Zeitschriftenartikel: „Understanding your priorities“

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Zaleta, Alexandra Katherine, Shauna McManus, Melissa F. Miller, Eva Yuen, Kevin Stein, Karen Hurley, Lillie D. Shockney, Sara Goldberger, Mitch Golant und Joanne S. Buzaglo. „Valued outcomes in the cancer experience: Patient priorities and control.“ Journal of Clinical Oncology 36, Nr. 30_suppl (20.10.2018): 84. http://dx.doi.org/10.1200/jco.2018.36.30_suppl.84.

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84 Background: In the era of value-based cancer care, identifying what is important to cancer survivors, and their perceived control over these experiences, can inform shared decision-making and support quality care. We examined cancer patient priorities and control to guide the development of a new measure of patient value, Valued Outcomes in the Cancer Experience (VOICE). Methods: 459 cancer patients completed an online survey and rated level of importance and control over 54 value items (0 = not at all; 4 = very much). Items of most and least importance, items with most and least control, and rating discrepancies (importance-control) were identified. Bivariate associations with socio-demographics were examined. Results: Participants were 86% non-Hispanic White; mean age = 60 years, SD= 10; 38% breast cancer, 18% blood, 9% lung, 9% prostate; mean time since diagnosis = 6.5 years, SD= 6; 22% metastatic. Items of highest importance (quite a bit to very much) included, “Having your health care team (HCT) talk to you in a way that makes sense to you” (99% of participants); “Making decisions for yourself” (99%); “Talking honestly with your HCT about your illness” (99%). Participants reported the most control over, “Talking honestly with your HCT about your illness” (89%); “Making decisions for yourself” (88%), “Understanding your illness” (84%). Greatest discrepancies were, “Having your illness not get worse or come back” (96% Important; 27% Control); “Having energy to do things that are important to you (98% Important; 41% Control); “Being able to afford medical expenses” (96% Important; 49% Control); “Having a death free from suffering” (91% Important; 40% Control); “Having your medical providers communicate with each other about your care” (94% Important; 44% Control). Greater importance/control discrepancies were associated with lower income, unemployment due to disability, and poorer health ( ps < .05). Conclusions: Cancer patients experience notable discrepancies between personal priorities and their ability to control these experiences, suggesting key areas for intervention and support. Next steps include psychometric assessment to refine the VOICE scale to guide clinical and research efforts to improve patient care outcomes.

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Fede, Jacquelyn, Stephen Kogut, Anthony Hayward, John F. Stevenson, Amy Nunn, Julie Plaut und Judy A. Kimberly. „25309 Applying Community Health Priorities to the Translational Research Agenda“. Journal of Clinical and Translational Science 5, s1 (März 2021): 68–69. http://dx.doi.org/10.1017/cts.2021.579.

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ABSTRACT IMPACT: This work has begun to provide the foundation for better ensuring that translational research funded and supported by our IDeA-CTR grant is more directly addressing community- and stakeholder-authored health priorities. OBJECTIVES/GOALS: In order to effectively engage diverse, societal perspectives, we aimed to determine the relevance and feasibility of purposefully aligning translational research with health priorities adopted by the RI Department of Health, health-focused organizations, and community leaders. METHODS/STUDY POPULATION: Individuals from 27 community organizations in RI were asked, ‘What are your health related goals for your community’ and submitted responses online for 2 weeks. Participants generated 71 goals which they sorted into meaningful clusters and rated for importance and feasibility. Clusters were contrasted with RI health priorities to gauge alignment and saturation. In the next phase of this project, researchers and service users funded by Advance-CTR will be asked in routinely administered surveys how their current work may align with RI health goals and whether their future work can feasibly be connected to those priorities. RESULTS/ANTICIPATED RESULTS: Using Group Concept Mapping software, the 71 health goals identified by community organization representatives were fit into an 8-cluster model. Results suggested highest importance placed on Accessible & Healthy Housing (M=4.12, SD=0.29), Community (M=4.08, SD=0.28), Youth (M=4.04, SD=0.49) and Mental Health (M=4.03, SD=0.46). State agency priorities were found to overlap substantially with clusters defined by community leaders. We expect researchers will rate clusters differently, and find some community-endorsed health goals more relevant to their work than others. Perceived feasibility of tailoring future research to state health goals is expected to vary widely by item and researcher. DISCUSSION/SIGNIFICANCE OF FINDINGS: We intend to: 1) facilitate discussions about successes and challenges of translating community-authored priorities into research, and 2) foster better understanding between researchers and the communities they aim to serve on the role of CTR for addressing health challenges in the state.

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Segarra, Verónica A., Melanie L. Styers und Erin L. Dolan. „Optimizing your undergraduate teaching as you would an experiment: developing the next generation of cell biologists“. Molecular Biology of the Cell 30, Nr. 19 (01.09.2019): 2439–40. http://dx.doi.org/10.1091/mbc.e19-06-0349.

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The American Society for Cell Biology (ASCB) is a community dedicated to helping prepare the next generation of scientists to advance our understanding of the cell to an unprecedented level of sophistication and detail. Its Education Committee fosters this process by creating educational and professional development opportunities around best practices in science pedagogy, while its Minorities Affairs Committee aims to strengthen the scientific workforce by broadening participation of and support for underrepresented minorities in cell biology. To act upon these complementary priorities, the ASCB has developed a Declaration on Effective and Inclusive Biology Education. Its purpose is to outline practical actions for stakeholders in undergraduate education at the levels of faculty, departments, institutions, professional organizations, and funding agencies. Its recommendations are rooted in evidence-based best practices to support the success of diverse and heterogeneous undergraduate demographics and are designed to be highly adaptable to the existing strengths and needs of individual practitioners, student populations, and institutions. We acknowledge the ever-evolving nature of best practices in undergraduate education and hope that the dissemination of this declaration will play a role in this iterative process.

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Vinitha, S. Josphine. „Therapeutic Communication in Nursing Profession“. Galore International Journal of Applied Sciences and Humanities 6, Nr. 1 (04.02.2022): 18–21. http://dx.doi.org/10.52403/gijash.20220103.

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Therapeutic communication in nursing is a patient centered communication focuses on the patient to promote a greater understanding of patients needs, concerns and feeling. The nurse helps the patent explore their own thoughts and feelings, encourages, expression of them and avoid barriers in communication. Therapeutic communication enhances Trust, Genuine interest, empathy, acceptance, positive regard and therapeutic use of self. Nurses improve Therapeutic communication by effective communication and information sharing strategies, understanding patients preferables regarding the environment. Remembering to clear, cohesive, complete, concise and concrete will enhance Therapeutic communication in nursing profession. Nursing professionals should use techniques that priorities the physical, mental and emotional well being of patients when nurses communicate in a therapeutic manner, it helps the patent to feel safe and at ease. The openness and trust inevitably creates a safe space, which gives your patients the best experience possible. Keywords: Therapeutic communication, nursing professionals, emotional and mental wellbeing.

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Fitzgerald, Caitlin Anne, Ryan Peter Dumas, Michael W. Cripps, Jennifer M. Gurney, Kimberly A. Davis und Lisa Marie Knowlton. „Managing career transitions in the profession of acute care surgery“. Trauma Surgery & Acute Care Open 9, Nr. 1 (April 2024): e001334. http://dx.doi.org/10.1136/tsaco-2023-001334.

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Career shifts are a naturally occurring part of the trauma and acute care surgeon’s profession. These transitions may occur at various timepoints throughout a surgeon’s career and each has their own specific challenges. Finding a good fit for your first job is critical for ensuring success as an early career surgeon. Equally, understanding how to navigate promotions or a change in job location mid-career can be fraught with uncertainty. As one progresses in their career, knowing when to take on a leadership position is oftentimes difficult as it may mean a change in priorities. Finally, navigating your path towards a fulfilling retirement is a complex discussion that is different for each surgeon. The American Association for the Surgery of Trauma (AAST) convened an expert panel of acute care surgeons in a virtual grand rounds session in August 2023 to address the aforementioned career transitions and highlight strategies for successfully navigating each shift. This was a collaboration between the AAST Associate Member Council (consisting of surgical resident, fellow and junior faculty members), the AAST Military Liaison Committee and the AAST Healthcare Economics Committee. Led by two moderators, the panel consisted of early, mid-career and senior surgeons, and recommendations are summarized below and in figure 1.

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Nowell, W. B., K. Gavigan, K. Garza, A. Ogdie, M. George, J. A. Walsh, M. Danila, S. Venkatachalam, L. Stradford und J. Curtis. „POS1564-PARE EDUCATION TOPICS AND SMARTPHONE APP FUNCTIONS PRIORITIZED BY PEOPLE WITH RHEUMATIC AND MUSCULOSKELETAL DISEASES“. Annals of the Rheumatic Diseases 81, Suppl 1 (23.05.2022): 1128–29. http://dx.doi.org/10.1136/annrheumdis-2022-eular.2871.

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BackgroundGenerating information that people living with a rheumatic and musculoskeletal disease (RMD) find useful while making decisions about their treatment requires identifying and understanding educational needs and interests directly expressed from people living with RMD.ObjectivesTo identify what types of information US adults with RMD perceive as important to know about their disease and how they express and prioritize such information.MethodsUsing nominal group technique, focus groups of participants (pts) with RMD generated sets of rank-order educational items which were then aggregated across groups into themes. Based on nominal group results, a survey with the final 28 items was administered online, along with a question about desired functions of a smartphone app for RMD, to members of the ArthritisPower registry in January 2022.ResultsSix nominal groups (n=47) yielded 28 unique items for the online survey of educational priorities. To date, a total of 570 pts completed the survey, of whom 85.4% were female, 89.5% white, mean age of 59.6 (SD 11.2) years. Rheumatoid arthritis (52.5%), osteoarthritis (16.0%), psoriatic arthritis (12.5%), and axial spondyloarthritis (7.5%) were the most common RMDs. Knowing how to tell when a medication is not working, how RMD affects other medical conditions, understanding the results of tests used to monitor their RMD, available treatment options and possible side effects, and how life will change as an RMD progresses were each items that > 75% of pts considered extremely important (Table 1). Top functions pts listed as useful for a smartphone app included being able to participate in research, view lab results, record symptoms or flares, share how they are doing with their provider, and get educational information about their disease (Table 2).Table 1.Top Education Topics Adults with Rheumatic and Musculoskeletal Disease Consider Extremely Important (N=570).Itemn (%)Knowing when the medication is not working505 (88.6)Knowing how a rheumatologic condition can affect your other health conditions or medical issues481 (84.4)Understanding the results of tests used to monitor your condition471 (82.6)Knowing the side effects of available drugs, and how the drugs interact with each other461 (80.9)Finding the right rheumatologist453 (79.5)Having realistic expectations of the effectiveness of the medications445 (78.1)Knowing how the disease will progress, even if the news is bad439 (77.0)Knowing the available medications and treatments for your rheumatologic condition437 (76.7)Knowing how long it takes drugs to work436 (76.5)Understanding how your life will change as your disease progresses434 (76.1)Table 2.Desired Smartphone App Functions Rated By Adults with Rheumatic and Musculoskeletal Disease (N=570).App Functionn (%)Participate in patient-centered research299 (52.5)View my lab results283 (49.7)Record my symptoms (e.g. pain, fatigue) or disease flares to track my health over time278 (48.8)Record my symptoms and share how I am doing with my rheumatology provider to know if I am meeting my treatment goals230 (40.4)Get educational information about my disease225 (39.5)Keep track of the medications prescribed by doctor200 (35.1)Schedule and keep track of my medical appointments, rheumatology and other199 (34.9)Track the vaccines I get (i.e. vaccination record)188 (33.0)Help me improve some of my health habits (e.g. sleep, diet, exercise)187 (32.8)Keep track of my use of over-the-counter, complementary or alternative therapies (herbs, tinctures, acupuncture, massage, stretching, etc.)174 (30.5)Get support for my disease from trained patients with my same health condition (i.e. ‘peer coaching’)144 (25.3)ConclusionPeople with RMD prioritized information about medications and prognosis in educational materials, providing guidance for the development of educational tools. A sizeable minority felt educational materials were an important component of a smartphone app, but also identified other important features such as participation in research.Disclosure of InterestsW. Benjamin Nowell Grant/research support from: Research support from AbbVie, Amgen, Eli Lilly and Scipher, Kelly Gavigan: None declared, Kimberly Garza: None declared, Alexis Ogdie: None declared, Michael George: None declared, Jessica A. Walsh Consultant of: AbbVie, Amgen, Eli Lilly and Company, Janssen, Novartis, Pfizer, and UCB, Grant/research support from: AbbVie, Merck, and Pfizer, Maria Danila: None declared, Shilpa Venkatachalam: None declared, Laura Stradford: None declared, Jeffrey Curtis Consultant of: AbbVie, Amgen, BMS, Corrona, Eli Lilly and Company, Gilead, Janssen, Myriad, Novartis, Pfizer, Regeneron, Roche, and UCB, Grant/research support from: AbbVie, Amgen, BMS, Corrona, Eli Lilly and Company, Janssen, Myriad, Pfizer, Regeneron, Roche, and UCB

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Gubitz, Gord, Monica Saini, Sarah Belson, Ramesh Sahathevan und Peter Sandercock. „How can the World Stroke Organization (WSO) optimize education in stroke medicine around the world? Report of the 2018 WSO Global Stroke Stakeholder Workshop“. International Journal of Stroke 14, Nr. 8 (10.09.2019): 803–5. http://dx.doi.org/10.1177/1747493019874726.

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Background Education in stroke is relevant to stroke survivors, clinicians, care providers, and healthcare system administrators and is of special importance in resource-limited settings. The World Stroke Organization Education Committee undertook a program of work, culminating in a focused workshop, to establish the key educational priorities, and work toward maximizing the WSOs impact on the global burden of stroke. Methods A facilitated workshop took place during the World Stroke Congress in Montreal, Canada in October 2018. The workshop was developed using opinions on priority topics for World Stroke Organization educational activities obtained from web-based surveys of World Stroke Organization Members, supplemented by interviews with international stroke support organizations. The workshop included over 50 international participants, selected to represent a balance of age, gender, geographical region, and different levels of health resources. Participants also included members of the World Stroke Organization Education Committee, the World Stroke Academy, stroke support organizations, and the International Journal of Stroke editorial board. The workshop focused on understanding more about educational needs (at all levels), with emphasis on resource-limited settings. Three broad questions were posed: (1) What are the key educational needs: (a) in your region, (b) from your perspective (e.g. stroke support organization)? (2) Do the current educational activities offered by World Stroke Organization and WSA meet your needs? (3) What could World Stroke Organization/World Stroke Academy offer in your region that would meet your needs? The facilitated discussions were recorded, and the results transcribed and summarized by members of the World Stroke Organization Education Committee. Results Five key needs were identified: 1. Collaborative interdisciplinary, training in both stroke care and how to advocate for stroke. 2. Educational materials provided in a wider range of formats that could be adapted to local circumstances and clinical practices. 3. Educational activities for healthcare providers and stroke support organizations organized regionally, with the World Stroke Organization providing organizational support, and a pool of experts, therapists, nurses, etc. to deliver locally relevant materials. 4. Clear and authoritative online resources, where it is easy to find key policy and protocol guidance. 5. A range of online interactive education and training resources to help build knowledge and competence in stroke care. Conclusion The results of the workshop have been presented to the World Stroke Organization Board and will be used to help to guide the educational initiatives of the World Stroke Organization and World Stroke Academy going forward.

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Pemberton-Whiteley, Zack, Samantha Nier, David Mott, Chris Skedgel und Jake Hitch. „Understanding Relapsed/Refractory Acute Leukemia Patients' Treatment Preferences: Insights from Qualitative Research“. Blood 142, Supplement 1 (28.11.2023): 3730. http://dx.doi.org/10.1182/blood-2023-172871.

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Introduction Evidence on patient preferences is increasingly being used to inform regulatory and reimbursement decisions. In acute leukemia, the number of treatment options is expanding but there is limited quantitative evidence on patients' treatment preferences, especially in the event of relapse. The Acute Leukemia Advocates Network (ALAN) in collaboration with The Office of Health Economics are running a quantitative patient preference study using a discrete choice experiment (DCE) to 1/ Elicit adult acute leukemia patients' preferences for treatment outcomes and characteristics in the event of a future relapse 2/ Explore the tradeoffs that patients are willing to make between different hypothetical treatments 3/ Describe preference heterogeneity in the patient population and 4/ Provide useful insights that could demonstrate patient value for a range of upcoming health technology assessments of relapsed/refractory treatments and guide innovation and development throughout the medical product lifecycle. Here we report on two stages of qualitative research: 1/ Online bulletin boards (OBBs) to identify potential attributes for the DCE and 2/ Cognitive ‘think aloud’ pilot interviews to test participant understanding of the draft DCE survey. Methods Two structured OBBs were conducted - one each for acute myeloid leukemia (AML) and acute lymphoblastic leukemia (ALL). Each day, participants were asked up to four open questions on the following topics: “your diagnosis and expectation of treatment”, “your first experience of treatment”, “treatment following a relapse”, and “your treatment priorities”. Participants could see and respond to each other's answers. Three researchers acted as moderators and engaged in discussions where appropriate. Following the design of the DCE survey, a series of online one-on-one think-aloud interviews with AML and ALL participants was subsequently conducted to pilot the DCE survey. Interviewees were asked to verbally reflect on their responses, with occasional interviewer prompts. The pilots were conducted in two separate weeks, with a week in between to allow for changes to be made. All participants were recruited via ALAN and its members. Results A total of 12 AML and nine ALL patients took part in the OBBs, of which 15 were female. Age (range: 26-71; average: 51.1) and years of living with the disease (range: <3 to > 10 years) were varied. Both the AML and ALL groups agreed that the effectiveness of the treatment in achieving long-term stable remission would be most important. Severe long-term side effects would also be an important concern but many participants said they could put up with potentially severe short-term side effects for a good chance of long-term survival. Additional concerns were the length of hospital stays, availability of psychological/mental/emotional support, catheter-related pain and infections, and mode of administration (MoA). Several participants argued that an individualized approach to treatment is preferred. Thematic analysis of the OBB data led to the identification of five attributes for the DCE: chance of response (20-95%), duration of response (6-18 months), quality of life (QoL) during treatment (0-50%), QoL during response (25-75%), and MoA (tablets taken at home, injections requiring a hospital stay, injections as outpatient appointments). The DCE was designed using an efficient experimental design and coded as part of an online survey, and subsequently piloted (see Figure 1). In week 1 of the pilots (n=5 interviews), ‘duration of response’, was often misinterpreted as ‘duration of treatment’. Interviewees also interpreted treatment and response as potentially overlapping, and therefore struggled to separate the two QoL attributes. Therefore, we made several changes including explicitly structuring the choice tasks to distinguish treatment and response phases. The changes improved understanding in week 2 (n=5 interviews) and raised some additional minor issues for consideration. Conclusion People with acute leukemia have a range of concerns about treatments in the context of a relapse. However, the primary issues identified in the qualitative research relate to the chance and duration of treatment success, QoL during and after treatment, and the MoA. The pilot interviews were valuable in improving the wording and overall quality of the final survey, which has since been fully launched.

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Qamar, Wajiha. „Dental health in the shadows of global commitments: Addressing neglected priorities in lower middle-income countries“. Journal of the Pakistan Medical Association 74, Nr. 2 (20.01.2024): 413–14. http://dx.doi.org/10.47391/jpma.10750.

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I am writing to draw your attention to a serious concern that requires our attention around global health commitments: the frequently disregarded and undervalued dental reforms. In the realm of global health commitments, dental reforms are often ignored and underestimated. (1) Despite significant advancements in many other facets of health owing to these commitments, dental health remains marginalized within its sphere creating a glaring disparity, especially in lower middle-income countries where it’s a crucial concern.(2) Dental health has a significant impact on a person's quality of life in addition to preventing oral diseases. It has a significant impact on a person's quality of life, having an impact on their mental and physical well-being. Neglected oral health can affect speech, self-esteem, and psychosocial wellbeing as well as cause pain, infections, malnutrition, and systemic health problems.(3) The disruptive relationship between oral diseases and significant medical conditions like diabetes, cardiovascular disease, and adverse pregnancy outcomes emphasizes the complex relationship between dental health and overall health. Despite efforts to promote understanding, such as Universal Health Coverage (UHC) and the International Health Regulations (IHR), oral health is often disregarded in global discussion. Particularly in lower middle-income countries, oral health is neglected due to a lack of tailored interventions, which decreases its significance. A significant leap forward has been made with the recent World Health Organization (WHO) resolution that declares oral health a global priority and calls for its inclusion in national strategies. The WHO has acknowledged the need to address this problem immediately.(4) The challenge, however, is recognition into concrete, commitment-backed activities and specific interventions. The resolution has potential, but its effectiveness will be judged by the concrete measures taken to bridge the gaps. The Sustainable Development Goals (SDGs) offer a potential reference point for rectifying this gap. By integrating oral health in SDGs like Goal 3 on excellent health and well-being, a holistic approach may be taken. This integration could help bridge the gap between international commitments, raise the public's awareness of oral health, and foster tailored initiatives for dental reforms. ---Continue

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Brewer, Dawn, Hannah Bellamy, Anna Hoover, Annie Koempel und Lisa Gaetke. „Nutrition and Environmental Pollution Extension Curriculum Improved Diet-Related Behaviors and Environmental Health Literacy“. Environmental Health Insights 13 (Januar 2019): 117863021983699. http://dx.doi.org/10.1177/1178630219836992.

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Kentucky experiences some of the nation’s worst health outcomes related to obesity, diabetes, high blood pressure, and other age-related chronic diseases linked with oxidative stress and inflammation, which in turn are associated with poor diet, lack of physical activity, and exposure to certain environmental pollutants. In the Commonwealth, deteriorating infrastructure, inappropriate waste disposal, and potential occupational injury related to mining, agriculture, and other regionally important industries exacerbate the need for residents to have basic knowledge of potential environmental health threats. Unfortunately, community-level understanding of the complex connections between environmental exposures and health is limited, with many Kentuckians unaware that the Commonwealth is home to 13 hazardous waste sites included in the United States Environmental Protection Agency Superfund National Priorities List (NPL). The NPL highlights priority sites for long-term remedial action to reduce environmental contaminants. To enhance the understanding of environmental health and protective actions, the University of Kentucky Superfund Research Center Community Engagement Core developed a 9-lesson extension curriculum “Body Balance: Protect Your Body from Pollution with a Healthy Lifestyle” (Body Balance) and partnered with Kentucky’s Family and Consumer Sciences (FCS) Cooperative Extension Service to pilot the curriculum in Kentucky communities. FCS agents in 4 Kentucky counties delivered the Body Balance pilot study (18-31 participants per lesson). Pre- and post-lesson questionnaires revealed increased knowledge and awareness of the effects of environmental pollution on health and the protective role of dietary strategies. Focus group participants (n = 18) self-reported positive behavior changes because of increases in knowledge and leadership from their FCS agent. The Body Balance curriculum appeared to be a promising mechanism for raising environmental health and diet knowledge, as well as for promoting positive behavior changes among white, middle/older-aged women in rural Kentucky communities.

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Masselink, Leah E., Alfred I. Lee und Clese E. Erikson. „Hematology/Oncology Fellows' Future Plans and Job Expectations: Findings from the 2019 Hematology/Oncology Fellows Survey“. Blood 134, Supplement_1 (13.11.2019): 5780. http://dx.doi.org/10.1182/blood-2019-126899.

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Introduction/Background The American Society of Hematology and researchers at the Fitzhugh Mullan Institute for Health Workforce Equity at the George Washington University are conducting a 3-year study of the hematology workforce to understand training, mentorship, and job market factors that influence the supply of hematology services in the U.S. The 2019 Hematology/Oncology Fellows Survey is one of a series of annual surveys of hematology/oncology fellows, focused specifically on second year fellows. Its goals include 1) examining how training and mentorship experiences during fellowship contribute to changes in fellows' career goals and 2) understanding their perceptions of job prospects in their chosen field (hematology, oncology, or both). Methods We collected the 2019 Hematology/Oncology Fellows Survey data via Qualtrics, an online survey platform. The survey included questions about fellows' training and mentorship experiences, career goals, and perceptions. This analysis uses data from the following questions: -At this point in your training, which of the following best describes your intended focus post fellowship? (malignant and/or benign hematology only, oncology only, both or undecided) -Given your current career plans, how confident are you that you will be able to find a position that offers what you are seeking in terms of (1) clinical focus, (2) research opportunities, (3) grant funding, (4) work-life balance, (5) income, (6) prestige, and (7) intellectual stimulation? (very confident, somewhat confident, not confident, not applicable) We used Fisher's exact tests to compare responses to each question about future position expectations by intended focus post fellowship (hematology only vs. oncology only vs. both/undecided) in Stata 15 (p<0.05=statistically significant difference). Results Among second year fellows invited to complete the survey, 204 (27.8%) had complete data to be included in the analysis: 71 (34.8%) with intended hematology-only focus, 64 (31.4%) oncology-only, and 69 (33.8%) both/undecided. We found statistically significant differences between future position expectations across focus areas in 3 domains: research opportunities (p<0.01), grant funding (p<0.01) and income (p<0.01). Fellows with a hematology-only focus were most likely to report being "very confident" they would find a position meeting their expectations for both research opportunities (21.1% vs. 17.2% for oncology-only and 11.6% for both/undecided) and grant funding (8.5% vs. 6.3% for oncology-only and 4.4% for both/undecided), while fellows with a both/undecided focus were most likely to report that these considerations did not apply (34.8% and 50.0% respectively). Fellows in the both/undecided category were most likely to say they were "very confident" they would find a position meeting their income expectations (30.4% vs. 14.1% hematology only and 9.4% oncology only). Fellows with a hematology-only focus were most likely to say they were "not confident" they would find positions meeting their income expectations (23.9%), followed by oncology only (18.8%) vs. only 5.8% both/undecided. Differences in work-life balance expectations (p=0.07) and prestige (p=0.08) also approached statistical significance. For both metrics, fellows with a both/undecided focus were most likely to report being "very confident" they would find positions with their desired work-life balance (24.6% vs. 8.5% hematology only and 9.4% oncology only) and prestige (18.8% vs. 11.3% hematology only and 9.4% oncology only). We found no statistically significant differences between fellows' expectations of finding their desired clinical focus (p=0.30) or intellectual stimulation (p=0.49) across focus areas. Conclusions Findings suggest that roughly ⅓ of hematology/oncology fellows plan to focus on each of 3 career paths: hematology only, oncology only, and both. Statistical analyses suggest stark differences between fellows' priorities and expectations of their future positions across focus areas, likely reflecting differences between more specialized academic positions (which offer greater research opportunities and expectations but possibly lower income) and less specialized, often private practice positions that offer greater income security and work-life balance. Disclosures No relevant conflicts of interest to declare.

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Piehl, Mark, und Chan W. Park. „When Minutes Matter: Rapid Infusion in Emergency Care“. Current Emergency and Hospital Medicine Reports 9, Nr. 4 (18.11.2021): 116–25. http://dx.doi.org/10.1007/s40138-021-00237-6.

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Abstract Purpose of Review This review provides historical context and an update on recent advancements in volume resuscitation for circulatory shock. Emergency department providers who manage critically ill patients with undifferentiated shock will benefit from the insights of early pioneers and an overview of newer techniques which can be used to optimize resuscitation in the first minutes of care. Recent Findings Rapid infusion of fluids and blood products can be a life-saving intervention in the management of circulatory and hemorrhagic shock. Recent controversy over the role of fluid resuscitation in sepsis and trauma management has obscured the importance of early and rapid infusion of sufficient volume to restore circulation and improve organ perfusion. Evidence from high-quality studies demonstrates that rapid and early resuscitation improves patient outcomes. Summary Current practice standards, guidelines, and available literature support the rapid reversal of shock as a key priority in the treatment of hypotension from traumatic and non-traumatic conditions. An improved understanding of the physiologic rationale of rapid infusion and the timing, volume, and methods of fluid delivery will help clinicians improve care for critically ill patients presenting with shock. Clinical Case A 23-year-old male presents to the emergency department (ED) after striking a tree while riding an all-terrain vehicle. On arrival at the scene, first responders found an unconscious patient with an open skull fracture and a Glasgow coma scale score of 3. Bag-valve-mask (BVM) ventilation was initiated, and a semi-rigid cervical collar was placed prior to transport to your ED for stabilization while awaiting air transport to the nearest trauma center. You are the attending emergency medicine physician at a community ED staffed by two attending physicians, two physicians assistants, and six nurses covering 22 beds. On ED arrival, the patient has no spontaneous respiratory effort, and vital signs are as follows: pulse of 140 bpm, blood pressure of 65/30 mmHg, and oxygen saturation 85% while receiving BVM ventilation with 100% oxygen. He is bleeding profusely through a gauze dressing applied to the exposed dura. The prehospital team was unable to establish intravenous access. What are the management priorities for this patient in shock, and how should his hypotension best be addressed?

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Previdoli, G., J. Silcock, D. Alldred, V.-L. Cheong, S. Tyndale-Briscoe, D. Okeowo und B. Fylan. „475 Co-designing an intervention to support safe medicines self-management for older people living with frailty and polypharmacy“. International Journal of Pharmacy Practice 31, Supplement_1 (01.04.2023): i23—i24. http://dx.doi.org/10.1093/ijpp/riad021.026.

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Abstract Introduction Older people face numerous challenges and safety risks when managing multiple medicines. They are required to cope with complex and changing regimens and co-ordinate input from multiple healthcare professionals. If not well managed, medicines can cause harm, and older people are more susceptible to errors. Some older people can devise and implement strategies to manage their medicines, e.g. creating checklists, ensuring timely supplies, solving problems, and seeking help (1). However, no interventions address the multiple tasks polypharmacy patients must perform to safely manage their regimens. Aim To develop an intervention to support medicines self-management for older people living with frailty and polypharmacy using experience-based co-design (EBCD) (2). Methods Following video or audio-recorded qualitative interviews with 32 older people taking 5 or more medicines, a ‘trigger film’ of patients’ medicines management experiences was produced and used during EBCD to facilitate priority setting. Separate meetings were held (1) with 16 staff (2 GPs, 4 GP practice administrators, 4 GP practice pharmacists, 1 practice lead, 2 senior nurses, 2 pharmacy technicians, 1 community pharmacist) and (2) with 13 patients and 2 family members, followed by a joint meeting with 8 older people and 9 staff where a shared set of three priorities was agreed. Two subsequent co-design workshops with 6 patients, 2 family members and 7 staff developed three candidate interventions. Workshop 1 explored key themes from the trigger film to develop solutions. Workshop 2 reviewed solutions and further developed design ideas. Intervention components were merged and those addressing patient safety challenges were retained to form the prototype intervention. Ethical approval was obtained for the interviews included in the trigger film, but not required for EBCD. EBCD meetings and workshops were conducted as quality improvement: people involved were collaborators, personal information was not captured, discussions were not recorded or analysed. Results Co-design priorities were to support patients in: day-to-day practical medicines management; understanding the wider medicines management system; communication with healthcare teams. The three solutions were: a quick-start guide to managing multiple medicines including talking about medicines and managing new routines; tips and tricks to support day-to-day management, including planning and adherence tools; a tool supporting preparation for medication reviews and asking questions about medicines. After merging intervention components and identifying those addressing medicines-self-management patient safety challenges, five areas were retained for the prototype intervention: checking what you get; keeping on top of supplies; monitoring how you take your medicines; times when problems are more likely; and how do I know if I need help? Discussion/Conclusion Through EBCD patients and staff worked together to improve people’s experiences of managing medicines and to enhance safety. The prototype intervention addresses five areas where older people with complex medicines regimens require support. The intervention requires feasibility testing and subsequent robust evaluation. Strengths and limitations: • A variety of staff roles joined the co-design, offering multiple different perspectives on medicines management • EBCD meetings and workshops were run online to avoid Covid infections. This may have excluded older people with no access to internet. References 1. Tomlinson J, Silcock J, Smith H, Karban K, Fylan B. Post-discharge medicines management: the experiences, perceptions and roles of older people and their family carers. Health Expect [Internet]. 2020;23(6):1603–13. Available from: http://dx.doi.org/10.1111/hex.13145 2. Fylan B, Tomlinson J, Raynor DK, Silcock J. Using experience-based co-design with patients, carers and healthcare professionals to develop theory-based interventions for safer medicines use. Res Social Adm Pharm [Internet]. 2021;17(12):2127–35. Available from: http://dx.doi.org/10.1016/j.sapharm.2021.06.004

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Courtay de Gaulle, A., P. Bey, A. Carayon, A. Ly, C. Gombe M. Balawa und J. Godet. „Finding Adequate Information: A Major Challenge for Policy-Makers in the Field of Cancer“. Journal of Global Oncology 4, Supplement 2 (01.10.2018): 169s. http://dx.doi.org/10.1200/jgo.18.15300.

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Background and context: A global cancer epidemic is developing (GLOBOCAN 2012). In the case of low- and-middle-income countries, difficulties are cumulative: inadequate health systems, lack of training for professionals. Drastic decisions have to be taken in a very complex field. Good decision needs good information. What about information dedicated to policy-makers: to decide a question, they need specific information, marked by these features: synthetic, clear, scientifically validated. Actually, this is not easy to find. Moreover policy-makers can't really benefit from: 1. Information for health professionals which is complex and overabundant (the request “cancer” on PubMed “out” nearly 1.5 millions references). 2. Documents or testimonials for patients. Written by scientific societies or patients' associations, they mostly focus on 2 topics “understand your disease” and “how to cope with”. 3. Information from the Web, not always reliable in terms of quality. Strategy/Tactics: While policy advisors and international organizations provide appropriate studies and reports, mostly focused on “what should be done”, we believe that knowledge of basic cancer data are necessary to understand the proposals. We talk about issues like “what is cancer”, “what exactly cover radiotherapy, oncological surgery…”. Regarding French speaking Africa, Alliance Ligues Africaines and Méditérranéennes (ALIAM) and The French League have produced targeted information for decision-makers. The document was presented in Brazzaville in June 2017. Access to this book is free: www.livre-cancer.aliam.org . The editorial method was discussed and we made the choice to write short sheets, to quickly understand the useful definitions and problems. Rather than comprehensiveness, a pedagogical will and a desire for clarity guided the writing. Diagrams and photos had to be abundant to facilitate understanding. Moreover, this format allows a permanent update of the subjects and the introduction of new topics as needed. What was learned: On the basis of this experience, ALIAM and the league are convinced that a pedagogic document with an international vocation would be useful for all policy makers. Proposal for action: UICC would be the perfect organizer of a working group to produce such a document. The goal would be to develop a consensus text which resume essential data on all common themes of cancer. About 25 themes could be identified, e.g., definition and mechanisms of development of cancers, risk factors, screening and early diagnosis, anatomic pathology and telepathology, molecular biology, imaging and interventional radiology, surgery, radiotherapy, chemotherapy and innovative therapies, palliative care etc. Moreover, focus on specific location of cancer (breast, cervix, lung…) and pediatric cancers should be developed. Then, it would be easier for any world regions to supplement this validated information with additional specific data describing the local situation. Hierarchizing action priorities would be facilitated.

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Percy, Carol, Andrew Turner und Charys Orr. „Developing a Novel Web-Based Self-Management Support Intervention for Polycystic Ovary Syndrome: Mixed Methods Study With Patients and Health Care Professionals“. JMIR Formative Research 8 (07.03.2024): e52427. http://dx.doi.org/10.2196/52427.

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Background Polycystic ovary syndrome (PCOS) represents a significant global health burden requiring urgent attention. This common chronic endocrine and cardiometabolic condition affects around 1 in 10 women and individuals assigned female at birth, with significant adverse effects on well-being, quality of life, and mental health, as well as serious and complex long-term health consequences. International guidelines for best health care practice recommend the provision of comprehensive cognitive behavioral interventions to support self-management and improve health outcomes for those living with PCOS. Web-based health interventions have the potential to meet this need in an accessible and scalable way. Objective We aim to identify barriers to self-management and psychological well-being in women with PCOS and adapt a web-based self-management program to provide a prototype digital support intervention for them. Methods We adapted an existing support program (HOPE) for PCOS using the antecedent target measure approach. We conducted qualitative interviews with 13 adult women living with PCOS, 3 trustees of a patients with PCOS advocacy charity, and 4 endocrinologists to identify “antecedents” (barriers) to self-management and psychological well-being. Framework analysis was used to identify potentially modifiable antecedents to be targeted by the novel intervention. At a national conference, 58 key stakeholders (patients and health professionals) voted for the antecedents they felt were most important to address. We used research evidence and relevant theory to design a prototype for the PCOS intervention. Results Voting identified 32 potentially modifiable antecedents, relating to knowledge, understanding, emotions, motivation, and behaviors, as priorities to be targeted in the new intervention. A modular, web-based prototype HOPE PCOS intervention was developed to address these, covering six broad topic areas (instilling HOPE for PCOS; managing the stress of PCOS; feeding your mind and body well; body image, intimacy, and close relationships; staying healthy with PCOS; and keeping PCOS in its place). Conclusions We identified barriers to self-management and psychological well-being in women with PCOS and used these to adapt a web-based self-management program, tailoring it for PCOS, which is a comprehensive group intervention combining education, empowerment, lifestyle management, peer support with cognitive behavioral tools, and goal-setting (to be delivered by peers or codelivered with health care professionals). The modular structure offers flexibility to adapt the program further as new clinical recommendations emerge. The intervention has the potential to be delivered, evaluated for feasibility, and, if effective, integrated into health care services. Self-management interventions are not designed to replace clinical care; rather, they serve as an additional source of support. The HOPE PCOS program conveys this message in its content and activities. Future research should evaluate the prototype intervention using primary outcomes such as measures of psychological well-being, self-management self-efficacy, depression, anxiety, and PCOS-related quality of life. They should also assess the intervention’s acceptability, scalability, and cost-effectiveness.

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Razani, Nooshin, Dayna Long, Danielle Hessler, George W. Rutherford und Laura M. Gottlieb. „Screening for Park Access during a Primary Care Social Determinants Screen“. International Journal of Environmental Research and Public Health 17, Nr. 8 (17.04.2020): 2777. http://dx.doi.org/10.3390/ijerph17082777.

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While there is evidence that access to nature and parks benefits pediatric health, it is unclear how low-income families living in an urban center acknowledge or prioritize access to parks. Methods: We conducted a study about access to parks by pediatric patients in a health system serving low-income families. Adult caregivers of pediatric patients completed a survey to identify and prioritize unmet social and economic needs, including access to parks. Univariate and multivariate analyses were conducted to explore associations between lack of access to parks and sociodemographic variables. We also explored the extent to which access to parks competed with other needs. Results: The survey was completed by 890 caregivers; 151 (17%) identified “access to green spaces/parks/playgrounds” as an unmet need, compared to 397 (45%) who endorsed “running out of food before you had money or food stamps to buy more”. Being at or below the poverty line doubled the odds (Odds ratio 1.96, 95% CI 1.16–3.31) of lacking access to a park (reference group: above the poverty line), and lacking a high school degree nearly doubled the odds. Thirty-three of the 151 (22%) caregivers who identified access to parks as an unmet need prioritized it as one of three top unmet needs. Families who faced competing needs of housing, food, and employment insecurity were less likely to prioritize park access (p < 0.001). Conclusion: Clinical interventions to increase park access would benefit from an understanding of the social and economic adversity faced by patients.

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Романова und M. Romanova. „“Follow the Dream!” or Not Fabulous Story about Boy Fedya“. Primary Education 4, Nr. 5 (18.10.2016): 46–47. http://dx.doi.org/10.12737/22537.

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The article describes how you can use the story composed by the teacher about the life of a peer with the purpose of formation by younger schoolchildren understanding of the need of learning for successful future life. A brief scenario of the lesson or class hour is given, in which the basis for discussions with children on the theme of adult about the choice of target life priorities laid teacher’s told history.

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Fuller, Graham E. „Freedom and Security“. American Journal of Islamic Social Sciences 22, Nr. 3 (01.07.2005): 21–28. http://dx.doi.org/10.35632/ajiss.v22i3.466.

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The DebateQuestion 1: Various commentators have frequently invoked the importance of moderate Muslims and the role that they can play in fighting extremism in the Muslim world. But it is not clear who is a moderate Muslim. The recent cancellation of Tariq Ramadan’s visa to the United States, the raids on several American Muslim organizations, and the near marginalization of mainstream American Muslims in North America pose the following question: If moderate Muslims are critical to an American victory in the war on terror, then why does the American government frequently take steps that undermine moderate Muslims? Perhaps there is a lack of clarity about who the moderate Muslims are. In your view, who are these moderate Muslims and what are their beliefs and politics? GEF: Who is a moderate Muslim? That depends on whom you ask and what that person’s (or government’s) agenda is. Moderate is also a quite relative term, understood differently by different people. For our purposes here, let’s examine two basically different approaches to this question: an American view and a Middle Eastern view of what characterizes a moderate Muslim. Most non-Muslims would probably define a moderate Muslim as anyone who believes in democracy, tolerance, a non-violent approach to politics, and equitable treatment of women at the legal and social levels. Today, the American government functionally adds several more criteria: Amoderate Muslim is one who does not oppose the country’s strategic and geopolitical ambitions in the world, who accepts American interests and preferences within the world order, who believes that Islam has no role in politics, and who avoids any confrontation – even political – with Israel. There are deep internal contradictions and warring priorities within the American approach to the Muslim world. While democratization and “freedom” is the Bush administration’s self-proclaimed global ideological goal, the reality is that American demands for security and the war against terror take priority over the democratization agenda every time. Democratization becomes a punishment visited upon American enemies rather than a gift bestowed upon friends. Friendly tyrants take priority over those less cooperative moderate and democratic Muslims who do not acquiesce to the American agenda in the Muslim world. Within the United States itself, the immense domestic power of hardline pro-Likud lobbies and the Israel-firsters set the agenda on virtually all discourse concerning the Muslim world and Israel. This group has generally succeeded in excluding from the public dialogue most Muslim (or even non-Muslim) voices that are at all critical of Israel’s policies. This de facto litmus test raises dramatically the threshold for those who might represent an acceptable moderate Muslim interlocutor. The reality is that there is hardly a single prominent figure in the Muslim world who has not at some point voiced anger at Israeli policies against the Palestinians and who has not expressed ambivalence toward armed resistance against the Israeli occupation of Palestinian lands. Thus, few Muslim leaders enjoying public legitimacy in the Muslim world can meet this criterion these days in order to gain entry to the United States to participate in policy discussions. In short, moderate Muslimis subject to an unrealistic litmus test regarding views on Israel that functionally excludes the great majority of serious voices representative of genuine Muslim thinkers in the Middle East who are potential interlocutors. There is no reason to believe that this political framework will change in the United States anytime soon. In my view, a moderate Muslim is one who is open to the idea of evolutionary change through history in the understanding and practice of Islam, one who shuns literalism and selectivism in the understanding of sacred texts. Amoderate would reject the idea that any one group or individual has a monopoly on defining Islam and would seek to emphasize common ground with other faiths, rather than accentuate the differences. Amoderate would try to seek within Islam the roots of those political and social values that are broadly consonant with most of the general values of the rest of the contemporary world. A moderate Muslim would not reject the validity of other faiths. Against the realities of the contemporary Middle East, a moderate Muslim would broadly eschew violence as a means of settling political issues, but still might not condemn all aspects of political violence against state authorities who occupy Muslim lands by force – such as Russia in Chechnya, the Israeli state in the Palestine, or even American occupation forces in Iraq. Yet even here, in principle, a moderate must reject attacks against civilians, women, and children in any struggle for national liberation. Moderates would be open to cooperation with the West and the United States, but not at the expense of their own independence and sovereignty.

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Fuller, Graham E. „Freedom and Security“. American Journal of Islam and Society 22, Nr. 3 (01.07.2005): 21–28. http://dx.doi.org/10.35632/ajis.v22i3.466.

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The DebateQuestion 1: Various commentators have frequently invoked the importance of moderate Muslims and the role that they can play in fighting extremism in the Muslim world. But it is not clear who is a moderate Muslim. The recent cancellation of Tariq Ramadan’s visa to the United States, the raids on several American Muslim organizations, and the near marginalization of mainstream American Muslims in North America pose the following question: If moderate Muslims are critical to an American victory in the war on terror, then why does the American government frequently take steps that undermine moderate Muslims? Perhaps there is a lack of clarity about who the moderate Muslims are. In your view, who are these moderate Muslims and what are their beliefs and politics? GEF: Who is a moderate Muslim? That depends on whom you ask and what that person’s (or government’s) agenda is. Moderate is also a quite relative term, understood differently by different people. For our purposes here, let’s examine two basically different approaches to this question: an American view and a Middle Eastern view of what characterizes a moderate Muslim. Most non-Muslims would probably define a moderate Muslim as anyone who believes in democracy, tolerance, a non-violent approach to politics, and equitable treatment of women at the legal and social levels. Today, the American government functionally adds several more criteria: Amoderate Muslim is one who does not oppose the country’s strategic and geopolitical ambitions in the world, who accepts American interests and preferences within the world order, who believes that Islam has no role in politics, and who avoids any confrontation – even political – with Israel. There are deep internal contradictions and warring priorities within the American approach to the Muslim world. While democratization and “freedom” is the Bush administration’s self-proclaimed global ideological goal, the reality is that American demands for security and the war against terror take priority over the democratization agenda every time. Democratization becomes a punishment visited upon American enemies rather than a gift bestowed upon friends. Friendly tyrants take priority over those less cooperative moderate and democratic Muslims who do not acquiesce to the American agenda in the Muslim world. Within the United States itself, the immense domestic power of hardline pro-Likud lobbies and the Israel-firsters set the agenda on virtually all discourse concerning the Muslim world and Israel. This group has generally succeeded in excluding from the public dialogue most Muslim (or even non-Muslim) voices that are at all critical of Israel’s policies. This de facto litmus test raises dramatically the threshold for those who might represent an acceptable moderate Muslim interlocutor. The reality is that there is hardly a single prominent figure in the Muslim world who has not at some point voiced anger at Israeli policies against the Palestinians and who has not expressed ambivalence toward armed resistance against the Israeli occupation of Palestinian lands. Thus, few Muslim leaders enjoying public legitimacy in the Muslim world can meet this criterion these days in order to gain entry to the United States to participate in policy discussions. In short, moderate Muslimis subject to an unrealistic litmus test regarding views on Israel that functionally excludes the great majority of serious voices representative of genuine Muslim thinkers in the Middle East who are potential interlocutors. There is no reason to believe that this political framework will change in the United States anytime soon. In my view, a moderate Muslim is one who is open to the idea of evolutionary change through history in the understanding and practice of Islam, one who shuns literalism and selectivism in the understanding of sacred texts. Amoderate would reject the idea that any one group or individual has a monopoly on defining Islam and would seek to emphasize common ground with other faiths, rather than accentuate the differences. Amoderate would try to seek within Islam the roots of those political and social values that are broadly consonant with most of the general values of the rest of the contemporary world. A moderate Muslim would not reject the validity of other faiths. Against the realities of the contemporary Middle East, a moderate Muslim would broadly eschew violence as a means of settling political issues, but still might not condemn all aspects of political violence against state authorities who occupy Muslim lands by force – such as Russia in Chechnya, the Israeli state in the Palestine, or even American occupation forces in Iraq. Yet even here, in principle, a moderate must reject attacks against civilians, women, and children in any struggle for national liberation. Moderates would be open to cooperation with the West and the United States, but not at the expense of their own independence and sovereignty.

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McCusker, Louise, Marie-Louise Turner, Georgina Pike und Helen Startup. „Meaningful Ways of Understanding and Measuring Change for People with Borderline Personality Disorder: A Thematic Analysis“. Behavioural and Cognitive Psychotherapy 46, Nr. 5 (19.02.2018): 528–40. http://dx.doi.org/10.1017/s1352465818000036.

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Background:The effective treatment of Borderline Personality Disorder (BPD) presents healthcare providers with a significant challenge. The evidence base remains limited partially due to a lack of professional consensus and service user involvement regarding ways of measuring change. As a result, the limited evidence that is available draws on such a wide range of outcome measures, that comparison across treatment types is hindered, maintaining a lack of clarity regarding the clinical needs of this group.Aims:This investigation aimed to follow the National Institute of Clinical Excellence (NICE, 2009) research recommendations by asking service users about meaningful change within their recovery. This forms a starting point for the future development of a tailored outcome measure.Method:Fifteen service users with a diagnosis of BPD participated in three focus groups across two specialist Personality Disorder services. The focus groups were analysed using Thematic Analysis.Results:Two superordinate themes were synthesized from the data: (1) recovery to what?: ‘How do you rewrite who you are?’; and (2) conditions for change. Each superordinate theme further consisted of three subordinate themes which elucidated the over-arching themes.Conclusion:This investigation highlights the complex nature of measuring change in people who have received a BPD diagnosis. Further research is needed to develop meaningful ways of measuring change according to the needs and priorities of people with BPD.

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Ekawati, Nia, und Elsari Fatkhur Jannati. „MEMILIH SEKOLAH DASAR UNTUK ANAK MENGGUNAKAN FUZZY LOGIC METODE MAMDANI“. eScience Humanity Journal 2, Nr. 2 (21.05.2022): 113–24. http://dx.doi.org/10.37296/esci.v2i2.42.

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Education Batam City has an education that follows the development of the current era. Because the city of Batam itself is very close to neighboring countries, namely Singapore and Malaysia. As reported from the online electronic media Kompas newspaper on January 17, 2017, as a parent, of course you also don't want to look for a school for your baby. The reason is, choosing the right school, especially kindergarten (TK) and elementary school (SD), is a "long-term investment" for the future of children. Having a child who will enter a higher school, from the kindergarten (TK) period, of course, must choose an elementary school (SD) which can be said to have good quality besides that it can be seen in the results of those who have graduated from the elementary school. Because in the modern era, children must be introduced to the international language from an early age but not abandon the national language, Sultan Agung School puts the concept of the National Plus School in front. The consideration that can be taken for parents is choosing a public or private elementary school with different concepts and advantages, of course, it is enough to think carefully, so as not to make the wrong choice. In general, the new alternative schools offer the same concept, namely promoting children's verbal abilities and honing children's creativity. As a parent, of course, you will look for information on the meaning of the national plus school understanding. The concept taken with the national plus is that the school prioritizes all students being able to use the Indonesian language and is equipped with the help of an international language, namely English.

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Poyser, Bethan, und Sam Poyser. „Police practitioners and place managers’ understandings and perceptions of heritage crime in Nottinghamshire“. International Journal of Police Science & Management 19, Nr. 4 (21.09.2017): 247–60. http://dx.doi.org/10.1177/1461355717730837.

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‘So you know, as daft as it sounds, if you’ve got a building, that really isn’t a priority, is it?’ Despite the wealth of heritage sites in the UK, the topic is a marginalised area of criminological study here. It has been argued that there is discordance between the concepts of ‘heritage’ and ‘crime’. One is holistic; the other set in the law. Through a programme of semi-structured interviews with ‘heritage place managers’ and questionnaires delivered to neighbourhood policing teams in Nottinghamshire Police, this research aimed to examine this clash. In particular, it aimed to compare and contrast heritage place managers’ understandings and experiences of heritage crime with those of police practitioners. It was found that the two groups differed markedly in this respect, creating feelings of frustration and stagnation for both. Such findings are of particular concern in the light of statistics which demonstrate that heritage crime is occurring frequently across the UK, and evidence that offenders are targeting new heritage assets and sites in response to changing legislation. Budget cuts, which continue to impact upon policing priorities in Nottinghamshire, further compound the problem. The conclusion of this article details the potential impacts of these findings and suggests changes relating to both the heritage and policing sectors.

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Al-Moustafa, Sara S., Thowayeb H. Hassan, Mahmoud I. Saleh, Mohamed Y. Helal, Amany E. Salem und Khaled Ghazy. „Unlocking Tourism’s Potential: Pricing Strategies for the Post-COVID Renaissance“. Sustainability 15, Nr. 19 (30.09.2023): 14400. http://dx.doi.org/10.3390/su151914400.

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In response to the challenges faced by tourism managers in devising effective pricing strategies to overcome the impacts of the COVID-19 pandemic, this study aims to make a valuable contribution to the existing literature on tourism management and marketing. Specifically, we investigate the pricing strategies that tourists are most likely to prefer in the aftermath of the pandemic. To achieve this, we conducted semi-structured interviews with a sample size of experienced tourists in Egypt. Our findings reveal that tourists exhibit a strong inclination towards hedonic and bundling pricing strategies. This suggests that tourism managers should prioritize the incorporation of these strategies into their post-pandemic business plans. However, it is crucial for managers to carefully consider tourists’ behavioral responses to dynamic and pay-what-you-want pricing strategies, as these are influenced by various constraints that necessitate careful attention. Furthermore, our study highlights potential negative consequences associated with the implementation of the dual-pricing strategy following the pandemic. This strategy has the potential to compromise tourists’ intentions to utilize certain services, thereby leading to unfavorable behavioral outcomes for tourism destinations. The implications of this study are of practical significance for tourism managers seeking to design more effective pricing strategies to capitalize on the opportunities presented by the post-pandemic recovery period. By understanding tourists’ preferences and considering the potential drawbacks associated with certain pricing strategies, managers can make informed decisions that promote the sustainable and successful revival of the tourism industry. Moreover, our study employed the checkpoints method, which allowed us to identify respondents’ priorities for the pricing strategies during the crisis, further enhancing the validity and reliability of our findings.

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Smeltzer, Matthew P., Taylor P. Hodges, Jamie Whartenby, Jane S. Hankins und Robert Davis. „Three Wishes for Sickle Cell Disease: Results from a multi-stakeholder vision-casting project in Tennessee“. Clinical Health Promotion - Research and Best Practice for patients, staff and community 11, Nr. 2 (16.09.2021): e21014. http://dx.doi.org/10.29102/clinhp.21014.

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Although sickle cell disease (SCD) is one of the most common genetic disorders in the US, disparities in research and funding persist. To better understand stakeholder priorities, we conducted a virtual vision-casting session utilizing a graphic recorder and content analysis. Stakeholders responded to the question: “If you had three magic wishes for SCD in TN, what would they be?”. Wishes for SCD centered around information and data, care and policy, and community. Better patient-centered information about treatments and modernization of data were high priorities. Stakeholders identified a need for heath equity, starting with lifetime continuity of care and access to curative treatment for all persons with SCD. Key points concerning the community included better patient inclusion in research, increased awareness, and greater public knowledge. SCD patients expressed a desire for honesty, transparency, compassion, and trust. Key areas to address in SCD include better data coordination, more influence on health policy, broader access to care and more community awareness, with the ultimate goal of improving the lives of persons with SCD. Using data to improve care and address health disparities will require researchers listening to stakeholders and understanding multiple perspectives to form unified goals.

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Sumida Huaman, Elizabeth, Nathan D. Martin und Carnell T. Chosa. „“Stay with your words”: Indigenous youth, local policy, and the work of language fortification“. education policy analysis archives 24 (02.05.2016): 52. http://dx.doi.org/10.14507/epaa.24.2346.

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This article focuses on the work of cultural and language maintenance and fortification with Indigenous youth populations. Here, the idea of work represents two strands of thought: first, research that is partnered with Indigenous youth-serving institutions and that prioritizes Indigenous youth perspectives; and second, the work of cultural and linguistic engagement that is often taken for granted as part of the sociocultural fabric of Indigenous communities where youth are active participants. By highlighting a study with Pueblo Indian youth in the southwestern United States, we aim to build on the counter-narrative frameworks of other educational scholars and community-based researchers in order to offer alternative approaches towards understanding how Indigenous youth can and do participate in representing themselves as cultural and language agents of change. Arriving at this realization requires several key steps, including deconstructing dominant assumptions, holding ourselves accountable for interrogating and revisiting our own biases, and ultimately committing to long-term research and support with Indigenous youth. As such, we offer empirical evidence that contradicts universal discourse of Indigenous peoples and youth as victims at risk. Instead, we focus on the ways in which Indigenous youth demonstrate both tentative and bold fortification of key elements in their Indigenous identities and illustrate promise in contribution to multiple levels of policy development to address their communities’ most urgent needs and goals.

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Vu, Milkie, Yenan Zhu und Ryan Suk. „Abstract A074: Cancer fatalism among Asian American adults by origin group, 2014-2022“. Cancer Epidemiology, Biomarkers & Prevention 32, Nr. 12_Supplement (01.12.2023): A074. http://dx.doi.org/10.1158/1538-7755.disp23-a074.

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Abstract Background: Cancer fatalism encompasses beliefs about external causes of cancer and the perceived inability of humans to prevent it. Existing research suggests that individuals with higher levels of cancer fatalism are less likely to engage in cancer prevention behaviors or adhere to cancer screening practices. However, limited information exists regarding the prevalence of cancer fatalism within various Asian origin groups. Understanding whether this prevalence varies by origin group can offer valuable insights for developing strategies to enhance beliefs and knowledge about cancer among these populations, ultimately leading to improved health outcomes. To fill this gap in the literature, we conduct a disaggregated analysis of cancer fatalism among Asian origin groups (Chinese, Filipino, Indian, Vietnamese, and other Asian respondents), using nationally representative samples. Methods: We performed a pooled cross-sectional study utilizing the Health Information National Trend Survey data (HINTS-4 cycle 4 [2014], HINTS-5 cycles 1-3 [2017-2019], and HINTS-6 [2022]), a nationally representative survey administered by the National Cancer Institute. We analyzed respondents’ agreement to two items: “It seems like everything causes cancer”; and “There’s not much you can do to lower your chances of getting cancer.” We used a survey-design adjusted Wald chi-square test for bivariate analyses. Results: The sample included 234 Chinese respondents, 173 Filipino respondents, 185 Indian respondents, 97 Vietnamese respondents, and 222 other Asian respondents (e.g., Korean, Japanese). Significantly lower proportions of Indian respondents (38.9%; 95% CI 26.1 – 51.8%) endorsed the statement “It seems like everything causes cancer,” when compared with Vietnamese respondents (70.4%; 95% CI 54.9% – 86.0%) and Filipino respondents (76.2%; 95% CI 65.1% – 87.4%). Additionally, lower proportions of Indian and Chinese respondents endorsed the statement “There’s not much you can do to lower your chances of getting cancer” when compared with Vietnamese and Filipino respondents, though these differences did not reach statistical significance. Conclusions: Our study represents one of the first efforts to use nationally representative data to explore disaggregated prevalence of cancer fatalism beliefs among Asian American origin groups. Filipino adults exhibit nearly double the prevalence of one of the cancer fatalism beliefs compared to Indian adults. Vietnamese adults also have a high level of cancer fatalism beliefs. These findings highlight the heterogeneity among Asian American origin groups and emphasize the importance of culturally tailored interventions, specifically targeting those groups with higher levels of fatalism beliefs. Data collection that is disaggregated by Asian origin group should be prioritized to gain a comprehensive understanding of these beliefs and design effective interventions. Citation Format: Milkie Vu, Yenan Zhu, Ryan Suk. Cancer fatalism among Asian American adults by origin group, 2014-2022 [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr A074.

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Fernandes, Suzette, und Monica S. Castelhano. „The Foreground Bias: Initial Scene Representations Across the Depth Plane“. Psychological Science 32, Nr. 6 (21.05.2021): 890–902. http://dx.doi.org/10.1177/0956797620984464.

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When you walk into a large room, you perceive visual information that is both close to you in depth and farther in the background. Here, we investigated how initial scene representations are affected by information across depth. We examined the role of background and foreground information on scene gist by using chimera scenes (images with a foreground and background from different scene categories). Across three experiments, we found a foreground bias: Information in the foreground initially had a strong influence on the interpretation of the scene. This bias persisted when the initial fixation position was on the scene background and when the task was changed to emphasize scene information. We concluded that the foreground bias arises from initial processing of scenes for understanding and suggests that scene information closer to the observer is initially prioritized. We discuss the implications for theories of scene and depth perception.

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Venter, Katharine, Denise Currie und Martin McCracken. „‘You Can’t Win’: The Non-Profit Double-Bind and Experiences of Organisational Contradictions in the Non-Profit and Voluntary Sector“. Work, Employment and Society 33, Nr. 2 (11.08.2017): 244–61. http://dx.doi.org/10.1177/0950017017713949.

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There is growing evidence that in the UK demands for non-profit and voluntary sector organisations to comply with funders’ target driven priorities are often in tension with organisations’ social goals. The implications of this for employees are not yet sufficiently understood. The present article builds on Bateson et al.’s theory of double-bind to develop a socially contextualised model to understand employees’ experiences of workplace contradictions in the sector. Drawing from data provided by 49 individuals working in three case study organisations, our conceptualisation of a ‘non-profit double-bind’ provides a new and novel way of understanding how social meta-communicative processes serve to embed or reframe contradictions within intense employment relationships.

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Y., Bidenko. „TOLERANCE AND DEMOCRACY AS KEY PRIORITIES IN THE SYSTEM OF MORAL VALUES OF EUROPEAN EDUCATIONAL SPACE“. HUMANITARIAN STUDIOS: PEDAGOGICS, PSYCHOLOGY, PHILOSOPHY 12, Nr. 1 (2021): 66–74. http://dx.doi.org/10.31548/hspedagog2021.01.066.

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The article analyzes the basic values of the European educational space, including peace, democracy, human rights, tolerance, humanism and solidarity. Their formation by means of education is the main requirement of full-fledged preparation of a person for life as a citizen and an individual. Each of these values is a kind of part of the spiritual world of the individual, the integrity of which ensures their unity and interaction, transfusion and complementarity. A special place and role in this process belong to such values (competencies) as tolerance and democracy. Tolerance is one of the ascending core values of the European educational space. It is the least politicized and ideologized, and therefore – performs a regulatory function in the system of interaction of these values, ensures their unity both at the individual level and at the team level. Tolerance cultivates a willingness to communicate, cooperate and understanding, allows you to establish constructive communication with representatives of different groups with a different worldview. The same burden is placed on the phenomenon of democracy. The unity of these spiritual priorities, their organic interaction, the power of which extends to the entire axiological palette of spiritual life, forms a universal platform for the humanization and humanization of education, the interaction of educational systems in Europe.

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Worrall, Sharyn F., Andrea J. Dwyer, Reese M. Garcia, Keavy E. McAbee und Anjelica Q. Davis. „Priorities of Unmet Needs for Those Affected by Colorectal Cancer: Considerations From a Series of Nominal Group Technique Sessions“. Journal of the National Comprehensive Cancer Network 19, Nr. 6 (Juni 2021): 693–99. http://dx.doi.org/10.6004/jnccn.2020.7655.

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Background: Colorectal cancer (CRC) is the third most common cancer among men and women in the United States. Patients and survivors experience a range of challenges, including anxiety, financial issues, long-term adverse effects, and more. The intent of this project was to assess the needs of the CRC community directly from survivors and their caregivers and to lay a foundation for ongoing support. Methods: Twelve nominal group technique sessions were facilitated. Participants were randomized and presented with the following questions: “What information do you wish you had at the time of diagnosis?” and “What information do you need now as a survivor?” After the nominal group technique process, each statement’s score was divided by the number of people in the session, providing the average to identify the top-ranked statements. Themes and subthemes were applied to statements. Results were compared between coders. Results: There was a total of 79 participants, 49 of whom self-identified as a patient with or survivor of cancer. Patient/survivor demographics were as follows: stage IV disease (n=20), stage III disease (n=22), stage II disease (n=5), stage I disease (n=2), caregiver/family member (n=30), male (n=16), female (n=63), White (n=50), Native Hawaiian/Pacific Islander (n=1), Hispanic/Latino (n=13), Black/African American (n=11), Asian (n=1), and more than one race/ethnicity (n=3). The most frequent themes among responses to the first question were communication and coordination with care team and access to CRC resources. The most frequent themes among responses to the second question were psychosocial support and family/caregiver support. Frequent themes among responses across both questions were understanding treatment options and adverse effects. Conclusions: These findings highlight gaps in support for individuals affected by CRC, and lay a foundation for ongoing assistance. Future studies exploring differences based on disease stage, race/ethnicity, age, gender identity, geographic location, and tumor location are needed to further tailor support for those experiencing CRC. Themes identified in this project require a multidisciplinary approach to ensure that the unmet needs of survivors are addressed.

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Yazid, Azy Athoillah. „Literature Review: Menumbuhkan Jiwa Enterpreneursip Religius Terhadap Mahasiswa“. Economic : Jurnal Ekonomi dan Hukum Islam 13, Nr. 02 (13.12.2022): 124–36. http://dx.doi.org/10.59943/economic.v13i02.94.

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This journal aims to research the Development of a Religious Entrepreneurial Spirit in Students. This research explores various aspects of student entrepreneurship, especially in the context of religious values, through a literature review method. Data is taken from scientific papers which highlight several steps that need to be instilled in students to become entrepreneurs. The research results show that first-time entrepreneurial students need to develop self-confidence and the ability to innovate. Second, focus on the desired results. Third, the formation of mental discipline through practice and practical experience. And fourth, developing leadership abilities by maximizing your potential. The entrepreneurial spirit can be enriched through a focused educational process and real experience that will equip students to enter the business world. Apart from understanding independence in business, students also need to internalize religious values (integration between business and religion) to ensure that their entrepreneurial activities do not only prioritize profit, but also reflect ethics and values in business

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Lemos, Maria Panisson Kaltbach, und Vera Lucia Luiza. „Policy on Integrative Health Practices of Federal District in Brazil: Evaluability Study“. Saúde em Debate 47, Nr. 137 (2023): 116–32. http://dx.doi.org/10.1590/0103-1104202313708i.

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ABSTRACT Integrative and Complementary Practices in Health include different health care forms and have been present for more than decades in health services in the Federal District, where the implementation assessment of your policy is not completely defined. To assist in understanding reality, an Evaluability Study was carried out collaboratively, involving discussion with stakeholders, questionnaires and consultation of documents. The policy components were identified, organized and modeled. A simplified-logical-model and one of the operational-logical-models, validated by the participants, are presented in this article. For policy evaluation, the initial aspects of the modeled logical implementation chain were prioritized. It was identified as fundamental the promotion of the actors’ knowledge about the set of resources to the implementation of the Integrative Practices services and about the related intersectoral responsibilities. Formative, qualitative and collaborative assessments are suggested. The modeling carried out in the studies of this policy, shed light on the study of similar ones.

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Scott, Julie-Ann, und Hunter Houtzer. „“She Was Here”: Research as Resistance to the Loss of “Culturally Uncomfortable” Identities“. Qualitative Inquiry 24, Nr. 2 (20.01.2017): 134–50. http://dx.doi.org/10.1177/1077800416684876.

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This essay traces a co-exploration into understanding aging, memory, and purpose through the analysis of elders stories told during varying stages of memory loss. Responding to the prompt, “What are the memories you don’t want to forget?” participants told stories of “culturally uncomfortable” identities they worried no one else prioritized remembering. As the researchers, we were faced with the struggle to continue human connection beyond vulnerable, inescapably mortal bodies. We analyze our reactions within our analysis of their stories to offer a dynamic means to make sense of data, ourselves, and shared cultural responsibility through telling and listening to personal narratives.

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Askelson, Natoshia M., Cristian Meier, Barbara Baquero, Julia Friberg, Doris Montgomery und Christine Hradek. „Understanding the Process of Prioritizing Fruit and Vegetable Purchases in Families With Low Incomes: “A Peach May Not Fill You Up as Much as Hamburger”“. Health Education & Behavior 45, Nr. 5 (20.01.2018): 817–23. http://dx.doi.org/10.1177/1090198117752790.

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Fruits and vegetables (F&V) are an important component of a healthy diet, but few children are meeting the recommended number of servings. Children from families with limited resources may be least likely to meet the recommendation. This study was designed to understand the strategies and priorities of families with low income related to purchasing F&V. We conducted qualitative, in-depth telephone interviews with low-income parents of elementary school–aged children as part of a random sample of parents participating in a telephone survey who agreed to be contacted for an in-depth interview. Interview transcripts were coded based on predetermined codes that were informed by the research questions. F&V were not considered staples by parents and cost was one of the main concerns. Parents equated F&V with fresh F&V. Interventions encouraging F&V purchasing by families with low income need to find new ways to address the issue of cost, including advocating for F&V in all forms (fresh, frozen, canned, and dried).

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Driessnack, Martha. „“Who Are You From?”: The Importance of Family Stories“. Journal of Family Nursing 23, Nr. 4 (23.10.2017): 434–49. http://dx.doi.org/10.1177/1074840717735510.

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This article emphasizes the importance of family stories, or intergenerational narratives, and their health benefits across the lifespan. Knowing and sharing the story of who you are from complements the current focus on knowing and sharing one’s geographic heritage, or where you are from. Knowing one’s family stories creates meaning that goes beyond the individual to provide a sense of self, through time, and in relation to family. This expanded sense of self is referred to as our intergenerational self, which not only grounds an individual but also provides a larger context for understanding and dealing with life’s experience(s) and challenges. This connection across generations appears to contribute to resilience at all stages of life. This shift in focus challenges family nurses to rethink and/or prioritize the use of family stories as a key health-promoting intervention for not only children but also their parents, and their parents’ parents.

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., Muhith. „TAFSÎR JAMÂ’Î SEBAGAI SARANA MEMADUKAN TEKS DAN KONTEKS ASBÂB AL-NUZÛL“. Al-Munir: Jurnal Studi Ilmu Al-Qur'an dan Tafsir 4, Nr. 02 (14.12.2022): 265–98. http://dx.doi.org/10.24239/al-munir.v4i2.157.

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The first an Interpreter to notice is the text, because if you don't pay attention to the text, you will certainly get the wrong understanding, and his explanation of the verse will be wrong or make unfounded conclusions. The first step that should not be neglected in the interpretation of the Qur'an is understanding the text. While contextual adherents are groups who really like to do qiyas or analogies. This group prioritizes the meaning of the pronunciation rather than the pronunciation itself. Contextual meaning implies that a word or speech symbol has no meaning if it is separated from the context. Along with the rapid development of technology, the interpreters must be adapted, dare to make changes in interpreting the verses of the Qur'an with various disciplines, namely with an interdisciplinary and multidisciplinary approach or called tafsir jamâ'î, where the mufasir interprets the Qur'an with an anthropological approach, a sociological approach, a psychological critical discourse analysis approach and a natural or scientific approach. Why? because not all mufasir are figures who master all fields of science, so do scientists who are able to explain various physical and social phenomena, do not have knowledge of interpretation, it is these two groups that are expected to unite because they are considered capable of integrating the text and context of asbâb al-nuzûl.

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Tatlow, Stephen. „Everyone in Space Wants to Hear You Scream“. Journal of Sound and Music in Games 1, Nr. 3 (2020): 15–34. http://dx.doi.org/10.1525/jsmg.2020.1.3.15.

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When considering player voice in the context of game sound, existing examinations remain inconclusive. As player voice exists in a liminal position between reality and virtuality, some academics see them as sonic violations of the game space. Voice can convey information about identity, which may oppose our understanding of the avatars within the game world. Voice can facilitate social communication, which may remind us of the physical world outside the virtuality. Mediations of voice into the virtual world may introduce obstacles or inflections that interfere with our enjoyment of the virtual space. Alongside these concerns, however, we can also find virtual worlds that prioritize and privilege player voice. Player voice can become part of character identity. Gameworlds can encourage us to communicate ludically, without disrupting immersion. Interruptions and disruptions can be limited by players. Amongst others, the virtual world of the long-running MMORPG EVE Online demonstrates how voice can coexist with immersion. Marketing materials for the game now place player voice at the center of consumer focus. Including an interview with one of the videographers who placed player voice at the center of his fan videos, the article uses EVE Online as a case study for the integration of player voice into virtual worlds. By examining virtual worlds and the role of voice within them, this article develops a framework for understanding player voice in the context of game sound. This allows us to recognize how player voice, an often overlooked aspect of game sound, can function within virtual worlds.

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Jones, Serena Mackenzie, und Paul Willis. „Are you delivering trans positive care?“ Quality in Ageing and Older Adults 17, Nr. 1 (14.03.2016): 50–59. http://dx.doi.org/10.1108/qaoa-05-2015-0025.

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Purpose – For the vast majority of cisgendered people who experience alignment between the sex they were assigned at birth, the body they have and their gender identity they are comfortable with (Schilt and Westbrook, 2009), the experience of trans people is a distant one. More of us share an experience of aging and the associated concerns about reduced independence, deterioration of health and increased need for care and support. The paper aims to discuss these issues. Design/methodology/approach – For trans elders, the experience of aging has specific features that have a major impact on their lives if not understood, planned for and responded to appropriately. This paper presents findings from a qualitative study exploring trans peoples experiences, concerns and suggestions for how agencies providing elder care can better meet their expectations (Jones, 2013). Findings – The research revealed low confidence in the ability of current aged care services to meet the needs of trans elders due to a limited understanding of the relationship between health and social care specific to trans people; undervaluing the networks in trans people’s lives; the need to demonstrate culturally competent services and real concerns regarding tackling discrimination and abuse. Despite legislative advancements, there was a sense that activism is central to tackling these issues and trans people are articulating their demands for shaping future provision. The research identifies a number of recommendations for care providers and future areas of research. Originality/value – In response to identifying an absence of trans voices being heard on the subject of trans elder care, this study sought to understand expectations of services, amplify the voices of the participants and share the priorities they articulated to influence future service design and practice.

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Colleran, Ann, Anne O'Connor, Michael J. Hogan, Owen M. Harney, Hannah Durand und Michelle Hanlon. „Who asked you? Young People and practitioners identify ways to facilitate access to mental health supports“. HRB Open Research 4 (14.07.2021): 74. http://dx.doi.org/10.12688/hrbopenres.13328.1.

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Background: Despite representing the highest level of total population mental health burden, young people are the least likely to seek help from mental health services. It has been suggested that service design can influence the likelihood that young people will look for help, but little is known about how young people would like a service to be designed. This study addresses a gap in research regarding how mental health services can be designed to facilitate access for young people. Methods: A collective intelligence, scenario-based design methodology was used to facilitate stakeholders to identify and prioritise ways to improve youth mental health services. In total, 74 15–17-year-olds from three geographically diverse schools in Ireland worked to identify barriers to help-seeking and to generate and prioritise options in response to barriers. Nine practitioners with experience of working in youth mental health services rated all options in terms of both potential impact on help-seeking and feasibility for service implementation. Results: A total of 326 barriers across 15 themes were generated by youth stakeholders, along with 133 options in response to barriers. Through a process of voting, young people identified 30 options as the most impactful for improving access to mental health services. Of these options, 12 were also rated by practitioners as having both high potential impact and high feasibility. These 12 options focused on four areas: making services more familiar and welcoming; providing specialist mental health input in schools; improving parental understanding; and improving the visibility of appropriate supports. Conclusions: The results of the current study inform mental health service innovation and development, in particular, by highlighting potentially impactful and feasible ways to adapt existing mental health services to improve young people’s help-seeking behaviour.

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Hu, Yingjie, Jin Sun und Ji Zheng. „Comparative analysis of carbon footprint between conventional smallholder operation and innovative largescale farming of urban agriculture in Beijing, China“. PeerJ 9 (29.06.2021): e11632. http://dx.doi.org/10.7717/peerj.11632.

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The sustainable development of agriculture is one of the key issues of ensuring food security and mitigating climate change. Since innovative large-scale agriculture is gaining popularity in cities in China, where the agricultural landscape is dominated by conventional smallholder farming, it is necessary to investigate the difference in carbon emissions between conventional smallholder operation and innovative largescale agriculture. This study evaluated the carbon footprint (CF) of conventional and innovative urban agriculture in Beijing using the cradle-to-consumption Life Cycle Assessment (LCA). Two modes of greenhouse vegetable and fruit production were analyzed and compared respectively: conventional smallholder operated vegetable farms that sell in local markets versus largescale home-delivery agriculture (HDA) that deliver vegetables to consumers’ home directly, conventional smallholder operated fruit farms that sell in farm shops versus largescale pick-your-own (PYO) initiatives. Results showed that HDA and PYO can reduce CF per area in on-farm cultivation compared to smallholder operation, while may bring an increase in CF per product weight unit and the gap was wider if the supply chain was considered. This is mainly because innovative large-scale farming consumes fewer agricultural inputs (e.g., fertilizer, pesticides) and obtains lower yields than conventional smallholder operations. Plastic materials with high carbon emission, fossil energy dependence and transportation efficiency are CF hotspots of both modes and therefore can be prioritized and targeted for carbon reduction adjustment. The results of this work further advance understanding of how innovative largescale agriculture and conventional smallholder operation compare and which particular inputs and activities should be prioritized to effectively reduce the CF in China during agricultural transformation.

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Fahimah, Siti, und Dewi Ayu Lestari. „Al-Jawahir Fi Tafsiril Al-Qur’anil Karim Karya Tanthawi Jauhari: Kajian Tafsir Ilmi“. Al Furqan: Jurnal Ilmu Al Quran dan Tafsir 6, Nr. 1 (30.06.2023): 136–49. http://dx.doi.org/10.58518/alfurqon.v6i1.1779.

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The development of commentary books is always rife, starting from the classical to contemporary periods, as well as the styles adopted by the commentators are also varied. One of the interpretations that emerged in the contemporary era is one with a scientific pattern. The mufaasir who carries this model is Thatnthawi Jauhari in his commentary al-Jawahir fi Tafsir al-Quran al-Karim. In compiling his book of commentaries, in this interpretation he reveals about the many new things in interpreting the Koran, so you don't have to stick to classic things that don't have much contribution in understanding the Koran, because of that idea many people criticize Tantawai that he is not a mufassir but a person who will understand the Koran only from the point of view of reason not naqli. This study uses a qualitative approach with the library research method. The results of this study are that Tantawi uses the tahlili method with the nuances of scientific interpretation that prioritizes ratios.

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Gill, Joel C., Faith E. Taylor, Melanie J. Duncan, Solmaz Mohadjer, Mirianna Budimir, Hassan Mdala und Vera Bukachi. „Invited perspectives: Building sustainable and resilient communities – recommended actions for natural hazard scientists“. Natural Hazards and Earth System Sciences 21, Nr. 1 (19.01.2021): 187–202. http://dx.doi.org/10.5194/nhess-21-187-2021.

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Abstract. Reducing disaster risk is critical to securing the ambitions of the Sustainable Development Goals (SDGs), and natural hazard scientists make a key contribution to achieving this aim. Understanding Earth processes and dynamics underpins hazard analysis, which (alongside analysis of other disaster risk drivers) informs the actions required to manage and reduce disaster risk. Here we suggest how natural hazard research scientists can better contribute to the planning and development of sustainable and resilient communities through improved engagement in disaster risk reduction (DRR). Building on existing good practice, this perspective piece aims to provoke discussion in the natural hazard science community about how we can strengthen our engagement in DRR. We set out seven recommendations for enhancing the integration of natural hazard science into DRR: (i) characterise multi-hazard environments; (ii) prioritise effective, positive, long-term partnerships; (iii) understand and listen to your stakeholders; (iv) embed cultural understanding into natural hazard research; (v) ensure improved and equitable access to hazard information; (vi) champion people-centred DRR (leaving no one behind); and (vii) improve links between DRR and sustainable development. We then proceed to synthesise key actions that natural hazard scientists and research funders should consider taking to improve education, training, and research design and to strengthen institutional, financial, and policy actions. We suggest that these actions should help to strengthen the effective application of natural hazard science to reduce disaster risk. By recognising and taking steps to address the issues raised in these recommendations, we propose that the natural hazard science community can more effectively contribute to the inter-/transdisciplinary, integrated work required to improve DRR.

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Subrahmanyam, Annamdevula, und Bellamkonda Raja Shekhar. „Where do you find loyalty in the contemporary university scene?“ Journal of Applied Research in Higher Education 9, Nr. 3 (03.07.2017): 378–93. http://dx.doi.org/10.1108/jarhe-01-2016-0004.

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Purpose The purpose of this paper is to ascertain the antecedents of student satisfaction and tests the interrelationships between student satisfaction, motivation and loyalty. Design/methodology/approach The study used survey research design and collected valid sample 738 from the three oldest public universities in the state of Andhra Pradesh, India. Findings The study extracted four antecedents: academic facilities, administration services, support services and campus infrastructure. The results established that student motivation serves as a mediation role between satisfaction and loyalty and also proved a direct effect of student satisfaction on student loyalty. Research limitations/implications The study focuses on student satisfaction and motivation, as these two constructs are the most important inputs in the creation of student loyalty. Student satisfaction and motivation have been found to be critical inputs for the development of student loyalty. Practical implications This research helps the management in acquiring a better understanding of the relationship between student satisfaction, motivation and loyalty, to exercise better strategies to improve its own performance and ultimately to well understand student priorities. Social implications The Indian higher education institutions are facing enormous issues related to quality in education. Changes in the requirements of higher education and related services as well as intense competition have necessitated higher performance levels in the realm of Indian higher education (universities). The key issues examined in the course of the authors research along with the findings can help in achieving such levels. Originality/value The present research contribute to the existing field of knowledge by providing support for the contention that student satisfaction is a key influencing factor in the creation of student loyalty and in the development of the mediation role of motivation between student satisfaction and loyalty.

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Morris, Iain. „How convincing is the case for God? The ‘Finnes Gud?‘ television series offers you the chance to assess it!“ Theofilos 12, Nr. 1 (15.12.2020): 201–7. http://dx.doi.org/10.48032/theo/12/1/15.

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There are times in life when one is conscious of a ‘wake-up call’. I seem to encounter them quite regularly and they tend to impact my life and my priorities. One memorable example was the first time I encountered Richard Dawkins on television. In a series on prime time on the UK’s Channel 4, he presented a series called The Root of All Evil? While the Bible claims that the root of (all kinds of) evil is the love of money, Dawkins implied it was religion – Christianity included. According to Dawkins, the insistence on there being a God is Medieval – fit only for a time when we had a more primitive understanding of science. Can there be anything more damaging than substituting science with magic? Can there be anything more destructive of intelligence and civilisation than teaching innocent children that there is a creator God who intended to bring the universe into existence – especially since we can show it achieved that all by itself! What amazed me about this Dawkins TV series is that it broke all the rules of balanced broadcasting. Interviews that had been conducted with Christian theologians and/or scientists, ended up in the trash bin. Because of that indirect encounter, I went on to produce a TV series called The God Question. It is available with Norwegian subtitles as Finnes Gud? More in a moment.

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Gautam, Tanvi. „Rising from the ashes: Satyam's story“. Emerald Emerging Markets Case Studies 4, Nr. 1 (21.02.2014): 1–8. http://dx.doi.org/10.1108/eemcs-02-2014-0062.

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Subject area Leadership, human resource management, crisis management, change management and communication. Study level/applicability Executive education; postgraduate; undergraduate. Case overview This case study describes the collapse of Satyam, a leading IT industry service provider from India. Satyam went into a crisis mode after revelation of financial fraud by its Chairman. This resulted in a crisis not just for the company, its clients and employees – but it also had the potential to shake up the entire Indian IT industry the world over, by shattering investor and client confidence in the Indian IT sector. The case provides the students with an inside view of the unfolding of events at Satyam and the people challenges that emerge in a crisis scenario. The case outlines reactions from the industry, government, clients and employees as they tried to make sense of a very chaotic situation, and its multi-level ramifications both within India and outside. The case ends with Thallapalli Hari, the Global Head of Marketing and Communication and ex-head of HR, trying to visualise and prioritise a course of action to propose to other members of the leadership team. Expected learning outcomes The key aim of this case is to provide a backdrop to the crisis, and also help students put themselves in the role of an HR crisis manager as well as portray the decision making and communication challenges that emerge in chaotic situations. The importance of an immediate and yet strategic response is emphasised and the case is a great starting point to have a discussion on the competencies and skills required in HR to lead under unusual circumstances. This case allows participants to get an in-depth understanding of the collapse of Satyam. The case also illustrates principles of leadership, change management and communication, in particular: Leadership: The Satyam story is an HR and leadership crisis nightmare come true. What should an HR leader do when you wake up to find your company with a ruined reputation, minimal financial capital, 53,000 employees on the payroll and more than 500 clients with pending deliverables worldwide. Where do you begin? The case illustrates a situation where immediate action is required to stop the tailspin into which the company was heading. Change management: The situation demanded that change be managed from a chaotic system to a stable system. The big issue though remains as to how one can get a system into a state of stability when everything is changing at the same time. Most change management plans have some stable variables, however in the case of Satyam there were multiple changes taking place simultaneously. A combination of change in leadership, client relationships, employee trust and confidence, market reactions together make for a perfect storm. Dealing with even one of these changes is a challenge for a company. In the case of Satyam, its entire existence was at stake. Communication: The demands for communicating effectively in a crisis situation are different than communicating under stable systems. The choice of medium, the speed of response, the content all need careful monitoring. Whereas most companies have teams that separately deal with internal and external communication, Satyam provides a unique situation where managing both effectively at the same time was critical to the future of the firm. The stakes for effective communication are much higher under the circumstances. This case can be used in organizational behaviour, human resources and corporate communications modules being taught to under-graduates, post-graduates and for executive education. Supplementary materials Teaching notes are available for educators only. Please contact your library to gain login details or email support@emeraldinsight.com to request teaching notes.

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Kovalenko, M. S., und N. N. Dyachkovskaya. „Analysis of the activities of state development institutions of the Republic of Sakha (Yakutia)“. Arctic XXI century. Humanities, Nr. 3 (29.09.2023): 43–58. http://dx.doi.org/10.25587/svfu.2023.99.41.004.

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In the current realities, regardless of whether the organization is commercial or budgetary, it can no longer pay attention only to the development of current work plans and the management of internal progress. There was an understanding that for the existence of one’s activity in modern conditions it is extremely important to apply strategic thinking, which allows one to pre-scribe a sequence of actions that will be aimed at realizing the goals and means of the chosen direction of the company’s movement. This is a tool that allows you to identify the parameters and indicators that require, can be both a strength and a weakness of the organization that require attention. This scientific article is devoted to just one of these tools – strategic analysis, which was carried out on the example of the Innovation Development Fund of the Republic of Sakha (Yakutia). The article provides an analysis of the external and internal environment of the organization, determines the factors influencing the activity of the object of consideration. The article offers strategic recommendations for improving the Fund’s activities and developing new strategic priorities. The study is conducted on the example of the Innovation Development Fund of the Republic of Sakha (Yakutia), one of the leading organizations in the field of innovation ecosystem development in the Republic. The results of the study can be useful for management personnel involved in the development of an innovative economy and the management of organizations in this area. The purpose of this work was to develop proposals for improving the strategy of the organization, which will positively affect the organization. To achieve the target, the following tasks were completed:– conducted external and internal analysis of the environment of the Innovation Development Fund of the Republic of Sakha (Yakutia); – a strategic analysis of the organization was carried out; – suggested recommendations for improving the strategic priorities and management of the organization.

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Lowe, Pam, Sharon Boden, Simon Williams, Clive Seale und Deborah Steinberg. „Who are you Sleeping With? the Construction of Heteronormativity in Stories about Sleep in British Newspapers“. Sociological Research Online 12, Nr. 5 (September 2007): 173–81. http://dx.doi.org/10.5153/sro.1578.

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In popular British understanding the terms ‘sleeping’ or ‘slept’ are often used to mean sex, and (hetero)sex is seen as crucial to sustaining intimate relationships. This study of UK newspapers coverage shows that stories about sleep and sleeping arrangements can be seen to (re)produce heteronormativity through focusing on the (heterosexual) ‘marital bed’. The ‘marital bed’ is constructed as both the physical and symbolic centre of successful heterosexual relationships. Moreover, the maintenance of this symbolic space is gendered with women given primary responsibility. The focus on the ‘marital bed’ helps to exclude non-heterosexuals from the idea of intimate relationships, by effectively silencing their experiences of sleep and sleeping arrangements. Normative ideas about male and female (hetero)sexualities are drawn on to undermine women's right to refuse sex within the martial bed. In addition, the term ‘sleep-sex’ is used to reconceptualise stories of rape, minimising the victim's experiences and absolve the perpetrator from full responsibility for the assault. By exploring these articles we can see both how the representation of the organisation of sleep is produced through heteronormativity, as well as how heteronormativity determines whose accounts of sleeping are prioritised.

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Tumilty, Emma, Cara Pennel, Krista Bohn, Claire Cynthia Hallmark und Sharon Croisant. „290 Are you trust-worthy: Trust-building activities in Translational Sciences“. Journal of Clinical and Translational Science 8, s1 (April 2024): 89. http://dx.doi.org/10.1017/cts.2024.266.

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OBJECTIVES/GOALS: Many researchers aim to build trust with communities and participants. Trust building is meant to achieve greater representation across aspects of research whether in participation, or more comprehensively as partners from design to dissemination. We provide practical guidance for trust building activities and the ethical issues that can arise. METHODS/STUDY POPULATION: While trust itself is inherently seen as an ethical good, often little attention is paid to the ethical aspects of trust building exercises themselves and the fact that trust can vary in type. Using a bioethical analysis of trustworthiness, we discuss how to approach trust in different relationships and settings. Explicit communication about the supports/constraints and potential outcomes of new trusted relationships is required for ethical practice. Where relationships are built without appropriate transparency and follow through, or with misunderstandings about potential shared values, priorities, or desired outcomes, significant harms can occur in the short- and long term. Using a bioethical framework and practical examples we provide guidance on how to engage in ethical trust building activities. RESULTS/ANTICIPATED RESULTS: While many people are good at the trust building work they do, this work is often not shared as best practices and is ascribed to individual skill. This is slowly changing and an evidence-base is being developed that can support those new to these activities. Ethical guidance to support trust building practices, especially for those new to these activities, is currently lacking. By providing both a conceptual and normative bioethical analysis grounded in practice, we provide the foundations for new activities and the necessary support for work that explores and determines best practices. This analysis provides an understanding of trust including a taxonomy and a discussion of how different types of trust can be built and can support research activities, as well as problems that can arise. DISCUSSION/SIGNIFICANCE: Trust building activities with communities and participants are crucial to much of translational science and research, but ethical guidance on how to engage in these activities well is lacking. We provide bioethical guidance and offer practical recommendations.

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King, A., und A. Speight. „P388 Asking teenagers and young adults with IBD; “what matters to you?”. A qualitative survey during the COVID-19 pandemic“. Journal of Crohn's and Colitis 16, Supplement_1 (01.01.2022): i387. http://dx.doi.org/10.1093/ecco-jcc/jjab232.515.

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Abstract Background Good paediatric to adult transition of IBD care is important to prevent disengagement and poor disease outcomes [1]. The aim of this study was to qualitatively measure what is important to patients before they attended a new transitional service. There may be a dichotomy between the treating healthcare workers’ priorities and teenagers’ priorities that form a barrier to effective communication. Unprepared services can result in negative consequences for those involved [2] and a greater understanding of what matters to teenagers and young adults may improve the clinicians’ ability to facilitate the transition process. Methods We asked, 75 teenagers and young adults, aged between, 14 and, 21, who attended a new transitional service at a tertiary IBD unit in the North of England, to complete a survey prior to their clinic review. This ‘what matters to you’ survey included, 12 suggestions they could circle, with no limitations on how many many they selected, but a suggestion to choose up to, 3 topics. The survey was conducted during the COVID-19 pandemic and UK national lockdown, between September, 2020 and September, 2021. Results Conclusion Inflammatory bowel disease is a condition with potentially a high morbidity from physical symptoms, and it is important not to forget this as a focus of a consultation. Medical therapies and their effects on the patient were important to, 48% of responders, and the transition process should include further education on treatment options with discussions of compliance. The impact on education and schooling feature as a significant topic and should be discussed during transition. Minimising the impact on education and employment should be considered when developing transitional services. Mental health wellbeing and body image were highly significant to a smaller number of patients and remain an important consideration. Interestingly not a single responder including the COVID-19 outbreak as a concern despite universally being on biological therapy or immunomodulators. It is important to note that whilst no patients reported ‘smoking, drugs and alcohol’ as important, risk-taking behaviours are increased in this patient population [3], they need to be sensitively discussed to become apparent and may be under-represented with the methodology used. References 1. Brooks AJ, Smith PJ, Cohen R, et al UK guideline on transition of adolescent and young persons with chronic digestive diseases from paediatric to adult care Gut, 2017;66:988–1000 2. van Rheenen, P, et al ECCO topical review on transitional care in inflammatory bowel disease. Journal of Crohn’s and Colitis, 2017;11,30-31 3. Brooks A et al. Health-related behaviours in young people with inflammatory bowel disease Gut, 2017;66:A153

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Lyss, Aaron J., Cheryl A. Crouse, Natalie R. Dickson, Jeffrey Patton, Christopher A. Waynick und Stephen Matthew Schleicher. „Understanding the challenges for oncologists in predicting the end-of-life phase of care in cancer patients with advanced solid tumor diagnoses.“ Journal of Clinical Oncology 37, Nr. 27_suppl (20.09.2019): 281. http://dx.doi.org/10.1200/jco.2019.37.27_suppl.281.

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281 Background: Early advanced care planning and palliative care improves outcomes during the end-of-life phase of care (EOL) for metastatic cancer patients. Identifying patients who are likely to transition to EOL is a necessary step to prioritize limited palliative care resources and is integral to success in value-based payment models. We analyzed whether physician documentation of prognosis in a clinical pathways system (CPS) could reliably predict when patients are nearing EOL for a large community oncology practice of more than 70 medical oncologists. Methods: Tennessee Oncology (TO) requires physicians to use CPS for all Medicare patients. CPS prompts physicians to answer the “prognostic question” “would you be surprised if this patient died in the next year?” for all OCM patients with advanced solid tumors at the beginning of treatment or at the time of a change in treatment plan. Prognostic question responses were compared to actual dates of death documented in the practice management system. Results: A total of 5,266 distinct patients were expected to trigger an OCM episode during 2017. The CPS prompted a response to the prognostic question for 1,228 (23%) of these OCM patients. There were 665 (54%) positive prognoses (expect patient to live more than 1 year) and 563 (46%) negative prognoses (expect patient to die within 1 year). Physicians documented accurate prognoses in 712 (58%) of cases. For patients with positive prognosis 557 (84%) were accurate. For patients with negative prognosis 155 (21.8%) were accurate. Conclusions: We found that for patients with terminal cancer, it is difficult for physicians to accurately predict prognosis. These findings support the importance of ASCO guidelines pertaining to patient access to palliative care during the entirety of cancer treatment for all patients with metastatic cancer. [Table: see text]

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