate, suggesting that comorbidity is neither an endophenocopy of the two pure disorders nor an additive pathology.

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While the role of leadership in improving schools is attracting more worldwide attention, there is a need for more research investigating leaders’ experiences in different national contexts. Using focus-group and semi-structured interview data, this paper explores the background, identities and experiences of a small group of Jamaican school leaders who were involved in a leadership development programme. By drawing on the concepts of culture, socialisation and identity, the paper examines how the participants’ journeys of becoming and being school leaders are influenced by national-level societal and cultural issues, experienced at a local level. The findings suggest that in becoming school leaders, the participants perceived that they had a strong sense of agency in attempting to change the social structures within the institutions they lead and in the surrounding local communities, which in turn, they hope, will have a lasting effect on the nation as a whole.

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Little is understood about the relationship between therapist competence and the outcome of patients treated for common mental health disorders. Understanding the relationship between competence and patient outcome is of fundamental importance to the dissemination and implementation of Cognitive Behavioural Therapy (CBT). The current study extends existing literature by exploring the relationship between CBT competence and patient outcome in routine clinical practice within the framework of the British Government’s Improving Access to Psychological Therapies (IAPT) programme. Participants comprised 43 therapists treating 1247 patients over a training period of one year. Results found little support of a general association between CBT competence and patient outcome; however significantly more patients of the most competent therapists demonstrated a reliable improvement in their symptoms of anxiety than would be expected by chance alone, and fewer experienced no reliable change. Conversely, significantly more patients treated by the least competent therapists experienced a reliable deterioration in their symptoms than would be expected. The implications of these results for the dissemination and implementation of CBT are discussed.

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Anxiety disorders that are the most commonly occurring psychiatric disorders in childhood, are associated with a range of social and educational impairments and often continue into adulthood. Cognitive behaviour therapy (CBT) is an effective treatment option for the majority of cases, although up to 35-45% of children do not achieve remission. Recent research suggests that some genetic variants may be associated with a more beneficial response to psychological therapy. Epigenetic mechanisms such as DNA methylation work at the interface between genetic and environmental influences. Furthermore, epigenetic alterations at the serotonin transporter (SERT) promoter region have been associated with environmental influences such as stressful life experiences. In this study, we measured DNA methylation upstream of SERT in 116 children with an anxiety disorder, before and after receiving CBT. Change during treatment in percentage DNA methylation was significantly different in treatment responders vs nonresponders. This effect was driven by one CpG site in particular, at which responders increased in methylation, whereas nonresponders showed a decrease in DNA methylation. This is the first study to demonstrate differences in SERT methylation change in association with response to a purely psychological therapy. These findings confirm that biological changes occur alongside changes in symptomatology following a psychological therapy such as CBT.

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This paper explores the idea that stakeholder proximity, that is, how much/little experience a stakeholder has with a focal organization, impacts the extent to which stakeholders rely on strategic group characteristics as an anchor when judging the reputation of higher education institutions. We synthesize theories from psychology (ie, cognitive categorization theory) and management (ie, strategic group theory) to explore how stakeholder proximity may influence the formation of organizational reputation. Specifically, we examine how the proximity of three key stakeholders (N=1,049; prospective students, parents of students and hiring managers of new graduates) influences the perceived strategic character and generalized favorability of three distinct groups of post-secondary institutions (research-intensive universities, teaching-intensive universities and career colleges). Our results suggest that high proximity stakeholders rely less on strategic group characteristics, while reputation at a strategic group level is suggested to have greater influence on stakeholders who have less direct experience of and low proximity to an organization. Interestingly, our findings reveal some consistent differences between perceptions of prospective students and hiring managers that pose important theoretical questions about the role and impact of direct experiences in the reputation-building process, while also suggesting that higher education institutions may benefit significantly from differentiated marketing strategies according to issues of proximity.

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This paper proposes a rights-based approach for participatory urban planning for climate change adaptation in urban areas. Participatory urban planning ties climate change adaptation to local development opportunities. Previous discussions suggest that participatory urban planning may help to understand structural inequalities, to gain, even if temporally, institutional support and to deliver a planning process in constant negotiation with local actors. Building upon an action research project which implemented a process of participatory urban planning for climate change in Maputo, Mozambique, this paper reflects upon the practical lessons that emerged from these experiences, in relation to the incorporation of climate change information, the difficulties to secure continued support from local governments and the opportunities for local impacts through the implementation of the proposals emerging from this process.

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Ubiquitous computing aims at providing services to users in everyday environments such as the home. One research theme in this area is that of building capture and access applications which support information to be recorded ( captured) during a live experience toward automatically producing documents for review (accessed). The recording demands instrumented environments with devices such as microphones, cameras, sensors and electronic whiteboards. Since each experience is usually related to many others ( e. g. several meetings of a project), there is a demand for mechanisms supporting the automatic linking among documents relative to different experiences. In this paper we present original results relative to the integration of our previous efforts in the Infrastructure for Capturing, Accessing, Linking, Storing and Presenting information (CALiSP). Ubiquitous computing aims at providing services to users in everyday environments such as the home. One research theme in this area is that of building capture and access applications which support information to be recorded (captured) during a live experience toward automatically producing documents for review (accessed). The recording demands instrumented environments with devices such as microphones, cameras, sensors and electronic whiteboards. Since each experience is usually related to many others (e.g. several meetings of a project), there is a demand for mechanisms supporting the automatic linking among documents relative to different experiences. In this paper we present original results relative to the integration of our previous efforts in the Infrastructure for Capturing, Accessing, Linking, Storing and Presenting information (CALiSP).

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Objective: To compare results from various tapping tests with diary responses in advanced PD. Background: A home environment test battery for assessing patient state in advanced PD, consisting of diary assessments and motor tests was constructed for a hand computer with touch screen and mobile communication. The diary questions: 1. walking, 2. time in off , on and dyskinetic states, 3. off at worst, 4. dyskinetic at worst, 5. cramps, and 6. satisfied with function, relate to the recent past. Question 7, self-assessment, allows seven steps from -3 ( very off ) to +3 ( very dyskinetic ) and relate to right now. Tapping tests outline: 8. Alternately tapping two fields (un-cued) with right hand 9. Same as 8 but using left hand 10. Tapping an active field (out of two) following a system-generated rhythm (increasing speed) with the dominant hand 11. Tapping an active field (out of four) that randomly changes location when tapped using the dominant hand Methods: 65 patients (currently on Duodopa, or candidates for this treatment) entered diary responses and performed tapping tests four times per day during one to six periods of seven days length. In total there were 224 test periods and 6039 test occasions. Speed for tapping test 10 was discardedand tests 8 and 9 were combined by taking means. Descriptive statistics were used to present the variation of the test variables in relation to self assessment (question 7). Pearson correlation coefficients between speed and accuracy (percent correct) in tapping tests and diary responses were calculated. Results: Mean compliance (percentage completed test occasions per test period) was 83% and the median was 93%. There were large differences in both mean tapping speed and accuracy between the different self-assessed states. Correlations between diary responses and tapping results were small (-0.2 to 0.3, negative values for off-time and dyskinetic-time that had opposite scale directions). Correlations between tapping results were all positive (0.1 to 0.6). Conclusions: The diary responses and tapping results provided different information. The low correlations can partly be explained by the fact that questions related to the past and by random variability, which could be reduced by taking means over test periods. Both tapping speed and accuracy reflect the motor function of the patient to a large extent.

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Amanda Sprang spent nine months, from September of 1995 to May of 1996, studying at Colby College's program in St. Petersburg, Russia. Through contacts made during previous trips to Russia in middle and high school, Amanda was able to quickly rekindle her old friendships and make new ones with many young Russians from different backgrounds. The following work is a collection of twelve essays about life in the New Russia. The essays are framed by a foreword and an epilogue that help place the entire work in a historical context. Although the theme of each essay emerges from a particular incident, within every story Amanda has addressed numerous topics relating to Russian life in today’s changing society. Her first essay, “Art Klinika," takes place in an avant-garde night club in St. Petersburg, and includes a brief yet impressionable, encounter with three young Russian men. “The Birthday Party” recalls a wild evening at the home of her close friend, showing how the Russians greet special occasions. Both the third and fourth essays take place in Moscow, where Amanda returns to visit old friends. These two essays portray the lives of the new economic elite in comparison with the average citizen, as well as show how young Russians face the new challenges that greet them. "Politics Russian Style" recalls a political rally in St. Petersburg, and attempts to shed light on the wacky political world of an infant democracy. Chapters Six through Ten take place away from the western cities of St. Petersburg and Moscow, as Amanda brings us to the cold, mysterious land of Siberia in the dead of winter. She recounts her five day train ride with a retired, high-powered, Communist party official, her experiences in the provincial city of Irkutsk, and a brief trip to a Buddhist monastery and, later, an excursion to Lake Baikal. Back in St. Petersburg, Chapter Eleven gives a humorous account of a ski trip with several Russian friends. Amanda finishes her work with her final chapter, “The Dacha," which describes a weekend spent at a Russian country home with her friend's family.

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This study originated from my concerns as critical care nurse, regarding the lived experience of the family member of the patient that is hospitalized in the intensive care unit - ICU. The purpose of the study was to comprehend the experience of the family members while having a loved one interned in an ICU, and to identify the common elements of the phenomenon, based on the descriptions of their experiences. Considering that the object of study involves subjective and social questions, the study was conducted using some fundamental ideas of descriptive phenomenology as a referential and the situated phenomenon as suggested by Martins and Bicudo (1989). Ten (10) family members of patients that were interned in the ICU of private hospital in Natal, RN were interviewed using the following leading question: What is it like to have a member of your family interned in the ICU? Five thematic structural categories emerged from the comprehensive analysis of the interviews: Fear of the family member s death; Lack of humanization; Social isolation; Confidence in the ICU; and Overload to the personal life. The description of the phenomenon enabled a new look at how the care team relates to the family members of the patients interned in the ICU, providing some guidance on how to construct a humanized care that involves the family and that is based on affective human relations. This involves a rethinking of the care provided by team to the family and stimulates the reformulation of personal and social attitudes, and of hospital organizational norms

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An extensive international literature has been developed regarding the risk trajectories of sex trade-involved children and youth. This literature has not, however, substantially incorporated the narratives of youths regarding their experiences. In this article, the contemporary literature on child and youth sex trade-involvement is reviewed and the findings of a qualitative analysis of the narratives of 14 youth from São Paulo, Brazil and 58 youth from Toronto, Canada are presented. Substantial similarities were found between the groups of narratives with respect to abusive and unstable home experiences, pathways into the sex trade, social exclusion, and the impacts of the sex trade on physical and mental health. Key areas of divergence included the roles of poverty and drug use in entering the sex trade. The implications of shared experiences of social exclusion and fragmented identity across differing sociocultural contexts for policy and intervention are discussed.