Prescribing of Psychoactive Drugs for Older People in Nursing Homes: An Analysis of Treatment Culture

Background There is increasing interest in how culture may affect the quality of healthcare services, and previous research has shown that ‘treatment culture’—of which there are three categories (resident centred, ambiguous and traditional)—in a nursing home may influence prescribing of psychoactive medications. Objective The objective of this study was to explore and understand treatment culture in prescribing of psychoactive medications for older people with dementia in nursing homes. Method Six nursing homes—two from each treatment culture category—participated in this study. Qualitative data were collected through semi-structured interviews with nursing home staff and general practitioners (GPs), which sought to determine participants’ views on prescribing and administration of psychoactive medication, and their understanding of treatment culture and its potential influence on prescribing of psychoactive drugs. Following verbatim transcription, the data were analysed and themes were identified, facilitated by NVivo and discussion within the research team. Results Interviews took place with five managers, seven nurses, 13 care assistants and two GPs. Four themes emerged: the characteristics of the setting, the characteristics of the individual, relationships and decision making. The characteristics of the setting were exemplified by views of the setting, daily routines and staff training. The characteristics of the individual were demonstrated by views on the personhood of residents and staff attitudes. Relationships varied between staff within and outside the home. These relationships appeared to influence decision making about prescribing of medications. The data analysis found that each home exhibited traits that were indicative of its respective assigned treatment culture. Conclusion Nursing home treatment culture appeared to be influenced by four main themes. Modification of these factors may lead to a shift in culture towards a more flexible, resident-centred culture and a reduction in prescribing and use of psychoactive medication. 

Maintaining legacy data: saving Belfast Harbour (UK) tide-gauge data (1902-2010)

Tide gauge data are identified as legacy data given the radical transition between observation method and required output format associated with tide gauges over the 20th-century. Observed water level variation through tide-gauge records is regarded as the only significant basis for determining recent historical variation (decade to century) in mean sea-level and storm surge. There are limited tide gauge records that cover the 20th century, such that the Belfast (UK) Harbour tide gauge would be a strategic long-term (110 years) record, if the full paper-based records (marigrams) were digitally restructured to allow for consistent data analysis. This paper presents the methodology of extracting a consistent time series of observed water levels from the 5 different Belfast Harbour tide gauges’ positions/machine types, starting late 1901. Tide-gauge data was digitally retrieved from the original analogue (daily) records by scanning the marigrams and then extracting the sequential tidal elevations with graph-line seeking software (Ungraph™). This automation of signal extraction allowed the full Belfast series to be retrieved quickly, relative to any manual x–y digitisation of the signal. Restructuring variably lengthed tidal data sets to a consistent daily, monthly and annual file format was undertaken by project-developed software: Merge&Convert and MergeHYD allow consistent water level sampling both at 60 min (past standard) and 10 min intervals, the latter enhancing surge measurement. Belfast tide-gauge data have been rectified, validated and quality controlled (IOC 2006 standards). The result is a consistent annual-based legacy data series for Belfast Harbour that includes over 2 million tidal-level data observations.

Analysis of the Market Potential of Syrian Organic Fruit and Vegetables for Exports to Germany

Syria has been a major producer and exporter of fresh fruit and vegetables (FFV) in the Arabic region. Prior to 2011, Syrian FFV were mainly exported to the neighbouring countries, the Gulf States and Northern Africa as well as to Eastern European countries. Although the EU is potentially one of the most profitable markets of high quality FFV (such as organic ones) in the world, Syrian exports of FFV to Western European countries like Germany have been small. It could be a lucrative opportunity for Syrian growers and exporters of FFV to export organic products to markets such as Germany, where national production is limited to a few months due to climatic conditions. Yet, the organic sector in Syria is comparatively young and only a very small area of FFV is certified according to EU organic regulations. Up to the author’s knowledge, little was known about Syrian farmers’ attitudes towards organic FFV production. There was also no study so far that explored and analysed the determining factors for organic FFV adoption among Syrian farmers as well as the exports of these products to the EU markets. The overarching aim of the present dissertation focused on exploring and identifying the market potential of Syrian exports of organic FFV to Germany. The dissertation was therefore concerned with three main objectives: (i) to explore if German importers and wholesalers of organic FFV see market opportunities for Syrian organic products and what requirements in terms of quality and quantity they have, (ii) to determine the obstacles Syrian producers and exporters face when exporting agricultural products to Germany, and (iii) to investigate whether Syrian farmers of FFV can imagine converting their farms to organic production as well as the underlying reasons why they do so or not. A twofold methodological approach with expert interviews and a farmer survey were used in this dissertation to address the abovementioned objectives. While expert interviews were conducted with German and Syrian wholesalers of (organic) FFV in 2011 (9 interviews each), the farmer survey was administrated with 266 Syrian farmers of FFV in the main region for the production of FFV (i.e. the coastal region) from November 2012 till May 2013. For modelling farmers’ decisions to adopt organic farming, the Theory of Planned Behaviour as theoretical framework and Partial Least Squares Structural Equation Modelling as the main method for data analysis were used in this study. The findings of this dissertation yield implications for the different stakeholders (governmental institutions and NGOs, farmers, exporters, wholesalers, etc.) who are interested in prompting the Syrian export of organic products. Based on the empirical results and a literature review, an action plan to promote Syrian production and export of organic products was developed which can help in the post-war period in Syria at improving the organic sector.

LDA-TM : A two-step approach to twitter topic data clustering

The Twitter System is the biggest social network in the world, and everyday millions of tweets are posted and talked about, expressing various views and opinions. A large variety of research activities have been conducted to study how the opinions can be clustered and analyzed, so that some tendencies can be uncovered. Due to the inherent weaknesses of the tweets - very short texts and very informal styles of writing - it is rather hard to make an investigation of tweet data analysis giving results with good performance and accuracy. In this paper, we intend to attack the problem from another aspect - using a two-layer structure to analyze the twitter data: LDA with topic map modelling. The experimental results demonstrate that this approach shows a progress in twitter data analysis. However, more experiments with this method are expected in order to ensure that the accurate analytic results can be maintained.

Exploring Service Innovation Practices Through a Longitudinal Ethnographic Case Study

Case study research has the advantage of investigating issues that are embedded within the context of the case. A novel approach to investigation of the implementation of service innovation process has been adopted through a longitudinal ethnographic case study. This approach was found useful, as the outcome of the study was intended to be an in-depth understanding of firm’s current innovation practices and its consequences with the implementation of a novel business process. In this applied research, an array of longitudinal data was generated chiefly through the technique of participant-observation. Participant-observation as a qualitative or naturalistic method has its roots in ethnographic research. Participant-observation involves “participating in the social world, in whatever role, and reflecting on the products of that participation” (Hammersley & Atkinson, 1983, p.16). This method offers a degree of understanding of the context under study that can come only from personal experience. In this presentation, I discuss the role of the researcher-practitioner as participant-observer and the usefulness of ethnographic case study methodology and participant-observation technique to investigating service innovation practices that are embedded within the context-specific setting of the case.

Data-Adaptive Modeling using Convex Regression

Thesis (Ph.D.)--University of Washington, 2016-08

“It’s the People That Drive It”: Motivating and Supporting Collaborative Data Use Practices in Three Teacher Education Programs

Thesis (Ph.D.)--University of Washington, 2016-08

How do Young People with ADHD Perceive their Condition: An Interpretative Phenomenological Analysis

Attention Deficit Hyperactivity Disorder (ADHD) is one the most prevalent of childhood diagnoses. There is limited research available from the perspective of the child or young person with ADHD. The current research explored how young people perceive ADHD. A secondary aim of the study was to explore to what extent they identify with ADHD. Five participants took part in this study. Their views were explored using semi-structured interviews guided by methods from Personal Construct Psychology. The data was analysed using Interpretative Phenomenological Analysis (IPA). Data analysis suggests that the young people’s views of ADHD are complex and, at times, contradictory. Four super-ordinate themes were identified: What is ADHD?, The role and impact of others on the experience of ADHD, Identity conflict and My relationship with ADHD. The young people’s contradictory views on ADHD are reflective of portrayals of ADHD in the media. A power imbalance was also identified where the young people perceive that they play a passive role in the management of their treatment. Finally, the young people’s accounts revealed a variety of approaches taken to make sense of their condition.

Falls and the Social Isolation of Older Adults in the National Health and Aging Trends Study

Thesis (Ph.D.)--University of Washington, 2016-08

Multi-Disciplinary Applications of Oceanographic Geophysical Data Collection

Thesis (Ph.D.)--University of Washington, 2016-08

Development of Effortful Control as a Moderator of the Longitudinal Relations of Negative Reactivity and Symptoms in Preschool

Thesis (Ph.D.)--University of Washington, 2016-08

The +Contigo Project in the Voice of Eight-Grade Students

The +Contigo Project is a longitudinal research project based on a multilevel network intervention aimed at promoting mental health and well-being and preventing suicidal behaviors. Students participate in social skills training sessions on the stigma of mental disorders, adolescence, self-esteem, problem-solving skills, and wellbeing. Problem statement: To identify the qualitative impact of the +Contigo Project. Objectives: To identify the importance of the project for students, the problem situations which it helped to solve, and its impact on an individual level. Research methods: Content analysis (Bardin, 2009) with a posteriori categorical identification. Semi-structured interview guide with 5 questions. A convenience sample of 16 students, from three schools of one school cluster in the Center Region of Portugal, was used. The ethical aspects of parental consent, voluntary participation and data confidentiality were addressed. Findings: Fourteen categories emerged from the data analysis. The answers to Question 4 'How was this project important to you?' were particularly relevant. Students mentioned that it improved their self-esteem by increasing self-confidence and interpersonal skills, and that it increased their reflection and awareness on problems with which they learned how to cope during the sessions. Conclusions: All interviewees considered that the +Contigo project helped them to solve problems, improve their interpersonal skills and cope with the adolescence period. Students improved their self-esteem and self-knowledge, and were able to apply what they had learned in the sessions in their daily lives. We concluded that the project had a positive impact on the students' mental health.

A prematuridade e sua inter-relação com a rede de atenção à saúde

A prematuridade é um problema de saúde pública que está intimamente ligada aos índices de mortalidade infantil. Para que se consiga solucionar esse problema é necessário o preparo do sistema de saúde em atender as necessidades das gestantes e por meio de uma eficaz assistência pré-natal sejam identificados precocemente os fatores de risco na gestante, de forma a possibilitar uma intervenção efetiva, caso seja necessário. Este estudo tem por objetivo analisar a inter-relação entre as alterações de saúde e complicações gestacionais que costumam estar relacionadas à ocorrência do parto prematuro e a rede de atenção à saúde disponibilizada às gestantes. Estudo quantitativo longitudinal, do tipo estudo de caso-controle. O local foi município do Rio Grande – RS e os contextos de estudo referem-se às maternidades dos dois hospitais existentes no município, Hospital Universitário Dr. Miguel Riet Corrêa Jr. e Associação de Caridade Santa Casa. Esta pesquisa trabalhou com dados secundários, com a coleta realizada no banco de dados da pesquisa intitulada “Parto prematuro: estudo dos fatores associados para construção de estratégias de prevenção”, do Grupo de Pesquisa Viver Mulher, da Escola de Enfermagem, da Universidade Federal do Rio Grande. A população da pesquisa foram mulheres que apresentaram seu parto de forma prematura (casos) e mulheres com parto a termo (controles) em momento imediatamente posterior às que têm parto prematuro, durante os meses de novembro e dezembro de 2013, totalizando 29 casos e 29 controles. A coleta de dados foi iniciada em 01 de novembro e finalizada em 31 de dezembro, sendo realizada por integrantes do Grupo de Pesquisa Viver Mulher. A análise dos dados se deu por meio da estatística descritiva simples, com medidas de frequência, para que se consiga visualizar a presença de complicações e presença de tratamento aos agravos de saúde e como foi organizada a rede de atenção à saúde nos casos e controles e assim constatar a relação das causas e dos efeitos nestes dois grupos. Os aspectos éticos envolvendo pesquisas com seres humanos foram respeitados, bem como se obteve aprovação dos comitês de ética das instituições envolvidas, parecer n° 134/2013 CEPAS – FURG, parecer n° 05/2013 CEPAS – Santa Casa

The effect of maternal employment on adolescents' transition to young adulthood

The purpose of this study was to examine relationships between multiple characteristics of maternal employment, parenting practices, and adolescents’ transition outcomes to young adulthood. The research addressed four main research questions. First, are the characteristics of maternal work (i.e., hours worked, multiple jobs held, work schedules, earnings, and occupation) related to adolescents’ enrollment in post-secondary education, employment, or involvement in neither of these types of activities as young adults? Second, are the work characteristics related to parental involvement and monitoring, and are the parenting practices related to adolescents’ transition outcomes? Third, do parental involvement and monitoring mediate any relationships between the characteristics of maternal employment and adolescents’ transition outcomes? Finally, do any associations between characteristics of maternal employment and parenting practices and adolescents’ transition outcomes vary by poverty status, race/ethnicity, or gender? To address these research questions, secondary data analysis was conducted, using data from the National Longitudinal Survey of Youth (NLSY) from 1998 through 2004. The study sample consisted of 849 youths who were 15 through 17 years of age in either 1998 or 2000, and were 19 through 21 years of age when their transition outcomes in young adulthood were measured four years later. Multinomial logistic and ordinary least squares regression models were estimated to answer the research questions. Study findings indicated that of the maternal work characteristics, mothers’ multiple jobs held, occupation, and work schedule were significantly related to the youths’ transition outcomes. When mothers held multiple jobs for 1 to 25 weeks per year, and when mothers held jobs involving lower levels of occupational complexity, their youths were more likely to experience employment rather than post-secondary education. Adolescents whose mothers worked a standard work schedule were less likely to experience other types of transitions than post-secondary education. With regard to the effects of maternal employment on parenting practices, none of the maternal work variables were related to parental involvement, and only one variable, mothers working less than 40 hours per week, was negatively related to parental monitoring. In addition, when parents were more involved with their youths’ education, the youths were less likely to transition into employment and other types of transitions rather than post-secondary education. The parenting practices did not mediate the relation between the significant work variables (holding multiple jobs, work schedule, and occupation) and youths’ transition outcomes. Finally, none of the interactions between maternal work characteristics and poverty status, race/ethnicity, and gender met the criteria for determining significance; but in a series of sub-group analyses, some differences according to poverty status and gender were found. Despite the lack of mediation and moderation, the findings of this study have important implications for social policy and social work intervention. Based on the findings, suggestions are made in these areas to improve working mothers’ lives and their adolescents’ development and successful transition to adulthood. Finally, directions for future research are discussed.