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Sample records for single qualitative case

  1. A qualitative single case study of parallel processes

    DEFF Research Database (Denmark)

    Jacobsen, Claus Haugaard

    2007-01-01

    Parallel process in psychotherapy and supervision is a phenomenon manifest in relationships and interactions, that originates in one setting and is reflected in another. This article presents an explorative single case study of parallel processes based on qualitative analyses of two successive...

  2. Qualitative methodology in a psychoanalytic single case study

    DEFF Research Database (Denmark)

    Grünbaum, Liselotte

    This study concerns the systematic integration of qualitative research strategies in a psychoanalytic single case study of a child who had suffered early abuse and neglect. A systematic exploration of core features of the therapeutic relationship was carried out, possible links between such core...... with Interpretational Phenomenological Analysis were applied on recorded session notes and other case-file material from a concluded child psychotherapy case as well as on transcripts from follow-up interviews with the child’s birth and foster parents. The case material analyzed in three steps; principles...

  3. [Music therapy single case research--a qualitative approach].

    Science.gov (United States)

    Langenberg, M; Frommer, J; Tress, W

    1995-12-01

    A qualitative approach for describing music psychotherapy treatment is developed. For this purpose we employ the methodological principle of triangulation of perspectives (patient, therapist, independent observers, composers). Our approach is based on the concept of the resonator function describing the perceptive capacity of all participants for effective and relationship-referred significance of the work produced during the treatment. The qualitative method importing and extending the knowledge of the inner context of the case is illustrated by two musical improvisations from the treatment of a female patient suffering from chronic migraine.

  4. Qualitative methodology in a psychoanalytic single case study

    DEFF Research Database (Denmark)

    Grünbaum, Liselotte

    , and in transcripts from follow-up interviews. 3) The same predefined themes studied in systematically selected sessions around four Christmas breaks and in no-break periods. The application of certain analytic instruments is discussed: a) a 3-point Likert scale to allow for disconfirming case analysis; b) mapping...

  5. Psychological Challenges of Saudi Female International Students in Virginia: Single Qualitative Case Study

    Science.gov (United States)

    Davis, Joyce G.

    2016-01-01

    Saudi Arabian female international students enrolled in a public university in Northern Virginia used either problem-focused coping or emotion-focused coping strategies to overcome psychological and social challenges. Sixteen Saudi females participated in this qualitative case study. Semi-structured interviews were conducted to obtain the opinions…

  6. Student and Faculty Perceptions of Academic Dishonesty: A Qualitative Single-Case Study

    Science.gov (United States)

    Allemand, Kristina R.

    2012-01-01

    Educators are concerned that academic dishonesty is increasing among students, particularly in higher education. There is not a single definition of academic dishonesty accepted by all stakeholders in the field of education. Most studies of academic dishonesty do not include both student and faculty perceptions of academic dishonesty. An in-depth…

  7. Toward Understanding the Role of Web 2.0 Technology in Self-Directed Learning and Job Performance in a Single Organizational Setting: A Qualitative Case Study

    Science.gov (United States)

    Caruso, Shirley J.

    2016-01-01

    This single instrumental qualitative case study explores and thickly describes job performance outcomes based upon the manner in which self-directed learning activities of a purposefully selected sample of 3 construction managers are conducted, mediated by the use of Web 2.0 technology. The data collected revealed that construction managers are…

  8. Qualitative Case Study Guidelines

    Science.gov (United States)

    2013-11-01

    21. Glaser , B. G. and Strauss, A. L. (1967) The Discovery of Grounded Theory . London, Weidenfeld and Nicolson UNCLASSIFIED DSTO-GD-0773...Evaluations. United States General Accounting Office 20. Glaser , B. G. (2002) Constructivist Grounded Theory ? Forum: Qualitative Social Research 3 (3...sampling, originated with the development of grounded theory [21]. In contrast to statistical sampling, the goal of theoretical sampling is not to

  9. Always single and single again women: a qualitative study.

    Science.gov (United States)

    Lewis, K G; Moon, S

    1997-04-01

    What is it like to be a single woman today? Are the experiences of women who have always been single different from those who find themselves single again after having been married? How can family therapists promote the development of single women both individually and relationally? The purpose of this phenomenological, multiple-case study was to investigate perceptions of being single among heterosexual single women between the ages of 30 and 65. Nine focus group interviews and a semistructured, mailed questionnaire were used to collect the data. Constant comparative analyses were used to develop the findings. The findings were organized around the most salient theme that emerged from the analyses: single women have unresolved or unrecognized ambivalences about being single. This overarching theme was supported by three subassertions: (a) single women are aware of both the advantages and the drawbacks of being single; (b) single women are ambivalent about the reasons for their singleness; (c) although content with being single, many women simultaneously experience feelings of loss and grief. Implications for the clinical practice of family therapy and future research on single women are discussed.

  10. Qualitative Case Study Research as Empirical Inquiry

    Science.gov (United States)

    Ellinger, Andrea D.; McWhorter, Rochell

    2016-01-01

    This article introduces the concept of qualitative case study research as empirical inquiry. It defines and distinguishes what a case study is, the purposes, intentions, and types of case studies. It then describes how to determine if a qualitative case study is the preferred approach for conducting research. It overviews the essential steps in…

  11. Innovative Interpretive Qualitative Case Study Research Method ...

    African Journals Online (AJOL)

    lc2o

    SUMMARY. The aim of this paper is to review the methodology for interpretive qualitative case study research method using ... encourages a quantitative approach to research (Darling and. 40. AJPARS ... Interpretive Qualitative Case Study Aligned with Systems Theory for Physiotherapy and Rehabilitation Research. Scott ...

  12. Qualitative Secondary Analysis: A Case Exemplar.

    Science.gov (United States)

    Tate, Judith Ann; Happ, Mary Beth

    2017-12-15

    Qualitative secondary analysis (QSA) is the use of qualitative data that was collected by someone else or was collected to answer a different research question. Secondary analysis of qualitative data provides an opportunity to maximize data utility, particularly with difficult-to-reach patient populations. However, qualitative secondary analysis methods require careful consideration and explicit description to best understand, contextualize, and evaluate the research results. In this article, we describe methodologic considerations using a case exemplar to illustrate challenges specific to qualitative secondary analysis and strategies to overcome them. Copyright © 2017 National Association of Pediatric Nurse Practitioners. Published by Elsevier Inc. All rights reserved.

  13. Functional mapping of left parietal areas involved in simple addition and multiplication. A single-case study of qualitative analysis of errors.

    Science.gov (United States)

    Della Puppa, Alessandro; De Pellegrin, Serena; Salillas, Elena; Grego, Alberto; Lazzarini, Anna; Vallesi, Antonino; Saladini, Marina; Semenza, Carlo

    2015-09-01

    All electrostimulation studies on arithmetic have so far solely reported general errors. Nonetheless, a classification of the errors during stimulation can inform us about underlying arithmetic processes. The present electrostimulation study was performed in a case of left parietal glioma. The patient's erroneous responses suggested that calculation was mainly applied for addition and a combination of retrieval and calculation was mainly applied for multiplication. The findings of the present single-case study encourage follow up with further data collection with the same paradigm. © 2014 The British Psychological Society.

  14. Emergence of psychotic content in psychotherapy: An exploratory qualitative analysis of content, process, and therapist variables in a single case study.

    Science.gov (United States)

    Leonhardt, Bethany L; Kukla, Marina; Belanger, Elizabeth; Chaudoin-Patzoldt, Kelly A; Buck, Kelly D; Minor, Kyle S; Vohs, Jenifer L; Hamm, Jay A; Lysaker, Paul H

    2018-03-01

    Emerging integrative metacognitive therapies for schizophrenia seek to promote subjective aspects of recovery. Beyond symptom remission, they are concerned with shared meaning-making and intersubjective processes. It is unclear, however, how such therapies should understand and respond to psychotic content that threatens meaning-making in therapeutic contexts. Accordingly, we sought to understand what factors precede and potentially trigger psychotic content within psychotherapy and what aids in resolution and return to meaning-making. Forty-eight transcripts from a single psychotherapy case were analyzed with thematic analysis. Passages of delusional or disorganized content were identified and themes present prior to the emergence and resolution of such material were identified and coded. Themes that preceded the emergence of psychotic content varied across early, middle, and late phases of therapy. Material related to the patient's experience of inadequacy and potential vulnerability, therapist setting boundaries within the therapeutic relationship and making challenges appeared to trigger psychotic content, especially early in treatment. Psychotic content may emerge in session following identifiable antecedents which change over phases of therapy. Attending to psychotic content by assuming a non-hierarchical stance and not dismissing psychotic content may aid in maintaining intersubjectivity and support patient's movements toward recovery in integrative metacognitive therapies.

  15. Linking Flexible-Dynamic Team Structures through Distributed Leadership: A Qualitative Evaluation with Single Design Case Approach and Application of Roster Method

    Directory of Open Access Journals (Sweden)

    Aykut BERBER

    2012-09-01

    Full Text Available Fierce competition in every sector has forced companies to re-design their structures towards being more customer-focused, faster and more responsive. In this vein, there is rising dominance of flexible-dynamic team structures in organizations and these teams are, most of the times, self-managed. Among these team structures, leadership characteristics are not only observed in official team leaders but such characteristics are distributed among team members. The concept of "leading without leaders" has gained scholarly interest and in this paper, aim is to evaluate and combine constructs of distributed leadership and flexible-dynamic team structures within a single design case approach. Local division of a multinational company that operates in luxury cosmetics sector is selected. In-depth interviews were conducted at the company site, and flexible-dynamic team structures were examined in detail. As a second tool, Roster method is applied to see existence and strength of distributed leadership among different departments. Findings supported that organizational structure of this company has become more flexible-dynamic with distributed leadership characteristics seen across all departments. These findings were significant because our selected company entered into Turkey market twice and the second entry has been operationally successful. Arguments are offered regarding differences between two periods and further implications are suggested in relation to adoption of a new and more responsive company structure. Structural changes between two periods constituted the focal point of this research.

  16. Innovative Interpretive Qualitative Case Study Research Method ...

    African Journals Online (AJOL)

    The aim of this paper is to review the methodology for interpretive qualitative case study research method using systems theory. The paper also addresses the underlying assumptions of this research methodology and how these affect the way research questions are answered. In reviewing this methodology, an example is ...

  17. Rethinking a Case Study Method in Educational Research: A Comparative Analysis Method in Qualitative Research

    Science.gov (United States)

    Murakami, Yusuke

    2013-01-01

    There are two types of qualitative research that analyze a small number of cases or a single case: idiographic differentiation and nomothetic/generalization. There are few case studies of generalization. This is because theoretical inclination is weak in the field of education, and the binary framework of quantitative versus qualitative research…

  18. Generalization from Single Cases and the Concept of Double Dialogicality

    DEFF Research Database (Denmark)

    Demuth, Carolin

    2017-01-01

    The present paper addresses how the concept of double-dialogicality may contribute to our understanding of how to generalize from single cases. Various attempts have been made within qualitative social research to define how generalization is possible from single cases. One problem with generaliz......The present paper addresses how the concept of double-dialogicality may contribute to our understanding of how to generalize from single cases. Various attempts have been made within qualitative social research to define how generalization is possible from single cases. One problem...... in this. In social interactions, persons draw on culturally available resources without which communicative meaning would be impossible. Double dialogicality as introduced by Per Linell helps to understand this relation and allows for identifying the general in the unique....

  19. Compassion: A Qualitative Instrumental Case Study on Student Retention

    Science.gov (United States)

    Shedletsky, Nikki

    2017-01-01

    This qualitative case study examined the past and current student retention literature and research in order to fill voids in the literature and knowledge and contribute to increasing retention of more students by understanding Spalding University's culture and how they make it work to serve students. Data was collected from surveys, interviews…

  20. Giftedness, Trauma, and Development: A Qualitative, Longitudinal Case Study

    Science.gov (United States)

    Peterson, Jean Sunde

    2014-01-01

    A qualitative, longitudinal, phenomenological case study explored how a gifted female experienced various life events and aspects of development during adolescence and young adulthood (ages 15-30 years), particularly as related to multiple traumatic experiences, which were revealed late in the first year of the study. Additional experiences, well…

  1. Qualitative case study data analysis: an example from practice.

    Science.gov (United States)

    Houghton, Catherine; Murphy, Kathy; Shaw, David; Casey, Dympna

    2015-05-01

    To illustrate an approach to data analysis in qualitative case study methodology. There is often little detail in case study research about how data were analysed. However, it is important that comprehensive analysis procedures are used because there are often large sets of data from multiple sources of evidence. Furthermore, the ability to describe in detail how the analysis was conducted ensures rigour in reporting qualitative research. The research example used is a multiple case study that explored the role of the clinical skills laboratory in preparing students for the real world of practice. Data analysis was conducted using a framework guided by the four stages of analysis outlined by Morse ( 1994 ): comprehending, synthesising, theorising and recontextualising. The specific strategies for analysis in these stages centred on the work of Miles and Huberman ( 1994 ), which has been successfully used in case study research. The data were managed using NVivo software. Literature examining qualitative data analysis was reviewed and strategies illustrated by the case study example provided. Discussion Each stage of the analysis framework is described with illustration from the research example for the purpose of highlighting the benefits of a systematic approach to handling large data sets from multiple sources. By providing an example of how each stage of the analysis was conducted, it is hoped that researchers will be able to consider the benefits of such an approach to their own case study analysis. This paper illustrates specific strategies that can be employed when conducting data analysis in case study research and other qualitative research designs.

  2. Qualitative case study methodology in nursing research: an integrative review.

    Science.gov (United States)

    Anthony, Susan; Jack, Susan

    2009-06-01

    This paper is a report of an integrative review conducted to critically analyse the contemporary use of qualitative case study methodology in nursing research. Increasing complexity in health care and increasing use of case study in nursing research support the need for current examination of this methodology. In 2007, a search for case study research (published 2005-2007) indexed in the CINAHL, MEDLINE, EMBASE, PsychINFO, Sociological Abstracts and SCOPUS databases was conducted. A sample of 42 case study research papers met the inclusion criteria. Whittemore and Knafl's integrative review method guided the analysis. Confusion exists about the name, nature and use of case study. This methodology, including terminology and concepts, is often invisible in qualitative study titles and abstracts. Case study is an exclusive methodology and an adjunct to exploring particular aspects of phenomena under investigation in larger or mixed-methods studies. A high quality of case study exists in nursing research. Judicious selection and diligent application of literature review methods promote the development of nursing science. Case study is becoming entrenched in the nursing research lexicon as a well-accepted methodology for studying phenomena in health and social care, and its growing use warrants continued appraisal to promote nursing knowledge development. Attention to all case study elements, process and publication is important in promoting authenticity, methodological quality and visibility.

  3. Generalization from Single Cases and the Concept of Double Dialogicality

    DEFF Research Database (Denmark)

    Demuth, Carolin

    2017-01-01

    with generalization in psychology is that any human activity and sense making is situated/occasioned and all psychological phenomenon are hence unique. However, they are not arbitrary but dialogically intertwined with socio-cultural traditions of sense making and acting. Discursive practices play a pivotal role...... in this. In social interactions, persons draw on culturally available resources without which communicative meaning would be impossible. Double dialogicality as introduced by Per Linell helps to understand this relation and allows for identifying the general in the unique.......The present paper addresses how the concept of double-dialogicality may contribute to our understanding of how to generalize from single cases. Various attempts have been made within qualitative social research to define how generalization is possible from single cases. One problem...

  4. Two single mutations commonly cause qualitative change of nonspecific carboxylesterases in insects.

    Science.gov (United States)

    Cui, Feng; Lin, Zhe; Wang, Hongsheng; Liu, Silu; Chang, Haijing; Reeck, Gerald; Qiao, Chuanling; Raymond, Michel; Kang, Le

    2011-01-01

    Carboxylesterases provide key mechanisms of resistance to insecticides, particularly organophosphates (OPs), in insects. One resistance mechanism is a qualitative change in the properties of a carboxylesterase. Two mutant forms, G151D and W271L, have been observed, mostly in dipteran species, to affect substrate specificity of enzymes. But whether these two single mutations can commonly change character of insect carboxylesterases is unknown. In our study carboxylesterase genes from seven insects distributed among four orders were cloned, mutated at position 151 or 271 and expressed in Escherichia coli. The kinetics of the purified recombinant proteins was examined towards an artificial carboxylester and two OP insecticides. The G/A151D and W271L mutation significantly reduced carboxylesterase activity in 87.5% and 100% cases, respectively, and at the same time conferred OP hydrolase activities in 62.5% and 87.5% cases, respectively. Thus, the change at position 271 is more effective to influence substrate specificity than that at position 151. These results may suggest that these two mutations have the potential to cause insecticide resistance broadly in insects. Copyright © 2010 Elsevier Ltd. All rights reserved.

  5. Collaboration and patient safety at an emergency department - a qualitative case study.

    Science.gov (United States)

    Pedersen, Anna Helene Meldgaard; Rasmussen, Kurt; Grytnes, Regine; Nielsen, Kent Jacob

    2018-03-19

    Purpose The purpose of this paper is to examine how conflicts about collaboration between staff at different departments arose during the establishment of a new emergency department and how these conflicts affected the daily work and ultimately patient safety at the emergency department. Design/methodology/approach This qualitative single case study draws on qualitative semi-structured interviews and participant observation. The theoretical concepts "availability" and "receptiveness" as antecedents for collaboration will be applied in the analysis. Findings Close collaboration between departments was an essential precondition for the functioning of the new emergency department. The study shows how a lack of antecedents for collaboration affected the working relation and communication between employees and departments, which spurred negative feelings and reproduced conflicts. This situation was seen as a potential threat for the safety of the emergency patients. Research limitations/implications This study presents a single case study, at a specific point in time, and should be used as an illustrative example of how contextual and situational factors affect the working environment and through that patient safety. Originality/value Few studies provide an in-depth investigation of what actually takes place when collaboration between professional groups goes wrong and escalates, and how problems in collaboration may affect patient safety.

  6. The Use of Qualitative Content Analysis in Case Study Research

    OpenAIRE

    Kohlbacher, Florian

    2006-01-01

    Dieser Beitrag hat zum Ziel, Möglichkeiten zu untersuchen und zu diskutieren, wie qualitative Inhaltsanalyse als (Text-) Interpretationsmethode in der Fallstudienforschung angewendet werden kann. Zunächst wird die Fallstudienforschung als eine Forschungsstrategie innerhalb der qualitativen Sozialforschung kurz dargestellt. Danach folgt eine Einführung in die (qualitative) Inhaltsanalyse als Interpretationsmethode für qualitative Interviews und anderes Datenmaterial. Abschließend wird der Eins...

  7. The Aircraft Electric Taxi System: A Qualitative Multi Case Study

    Science.gov (United States)

    Johnson, Thomas Frank

    The problem this research addresses is the airline industry, and the seemingly unwillingness attitude towards adopting ways to taxi aircraft without utilizing thrust from the main engines. The purpose of the study was to get a better understanding of the decision-making process of airline executives, in respect to investing in cost saving technology. A qualitative research method is used from personal interviews with 24 airline executives from two major U.S. airlines, related industry journal articles, and aircraft performance data. The following three research questions are addressed. RQ1. Does the cost of jet fuel influence airline executives' decision of adopting the aircraft electric taxi system technology? RQ2 Does the measurable payback period for a return on investment influence airline executives' decision of adopting ETS technology? RQ3. Does the amount of government assistance influence airline executives' decision of adopting ETS technology? A multi case research study design is used with a triangulation technique. The participant perceptions indicate the need to reduce operating costs, they have concerns about investment risk, and they are in favor of future government sponsored performance improvement projects. Based on the framework, findings and implications of this study, a future research paper could focus on the positive environmental effects of the ETS application. A study could be conducted on current airport area air quality and the effects that aircraft main engine thrust taxiing has on the surrounding air quality.

  8. Experiences of case management with chronic illnesses: a qualitative systematic review.

    Science.gov (United States)

    Joo, J Y; Liu, M F

    2018-03-01

    This qualitative systematic review aimed to identify and synthesize recent qualitative studies to improve understanding of the experiences and perceptions of case management interventions that individuals with chronic illnesses and their caregivers have. Case management has been shown to be effective at improving quality of care and lowering costs for individuals with chronic illnesses. However, no qualitative review has been synthesized with recent qualitative studies about case management experiences by individual with chronic illnesses. This qualitative systematic review uses a thematic synthesis method to review 10 qualitative studies published within the last 10 years, from 2007 to 2016, thereby identifying and discussing the understandings that individuals with chronic illnesses and their caregivers have about case management. From this synthesis, three themes were identified as facilitators of case management (access to healthcare resources, health status supports and emotional aid) and two themes were identified as barriers to it (low information about case management and time constraints). This is the first qualitative systematic review of the perceptions and experiences that individuals with chronic illnesses and their caregivers have about case management. The facilitators of case management can be employed to inform patients about the benefits of case management and to improve population health. The findings about barriers to case management can be used to reform case management for populations with chronic illnesses. These factors should be considered by nursing researchers and healthcare policymakers when implementing case management. © 2018 International Council of Nurses.

  9. Incorporating Translation in Qualitative Studies: Two Case Studies in Education

    Science.gov (United States)

    Sutrisno, Agustian; Nguyen, Nga Thanh; Tangen, Donna

    2014-01-01

    Cross-language qualitative research in education continues to increase. However, there has been inadequate discussion in the literature concerning the translation process that ensures research trustworthiness applicable for bilingual researchers. Informed by the literature on evaluation criteria for qualitative data translation, this paper…

  10. Children and youth with disabilities: innovative methods for single qualitative interviews.

    Science.gov (United States)

    Teachman, Gail; Gibson, Barbara E

    2013-02-01

    There is a paucity of explicit literature outlining methods for single-interview studies with children, and almost none have focused on engaging children with disabilities. Drawing from a pilot study, we address these gaps by describing innovative techniques, strategies, and methods for engaging children and youth with disabilities in a single qualitative interview. In the study, we explored the beliefs, assumptions, and experiences of children and youth with cerebral palsy and their parents regarding the importance of walking. We describe three key aspects of our child-interview methodological approach: collaboration with parents, a toolkit of customizable interview techniques, and strategies to consider the power differential inherent in child-researcher interactions. Examples from our research illustrate what worked well and what was less successful. Researchers can optimize single interviews with children with disabilities by collaborating with family members and by preparing a toolkit of customizable interview techniques.

  11. Married Black Men's Opinions as to Why Black Women Are Disproportionately Single: A Qualitative Study.

    Science.gov (United States)

    Hurt, Tera R; McElroy, Stacey E; Sheats, Kameron J; Landor, Antoinette M; Bryant, Chalandra M

    2014-03-01

    This study's purpose was to explore the reasons Black women are disproportionately single according to the unique viewpoint of married Black men. The sample comprised 52 married Black men who resided in northeast Georgia (mean age = 43). Qualitative interviews were conducted in 2010 as part of the Pathways to Marriage study. The authors analyzed the data in a collaborative fashion and utilized content analyses to explore the relationships in the data which were derived from qualitative interviews with the men. Findings on the reasons for the disproportionality of singlehood among Black women reflected these four themes: gender relations, marriage education and socialization, individual development, and a preference for gay/lesbian relationships. Recommendations for future research are discussed.

  12. Single Finds. The case of Roman Egypt

    DEFF Research Database (Denmark)

    Christiansen, Erik

    2006-01-01

    Survery of single or stray finds from Roman Egypt and discussion of them as evidence for the circulation and use of coins......Survery of single or stray finds from Roman Egypt and discussion of them as evidence for the circulation and use of coins...

  13. Methodology or method? A critical review of qualitative case study reports

    OpenAIRE

    Hyett, Nerida; Kenny, Amanda; Dickson-Swift, Virginia

    2014-01-01

    Despite on-going debate about credibility, and reported limitations in comparison to other approaches, case study is an increasingly popular approach among qualitative researchers. We critically analysed the methodological descriptions of published case studies. Three high-impact qualitative methods journals were searched to locate case studies published in the past 5 years; 34 were selected for analysis. Articles were categorized as health and health services (n=12), social sciences and anth...

  14. Conflicting Discourses in Qualitative Research: The Search for Divergent Data within Cases

    Science.gov (United States)

    Antin, Tamar M. J.; Constantine, Norman A.; Hunt, Geoffrey

    2015-01-01

    The search for disconfirming evidence, or negative cases, is often considered a valuable strategy for assessing the credibility or validity of qualitative research claims. This article draws on a multimethod qualitative research project to illustrate how a search for disconfirming evidence evolved from a check on the validity of findings to a…

  15. Effect Sizes in Single Case Research: How Large is Large?

    Science.gov (United States)

    Parker, Richard I.; Brossart, Daniel F.; Vannest, Kimberly J.; Long, James R.; De-Alba, Roman Garcia; Baugh, Frank G.; Sullivan, Jeremy R.

    2005-01-01

    This study examined the problem of interpreting effect sizes in single case research. Nine single case analytic techniques were applied to a convenience sample of 77 published interrupted time series (AB) datasets, and the results were compared by technique across the datasets. Reanalysis of the published data helped answer questions about the…

  16. Perspectives about family meals from single-headed and dual-headed households: a qualitative analysis.

    Science.gov (United States)

    Berge, Jerica M; Hoppmann, Caroline; Hanson, Carrie; Neumark-Sztainer, Dianne

    2013-12-01

    Cross-sectional and longitudinal research has shown that family meals are protective for adolescent healthful eating behaviors. However, little is known about what parents think of these findings and whether parents from single- vs dual-headed households have differing perspectives about the findings. In addition, parents' perspectives regarding barriers to applying the findings on family meals in their own homes and suggestions for more widespread adoption of the findings are unknown. The current study aimed to identify single- and dual-headed household parents' perspectives regarding the research findings on family meals, barriers to applying the findings in their own homes, and suggestions for helping families have more family meals. The current qualitative study included 59 parents who participated in substudy of two linked multilevel studies-EAT 2010 (Eating and Activity in Teens) and Families and Eating and Activity in Teens (F-EAT). Parents (91.5% female) were racially/ethnically and socioeconomically diverse. Data were analyzed using a grounded theory approach. Results from the current study suggest that parents from both single- and dual-headed households have similar perspectives regarding why family meals are protective for healthful eating habits for adolescents (eg, provides structure/routine, opportunities for communication, connection), but provide similar and different reasons for barriers to family meals (eg, single-headed=cost vs dual-headed=lack of creativity) and ideas and suggestions for how to increase the frequency of family meals (eg, single-headed=give fewer options vs dual-headed=include children in the meal preparation). Findings can help inform public health intervention researchers and providers who work with adolescents and their families to understand how to approach discussions regarding reasons for having family meals, barriers to carrying out family meals, and ways to increase family meals depending on family structure. Copyright

  17. General practitioners learning qualitative research: A case study of postgraduate education.

    Science.gov (United States)

    Hepworth, Julie; Kay, Margaret

    2015-10-01

    Qualitative research is increasingly being recognised as a vital aspect of primary healthcare research. Teaching and learning how to conduct qualitative research is especially important for general practitioners and other clinicians in the professional educational setting. This article examines a case study of postgraduate professional education in qualitative research for clinicians, for the purpose of enabling a robust discussion around teaching and learning in medicine and the health sciences. A series of three workshops was delivered for primary healthcare academics. The workshops were evaluated using a quantitative survey and qualitative free-text responses to enable descriptive analyses. Participants found qualitative philosophy and theory the most difficult areas to engage with, and learning qualitative coding and analysis was considered the easiest to learn. Key elements for successful teaching were identified, including the use of adult learning principles, the value of an experienced facilitator and an awareness of the impact of clinical subcultures on learning.

  18. Methodology or method? A critical review of qualitative case study reports.

    Science.gov (United States)

    Hyett, Nerida; Kenny, Amanda; Dickson-Swift, Virginia

    2014-01-01

    Despite on-going debate about credibility, and reported limitations in comparison to other approaches, case study is an increasingly popular approach among qualitative researchers. We critically analysed the methodological descriptions of published case studies. Three high-impact qualitative methods journals were searched to locate case studies published in the past 5 years; 34 were selected for analysis. Articles were categorized as health and health services (n=12), social sciences and anthropology (n=7), or methods (n=15) case studies. The articles were reviewed using an adapted version of established criteria to determine whether adequate methodological justification was present, and if study aims, methods, and reported findings were consistent with a qualitative case study approach. Findings were grouped into five themes outlining key methodological issues: case study methodology or method, case of something particular and case selection, contextually bound case study, researcher and case interactions and triangulation, and study design inconsistent with methodology reported. Improved reporting of case studies by qualitative researchers will advance the methodology for the benefit of researchers and practitioners.

  19. Methodology or method? A critical review of qualitative case study reports

    Science.gov (United States)

    Hyett, Nerida; Kenny, Amanda; Dickson-Swift, Virginia

    2014-01-01

    Despite on-going debate about credibility, and reported limitations in comparison to other approaches, case study is an increasingly popular approach among qualitative researchers. We critically analysed the methodological descriptions of published case studies. Three high-impact qualitative methods journals were searched to locate case studies published in the past 5 years; 34 were selected for analysis. Articles were categorized as health and health services (n=12), social sciences and anthropology (n=7), or methods (n=15) case studies. The articles were reviewed using an adapted version of established criteria to determine whether adequate methodological justification was present, and if study aims, methods, and reported findings were consistent with a qualitative case study approach. Findings were grouped into five themes outlining key methodological issues: case study methodology or method, case of something particular and case selection, contextually bound case study, researcher and case interactions and triangulation, and study design inconsistent with methodology reported. Improved reporting of case studies by qualitative researchers will advance the methodology for the benefit of researchers and practitioners. PMID:24809980

  20. Critical challenges in ERP implementation: A qualitative case study in the Canadian oil and gas industry

    Science.gov (United States)

    Menon, Sreekumar A.

    This exploratory qualitative single-case study examines critical challenges encountered during ERP implementation based on individual perspectives in four project roles: senior leaders, project managers, project team members, and business users, all specifically in Canadian oil and gas industry. Data was collected by interviewing participants belonging to these categories, and by analyzing project documentation about ERP implementation. The organization for the case study was a leading multinational oil and gas company having a substantial presence in the energy sector in Canada. The study results were aligned with the six management questions regarding critical challenges in ERP: (a) circumstances to implement ERP, (b) benefits and process improvements achieved, (c) best practices implemented, (d) critical challenges encountered, (e) strategies and mitigating actions used, and (f) recommendations to improve future ERP implementations. The study results highlight six key findings. First, the study provided valid circumstances for implementing ERP systems. Second, the study underscored the importance of benefits and process improvements in ERP implementation. Third, the study highlighted that adoption of best practices is crucial for ERP Implementation. Fourth, the study found that critical challenges are encountered in ERP Implementation and are significant during ERP implementation. Fifth, the study found that strategies and mitigating actions can overcome challenges in ERP implementation. Finally, the study provided ten major recommendations on how to improve future ERP implementations.

  1. Cybersecurity Implications for Industry, Academia, and Parents: A Qualitative Case Study in NSF STEM Education

    Science.gov (United States)

    Stevenson, Gregory V.

    Rationale: Former President Barack Obama's 3.9 trillion for the 2015 fiscal year budget request included a 2.9 billion investment in Science, Technology, Engineering and Math (STEM) education. Research then showed that the national spending for cybersecurity has exceeded $10.7 billion in the 2015 fiscal year. Nonetheless, the number of cyberattacks has risen year after year since 2012, potentially due to the lack of education and training in cybersecurity. Methodology: A qualitative case study research was conducted to explore and investigate the lived professional experiences of experts from San Antonio Texas whose efforts were aligned to increase the number of qualified cybersecurity professionals. To qualify the organizational needs for cybersecurity professionals, the study gathered expert opinions by surveying human resource managers pertaining to the needs of cybersecurity education. To refine and further validate data collection efforts, the study involved researcher observations and a survey of a narrow cohort to perform analytic induction to eliminate bias and exhaust the exploratory research (Maxwell, 2005). Result: The findings of the case study will: 1) help augment the importance of cybersecurity education in pre-kindergarten through 12th grade, 2) be utilized as a single guide for school leaders in the process of developing cybersecurity education strategies, and 3) in the longer term, be used by the National Sciences Foundation (NSF) as an effective model to institute cybersecurity education practices nationwide and thereby reduce the existing trouble of the nation by criminal cyber actors.

  2. How Academic Department Chairs View the Influence of Corporate Ethics Scandals on Ethics Education in Arizona Business Schools: A Qualitative Case Study at the Postsecondary Level

    Science.gov (United States)

    Gillis, Robert James

    2017-01-01

    The purpose of this qualitative single case study was to explore how department chairs described the influence of recent corporate ethics scandals on content and availability of ethics education in postsecondary business schools in Arizona. The following research questions guided this study: RQ1: How do department chairs describe the influence of…

  3. How Customer Facing Professionals Adapt to Changing Customer Needs in a Digital Environment: A Single Case Study

    Science.gov (United States)

    Hendriks, Stefan

    2017-01-01

    This qualitative single case study explored how customer facing professionals (CFPs) adapt to changing customer needs in a digital environment. This study focuses on: (1) Changing customer needs; (2) Competencies needed in a digital environment; (3) How they learn; and (4) What factors help or hinder their success. The site is a global Human…

  4. Exploring Stakeholder Definitions within the Aerospace Industry: A Qualitative Case Study

    Science.gov (United States)

    Hebert, Jonathan R.

    A best practice in the discipline of project management is to identify all key project stakeholders prior to the execution of a project. When stakeholders are properly identified, they can be consulted to provide expert advice on project activities so that the project manager can ensure the project stays within the budget and schedule constraints. The problem addressed by this study is that managers fail to properly identify key project stakeholders when using stakeholder theory because there are multiple conflicting definitions for the term stakeholder. Poor stakeholder identification has been linked to multiple negative project outcomes such as budget and schedules overruns, and this problem is heightened in certain industries such as aerospace. The purpose of this qualitative study was to explore project managers' and project stakeholders' perceptions of how they define and use the term stakeholder within the aerospace industry. This qualitative exploratory single-case study had two embedded units of analysis: project managers and project stakeholders. Six aerospace project managers and five aerospace project stakeholders were purposively selected for this study. Data were collected through individual semi-structured interviews with both project managers and project stakeholders. All data were analyzed using Yin's (2011) five-phased cycle approach for qualitative research. The results indicated that the aerospace project managers and project stakeholder define the term stakeholder as "those who do the work of a company." The participants build upon this well-known concept by adding that, "a company should list specific job titles" that correspond to their company specific-stakeholder definition. Results also indicated that the definition of the term stakeholder is used when management is assigning human resources to a project to mitigate or control project risk. Results showed that project managers tended to include the customer in their stakeholder definitions

  5. Combining life cycle assessment and qualitative risk assessment: the case study of alumina nanofluid production.

    Science.gov (United States)

    Barberio, Grazia; Scalbi, Simona; Buttol, Patrizia; Masoni, Paolo; Righi, Serena

    2014-10-15

    In this paper the authors propose a framework for combining life cycle assessment (LCA) and Risk Assessment (RA) to support the sustainability assessment of emerging technologies. This proposal includes four steps of analysis: technological system definition; data collection; risk evaluation and impacts quantification; results interpretation. This scheme has been applied to a case study of nanofluid alumina production in two different pilot lines, "single-stage" and "two-stage". The study has been developed in the NanoHex project (enhanced nano-fluid heat exchange). Goals of the study were analyzing the hotspots and highlighting possible trade-off between the results of LCA, which identifies the processes having the best environmental performance, and the results of RA, which identifies the scenarios having the highest risk for workers. Indeed, due to lack of data about exposure limits, exposure-dose relationships and toxicity of alumina nanopowders (NPs) and nanofluids (NF), the workplace exposure has been evaluated by means of qualitative risk assessment, using Stoffenmanager Nano. Though having different aims, LCA and RA have a complementary role in the description of impacts of products/substances/technologies. Their combined use can overcome limits of each of them and allows a wider vision of the problems to better support the decision making process. Copyright © 2014 Elsevier B.V. All rights reserved.

  6. Exploring Novice Teachers' Cognitive Processes Using Digital Video Technology: A Qualitative Case Study

    Science.gov (United States)

    Sun-Ongerth, Yuelu

    2012-01-01

    This dissertation describes a qualitative case study that investigated novice teachers' video-aided reflection on their own teaching. To date, most studies that have investigated novice teachers' video-aided reflective practice have focused on examining novice teachers' levels of reflective writing rather than the cognitive…

  7. Obstacles to moral education in a private school: a qualitative case study in Brazil

    OpenAIRE

    Leal Terra Silva, F. (Fabiana)

    2014-01-01

    Abstract This research intends to investigate obstacles to moral education in a private school in Brazil, based on teachers’ views, which were gathered through interviews, questionnaires and discussions during workshops. It is a qualitative case study conducted in a country where neoliberal values increasingly influence education, and where high rates of socio economic inequalities are easily observed. Similarly to other em...

  8. Human Trafficking and Education: A Qualitative Case Study of Two NGO Programs in Thailand

    Science.gov (United States)

    Spires, Robert Weber

    2012-01-01

    In this qualitative, ethnographic case study, I examine two Thai NGO shelters/schools working with human trafficking survivors and at-risk populations of children ages 5-18. The two NGOs had a residential component, meaning that children live at the shelter, and an educational component, meaning that children are taught academic and vocational…

  9. User profiles: from a qualitative case study approach to providing a better service

    OpenAIRE

    Sequeiros, Paula

    2009-01-01

    User profiles were designed through a qualitative approach to a case study of a public library, starting from an analysis of space social relations, of how the building’s design shaped reading practices and of how space was actually being used

  10. Business-IT alignment domains and principles for networked organizations: A qualitative multiple case study

    NARCIS (Netherlands)

    Santana Tapia, R.G.; Daneva, Maia; van Eck, Pascal; Castro Cárdenas, N.; van Oene, L.

    2008-01-01

    Applying principles for business-IT alignment in networked organizations seems to be key for their survival in competitive environments. In this paper, we present a qualitative multiple case study conducted in three collaborative networked organizations: (i) an outsourcing relation between an

  11. Perceptions of ESL Program Management in Canadian Higher Education: A Qualitative Case Study

    Science.gov (United States)

    Eaton, Sarah Elaine

    2017-01-01

    ESL programs at post-secondary institutions must often generate revenue in addition to teaching students English. Institutions often impose explicit expectations on these programs to generate profit, creating unique challenges for those who administer them. This qualitative case study investigated challenges faced by ESL program directors at one…

  12. SINGLE-CASE INVESTIGATION OF AN EMOTION-FOCUSED THERAPY GROUP FOR ANXIETY AND DEPRESSION

    Directory of Open Access Journals (Sweden)

    Adèle Lafrance Robinson

    2012-11-01

    Full Text Available Emotion-focused therapy (EFT is an evidence-based treatment for depression and trauma and has shown promise for other presentations including anxiety. Minimal research exists investigating the outcomes of emotion-focused therapy in a group setting. The current research presents a mixed-method single-case study of one client’s experiences and outcomes following a nine-week EFT group for depression and anxiety. Weekly measures of session-feelings evaluations were collected. Follow-up measures, including a qualitative interview, were administered one year post-treatment. Pre-, post-, and follow-up measures assessed depression, anxiety, and emotional regulation. Results showed clinically significant improvements in anxiety, depression, and emotional regulation over time. Indirect and direct evidence of client change were detected. Five super-ordinate themes with sub-themes emerged from the qualitative analysis.

  13. Swiss Armed Forces Organizational Level Leader Development: A Qualitative Case Study

    Science.gov (United States)

    2017-06-09

    author may be protected by more restrictions in their home countries, in which case further publication or sale of copyrighted images is not...of life experience without leaving home or school .”102 Third, Lead. Lead yourself and others like a humble gardener who shapes the ecosystem,103...SWISS ARMED FORCES ORGANIZATIONAL LEVEL LEADER DEVELOPMENT: A QUALITATIVE CASE STUDY A thesis presented to the Faculty of

  14. Bilateral single system ectopic ureters: Case report with literature ...

    African Journals Online (AJOL)

    Bilateral single system ureteral ectopia (BSSEU) is one of the rarest entities in urology, with less than 80 cases reported so far. Incontinence resulting from the underlying anomaly can be devastating to the child. It is generally agreed that suitable urinary continence and long dry intervals are seldom obtainable because of ...

  15. The Use of Qualitative Case Studies as an Experiential Teaching Method in the Training of Pre-Service Teachers

    Science.gov (United States)

    Arseven, Ilhami

    2018-01-01

    This study presents the suitability of case studies, which is a qualitative research method and can be used as a teaching method in the training of pre-service teachers, for experiential learning theory. The basic view of experiential learning theory on learning and the qualitative case study paradigm are consistent with each other within the…

  16. Schizophrenia and common sense: study of 3 single cases.

    Science.gov (United States)

    Naudin, J; Azorin, J; Mishara, A L; Wiggins, O P; Schwartz, M

    2000-01-01

    There is new interest in subjective experiences of schizophrenia. This kind of analysis emphasizes the subjective stories of patients, and the methods do not pretend to have the objectivity of science. However, the plausibility and the empathetic resonance of the single case may bring subjective confirmation to the validity of an insight and indicate new directions of research. Following this line, the authors present a study of 3 single cases of 'reflexive' residual type of schizophrenia. The methods for selecting the cases and the philosophical groundings of the concept of 'reflexive schizophrenia' are explained. The analysis of the single cases revealed that (1) schizophrenic persons' cognitive deficit is related to the constitution of common sense; (2) some schizophrenics cope with the cognitive deficit by creating a theoretical corpus of axioms stemming from common sense, namely the 'axioms of everyday life'; (3) this mechanism of coping is described as an inflexible attachment to 'axioms of everydayness', and (4) this attachment to common sense releases the patient from all personal investment of self in the process of anchoring in the living world and, on this basis, allows a relatively solid, although distant, attachment to reality. The nature of deficit in schizophrenia is also discussed by confronting the phenomenological point of view and the neuropsychological, that is the so-called 'theory of mind'. Copyright 2000 S. Karger AG, Basel.

  17. Capturing Crime: The Qualitative Analysis of Individual Cases for Advancing Criminological Knowledge.

    Science.gov (United States)

    Wright, Kevin A; Bouffard, Leana A

    2016-02-01

    The qualitative analysis of individual cases has a prominent place in the development of criminological theory, yet progression in the scientific study of crime has largely been viewed as a distinctly quantitative endeavor. In the process, much of the theoretical depth and precision supplied by earlier methods of criminological knowledge production have been sacrificed. The current work argues for a return to our criminological roots by supplementing quantitative analyses with the qualitative inspection of individual cases. We provide a specific example of a literature (i.e., criminal specialization/versatility) that has become increasingly quantitative and could benefit from the use of the proposed approach. We conclude by offering additional areas of research that might be advanced by our framework presented here. © The Author(s) 2014.

  18. Qualitative case study research. The case of a Ph.D. research project on organising and managing new product development systems

    NARCIS (Netherlands)

    de Weerd-Nederhof, Petronella C.

    2001-01-01

    Discusses methodological aspects of case study research and qualitative data collection and analysis. Discusses the choice of a research strategy and data collection and analysis methods according to theory as well as the arguments which lead to qualitative case research. Suggests steps in research

  19. Married Black Men’s Opinions as to Why Black Women Are Disproportionately Single: A Qualitative Study

    Science.gov (United States)

    Hurt, Tera R.; McElroy, Stacey E.; Sheats, Kameron J.; Landor, Antoinette M.; Bryant, Chalandra M.

    2015-01-01

    This study’s purpose was to explore the reasons Black women are disproportionately single according to the unique viewpoint of married Black men. The sample comprised 52 married Black men who resided in northeast Georgia (mean age = 43). Qualitative interviews were conducted in 2010 as part of the Pathways to Marriage study. The authors analyzed the data in a collaborative fashion and utilized content analyses to explore the relationships in the data which were derived from qualitative interviews with the men. Findings on the reasons for the disproportionality of singlehood among Black women reflected these four themes: gender relations, marriage education and socialization, individual development, and a preference for gay/lesbian relationships. Recommendations for future research are discussed. PMID:26082674

  20. Physical Activity Experiences and Beliefs among Single Mothers: A Qualitative Study

    Science.gov (United States)

    Dlugonski, Deirdre; Motl, Robert W.

    2016-01-01

    Purpose: Single motherhood has been associated with negative health consequences such as depression and cardiovascular disease. Physical activity might reduce these consequences, but little is known about physical activity experiences and beliefs that might inform interventions and programs for single mothers. The present study used…

  1. Heterophile antibody interference in qualitative urine/serum hCG devices: Case report.

    Science.gov (United States)

    Patel, Khushbu K; Gronowski, Ann M

    2016-06-01

    This case report investigates the origin of a false positive result on a serum qualitative human chorionic gonadotropin (hCG) device. A 46-year-old woman diagnosed with chronic myeloid leukemia presented with nausea and vomiting. A qualitative serum hCG test was interpreted as positive; however, a quantitative serum hCG test was negative (hCG devices composed of antibodies from different animal sources. Blocking reagent from an automated quantitative immunoassay was also tested for its ability to inhibit the heterophile antibody interference. The qualitative test result was negative after pretreatment with heterophilic blocking reagent. Other devices composed of antibodies from different animal sources also demonstrated mixed results with the patient's sample. Blocking reagent obtained from the automated quantitative assay inhibited the heterophile antibody interference in the patient's sample. This case demonstrates that positive serum point-of-care hCG results should be interpreted with caution and confirmed with a quantitative serum hCG immunoassay when clinical suspicion is raised. Copyright © 2016 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.

  2. Single oral paracoccidioidomycosis mimicking other lesions: report of eight cases.

    Science.gov (United States)

    de Oliveira Gondak, Rogério; Mariano, Fernanda Viviane; dos Santos Silva, Alan Roger; Vargas, Pablo Agustin; Lopes, Márcio Ajudarte

    2012-01-01

    Paracoccidioidomycosis is a fungal infection caused by Paracoccidioides brasiliensis. It is an endemic disease, representing a serious health problem in Latin American countries. This infection primarily affects the lungs and is acquired by inhalation of the fungus. It can spread to other organs and tissues, mainly the oral cavity affecting more adult men from 30 to 50 years of age. On clinical presentation, several signs associated with impaired general and nutritional conditions can be noted. Oral manifestation is more common in the soft palate, gingiva, lower lip, buccal mucosa, and tongue. The classical clinical presentation is a superficial ulcer with granular appearance and hemorrhagic points. Usually, the oral lesion is extensive and generalized. Although uncommon, when the oral manifestation is single, others lesions, particularly squamous cell carcinoma, must be included in the differential diagnosis. In this article, the authors discuss the unusual presentation of eight cases of single oral paracoccidioidomycosis and its diagnostic importance.

  3. Variability of writing disorders in Wernicke's aphasia underperforming different writing tasks: A single-case study.

    Science.gov (United States)

    Kozintseva, Elena; Skvortsov, Anatoliy

    2016-03-01

    The aim of our study was to evolve views on writing disorders in Wernicke's agraphia by comparing group data and analysis of a single patient. We showed how a single-case study can be useful in obtaining essential results that can be hidden by averaging group data. Analysis of a single patient proved to be important for resolving contradictions of the "holistic" and "elementaristic" paradigms of psychology and for the development of theoretical knowledge with the example of a writing disorder. The implementation of a holistic approach was undertaken by presenting the tasks differing in functions in which writing had been performed since its appearance in human culture (communicative, mnestic, and regulatory). In spite of the identical composition of involved psychological components, these differences were identified when certain types of errors were analyzed in the single subject. The results are discussed in terms of used writing strategy, resulting in a way of operation of involved components that lead to qualitative and quantitative changes of writing errors within the syndrome of Wernicke's agraphia. © 2016 The Institute of Psychology, Chinese Academy of Sciences and John Wiley & Sons Australia, Ltd.

  4. Considerations in Writing About Single-Case Experimental Design Studies.

    Science.gov (United States)

    Skolasky, Richard L

    2016-12-01

    Single-case experimental design (SCED) studies are particularly useful for examining the processes and outcomes of psychological and behavioral studies. Accurate reporting of SCED studies is critical in explaining the study to the reader and allowing replication. This paper outlines important elements that authors should cover when reporting the results of a SCED study. Authors should provide details on the participant, independent and dependent variables under examination, materials and procedures, and data analysis. Particular emphasis should be placed on justifying the assumptions made and explaining how violations of these assumptions may alter the results of the SCED study.

  5. A Qualitative Case Study on the Implementation of a Priority Seating Program at an NCAA Division I School

    National Research Council Canada - National Science Library

    Delich, Joseph R

    2004-01-01

    ...) athletic department's priority seating program. A qualitative case study was the chosen methodology and the use of personal interviews and documents were the primary sources of evidence for data collection...

  6. Implementation of case studies in undergraduate didactic nursing courses: a qualitative study.

    Science.gov (United States)

    Dutra, Danette K

    2013-07-04

    The implementation of unfolding scenario-based case studies in the didactic classroom is associated with learner-centered education. The utilization of learner-centered pedagogies, such as case studies, removes the focus from the instructor and instead places it on the student. Learner-centered pedagogies are believed to improve students' levels of cognition. The purpose of this study was to examine how nurse educators are implementing the pedagogies of case studies in their undergraduate didactic courses. The goal was to examine, document, report, and, ultimately, implement the strategies. Purposeful sampling was utilized in this qualitative, multisite-designed study. For each of the four participants, three separate site visits were completed. Observations and post-observational interviews took place at each site visit. Transcribed data from interviews, observations, and course documents were imported into the computer program Nvivo8. Repetitive comparative analysis was utilized to complete the data coding process. The guiding research question of this study sought to investigate the implementation strategies of case studies in didactic nursing courses. The implementation of case studies by the participants reflected two primary patterns: Formal Implementation (FI) and Informal Implementation (II) of case studies. The FI of case studies was further divided into two subcategories: Formal Implementation of case studies used Inside the Classroom setting (FIIC) and Formal Implementation of cases studies used Outside of the Classroom (FIOC). Results of this investigation have led to an increased understanding of implementation strategies of unfolding scenario-based case studies in undergraduate nursing didactic courses. Data collected were rich in the description of specific methodologies for utilization of case studies and may serve as a resource for faculty in development of creative strategies to enhance the didactic classroom experience.

  7. Quantitative or qualitative transcriptional diagnostic signatures? A case study for colorectal cancer.

    Science.gov (United States)

    Guan, Qingzhou; Yan, Haidan; Chen, Yanhua; Zheng, Baotong; Cai, Hao; He, Jun; Song, Kai; Guo, You; Ao, Lu; Liu, Huaping; Zhao, Wenyuan; Wang, Xianlong; Guo, Zheng

    2018-01-29

    Due to experimental batch effects, the application of a quantitative transcriptional signature for disease diagnoses commonly requires inter-sample data normalization, which would be hardly applicable under common clinical settings. Many cancers might have qualitative differences with the non-cancer states in the gene expression pattern. Therefore, it is reasonable to explore the power of qualitative diagnostic signatures which are robust against experimental batch effects and other random factors. Firstly, using data of technical replicate samples from the MicroArray Quality Control (MAQC) project, we demonstrated that the low-throughput PCR-based technologies also exist large measurement variations for gene expression even when the samples were measured in the same test site. Then, we demonstrated the critical limitation of low stability for classifiers based on quantitative transcriptional signatures in applications to individual samples through a case study using a support vector machine and a naïve Bayesian classifier to discriminate colorectal cancer tissues from normal tissues. To address this problem, we identified a signature consisting of three gene pairs for discriminating colorectal cancer tissues from non-cancer (normal and inflammatory bowel disease) tissues based on within-sample relative expression orderings (REOs) of these gene pairs. The signature was well verified using 22 independent datasets measured by different microarray and RNA_seq platforms, obviating the need of inter-sample data normalization. Subtle quantitative information of gene expression measurements tends to be unstable under current technical conditions, which will introduce uncertainty to clinical applications of the quantitative transcriptional diagnostic signatures. For diagnosis of disease states with qualitative transcriptional characteristics, the qualitative REO-based signatures could be robustly applied to individual samples measured by different platforms.

  8. Needs in early onset dementia: A qualitative case from the NeedYD study.

    NARCIS (Netherlands)

    Bakker, C.; Vugt, M.E. de; Vernooij-Dassen, M.J.F.J.; Vliet, D. van; Verhey, F.R.J.; Koopmans, R.T.C.M.

    2010-01-01

    OBJECTIVES: The aim was to explore the experiences of a caregiver of a patient with early onset dementia (EOD) and the needs of patient and caregiver. METHODS: A single case study design was used to explore (1) unmet needs of patient and caregiver and (2) caregiver's experiences of transitions in

  9. Single mothering as experienced by Burundian refugees in Australia: a qualitative inquiry.

    Science.gov (United States)

    Tsai, Lily P; Barr, Jennieffer A; Welch, Anthony

    2017-01-01

    Refugee mothers have fled from their homeland to escape persecutions with their children only to find other threats to their well-being in the new country. Building on previous research, it is known that being a new immigrant is challenging and requires adaptation. The adaptation process, known as acculturation, may not be successful leading to psychological distress. It is also known that a generation gap can occur when children acculturate faster than their parents. What was lacking was understanding about the experiences of single refugee mothers. Interpretative phenomenological study was undertaken to explore the lived experiences of eight Burundian refugee single mothers in Australia. Data were collected by in-depth interviews. Each interviews were transcribed and analyzed using thematic analysis. Findings revealed three themes. First theme 'Traditional mothering practices of Burundian culture' illustrated mothering strategies as practiced prior to their arrival in Australia including mothering with sufficient social support, strong position of parents, and regular use of physical disciplining. Second theme 'Challenges identified after arrival to new country' revealed that mothers felt their children acculturated faster than themselves which led to intergenerational gap. This has also led participants to live in a continuous dilemma, experiencing inner conflicts and struggles associated with their mothering practices, especially when mothers had arrived with a lack of knowledge relating to acceptable mothering practices in a new culture. Final theme, 'Reforming family life in Australia' highlighted the decisions made by single refugee mothers which is to embrace both new and original cultures, leading to successful acculturation. However, lack of appropriate knowledge of acceptable mothering practices led to involvement of legal authorities who threatening to remove children from the mother's care. This has led mothers feeling change of power from 'mother to

  10. Nurses' ethical reasoning in cases of physical restraint in acute elderly care: a qualitative study.

    Science.gov (United States)

    Goethals, Sabine; Dierckx de Casterlé, Bernadette; Gastmans, Chris

    2013-11-01

    In their practice, nurses make daily decisions that are ethically informed. An ethical decision is the result of a complex reasoning process based on knowledge and experience and driven by ethical values. Especially in acute elderly care and more specifically decisions concerning the use of physical restraint require a thoughtful deliberation of the different values at stake. Qualitative evidence concerning nurses' decision-making in cases of physical restraint provided important insights in the complexity of decision-making as a trajectory. However a nuanced and refined understanding of the reasoning process in terms of ethical values is still lacking. A qualitative interview design, inspired by the Grounded Theory approach, was carried out to explore nurses' reasoning process in terms of ethical values. We interviewed 21 acute geriatric nurses from 12 hospitals in different regions in Flanders, Belgium in the period October 2009-April 2011. The Qualitative Analysis Guide of Leuven was used to analyse interview data. Nurses' decision-making is characterized as an ethical deliberation process where different values are identified and where the process of balancing these values forms the essence of ethical deliberation. Ethical decision-making in cases of physical restraint implies that nurses have to choose which values receive priority in the process, which entails that not all values can be respected to the same degree. As a result, decision making can be experienced as difficult, even as a dilemma. Driven by the overwhelming goal of protecting physical integrity, nurses took into account the values of dignity and justice more implicitly and less dominantly.

  11. Development of a qualitative exploratory case study research method to explore sustained delivery of cognitive services.

    Science.gov (United States)

    Kaae, Susanne; Søndergaard, Birthe; Haugbølle, Lotte Stig; Traulsen, Janine Morgall

    2010-02-01

    To develop, apply and evaluate a new research method to establish relationships between structural and process elements of the provision of cognitive services. In-depth knowledge about how local organisational structural elements of community pharmacies shape the implementation process of cognitive services is needed to develop targeted quality assurance systems to ensure that the services are continuously provided to the patients who need them. The first publicly reimbursed cognitive service in Denmark, the Inhaler Technique Assessment Service (ITAS) is used as the case. The research method was developed at the Faculty of Pharmaceutical Sciences at the University of Copenhagen and later applied to seven community pharmacies geographically spread around Denmark. A pilot study as well as a subsequent literature review was conducted to determine which structure-process elements to focus on in the research method as well as to select appropriate theories and methods. The developed research method was a qualitative exploratory multi-case study, that was based on method triangulation of field observations, semi-structured interviews, group interviews as well as collection of documentary material. The three main themes of the research method were: the administration of tasks, leadership style and professional values. We integrated the organisational theories of Mintzberg, Bolman and Deal as well as Sørensen to support and clarify the data collection process and analyses. A cross-case analysis and an exploratory contextual analysis relating the leadership style of the pharmacy owner to the ITAS provision were applied to the collected data. The developed qualitative exploratory multi-case study research method was satisfactory with regard to achieving nuanced and in-depth results of some relationships between structural and process elements of provision of cognitive services. The research method can be considered an important supplement to the existing literature on the

  12. An Exploration Study of RimbaIlmu: A Qualitative Evaluation of Shared Single Display Groupware in Sarawak, Malaysia

    Directory of Open Access Journals (Sweden)

    Cheah Waishiang

    2015-02-01

    Full Text Available Shared single display groupware that enables collaboration among people from different cultures and social practices encourages peer learning and teaching, whilst strengthening communication skills. It has been successfully evaluated in remote schools in China and India. Due to this, the question arises whether it can be deployed in rural schools or semi-urban schools in Sarawak? What are the issues and challenges? What are the impact of this technology among the students and teachers? This paper investigates the deployment of shared single display groupware in rural and semi-urban schools in Sarawak (one of the Malaysian states. We introduce a shared single display application, RimbaIlmu, in one semi-urban school and one rural school and conduct qualitative analysis from the observations among the participants. Observational data has shown that RimbaIlmu is able to stimulate collaboration between different genders; an engaging technology among students; a tool for group and individual assessment; a tool to facilitate leadership skills; fun to play with; allows ease of lab management and control; enabling novices to learn computers; promoting membership in collaboration learning and finally provide environment for task accomplishment with minimum teacher intervention.

  13. Single Minute Exchange of Die. A Case Study Implementation

    Directory of Open Access Journals (Sweden)

    António Carrizo Moreira

    2011-03-01

    Full Text Available The Single Minute Exchange of Die (SMED, a process-based innovation originally published in the mid 1980s, involves the separation and conversion of internal setup operations into external ones. Although very important in increasing productivity SMED experiences are not very widespread in Ibero-America. Accordingly, this article has as its main objective to contribute to the literature addressing this less studied topic: SMED. A case study was put forward emphasizing a process-based view. The main finding is that by implementing SMED techniques the firm managed to eliminate wastefulness and non-added value activities worth around 360 000€, which is about 2% of the firm’s sales volume.

  14. Manual therapy treatment of lumbar radiculopathy: A single case report

    OpenAIRE

    J.A. Riley

    2011-01-01

    Patients  with  lumbar  radiculopathy  are  often  managed with  manual therapy.  The  aim  of  this  single  case  study  was  to  describe  the outcome of manual therapy treatment of a patient with lumbar radiculopathy.  A 47-year-old female presented with acute, severe left buttock and postero-lateral thigh pain.  Symptom provocation occurred during lumbar flexion, coughing, sneezing, driving and prolonged sitting. her left straight leg raise neurodynamic test was limited and reproduced he...

  15. Computing tools for implementing standards for single-case designs.

    Science.gov (United States)

    Chen, Li-Ting; Peng, Chao-Ying Joanne; Chen, Ming-E

    2015-11-01

    In the single-case design (SCD) literature, five sets of standards have been formulated and distinguished: design standards, assessment standards, analysis standards, reporting standards, and research synthesis standards. This article reviews computing tools that can assist researchers and practitioners in meeting the analysis standards recommended by the What Works Clearinghouse: Procedures and Standards Handbook-the WWC standards. These tools consist of specialized web-based calculators or downloadable software for SCD data, and algorithms or programs written in Excel, SAS procedures, SPSS commands/Macros, or the R programming language. We aligned these tools with the WWC standards and evaluated them for accuracy and treatment of missing data, using two published data sets. All tools were tested to be accurate. When missing data were present, most tools either gave an error message or conducted analysis based on the available data. Only one program used a single imputation method. This article concludes with suggestions for an inclusive computing tool or environment, additional research on the treatment of missing data, and reasonable and flexible interpretations of the WWC standards. © The Author(s) 2015.

  16. Effects of Single and Combined Application of Organic and Biological Fertilizers on Quantitative and Qualitative Yield of Anisum (Pimpinella anisum

    Directory of Open Access Journals (Sweden)

    N Kamayestani

    2015-07-01

    Full Text Available In order to study the effects of single and combined applications of biofertilazer and organic fertilizers on quantitative and qualitative characteristics of anisum (Pimpinella anisum, an experiment was conducted based on a Randomized Complete Block Design with three replications and fifteen treatments at Research Station, Faculty of Agriculture, Ferdowsi University of Mashhad, Iran, in 2011 year. Treatments were: (1 mycorrhiza (Glomus intraradices, (2 mycorrhiza + cow manure, (3 mycorrhiza + vermicompost, (4 mycorrhiza+ compost, (5 mycorrhiza + chemical fertilizer, (6 biosulfur (Thiobacillus sp. + Bentonite, (7 biosulfur + chemical fertilizer, (8 biosulfur + cow manure, (9 biosulfur + vermicompost, (10 biosulfur+compost,11 (cow manure, (12 vermicompost, (13 chemical fertilizer (NPK, (14compost and (15 control. The results showed that application of fertilizer treatments had significant effect on most characteristics of anisum. The highest number of seed per umbelet (7.24, economic yield (1263.4kg/ha were obtained fram biosulfur treatment. The highest dry matter yield (4504.1 kg/ha resulted from combined application of biosulfur + chemical fertilizer and the highest harvest index (25.97% observed in biosulfur+cow manure. The combined application of mycorrhiza affected some qualification traits, as the highest number of umbel per plant (65.7, 1000 seed-weight (3.24 g and essential oil percentage (5.3% resulted from combined application of mycorrhiza+chemical fertilizer. In general, it can be concluded that application of organic and biological fertilizer particularly mycorrhiza and biosulfur had a significant effect on improving of quantitative and qualitative characteristics of anisum. Furthermore, the combined application of organic and biological fertilizer had higher positive effects than their single application.

  17. Qualitative simulation of bathymetric changes due to reservoir sedimentation: A Japanese case study.

    Directory of Open Access Journals (Sweden)

    Ahmed Bilal

    Full Text Available Sediment-dynamics modeling is a useful tool for estimating a dam's lifespan and its cost-benefit analysis. Collecting real data for sediment-dynamics analysis from conventional field survey methods is both tedious and expensive. Therefore, for most rivers, the historical record of data is either missing or not very detailed. Available data and existing tools have much potential and may be used for qualitative prediction of future bathymetric change trend. This study shows that proxy approaches may be used to increase the spatiotemporal resolution of flow data, and hypothesize the river cross-sections and sediment data. Sediment-dynamics analysis of the reach of the Tenryu River upstream of Sakuma Dam in Japan was performed to predict its future bathymetric changes using a 1D numerical model (HEC-RAS. In this case study, only annually-averaged flow data and the river's longitudinal bed profile at 5-year intervals were available. Therefore, the other required data, including river cross-section and geometry and sediment inflow grain sizes, had to be hypothesized or assimilated indirectly. The model yielded a good qualitative agreement, with an R2 (coefficient of determination of 0.8 for the observed and simulated bed profiles. A predictive simulation demonstrated that the useful life of the dam would end after the year 2035 (±5 years, which is in conformity with initial detailed estimates. The study indicates that a sediment-dynamic analysis can be performed even with a limited amount of data. However, such studies may only assess the qualitative trends of sediment dynamics.

  18. Qualitative and quantitative assessment of single fingerprints in forensic DNA analysis.

    Science.gov (United States)

    Ostojic, Lana; Klempner, Stacey A; Patel, Rosni A; Mitchell, Adele A; Axler-DiPerte, Grace L; Wurmbach, Elisa

    2014-11-01

    Fingerprints and touched items are important sources of DNA for STR profiling, since this evidence can be recovered in a wide variety of criminal offenses. However, there are some fundamental difficulties in working with these samples, including variability in quantity and quality of extracted DNA. In this study, we collected and analyzed over 700 fingerprints. We compared a commercially available extraction protocol (Zygem) to two methods developed in our laboratory, a simple one-tube protocol and a high sensitivity protocol (HighSens) that includes additional steps to concentrate and purify the DNA. The amplification protocols tested were AmpFLSTR® Identifiler® using either 28 or 31 amplification cycles, and Identifiler® Plus using 32 amplification cycles. We found that the HighSens and Zygem extraction methods were significantly better in their DNA yields than the one-tube method. Identifiler® Plus increased the quality of the STR profiles for the one-tube extraction significantly. However, this effect could not be verified for the other extraction methods. Furthermore, microscopic analysis of single fingerprints revealed that some individuals tended to shed more material than others onto glass slides. However, a dense deposition of skin flakes did not strongly correlate with a high quality STR profile. © 2014 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  19. Qualitative case studies of five cochlear implant recipients' experience with music.

    Science.gov (United States)

    Bartel, Lee R; Greenberg, Simon; Friesen, Lendra M; Ostroff, Jodi; Bodmer, Daniel; Shipp, David; Chen, Joseph M

    2011-02-01

    Cochlear implantation has revolutionized the management of those who suffer from severe-to-profound hearing loss because many patients now achieve excellent speech understanding with objective testing. Nevertheless, speech understanding in noisy conditions and music appreciation remain significant challenges to cochlear implant (CI) users. Music appreciation is an extremely complex experience that is difficult to quantify through a conventional outcome study. This paper aims at documenting the experience of five CI patients with regard to music appreciation using qualitative techniques. This information was obtained through a semi-structured interview process. The interviews were then transcribed and analysed using a constant comparative method of qualitative description. The results together with medical case records were used to identify emerging themes. The common themes that evolved were: musical background, the experience of receiving the implant, current experience with music, attention, musical prediction ability, internal hearing, hedonic vs. critical listening, determination, and timbre perception. By documenting their experiences in this manner, novel insights into the patient perspective are provided that are unique to the literature. These descriptions will aid clinicians and researchers who work in the area of cochlear implantation to better understand the needs of their patients.

  20. Battling illness with wellness: a qualitative case study of a young rapper's experiences with music therapy.

    Science.gov (United States)

    Solli, Hans Petter

    2015-07-03

    Mental health difficulties are connected with major interpersonal and social challenges. Recent qualitative research indicates that music therapy can facilitate many of the core elements found to promote social recovery and social inclusion, findings also reflected in results from a growing body of effect studies. The objective of this study was to explore how music therapy might afford possibilities for social recovery to one man with psychosis admitted to a psychiatric intensive care unit. This was achieved by means of a qualitative case study featuring a description of the music therapeutic process alongside first-hand accounts of the participant's subjective experiences. The data were analysed using interpretative phenomenological analysis (IPA). The findings are presented in a narrative form reflecting processes and activities considered particularly important for the process of social recovery. Theoretical perspectives from the recovery literature and current perspectives in music therapy are discussed with a view to the possible use of music therapy for strengthening agency, (re)building identity, developing positive relationships, and expanding social networks.

  1. Understanding girls' enrollment at Louise's Farm School: A qualitative case study

    Science.gov (United States)

    Nowak, Ashley E. P.

    This thesis presents a qualitative case study of enrollment and retention considerations at Louise's Farm School (LFS) in Palmer, Alaska, with a focus on how gender is performed in this domain. Interviews with 25 students, 12 parents, and 14 instructors revealed the enrollment decision-making process, identifying constraints to and enablers of girls' participation. Findings included three primary factors as greatly influencing girls' enrollment: (1) mothers' backgrounds; (2) mothers' knowledge of and the misperceptions regarding outcomes of LFS programing; and (3) girls' interest in LFS curriculum. Findings also exposed differences in mothers' and instructors' expectations for the educative development of girls and boys, suggesting that there is greater pressure on girls to perform academically while boys are expected to need greater space for physical expression.

  2. Case studies of patient interactions, care provision and the impact of emotions: a qualitative study.

    Science.gov (United States)

    Banning, Maggi; Gumley, Virginia

    2013-12-01

    Caring is a complex phenomenon. Nurses aim to relieve patient suffering, acknowledge subjective experiences, display empathy but also manage emotions related to care provision. This study explored nurses' perceptions, experiences and emotions related to caring for cancer patients. This qualitative study used semi-structured interviews to explore the emotions management of 32 nurses working in a cancer hospital in Pakistan. Data saturation occurred after 20 interviews. Three themes emerged from the data related to caring, acknowledgement of patients' feelings, professional behaviour, patient involvement and emotional control. Some nurses repressed their emotions and feelings over patients who had difficulties sustaining hope. In such cases nurses require supportive networks to assist their emotions management and intra-personal skills. Educational support is needed to help nurses express their views in relation to emotional contagion, significance of repressed emotions and to identify supportive ways to assist nurses to communicate their experiences.

  3. Adding to the Truth of the Matter: The Case for Qualitative Research.

    Science.gov (United States)

    Florczak, Kristine L

    2017-10-01

    The purpose of this column is to discuss the impact that qualitative research has on translational research, whose aim is to improve the health and well-being of individuals. To that end, rigorous qualitative research is examined; translational research is entertained and the manner in which qualitative research can be a co-equal partner with quantitative research is proposed.

  4. Toward Eco Product Development with Qualitative and CAE Design Process - Case Study of Flame Guiding Module

    Science.gov (United States)

    Chen, W. L.; Chao, F. L.

    2018-04-01

    Sustainable products become increasingly important for company in addressing eco-performance to satisfy global environmental regulations. Case study of flame guiding module reviewed design process and concerns related to the torch design. For enhancing flame height, the torch was embedded with an airflow guidance structure. The design process and design methodologies were investigated as an eco-design case study. Combine qualitative and CAE simulation were proposed to fulfil its main and auxiliary functions including reduction of impact during use. The design guidelines help prevent mistake arrangements, CAE helps understand combustion phenomenon. The flow field simulation enables fine tune of geometric design. Functional test and measurement are carried out to confirm the product features. On Eco-performance, we choose 5 items for evaluation the status of previous and redesign module, namely function need, low impact material, few manufacturing steps, low energy consumption, and safety. The radar diagram indicates that eco-performance of redesign module is better. Life cycle assessment calculated the carbon footprint of the manufacturing and processing stage with Eco-it. By using recycled steel in the flame module, it reduces raw material stage carbon footprint significantly.

  5. Priority-setting and hospital strategic planning: a qualitative case study.

    Science.gov (United States)

    Martin, Douglas; Shulman, Ken; Santiago-Sorrell, Patricia; Singer, Peter

    2003-10-01

    To describe and evaluate the priority-setting element of a hospital's strategic planning process. Qualitative case study and evaluation against the conditions of 'accountability for reasonableness' of a strategic planning process at a large urban university-affiliated hospital. The hospital's strategic planning process met the conditions of 'accountability for reasonableness' in large part. Specifically: the hospital based its decisions on reasons (both information and criteria) that the participants felt were relevant to the hospital; the number and type of participants were very extensive; the process, decisions and reasons were well communicated throughout the organization, using multiple communication vehicles; and the process included an ethical framework linked to an effort to evaluate and improve the process. However, there were opportunities to improve the process, particularly by giving participants more time to absorb the information relevant to priority-setting decisions, more time to take difficult decisions and some means to appeal or revise decisions. A case study linked to an evaluation using 'accountability for reasonableness' can serve to improve priority-setting in the context of hospital strategic planning.

  6. Multipurpose internal retractor for Single-incision surgery (SIS): single-institution case series.

    Science.gov (United States)

    Galvani, Carlos A; Garza, Ulises; Echeverria, Angela; Kaul, Amit; Samamé, Julia

    2014-04-01

    Single-incision laparoscopic surgery (SIS) is less invasive than standard laparoscopic surgery; however, it is more difficult due to restriction of motion and the impossibility to use assistants. To overcome these obstacles, we developed a self-sustaining multipurpose internal retractor by attaching a Lone Star retractor hook to a laparoscopic bulldog clamp. Herein, we report our SIS experience using our novel retractor. Between October 2008 and April 2011, 104 patients underwent SIS using the internal retractor: 67 bandings (43% simultaneous hiatal hernia repair), 8 sleeve gastrectomies, 27 cholecystectomies, and 2 Nissen fundoplication. Mean age was 40 (range, 21 to 85) and mean body mass index was 40 kg/m (range, 20 to 64 kg/m). No intraoperative complications were observed from the use of the retractor but 2 cases required additional retraction due to liver size. This retractor has been successfully used for different SIS procedures showing to be safe, adaptable, and easy to use, lessening some challenges of SIS.

  7. Stakeholder perceptions of communication about vaccination in two regions of Cameroon: A qualitative case study.

    Directory of Open Access Journals (Sweden)

    Heather Ames

    Full Text Available Understanding stakeholders' (parents', communities' and health workers' perspectives of communication about childhood vaccination, including their preferences for its format, delivery and content, is an important step towards designing better communication strategies and ensuring more informed parents. Our objectives were to explore stakeholders' views, experiences and preferences for childhood vaccination communication in Cameroon.In 2014, in the Central and North West Regions of Cameron, we gathered qualitative data for our case study using the following methods: semi structured interviews; observations and informal conversations during routine immunization clinics and three rounds of the National Polio Immunization Campaign; document analysis of reports and mass media communications about vaccination; and a survey of parents. We conducted a thematic analysis of the qualitative data to identify themes relating to views, experiences and perceptions of vaccination information and its delivery. Survey data were analysed using simple descriptive statistics.All of the parents interviewed felt that vaccinating their child was important, and trusted the information provided by health workers. However, many parents wanted more information. Parents did not always feel that they could ask questions during vaccination appointments. All participants felt that health workers and vaccination clinics were important sources of information. Social mobilisation activities such as door-to-door visits and announcements during religious services were important and accepted ways of communicating information, especially during vaccination campaigns. Information communicated through mass media and text messages was also seen as important. In general, stakeholders believed that more consistent messaging about routine vaccination through community channels would be helpful to remind parents of the importance of routine vaccination during ongoing rounds of vaccination

  8. Stakeholder perceptions of communication about vaccination in two regions of Cameroon: A qualitative case study.

    Science.gov (United States)

    Ames, Heather; Njang, Diangha Mabel; Glenton, Claire; Fretheim, Atle; Kaufman, Jessica; Hill, Sophie; Oku, Afiong; Cliff, Julie; Cartier, Yuri; Bosch-Capblanch, Xavier; Rada, Gabriel; Muloliwa, Artur Manuel; Oyo-Ita, Angela; Kum, Awah Paschal; Lewin, Simon

    2017-01-01

    Understanding stakeholders' (parents', communities' and health workers') perspectives of communication about childhood vaccination, including their preferences for its format, delivery and content, is an important step towards designing better communication strategies and ensuring more informed parents. Our objectives were to explore stakeholders' views, experiences and preferences for childhood vaccination communication in Cameroon. In 2014, in the Central and North West Regions of Cameron, we gathered qualitative data for our case study using the following methods: semi structured interviews; observations and informal conversations during routine immunization clinics and three rounds of the National Polio Immunization Campaign; document analysis of reports and mass media communications about vaccination; and a survey of parents. We conducted a thematic analysis of the qualitative data to identify themes relating to views, experiences and perceptions of vaccination information and its delivery. Survey data were analysed using simple descriptive statistics. All of the parents interviewed felt that vaccinating their child was important, and trusted the information provided by health workers. However, many parents wanted more information. Parents did not always feel that they could ask questions during vaccination appointments. All participants felt that health workers and vaccination clinics were important sources of information. Social mobilisation activities such as door-to-door visits and announcements during religious services were important and accepted ways of communicating information, especially during vaccination campaigns. Information communicated through mass media and text messages was also seen as important. In general, stakeholders believed that more consistent messaging about routine vaccination through community channels would be helpful to remind parents of the importance of routine vaccination during ongoing rounds of vaccination campaigns against

  9. Manual therapy treatment of lumbar radiculopathy: A single case report

    Directory of Open Access Journals (Sweden)

    J.A. Riley

    2011-01-01

    Full Text Available Patients  with  lumbar  radiculopathy  are  often  managed with  manual therapy.  The  aim  of  this  single  case  study  was  to  describe  the outcome of manual therapy treatment of a patient with lumbar radiculopathy.  A 47-year-old female presented with acute, severe left buttock and postero-lateral thigh pain.  Symptom provocation occurred during lumbar flexion, coughing, sneezing, driving and prolonged sitting. her left straight leg raise neurodynamic test was limited and reproduced her pain, as did trigger points in the left lumbar and gluteal muscles. clinical neuro-conduction testing revealed weakness of the big and other toe extensors, as well as eversion and plantar flexion of the left ankle, and a diminished left ankle reflex. This indicated possible involvement of both the l5 and S1 nerve roots.   A  manual  therapy  treatment  approach including  lumbar rotation mobilisations (Maitland approach, massage, trigger point pressure release  and  Transversus  Abdominus muscle activation  was  used.   The  patient  was  symptom  free,  had  full pain-free  range  of  all  lumbar  movements,  a full  pain-free  left  straight leg  raise  neurodynamic  test  and  normal  neurological  conduction  six weeks  after  onset, following seven manual therapy treatments.  Although the results of this case report cannot be generalised, it describes the successful outcome of a patient with severe radicular pain and neurological deficits, whose signs and symptoms  had completely resolved following manual therapy treatment.

  10. How Single-Parent Children Speak about Poverty and Social Exclusion: Policy Implications from a Comparative, Qualitative, Cross-National Project

    Science.gov (United States)

    Spyrou, Spyros

    2013-01-01

    This article presents some of the key findings from a comparative, qualitative research study carried out in the United Kingdom, Greece, and Cyprus. The main goal of the study was to investigate single-parent children's experiences and understandings of poverty and social exclusion in their everyday lives and to make relevant policy…

  11. How Beginning Secondary Teachers Understand and Enact Academic Literacies in Their Classrooms: A Qualitative Multi-Case Study

    Science.gov (United States)

    Hawley, Cassandra Helen

    2010-01-01

    Significant numbers of secondary school students are failing to acquire advanced literacies that will enable them to move on to higher levels of education, to be successful in the workforce, and to participate in a democracy. This qualitative multi-case study was designed to explore new teachers' understandings and enactments with academic…

  12. A Qualitative Exploration of Multiple Case Studies of the Perception of School Social Workers Concerning Their Roles in Public Schools

    Science.gov (United States)

    Morrison, Alesha Nicole

    2016-01-01

    This qualitative exploration in the form of multiple case studies interviewed a group of seven social workers from the St. Louis Metropolitan area to gain their perception as school social workers concerning their roles in public schools. The literature on school social workers indicated that school social workers brought unique knowledge and…

  13. The Educational Needs of and Barriers Faced by Syrian Refugee Students in Turkey: A Qualitative Case Study

    Science.gov (United States)

    Aydin, Hasan; Kaya, Yeliz

    2017-01-01

    The purpose of this study is to explore the educational status of Syrian refugees in Turkish schools, and the perspectives of teachers and school principals regarding the needs of Syrian refugee students in two inner-city elementary schools in Istanbul, Turkey. A qualitative interpretive case study method was employed. Eight participants (seven…

  14. Engaged Scholarship in Partnership with a Local Hospice: A Qualitative Case Study in a Radiation Therapy Classroom

    Science.gov (United States)

    Trad, Megan

    2012-01-01

    This qualitative case study focuses on providing answers to the following research questions. How do radiation therapy students respond to the implementation of an engaged scholarship partnership with the local hospice in relation to educational gains, experiential learning, transformational learning, and professional growth? This question is…

  15. Rationales Shaping International Linkages in Higher Education: A Qualitative Case Study of the ASU-ITESM Strategic Alliance

    Science.gov (United States)

    Camacho Lizarraga, Monica Irene

    2011-01-01

    This qualitative case study examines the rationales of the relationship between Arizona State University (ASU)--an American public research university--and Tecnologico de Monterrey (ITESM), a Mexican private not for profit research university. The focus of the study is to document the different meanings participants attached to the rationales of…

  16. Program Outcomes Assessment in Higher Education Hospitality Management Programs: A Qualitative Comparative Case Study of Learning Cultures

    Science.gov (United States)

    Hughes, John George

    2010-01-01

    The purpose of this qualitative, comparative case study was to determine the extent to which learning and improvement cultures were perceived to be linked to the traditional and non-traditional accreditation and Program Outcomes Assessment paradigms in use in two university hospitality programs. The findings of this study revealed that the…

  17. Bilingual Education in English-Only: A Qualitative Case Study of Language Policy in Practice at Lincoln Elementary School

    Science.gov (United States)

    Colón, Ingrid; Heineke, Amy J.

    2015-01-01

    In this qualitative case study, we investigate teachers' appropriation of language policy at one urban elementary school in Illinois. Recognizing classroom teachers' central role in the education of English learners, we probe teachers' policy appropriation, or how bilingual educators take state-, district-, and school-level policies and…

  18. Electroconvulsive therapy in single manic episodes: a case series ...

    African Journals Online (AJOL)

    Objective: To evaluate the effectiveness of electroconvulsive therapy in the treatment of Bipolar I Disorder patients with a single manic episode. Method: In a retrospective study, we reviewed medical records of inpatients who had been admitted to treat a single manic episode of Bipolar I Disorder at Noor University Hospital, ...

  19. Triple dens invaginatus in a single tooth: Rarest of rare case report.

    Science.gov (United States)

    Chhina, Amandeep; Chhina, Kamalpreet; Kaushal, Nitin; Walia, Ira

    2017-01-01

    Dens invaginatus is a rare malformation affecting the teeth. The teeth that are most commonly affected are the permanent maxillary lateral incisors. The mandibular posterior teeth are rarely affected by dens invaginatus. In most of the cases, a single dens invaginatus is seen affecting the tooth. Cases of double dens invaginatus affecting a single tooth are rare, and those of triple dens invaginatus in a single tooth are even rarer. Here, we present a case of a 14-year-old where three dens invaginatus were seen in the mandibular second premolar. This is the fourth case of three dens invaginatus in a single tooth as only three have been reported previously.

  20. Employee motivation of senior engineers in aerospace companies in southern California: A qualitative case study

    Science.gov (United States)

    Banh, My-Le

    The purpose of this qualitative exploratory case study was to explore the lack of motivation of engineers with more than 15 years of experience working in aerospace companies in southern California. The sample size for this study consisted of 18 senior engineers. These participants held either a bachelor's or master's degree in engineering fields. Participants were recruited through networking with colleagues and snowball sampling. The data was collected through face-to-face and phone interviews. Participants also had the opportunity to review their responses after the interview. The data analysis resulted in 12 themes regarding the participants' perception of motivation. The top six predominant themes were (1) challenging and new assignments, (2) commitment, (3) opportunity, (4) supporting from managers, (5) team spirit, and (6) open communication. The study resulted in an in-depth understanding of how important motivation is to senior engineers. Based on the findings, leaders should create opportunities for senior employees to work on challenging assignments, acquire autonomy, and obtain more responsibilities. Providing such opportunities may motivate employees to perform well and committee with the organizations.

  1. Structuring and coding in health care records: a qualitative analysis using diabetes as a case study

    Directory of Open Access Journals (Sweden)

    Ann R R Robertson

    2015-03-01

    Full Text Available Background   Globally, diabetes mellitus presents a substantial burden to individuals and healthcare systems. Structuring and/or coding of medical records underpin attempts to improve information sharing and searching, potentially bringing clinical and secondary uses benefits.Aims and objectives   We investigated if, how and why records for adults with diabetes were structured and/or coded, and explored stakeholders’ perceptions of current practice.Methods   We carried out a qualitative, theoretically-informed case study of documenting healthcare information for diabetes patients in family practice and hospital settings, using semi-structured interviews, observations, systems demonstrations and documentary data.Results   We conducted 22 interviews and four on-site observations, and reviewed 25 documents. For secondary uses – research, audit, public health and service planning – the benefits of highly structured and coded diabetes data were clearly articulated. Reported clinical benefits in terms of managing and monitoring diabetes, and perhaps encouraging patient self-management, were modest. We observed marked differences in levels of record structuring and/or coding between settings, and found little evidence that these data were being exploited to improve information sharing between them.Conclusions   Using high levels of data structuring and coding in medical records for diabetes patients has potential to be exploited more fully, and lessons might be learned from successful developments elsewhere in the UK.

  2. Complex young lives: a collective qualitative case study analysis of young fatherhood and breastfeeding.

    Science.gov (United States)

    Ayton, Jennifer; Hansen, Emily

    2016-01-01

    Of all births in Australia, 10 % are to young fathers aged less than 24 years. How young fathers experience any breastfeeding and how this is shaped by their social context is poorly understood. Our aim is to increase understanding of the lived experience of young fathers (aged less than 24 years) and to explore the way they speak about breastfeeding in the context of their lives and parenting. This collective case study analysis uses qualitative data from interviews and focus groups with young fathers (aged less than 24 years) and community support staff. The research was undertaken in Tasmania, Australia, March to December 2013. Young fathers in our study had complex social and emotional circumstances that meant breastfeeding was not a high priority despite them valuing the health benefits of breastfeeding for their babies. If supported by peers and their community they appear to have a more positive parenting experience. Breastfeeding although understood by the young fathers in our study as healthy and desirable is not a priority in their lives. Learning to be a parent and support their partners to breastfeed may be more effectively gained through mentoring and father-to-father localized community based support services.

  3. Not so ‘invisible’: A Qualitative Case Study Exploring Gender Relations and Farm Management Software

    Directory of Open Access Journals (Sweden)

    Dale Carolyn Mackrell

    2010-01-01

    Full Text Available This qualitative case study explored farm management practices by women cotton growers who used computer-based information systems, most particularly the agricultural farm management software, CottonLOGIC, within the Australian cotton industry. This study found that, although gender differences and inequalities persist in rural parts of the region, the agency of women cotton growers ensures not only a sustainable future for themselves and their families, but also for the broader cotton industry as a whole. The use of farm management software by women cotton farmers was informed by Connell’s theoretical framework of gender relations (2002. The findings suggested that, women’s active participation in family farm partnerships and their acquisition of technological skills through the use of farm management software like CottonLOGIC, meant that all cotton growers benefit through the feminizing of specific farm management practices in family farm enterprises. This, therefore, has significant implications for developing the cotton industry into a truly sustainable entity.

  4. Supportive Communication to Facilitate Chinese Patients' Adaptation to a Permanent Colostomy: A Qualitative Case Study Approach.

    Science.gov (United States)

    Tao, Hui; Songwathana, Praneed; Isaramalai, Sang-Arun; Wang, Qingxi

    2016-01-01

    This study, which is a part of action research, aims to explore how supportive communication can impact individuals' adaptation to a permanent colostomy in a Chinese cultural context. Two Chinese rectal cancer patients with complexity and difficulty in living with a permanent colostomy were selected using a qualitative case study approach. The researcher (H.T.) interacted with the participants along their journey from the preoperative period until the third postoperative month after discharge via face-to-face or telephone interviews. Content analysis was applied. Supportive communication was characterized by "communication as a supportive tool," which consisted of 4 elements: respect, description, empathy, and empowerment. The nursing strategies included (1) developing a collaborative relationship with patients and families; (2) understanding patients' concerns and problems; (3) discussing potential solutions; (4) encouraging patients to take action; (5) bringing out emotional expression; (6) normalizing negative emotions; and (7) protecting hope. The findings of this study informed that supportive communication is a valuable tool for nurses to provide informational and emotional support to Chinese patients in order to enhance their adaptation to living with a permanent colostomy. Developing an operational manual to enhance supportive communication for patients with colostomy is suggested.

  5. Supraventricular tachycardia during pediatric anesthesia: a case series and qualitative analysis.

    Science.gov (United States)

    Cripe, Chad C; Patel, Akash R; Markowitz, Scott D; Behringer, Tiffany S; Litman, Ronald S

    2014-06-01

    To perform a qualitative analysis of noncardiac patients who developed suspected intraoperative supraventricular tachycardia (SVT) during general anesthesia. Retrospective database analysis and chart review. Operating room of a university-affiliated children's hospital. The records of children without cardiac disease who received general anesthesia at The Children's Hospital of Philadelphia from July 1998 through June 2011 were reviewed. Patients with heart rate values above 180 beats per minute were identified, as were specific medications or key words in the free-text fields of the anesthesia records that would be indicative of a tachyarrhythmia. Each case was reviewed by at least two authors; each patient was assigned a diagnosis classification of "highly suspicious" or "unlikely" SVT. The highly suspicious SVT cases were examined in detail to determine the specific aims. 36 subjects out of a total of 285,353 anesthetics administered during the study period were suspected by the anesthesia care team to have had an episode of intraoperative SVT: 22 were "highly suspicious" events, and 14 were "unlikely" events. The highly suspicious SVT events occurred in all phases of anesthesia, and none led to any hemodynamic instability. Effective treatments included vagal maneuvers, pharmacologic antiarrhythmics, or no treatment if the event resolved spontaneously before treatment. Six patients had outpatient follow-up and three received antiarrhythmic medications to control ongoing SVT. SVT during the intraoperative period in noncardiac pediatric patients was uncommon. When it occurred, it was not associated with clinically significant patient morbidity. For some patients, the anesthesia unmasked a predisposition for re-entrant SVT and those patients remained on maintenance antiarrhythmic therapy following discharge home. Copyright © 2014 Elsevier Inc. All rights reserved.

  6. A qualitative case study to identify possible barriers that limit effective elementary science education

    Science.gov (United States)

    Foster, Donald Carey

    The purpose of this case study was to identify barriers that limit the effectiveness of elementary teachers in the teaching of science. It is of the utmost urgency that barriers be first identified, so that possible solutions can be explored to bring about the improvement of elementary science education. This urgency has been imposed by the scheduled national testing of students in science by 2007, as mandated by the No Child Left Behind Act of 2001. Using qualitative case study methods, the researcher conducted interviews with 8 elementary teachers from two schools within one school district who taught 3rd, 4th, and 5th grade. These interviews were designed to gain insight into barriers these elementary teachers perceived as factors limiting their effectiveness in teaching science and preparing students for high-stakes testing. Barriers in the areas of teacher background, typical teaching day, curriculum, inservices, and legislative influences were explored. This study concluded that the barriers explored do have a substantial negative affect on the teaching and learning of science in the elementary grades. Specifically, the barriers revealed in this study include the limited science background of elementary teachers, inadequate class time devoted to science, non-comprehensive curriculum, ineffective or lack of inservice training, and pressures from legislated mandates. But it is also clear that these barriers are so intertwined that one cannot remove these barriers one at a time. It will take a collective effort from all involved, including legislators, administrators, teachers, parents, and students, to alleviate these barriers and discover effective solutions to improve elementary science education.

  7. Navigating the complexities of qualitative comparative analysis: case numbers, necessity relations, and model ambiguities.

    Science.gov (United States)

    Thiem, Alrik

    2014-12-01

    In recent years, the method of Qualitative Comparative Analysis (QCA) has been enjoying increasing levels of popularity in evaluation and directly neighboring fields. Its holistic approach to causal data analysis resonates with researchers whose theories posit complex conjunctions of conditions and events. However, due to QCA's relative immaturity, some of its technicalities and objectives have not yet been well understood. In this article, I seek to raise awareness of six pitfalls of employing QCA with regard to the following three central aspects: case numbers, necessity relations, and model ambiguities. Most importantly, I argue that case numbers are irrelevant to the methodological choice of QCA or any of its variants, that necessity is not as simple a concept as it has been suggested by many methodologists, and that doubt must be cast on the determinacy of virtually all results presented in past QCA research. By means of empirical examples from published articles, I explain the background of these pitfalls and introduce appropriate procedures, partly with reference to current software, that help avoid them. QCA carries great potential for scholars in evaluation and directly neighboring areas interested in the analysis of complex dependencies in configurational data. If users beware of the pitfalls introduced in this article, and if they avoid mechanistic adherence to doubtful "standards of good practice" at this stage of development, then research with QCA will gain in quality, as a result of which a more solid foundation for cumulative knowledge generation and well-informed policy decisions will also be created. © The Author(s) 2014.

  8. Influence of primary care practices on patients’ uptake of diabetic retinopathy screening: a qualitative case study

    Science.gov (United States)

    Lindenmeyer, Antje; Sturt, Jackie A; Hipwell, Alison; Stratton, Irene M; al-Athamneh, Nidal; Gadsby, Roger; O’Hare, Joseph Paul; Scanlon, Peter H

    2014-01-01

    Background The NHS Diabetic Eye Screening Programme aims to reduce the risk of sight loss among people with diabetes in England by enabling prompt diagnosis of sight-threatening retinopathy. However, the rate of screening uptake between practices can vary from 55% to 95%. Existing research focuses on the impact of patient demographics but little is known about GP practice-related factors that can make a difference. Aim To identify factors contributing to high or low patient uptake of retinopathy screening. Design and setting Qualitative case-based study; nine purposively selected GP practices (deprived/affluent; high/low screening uptake) in three retinopathy screening programme areas. Methods Semi-structured interviews were conducted with patients, primary care professionals, and screeners. A comparative case-based analysis was carried out to identify factors related to high or low screening uptake. Results Eight possible factors that influenced uptake were identified. Five modifiable factors related to service and staff interactions: communication with screening services; contacting patients; integration of screening with other care; focus on the newly diagnosed; and perception of non-attenders. Three factors were non-modifiable challenges related to practice location: level of deprivation; diversity of ethnicities and languages; and transport and access. All practices adopted strategies to improve uptake, but the presence of two or more major barriers made it very hard for practices to achieve higher uptake levels. Conclusions A range of service-level opportunities to improve screening attendance were identified that are available to practices and screening teams. More research is needed into the complex interfaces of care that make up retinopathy screening. PMID:25071061

  9. Influence of primary care practices on patients' uptake of diabetic retinopathy screening: a qualitative case study.

    Science.gov (United States)

    Lindenmeyer, Antje; Sturt, Jackie A; Hipwell, Alison; Stratton, Irene M; Al-Athamneh, Nidal; Gadsby, Roger; O'Hare, Joseph Paul; Scanlon, Peter H

    2014-08-01

    The NHS Diabetic Eye Screening Programme aims to reduce the risk of sight loss among people with diabetes in England by enabling prompt diagnosis of sight-threatening retinopathy. However, the rate of screening uptake between practices can vary from 55% to 95%. Existing research focuses on the impact of patient demographics but little is known about GP practice-related factors that can make a difference. To identify factors contributing to high or low patient uptake of retinopathy screening. Qualitative case-based study; nine purposively selected GP practices (deprived/affluent; high/low screening uptake) in three retinopathy screening programme areas. Semi-structured interviews were conducted with patients, primary care professionals, and screeners. A comparative case-based analysis was carried out to identify factors related to high or low screening uptake. Eight possible factors that influenced uptake were identified. Five modifiable factors related to service and staff interactions: communication with screening services; contacting patients; integration of screening with other care; focus on the newly diagnosed; and perception of non-attenders. Three factors were non-modifiable challenges related to practice location: level of deprivation; diversity of ethnicities and languages; and transport and access. All practices adopted strategies to improve uptake, but the presence of two or more major barriers made it very hard for practices to achieve higher uptake levels. A range of service-level opportunities to improve screening attendance were identified that are available to practices and screening teams. More research is needed into the complex interfaces of care that make up retinopathy screening. © British Journal of General Practice 2014.

  10. Challenges facing translational research organizations in China: a qualitative multiple case study

    Science.gov (United States)

    2013-01-01

    Background Translational medicine is attracting much attention worldwide and many translational research organizations (TROs) have been established. In China, translational medicine has developed rapidly, but faces many challenges. This study was aimed at exploring these challenges faced by emerging TROs in China. Method A qualitative, multiple case study approach was used to assess the challenges faced by TROs in China. Data were collected between May and August 2012. Results Eight cases were identified. Overall, four themes that characterized TROs in China emerged from analyses: 1. objectives, organizer, and funding resources, 2. participating partners and research teams, 3. management, and 4. achievements. All TROs had objectives related to translating basic discovery to clinic treatment and cultivating translational researchers. In terms of organizer and funding resources, 7 out of 8 TROs were launched only by universities and/or hospitals, and funded mostly through research grants. As for participating partners and multidisciplinary research teams, all but one of the TROs only involved biomedical research institutions who were interested in translational research, and characterized as clinical research centers; 7 out of 8 TROs involved only researchers from biomedicine and clinical disciplines and none involved disciplines related to education, ethnicity, and sociology, or engaged the community. Current management of the TROs were generally nested within the traditional research management paradigms, and failed to adapt to the tenets of translational research. Half of the TROs were at developmental stages defined as infrastructure construction and recruitment of translational researchers. Conclusions TROs in China face the challenge of attracting sustainable funding sources, widening multidisciplinary cooperation, cultivating multi-disciplinary translational researchers and adapting current research management to translational research. Greater emphasis should

  11. Collecting and analyzing qualitative data: Hermeneutic principles, methods and case examples

    Science.gov (United States)

    Michael E. Patterson; Daniel R. Williams

    2002-01-01

    Over the past three decades, the use of qualitative research methods has become commonplace in social science as a whole and increasingly represented in tourism and recrearion research. In tourism, for example, Markwell and Basche (1998) recently noted the emergence of a pluralistic perspective on science and the growth of research employing qualitative frameworks....

  12. Using Generic Inductive Approach in Qualitative Educational Research: A Case Study Analysis

    Science.gov (United States)

    Liu, Lisha

    2016-01-01

    Qualitative research strategy has been widely adopted by educational researchers in order to improve the quality of their empirical studies. This paper aims to introduce a generic inductive approach, pragmatic and flexible in qualitative theoretical support, by describing its application in a study of non-English major undergraduates' English…

  13. Primary mandibular first molar with single root and single canal: a case report of a rare morphology.

    Directory of Open Access Journals (Sweden)

    Zahra Bahrololoomi

    2014-06-01

    Full Text Available Single rooted primary mandibular first molar is a rare developmental anomaly. Literatures reveal that failure of invagination of Hertwig's epithelial root sheath leads to this unusual root form. Thorough knowledge of root canal morphology and anatomical variations of primary teeth can help a pediatric dentist in successful root canal treatment. Hereby, we describe two cases of primary mandibular first molars with an unusual morphology as a single root called pyramidal molar.

  14. Qualitative Work and the Testing and Development of Theory: Lessons from a Study Combining Cross-Case and Within-Case Analysis via Ragin's QCA

    Directory of Open Access Journals (Sweden)

    Barry Cooper

    2012-03-01

    Full Text Available Charles RAGIN's work, especially his development of Qualitative Comparative Analysis (QCA, offers social scientists a way of bringing together the strengths of the qualitative and quantitative traditions. QCA takes a case-based rather than a variable-based analytic approach to cross-case analysis. One problem that arises in attempting to use QCA to explore causation in larger datasets, especially survey datasets, is that the detailed case knowledge available to those working in the qualitative tradition is usually unavailable. In the same way therefore that it can be difficult to establish causation from correlational analyses, the derivation of causal claims from QCA analyses can also be problematic. We discuss these problems in detail and then argue that they can be addressed by using QCA to identify particular types of cases for detailed within-case analysis focusing on causal processes. More specifically, we show how such in-depth, within-case analysis can identify factors that can be used to improve QCA models, including those used to select these cases for analysis. We illustrate this particular mode of combining methods by drawing on our work on educational transitions in Germany, drawing on both the German Socio-Economic Panel (SOEP dataset and 43 individual interviews with German 17-year olds. URN: http://nbn-resolving.de/urn:nbn:de:0114-fqs120247

  15. Process-experiential/emotion-focused therapy for social anxiety: a Hermeneutic Single-Case Efficacy Design study.

    Science.gov (United States)

    MacLeod, Rachel; Elliott, Robert; Rodgers, Brian

    2012-01-01

    Social Anxiety (SA) is a common and debilitating problem. Although a range of therapies have been applied to treat SA, only a narrow range of these has been researched to date. In this study, Hermeneutic Single Case Efficacy Design (HSCED) was used to investigate Process-Experiential/Emotion-Focused Therapy (PE-EFT) with a socially isolated client with Social Anxiety. Using a combination of qualitative and quantitative data, we constructed a rich case record and a set of documents arguing for and against client change; these were judged by three graduate student peer judges. The judges found the client to have changed substantially over the first 16 sessions of therapy, and PE-EFT was found to have contributed substantially to this change.

  16. High-performance work systems in health care management, part 2: qualitative evidence from five case studies.

    Science.gov (United States)

    McAlearney, Ann Scheck; Garman, Andrew N; Song, Paula H; McHugh, Megan; Robbins, Julie; Harrison, Michael I

    2011-01-01

    : A capable workforce is central to the delivery of high-quality care. Research from other industries suggests that the methodical use of evidence-based management practices (also known as high-performance work practices [HPWPs]), such as systematic personnel selection and incentive compensation, serves to attract and retain well-qualified health care staff and that HPWPs may represent an important and underutilized strategy for improving quality of care and patient safety. : The aims of this study were to improve our understanding about the use of HPWPs in health care organizations and to learn about their contribution to quality of care and patient safety improvements. : Guided by a model of HPWPs developed through an extensive literature review and synthesis, we conducted a series of interviews with key informants from five U.S. health care organizations that had been identified based on their exemplary use of HPWPs. We sought to explore the applicability of our model and learn whether and how HPWPs were related to quality and safety. All interviews were recorded, transcribed, and subjected to qualitative analysis. : In each of the five organizations, we found emphasis on all four HPWP subsystems in our conceptual model-engagement, staff acquisition/development, frontline empowerment, and leadership alignment/development. Although some HPWPs were common, there were also practices that were distinctive to a single organization. Our informants reported links between HPWPs and employee outcomes (e.g., turnover and higher satisfaction/engagement) and indicated that HPWPs made important contributions to system- and organization-level outcomes (e.g., improved recruitment, improved ability to address safety concerns, and lower turnover). : These case studies suggest that the systematic use of HPWPs may improve performance in health care organizations and provide examples of how HPWPs can impact quality and safety in health care. Further research is needed to specify

  17. The Single-Case Reporting Guideline in BEhavioural Interventions (SCRIBE) 2016 Statement

    Science.gov (United States)

    Tate, Robyn L.; Perdices, Michael; Rosenkoetter, Ulrike; Shadish, William; Vohra, Sunita; Barlow, David H.; Horner, Robert; Kazdin, Alan; Kratochwill, Thomas; McDonald, Skye; Sampson, Margaret; Shamseer, Larissa; Togher, Leanne; Albin, Richard; Backman, Catherine; Douglas, Jacinta; Evans, Jonathan J.; Gast, David; Manolov, Rumen; Mitchell, Geoffrey; Nickels, Lyndsey; Nikles, Jane; Ownsworth, Tamara; Rose, Miranda; Schmid, Christopher H.; Wilson, Barbara

    2016-01-01

    We developed a reporting guideline to provide authors with guidance about what should be reported when writing a paper for publication in a scientific journal using a particular type of research design: the single-case experimental design. This report describes the methods used to develop the Single-Case Reporting guideline In BEhavioural…

  18. When trauma, spirituality, and mental illness intersect: A qualitative case study.

    Science.gov (United States)

    Starnino, Vincent R

    2016-05-01

    Studies have identified spirituality to be a helpful resource for dealing with various types of trauma experiences. This coincides with a heightened focus on the role of spirituality within trauma-related theory (e.g., spiritual coping, meaning-making, and posttraumatic growth). Little remains known, however, about the relationship between trauma and spirituality among people with severe psychiatric disorders. Meanwhile, a high percentage of those with psychiatric disabilities are known to have trauma histories, whereas a majority self-identify as spiritual and/or religious. Two cases from a hermeneutic phenomenological qualitative study of people with co-occurring psychiatric disabilities and trauma histories are highlighted. Themes related to trauma and spirituality are discussed in-depth. Study participants drew upon a variety of spiritual coping strategies (e.g., prayer, meditation, spiritual readings) to help deal with trauma experiences. Participants additionally experienced spiritual struggles-a detailed account is given of a participant who was able to work through such struggles by shifting to a less self-blaming spiritual worldview (e.g., shifted from believing in a "punishing God" to viewing oneself as part of "oneness with humanity"). The study also examined the meaning-making process and shows how concepts such as global and appraised meaning-making are applicable to people with psychiatric disabilities. Finally, unique challenges related to posttraumatic growth are discussed (e.g., intrusive ruminations and "voices" with spiritual themes). This study offers useful examples of how spirituality and trauma can impact one another, and how people with psychiatric disabilities draw upon spirituality to cope as they strive for recovery. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  19. Structuring and coding in health care records: a qualitative analysis using diabetes as a case study.

    Science.gov (United States)

    Robertson, Ann R R; Fernando, Bernard; Morrison, Zoe; Kalra, Dipak; Sheikh, Aziz

    2015-03-27

    Globally, diabetes mellitus presents a substantial and increasing burden to individuals, health care systems and society. Structuring and coding of information in the electronic health record underpin attempts to improve sharing and searching for information. Digital records for those with long-term conditions are expected to bring direct and secondary uses benefits, and potentially to support patient self-management. We sought to investigate if how and why records for adults with diabetes were structured and coded and to explore a range of UK stakeholders' perceptions of current practice in the National Health Service. We carried out a qualitative, theoretically informed case study of documenting health care information for diabetes in family practice and hospital settings in England, using semi-structured interviews, observations, systems demonstrations and documentary data. We conducted 22 interviews and four on-site observations. With respect to secondary uses - research, audit, public health and service planning - interviewees clearly articulated the benefits of highly structured and coded diabetes data and it was believed that benefits would expand through linkage to other datasets. Direct, more marginal, clinical benefits in terms of managing and monitoring diabetes and perhaps encouraging patient self-management were also reported. We observed marked differences in levels of record structuring and/or coding between family practices, where it was high, and the hospital. We found little evidence that structured and coded data were being exploited to improve information sharing between care settings. Using high levels of data structuring and coding in records for diabetes patients has the potential to be exploited more fully, and lessons might be learned from successful developments elsewhere in the UK. A first step would be for hospitals to attain levels of health information technology infrastructure and systems use commensurate with family practices.

  20. Mothers’ experiences in the Nurse-Family Partnership program: a qualitative case study

    Directory of Open Access Journals (Sweden)

    Landy Christine

    2012-09-01

    Full Text Available Abstract Background Few studies have explored the experiences of low income mothers participating in nurse home visiting programs. Our study explores and describes mothers' experiences participating in the Nurse-Family Partnership (NFP Program, an intensive home visiting program with demonstrated effectiveness, from the time of program entry before 29 weeks gestation until their infant's first birthday. Methods A qualitative case study approach was implemented. A purposeful sample of 18 low income, young first time mothers participating in a pilot study of the NFP program in Hamilton, Ontario, Canada partook in one to two face to face in-depth interviews exploring their experiences in the program. All interviews were digitally recorded and transcribed verbatim. Conventional content analysis procedures were used to analyze all interviews. Data collection and initial analysis were implemented concurrently. Results The mothers participating in the NFP program were very positive about their experiences in the program. Three overarching themes emerged from the data: 1. Getting into the NFP program; 2. The NFP nurse is an expert, but also like a friend providing support; and 3. Participating in the NFP program is making me a better parent. Conclusions Our findings provide vital information to home visiting nurses and to planners of home visiting programs about mothers' perspectives on what is important to them in their relationships with their nurses, how nurses and women are able to develop positive therapeutic relationships, and how nurses respond to mothers' unique life situations while home visiting within the NFP Program. In addition our findings offer insights into why and under what circumstances low income mothers will engage in nurse home visiting and how they expect to benefit from their participation.

  1. Electroconvulsive therapy in single manic episodes: a case series

    African Journals Online (AJOL)

    2Department of Epidemiology, Reproductive Medicine Research Center, Royan Institute, Isfahan, Iran. Abstract. Objective: To evaluate the effectiveness of electroconvulsive therapy in the treatment of Bipolar I Disorder patients with a single manic episode. Method: In a retrospective study, we reviewed medical records of ...

  2. Single-case research design in pediatric psychology: considerations regarding data analysis.

    Science.gov (United States)

    Cohen, Lindsey L; Feinstein, Amanda; Masuda, Akihiko; Vowles, Kevin E

    2014-03-01

    Single-case research allows for an examination of behavior and can demonstrate the functional relation between intervention and outcome in pediatric psychology. This review highlights key assumptions, methodological and design considerations, and options for data analysis. Single-case methodology and guidelines are reviewed with an in-depth focus on visual and statistical analyses. Guidelines allow for the careful evaluation of design quality and visual analysis. A number of statistical techniques have been introduced to supplement visual analysis, but to date, there is no consensus on their recommended use in single-case research design. Single-case methodology is invaluable for advancing pediatric psychology science and practice, and guidelines have been introduced to enhance the consistency, validity, and reliability of these studies. Experts generally agree that visual inspection is the optimal method of analysis in single-case design; however, statistical approaches are becoming increasingly evaluated and used to augment data interpretation.

  3. Beliefs and expectations of rural hospital practitioners towards a developing trauma system: A qualitative case study.

    Science.gov (United States)

    Adams, Ryan D F; Cole, Elaine; Brundage, Susan I; Morrison, Zoe; Jansen, Jan O

    2018-03-22

    An understanding of stakeholders' views is key to the successful development and operation of a rural trauma system. Scotland, which has large remote and rural areas, is currently implementing a national trauma system. The aim of this study was to identify key barriers and enablers to the development of an effective trauma system from the perspective of rural healthcare professionals. This is a qualitative study, which was conducted in rural general hospitals (RGH) in Scotland, from April to June 2017. We used an opportunistic sampling strategy to include hospital providers of rural trauma care across the region. Semi-structured interviews were conducted, recorded, and transcribed. Thematic analysis was used to identify and group participant perspectives on key barriers and enablers to the development of the new trauma system. We conducted 15 interviews with 18 participants in six RGHs. Study participants described barriers and enablers across three themes: 1) quality of care, 2) interfaces within the system and 3) interfaces with the wider healthcare system. For quality of care, enablers included confidence in basic trauma management, whilst a perceived lack of change from current management was seen as a barrier. The theme of interfaces within the system identified good interaction with other services and a single point of contact for referral as enablers. Perceived barriers included challenges in referring to tertiary care. The final theme of interfaces with the wider healthcare system included an improved transport system, increased audit resource and coordinated clinical training as enablers. Perceived barriers included a rural staffing crisis and problematic patient transfer to further care. This study provides insight into rural professionals' perceptions regarding the implementation of a trauma system in rural Scotland. Barriers included practical issues, such as retrieval, transfer and referral processes. Importantly, there is a degree of uncertainty

  4. The Single-Case Reporting Guideline In BEhavioural Interventions (SCRIBE) 2016 statement: Énoncé concernant la Single-Case Reporting Guideline In BEhavioural Interventions (SCRIBE) 2016.

    Science.gov (United States)

    Tate, Robyn L; Perdices, Michael; Rosenkoetter, Ulrike; Shadish, William; Vohra, Sunita; Barlow, David H; Horner, Robert; Kazdin, Alan; Kratochwill, Thomas; McDonald, Skye; Sampson, Margaret; Shamseer, Larissa; Togher, Leanne; Albin, Richard; Backman, Catherine; Douglas, Jacinta; Evans, Jonathan J; Gast, David; Manolov, Rumen; Mitchell, Geoffrey; Nickels, Lyndsey; Nikles, Jane; Ownsworth, Tamara; Rose, Miranda; Schmid, Christopher H; Wilson, Barbara

    2016-06-01

    We developed a reporting guideline to provide authors with guidance about what should be reported when writing a paper for publication in a scientific journal using a particular type of research design: the single-case experimental design. This report describes the methods used to develop the Single-Case Reporting guideline In BEhavioural interventions (SCRIBE) 2016. As a result of 2 online surveys and a 2-day meeting of experts, the SCRIBE 2016 checklist was developed, which is a set of 26 items that authors need to address when writing about single-case research. This article complements the more detailed SCRIBE 2016 Explanation and Elaboration article (Tate et al., 2016) that provides a rationale for each of the items and examples of adequate reporting from the literature. Both these resources will assist authors to prepare reports of single-case research with clarity, completeness, accuracy, and transparency. They will also provide journal reviewers and editors with a practical checklist against which such reports may be critically evaluated. We recommend that the SCRIBE 2016 is used by authors preparing manuscripts describing single-case research for publication, as well as journal reviewers and editors who are evaluating such manuscripts.Reporting guidelines, such as the Consolidated Standards of Reporting Trials (CONSORT) Statement, improve the reporting of research in the medical literature (Turner et al., 2012). Many such guidelines exist and the CONSORT Extension to Nonpharmacological Trials (Boutron et al., 2008) provides suitable guidance for reporting between-groups intervention studies in the behavioral sciences. The CONSORT Extension for N-of-1 Trials (CENT 2015) was developed for multiple crossover trials with single individuals in the medical sciences (Shamseer et al., 2015; Vohra et al., 2015), but there is no reporting guideline in the CONSORT tradition for single-case research used in the behavioral sciences. We developed the Single-Case

  5. Thymomas in childhood: 11 cases from a single institution.

    Science.gov (United States)

    Yalçin, Bilgehan; Demir, Haci Ahmet; Ciftçi, Arbay Ozden; Orhan, Diclehan; Varan, Ali; Akyüz, Canan; Kutluk, Tezer; Büyükpamukçu, Münevver

    2012-11-01

    Thymomas are rare in children. Our aim was to review clinical and pathologic characteristics and outcome in children with thymomas. Between 1979 and 2011, 11 children with thymomas were diagnosed. Hospital files were reviewed for presenting complaints, clinical, radiologic, and other laboratory data, surgical practices, chemotherapy and radiotherapy outcomes. Median age was 8 years (range, 1 to 13 y). Male to female ratio was 9/2. Most common initial complaints were dyspnea, cough, chest pain, and fever. Median time from onset of symptoms was 1 month (range, 0.23 to 3 mo). Associated conditions including hyper-IgE syndrome, hypogammaglobulinemia, and systemic lupus erythematosus plus idiopathic thrombocytopenic purpura were present in 3 patients. Chest x-rays and/or thoracic computed tomographies displayed thymic hyperplasia and/or masses in anterior mediastinum accompanied by pleural (n = 2) and pericardial effusions (n = 1), pulmonary metastases (n = 1), and cervical lymph node metastasis (n = 1). Compression or invasion of trachea or vessels was documented in 5 cases. Seven cases underwent initial tumor resection; others experienced open or trucut biopsies. Histopathologically, 5 cases had invasive and 6 had benign thymomas. Benign thymomas did not receive any postoperative treatment; all cases are disease free at a median follow-up of 211 months. Three of 5 cases with invasive thymomas underwent surgery, 4/5 received chemotherapy and external radiotherapy (3600 to 4500 cGy). Two invasive thymomas died of disease. Three cases with invasive thymomas are disease free at a median follow-up of 209 months. Benign thymomas have excellent prognosis. For invasive thymomas with or without metastasis, radiotherapy, and chemotherapy offers survival advantage. Complete surgical resection may increase chances for cure.

  6. Single patent vessel over an embedded ring: a case report.

    Science.gov (United States)

    Awan, Bassim; Samargandi, Osama A; Aljaaly, Hattan A; Makhdom, Asim M

    2013-01-01

    Embedded ring injury is rarely encountered in clinical practice, and most of the few reported cases share common features, including deliberate neglect, mental illness, poor social support, female gender, and adult age group. Ischemia has never been reported in such injuries. Here, we report the case of a 16-year-old girl who presented with a completely embedded ring in the right index finger and a partially embedded ring in the left ring finger. Revascularization after ring embedment probably explains the intact vessel that was observed on the outer aspect of the embedded ring during surgical exploration of the right index finger.

  7. Handling Imprecision in Qualitative Data Warehouse: Urban Building Sites Annoyance Analysis Use Case

    Science.gov (United States)

    Amanzougarene, F.; Chachoua, M.; Zeitouni, K.

    2013-05-01

    Data warehouse means a decision support database allowing integration, organization, historisation, and management of data from heterogeneous sources, with the aim of exploiting them for decision-making. Data warehouses are essentially based on multidimensional model. This model organizes data into facts (subjects of analysis) and dimensions (axes of analysis). In classical data warehouses, facts are composed of numerical measures and dimensions which characterize it. Dimensions are organized into hierarchical levels of detail. Based on the navigation and aggregation mechanisms offered by OLAP (On-Line Analytical Processing) tools, facts can be analyzed according to the desired level of detail. In real world applications, facts are not always numerical, and can be of qualitative nature. In addition, sometimes a human expert or learned model such as a decision tree provides a qualitative evaluation of phenomenon based on its different parameters i.e. dimensions. Conventional data warehouses are thus not adapted to qualitative reasoning and have not the ability to deal with qualitative data. In previous work, we have proposed an original approach of qualitative data warehouse modeling, which permits integrating qualitative measures. Based on computing with words methodology, we have extended classical multidimensional data model to allow the aggregation and analysis of qualitative data in OLAP environment. We have implemented this model in a Spatial Decision Support System to help managers of public spaces to reduce annoyances and improve the quality of life of the citizens. In this paper, we will focus our study on the representation and management of imprecision in annoyance analysis process. The main objective of this process consists in determining the least harmful scenario of urban building sites, particularly in dense urban environments.

  8. Gorlin syndrome: single case report and review | Bashir | Sudanese ...

    African Journals Online (AJOL)

    We report a 25 year old Sudanese male patient, Hawaeer tribe. He presented with multiple naevoid basal cell carcinomas in the face (14 in number), and multiple mandibular odontogenic keratocytes. This is considered as the first case record from Sudan, as Gorlin syndrome is known to be a rare presentation in Africans.

  9. A single centre case series of gallstone sigmoid ileus management

    Directory of Open Access Journals (Sweden)

    Nicholas Farkas

    2017-01-01

    Conclusions: This is the first case series highlighting the differing strategies and challenges faced by clinicians managing gallstone sigmoid ileus. Conservative measures (including manual evacuation, endoscopy, lithotripsy and surgery all play important roles in relieving large bowel obstruction. It is essential to tailor care to individual patients’ needs given the complexities of this potentially life threatening condition.

  10. Exploring Operational Test and Evaluation of Unmanned Aircraft Systems: A Qualitative Case Study

    Science.gov (United States)

    Saliceti, Jose A.

    The purpose of this qualitative case study was to explore and identify strategies that may potentially remedy operational test and evaluation procedures used to evaluate Unmanned Aircraft Systems (UAS) technology. The sample for analysis consisted of organizations testing and evaluating UASs (e.g., U.S. Air Force, U.S. Navy, U.S. Army, U.S. Marine Corps, U.S. Coast Guard, and Customs Border Protection). A purposeful sampling technique was used to select 15 subject matter experts in the field of operational test and evaluation of UASs. A questionnaire was provided to participants to construct a descriptive and robust research. Analysis of responses revealed themes related to each research question. Findings revealed operational testers utilized requirements documents to extrapolate measures for testing UAS technology and develop critical operational issues. The requirements documents were (a) developed without the contribution of stakeholders and operational testers, (b) developed with vague or unrealistic measures, and (c) developed without a systematic method to derive requirements from mission tasks. Four approaches are recommended to develop testable operational requirements and assist operational testers: (a) use a mission task analysis tool to derive requirements for mission essential tasks for the system, (b) exercise collaboration among stakeholders and testers to ensure testable operational requirements based on mission tasks, (c) ensure testable measures are used in requirements documents, and (d) create a repository list of critical operational issues by mission areas. The preparation of operational test and evaluation processes for UAS technology is not uniform across testers. The processes in place are not standardized, thus test plan preparation and reporting are different among participants. A standard method to prepare and report UAS technology should be used when preparing and reporting on UAS technology. Using a systematic process, such as mission

  11. Exploratory qualitative case study of lab-type activity interactions in an online graduate geoscience course

    Science.gov (United States)

    Ciavarella, Veronica C.

    This exploratory qualitative case study investigated the use of lab-type activities in an online graduate geoscience course. Constructivism is the theoretical framework used to explain how learning happens in lab-type activity, and provided the goals to which successful learning in lab-type activity is compared. This study focused on the learner-instructor, learner-learner, and perceptions of the learner-content interactions that occurred related to lab-type activities in an online graduate geoscience course to determine: if the instructor appeared as a facilitator of the learning process in the interactions over the activities; if students engaged in discussion and reflection about the activities; if students perceived the activities as meaningful and authentic; and if students perceived using higher order thinking and prior knowledge while interacting with the content. Ten graduate students from three offerings of the course participated in this study, as well as the instructor and designer of the course content and lab-type activities. Data were collected through interviews, and observation and analysis of the lab-type activities, instructor feedback to students in their graded activities, and discussion that occurred between the instructor and students and among students about the lab-type activities in discussion forums. The nature of the instructor's interactions in discussion forums, in feedback to students on graded activities, and reported by students' in interviews supported that, in the learner-instructor interactions, the instructor of this course was a facilitator who guided and scaffolded the students towards successfully completing the activities. Students engaged in discussion and reflected on the activities, but most learner-learner interactions in discussion forums about the lab-type activities appeared to occur for the purpose of comparison of results, support, and empathy. Students' success at higher order thinking type questions in lab

  12. Hepatic Portocholecystostomy: 97 Cases From a Single Institution.

    Science.gov (United States)

    Hery, Géraldine; Gonzales, Emmanuel; Bernard, Olivier; Fouquet, Virginie; Gauthier, Frédéric; Branchereau, Sophie

    2017-10-01

    Approximately 20% of cases of biliary atresia do not involve the gallbladder, the cystic duct, and the common bile duct. In these cases, a hepatoportocholecystostomy (HPC) may be performed instead of the classical hepatoportoenterostomy (HPE). We reviewed our cohort to investigate the efficacy of HPC and the associated surgical complications and clinical problems. From 1984 to 2009, 97 patients underwent HPC in our institution. In the first 6 months of the postoperative period no patient presented with bacterial cholangitis. Nine patients had bile leakage, and 1 patient had a gallbladder obstruction. For these 10 patients, HPC was modified in HPE. Jaundice clearance was maintained after HPE, but 4 of the patients presented 1 or more cholangitis episodes. After 6 months, there were no cases of cholangitis recorded, 2 patients presented bile leakage and 4 patients experienced gallbladder obstruction. After 5 years of follow-up, 46% of the patients were jaundice free with their native liver and 29.4% were transplanted. In patients with biliary atresia with patent extrahepatic bile ducts, hepatoportocholecystomy is a good surgical technique that can prevent cholangitis. These results are counterbalanced by specific surgical complications that need to be known and looked for in the postoperative period.

  13. A Qualitative Case Study of Reading-While-Listening to Audiobooks Simultaneously

    Science.gov (United States)

    Linton, Sorena Christina

    2017-01-01

    This study was a qualitative, evaluative, multicase study to determine the educator perspectives on the barriers to using Reading While Listening (RWL) simultaneously to audiobooks and their corresponding printed material. The goal of this study was to understand whether RWL should be used more extensively, implemented into a set curriculum, and…

  14. Ethics and the Promotion of Inclusiveness within Qualitative Research: Case Examples from Asia and the Pacific

    Science.gov (United States)

    Czymoniewicz-Klippel, Melina T.; Brijnath, Bianca; Crockett, Belinda

    2010-01-01

    Qualitative researchers are often confronted by ethical challenges when making research decisions because current guidelines and principles guiding research ethics do not wholly cover the concerns that can arise in complex social research situations. In this article, the authors explore this dilemma in relation to our experiences of conducting…

  15. Entry Points When Undergraduate Research Mentors Reflect on Their Role: A Qualitative Case Study

    Science.gov (United States)

    Wallin, Patric; Adawi, Tom

    2018-01-01

    Graduate students and postdoctoral researchers are increasingly taking on mentoring roles in undergraduate research (UR). There is, however, a paucity of research focusing on how they conceptualize their mentoring role. In this qualitative interview study, we identified three entry points that mentors reflect on to define their role: (1) What are…

  16. Ericksonian hypnotherapy for selective mutism: A single-case study.

    Science.gov (United States)

    Cavarra, Mauro; Brizio, Adelina; Gava, Nicoletta

    2017-01-16

    Children affected by selective mutism don't speak in contexts that are unfamiliar to them or in which speaking is expected or required (e.g. school, kindergarten…). Such disorder interferes with the child's normal activities, may have invalidating consequences in the long run if left untreated, is associated to anxious conditions and is considered hard to treat. Contemporary research is still in need of methodologically rigorous outcome studies and the results described in the small number of published randomized controlled trials and retrospective studies indicate cognitive-behavioral interventions lasting 20-24 sessions as the best therapeutic option. This case study, involving a 7-year-old girl, aims at providing preliminary evidence on the effectiveness of Ericksonian hypnosis in the treatment of this condition. A brief review of current evidence is provided. The case was treated by a licensed hypnotherapist, specialized in family therapy, in 5 sessions during the course of 3 months. After 3 months the symptoms of the client were resolved and the diagnosis was no longer applicable. Other improvements regarded her mood, social skills and school performance.  Conclusions: Ericksonian Hypnotherapy lead to the remission of the disorder and to the improvement of the general well being of the client in 5 sessions, a much briefer time span compared to what is reported in current literature. This paper represents the first step in the elaboration of replicable and reliable intervention principles.

  17. Using qualitative research methods in biomedical innovation: the case of cultured red blood cells for transfusion.

    Science.gov (United States)

    Lyall, Catherine; King, Emma

    2016-05-11

    Qualitative research has a key role to play in biomedical innovation projects. This article focuses on the appropriate use of robust social science methodologies (primarily focus group studies) for identifying the public's willingness and preference for emerging medical technologies. Our study was part of the BloodPharma project (now known as the Novosang project) to deliver industrially generated red blood cells for transfusion. Previous work on blood substitutes shows that the public prefers donated human blood. However, no research has been conducted concerning attitudes to stem cell derived red blood cells. Qualitative research methods including interviews and focus groups provide the methodological context for this paper. Focus groups were used to elicit views from sub-sections of the UK population about the potential use of such cultured red blood cells. We reflect on the appropriateness of that methodology in the context of the BloodPharma project. Findings are in the form of lessons transferable to other interdisciplinary, science-led teams about what a social science dimension can bring; why qualitative research should be included; and how it can be used effectively. Qualitative data collection offers the strength of exploring ambivalence and investigating the reasons for views, but not necessarily their prevalence in wider society. The inherent value of a qualitative method, such as focus groups, therefore lies in its ability to uncover new information. This contrasts with a quantitative approach to simply 'measuring' public opinion on a topic about which participants may have little prior knowledge. We discuss a number of challenges including: appropriate roles for embedded social scientists and the intricacies of doing upstream engagement as well as some of the design issues and limitations associated with the focus group method.

  18. LIVER TRANSPLANTATION. A SINGLE CENTER EXPERIENCE OF 100 CASES

    Directory of Open Access Journals (Sweden)

    A. M. Granov

    2012-01-01

    Full Text Available A single center experience of first 100 liver transplantations (LTs is summarized. Analysis of trends in cadaver donor population and waiting list status changes, and also of early and late postoperative complications are presented. 100 LTs were performed for 95 patients (pts, retransplantation – 4 pts; one patient received 3 liver transplants (female – 55 pts, male – 40 pts, mean age – 39.9 ± 12.1 years. Cumulative 1-year survival rate of pts by Kaplan–Meyer was 91%, 3-year – 83%. Biliary complications were revealed in 9% of pts during 2–9 months after LT. 77 pts have been regularly observed in outpatient clinic, mean age – 44 ± 9.2 years, male – 35, fema- le – 42, follow-up period – 1 months up to 13 years after LT. 3.9% remained invalid with limitation of ability to work, 61.8% have been working, 22.3% were capable to work, retirees were 10.5%. Development of preoperati- ve planning, adequate organ selection will allow to improve the results of LT. Study of hematopoietic stem cells role will expand tools of prognosis of posttransplant complications. 

  19. Primary cystic mediastinal hemangiopericytoma: tracking a single case

    Directory of Open Access Journals (Sweden)

    Rezwanul Hoque

    2017-10-01

    Full Text Available The mediastinum is an extremely uncommon site for hemangiopericytoma, a rare tumor arising from the pericytes of Zimmermann in the outer wall of capillaries. Histopathology and immunohistochemistry are two main diagnostic tools which differentiate these from synovial sarcoma and solitary fibrous histiocytoma. Surgery is the mainstay of treatment for this tumor with variable malignant potential, adjuvant therapy does not help much. We report a case of primary mediastinal hemangiopericytoma in a 15-year-old lady which recurred after complete surgical excision and a second surgical operation resulted in recurrence again. The first histopathological report after removal of the tumor, revealed a primary cystic hemangiopericytoma, histopathology of the subsequently resected tumor established malignant hemangiopericytoma. Hemangiopericytomas are potentially malignant tumors with high recurrence rate and are very difficult to cure.

  20. Triple dens invaginatus in a single tooth: Rarest of rare case report

    Directory of Open Access Journals (Sweden)

    Amandeep Chhina

    2017-01-01

    Full Text Available Dens invaginatus is a rare malformation affecting the teeth. The teeth that are most commonly affected are the permanent maxillary lateral incisors. The mandibular posterior teeth are rarely affected by dens invaginatus. In most of the cases, a single dens invaginatus is seen affecting the tooth. Cases of double dens invaginatus affecting a single tooth are rare, and those of triple dens invaginatus in a single tooth are even rarer. Here, we present a case of a 14-year-old where three dens invaginatus were seen in the mandibular second premolar. This is the fourth case of three dens invaginatus in a single tooth as only three have been reported previously.

  1. Incorporating nonoverlap indices with visual analysis for quantifying intervention effectiveness in single-case experimental designs.

    Science.gov (United States)

    Brossart, Daniel F; Vannest, Kimberly J; Davis, John L; Patience, Marc A

    2014-01-01

    The field of neuropsychological rehabilitation frequently employs single case experimental designs (SCED) in research, but few if any, of the published studies use the effect sizes recommended by the American Psychological Association. Among the available methods for analysing single case designs, this paper focuses on nonoverlap methods. This paper provides examples and suggestions for integrating visual and statistical analysis, pointing out where contradictions may occur and how to be a critical consumer.

  2. Beyond Clinical Case Studies in Psychoanalysis: A Review of Psychoanalytic Empirical Single Case Studies Published in ISI-Ranked Journals

    Science.gov (United States)

    Meganck, Reitske; Inslegers, Ruth; Krivzov, Juri; Notaerts, Liza

    2017-01-01

    Single case studies are at the origin of both theory development and research in the field of psychoanalysis and psychotherapy. While clinical case studies are the hallmark of psychoanalytic theory and practice, their scientific value has been strongly criticized. To address problems with the subjective bias of retrospective therapist reports and uncontrollability of clinical case studies, systematic approaches to investigate psychotherapy process and outcome at the level of the single case have been developed. Such empirical case studies are also able to bridge the famous gap between academic research and clinical practice as they provide clinically relevant insights into how psychotherapy works. This study presents a review of psychoanalytic empirical case studies published in ISI-ranked journals and maps the characteristics of the study, therapist, patient en therapies that are investigated. Empirical case studies increased in quantity and quality (amount of information and systematization) over time. While future studies could pay more attention to providing contextual information on therapist characteristics and informed consent considerations, the available literature provides a basis to conduct meta-studies of single cases and as such contribute to knowledge aggregation. PMID:29046660

  3. Qualitative Research in a Changing Epistemic Context. The Case of a Small Social Science Community

    Directory of Open Access Journals (Sweden)

    Frane Adam

    2005-09-01

    Full Text Available The fact that qualitative approaches are gaining more and more recognition in social sciences can be explained as a consequence of a change in epistemic and institutional parameters. In this sense we can speak about the "post-positivist" era in which more complex and inclusive research designs are needed. Analyzing the development and the state of the art of qualitative research in a small research community, two conclusions can be drawn. First, the attractiveness and utilization of this approach has been increasing in the last decade, while its institutional status (in terms of academic curricula is still weak. It has been shown that the major step towards the post-positivist state has been taken by international research projects in which Slovenian social scientists have been involved. URN: urn:nbn:de:0114-fqs0503400

  4. CONSUMPTION AND COMMUNICATION OF LUXURY BRANDS ONLINE – ILLUSTRATING A QUALITATIVE ONLINE CASE STUDY

    Directory of Open Access Journals (Sweden)

    Anita Radón

    2013-06-01

    Full Text Available Internet research has grown tremendously over the last decade and we see new and elaborate ways to use the Internet for data generation with increased technological abilities as well as increased Internet usage among companies and consumers. This paper illustrates a qualitative online study within the field of marketing with focus on the consumption and communication of brands. The specific interest is in showing how a particular phenomenon is studied using different Internet research methods and how this has resulted in more thick qualitative descriptions of consumption and communication in an online environment. The paper shows how the aim and context of a study leads to an Internet research approach and how the online study was conducted, the methods that were used, the results it gave and thus also sketches the possibilities and future of Internet research.

  5. Qualitative Case Study on Cell Phone Appropriation for Language Learning Purposes in a Dominican Context

    OpenAIRE

    Martiz, Gisela

    2015-01-01

    This research study investigated how a Dominican English language teacher and her students appropriated cell phone features for educational purposes inside and outside the classroom. The dissertation used a qualitative approach that focused on the teacher, and four students selected from a class of 23. Data collection took place for 8 weeks in an English language center located at a public university in the Dominican Republic in the summer of 2014. I collected data through interviews, convers...

  6. RT-12OUTCOMES IN MEDULLOBLASTOMA: SINGLE INSTITUTION CASE SERIES

    Science.gov (United States)

    Kannan, V.; Bajpai, Ranjeet; Anand, Vivek; Deshpande, Sudesh; Misra, Basant K.; Kapadia, Asha; Almel, Sachin; Sankhe, Milind; Desai, Ketan; Kannan, Aarthi; Dubey, Sandhya; Ashok, P.P.; Shinde, Sandip

    2014-01-01

    BACKGROUND: We have seen a paradigm shift in terms of use of radiation technology for the treatment of patients with medulloblastoma, from conventional 2-D shifting fields to 3-D CRT, IMRT and proton therapy. Similarly from prone to supine position and reduced dose to the cranio-spinal axis with an intent to have equivalent outcomes with reduced probability of late sequelae including second malignancies. METHODS: We have analysed data of 21 consecutive patients in May 2014, registered and treated in our hospital between 2002 and 2011. The cohort consisted of 14 male and 7 female patients with a median age of 8 (Range 3-30) Years. With no known co-morbidities and median KPS of 70 they all had tumors mostly in the IV ventricle(43%) and cerebellum(38%), for which they underwent surgery including decompression(72%) subtotal excision(9%), near total or total excision(19%). All patients were histologically grade IV medulloblastoma who underwent adjuvant radiation alone (40%) or followed by chemotherapy (60%) based on the risk stratification. 57% received 3D CRT in supine position while rest are treated with conventional techniques, median dose given to cranio-spinal axis was 23.4 Gy, posterior fossa was 36 Gy and to the tumor bed was 55.8 Gy at 1.8Gy per fraction. Chemotherapy was usually procarbazine/cisplatin/vincristine based regimen. Regular IQ, endocrine, ophthalmic and auditory evaluation was done in all the patients on follow-up. RESULT: Overall survival at 5 year was documented at 45% and 10 year survival at 35% for the entire cohort taking worst case scenario.3/13 patients developed IQ problems, 7/13 developed endocrine dysfunction, 3/12 developed auditory abnormality. CONCLUSION: Outcome of this cohort is comparable to the literature on risk group stratification. More importantly, risk adapted strategy for the treatment was found to be technically and logistically feasible and effective for a comparatively rare tumor in our setup.

  7. Qualitative and quantitative simulation of androgen receptor antagonists: A case study of polybrominated diphenyl ethers.

    Science.gov (United States)

    Wu, Yang; Shi, Wei; Xia, Pu; Zhang, Xiaowei; Yu, Hongxia

    2017-12-15

    Recently, great attention has been paid to the identification and prediction of the androgen disrupting potencies of polybrominated diphenyl ethers (PBDEs). However, few existing models can discriminate active and inactive compounds, which make the quantitative prediction process including the quantitative structure-activity relationship (QSAR) technique unreliable. In this study, different grouping methods were investigated and compared for qualitative identification, including molecular docking and molecular dynamics simulations (MD). The results showed that qualitative identification based on MD, which is lab-independent, accurate and closer to the real transcriptional activation process, could separate 90.5% of active and inactive chemicals and was preferred. The 3D-QSAR models built as the quantitative simulation method showed r 2 and q 2 values of 0.513 and 0.980, respectively. Together, a novel workflow combining qualitative identification and quantitative simulations was generated with processes including activeness discrimination and activity prediction. This workflow, for analyzing the antagonism of androgen receptor (AR) of PBDEs is not only allowing researchers to reduce their intense laboratory experiments but also assisting them in inspecting and adjusting their laboratory systems and results. Copyright © 2017. Published by Elsevier B.V.

  8. What’s Gay About Being Single? A Qualitative Study of the Lived Experiences of Older Single Gay Men

    OpenAIRE

    Yiu Tung Suen

    2015-01-01

    This paper contributes to the theorization of ‘choice’ within sociological understanding of singlehood. Previous sociological research on singlehood has largely focused on the lives of heterosexual singles. A choice narrative permeates such literature, depicting singlehood as a celebratory story that brings about the potential to disrupt the couplehood culture in society. Based on in-depth interviews with 25 self-identified single gay men over the age of 50 in England, this article finds ...

  9. Neoliberalism, welfare policy and health: a qualitative meta-synthesis of single parents' experience of the transition from welfare to work.

    Science.gov (United States)

    Cook, Kay

    2012-09-01

    Following the United States' lead, the emergence of neoliberal welfare policy across the western world has resulted in employment programmes for single parents, who are predominantly single mothers. While some governments claim that employment will improve single parents' incomes and well-being, researchers dispute that single parents can unproblematically move into the workforce, with net positive effects. While researchers have quantified the socio-economic effect of these programmes, in particular on participant health, no study has yet synthesized participants' experiences of welfare-to-work. Here, I present a meta-synthesis of eight qualitative health-related studies of single parents' (and exclusively single mothers') welfare-to-work transition. I report that single mothers faced a combination of health and economic issues which made their transition from welfare to work difficult, including degrees of poor physical and mental health. For participants in the United States, these health issues were often compounded by a loss of health benefits on moving into low-wage employment. In countries where a return to employment was required before children reached school age, a lack of affordable and appropriate child care, especially for children with health problems, exacerbated these difficulties. As a result of scarce resources, single mothers in receipt of welfare benefits often relied on food banks or went without food. A return to the workforce did not alleviate this problem as additional child care and reduced government subsidies depleted the funds available for food. I conclude that welfare-to-work policies are underpinned by the neoliberal assumption that the market more efficiently distributes resources than the State. However, for the women in the studies examined here, labour market participation often depleted access to essential resources. Interventions to address the 'problem' of welfare dependency must recognize the complex interplay between work

  10. Clinical Perspective A case of effective single-session treatment for ...

    African Journals Online (AJOL)

    This article reports a systematic clinical case study of the psychological assessment and treatment of Daniel (9), a coloured South African boy with a diagnosis of attention deficit hyperactivity disorder (ADHD) (inattentive type). The case is of scientific interest because: (1) there was only a single treatment session, in which ...

  11. Providers' Perspectives on Case Management of a Healthy Start Program: A Qualitative Study.

    Directory of Open Access Journals (Sweden)

    Imelda K Moise

    Full Text Available Although Healthy Start case managers recognized the benefits of case management for facilitating optimal service delivery to women and their families, structural factors impact effective implementation. This study investigated case managers' views of 1 the structural challenges faced in implementing case management for program participants, and 2 possible strategies to enhance case management in medical home settings. Two focus groups were conducted separately with case managers from the four program service sites to gain insight into these issues noted above. Each group was co-facilitated by two evaluators using a previously developed semi-structured interview guide. The group discussions were audio recorded and the case managers' comments were transcribed verbatim. Transcripts were analyzed using thematic analysis, a deductive approach. Data were collected in 2013 and analyzed in 2015. Case managers are challenged by externalities (demographic shifts in target populations, poverty; contractual requirements (predefined catchment neighborhoods, caseload; limited support (client incentives, tailored training, and a high staff turnover rate; and logistic difficulties (organizational issues. Their approach to case management tends to be focused on linking Although Healthy Start case managers recognized the benefits of case management for facilitating optimal service delivery to women and their families, structural factors impact effective implementation. This study investigated case managers' views of 1 the structural challenges faced in implementing case management for program participants, and 2 possible strategies to enhance case management in medical home settings. Two focus groups were conducted separately with case managers from the four program service sites to gain insight into these issues noted above. Each group was co-facilitated by two evaluators using a previously developed semi-structured interview guide. The group discussions were

  12. Event-specific qualitative and quantitative detection of five genetically modified rice events using a single standard reference molecule.

    Science.gov (United States)

    Kim, Jae-Hwan; Park, Saet-Byul; Roh, Hyo-Jeong; Shin, Min-Ki; Moon, Gui-Im; Hong, Jin-Hwan; Kim, Hae-Yeong

    2017-07-01

    One novel standard reference plasmid, namely pUC-RICE5, was constructed as a positive control and calibrator for event-specific qualitative and quantitative detection of genetically modified (GM) rice (Bt63, Kemingdao1, Kefeng6, Kefeng8, and LLRice62). pUC-RICE5 contained fragments of a rice-specific endogenous reference gene (sucrose phosphate synthase) as well as the five GM rice events. An existing qualitative PCR assay approach was modified using pUC-RICE5 to create a quantitative method with limits of detection correlating to approximately 1-10 copies of rice haploid genomes. In this quantitative PCR assay, the square regression coefficients ranged from 0.993 to 1.000. The standard deviation and relative standard deviation values for repeatability ranged from 0.02 to 0.22 and 0.10% to 0.67%, respectively. The Ministry of Food and Drug Safety (Korea) validated the method and the results suggest it could be used routinely to identify five GM rice events. Copyright © 2017 Elsevier Ltd. All rights reserved.

  13. Treatment of obsessive morbid jealousy with cognitive analytic therapy: An adjudicated hermeneutic single-case efficacy design evaluation.

    Science.gov (United States)

    Curling, Louise; Kellett, Stephen; Totterdell, Peter; Parry, Glenys; Hardy, Gillian; Berry, Katherine

    2018-03-01

    The evidence base for the treatment of morbid jealousy with integrative therapies is thin. This study explored the efficacy of cognitive analytic therapy (CAT). An adjudicated hermeneutic single-case efficacy design evaluated the cognitive analytic treatment of a patient meeting diagnostic criteria for obsessive morbid jealousy. A rich case record was developed using a matrix of nomothetic and ideographic quantitative and qualitative outcomes. This record was then debated by sceptic and affirmative research teams. Experienced psychotherapy researchers acted as judges, assessed the original case record, and heard the affirmative-versus-sceptic debate. Judges pronounced an opinion regarding the efficacy of the therapy. The efficacy of CAT was supported by all three judges. Each ruled that change had occurred due to the action of the therapy, beyond any level of reasonable doubt. This research demonstrates the potential usefulness of CAT in treating morbid jealousy and suggests that CAT is conceptually well suited. Suggestions for future clinical and research directions are provided. The relational approach of CAT makes it a suitable therapy for morbid jealousy. The narrative reformulation component of CAT appears to facilitate early change in chronic jealousy patterns. It is helpful for therapists during sessions to use CAT theory to diagrammatically spell out the patterns maintaining jealousy. © 2017 The British Psychological Society.

  14. Single-Case Experimental Designs to Evaluate Novel Technology-Based Health Interventions

    Science.gov (United States)

    Cassidy, Rachel N; Raiff, Bethany R

    2013-01-01

    Technology-based interventions to promote health are expanding rapidly. Assessing the preliminary efficacy of these interventions can be achieved by employing single-case experiments (sometimes referred to as n-of-1 studies). Although single-case experiments are often misunderstood, they offer excellent solutions to address the challenges associated with testing new technology-based interventions. This paper provides an introduction to single-case techniques and highlights advances in developing and evaluating single-case experiments, which help ensure that treatment outcomes are reliable, replicable, and generalizable. These advances include quality control standards, heuristics to guide visual analysis of time-series data, effect size calculations, and statistical analyses. They also include experimental designs to isolate the active elements in a treatment package and to assess the mechanisms of behavior change. The paper concludes with a discussion of issues related to the generality of findings derived from single-case research and how generality can be established through replication and through analysis of behavioral mechanisms. PMID:23399668

  15. The Single-Case Reporting Guideline In BEhavioural Interventions (SCRIBE 2016 Statement

    Directory of Open Access Journals (Sweden)

    Robyn L. Tate

    2016-04-01

    Full Text Available We developed a reporting guideline to provide authors with guidance about what should be reported when writing a paper for publication in a scientific journal using a particular type of research design: the single-case experimental design. This report describes the methods used to develop the Single-Case Reporting guideline In BEhavioural interventions (SCRIBE 2016. As a result of 2 online surveys and a 2-day meeting of experts, the SCRIBE 2016 checklist was developed, which is a set of 26 items that authors need to address when writing about single-case research. This article complements the more detailed SCRIBE 2016 Explanation and Elaboration article (Tate et al., 2016 that provides a rationale for each of the items and examples of adequate reporting from the literature. Both these resources will assist authors to prepare reports of single-case research with clarity, completeness, accuracy, and transparency. They will also provide journal reviewers and editors with a practical checklist against which such reports may be critically evaluated. We recommend that the SCRIBE 2016 is used by authors preparing manuscripts describing single-case research for publication, as well as journal reviewers and editors who are evaluating such manuscripts.

  16. Connections Between Qualitative and Quantitative Thinking About Proportion: The Case of Paulina

    Science.gov (United States)

    Ruiz Ledesma, Elena Fabiola; Valdemoros Alvarez, Marta Elena

    2004-01-01

    The case study presented in this report was part of assessing a teaching proposal on ratio and proportion. A group of sixth-grade students of elementary education in Mexico participated in the implementation of the proposal. The girl of the case study was representative of those students in the group who had a lot of recourse to handling…

  17. A Case Study of Spirituality in Senior Center Education: Qualitative Research in Adult Education

    Science.gov (United States)

    Demarse, Laura

    2016-01-01

    This article presents a case study on the role of spirituality in adult education at a suburban senior center located in the southeast region of the country. The purpose of the case study was to understand the deeply personal role of spirituality in adult education as seen through teaching seniors and examine the personal manifestation of…

  18. Case writing as a vehicle for promoting cultural competency: a retrospective, descriptive qualitative analysis.

    Science.gov (United States)

    Foreman, Juron S; Hark, Lisa; DeLisser, Horace M

    2012-01-01

    A variety of approaches are available that provide cultural competency education for practicing physicians. There is, however, still a need for additional, innovative approaches that address continuing education and professional improvement regarding cultural competency for physicians after their training. To assess the potential impact on established clinicians of writing an extended case narrative on cultural competency. We conducted structured interviews of physician contributors (n = 14) to a book of cases on cultural competency. Authors were invited to contribute to the book based on their experiences as established clinicians, and previous expertise in cultural competency research or education was not required. Because of this, the editors employed a process in which they worked with contributors in a one-on-one manner to develop their case(s). The participants were experienced physicians (all > 10 years since medical school graduation), most of whom were white (64%) and affiliated with an academic medical center (86%). The majority of the contributors (1) reported that writing their case(s) increased their awareness of, and sensitivity to, issues of cultural competency; (2) indicated that the writing of their case(s) changed their approach to patient care and/ or their education of medical students or graduate medical trainees; and (3) would recommend case writing as a vehicle for promoting cultural sensitivity and awareness. Although preliminary, these data suggest that the cultural awareness, sensitivity, and competence of established physicians might be enhanced by a process in which clinicians are facilitated in the writing of cases that address issues of culture that are pertinent to their practice and patient experiences.

  19. A Qualitative Case Study of Smartphone-Connected Hearing Aids: Influences on Patients, Clinicians, and Patient-Clinician Interactions.

    Science.gov (United States)

    Ng, Stella L; Phelan, Shanon; Leonard, MaryAnn; Galster, Jason

    2017-06-01

    Innovations in hearing aid technology influence clinicians and individuals who use hearing aids. Little research, to date, explains the innovation adoption experiences and perspectives of clinicians and patients, which matter to a field like audiology, wherein technology innovation is constant. By understanding clinician and patient experiences with such innovations, the field of audiology may develop technologies and ways of practicing in a manner more responsive to patients' needs, and attentive to society's influence. The authors aimed to understand how new innovations influence clinician and patient experiences, through a study focusing on connected hearing aids. "Connected" refers to the wireless functional connection of hearing aids with everyday technologies like mobile phones and tablets. The authors used a qualitative collective case study methodology, borrowing from constructivist grounded theory for data collection and analysis methods. Specifically, the authors designed a collective case study of a connected hearing aid and smartphone application, composed of two cases of experience with the innovation: the case of clinician experiences, and the case of patient experiences. The qualitative sampling methods employed were case sampling, purposive within-case sampling, and theoretical sampling, and culminated in a total collective case n = 19 (clinician case n = 8; patient case n = 11). These data were triangulated with a supplementary sample of ten documents: relevant news and popular media collected during the study time frame. The authors conducted interviews with the patients and clinicians, and analyzed the interview and document data using the constant comparative method. The authors compared their two cases by looking at trends within, between, and across cases. The clinician case highlighted clinicians' heuristic-based candidacy judgments in response to the adoption of the connected hearing aids into their practice. The patient case revealed

  20. Enhancing the hermeneutic single-case efficacy design: Bridging the research-practice gap.

    Science.gov (United States)

    Wall, Jessie M; Kwee, Janelle L; Hu, Monica; McDonald, Marvin J

    2017-09-01

    Systematic case study designs are emerging as alternative paradigm strategies for psychotherapy and social science research. Through enhanced sensitivity to context, these designs examine idiographic profiles of causal processes. We specifically advocate the use of the hermeneutic single-case efficacy design (HSCED). HSCED has recently been used to investigate the efficacy of an existing therapy with a new population (Observed and Experiential Integration for athlete performance barriers) and an emerging therapy (Lifespan Integration Therapy). We describe innovations in HSCED that were implemented for these studies. These developments include (a) integrating psychotherapists as case developers, (b) incorporating multiple cases in one investigation, and (c) tailoring the repertoire of assessment tools. These extensions strategically incorporated principles of contextual paradigms in HSCED, thus complementing single-case designs that neglect idiographic contexts. We discuss recommendations for using HSCED in practice-based research, highlighting its potential as a bridge to address the research-practice gap.

  1. A qualitative analysis of student-written law and ethics cases: A snapshot of PY2 student experience.

    Science.gov (United States)

    Karwaki, Tanya E; Hazlet, Thomas K

    2017-05-01

    This study was designed to better understand pharmacy students' experiences and recognition of legal and ethical tensions existing in pharmacy practice as demonstrated in student-written law and ethics cases. A qualitative analysis of 132 student-written cases representing the team efforts of 1053 students over a 12-year time period was conducted. Student-written cases were coded and analyzed thematically. Our results demonstrate the types of ethical and legal issues our students have experienced in pharmacy practice during the first five quarters of their professional education. Our data highlight three themes: 1) ethical dilemmas presented when the law is misapplied; 2) ethical dilemmas presented when an institutional policy or law was viewed as insufficient; and 3) ethical dilemmas presented as provider distress. The third theme was further subdivided into five subthemes. The themes that emerged from this study represent some of the ethical dilemmas that second professional year students have encountered and how these dilemmas may intersect with legal boundaries. Educators can use cases demonstrating these themes to reinforce law and ethics education in the curriculum, thus helping prepare students for pharmacy practice. This article recommends how and when to use case examples. Copyright © 2017 Elsevier Inc. All rights reserved.

  2. Qualitative Event-Based Diagnosis: Case Study on the Second International Diagnostic Competition

    Science.gov (United States)

    Daigle, Matthew; Roychoudhury, Indranil

    2010-01-01

    We describe a diagnosis algorithm entered into the Second International Diagnostic Competition. We focus on the first diagnostic problem of the industrial track of the competition in which a diagnosis algorithm must detect, isolate, and identify faults in an electrical power distribution testbed and provide corresponding recovery recommendations. The diagnosis algorithm embodies a model-based approach, centered around qualitative event-based fault isolation. Faults produce deviations in measured values from model-predicted values. The sequence of these deviations is matched to those predicted by the model in order to isolate faults. We augment this approach with model-based fault identification, which determines fault parameters and helps to further isolate faults. We describe the diagnosis approach, provide diagnosis results from running the algorithm on provided example scenarios, and discuss the issues faced, and lessons learned, from implementing the approach

  3. The role of qualitative risk assessment in environmental management: A Kazakhstani case study

    International Nuclear Information System (INIS)

    Kajenthira, Arani; Holmes, John; McDonnell, Rachael

    2012-01-01

    Successful environmental management is partly contingent on the effective recognition and communication of environmental health risks to the public. Yet risk perceptions are known to differ between experts and laypeople; laypeople often exhibit higher perceptions of risk in comparison to experts, particularly when these risks are associated with radiation, nuclear power, or nuclear waste. This paper consequently explores stakeholder risk perceptions associated with a mercury-contaminated chloralkali production facility in Kazakhstan. Using field observations and in-depth interviews conducted in the vicinity of the Pavlodar Chemical Plant, this work assesses the relevance of the substantial on-site mercury contamination to the health and livelihoods of the local population with the goal of informing remediation activity through a combination of quantitative and qualitative risk assessments. The findings of this research study cannot be broadly generalized to all the primary stakeholders of the site due to the small sample size; however, the indifference of the local population towards both the possibility of mercury-related health risks and the need for mitigation activity could pose a substantial barrier to successful site remediation and also suggests that a qualitative understanding of stakeholder risk perceptions could play an important role in striving towards sustainable, long-term environmental risk management. - Highlights: ► A mercury spill in Kazakhstan created environmental and health risks. ► We evaluated the role of risk communication/perception in environmental management. ► Long-term risk mitigation was impeded by lack of engagement of site stakeholders. ► Prioritizing engagement of the local population is critical for remediation success.

  4. The Single-Case Reporting Guideline In BEhavioural Interventions (SCRIBE) 2016 Statement †

    Science.gov (United States)

    Tate, Robyn L.; Perdices, Michael; Rosenkoetter, Ulrike; Shadish, William; Vohra, Sunita; Barlow, David H.; Horner, Robert; Kazdin, Alan; Kratochwill, Thomas; McDonald, Skye; Sampson, Margaret; Shamseer, Larissa; Togher, Leanne; Albin, Richard; Backman, Catherine; Douglas, Jacinta; Evans, Jonathan J.; Gast, David; Manolov, Rumen; Mitchell, Geoffrey; Nickels, Lyndsey; Nikles, Jane; Ownsworth, Tamara; Rose, Miranda; Schmid, Christopher H.; Wilson, Barbara

    2017-01-01

    ABSTRACT We developed a reporting guideline to provide authors with guidance about what should be reported when writing a paper for publication in a scientific journal using a particular type of research design: the single-case experimental design. This report describes the methods used to develop the Single-Case Reporting guideline In BEhavioural interventions (SCRIBE) 2016. As a result of 2 online surveys and a 2-day meeting of experts, the SCRIBE 2016 checklist was developed, which is a set of 26 items that authors need to address when writing about single-case research. This article complements the more detailed SCRIBE 2016 Explanation and Elaboration article (Tate et al., 2016) that provides a rationale for each of the items and examples of adequate reporting from the literature. Both these resources will assist authors to prepare reports of single-case research with clarity, completeness, accuracy, and transparency. They will also provide journal reviewers and editors with a practical checklist against which such reports may be critically evaluated. We recommend that the SCRIBE 2016 is used by authors preparing manuscripts describing single-case research for publication, as well as journal reviewers and editors who are evaluating such manuscripts. SCIENTIFIC ABSTRACT Reporting guidelines, such as the Consolidated Standards of Reporting Trials (CONSORT) Statement, improve the reporting of research in the medical literature (Turner et al., 2012). Many such guidelines exist and the CONSORT Extension to Nonpharmacological Trials (Boutron et al., 2008) provides suitable guidance for reporting between-groups intervention studies in the behavioural sciences. The CONSORT Extension for N-of-1 Trials (CENT 2015) was developed for multiple crossover trials with single individuals in the medical sciences (Shamseer et al., 2015; Vohra et al., 2015), but there is no reporting guideline in the CONSORT tradition for single-case research used in the behavioural sciences. We

  5. Evaluation of how a curriculum change in nurse education was managed through the application of a business change management model: A qualitative case study.

    Science.gov (United States)

    Chowthi-Williams, Annette; Curzio, Joan; Lerman, Stephen

    2016-01-01

    Curriculum changes are a regular feature of nurse education, yet little is known about how such changes are managed. Research in this arena is yet to emerge. Evaluation of how a curriculum change in nurse education was managed through the application of a business change management model. A qualitative case study: the single case was the new curriculum, the Primary Care Pathway. One executive, three senior managers, two academics and nineteen students participated in this study in one faculty of health and social care in a higher education institution. The findings suggest that leadership was pivotal to the inception of the programme and guiding teams managed the change and did not take on a leadership role. The vision for the change and efforts to communicate it did not reach the frontline. Whilst empowerment was high amongst stakeholders and students, academics felt dis-empowered. Short-term wins were not significant in keeping up the momentum of change. The credibility of the change was under challenge and the concept of the new programme was not yet embedded in academia. Differences between the strategic and operational part of the organisation surfaced with many challenges occurring at the implementation stage. The business change model used was valuable, but was found to not be applicable during curriculum changes in nurse education. A new change model emerged, and a tool was developed alongside to aid future curriculum changes. Copyright © 2015 Elsevier Ltd. All rights reserved.

  6. [CIPA (Comprehensive Individualized Process Analysis)--a method for combining quantitative and qualitative individual case analysis].

    Science.gov (United States)

    Regli, D; Grawe, K; Gassmann, D; Dick, A

    1998-07-01

    The main question of psychotherapy research nowadays is how psychotherapy works. Hence, interest focuses mainly on the process of psychotherapy. General change mechanisms as well as the therapeutic interaction are in the center of research interest. On the basis of process outcome findings (Orlinsky, Grawe, Parks 1994) and the schema theory of Grawe (1987) we developed a research instrument allowing the analysis of therapies from a theoretically and quantitative approaches. The research instrument (CIPA-Comprehensive Individualized Process Analysis) consist of three parts: The scales of the first part assess the general working mechanisms and the therapeutic relationship. The second part allows a rating of the patient's interactions inside and outside the therapy. In the third part the individual schemata are rated. The instrument and the research strategy are being illustrated by means of a selected therapy recorded completely on video tape. The results are interpreted on the basis of the individual schema structure as well as the therapy outcome. The possibility offered by the new instrument to combine quantitative and qualitative research strategies is discussed.

  7. The Experience of Being a Guide Dog Puppy Raiser Volunteer: A Longitudinal Qualitative Collective Case Study

    Directory of Open Access Journals (Sweden)

    Anna Chur-Hansen

    2014-12-01

    Full Text Available There are no published studies that consider the experiences of guide dog puppy raisers. As these people are volunteers, their continued willingness to participate in the training of dogs for assisting the vision impaired and blind is essential for the viability of guide dog schools around the world. Using a qualitative, longitudinal methodology, data were collected from nine guide dog puppy raisers at four time points: before receiving the puppy, one week, then three months after the puppy arrived, and 13 months after the puppy arrived (at which time all puppies had left the raisers. Participants reported more challenges than benefits in raising the puppies. Volunteering to be a guide dog puppy raiser may not be the pleasant experience that is anticipated when community members first offer their services. Understanding what it is like to be a puppy raiser and working towards ways in which to address problems is essential, given that, without volunteers to train and care for puppies, vision impaired and blind people would not have access to guide dogs.

  8. The Experience of Being a Guide Dog Puppy Raiser Volunteer: A Longitudinal Qualitative Collective Case Study.

    Science.gov (United States)

    Chur-Hansen, Anna; Werner, Lucy-Kate; McGuiness, Clare E; Hazel, Susan

    2014-12-23

    There are no published studies that consider the experiences of guide dog puppy raisers. As these people are volunteers, their continued willingness to participate in the training of dogs for assisting the vision impaired and blind is essential for the viability of guide dog schools around the world. Using a qualitative, longitudinal methodology, data were collected from nine guide dog puppy raisers at four time points: before receiving the puppy, one week, then three months after the puppy arrived, and 13 months after the puppy arrived (at which time all puppies had left the raisers). Participants reported more challenges than benefits in raising the puppies. Volunteering to be a guide dog puppy raiser may not be the pleasant experience that is anticipated when community members first offer their services. Understanding what it is like to be a puppy raiser and working towards ways in which to address problems is essential, given that, without volunteers to train and care for puppies, vision impaired and blind people would not have access to guide dogs.

  9. Schwannomatosis with Cystic Degeneration Arising from a Single Intercostal Nerve: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Kun Woo; Lee, Young Kyung [Dept. of Radiology, Kyung Hee University College of Medicine, Seoul (Korea, Republic of); Kim, Dae Hyun [Dept. of Thoracic and Cardiovascular, Kyung Hee Hospital at Gangdong, Kyung Hee University College of Medicine, Seoul (Korea, Republic of); Sung, Dong Wook [Dept. of Radiology, Kyung Hee Medical Center, Kyung Hee University College of Medicine, Seoul (Korea, Republic of)

    2012-03-15

    An intrathoracic schwannoma is a benign neurogenic tumor that arises from the posterior mediastinum and is commonly found to be solitary. Schwannomatosis that manifests as multiple cysts is extremely rare. In this case study, we report a rare case of a 36-year-old man with no respiratory symptoms, with multiple cystic tumors in the posterior chest wall and pathologically confirmed schwannomatosis with cystic degeneration arising from a single intercostal nerve.

  10. Reversed single string technique for coronary bifurcation stenting-First report of case demonstrations in vitro.

    Science.gov (United States)

    Adjedj, Julien; Toth, Gabor G; Pellicano, Mariano; Wijns, William

    2018-02-15

    This work reports the concept and the practical feasibility of Reversed Single String bifurcation stenting technique by demonstrating three in vitro cases. Provisional T stenting is the most used interventional technique to treat coronary bifurcation lesions. However, after main branch (MB) stenting, treatment of the side branch (SB) may become indicated to provide a good final result. Currently applied methods all have their structural limitations with respect to wall coverage, multiple strut layers, poor apposition rate. We reasoned that reversing the Single String technique principle could be used as a bail out after inadequate provisional T stenting. We simulated in three silicone bifurcation phantoms a scenario whereby stenting the SB becomes indicated after provisional T stenting. Thereafter, as first step of Reversed Single String, a stent was deployed into the SB ostium with one single protruding stent-cell into the MB. After wiring that stent-cell and positioning MB balloon across it, final kissing balloon dilation was performed. Results of the in vitro Reversed Single String cases were evaluated by X-ray angiography, optical frequency domain imaging, and 3-Dimensional (3D) reconstruction (OFDI). Each case was successfully performed and completed. In the bifurcation area, perfect apposition was documented in over 81% of the struts. Malapposition remained below 4% of struts in each case. 3D OFDI reconstruction did not reveal any strut fracture. This report suggests that Reversed Single String technique might offer a potential bail out solution for provisional T-stenting cases, when treatment of the SB becomes indicated. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

  11. Virtual peer-delivered memory intervention: a single-case experimental design in an adolescent with chronic memory impairment.

    Science.gov (United States)

    Cooper, Janine M; Lockett, Stephen; McIlroy, Alissandra; Gonzalez, Linda

    2018-01-01

    Children and adolescents with chronic memory impairment may develop coping strategies that enable functioning, yet these often remain undetectable using traditional psychometric measures. Personalized intervention studies that promote the use of such strategies designed specifically for use by this young cohort are scarce. To investigate the effect of a novel virtual reality peer-delivered memory intervention on the everyday functioning and well-being of SE, a 17-year-old female with a history of chronic verbal memory issues, impaired autobiographical event recall and elevated mood symptoms. A single-case ABA experimental design study was used to assess change. Following initial baseline assessment using objective neuropsychological and subjective functional questionnaires and intervention training, case SE used the intervention daily for 3 weeks before repeating key outcome measures. Using non-overlap of all pairs and qualitative feedback analysis, the results revealed a significant increase in event recall and self-reported positive changes to levels of everyday functioning. Supporting autobiographical event recall and prospective memory via a virtual peer-delivered intervention may lead to reduction in cognitive load, and benefit overall well-being and everyday functioning.

  12. University ERP Implementation in Germany: Qualitative Exploratory Case Study of Administrative Staff Experiences

    Science.gov (United States)

    Thelen, Anja

    2015-01-01

    Enterprise Resource Planning (ERP) implementations are expensive, time-consuming, and often do not lead to the expected outcome of integrated IT systems. Many German universities are implementing ERP systems as Campus Management Systems (CMS) and a solution to any problem, need, or requirement the organization has. This exploratory case study…

  13. A Lacanian view on Balint group meetings: a qualitative analysis of two case presentations.

    Science.gov (United States)

    Van Roy, Kaatje; Vanheule, Stijn; Debaere, Virginie; Inslegers, Ruth; Meganck, Reitske; Deganck, Julie

    2014-03-21

    GPs' subjectivity is an intrinsic instrument in their daily work. By offering GPs a platform to present and discuss difficult interactions with patients, Balint group work be might provide them an opportunity to explore and articulate aspects of their subjectivity. In order to get a more profound understanding of what participation in a Balint group can offer, we focused on the process of change that can be observed during Balint group meetings. To that end, this study scrutinized two Balint group case discussions on a micro-level. Two cases were selected from a larger data set of 68 audio-taped case discussions in four Balint groups. In order to shed light on the type of change that characterizes the presenter's narrative, we used Lacan's theoretical distinction between imaginary and symbolic modes of relating to the other. In both case discussions, the GPs presenting the case initially appeared to be stuck in a fixed image of a situation, referred to as 'imaginary relating to the other.' Through a range of interactions with the group, the presenters were encouraged to explore different subject positions, which allowed them to broaden their initial image of the situation and to discover other issues at stake. This was referred to as a more symbolic way of relating to the other. This study throws light on the type of change Balint group participation allows for and on the way this might be achieved. We conclude that Balint group work is potentially beneficial to the participating GPs as well as to the relationship with their patients.

  14. Public Health Economic Burden Associated with Two Single Measles Case Investigations - Colorado, 2016-2017.

    Science.gov (United States)

    Marx, Grace E; Chase, Jennifer; Jasperse, Joseph; Stinson, Kaylan; McDonald, Carol E; Runfola, Janine K; Jaskunas, Jillian; Hite, Donna; Barnes, Meghan; Askenazi, Michele; Albanese, Bernadette

    2017-11-24

    During July 2016-January 2017, two unrelated measles cases were identified in the Denver, Colorado area after patients traveled to countries with endemic measles transmission. Each case resulted in multiple exposures at health care facilities and public venues, and activated an immediate and complex response by local and state public health agencies, with activities led by the Tri-County Health Department (TCHD), which serves Adams, Arapahoe, and Douglas counties. To track the economic burden associated with investigating and responding to single measles cases, personnel hours and supply costs incurred during each investigation were tracked prospectively. No secondary cases of measles were identified in either investigation. Postexposure prophylaxis (PEP) was administered to 31 contacts involving the first case; no contacts of the second case were eligible for PEP because of a delay in diagnosing measles disease. Public health costs of disease investigation in the first and second case were estimated at $49,769 and $18,423, respectively. Single measles cases prompted coordinated public health action and were costly and resource-intensive for local public health agencies.

  15. Qualitative and Quantitative Assessment of Wastewater of Pistachio Processing Terminals (Case Study: Kerman city

    Directory of Open Access Journals (Sweden)

    F Khademi

    2016-03-01

    Full Text Available Introduction: Wastewaters resulting from seasonal processing such as pistachio processing industry are one of the most important factors of environmental pollution. High concentration of pollutants are the qualitative characteristics of wastewaters that due high consumption of water and energy resources as well as high levels production of waste have a good potential to realization of projects to reduce the environmental impacts and optimizing the consumption of energy resources.The aim of this study was to determine the wastewater̛ s quality and quantity of pistachio processing terminals. Methods: this study is cross-sectional study that has been implemented from mid –September until late October (pistachio harvest season in each of the years 2012-2013-2014 in Kerman.Firstely according to field study, the characteristics and location of 20 pistachio processing terminals were determined by a GPS device. Then 8 pistachio processing terminals were selected in around of wastewater collection system. Composite sampling method with total of 72 samples was done in each year during pistachio operation. Samples were conducted from pistachio processing wastewater screen filter outlet. In each of samples BOD5, COD, TSS, pH and Total phenolic were determined. Sampling and tests were done according to water and wastewater standard methods book (20th edition. Concentration of Phenolic compounds was measured by folin ciocaltive method. The Data was analyzed by SPSS software. Results: the average of total produced wastewater in pistachio processing terminals in this study was 85.9m3/d. The average BOD5, COD, TSS, Total phenolic and PH were 6106, 21570, 682, 4154 (mg/L and 5.5 respectively. Conclusion: The obtained results from raw wastewater of pistachio processing terminals showed they have high BOD and COD. This is caused by presentation of priority pollutants (phenolic compounds which have high potential in pollution and toxicity for discharging any

  16. Perceived value of stroke outcome measures across the post-acute care continuum: a qualitative case study.

    Science.gov (United States)

    Danzl, Megan M; Hunter, Elizabeth G

    2013-04-01

    Connecting the continuum of post-acute care stroke services may be important for easing patients' transition between settings and facilitating recovery and community reintegration. The use of outcome measures is suggested as one means of connecting the continuum. The purpose of this qualitative case study is to describe administrators' and physiotherapists' perceived value of an outcomes program across the post-acute care stroke continuum at a rehabilitation hospital. Data were collected through individual interviews and focus groups with 18 participants. Three themes emerged on the value of the outcomes program: 1) enhanced communication; 2) supports clinical decision-making; and 3) value of objective data. These findings lend support for the use of standardized outcome measures by physiotherapists in stroke rehabilitation. Findings from this study may be useful for organizations and physiotherapists who wish to integrate outcome measures into practice.

  17. Qualitative use of Dynamic Energy Budget theory in ecotoxicology. Case study on oil contamination and Arctic copepods

    Science.gov (United States)

    Klok, Chris; Hjorth, Morten; Dahllöf, Ingela

    2012-10-01

    The Dynamic Energy Budget (DEB) theory provides a logic and consistent framework to evaluate ecotoxicological test results. Currently this framework is not regularly applied in ecotoxicology given perceived complexity and data needs. However, even in the case of low data availability the DEB theory is already useful. In this paper we apply the DEB theory to evaluate the results in three previously published papers on the effects of PAHs on Arctic copepods. Since these results do not allow for a quantitative application we used DEB qualitatively. The ecotoxicological results were thereby set in a wider ecological context and we found a logical explanation for an unexpected decline in hatching success described in one of these papers. Moreover, the DEB evaluation helped to derive relevant ecological questions that can guide future experimental work on this subject.

  18. Peer Management Interventions: A Meta-Analytic Review of Single-Case Research

    Science.gov (United States)

    Dart, Evan H.; Collins, Tai A.; Klingbeil, David A.; McKinley, Lauren E.

    2014-01-01

    Peer management intervention is a subtype of peer-mediated intervention that involves training individuals to implement standardized intervention protocols to modify the behavior of their peers. This meta-analysis of single-case research synthesized the results of 29 studies examining the effectiveness of school-based peer management…

  19. Single-port access laparoscopic abdominoperineal resection through the colostomy site: a case report

    DEFF Research Database (Denmark)

    Lauritsen, Morten; Bulut, O

    2012-01-01

    Single-port access (SPA) laparoscopic surgery is emerging as an alternative to conventional laparoscopic and open surgery, although its benefits still have to be determined. We present the case of a 87-year-old woman who underwent abdominoperineal resection (APR) with SPA. The abdominal part...

  20. Male infertility: An audit of 70 cases in a single centre

    African Journals Online (AJOL)

    E.A. Jeje

    2016-07-25

    Jul 25, 2016 ... Male infertility: An audit of 70 cases in a single centre. E.A. Jejea, T.O. Alabia, R.W. ... Objectives: To audit the aetiology, treatment and predictors of outcome in infertile men who attended urology clinic of a private hospital in ..... Ethics Committee of Lagoon Hospital Limited, Apapa, Lagos. Conflict of interest.

  1. Cognitive-Behavioral Treatment of Men and Anger: Three Single Case Studies

    Science.gov (United States)

    Gonzalez-Prendes, A. Antonio

    2007-01-01

    The treatment of men with anger problems presents significant challenges for practitioners. This article discusses a cognitive-behavioral, individual therapy, approach within the framework of three single case studies involving men. Treatment challenges and methodology are presented. Key treatment issues included: establishing a therapeutic…

  2. Single-Case Research Design: An Alternative Strategy for Evidence-Based Practice

    Science.gov (United States)

    Stapleton, Drue; Hawkins, Andrew

    2015-01-01

    Objective: The trend of utilizing evidence-based practice (EBP) in athletic training is now requiring clinicians, researchers, educators, and students to be equipped to both engage in and make judgments about research evidence. Single-case design (SCD) research may provide an alternative approach to develop such skills and inform clinical and…

  3. The Iterative Use of Single Case Research Designs to Advance the Science of EI/ECSE

    Science.gov (United States)

    Barton, Erin E.; Ledford, Jennifer R.; Lane, Justin D.; Decker, Jessica; Germansky, Sara E.; Hemmeter, Mary Louise; Kaiser, Ann

    2016-01-01

    Research in early intervention/early childhood special education (EI/ECSE) is focused on identifying effective practices related to positive outcomes for young children with disabilities and their families. Individual responses to evidence-based practices are often variable, and non-responders are common. Single case research (SCR) might be…

  4. Applying Quality Indicators to Single-Case Research Designs Used in Special Education: A Systematic Review

    Science.gov (United States)

    Moeller, Jeremy D.; Dattilo, John; Rusch, Frank

    2015-01-01

    This study examined how specific guidelines and heuristics have been used to identify methodological rigor associated with single-case research designs based on quality indicators developed by Horner et al. Specifically, this article describes how literature reviews have applied Horner et al.'s quality indicators and evidence-based criteria.…

  5. Randomization and Data-Analysis Items in Quality Standards for Single-Case Experimental Studies

    Science.gov (United States)

    Heyvaert, Mieke; Wendt, Oliver; Van den Noortgate, Wim; Onghena, Patrick

    2015-01-01

    Reporting standards and critical appraisal tools serve as beacons for researchers, reviewers, and research consumers. Parallel to existing guidelines for researchers to report and evaluate group-comparison studies, single-case experimental (SCE) researchers are in need of guidelines for reporting and evaluating SCE studies. A systematic search was…

  6. Enhancing Cultural Adaptation through Friendship Training: A Single-Case Study.

    Science.gov (United States)

    Liu, Yi-Ching; Baker, Stanley B.

    1993-01-01

    Four-year-old girl from mainland China experienced culture shock when attending American university day-care center. Counseling intern from Taiwan designed friendship training program based on assumptions concerning adaptation, acculturation, and peer relationships. Evaluated as intensive single-case study, findings indicated the program may be…

  7. Forecasting demand for single-period products : A case study in the apparel industry

    NARCIS (Netherlands)

    Mostard, Julien; Teunter, Ruud; de Koster, Rene

    2011-01-01

    The problem considered is that of forecasting demand for single-period products before the period starts. We study this problem for the case of a mail order apparel company that needs to order its products pre-season. The lack of historical demand data implies that other sources of data are needed.

  8. Academic Benefits of Peer Tutoring: A Meta-Analytic Review of Single-Case Research

    Science.gov (United States)

    Bowman-Perrott, Lisa; Davis, Heather; Vannest, Kimberly; Williams, Lauren; Greenwood, Charles; Parker, Richard

    2013-01-01

    Peer tutoring is an instructional strategy that involves students helping each other learn content through repetition of key concepts. This meta-analysis examined effects of peer tutoring across 26 single-case research experiments for 938 students in Grades 1-12. The TauU effect size for 195 phase contrasts was 0.75 with a confidence interval of…

  9. No Randomization? No Problem: Experimental Control and Random Assignment in Single Case Research

    Science.gov (United States)

    Ledford, Jennifer R.

    2018-01-01

    Randomization of large number of participants to different treatment groups is often not a feasible or preferable way to answer questions of immediate interest to professional practice. Single case designs (SCDs) are a class of research designs that are experimental in nature but require only a few participants, all of whom receive the…

  10. Procedural Sensitivities of Effect Sizes for Single-Case Designs with Directly Observed Behavioral Outcome Measures

    Science.gov (United States)

    Pustejovsky, James E.

    2018-01-01

    A wide variety of effect size indices have been proposed for quantifying the magnitude of treatment effects in single-case designs. Commonly used measures include parametric indices such as the standardized mean difference, as well as non-overlap measures such as the percentage of non-overlapping data, improvement rate difference, and non-overlap…

  11. The Causes of Churn in the Telecommunication Industry: A Single, Exploratory Case Study on Kenyan Carriers

    Science.gov (United States)

    Halim, Joseph

    2015-01-01

    This single explorative case study investigated the causes of churn in the telecommunication industry in Kenya, narrowed down to include only the capital city of Nairobi. The question of this dissertation was split into three sub-questions. The first sub-question investigated the behavioral patterns of customers causing churn. The second…

  12. Generalized Single-Case Randomization Tests: Flexible Analyses for a Variety of Situations.

    Science.gov (United States)

    Levin, Joel R.; Wampold, Bruce E.

    1999-01-01

    Presents a general class of single-case statistical procedures derived from previously developed nonparametric randomization tests. Designs are illustrated that focus on the general and comparative effectiveness of alternative interventions, multiple units with differentiable characteristics, and multiple outcome measures. Provides operational…

  13. Can you see me? Experiences of nurses working night shift in Australian regional hospitals: a qualitative case study.

    Science.gov (United States)

    Powell, Idona

    2013-10-01

    To report a study that explored the experiences of night-shift nurses, focusing on employee interrelationships and work satisfaction. Night-shift nurses are a critical component in hospital care making it essential to understand the experiences that give meaning to their work and understand how these nurses and the organization can benefit from their contribution to hospital care. A literature review revealed minimal research in this area. Qualitative case study. A qualitative case study using semi-structured interviews and self-completed diaries was conducted in 2010 in regional public hospitals in Australia. Participants were 14 nurses working nights half or more of their shifts in medical or surgical wards. Thematic analysis identified four major areas of concern: work relationships, work environment, work practices and lifestyle impact. Notably, work relationships were most meaningful for nurses on the same shift; night-shift nurses experienced working conditions inferior to their daytime counterparts including a perception of minimal leadership. Despite limited education opportunities, night shift provided opportunity for professional growth for some nurses with a slippage in skills for others; night shift provided flexibility for family and social activities, yet impeded these same activities, primarily due to pervasive fatigue. Night-shift nurses considered their role critical, yet believed that they were poorly regarded. The strong interpersonal relationships developed between night-shift workers need to be capitalized on whilst developing a more effective leadership model, improved work environment, more equitable professional development, and genuine recognition of the critical role of night nurses. © 2013 Blackwell Publishing Ltd.

  14. A qualitative model for strategic analysis of organizations. Application and alternative proposal on a study case

    Directory of Open Access Journals (Sweden)

    Santiago Ferro Moreno

    2015-12-01

    Full Text Available The strategic analysis of organizations is based on the internal and external environments, in order to identify positive and negative variables and factors. The interrelation and timing of these strategic forces are essential to create alternative solutions that tend to achieve the organizational objectives.The normative prospective has theorical and methodological foundations to create a desired future and from it, be able to identify impelling and restraining forces that have influence on the particular problematic situation (go from the current situation to a better one in a certain time.The aim of this article is to analyze on a strategic way a real case with a normative-prospective model that considers the temporal dynamics of the factors impact and variables in time allowing to suggest alternative solutions.Semi-structured interviews were performed with all the employees of this case and structured observations and workshops with the commercial and general management.In consequence, with the results, the desired, current and improved situations were built. Additionally, forces were identified classified and appreciated and lastly solutions were suggested. With the proposed prospective method, alternative solutions could be constructed in order to settle temporary organizational objectives. No constraints were found to use the current method in other cases.Keywords: Strategic forces, Normative prospective, Problematic situations, Strategies

  15. Literacy learning in secondary school science classrooms: A cross-case analysis of three qualitative studies

    Science.gov (United States)

    Dillon, Deborah R.; O'Brien, David G.; Moje, Elizabeth B.; Stewart, Roger A.

    The purpose of this cross-case analysis is to illustrate how and why literacy was incorporated into science teaching and learning in three secondary classrooms. Research questions guiding the analysis include: (a) How were literacy events shaped by the teachers' philosophies about teaching science content and teaching students? and (b) How was literacy (reading, writing, and oral language) structured by the teachers and manifested in science lessons? The methodology of ethnography and the theoretical framework of symbolic interactionism were employed in the three studies on which the cross-case analysis was based. The researchers assumed the role of participant observers, collecting data over the period of 1 year in each of the three classrooms. Data, in the form of fieldnotes, interviews, and artifacts, were collected. In each study, data were analyzed using the constant comparative method (Glaser & Strauss, 1967) to determine patterns in the teachers' beliefs about learning and how these influenced their choice of literacy activities. The cross-case analysis was conducted to determine patterns across the three teachers and their classrooms. The findings from this analysis are used to compare how the teachers' philosophies of teaching science and their beliefs about how students learn influenced their use of literacy practices during lessons. Specifically, each teacher's use of literacy activities varied based on his or her beliefs about teaching science concepts. Furthermore, reading, writing, and oral language were important vehicles to learning science concepts within daily classroom activities in the three classrooms.Received: 1 April 1993; Revised: 30 August 1993;

  16. A qualitative analysis of student Balint groups in medical education: contexts and triggers of case presentations and discussion themes.

    Science.gov (United States)

    Torppa, Martina A; Makkonen, Eeva; Mårtenson, Camilla; Pitkälä, Kaisu H

    2008-07-01

    No previous rigorous qualitative studies exist on student Balint groups. The aim of this study was to explore the contexts and triggers of cases presented in student Balint groups and to clarify the themes in the group discussions. Fifteen student Balint sessions in two groups were organised. Nine female students participated. A grounded theory-based approach with thematic content analysis of the field notes was used. We identified five triggers for case narrations (witnessing injustice, value conflict, difficult human relationships, incurable patient, role confusion) that originated from three distinct contexts (patient encounters, confusing experiences in medical education, tension between privacy and profession). Four main discussion themes could be identified (feelings related to patients, building professional identity, negative role models, cooperation with other medical professionals). The concept of case in student Balint groups was wider than in traditional Balint groups. Feelings related to patients and to one's own role as a doctor were openly discussed in groups. The discussions often touched on professional growth and future professional identity as doctors. The Balint groups may support medical students' professional growth process. This topic warrants further study in more heterogeneous student groups.

  17. Monitoring progression of clinical reasoning skills during health sciences education using the case method - a qualitative observational study.

    Science.gov (United States)

    Orban, Kristina; Ekelin, Maria; Edgren, Gudrun; Sandgren, Olof; Hovbrandt, Pia; Persson, Eva K

    2017-09-11

    Outcome- or competency-based education is well established in medical and health sciences education. Curricula are based on courses where students develop their competences and assessment is also usually course-based. Clinical reasoning is an important competence, and the aim of this study was to monitor and describe students' progression in professional clinical reasoning skills during health sciences education using observations of group discussions following the case method. In this qualitative study students from three different health education programmes were observed while discussing clinical cases in a modified Harvard case method session. A rubric with four dimensions - problem-solving process, disciplinary knowledge, character of discussion and communication - was used as an observational tool to identify clinical reasoning. A deductive content analysis was performed. The results revealed the students' transition over time from reasoning based strictly on theoretical knowledge to reasoning ability characterized by clinical considerations and experiences. Students who were approaching the end of their education immediately identified the most important problem and then focused on this in their discussion. Practice knowledge increased over time, which was seen as progression in the use of professional language, concepts, terms and the use of prior clinical experience. The character of the discussion evolved from theoretical considerations early in the education to clinical reasoning in later years. Communication within the groups was supportive and conducted with a professional tone. Our observations revealed progression in several aspects of students' clinical reasoning skills on a group level in their discussions of clinical cases. We suggest that the case method can be a useful tool in assessing quality in health sciences education.

  18. Making the case for a fracture liaison service: a qualitative study of the experiences of clinicians and service managers.

    Science.gov (United States)

    Drew, Sarah; Gooberman-Hill, Rachael; Farmer, Andrew; Graham, Laura; Javaid, M Kassim; Cooper, Cyrus; Judge, Andrew

    2015-10-01

    To develop services, healthcare professionals must make business cases to managerial bodies within Hospital Trusts and if approved, to commissioning bodies. Patients with hip fracture are at high risk of subsequent fracture. To prevent this, guidance recommends structuring fracture prevention services around coordinator based models. These are known as Fracture Liaison Services (FLS). 33 semi-structured qualitative interviews were conducted with healthcare professionals with experience of making business cases for FLS. Data was analysed thematically. Challenges in the development of business cases included collecting all the relevant data and negotiating compartmentalised budgets that impeded service development. Participants described communication and cooperation between providers and commissioners as variable. They felt financial considerations were the most important factor in funding decisions, while improved quality of care was less influential. Other factors included national guidelines and political priorities. The personalities of clinicians championing services, and the clinical interests of commissioners were seen to influence the decision-making process, suggesting that participants felt that decisions were not always made on the basis of evidence-based care. Effective strategies included ways of providing support, demonstrating potential cost effectiveness and improved quality of care. Using a range of sources including audit data collected on the successful Glasgow FLS, and improving cooperation between stakeholders was advocated. Participants felt that the work of commissioners and providers should be better integrated and suggested strategies for doing this. This study provides information to healthcare professionals about how best to develop business cases for FLS. We conclude with recommendations on how to develop effective cases. These include using guidance such as toolkits, aligning the aims of FLS with national priorities and benchmarking

  19. Factors associated with sustainability of 2 quality improvement programs after achieving early implementation success. A qualitative case study.

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    Ament, Stephanie M C; Gillissen, Freek; Moser, Albine; Maessen, José M C; Dirksen, Carmen D; von Meyenfeldt, Maarten F; van der Weijden, Trudy

    2017-12-01

    Sustainability of innovations is a relatively new concept in health care research and has become an issue of growing interest. The current study explored factors related to the sustainability of 2 multidisciplinary hospital-based programs 3 to 6 years after achieving early implementation success. An exploratory qualitative study was conducted into 2 implementation cases, an Enhanced Recovery After Surgery program for colorectal surgery and a short-stay program for breast cancer surgery. Semistructured interviews were held with key persons involved in the care process in 14 hospitals from both cases minimally 3 years after the implementation, between March 2012 and May 2013. The Consolidated Framework for Implementation Research was used to direct the development of the interview guide, during data collection and during analysis. A directed content analysis was performed. A total of 21 interviews with 26 individuals were held, 18 regarding the Enhanced Recovery After Surgery case and 8 regarding the short-stay program case. Respondents mentioned the following factors associated with sustainability of the programs: modification and adaptability of the program, cost-effectiveness, institutionalization into existing systems, short communication lines within the multidisciplinary team, an innovative culture, benefits for patients, cosmopolitanism, the existence of external policies and incentives, trust and belief in the program, and spread of the program to other settings. Two factors are not covered by the Consolidated Framework for Implementation Research, ie, modification of the program over the years and spread of the program to other contexts. The factors associated with sustainability put forward in both cases were largely the same. Leadership and the implementation project were not mentioned as having influenced the long-term sustainability of the benefits achieved. Sustainability of the innovations is influenced by determinants stemming from all ecological

  20. The quantitative and qualitative contributions of faith-based organizations to healthcare: The Kenya case

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    Alfredo L. Fort

    2017-01-01

    Full Text Available Although faith based organizations (FBOs have had a long presence teaching health personnel and delivering health services to many rural and remote populations in the developing world, their poor visibility for this work can be due to several factors. FBOs may keep a low profile, be confused with non-religious non-governmental organizations (NGOs, or be excluded from surveys because respondents may not know the affiliation of the healthcare facility from which they last received services. It has been argued that their large networks, logistics agreements with governments, and mission-driven stance bring them closer to the communities they serve and that their services have been a higher quality than average.Kenya has had a long history of established FBOs but there has also been substantial recent health investment by the government. We aimed to find the quantitative and qualitative contributions of FBOs by analyzing two recent data sources: the live web-based nationwide Master Health Facility List and the 2010 nationwide Service Provision Assessment (SPA survey. Using this information, we found that FBOs contribute to 11% of all health facilities’ presence in the country, doubling to 23% of all available beds, indicating their relative strength in owning mid-level hospitals around the country.We also constructed an index of “readiness” as a weighted average from services offered, good management practices, and availability of medicines and commodities for 17 items assessed during the SPA survey. We found that FBOs topped the list of managing authorities, with 69 percent of their health facilities achieving such readiness, followed closely by the government at 68 percent, NGOs at 60 percent and lastly a distant private for-profit sector at 51 percent.These results seem to confirm that FBOs continue to contribute to an important proportion of health care coverage in Kenya and do so with a relatively high quality of care among all actors

  1. Treatment of visuospatial neglect with biparietal tDCS and cognitive training: a single-case study

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    Anna-Katharine eBrem

    2014-09-01

    Full Text Available Symptoms of visuospatial neglect occur frequently after unilateral brain damage. Neglect hampers rehabilitation progress and is associated with reduced quality of life. However, existing treatment methods show limited efficacy. Transcranial direct current stimulation (tDCS is a neuromodulatory technique, which can be used to increase or decrease brain excitability. Its combination with conventional neglect therapy may enhance treatment efficacy.A 72-year-old male with a subacute ischaemic stroke of the right posterior cerebral artery suffering from visuospatial neglect, hemianopia, and hemiparesis was treated with biparietal tDCS and cognitive neglect therapy in a double-blind, sham-controlled single-case study. Four weeks of daily treatment sessions (5 days per week, 30 min were started 26 days post-stroke. During week 1 and 4 the patient received conventional neglect therapy, during week 2, conventional neglect therapy was combined once with sham and once with real biparietal tDCS. Week 3 consisted of daily sessions of real biparietal tDCS (1 mA, 20 min combined with neglect therapy. Outcome measures were assessed before, immediately after, as well as 1 week and 3 months after the end of treatment. They included subtests of the Test for Attentional Performance (TAP: covert attention (main outcome, alertness, visual field; the Neglect-Test (NET: line bisection, cancellation, copying; and activities of daily living (ADL. After real stimulation, covert attention allocation towards left-sided invalid stimuli was significantly improved, and line bisection and copying improved qualitatively as compared to sham stimulation. ADL were only improved at the 3-month follow-up. This single-case study demonstrates for the first time that combined application of tDCS and cognitive training may enhance training-induced improvements in measures of visuospatial neglect and is applicable in a clinical context.

  2. Meeting End User Needs in Collaborative Medical Device Technology Development Research Projects: A Qualitative Case Study.

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    Strisland, Frode; Svagård, Ingrid Storruste; Austad, Hanne Opsahl; Reitan, Jarl

    2017-01-01

    The aim of this case study has been to investigate to what extent user centered design (UCD) methodologies have been applied, how the process and outcomes were perceived by project team members, and what were potential barriers towards meeting end user needs. The case studied was the European Union Framework 7 integrated project d-LIVER (2011-2015), which aimed at developing an integrated care system for chronic liver disease patient management. d-LIVER is an example of a public funded, international, multidisciplinary, collaborative research project where development starts from a low technology readiness level, but where research is motivated by societal needs for better health care solutions. Awareness of central end user needs are therefore crucial. 14 project participants were interviewed. To meet societal and end user needs represent a prominent motivation factor for participants. The project organization with only clinical partners interacting with end users was accepted as a fact of life and not as a project pain point. A summary of observations and recommendations for good practice is given.

  3. Defining the Meaning of Spirituality Through a Qualitative Case Study of Sheltered Homeless Women.

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    Hurlbut, Jené; Ditmyer, Marcia

    2016-01-01

    The primary purpose of this case study was to assess the meaning of spirituality in a convenience sample of women located in an urban city in the southwest United States. The secondary purpose was to describe their lived experiences associated with spirituality. From these interviews five themes emerged: Belief in God or a Higher Power, Distinction Between Religion and Spirituality, Belief That There Is a Plan for Their Lives, Spirituality Providing Guidance for What Is Right/Wrong, and Belief That Their Lives Will Improve. These findings support the perceived fundamental importance of spirituality in the lives of homeless women. Nurses and other clinicians can use this information to develop interventions to help support women using spirituality practices and to help improve the outlook of homelessness for these women. © 2016 AWHONN, the Association of Women’s Health, Obstetric and Neonatal Nurses.

  4. Student Response to Remote-Online Case-Based Learning: A Qualitative Study.

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    Nicklen, Peter; Keating, Jennifer L; Maloney, Stephen

    2016-03-22

    Case-based learning (CBL) typically involves face-to-face interaction in small collaborative groups with a focus on self-directed study. To our knowledge, no published studies report an evaluation of Web conferencing in CBL. The primary aim of this study was to explore student perceptions and attitudes in response to a remote-online case-based learning (RO-CBL) experience. This study took place over a 2-week period in 2013 at Monash University, Victoria, Australia. A third year cohort (n=73) of physiotherapy students was invited to participate. Students were required to participate in 2 training sessions, followed by RO-CBL across 2 sessions. The primary outcome of interest was the student feedback on the quality of the learning experience during RO-CBL participation. This was explored with a focus group and a survey. Most students (68/73) completed the postintervention survey (nonparticipation rate 8%). RO-CBL was generally well received by participants, with 59% (40/68) of participates stating that they'd like RO-CBL to be used in the future and 78% (53/68) of participants believing they could meet the CBL's learning objectives via RO-CBL. The 4 key themes relevant to student response to RO-CBL that emerged from the focus groups and open-ended questions on the postintervention survey were how RO-CBL compared to expectations, key benefits of RO-CBL including flexibility and time and cost savings, communication challenges in the online environment compared to face-to-face, and implications of moving to an online platform. Web conferencing may be a suitable medium for students to participate in CBL. Participants were satisfied with the learning activity and felt they could meet the CBL's learning objectives. Further study should evaluate Web conferencing CBL across an entire semester in regard to student satisfaction, perceived depth of learning, and learning outcomes.

  5. Characteristics of Patient-Centered Medical Home Initiatives that Generated Savings for Medicare: a Qualitative Multi-Case Analysis.

    Science.gov (United States)

    Burton, Rachel A; Lallemand, Nicole M; Peters, Rebecca A; Zuckerman, Stephen

    2018-02-05

    Through the Multi-Payer Advanced Primary Care Practice (MAPCP) Demonstration, Medicare, Medicaid, and private payers offered supplemental payments to 849 primary care practices that became patient-centered medical homes (PCMHs) in eight states; practices also received technical assistance and data reports. Average Medicare payments were capped at $10 per beneficiary per month in each state. Since there was variation in the eight participating states' demonstration designs, experiences, and outcomes, we conducted a qualitative multi-case analysis to identify the key factors that differentiated states that were estimated to have generated net savings for Medicare from states that did not. States' MAPCP Demonstration initiatives were comprehensively profiled in case studies based on secondary document review, three rounds of annual interviews with state staff, payers, practices, and other stakeholders, and other data sources. Case study findings were summarized in a case-ordered predictor-outcome matrix, which identified the presence or absence of key demonstration design features and experiences and arrayed states based on the amount of net savings or losses they generated for Medicare. We then used this matrix to identify initiative features that were present in at least three of the four states that generated net savings and absent from at least three of the four states that did not generate savings. A majority of the states that generated net savings: required practices to be recognized PCMHs to enter the demonstration, did not allow late entrants into the demonstration, used a consistent demonstration payment model across participating payers, and offered practices opportunities to earn performance bonuses. Practices in states that generated net savings also tended to report receiving the demonstration payments and bonuses they expected to receive, without any issues. Designers of future PCMH initiatives may increase their likelihood of generating net savings by

  6. Evaluating fidelity in home-visiting programs a qualitative analysis of 1058 home visit case notes from 105 families.

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    Thomas Saïas

    Full Text Available Implementation fidelity is a key issue in home-visiting programs as it determines a program's effectiveness in accomplishing its original goals. This paper seeks to evaluate fidelity in a 27-month program addressing maternal and child health which took place in France between 2006 and 2011.To evaluate implementation fidelity, home visit case notes were analyzed using thematic qualitative and computer-assisted linguistic analyses.During the prenatal period, home visitors focused on the social components of the program. Visitors discussed the physical changes in pregnancy, and psychological and social environment issues. Discussing immigration, unstable employment and financial related issues, family relationships and dynamics and maternity services, while not expected, were found in case notes. Conversely, health during pregnancy, early child development and postpartum mood changes were not identified as topics within the prenatal case notes. During the postnatal period, most components of the intervention were addressed: home visitors observed the mother's adaptation to the baby; routine themes such as psychological needs and medical-social networks were evaluated; information on the importance of social support and on adapting the home environment was given; home visitors counseled on parental authority, and addressed mothers' self-esteem issues; finally, they helped to find child care, when necessary. Some themes were not addressed or partially addressed: health education, child development, home environment, mother's education plans and personal routine, partner support and play with the child. Other themes were not expected, but found in the case notes: social issues, mother-family relationship, relation with services, couple issues, quality of maternal behavior and child's language development.In this program, home visitors experienced difficulties addressing some of the objectives because they gave precedence to the families' urgent needs

  7. How novice, skilled and advanced clinical researchers include variables in a case report form for clinical research: a qualitative study.

    Science.gov (United States)

    Chu, Hongling; Zeng, Lin; Fetters, Micheal D; Li, Nan; Tao, Liyuan; Shi, Yanyan; Zhang, Hua; Wang, Xiaoxiao; Li, Fengwei; Zhao, Yiming

    2017-09-18

    Despite varying degrees in research training, most academic clinicians are expected to conduct clinical research. The objective of this research was to understand how clinical researchers of different skill levels include variables in a case report form for their clinical research. The setting for this research was a major academic institution in Beijing, China. The target population was clinical researchers with three levels of experience, namely, limited clinical research experience, clinicians with rich clinical research experience and clinical research experts. Using a qualitative approach, we conducted 13 individual interviews (face to face) and one group interview (n=4) with clinical researchers from June to September 2016. Based on maximum variation sampling to identify researchers with three levels of research experience: eight clinicians with limited clinical research experience, five clinicians with rich clinical research experience and four clinical research experts. These 17 researchers had diverse hospital-based medical specialties and or specialisation in clinical research. Our analysis yields a typology of three processes developing a case report form that varies according to research experience level. Novice clinician researchers often have an incomplete protocol or none at all, and conduct data collection and publication based on a general framework. Experienced clinician researchers include variables in the case report form based on previous experience with attention to including domains or items at risk for omission and by eliminating unnecessary variables. Expert researchers consider comprehensively in advance data collection and implementation needs and plan accordingly. These results illustrate increasing levels of sophistication in research planning that increase sophistication in selection for variables in the case report form. These findings suggest that novice and intermediate-level researchers could benefit by emulating the comprehensive

  8. Task shifting of HIV/AIDS case management to Community Health Service Centers in urban China: a qualitative policy analysis.

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    Ma, Fuchang; Lv, Fan; Xu, Peng; Zhang, Dapeng; Meng, Sining; Ju, Lahong; Jiang, Huihui; Ma, Liping; Sun, Jiangping; Wu, Zunyou

    2015-07-02

    The growing number of people living with HIV/AIDS (PLWHA) in China points to an increased need for case management services of HIV/AIDS. This study sought to explore the challenges and enablers in shifting the HIV/AIDS case management services from Centers for Disease Control and Prevention (CDCs) to Community Health Service Centers (CHSCs) in urban China. A qualitative method based on the Health Policy Triangle (HPT) framework was employed to gain in-depth insights into four elements of the task shifting strategy. This included a review on published literature and health policy documents, 15 focus group discussions (FGDs) and 30 in-depth interviews (IDIs) with four types of key actors from three cities in China. A total of 78 studies and 17 policy files at the national, municipal and local levels were obtained and reviewed comprehensively. Three semi-structured interview guides were used to explore key actors' views on shifting the HIV/AIDS case management services to CHSCs. It is necessary and feasible for CHSCs to engage in case management services for PLWHA in local communities. The increasing number of PLWHA and shortage of qualified health professionals in CDCs made shifting case management services downwards to CHSCs an urgent agenda. CHSCs' wide distribution, technical capacity, accessibility and current practice enabled them to carry out case management services for PLWHA. However our findings indicated several challenges in this task shifting process. Those challenges included lack of specific policy and stable financial support for CHSCs, inadequate manpower, relatively low capacity for health service delivery, lack of coordination among sectors, PLWHA's fear for discrimination and privacy disclosure in local communities, which may compromise the effectiveness and sustainability of those services. Shifting the HIV/AIDS case management services from CDCs to CHSCs is a new approach to cope with the rising number of PLWHA in China, but it should be

  9. Functionally generated amalgam stops for single complete denture: A case report

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    Pravinkumar G Patil

    2009-01-01

    Full Text Available Single complete denture opposing natural dentition is a common occurrence in clinical practice. This article reports a case of a single complete denture with a technique of occlusal refinement by func-tionally generated amalgam stops condensed in prepared resin teeth after initial balancing of the den-ture with semi-adjustable articulator. This technique provides intimacy of contact in all excursions by carving the amalgam in plastic stage. Amalgam stops improve the efficiency of the resin teeth. Den-tures fabricated using this technique require fewer and simpler post-insertion adjustments.

  10. A qualitative case study of evaluation use in the context of a collaborative program evaluation strategy in Burkina Faso.

    Science.gov (United States)

    D'Ostie-Racine, Léna; Dagenais, Christian; Ridde, Valéry

    2016-05-26

    Program evaluation is widely recognized in the international humanitarian sector as a means to make interventions and policies more evidence based, equitable, and accountable. Yet, little is known about the way humanitarian non-governmental organizations (NGOs) actually use evaluations. The current qualitative evaluation employed an instrumental case study design to examine evaluation use (EU) by a humanitarian NGO based in Burkina Faso. This organization developed an evaluation strategy in 2008 to document the implementation and effects of its maternal and child healthcare user fee exemption program. Program evaluations have been undertaken ever since, and the present study examined the discourses of evaluation partners in 2009 (n = 15) and 2011 (n = 17). Semi-structured individual interviews and one group interview were conducted to identify instances of EU over time. Alkin and Taut's (Stud Educ Eval 29:1-12, 2003) conceptualization of EU was used as the basis for thematic qualitative analyses of the different forms of EU identified by stakeholders of the exemption program in the two data collection periods. Results demonstrated that stakeholders began to understand and value the utility of program evaluations once they were exposed to evaluation findings and then progressively used evaluations over time. EU was manifested in a variety of ways, including instrumental and conceptual use of evaluation processes and findings, as well as the persuasive use of findings. Such EU supported planning, decision-making, program practices, evaluation capacity, and advocacy. The study sheds light on the many ways evaluations can be used by different actors in the humanitarian sector. Conceptualizations of EU are also critically discussed.

  11. THE EFFECTS OF CULTURE ON KNOWLEDGE MANAGEMENT PRACTICE: A QUALITATIVE CASE STUDY OF MSC STATUS COMPANIES

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    Charmaine Ryan

    2006-01-01

    Full Text Available Knowledge is recognised as being an important asset in organisations these days. Despite this, many organisations are not doing enough to effectively manage this important asset for its competitive advantage. In response to this, knowledge management which is defined as a process that effectively creates, captures, shares and uses organisation-wide knowledge to improve the organisation’s performance was conceived and has since gained widespread acceptance the world over. Despite its widespread acceptance, little is known about the current levels of knowledge management within the Malaysian context, in particular amongst the Multimedia Super Corridor (MSC status companies in Malaysia. Furthermore, the extent to which cultural factors impact upon knowledge management practice in these companies is not known. This study investigated the various cultural factors (collaboration, mutual trust, leadership and incentives/rewards using a multiple case study approach operating within a critical realism research paradigm and found that these factors have impact on the level of knowledge management practice. The study also established that cultural factors do play an important role in facilitating knowledge management practice in these MSC status companies in Malaysia. It was found that collaboration, mutual trust, leadership, kiasu-ism and incentives/rewards have significant impact on the level of knowledge management practice. In view of the findings of this study, it is suggested that the relevant authorities pay adequate attention on these cultural factors to ensure that the knowledge management initiatives undertaken by Malaysian companies are effectively deployed.

  12. The case of Iranian immigrants in the greater Toronto area: a qualitative study

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    Dastjerdi Mahdieh

    2012-02-01

    Full Text Available Abstract Introduction Iranians comprise an immigrant group that has a very different cultural background from that of the mainstream Canadian population and speaks a language other than English or French; in this case mainly Farsi (Persian. Although Iranian immigrants in Toronto receive a high proportion of care from Farsi-speaking family physicians and health care providers than physicians who cannot speak Farsi, they are still not satisfied with the provided services. The purpose of this study was to identify the obstacles and issues Iranian immigrants faced in accessing health care services as seen through the eyes of Iranian health care professionals/providers and social workers working in Greater Toronto Area, Canada. Methods Narrative inquiry was used to capture and understand the obstacles this immigrant population faces when accessing health care services, through the lens of fifty Iranian health care professionals/providers and social workers. Thirty three health care professionals and five social workers were interviewed. To capture the essence of issues, individual interviews were followed by three focus groups consisting of three health care professionals and one social worker in each group. Results Three major themes emerged from the study: language barrier and the lack of knowledge of Canadian health care services/systems; lack of trust in Canadian health care services due to financial limitations and fear of disclosure; and somatization and needs for psychological supports. Conclusion Iranians may not be satisfied with the Canadian health care services due to a lack of knowledge of the system, as well as cultural differences when seeking care, such as fear of disclosure, discrimination, and mistrust of primary care. To attain equitable, adequate, and effective access to health care services, immigrants need to be educated and informed about the Canadian health care system and services it provides. It would be of great benefit to

  13. Direct Training to Improve Educators' Treatment Integrity: A Systematic Review of Single-Case Design Studies.

    Science.gov (United States)

    Fallon, Lindsay M; Kurtz, Kathryn D; Mueller, Marlana R

    2017-06-15

    In consultation, school psychologists may offer educators direct training to support the implementation of classroom interventions aimed to improve student outcomes. The purpose of this study was to conduct a systematic literature review of single-case design research studies during which educators received direct training to implement a classroom intervention, specifically instructions, modeling, practice, and feedback. Two doctoral students in school psychology screened 228 articles and evaluated 33 studies to determine if direct training is effective and an evidence-based practice per single-case design standards proposed by the What Works Clearinghouse. Results of the review indicate that there is support for the practice to be deemed evidence-based and associated with better intervention implementation than before its application. Implications include direct training being considered for intensive, complex interventions to promote educator success with implementation. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  14. Single-port Robotic Pelvic Bulky Lymph Node Resection: A Case Report.

    Science.gov (United States)

    Gungor, Mete; Takmaz, Ozguc; Afsar, Selim; Ozbasli, Esra; Gundogan, Savas

    To report the feasibility of bulky pelvic lymph node resection with robotic-assisted single-port laparoscopy in a patient with cervical cancer before chemoradiation therapy. Resection of pelvic bulky lymph nodes with a narrated video of da Vinci single-port platform surgery (Intuitive Surgical, Sunnyvale, CA) (Canadian Task Force classification III). Although not enough evidence exists to reveal that single-site surgery is better than traditional endoscopic surgery, several studies have suggested that single-site robotic surgery has certain advantages such as less postoperative analgesic use, shorter hospital stay, and quicker recovery. Furthermore, robotic single-site surgery has evolved single-site procedures. Compared with the single-port laparoendoscopic procedure, the robotic-assisted single-port laparoscopic procedure offers some advantages to minimally invasive surgery such as greater dexterity, 3-dimensional visualization, and fewer instrument clashes. These advantages make robotic single-port surgery more preferable; nevertheless, the lack of articulating instruments and the low quality of optical exposure are still challenges. Robotic single-port pelvic lymphadenectomy was first described by Tateo et al [1] in an endometrial carcinoma patient. We present a robotic single-port pelvic bulky lymph node resection in an advanced cervical cancer patient. Even though current data are controversial about removing bulky lymph nodes in patients with advanced cervical cancer, some studies have recommended that debulking of tumor-involved lymph nodes before chemoradiation may be benefical for these patients (Leblanc et al [2], Marnitz et al [3]). In our case, the patient underwent robotic-assisted single-port laparoscopy using the da Vinci Single-Site platform. The abdominal cavity was insufflated from a 3-cm umblical incision, and a 5-lumen single port was inserted. Then, an 8.5-mm 3-dimensional camera was inserted through the port, and for dissection and

  15. Evaluation of how a real time pre-registration health care curricula was managed through the application of a newly designed Change Management Model: A qualitative case study.

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    Chowthi-Williams, Annette

    2018-02-01

    Curricula change in nurse education is of international importance. The pace of such change has been continuous and has triggered criticisms of inadequate preparation of practitioners. There are no change formulae for managing curricula change and despite a raft of change methods, globally change success remains low. A lack of a unified voice, undue focus on cognition, and arguably no existing models for academia and a literature gap contribute to change challenge. A new Change Management Model designed from research with emotion as its underpinning philosophy is evaluated. Evaluation of a newly designed Change Management Model through a real time pre-registration health care curricula change. A qualitative case study was adopted. The single case study was the new pre-registration health care curricula. This study took place in a Faculty of Health and Social care in one HEI in the UK. Four senior academics and fifteen academics across professions and specialisms involved in the curricula change took part in the study. The findings suggested that leadership operated differently throughout the organisation. Distributive and collective leadership created a critical mass of people to help deliver the new curricula but academics felt excluded at the strategic level. Emotion at the strategic level inhibited innovation but boosted engagement, emotional relationships and creativity at the operational level. Face to face communication was favoured for its emotional connection. A top down approach created an emotional disconnect and impacted inclusiveness, engagement, empowerment, vision and readiness for change. Testing the new model widely not only in organisations, practice and team changes but personal change in improving health and wellbeing could be beneficial. The continuing gap in knowledge on the link between emotion and curricula change, practice and organisational change and therapeutic value of the model also warrants further research. Crown Copyright © 2017

  16. Bilateral involvement of a single cranial nerve: analysis of 578 cases.

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    Keane, James R

    2005-09-27

    The author reviewed 34 years of personal experience with inpatients in a large municipal hospital to analyze the seats and causes of involvement of single pairs of cranial nerves. Among 578 cases, the sixth (n = 234) and second (211) nerves predominated, followed by the fourth (48), seventh (30), third (27), and eighth (18) cranial nerves. Trauma (99), infection (94), tumor (92), increased intracranial pressure (85), vascular disease (74), and demyelination (66) were common causes.

  17. Single-session treatment of a major complication of dens invaginatus: a case report.

    Science.gov (United States)

    Caldari, Mauro; Monaco, Carlo; Ciocca, Leonardo; Scotti, Roberto

    2006-05-01

    Dens invaginatus is a dental malformation that may give rise to several complications. Caries of the invagination can severely weaken the whole tooth, making it susceptible to fracture. Subgingival fractures are major complications threatening tooth survival and usually require periodontal/orthodontic/prosthetic treatment if long-term viability is to be ensured. This article describes a case of single-session restoration of a fractured invaginated tooth by means of endodontic treatment followed by fragment reattachment.

  18. Naturally-Emerging Technology-Based Leadership Roles in Three Independent Schools: A Social Network-Based Case Study Using Fuzzy Set Qualitative Comparative Analysis

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    Velastegui, Pamela J.

    2013-01-01

    This hypothesis-generating case study investigates the naturally emerging roles of technology brokers and technology leaders in three independent schools in New York involving 92 school educators. A multiple and mixed method design utilizing Social Network Analysis (SNA) and fuzzy set Qualitative Comparative Analysis (FSQCA) involved gathering…

  19. Teachers' Perceptions of Whole-Class Mathematical Discourse: A Qualitative Multi-Phased Case Study of Middle Level Public School Mathematics Teachers

    Science.gov (United States)

    Bennett, Cory A.

    2010-01-01

    This four phase qualitative case study examined middle level mathematics teachers' perspective on the use of whole-class discourse as an instructional strategy to help all students learn mathematics. The primary research question that guided this study was what were middle level teachers' perceptions towards classroom discourse and how did their…

  20. A Qualitative Multi-Case Study of the Influence of Personal and Professional Ethics on the Leadership of Public School Superintendents

    Science.gov (United States)

    McDermott, Brian J.

    2010-01-01

    The purpose of this study is to examine the influence of personal and professional ethics on the leadership of public school superintendents. A multi-case, qualitative research design was used to gather data from four practicing public school superintendents. Transformational leadership theory and the three pillars of ethics of leadership…

  1. The Impact of TRIO's Upward Bound and Student Support Services: A Qualitative Case Study of Students Who Participated in Both Programs

    Science.gov (United States)

    Shipp Meeks, Jada

    2009-01-01

    The purpose of this qualitative case study was to understand how students' involvement in TRIO Upward Bound and Student Support Services has affected their decision to persist in obtaining a postsecondary degree. The overall aim in the study was to explore critical influences on the student's participation in these services, particularly those…

  2. Operationally Comparable Effect Sizes for Quantifying Changes in Behavior, with Application to Meta-Analysis of Single-Case Studies

    Science.gov (United States)

    Pustejovsky, James E.

    2013-01-01

    Single-case designs (SCDs) are a class of research methods for evaluating intervention effects by taking repeated measurements of an outcome over time on a single case, both before and after the deliberate introduction of a treatment. SCDs are used heavily in fields such as special education, school psychology, social work, and applied behavior…

  3. Comparing Single Case Design Overlap-Based Effect Size Metrics from Studies Examining Speech Generating Device Interventions

    Science.gov (United States)

    Chen, Mo; Hyppa-Martin, Jolene K.; Reichle, Joe E.; Symons, Frank J.

    2016-01-01

    Meaningfully synthesizing single case experimental data from intervention studies comprised of individuals with low incidence conditions and generating effect size estimates remains challenging. Seven effect size metrics were compared for single case design (SCD) data focused on teaching speech generating device use to individuals with…

  4. Masked Visual Analysis: Minimizing Type I Error in Visually Guided Single-Case Design for Communication Disorders

    Science.gov (United States)

    Byun, Tara McAllister; Hitchcock, Elaine R.; Ferron, John

    2017-01-01

    Purpose: Single-case experimental designs are widely used to study interventions for communication disorders. Traditionally, single-case experiments follow a response-guided approach, where design decisions during the study are based on participants' observed patterns of behavior. However, this approach has been criticized for its high rate of…

  5. Determining performance parameters in qualitative multivariate methods using probability of detection (POD) curves. Case study: Two common milk adulterants.

    Science.gov (United States)

    Gondim, Carina de Souza; Junqueira, Roberto Gonçalves; de Souza, Scheilla Vitorino Carvalho; Callao, M Pilar; Ruisánchez, Itziar

    2017-06-01

    A strategy for determining performance parameters of two-class multivariate qualitative methods was proposed. As case study, multivariate classification methods based on mid-infrared (MIR) spectroscopy coupled with the soft independent modelling of class analogy (SIMCA) technique for detection of hydrogen peroxide and formaldehyde in milk were developed. From the outputs (positive/negative/inconclusive) of the samples, which were unadulterated and adulterated at target value, the main performance parameters were obtained. Sensitivity and specificity values for the unadulterated and adulterated classes were satisfactory. Inconclusive ratios 12% and 21%, respectively, for hydrogen peroxide and formaldehyde were obtained. To evaluate the performance parameters related to concentration, Probability of Detection (POD) curves were established, estimating the decision limit, the capacity of detection and the unreliability region. When inconclusive outputs were obtained, two additional concentration limits were defined: the decision limit with inconclusive outputs and the detection capability with inconclusive outputs. The POD curves showed that for concentrations below 3.7gL -1 of hydrogen peroxide and close to zero of formaldehyde, the chance of giving a positive output (adulterated sample) was lower than 5%. For concentrations at or above 11.3gL -1 of hydrogen peroxide and 10mgL -1 of formaldehyde, the probability of giving a negative output was also lower than 5%. Copyright © 2017 Elsevier B.V. All rights reserved.

  6. A qualitative case study of LifeGuide: users' experiences of software for developing Internet-based behaviour change interventions.

    Science.gov (United States)

    Williams, Sarah; Yardley, Lucy; Wills, Gary B

    2013-03-01

    Previously, behavioural scientists seeking to create Internet-based behaviour change interventions have had to rely on computer scientists to actually develop and modify web interventions. The LifeGuide software was designed to enable behavioural researchers to develop and adapt Internet-based behavioural interventions themselves. This article reports a qualitative case study of users' experiences and perceptions of the LifeGuide software. The aim was to explore users' experiences and their perceptions of the benefits and limitations of this approach to intervention development. Twenty LifeGuide users took part in semi-structured interviews and one provided feedback via email. Thematic analysis identified three overarching themes: 'Recognising LifeGuide's potential', 'I'm not a programmer' and 'Knowledge sharing - the future of LifeGuide'. Users valued LifeGuide's potential to allow them to flexibly develop and modify interventions at little cost. However, users noted that their lack of programming experience meant that they needed to learn new skills for using the software, and they varied in the extent to which they felt able to develop interventions without any input from programmers. Respondents saw the potential of using the LifeGuide Community Website to share technical support and examples of intervention components to support their use of LifeGuide.

  7. Credibility and (disuse of feedback to inform teaching : a qualitative case study of physician-faculty perspectives

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    Carr TF

    2015-06-01

    Full Text Available Evaluation plays a central role in teaching in that physician-faculty theoretically use evaluations from clinical learners to inform their teaching. Knowledge about how physician-faculty access and internalize feedback from learners is sparse and concerning given its importance in medical training. This study aims to broaden our understanding. Using multiple data sources, this cross-sectional qualitative case study conducted in Spring of 2014 explored the internalization of learner feedback among physician-faculty teaching medical students, residents and fellows at a southwest academic medical center. Twelve one-on-one interviews were triangulated with observation notes and a national survey. Thematic and document analysis was conducted. Results revealed that the majority accessed and reviewed evaluations about their teaching. Most admitted not using learner feedback to inform teaching while a quarter did use them. Factors influencing participants use or disuse of learner feedback were the a reporting metrics and mechanisms, and b physician-faculty perception of learner credibility. Physician-faculty did not regard learners’ ability to assess and recognize effective teaching skills highly. To refine feedback for one-on-one teaching in the clinical setting, recommendations by study participants include: a redesigning of evaluation reporting metrics and narrative sections, and b feedback rubric training for learners.

  8. How do public child healthcare professionals and primary school teachers identify and handle child abuse cases? A qualitative study.

    Science.gov (United States)

    Schols, Manuela W A; de Ruiter, Corine; Öry, Ferko G

    2013-09-05

    Public child healthcare doctors and nurses, and primary school teachers play a pivotal role in the detection and reporting of child abuse, because they encounter almost all children in the population during their daily work. However, they report relatively few cases of suspected child abuse to child protective agencies. The aim of this qualitative study was to investigate Dutch frontline workers' child abuse detection and reporting behaviors. Focus group interviews were held among 16 primary school teachers and 17 public health nurses and physicians. The interviews were audio recorded, transcribed, and thematically analyzed according to factors of the Integrated Change model, such as knowledge, attitude, self-efficacy, skills, social influences and barriers influencing detection and reporting of child abuse. Findings showed that although both groups of professionals are aware of child abuse signs and risks, they are also lacking specific knowledge. The most salient differences between the two professional groups are related to attitude and (communication) skills. The results suggest that frontline workers are in need of supportive tools in the child abuse detection and reporting process. On the basis of our findings, directions for improvement of child abuse detection and reporting are discussed.

  9. Qualitative case studies of professional-level workers with traumatic brain injuries: A contextual approach to job accommodation and retention.

    Science.gov (United States)

    Roessler, Richard T; Rumrill, Phillip D; Rumrill, Stuart P; Minton, Deborah L; Hendricks, Deborah J; Sampson, Elaine; Stauffer, Callista; Scherer, Marcia J; Nardone, Amanda; Leopold, Anne; Jacobs, Karen; Elias, Eileen

    2017-09-14

    Traumatic brain injury (TBI) is a multi-systemic disability that causes a wide range of difficulties with personal and social functioning. Four individuals with TBI participated in an evaluation of barriers to their continued employment following graduation from college. A trained interviewer completed the Work Experience Survey (WES) in teleconsultation sessions with each participant. Researchers applied a qualitative case study research design. Participants reported a wide range of difficulties in performing essential functions of their jobs (3 to 24) that have the potential to significantly affect their productivity. Career mastery problems reflected outcomes associated with TBI such as 'believing that others think I do a good job' and 'having the resources (e.g., knowledge, tools, supplies, and equipment) needed to do the job.' Indicative of their wish to continue their current employment, participants reported high levels of job satisfaction. The WES is a cost-effective needs assessment tool to aid health and rehabilitation professionals in providing on-the-job supports to workers with TBI.

  10. How do public child healthcare professionals and primary school teachers identify and handle child abuse cases? A qualitative study

    Science.gov (United States)

    2013-01-01

    Background Public child healthcare doctors and nurses, and primary school teachers play a pivotal role in the detection and reporting of child abuse, because they encounter almost all children in the population during their daily work. However, they report relatively few cases of suspected child abuse to child protective agencies. The aim of this qualitative study was to investigate Dutch frontline workers’ child abuse detection and reporting behaviors. Methods Focus group interviews were held among 16 primary school teachers and 17 public health nurses and physicians. The interviews were audio recorded, transcribed, and thematically analyzed according to factors of the Integrated Change model, such as knowledge, attitude, self-efficacy, skills, social influences and barriers influencing detection and reporting of child abuse. Results Findings showed that although both groups of professionals are aware of child abuse signs and risks, they are also lacking specific knowledge. The most salient differences between the two professional groups are related to attitude and (communication) skills. Conclusion The results suggest that frontline workers are in need of supportive tools in the child abuse detection and reporting process. On the basis of our findings, directions for improvement of child abuse detection and reporting are discussed. PMID:24007516

  11. Barriers and bridges to infection prevention and control: results of a qualitative case study of a Netherlands' surgical unit.

    Science.gov (United States)

    Backman, Chantal; Marck, Patricia B; Krogman, Naomi; Taylor, Geoff; Sales, Anne; Bonten, Marc J M; Gigengack-Baars, Ada C M

    2012-01-01

    The objectives of the study are to observe the overall work environment including infection prevention and control (IP&C) practices on the target surgical unit; to analyse the policies and procedures in the hospital and unit environments; to analyse the barriers and bridges to IP&C that practitioners identify in visual narratives of their unit environment and to collect monthly specific IP&C-related anonymised data. In this qualitative case study analysis, a socio-ecological approach on health systems informed the research design and provided a framework to better understand the complexity of implementing effective IP&C. The study was conducted on a surgical unit at a Netherlands' hospital that reported successful reductions in the prevalence of targeted multidrug-resistant organisms. Research methods included unit observations (n=3), review of relevant policies and procedures, five practitioner-led photo walkabouts of the unit (n=7), three photo elicitation focus groups with practitioners (n=13) and the review of related IP&C data. The findings indicate some conditions and processes present that may influence the low prevalence of multidrug-resistant organisms, including the 'search and destroy' active surveillance strategy, low occupancy rates, a centralised bed cleaning system and the presence of an active grass roots Hygiene in Practice group, which engages practitioners in several ongoing activities to promote IP&C on the units. Further research on the benefits of practitioner-led community of practices on IP&C practices such as the Hygiene in Practice group is also recommended. Additional case studies to compare theses practices with other acute care hospital around the world would be a valuable way to better understand what IP&C programmes are most effective in which contexts and for what reasons. Further data are available by contacting the primary author directly.

  12. Creating advantages through franchising in healthcare: a qualitative, multiple embedded case study on the role of the business format.

    Science.gov (United States)

    Nijmeijer, Karlijn J; Huijsman, Robbert; Fabbricotti, Isabelle N

    2014-11-02

    Business format franchising is an organizational form that originates from the business sector. It is increasingly used in healthcare, being a promising organizational form for improving the competitiveness and efficiency of organizations, the quality of care, and the professional work environment. However, evidence is lacking concerning how these healthcare franchises should be designed to actually deliver the promised benefits. This study explores how the design of the central element in franchising, the business format (i.e., brand name, support systems, specification of the products and services), helps or hinders the achievement of positive results. A qualitative comparative embedded case study was conducted. The cases focused on three Dutch healthcare franchises providing mental healthcare, hospital care and care for the intellectually disabled. The data were collected through document analyses, observations, and 96 in-depth, semi-structured interviews with franchisors and unit actors (franchisees, unit managers, professionals). The interviews were recorded and transcribed verbatim. A conceptual model based on a systematic review of studies in other industries was used as an initial method for coding the data. New inductive codes were used to enrich and extend the analysis. The data were subjected to within-case and cross-case comparative thematic analyses. Different business format designs have different effects on results, as perceived by franchisors and unit actors. The analysis revealed how this variation in perceived effects can be explained by different dynamics with regard to system-wide adaptation, local adaptation, professionals' resistance to change, ease of knowledge sharing, bureaucracy, overhead, uniform brand presentation, accelerating effects and reliable performance levels. The analysis resulted in a new typology of four types of business formats, showing how combinations of business format elements facilitate or hinder the achievement of

  13. The performance of integrated health care networks in continuity of care: a qualitative multiple case study of COPD patients.

    Science.gov (United States)

    Waibel, Sina; Vargas, Ingrid; Aller, Marta-Beatriz; Gusmão, Renata; Henao, Diana; Vázquez, M Luisa

    2015-01-01

    Integrated health care networks (IHN) are promoted in numerous countries as a response to fragmented care delivery by providing a coordinated continuum of services to a defined population. However, evidence on their effectiveness and outcome is scarce, particularly considering continuity across levels of care; that is the patient's experience of connected and coherent care received from professionals of the different care levels over time. The objective was to analyse the chronic obstructive pulmonary disease (COPD) patients' perceptions of continuity of clinical management and information across care levels and continuity of relation in IHN of the public health care system of Catalonia. A qualitative multiple case study was conducted, where the cases are COPD patients. A theoretical sample was selected in two stages: (1) study contexts: IHN and (2) study cases consisting of COPD patients. Data were collected by means of individual, semi-structured interviews to the patients, their general practitioners and pulmonologists and review of records. A thematic content analysis segmented by IHN and cases with a triangulation of sources and analysists was carried out. COPD patients of all networks perceived that continuity of clinical management was existent due to clear distribution of roles for COPD care across levels, rapid access to care during exacerbations and referrals to secondary care when needed; nevertheless, patients of some networks highlighted too long waiting times to non-urgent secondary care. Physicians generally agreed with patients, however, also indicated unclear distribution of roles, some inadequate referrals and long waiting times to primary care in some networks. Concerning continuity of information, patients across networks considered that their clinical information was transferred across levels via computer and that physicians also used informal communication mechanisms (e-mail, telephone); whereas physicians highlighted numerous problems of the

  14. Treatment of chronic spontaneous urticaria with a single dose of omalizumab: A study of four cases

    Directory of Open Access Journals (Sweden)

    Radhakrishnan Subramaniyan

    2016-01-01

    Full Text Available Background: Chronic spontaneous urticaria (CSU has a detrimental effect on patients′ emotional and physical quality of life. Omalizumab, an anti-immunoglobulin E humanized monoclonal antibody, has been shown to be very effective in the treatment of refractory chronic urticaria patients but may not be an economically viable option for all CSU patients. However, we present a case series where a single dose of omalizumab gave sustained relief of symptoms in patients with CSU, which may be an economical option. Aims: The aim of this study is to assess the efficacy of a single dose of omalizumab in the treatment of CSU. Materials and Methods: Four patients of CSU whose disease was not controlled with four times the licensed dose of tablet fexofenadine 180 mg were exhibited one subcutaneous injection of omalizumab and were followed up at 4 weekly intervals for 24 weeks for Weekly Urticaria Activity Score 7 (UAS7 and Dermatology Life Quality Index (DLQI. Results: A sharp decline in UAS7 and DLQI was documented in 7-10 days. The decline was maintained up to 16 weeks in one case and 20 weeks in the other three cases. Both the scores at the end of the follow-up period of 24 weeks were better than the pre-omalizumab scores. Conclusion: The results of this case series indicate the efficacy of a single-dose omalizumab in treating moderate to severe refractory CSU. Further studies are required to identify the minimum frequency of administering omalizumab to effectively control CSU. This would greatly reduce the cost of this novel therapy.

  15. Single ventricle, bicuspid aorta and interatrial wall aneurysm as a rare complex adult congenital heart disease: a case report

    OpenAIRE

    Berisha, Blerim; Krasniqi, Xhevdet; Thaqi, Agim; Gashi, Masar; Ko?inaj, Dardan

    2009-01-01

    Background Single ventricle, bicuspid aortic valve and interatrial wall aneurysm in adulthood are a rare and unique case in medical literature. This presented case with congenital heart disease has never been treated surgically and clinical consequences seriously presented in adulthood. Case presentation A 27 year old man with complex congenital heart disease presented. At the age of six, the single ventricle was ultrasonographly diagnosed, but at age 27 clinical consequences started to be se...

  16. Qualitative Sybr Green real-time detection of single nucleotide polymorphisms responsible for target-site resistance in insect pests: the example of Myzus persicae and Musca domestica.

    Science.gov (United States)

    Puggioni, V; Chiesa, O; Panini, M; Mazzoni, E

    2017-02-01

    Chemical insecticides have been widely used to control insect pests, leading to the selection of resistant populations. To date, several single nucleotide polymorphisms (SNPs) have already been associated with insecticide resistance, causing reduced sensitivity to many classes of products. Monitoring and detection of target-site resistance is currently one of the most important factors for insect pest management strategies. Several methods are available for this purpose: automated and high-throughput techniques (i.e. TaqMan or pyrosequencing) are very costly; cheaper alternatives (i.e. RFLP or PASA-PCRs) are time-consuming and limited by the necessity of a final visualization step. This work presents a new approach (QSGG, Qualitative Sybr Green Genotyping) which combines the specificity of PASA-PCR with the rapidity of real-time PCR analysis. The specific real-time detection of Cq values of wild-type or mutant alleles (amplified used allele-specific primers) allows the calculation of ΔCqW-M values and the consequent identification of the genotypes of unknown samples, on the basis of ranges previously defined with reference clones. The methodology is applied here to characterize mutations described in Myzus persicae and Musca domestica and we demonstrate it represents a valid, rapid and cost-effective technique that can be adopted for monitoring target-site resistance in field populations of these and other insect species.

  17. Bridge flap technique as a single-step solution to mucogingival problems: A case series

    Directory of Open Access Journals (Sweden)

    Vivek Gupta

    2011-01-01

    Full Text Available Shallow vestibule, gingival recession, inadequate width of attached gingiva (AG and aberrant frenum pull are an array of mucogingival problems for which several independent and effective surgical solutions are reported in the literature. This case series reports the effectiveness of the bridge flap technique as a single-step surgical entity for increasing the depth of the vestibule, root coverage, increasing the width of the AG and solving the problem of abnormal frenum pull. Eight patients with 18 teeth altogether having Millers class I, II or III recession along with problems of shallow vestibule, inadequate width of AG and with or without frenum pull underwent this surgical procedure and were followed-up till 9 months post-operatively. The mean root coverage obtained was 55% and the mean average gain in width of the AG was 3.5 mm. The mean percentage gain in clinical attachment level was 41%. The bridge flap technique can be an effective single-step solution for the aforementioned mucogingival problems if present simultaneously in any case, and offers considerable advantages over other mucogingival surgical techniques in terms of simplicity, limited chair-time for the patient and the operator, single surgical intervention for manifold mucogingival problems and low morbidity because of the absence of palatal donor tissue.

  18. Postoperative discitis following single-level lumbar discectomy: Our experience of 17 cases.

    Science.gov (United States)

    Basu, Saumyajit; Ghosh, Jay Deep; Malik, Farid H; Tikoo, Agnivesh

    2012-07-01

    The established protocols of treatment of postoperative lumbar discitis have not been validated till date. We report a retrospective analysis of a series of patients with discitis following single level lumbar discectomy. We analyzed the outcome of conservative treatment of postoperative discitis with the objective to define when and what surgery was required when the conservative treatment failed. A total of 17 cases of postoperative discitis treated from 2002 to 2009 were followed up and evaluated clinically, radiologically and by laboratory investigations. All the patients were treated initially conservatively with rest and antibiotic therapy after diagnosis and those who did not respond to conservative treatment of at least 4 weeks were treated surgically. The cases were followed up with serial C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), X-ray, computed tomography (CT) scan and magnetic resonance imaging (MRI) for at least 1 year. The mean followup was 40.38 months (range 12-86 months). Four cases failed to respond to conservative therapy and were treated surgically. In three of these four cases, open debridement, transpedicular fixation and posterolateral fusion was performed, and in the fourth case percutaneous transpedicular fixation was done. In the former group, one case was diagnosed to be tubercular, in another case Staphylococcus aureus was cultured where as the third case culture was sterile. All operated patients showed evidence of interbody fusion at 1 year followup. Early detection and aggressive treatment are paramount in managing postoperative discitis and the majority do well with conservative treatment. Surgical management in the form of transpedicular fixation and debridement, when required, gives excellent results.

  19. Single Dose Methotrexate in Treatment of Ectopic Pregnancy: Review of 32 Case

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    Aysun Aybatlı

    2011-03-01

    Full Text Available Objective: To evaluate the efficacy of single dose intramuscular methotrexate in the treatment of ectopic pregnancy.Material and Methods: 32 patients who matched the inclusion criteria were enrolled. Success of treatment was defined as a resolution of ectopic pregnancy without performing surgical intervention. The cases in whom the treatment was successful and those that were not were compared for β-hCG values and clinical features.Results: β-hCG at diagnosis averaged 1293.9 mIU/ml. Of the 32 patients who received methotrexate, 26 were successfully treated. 23 patients (71.8% received a single dose of methotrexate, 3 patients (9.3% received an additional dose of methotrexate, 6 patients (18.7% who had failed methotrexate required surgery for cure. The success rate of single-dose methotrexate was 79.3%. Conclusion: Our study shows that single dose systemic methotrexate treatment can be used as an option in unruptured pregnancies.

  20. Social Aspects Regarding the Single-Parent Families Vulnerability - The Case Of Arad County

    Directory of Open Access Journals (Sweden)

    Marţian Iovan

    2016-07-01

    single-parent families must rely on the complete knowledge of this social phenomenon, with the need to establish databases and map the dispersion of single-parent families within administrative-territorial units. The decrease in the number of families with a high social risk over time is the result of correlated and harmonized public policies, aimed at fighting poverty, discrimination, unemployment, lack of access to education, while ensuring the general background for economic development and prosperity. The study is determined by the fact that many times the parents and the children of single parent families find themselves in the situation of not being able to make ends meet, the lack of finances, education and proper housing making it impossible for them to live a decent life. By identifying, through specific scientific methods such as document analysis, interviews, case studies, the particular types of problems facing single parent families, we consider we will succeed in offering a strong basis to motivate decision makers to establish additional social protection measures that will contribute to the reduction of the causes that maintain this social category among vulnerable groups.

  1. Co-infection of Primary Syphilis and HIV after a Single Exposure - a Case Report

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    Geleki Stamatina

    2015-09-01

    Full Text Available Human immunodeficiency virus type 1- infected patients with syphilis are among the most important transmitters of HIV-1 infection due to biological effects of genital ulcerations, and aggravation due to their continued risky behavior. The association between primary syphilis and acute HIV-1 co-infection is not well documented, and reports on isolated cases are raising special interest and indicate that this double primary co-infection may occur. We present a case of a 31-year-old man with no past medical history who presented with fever, papular rash on the face which lasted for a few days, and a single genital ulcer. He was diagnosed with primary syphilis and primary HIV-1 infection after a single exposure with an infected female sex worker. Male-to-female HIV transmission during vaginal intercourse is significantly more likely than female-to-male HIV transmission. However, high prevalence of sexually transmitted diseases among female sex workers contributed to high HIV transmission probability, as in our case.

  2. Bone single photon emission computed tomography (SPECT in a patient with Pancoast tumor: a case report

    Directory of Open Access Journals (Sweden)

    Hamid Javadi

    Full Text Available CONTEXT: Non-small cell lung carcinomas (NSCLCs of the superior sulcus are considered to be the most challenging type of malignant thoracic disease. In this disease, neoplasms originating mostly from the extreme apex of the lung expand to the chest wall and thoracic inlet structures. Multiple imaging procedures have been applied to identify tumors and to stage and predict tumor resectability in surgical operations. Clinical examinations to localize pain complaints in shoulders and down the arms, and to screen for Horner's syndrome and abnormalities seen in paraclinical assessments, have been applied extensively for differential diagnosis of superior sulcus tumors. Although several types of imaging have been utilized for diagnosing and staging Pancoast tumors, there have been almost no reports on the efficiency of whole-body bone scans (WBBS for detecting the level of abnormality in cases of superior sulcus tumors. CASE REPORT: We describe a case of Pancoast tumor in which technetium-99m methylene diphosphonate (Tc-99m MDP bone single-photon emission-computed tomography (SPECT was able to accurately detect multiple areas of abnormality in the vertebrae and ribs. In describing this case, we stress the clinical and diagnostic points, in the hope of stimulating a higher degree of suspicion and thereby facilitating appropriate diagnosis and treatment. From the results of this study, further clinical trials to evaluate the potential of SPECT as an efficient imaging tool for the work-up on cases of Pancoast tumor are recommended.

  3. Left Transperitoneal Adrenalectomy with a Laparoendoscopic Single-Site Surgery Combined Technique: Initial Case Reports

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    Yasuhiro Sumino

    2011-01-01

    Full Text Available Laparoendoscopic single-site surgery (LESS is a step toward the development of minimally invasive surgery. It is initially difficult for surgeons with limited experience to perform the surgery. We describe two cases of left adrenalectomy with a LESS combined with the addition of an accessory port. After a 2.5-cm skin incision was made at the level of the paraumbilicus to insert the primary 12-mm trocar for the laparoscope, a 5-mm nonbladed trocar was placed through the skin incision side-by-side with the primary trocar. A second 3-mm nonbladed trocar was then placed along the anterior axillary line; a multichannel trocar was not used as a single port. Both adrenalectomies were completed successfully. In patients with a minor adrenal tumor, a combined technique using LESS and an additional port is easier than LESS alone and may, therefore, be a bridge between the conventional laparoscopic approach and LESS.

  4. Cast Metal Occlusals: A Vital Tool for Single Complete Denture: A Case Report

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    Dipti S Shah

    2013-01-01

    Full Text Available Background: Occlusal surface of the acrylic teeth of a single complete denture in opposition to natural dentition wears out with its use for a longer period of time, which may lead to decrease in the chewing efficiency, loss of vertical dimension of occlusion, change in centric occlusion, denture instability, temporomandibular joint disturbances etc. Re-fabrication of new denture set over a period of time, inclusion of highly cross linked acrylic teeth, amalgam or metal inserts on occlusal surface, use of composite, gold or metal occlusal surface, etc. are some of the treatment options available to counteract that problem. Several articles have described methods to construct gold and metal occlusal surfaces, some of which are time-consuming, expensive and require many cumbersome steps. This clinical case describes the sequence of steps for construction of metal occlusal surfaces on single complete denture using the lost wax technique.

  5. The measurement of the vertical component of hydraulic conductivity in single cased and uncased boreholes

    International Nuclear Information System (INIS)

    Black, J.H.; Noy, D.J.; Brightman, M.A.

    1986-11-01

    The project summarised in the paper aimed to assess the different existing methods of measuring vertical hydraulic conductivity in single boreholes by carrying out some actual field testing. The measurements are relevant to the disposal of radioactive waste into argillaceous rocks, where the primary geological barrier to potential leachate migration is the mudrock. Also the prime parameter of interest in the assessment of mudrocks is the vertical component of hydraulic conductivity. A description of the methods of test analysis and interpretation is given. The experimental programme for open borehole testing and cased borehole testing is described, along with the practical and theoretical considerations. (U.K.)

  6. A fixed partial appliance approach towards treatment of anterior single tooth crossbite: Report of two cases

    Directory of Open Access Journals (Sweden)

    M Gawthaman

    2017-01-01

    Full Text Available Crossbite can be treated using both removable and fixed appliances. This paper describes the report of two cases by a method of treating anterior single tooth in crossbite which is locked out of arch form with a simple fixed partial appliance. Orthodontic treatment was initiated by creating space for the locked out incisor using open coil spring and further corrected using MBT brackets and nitinol archwire for alignment. Treatment goals were achieved, and esthetics and occlusion were maintained postoperatively. Treatment objectives were obtained within a short duration using this technique, and there was an improvement in patients' smile.

  7. Effects of donepezil on behavioural manifestations of thalamic infarction: a single case observation

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    Rodrigo eRiveros

    2011-03-01

    Full Text Available Objective: To examine the effect of donepezil for the treatment of cognitive and behavioural disorders associated with thalamic lesions in a 45 years old male who suffered an infarct in the left thalamus. Background: Recent studies suggest that donepezil may improve executive functions impairments due to subcortical ischemic lesionsMethod: The crossover effects of donepezil were analyzed in a single case of thalamic infarction with cognitive and behavioural alterations. Results: Significant behavioural modifications related to improved performances in executive functions were observed with the treatment. Conclusions: The results suggest that donepezil may have significant effect on executive functions that can alter behavioural outcomes after thalamic infarctions

  8. Prioritizing Surgical Care on National Health Agendas: A Qualitative Case Study of Papua New Guinea, Uganda, and Sierra Leone.

    Science.gov (United States)

    Dare, Anna J; Lee, Katherine C; Bleicher, Josh; Elobu, Alex E; Kamara, Thaim B; Liko, Osborne; Luboga, Samuel; Danlop, Akule; Kune, Gabriel; Hagander, Lars; Leather, Andrew J M; Yamey, Gavin

    2016-05-01

    Little is known about the social and political factors that influence priority setting for different health services in low- and middle-income countries (LMICs), yet these factors are integral to understanding how national health agendas are established. We investigated factors that facilitate or prevent surgical care from being prioritized in LMICs. We undertook country case studies in Papua New Guinea, Uganda, and Sierra Leone, using a qualitative process-tracing method. We conducted 74 semi-structured interviews with stakeholders involved in health agenda setting and surgical care in these countries. Interviews were triangulated with published academic literature, country reports, national health plans, and policies. Data were analyzed using a conceptual framework based on four components (actor power, ideas, political contexts, issue characteristics) to assess national factors influencing priority for surgery. Political priority for surgical care in the three countries varies. Priority was highest in Papua New Guinea, where surgical care is firmly embedded within national health plans and receives significant domestic and international resources, and much lower in Uganda and Sierra Leone. Factors influencing whether surgical care was prioritized were the degree of sustained and effective domestic advocacy by the local surgical community, the national political and economic environment in which health policy setting occurs, and the influence of international actors, particularly donors, on national agenda setting. The results from Papua New Guinea show that a strong surgical community can generate priority from the ground up, even where other factors are unfavorable. National health agenda setting is a complex social and political process. To embed surgical care within national health policy, sustained advocacy efforts, effective framing of the problem and solutions, and country-specific data are required. Political, technical, and financial support from

  9. Prioritizing Surgical Care on National Health Agendas: A Qualitative Case Study of Papua New Guinea, Uganda, and Sierra Leone.

    Directory of Open Access Journals (Sweden)

    Anna J Dare

    2016-05-01

    Full Text Available Little is known about the social and political factors that influence priority setting for different health services in low- and middle-income countries (LMICs, yet these factors are integral to understanding how national health agendas are established. We investigated factors that facilitate or prevent surgical care from being prioritized in LMICs.We undertook country case studies in Papua New Guinea, Uganda, and Sierra Leone, using a qualitative process-tracing method. We conducted 74 semi-structured interviews with stakeholders involved in health agenda setting and surgical care in these countries. Interviews were triangulated with published academic literature, country reports, national health plans, and policies. Data were analyzed using a conceptual framework based on four components (actor power, ideas, political contexts, issue characteristics to assess national factors influencing priority for surgery. Political priority for surgical care in the three countries varies. Priority was highest in Papua New Guinea, where surgical care is firmly embedded within national health plans and receives significant domestic and international resources, and much lower in Uganda and Sierra Leone. Factors influencing whether surgical care was prioritized were the degree of sustained and effective domestic advocacy by the local surgical community, the national political and economic environment in which health policy setting occurs, and the influence of international actors, particularly donors, on national agenda setting. The results from Papua New Guinea show that a strong surgical community can generate priority from the ground up, even where other factors are unfavorable.National health agenda setting is a complex social and political process. To embed surgical care within national health policy, sustained advocacy efforts, effective framing of the problem and solutions, and country-specific data are required. Political, technical, and financial

  10. Stakeholders' perceptions of integrated community case management by community health workers: a post-intervention qualitative study.

    Directory of Open Access Journals (Sweden)

    Denise L Buchner

    Full Text Available Integrated community case management (iCCM involves delivery of simple medicines to children with pneumonia, diarrhea and/or malaria by community health workers (CHWs. Between 2010 and 2012, an iCCM intervention trial was implemented by Healthy Child Uganda. This study used qualitative tools to assess whether project stakeholders perceived that iCCM improved access to care for children under five years of age.The intervention involved training and equipping 196 CHWs in 98 study villages in one sub-county in Uganda in iCCM. During the eight-month intervention, CHWs assessed sick children, provided antimalarials (coartem for fever, antibiotics (amoxicillin for cough and fast breathing, oral rehydration salts/zinc for diarrhea, and referred very sick children to health facilities. In order to examine community perceptions and acceptability of iCCM, post-intervention focus groups and key respondent interviews involving caregivers, health workers, CHWs and local leaders were carried out by experienced facilitators using semi-structured interview guides. Data were analyzed using thematic analysis techniques.Respondents reported increased access to health care for children as a result of iCCM. Access was reportedly closer to home, available more hours in a day, and the availability of CHWs was perceived as more reliable. CHW care was reported to be trustworthy and caring. Families reported saving money especially due to reduced transportation costs, and less time away from home. Respondents also perceived better health outcomes. Linkages between health facilities and communities were reportedly improved by the iCCM intervention due to the presence of trained CHWs in the community.iCCM delivered by CHWs may improve access to health care and is acceptable to families. Policymakers should continue to seek opportunities to implement and support iCCM, particularly in remote communities where there are health worker shortages.

  11. Perspectives on enhancing international practical training of students in health and social care study programs - A qualitative descriptive case study.

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    Hvalič-Touzery, Simona; Hopia, Hanna; Sihvonen, Sanna; Diwan, Sadhna; Sen, Soma; Skela-Savič, Brigita

    2017-01-01

    Internationalization of practical training in health and social care study programs is an important aspect of higher education. However, field mentors' and classroom teachers' competence in guiding culturally diverse students varies widely in European countries, and the majority does not have enough training in guiding foreign students. This study aimed to examine which factors enhance the efficacy of international practical placement experiences in health and social care study programs. A qualitative descriptive case study design was used. The study was conducted at six higher education institutions-two in Finland and one in Croatia, Estonia, the Netherlands and Slovenia. A convenience sample of 14 mentors, 15 teachers and 14 students with international experiences from six higher education institutions which are part of the Bologna Process was recruited. The data were collected from six focus groups using a semi-structured questionnaire based on a literature review. Each higher education institution conducted one group interview that was tape-recorded, transcribed and analysed for themes. Participants made several recommendations for enhancing the practical placement experience of students, teachers, and mentors. Most recommendations dealt with practical supervision of students. Three major themes noted were: 'Attitudes towards internationalization of practical placements', 'Factors impacting the international placement experience', and 'Pedagogical methods used and structural support available for internationalization.' The study highlights the need for strengthening the multicultural knowledge and skills of mentors and teachers. The findings provide practical guidelines for improving the international placement experience across health and social care fields. Copyright © 2016 Elsevier Ltd. All rights reserved.

  12. Crossover learning of gestures in two ideomotor apraxia patients: A single case experimental design study.

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    Shimizu, Daisuke; Tanemura, Rumi

    2017-06-01

    Crossover learning may aid rehabilitation in patients with neurological disorders. Ideomotor apraxia (IMA) is a common sequela of left-brain damage that comprises a deficit in the ability to perform gestures to verbal commands or by imitation. This study elucidated whether crossover learning occurred in two post-stroke IMA patients without motor paralysis after gesture training approximately 2 months after stroke onset. We quantitatively analysed the therapeutic intervention history and investigated whether revised action occurred during gesture production. Treatment intervention was to examine how to influence improvement and generalisation of the ability to produce the gesture. This study used an alternating treatments single-subject design, and the intervention method was errorless learning. Results indicated crossover learning in both patients. Qualitative analysis indicated that revised action occurred during the gesture-production process in one patient and that there were two types of post-revised action gestures: correct and incorrect gestures. We also discovered that even when a comparably short time had elapsed since stroke onset, generalisation was difficult. Information transfer between the left and right hemispheres of the brain via commissural fibres is important in crossover learning. In conclusion, improvements in gesture-production skill should be made with reference to the left cerebral hemisphere disconnection hypothesis.

  13. Management of gallbladder duplication using a single-site robotic-assisted approach: a case study.

    Science.gov (United States)

    Boyle, Melanie Adams; Kaplin, Aviva Wallace; Kushnir, Leon; Montero-Pearson, Per

    2016-06-01

    Gallbladder duplication is a rare congenital anomaly. Here, we describe a 29-year-old female who presents with classic symptoms of biliary colic. A duplicated gallbladder was recognized on preoperative ultrasound. This case report reviews a single-site robotic-assisted cholecystectomy with a cystic duct duplication. The patient underwent the surgery without complication. Due to the aberrant anatomy of the cystic triangle, it was decided to mobilize the gallbladder in a dome-down fashion. True gallbladder duplication can be categorized according to cystic duct orientation based on Boyden's classification. Preoperative diagnosis is essential to prevent surgical complications. A laparoscopic approach can be carried out safely in the hands of a skilled surgeon. This case report shows that the robotic-assisted surgical approach is a viable and safe alternative.

  14. [Xenophobia and experienced abandonment--a depth-hermeneutic analysis of a single case].

    Science.gov (United States)

    Taubner, Svenja; Hasper, Fritz; Wahl, Klaus

    2013-01-01

    A single case study is presented from a feasibility study on social, psychic and neurobiological causes of violence in adolescence focusing on right-wing extremist and xenophobic youth. Results from psychological assessments and a structured biografical reconstruction are analyzed. The case illustrates a typical developmental path of a right-wing, xenophobic and violent male adolescent who experienced early and repeated exclusion and social marginalization. Results from psychological testing demonstrated additional developmental risk factors, such as disorganized attachment representations and low mentalizing abilities. A depth-hermeneutic analysis ofa sequence during the attachment interview as well as a reflection of the research setting further illustrates how experiences of exclusion are re-enacted by a combination of fear of abandonment and aggression.

  15. Containing psychotic patients with fragile boundaries: a single-session group case study.

    Science.gov (United States)

    Lavarenne, Anaïs; Segal, Emily; Sigman, Maxine

    2013-01-01

    This case study describes a single group psychotherapy session of six individuals suffering from schizophrenia or schizoaffective illness, which was characterized by numerous manifestations of fragile Ego boundaries. Based on these illustrations of fragile Ego boundaries, we explore some of the group's core therapeutic actions against psychosis. We discuss how the group (1) provides access to a structuring auxiliary Ego, (2) acts as a containing object by establishing firm boundaries and by mentalizing patients' psychotic productions, and (3) may become a solid object representation introjected by individuals wrestling with porous Ego boundaries and a poor sense of self. We conclude that, in addition to the known role of group therapy in increasing mature defenses, developing insight and providing social support, the group promotes healthier Ego boundaries, and eventually improves self-differentiation, and also tolerance to interpersonal proximity. This case study clarifies group therapy dynamics with individuals suffering from psychosis.

  16. The influence of power dynamics and trust on multidisciplinary collaboration: a qualitative case study of type 2 diabetes mellitus

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    McDonald Julie

    2012-03-01

    Full Text Available Abstract Background Ongoing care for chronic conditions such as diabetes is best provided by a range of health professionals working together. There are challenges in achieving this where collaboration crosses organisational and sector boundaries. The aim of this article is to explore the influence of power dynamics and trust on collaboration between health professionals involved in the management of diabetes and their impact on patient experiences. Methods A qualitative case study conducted in a rural city in Australia. Forty five health service providers from nineteen organisations (including fee-for-service practices and block funded public sector services and eight patients from two services were purposively recruited. Data was collected through semi-structured interviews that were audio-taped and transcribed. A thematic analysis approach was used using a two-level coding scheme and cross-case comparisons. Results Three themes emerged in relation to power dynamics between health professionals: their use of power to protect their autonomy, power dynamics between private and public sector providers, and reducing their dependency on other health professionals to maintain their power. Despite the intention of government policies to support more shared decision-making, there is little evidence that this is happening. The major trust themes related to role perceptions, demonstrated competence, and the importance of good communication for the development of trust over time. The interaction between trust and role perceptions went beyond understanding each other's roles and professional identity. The level of trust related to the acceptance of each other's roles. The delivery of primary and community-based health services that crosses organisational boundaries adds a layer of complexity to interprofessional relationships. The roles of and role boundaries between and within professional groups and services are changing. The uncertainty and

  17. Musicogenic epilepsy: review of the literature and case report with ictal single photon emission computed tomography.

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    Wieser, H G; Hungerbühler, H; Siegel, A M; Buck, A

    1997-02-01

    We report a case of musicogenic epilepsy with ictal single photon emission computed tomography (SPECT) study and discuss the findings of this patient in the context of 76 cases with musicogenic epilepsy described in the literature and seven other cases followed in Zurich. We analyzed the 83 patients according to the precipitating musical factors, type of epilepsy, presumed localization of seizure onset, and demographic data. Fourteen of 83 patients (17%) had seizures triggered exclusively by music. At time of examination, music was the only known precipitating stimulus in 65 of 83 patients (78%). Various characteristics of the musical stimulus were significant, e.g., musical category, familiarity, and instruments. Musicogenic epilepsy is a particular form of epilepsy with a strong correlation to the temporal lobe and a right-sided preponderance. A high musial standard might predispose for musicogenic epilepsy. Moreover, the majority of cases do not fall into the category of a strictly defined "reflex epilepsy," but appear to depend on the indermediary of a certain emotional reaction mediated through limbic mesial temporal lobe structures.

  18. Single-case synthesis tools I: Comparing tools to evaluate SCD quality and rigor.

    Science.gov (United States)

    Zimmerman, Kathleen N; Ledford, Jennifer R; Severini, Katherine E; Pustejovsky, James E; Barton, Erin E; Lloyd, Blair P

    2018-03-03

    Tools for evaluating the quality and rigor of single case research designs (SCD) are often used when conducting SCD syntheses. Preferred components include evaluations of design features related to the internal validity of SCD to obtain quality and/or rigor ratings. Three tools for evaluating the quality and rigor of SCD (Council for Exceptional Children, What Works Clearinghouse, and Single-Case Analysis and Design Framework) were compared to determine if conclusions regarding the effectiveness of antecedent sensory-based interventions for young children changed based on choice of quality evaluation tool. Evaluation of SCD quality differed across tools, suggesting selection of quality evaluation tools impacts evaluation findings. Suggestions for selecting an appropriate quality and rigor assessment tool are provided and across-tool conclusions are drawn regarding the quality and rigor of studies. Finally, authors provide guidance for using quality evaluations in conjunction with outcome analyses when conducting syntheses of interventions evaluated in the context of SCD. Copyright © 2018 Elsevier Ltd. All rights reserved.

  19. Single-Case Experimental Designs: A Systematic Review of Published Research and Current Standards

    Science.gov (United States)

    Smith, Justin D.

    2013-01-01

    This article systematically reviews the research design and methodological characteristics of single-case experimental design (SCED) research published in peer-reviewed journals between 2000 and 2010. SCEDs provide researchers with a flexible and viable alternative to group designs with large sample sizes. However, methodological challenges have precluded widespread implementation and acceptance of the SCED as a viable complementary methodology to the predominant group design. This article includes a description of the research design, measurement, and analysis domains distinctive to the SCED; a discussion of the results within the framework of contemporary standards and guidelines in the field; and a presentation of updated benchmarks for key characteristics (e.g., baseline sampling, method of analysis), and overall, it provides researchers and reviewers with a resource for conducting and evaluating SCED research. The results of the systematic review of 409 studies suggest that recently published SCED research is largely in accordance with contemporary criteria for experimental quality. Analytic method emerged as an area of discord. Comparison of the findings of this review with historical estimates of the use of statistical analysis indicates an upward trend, but visual analysis remains the most common analytic method and also garners the most support amongst those entities providing SCED standards. Although consensus exists along key dimensions of single-case research design and researchers appear to be practicing within these parameters, there remains a need for further evaluation of assessment and sampling techniques and data analytic methods. PMID:22845874

  20. The impact of ordinate scaling on the visual analysis of single-case data.

    Science.gov (United States)

    Dart, Evan H; Radley, Keith C

    2017-08-01

    Visual analysis is the primary method for detecting the presence of treatment effects in graphically displayed single-case data and it is often referred to as the "gold standard." Although researchers have developed standards for the application of visual analysis (e.g., Horner et al., 2005), over- and underestimation of effect size magnitude is not uncommon among analysts. Several characteristics have been identified as potential contributors to these errors; however, researchers have largely focused on characteristics of the data itself (e.g., autocorrelation), paying less attention to characteristics of the graphic display which are largely in control of the analyst (e.g., ordinate scaling). The current study investigated the impact that differences in ordinate scaling, a graphic display characteristic, had on experts' accuracy in judgments regarding the magnitude of effect present in single-case percentage data. 32 participants were asked to evaluate eight ABAB data sets (2 each presenting null, small, moderate, and large effects) along with three iterations of each (32 graphs in total) in which only the ordinate scale was manipulated. Results suggest that raters are less accurate in their detection of treatment effects as the ordinate scale is constricted. Additionally, raters were more likely to overestimate the size of a treatment effect when the ordinate scale was constricted. Copyright © 2017 Society for the Study of School Psychology. Published by Elsevier Ltd. All rights reserved.

  1. Social validity in single-case research: A systematic literature review of prevalence and application.

    Science.gov (United States)

    Snodgrass, Melinda R; Chung, Moon Y; Meadan, Hedda; Halle, James W

    2018-03-01

    Single-case research (SCR) has been a valuable methodology in special education research. Montrose Wolf (1978), an early pioneer in single-case methodology, coined the term "social validity" to refer to the social importance of the goals selected, the acceptability of procedures employed, and the effectiveness of the outcomes produced in applied investigations. Since 1978, many contributors to SCR have included social validity as a feature of their articles and several authors have examined the prevalence and role of social validity in SCR. We systematically reviewed all SCR published in six highly-ranked special education journals from 2005 to 2016 to establish the prevalence of social validity assessments and to evaluate their scientific rigor. We found relatively low, but stable prevalence with only 28 publications addressing all three factors of the social validity construct (i.e., goals, procedures, outcomes). We conducted an in-depth analysis of the scientific rigor of these 28 publications. Social validity remains an understudied construct in SCR, and the scientific rigor of social validity assessments is often lacking. Implications and future directions are discussed. Copyright © 2018 Elsevier Ltd. All rights reserved.

  2. Analysis and meta-analysis of single-case designs: an introduction.

    Science.gov (United States)

    Shadish, William R

    2014-04-01

    The last 10 years have seen great progress in the analysis and meta-analysis of single-case designs (SCDs). This special issue includes five articles that provide an overview of current work on that topic, including standardized mean difference statistics, multilevel models, Bayesian statistics, and generalized additive models. Each article analyzes a common example across articles and presents syntax or macros for how to do them. These articles are followed by commentaries from single-case design researchers and journal editors. This introduction briefly describes each article and then discusses several issues that must be addressed before we can know what analyses will eventually be best to use in SCD research. These issues include modeling trend, modeling error covariances, computing standardized effect size estimates, assessing statistical power, incorporating more accurate models of outcome distributions, exploring whether Bayesian statistics can improve estimation given the small samples common in SCDs, and the need for annotated syntax and graphical user interfaces that make complex statistics accessible to SCD researchers. The article then discusses reasons why SCD researchers are likely to incorporate statistical analyses into their research more often in the future, including changing expectations and contingencies regarding SCD research from outside SCD communities, changes and diversity within SCD communities, corrections of erroneous beliefs about the relationship between SCD research and statistics, and demonstrations of how statistics can help SCD researchers better meet their goals. Copyright © 2013 Society for the Study of School Psychology. Published by Elsevier Ltd. All rights reserved.

  3. SILS cholecystectomy, early experience of a single institution: pilot study of 21 cases.

    Science.gov (United States)

    Ruffo, G; Barugola, G; Scopelliti, F; Sartori, A; Crippa, S; Partelli, S; Falconi, M

    2012-06-01

    Many surgeons have attempted to reduce the number and the size of ports in laparoscopic cholecystectomy to decrease parietal trauma and pain, and to improve cosmetic results. We report a series of laparoscopic cholecystectomies using a single-port technique (SILS) through an umbilical incision in a pilot group of 21 cases. Our goal was to validate and develop the single-port access as a viable option. All the operations were performed using an umbilical SILS port (Ethicon). Most reported techniques utilize special purpose-made instruments. This article provides a stepwise description of the procedure using all straight instruments. No special reticulating instruments or flexible telescopes were used. We report our early difficulties and concerns about the procedure and propose solutions to the problems. Patients' request for improved cosmesis impels surgeons toward the application of SILS, but the true advantage of the technique should be assessed by more evidences. For this reason, we are planning a single-institution, prospective randomized controlled trial to compare postoperative pain, operating time and cosmetic result between one port and standard laparoscopic surgery.

  4. [Drainage of amoebic liver abscess by single incision laparoscopic surgery. Report of a case].

    Science.gov (United States)

    Telich-Tarriba, José Eduardo; Parrao-Alcántara, Iris Jocelyn; Montes-Hernández, Jesús Manuel; Vega-Pérez, Jesús

    2015-01-01

    Single incision laparoscopic surgery has increased recently due to successful results, achieved in several procedures. The aim of the present work is to present the first case in which single incision laparoscopy is used for the drainage of an amoebic liver abscess. A 44-year-old man presented with intense right upper quadrant pain, generalised jaundice, tachycardia, fever, hepatomegaly and a positive Murphy's sign. Laboratory results revealed an increased plasma bilirubin, elevated alkaline phosphatase and transaminases, leucocytosis, negative viral panel for hepatitis, and positive antibodies against Entamoeba histolytica. On an abdominal computed tomography a 15 × 12.1 cm hypodense lesion was observed in the patient's liver, identified as an amoebic liver abscess. Analgesics and antibiotics were started and subsequently the patient was submitted to laparoscopic drainage of the abscess using a single port approach. Drainage and irrigation of the abscess was performed. Four days later the patient was discharged without complications. Management of amoebic liver abscess is focused on the elimination of the infectious agent and obliteration of the abscess cavity in order to prevent its complications, especially rupture. Laparoscopic surgery has proved to be a safe and effective way to manage this entity. Copyright © 2015 Academia Mexicana de Cirugía A.C. Published by Masson Doyma México S.A. All rights reserved.

  5. A Single Case of Rosai-Dorfman Disease Marked by Pathologic Fractures, Kidney Failure, and Liver Cirrhosis Treated with Single-Agent Cladribine

    Directory of Open Access Journals (Sweden)

    Koji eSasaki

    2014-10-01

    Full Text Available Rosai-Dorfman disease (RDD is a proliferative histiocytic disorder of unknown etiology which is characterized by sinus histiocytosis with massive lymphadenopathy. In most cases, RDD has a benign course and treatment is not necessary. However, severe cases of RDD require treatment, and the treatment strategy is determined on the basis of the severity of the disease or the extranodal involvement of vital organs. We report a single case of RDD with atypical presentation of persistent constitutional symptoms, progressing pathologic fractures, and end-organ dysfunction, including acute kidney failure and liver cirrhosis with esophageal varices.

  6. First case of robotic laparoendoscopic single-site radical prostatectomy with single-site VesPa platform.

    Science.gov (United States)

    Mattevi, D; Luciani, L G; Vattovani, V; Chiodini, S; Puglisi, M; Malossini, G

    2017-07-07

    This study aimed at reporting our first experience with robotic laparoendoscopic single-site radical prostatectomy (R-LESS-RP) with single-site VesPa platform (Intuitive Surgical Inc.). A 68-year-old-man presenting with a cT1c adenocarcinoma Gleason Score 3 + 4 = 7 in 4/12 bilateral cores underwent a transperitoneal robotic LESS-RP with a single-site Vespa platform. Initial PSA, prostate weight, and body mass index (BMI) were 4.4 ng/ml, 45 g, and 25, respectively. Instruments and camera cross within the Single-Site port; the da Vinci System software detects and reassigns the user's hands with the instruments position. The single-site port is inserted through a 2-cm intraumbilical incision. The robotic 8.5 mm scope and two surgical curved instruments (fenestrated bipolar forceps and cautery hook) are introduced through the ports and used for most of the procedure, whereas a wristed needle driver on the right hand is used for the reconstructive steps. An additional 12 mm port (Air Seal, SurgiQuest) is placed in a midline between the umbilicus and the right iliac spine in order to facilitate table assistance during surgery and to place a drain at the end of the procedure.Operative time and blood loss were 300 min and 400 mL, respectively. The postoperative course was uneventful. The drain and the catheter were removed on days 1 and 6, respectively. The patient experienced a temporary mild stress incontinence (one pad at sixth month) and erectile dysfunction.Our first robotic laparoendoscopic single-site radical prostatectomy (R-LESS-RP) with the single-site VesPa platform was associated with acceptable operative times and perioperative outcome. This procedure is feasible without complications, provided that a proper patient selection has occurred. Limited movements together with the lack of the fourth robotic arm require a considerable expertise in robotic surgery. Some tricks can help overcome technical limitations. The Robotic LESS-RP reduces in some

  7. Qualitative Research Methods in Visual Communication. Case Study: Visual Networks in the Promotional Videos of the European Year of Volunteering

    Directory of Open Access Journals (Sweden)

    Camelia Cmeciu

    2013-05-01

    Full Text Available European Years are a means of promoting European issues at a macro and micro-level. The objective of this paper is to provide the visual differences in the framing of the issue of volunteering at a European and national level. The approach focuses on a blending of two qualitative research methods in visual communication: ATLAS.ti (computer assisted/ aided qualitative data analysis software and social semiotics. The results of our analysis highlight two network views on volunteering promoted through videos, a salience of transactional processes in the implementation of volunteering at a European and national level, and a classification of various types of social practices specific to Romania. This study provides an insight into the way in which two different qualitative methods may be combined in order to provide a visual representation and interpretation to a European issue.

  8. Mycetoma: experience of 482 cases in a single center in Mexico.

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    Alexandro Bonifaz

    2014-08-01

    Full Text Available Mycetoma is a chronic granulomatous disease. It is classified into eumycetoma caused by fungi and actinomycetoma due to filamentous actinomycetes. Mycetoma can be found in geographic areas in close proximity to the Tropic of Cancer. Mexico is one of the countries in which this disease is highly endemic. In this retrospective study we report epidemiologic, clinical and microbiologic data of mycetoma observed in the General Hospital of Mexico in a 33 year-period (1980 to 2013. A total of 482 cases were included which were clinical and microbiology confirmed. Four hundred and forty four cases (92.11% were actinomycetomas and 38 cases (7.88% were eumycetomas. Most patients were agricultural workers; there was a male predominance with a sex ratio of 3:1. The mean age was 34.5 years old (most ranged from 21 to 40 years. The main affected localization was lower and upper limbs (70.74% and 14.52% respectively. Most of the patients came from humid tropical areas (Morelos, Guerrero and Hidalgo were the regions commonly reported. The main clinical presentation was as tumor-like soft tissue swelling with draining sinuses (97.1%. Grains were observed in all the cases. The principal causative agents for actinomycetoma were: Nocardia brasiliensis (78.21% and Actinomadura madurae (8.7%; meanwhile, for eumycetomas: Madurella mycetomatis and Scedosporium boydii (synonym: Pseudallescheria boydii were identified. This is a single-center, with long-follow up, cross-sectional study that allows determining the prevalence and characteristics of mycetoma in different regions of Mexico.

  9. Single Party Cabinets and Presidential Democracies: insights from the Argentinean case

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    Marcelo CAMERLO

    2013-07-01

    Full Text Available The study of presidential cabinets has mainly focused on coalitional formations, distinguishing individual ministers in terms of their party affiliation particularly at cabinet instauration and termination. This article moves the focus to single-party cabinets to study minister appointment in situations where the legislative support is less relevant. A model of analysis that observes extra-partisan affiliations, individual technical skills and personal liaison with the president is proposed and exploratory applied to the Argentinean case. The results suggest that well positioned presidents tend to apply closer strategies of portfolio distribution, with levels of institutionalization that depends on the president’s party organization and the president’s style of leadership.

  10. Single tooth replacement utilizing implants in the esthetic zone: a case report.

    Science.gov (United States)

    Egbert, Nicholas; Ahuja, Swati; Brandt, Robert; Jain, Vinay; Wicks, Russell

    2013-07-01

    Replacing a single tooth with an implant has become a common dental procedure; however, careful evaluation is necessary before placing one in the esthetic zone. Thorough diagnosis and planning - including the use of transposed diagnostic casts and cone beam computed tomography scans - can help dentists predict the final esthetic result prior to treatment, and help inform the patient of the potential result prior to performing any irreversible therapy. In the present case, the primary concern was the presurgical location of the facial free gingival margin (FGM) of the implant-supported crown, in relation to the adjacent teeth. Steps taken to correct the position of the facial FGM prior to implant placement led to a successful esthetic result.

  11. Bayesian unknown change-point models to investigate immediacy in single case designs.

    Science.gov (United States)

    Natesan, Prathiba; Hedges, Larry V

    2017-12-01

    Although immediacy is one of the necessary criteria to show strong evidence of a causal relation in single case designs (SCDs), no inferential statistical tool is currently used to demonstrate it. We propose a Bayesian unknown change-point model to investigate and quantify immediacy in SCD analysis. Unlike visual analysis that considers only 3-5 observations in consecutive phases to investigate immediacy, this model considers all data points. Immediacy is indicated when the posterior distribution of the unknown change-point is narrow around the true value of the change-point. This model can accommodate delayed effects. Monte Carlo simulation for a 2-phase design shows that the posterior standard deviations of the change-points decrease with increase in standardized mean difference between phases and decrease in test length. This method is illustrated with real data. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  12. Visual analysis in single case experimental design studies: brief review and guidelines.

    Science.gov (United States)

    Lane, Justin D; Gast, David L

    2014-01-01

    Visual analysis of graphic displays of data is a cornerstone of studies using a single case experimental design (SCED). Data are graphed for each participant during a study with trend, level, and stability of data assessed within and between conditions. Reliable interpretations of effects of an intervention are dependent on researchers' understanding and use of systematic procedures. The purpose of this paper is to provide readers with a rationale for visual analysis of data when using a SCED, a step-by-step guide for conducting a visual analysis of graphed data, as well as to highlight considerations for persons interested in using visual analysis to evaluate an intervention, especially the importance of collecting reliability data for dependent measures and fidelity of implementation of study procedures.

  13. Integrated cognitive retraining in agenesis of corpus callosum: a single case study

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    Rajakumari P. Reddy

    2010-04-01

    Full Text Available Individuals with Agenesis of corpus callosum (ACC have deficits in areas of cognitive functions, social, emotional processing and communication.The aims of the study were to examine: (a the neuropsychological profile pre- and post-intervention; (b to study the effects of the integrated integrative cognitive retraining in patient with ACC. We employed a single case experimental study with pre- and post-assessment. This design enabled evaluation of changes in the patient in response to the intervention. RR, a 25-year-old with diagnosis of ACC was assessed for poor concentration, memory, academic performance, anxiety, and interpersonal issues. Neuropsychological profile indicated deficits. He underwent six months of cognitive retraining (home & hospital based and brief cognitive behavior therapy. There was significant improvement post intervention. Integrative Cognitive retraining was efficacious in patient with ACC.

  14. Translating Occupational Justice Education Into Action: Reflections From an Exploratory Single Case Study.

    Science.gov (United States)

    Aldrich, Rebecca M; White, Norman A; Conners, Brittany L

    2016-09-03

    There is a growing body of scholarly literature about occupational justice, human rights, and power redistribution ready to be integrated into occupational science and occupational therapy education. As students around the world become familiar with the concepts and intents underlying occupational justice, it will be important to investigate their translation of occupational justice understandings into actions outside the classroom. This exploratory single case study describes curricular, university, and regional factors related to one former student's engagement in social protests following her occupational justice education. Based on her reflections, we emphasize the need to provide classroom opportunities where students can apply and critically reflect on (a) knowledge about occupational justice and (b) unintended consequences and potential professional tensions that may arise in relation to pursuing occupational justice. Future research will benefit from broader comparative studies that analyze personal, contextual, and programmatic differences among instances of occupational justice education and students' engagement in occupational reconstructions. © The Author(s) 2016.

  15. Single nucleotide polymorphisms and unacceptable late toxicity in breast cancer adjuvant radiotherapy: a case report

    Directory of Open Access Journals (Sweden)

    Lazzari G

    2017-05-01

    Full Text Available Grazia Lazzari,1 Maria Iole Natalicchio,2 Angela Terlizzi,3 Francesco Perri,4 Giovanni Silvano1 1Radiation Oncology Unit, San Giuseppe Moscati Hospital, Taranto, 2Molecular Biology Laboratory, Pathological Anatomy Department, Ospedali Riuniti, Foggia, 3Medical Physic Unit, San Giuseppe Moscati Hospital, 4Medical Oncology Unit, Presidio Ospedaliero Centrale - Santissima Annunziata, Taranto, Italy Background: There has recently been a strong interest in the inter-individual variation in normal tissue and tumor response to radiotherapy (RT, because tissue radiosensitivity seems to be under genetic control. Evidence is accumulating on the role of polymorphic genetic variants, such as single nucleotide polymorphisms (SNPs that could influence normal tissue response after radiation. The most studied SNPs include those in genes involved in DNA repair (single- and double-strand breaks, and base excision and those active in the response to oxidative stress.Case report: We present the case report of a 60-year-old woman with early breast cancer who underwent adjuvant hormone therapy and conventional radiotherapy, and subsequently developed unacceptable cosmetic toxicities of the irradiated breast requiring a genetic test of genes involved in DNA repair mechanisms. The patient was found to be heterozygous for G28152A (T/C and C18067T (A/G mutations in X-ray repair cross-complementing group 1 (XRCC1 and 3 (XRCC3, respectively, homozygous for A313G (G/G mutation in glutathione S transferase Pi 1 (GSTP1, and wild-type for A4541G (A/A in XRCC3 and G135C (G/G in RAD51 recombinase.Conclusion: The role of SNPs should be taken into account when a severe phenomenon appears in normal tissues after radiation treatment, because understanding the molecular basis of individual radiosensitivity may be useful for identifying moderately or extremely radiosensitive patients who may need tailored therapeutic strategies. Keywords: radiosensitivity, SNPs, fibrosis, DNA repair

  16. Working With People With Autistic Spectrum Conditions: A Single Case Study

    Directory of Open Access Journals (Sweden)

    Irina Roncaglia

    2014-04-01

    Full Text Available The aim of this paper is to present the work undertaken to support a young person with autistic spectrum conditions (ASC over a period of 6 years and to discuss the results of a holistic intervention strategy which addressed a range of difficulties experienced both in school and in the community. A brief overview of common approaches in the education and care support for individuals with ASC is presented. The discussion highlights and suggests that a holistic approach might be more suitable and effective in achieving a range of positive outcomes in an educational and social context. A mixed method single-subject design was adopted. Several data measurements at three age points were collated to demonstrate progress in the following three areas: (1 Positive Behavior Management, (2 Access to Curriculum Lessons and Community Based Activities (3 Level of Staff Support. Adopting a holistic, person-centered and highly individualized approach where opportunities for choice and control are nurtured and fostered suggests that in the long-term more durable and meaningful outcomes are achieved. The results of this single-subject case study have implications for future design, delivery and implementation of educational and care programs.

  17. Laparoendoscopic Single-Site Plus One-Port Donor Nephrectomy: Analysis of 169 Cases.

    Science.gov (United States)

    Cho, Hyuk Jin; Choi, Sae Woong; Kim, Kang Sup; Park, Yong Hyun; Bae, Woong Jin; Hong, Sung-Hoo; Lee, Ji Youl; Kim, Sae Woong; Hwang, Tae-Kon

    2015-08-01

    To present our experience with laparoendoscopic single-site plus one-port donor nephrectomy (LESSOP-DN) and compare the outcomes with laparoscopic donor nephrectomy (LDN). Prospectively collected data from 169 consecutive LESSOP-DNs and 83 LDNs performed by a single surgeon in the same time period were analyzed retrospectively. No differences in mean operative time (136 versus 130 minutes; P=.15), warm ischemia time (3.4 versus 3.5 minutes; P=.42), blood loss (50 versus 45 mL; P=.41), transfusion rates (0 versus 1 case), hospital stay (4.0 versus 3.9 days; P=.48), or overall complication rate (12.0% versus 7.7%; P=.25) were observed between the LDN and LESSOP-DN groups. The LESSOP-DN group had a shorter time to return to 100% recovery (39 versus 74 days; Pa smaller surgical incision (5.5 versus 8.2 cm; Pgroup. Renal function of the recipient based on estimated glomerular filtration rate at 1 and 3 months was similar between the groups. Health-related quality of life (QOL) was significantly higher in the LESSOP-DN group in four domains of the health survey than in the LDN group. LESSOP-DN might be associated with smaller surgical incision, improved cosmetic satisfaction, less time to recovery, less analgesic requirement, improved donor QOL, and equivalent recipient graft function.

  18. Single sternal metastasis due to malignant melanoma with unexpected long-term survival: a case report

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    Gogakos AS

    2016-01-01

    Full Text Available Apostolos S Gogakos,1 Dimitrios Paliouras,1 Christos Asteriou,1 Thomas Rallis,1 Achilleas Lazopoulos,1 Fotios Chatzinikolaou,2 Athanassios Zissimopoulos,3 Drosos Tsavlis,4 Katerina Tsirgogianni,4 Konstantinos Zarogoulidis,4 Konstantinos Porpodis,4 Kosmas Tsakiridis,5 Georgia Pitsiou,4 Ioannis Kioumis,4 Ilias Karapantzos,6 Chrysanthi Karapantzou,6 Nikos Sachpekidis,5 Paul Zarogoulidis,4 Nikolaos Barbetakis1 1Thoracic Surgery Department, 2Department of Pathology, Theagenio Cancer Hospital, Thessaloniki, 3Nuclear Medicine Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, 4Pulmonary Department – Oncology Unit, “G. Papanikolaou” General Hospital, Aristotle University of Thessaloniki, 5Cardiothoracic Surgery Department, 6Ear, Nose and Throat Department, “Saint Luke” Private Hospital, Panorama, Thessaloniki, Greece Abstract: Metastases from melanoma have a very poor prognosis for the patient. Single metastatic lesions in the sternum due to melanoma are extremely rare. A rare case of a presternal mass in a 56-year-old patient who had undergone excision for malignant melanoma is presented. Review of the patient’s history and surgical resection of a single metastatic soft tissue lesion offer the best chance of long-term survival. Keywords: melanoma, metastasis, chest wall, sternum

  19. Single Coronary Artery Anomaly: A Case Report and Review of Literature.

    Science.gov (United States)

    Elbadawi, Ayman; Baig, Basarat; Elgendy, Islam Y; Alotaki, Erfan; Mohamed, Ahmed H; Barssoum, Kirolos; Fries, David; Khan, Muhammad; Khouzam, Rami N

    2018-02-06

    Single coronary artery is a rare anomaly, which is usually associated with other cardiac congenital abnormalities. A 56-year-old female presented with unstable angina. The patient reported complaints of typical chest pain on exertion few months prior to presentation, which progressed to become at rest. The pain was associated palpitations and dizziness. Past medical history was significant for hypertension and hyperlipidemia. Vital signs were stable. Physical examination was non-remarkable. Electrocardiogram showed normal sinus rhythm, with intermittent episodes of sinus bradycardia, and non-specific T-wave changes. Trans-thoracic echocardiogram showed normal left ventricular function and no segmental wall-motion abnormalities. Selective coronary angiography showed a normal left main coronary artery arising from left coronary cusp. The left main branched to a normal left anterior descending artery and to the left circumflex artery; a large vessel which supplied also the territory of the right coronary artery (RCA) through its terminal extension. Aortography showed absence of RCA with no other vessels arising from the right or non-coronary cusps. The patient was managed conservatively and discharged home with resolution of symptoms. We report a rare case of isolated single coronary artery with absent RCA. The patient presented with unstable angina, and was managed conservatively. Cardiologists should be aware of this rare condition, which carries a potential risk of sudden cardiac death.

  20. Endoscopic incision of protruding right ureterocele in a single collecting system: a case report

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    Rinto Hariwibowo

    2017-01-01

    Full Text Available Protruding ureterocele is a very rare case found in the literature. We are reporting a 21 year-old female with an intermittent protruding mass from urethra, accompanied by dysuria, hematuria, and recurrent urinary tract infection. Inspection of the external genitalia revealed a protruding mass from the urethra which could be reduced manually. Excretory urography showed bilateral single collecting systems, grade II hydronephrosis of the right kidney, and a cobra head appearance of the lower right pelvis. The patient was diagnosed with a protruding right ureterocele in a single collecting system, and thus, endoscopic incision of a ureterocele was performed. Ultrasonography which was carried out three weeks after the procedure confirmed no residual hydronephrosis or ureterocele in the bladder. Voiding cystourethrography (VCUG underwent at a three-month-follow up revealed a grade 5 vesico-ureteral reflux (VUR on the right side. Surgical reimplantation was then considered. In conclusion, endoscopic incision was safe and yielded good result for protruding ureteroceles, but the need for secondary surgery in several conditions should be considered.

  1. Can osteopathic manipulative treatment modify the posture in elderly people? - a single-case study.

    Science.gov (United States)

    Pellerin, F; Papin-Richard, E; Guihéneuc, P; Niel, S; Guihard, G

    2015-04-01

    In this research, we have studied the consequences of three consecutive osteopathic manipulative sessions (OMS) on postural control by using a single-case research (SCR) design. The patient was a 77 years old woman complaining of altered balance and low-back pain. OMS were delivered by a single practitioner. The pain level was self-rated by using a visual Borg scale. The posture was monitored on a force platform. Postural parameters were deduced from the analysis of the centre of foot pressure (CoP) displacement. The statistical significance of the observed differences was established by using an SCR-related effect size indicator (i.e. Taunovlap). Our results indicate that OMS decrease the patient's pain, modify CoP mean position and decreased the length and velocity of the CoP displacement. Furthermore, modifications of the body oscillations were observed after OMS. This work indicates that OMS can improve body balance and that SCR allows the objective evaluation of the consequences of OMS. Copyright © 2014 Elsevier Ltd. All rights reserved.

  2. Immediate Replacement of Single Teeth With Immediately Loaded Implants: Retrospective Analysis of a Clinical Case Series.

    Science.gov (United States)

    Sethi, Ashok; Kaus, Thomas

    2017-02-01

    The purpose of this retrospective analysis of clinical data was to evaluate the predictability of replacing failing single teeth with immediately placed implants loaded via a transitional (provisional) restoration. Implants were placed immediately at the time of extraction of failing single teeth that met predetermined inclusion criteria. A detailed protocol was followed to enable immediate loading of the implant with the use of prefabricated abutments in combination with transitional restorations. A total of 375 immediate implants had been placed in 274 patients and loaded immediately. With the certainty of 95%, an estimated overall mean survival rate better than 97.6% was observed after a mean observation period of 36 months. The maximum observation period was 142 months. Four implants had been lost in function. Immediate loading of immediately placed implants is a possible treatment option that might be predictably and successfully achieved. Implants of adequate primary stability coupled with a range of prefabricated abutments permit function to be achieved using transitional restorations. The preliminary results of this clinical case series are very promising.

  3. Meta-Analysis of Single-Case Research Design Studies on Instructional Pacing.

    Science.gov (United States)

    Tincani, Matt; De Mers, Marilyn

    2016-11-01

    More than four decades of research on instructional pacing has yielded varying and, in some cases, conflicting findings. The purpose of this meta-analysis was to synthesize single-case research design (SCRD) studies on instructional pacing to determine the relative benefits of brisker or slower pacing. Participants were children and youth with and without disabilities in educational settings, excluding higher education. Tau-U, a non-parametric statistic for analyzing data in SCRD studies, was used to determine effect size estimates. The article extraction yielded 13 instructional pacing studies meeting contemporary standards for high quality SCRD research. Eleven of the 13 studies reported small to large magnitude effects when two or more pacing parameters were compared, suggesting that instructional pacing is a robust instructional variable. Brisker instructional pacing with brief inter-trial interval (ITI) produced small increases in correct responding and medium to large reductions in challenging behavior compared with extended ITI. Slower instructional pacing with extended wait-time produced small increases in correct responding, but also produced small increases in challenging behavior compared with brief wait-time. Neither brief ITI nor extended wait-time meets recently established thresholds for evidence-based practice, highlighting the need for further instructional pacing research. © The Author(s) 2016.

  4. Predictors of Default from Treatment for Tuberculosis: a Single Center Case-Control Study in Korea.

    Science.gov (United States)

    Park, Cheol-Kyu; Shin, Hong-Joon; Kim, Yu-Il; Lim, Sung-Chul; Yoon, Jeong-Sun; Kim, Young-Su; Kim, Jung-Chul; Kwon, Yong-Soo

    2016-02-01

    Default from tuberculosis (TB) treatment could exacerbate the disease and result in the emergence of drug resistance. This study identified the risk factors for default from TB treatment in Korea. This single-center case-control study analyzed 46 default cases and 100 controls. Default was defined as interrupting treatment for 2 or more consecutive months. The reasons for default were mainly incorrect perception or information about TB (41.3%) and experience of adverse events due to TB drugs (41.3%). In univariate analysis, low income (defaulter (15.2% vs. 2.0%, P = 0.005), and combined extrapulmonary TB (54.3% vs. 34.0%, P = 0.020) were significant risk factors for default. In multivariate analysis, the absence of TB stigma (adjusted odd ratio [aOR]: 46.299, 95% confidence interval [CI]: 8.078-265.365, P defaulters (aOR: 33.226, 95% CI: 2.658-415.309, P = 0.007), and low income (aOR: 5.246, 95% CI: 1.249-22.029, P = 0.024) were independent predictors of default from TB treatment. In conclusion, patients with absence of disease stigma, treated by a non-pulmonologist, who were former defaulters, and with low income should be carefully monitored during TB treatment in Korea to avoid treatment default.

  5. Hypertrophic cardiomyopathy with midventricular obstruction and apical aneurysm formation in a single family: case report

    Directory of Open Access Journals (Sweden)

    Paraskevaidis Stylianos

    2009-06-01

    Full Text Available Abstract Background Hypertrophic cardiomyopathy (HCM is an extremely heterogeneous disease. An under recognized and very often missed subgroup within this broad spectrum concerns patients with left ventricular (LV apical aneurysms in the absence of coronary artery disease. Case presentation We describe a case of HCM with midventricular obstruction and apical aneurysm formation in 3 patients coming from a single family. This HCM pattern was detected by 2D-echocardiography and confirmed by cardiac magnetic resonance imaging. A cardioverter defibrillator was implanted in one of the patients because of non-sustained ventricular tachycardia detected in 24-h Holter monitoring and an abrupt drop in systolic blood pressure during maximal exercise test. The defibrillator activated 8 months after implantation by suppression of a ventricular tachycardia providing anti-tachycardia pacing. The patient died due to refractory heart failure 2 years after initial evaluation. The rest of the patients are stable after a 2.5-y follow-up period. Conclusion The detection of apical aneurysm by echocardiography in HCM patients may be complicated. Ventricular tachycardia arising from the scarred aneurysm wall may often occur predisposing to sudden death.

  6. Effects of Single and Combined Application of Organic, Biological and Chemical Fertilizers on Quantitative and Qualitative Yield of Coriander (Coriandrum sativum

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    M. Aghhavani Shajari

    2016-07-01

    Full Text Available Introduction: Medicinal plants were one of the main natural resources of Iran from ancient times. Coriander (Coriandrum sativum L. is from Apiaceae family that it has cultivated extensively in the world. Management and environmental factors such as nutritional management has a significant impact on the quantity and quality of plants. Application of organic fertilizers in conventional farming systems is not common and most of the nutritional need of plants supply through chemical fertilizers for short period. Excessive and unbalanced use of fertilizers in the long period, reduce crop yield and soil biological activity, accumulation of nitrates and heavy metals, and finally cause negative environmental effects and increase the cost of production. The use of bio-fertilizers and organic matter are taken into consideration to reduce the use of chemical fertilizers and increase the quality of most crops. Stability and soil fertility through the use of organic fertilizers are important due to having most of the elements required by plants and beneficial effects on physical, chemical, biological and soil fertility. Therefore, the aim of this research was to evaluate the effects of organic, biological and chemical fertilizers on quality and quantity characteristics of coriander. Materials and Methods: In order to study the effects of single and combined applications of organic, biological and chemical fertilizers on quantitative and qualitative characteristics of Coriander (Coriandrum sativum, an experiment was conducted based on a randomized complete block design with three replications and 12 treatments at Research Station, Faculty of Agriculture, Ferdowsi University of Mashhad, Iran, in - 2011. Treatments included: (1 mycorrhizae (Glomus mosseae (2 biosulfur (Thiobacillus sp., (3 chemical fertilizer (NPK, (4 cow manure, 5( vermin compost, 6( mycorrhizae + chemical fertilizer, 7( mycorrhizae + cow manure, 8( mycorrhizae + vermicompost, 9( biosulfur

  7. The network structure of adaptive governance - A single case study of a fish management area

    Directory of Open Access Journals (Sweden)

    Annica Charlotte Sandström

    2009-09-01

    Full Text Available The challenge of establishing adaptive management systems is a widely discussed topic in the literature on natural resource management. Adaptive management essentially focuses on achieving a governance process that is both sensitive to and has the capacity to continuously react to changes within the ecosystem being managed. The adoption of a network approach that perceives governance structures as social networks, searching for the kind of network features promoting this important feature, has been requested by researchers in the field. In particular, the possibilities associated with the application of a formal network approach, using the tools and concepts of social network analysis (SNA, have been identified as having significant potential for advancing this branch of research. This paper aims to address the relation between network structure and adaptability using an empirical approach. With the point of departure in a previously generated theoretical framework as well as related hypotheses, this paper presents a case study of a governance process within a fish management area in Sweden. The hypotheses state that, although higher levels of network density and centralisation promote the rule-forming process, the level of network heterogeneity is important for the existence and spread of ecological knowledge among the actors involved. According to the empirical results, restricted by the single-case study design, this assumption is still a well-working hypothesis. However, in order to advance our knowledge concerning these issues and test the validity of the hypotheses, more empirical work using a similar approach in multiple case study designs is needed.

  8. Facilitating the recruitment of minority ethnic people into research: qualitative case study of South Asians and asthma.

    Science.gov (United States)

    Sheikh, Aziz; Halani, Laila; Bhopal, Raj; Netuveli, Gopalakrishnan; Partridge, Martyn R; Car, Josip; Griffiths, Chris; Levy, Mark

    2009-10-01

    There is international interest in enhancing recruitment of minority ethnic people into research, particularly in disease areas with substantial ethnic inequalities. A recent systematic review and meta-analysis found that UK South Asians are at three times increased risk of hospitalisation for asthma when compared to white Europeans. US asthma trials are far more likely to report enrolling minority ethnic people into studies than those conducted in Europe. We investigated approaches to bolster recruitment of South Asians into UK asthma studies through qualitative research with US and UK researchers, and UK community leaders. Interviews were conducted with 36 researchers (19 UK and 17 US) from diverse disciplinary backgrounds and ten community leaders from a range of ethnic, religious, and linguistic backgrounds, followed by self-completion questionnaires. Interviews were digitally recorded, translated where necessary, and transcribed. The Framework approach was used for analysis. Barriers to ethnic minority participation revolved around five key themes: (i) researchers' own attitudes, which ranged from empathy to antipathy to (in a minority of cases) misgivings about the scientific importance of the question under study; (ii) stereotypes and prejudices about the difficulties in engaging with minority ethnic populations; (iii) the logistical challenges posed by language, cultural differences, and research costs set against the need to demonstrate value for money; (iv) the unique contexts of the two countries; and (v) poorly developed understanding amongst some minority ethnic leaders of what research entails and aims to achieve. US researchers were considerably more positive than their UK counterparts about the importance and logistics of including ethnic minorities, which appeared to a large extent to reflect the longer-term impact of the National Institutes of Health's requirement to include minority ethnic people. Most researchers and community leaders view the

  9. Facilitating the recruitment of minority ethnic people into research: qualitative case study of South Asians and asthma.

    Directory of Open Access Journals (Sweden)

    Aziz Sheikh

    2009-10-01

    Full Text Available There is international interest in enhancing recruitment of minority ethnic people into research, particularly in disease areas with substantial ethnic inequalities. A recent systematic review and meta-analysis found that UK South Asians are at three times increased risk of hospitalisation for asthma when compared to white Europeans. US asthma trials are far more likely to report enrolling minority ethnic people into studies than those conducted in Europe. We investigated approaches to bolster recruitment of South Asians into UK asthma studies through qualitative research with US and UK researchers, and UK community leaders.Interviews were conducted with 36 researchers (19 UK and 17 US from diverse disciplinary backgrounds and ten community leaders from a range of ethnic, religious, and linguistic backgrounds, followed by self-completion questionnaires. Interviews were digitally recorded, translated where necessary, and transcribed. The Framework approach was used for analysis. Barriers to ethnic minority participation revolved around five key themes: (i researchers' own attitudes, which ranged from empathy to antipathy to (in a minority of cases misgivings about the scientific importance of the question under study; (ii stereotypes and prejudices about the difficulties in engaging with minority ethnic populations; (iii the logistical challenges posed by language, cultural differences, and research costs set against the need to demonstrate value for money; (iv the unique contexts of the two countries; and (v poorly developed understanding amongst some minority ethnic leaders of what research entails and aims to achieve. US researchers were considerably more positive than their UK counterparts about the importance and logistics of including ethnic minorities, which appeared to a large extent to reflect the longer-term impact of the National Institutes of Health's requirement to include minority ethnic people.Most researchers and community leaders

  10. Rating the methodological quality of single-subject designs and n-of-1 trials: introducing the Single-Case Experimental Design (SCED) Scale.

    Science.gov (United States)

    Tate, Robyn L; McDonald, Skye; Perdices, Michael; Togher, Leanne; Schultz, Regina; Savage, Sharon

    2008-08-01

    Rating scales that assess methodological quality of clinical trials provide a means to critically appraise the literature. Scales are currently available to rate randomised and non-randomised controlled trials, but there are none that assess single-subject designs. The Single-Case Experimental Design (SCED) Scale was developed for this purpose and evaluated for reliability. Six clinical researchers who were trained and experienced in rating methodological quality of clinical trials developed the scale and participated in reliability studies. The SCED Scale is an 11-item rating scale for single-subject designs, of which 10 items are used to assess methodological quality and use of statistical analysis. The scale was developed and refined over a 3-year period. Content validity was addressed by identifying items to reduce the main sources of bias in single-case methodology as stipulated by authorities in the field, which were empirically tested against 85 published reports. Inter-rater reliability was assessed using a random sample of 20/312 single-subject reports archived in the Psychological Database of Brain Impairment Treatment Efficacy (PsycBITE). Inter-rater reliability for the total score was excellent, both for individual raters (overall ICC = 0.84; 95% confidence interval 0.73-0.92) and for consensus ratings between pairs of raters (overall ICC = 0.88; 95% confidence interval 0.78-0.95). Item reliability was fair to excellent for consensus ratings between pairs of raters (range k = 0.48 to 1.00). The results were replicated with two independent novice raters who were trained in the use of the scale (ICC = 0.88, 95% confidence interval 0.73-0.95). The SCED Scale thus provides a brief and valid evaluation of methodological quality of single-subject designs, with the total score demonstrating excellent inter-rater reliability using both individual and consensus ratings. Items from the scale can also be used as a checklist in the design, reporting and critical

  11. When the Single Matters more than the Group (II): Addressing the Problem of High False Positive Rates in Single Case Voxel Based Morphometry Using Non-parametric Statistics.

    Science.gov (United States)

    Scarpazza, Cristina; Nichols, Thomas E; Seramondi, Donato; Maumet, Camille; Sartori, Giuseppe; Mechelli, Andrea

    2016-01-01

    In recent years, an increasing number of studies have used Voxel Based Morphometry (VBM) to compare a single patient with a psychiatric or neurological condition of interest against a group of healthy controls. However, the validity of this approach critically relies on the assumption that the single patient is drawn from a hypothetical population with a normal distribution and variance equal to that of the control group. In a previous investigation, we demonstrated that family-wise false positive error rate (i.e., the proportion of statistical comparisons yielding at least one false positive) in single case VBM are much higher than expected (Scarpazza et al., 2013). Here, we examine whether the use of non-parametric statistics, which does not rely on the assumptions of normal distribution and equal variance, would enable the investigation of single subjects with good control of false positive risk. We empirically estimated false positive rates (FPRs) in single case non-parametric VBM, by performing 400 statistical comparisons between a single disease-free individual and a group of 100 disease-free controls. The impact of smoothing (4, 8, and 12 mm) and type of pre-processing (Modulated, Unmodulated) was also examined, as these factors have been found to influence FPRs in previous investigations using parametric statistics. The 400 statistical comparisons were repeated using two independent, freely available data sets in order to maximize the generalizability of the results. We found that the family-wise error rate was 5% for increases and 3.6% for decreases in one data set; and 5.6% for increases and 6.3% for decreases in the other data set (5% nominal). Further, these results were not dependent on the level of smoothing and modulation. Therefore, the present study provides empirical evidence that single case VBM studies with non-parametric statistics are not susceptible to high false positive rates. The critical implication of this finding is that VBM can be used

  12. Experiences of nurse case managers within a central discharge planning role of collaboration between physicians, patients and other healthcare professionals: A sociocultural qualitative study.

    Science.gov (United States)

    Thoma, Jorun E; Waite, Marion A

    2018-03-01

    To gain knowledge of nurse case managers' experiences within the German acute care context of collaboration with patients and physicians in a discharge planning role; further to learn about patients' assignment to the management of the nurse case managers; and explicitly to explore critical incidences of interactions between nurse case managers, patients and healthcare practitioner in discharge planning to understand the factor that contributes to effective collaboration. The defined role of nurse case managers in many contexts is a patient-centred responsibility for a central task of discharge management of patients with complex physical and social needs. Some studies have indicated that the general impact of the role reduces readmission rates. Given the necessity to work interprofessionally to achieve a safe discharge, little is known about how nurse case managers achieve this collaboratively. A qualitative case study within a German teaching hospital of nurse case managers (N = 8). Data were collected through semi-structured interviews prompted by a critical incident technique and rigorously analysed through the lenses of sociocultural theory. Consistent object being worked upon was a safe and effective discharge from hospital with a focus on patient advocacy. Significant themes were a self-value or recognition by others of professional expertise, reciprocal value on the capabilities of others thorough relational expertise and negotiation with patients and an identification of case trajectories. More continuity of nurse case managers' care and management, clarity of role and transparency to peers, physicians and other professionals would be beneficial in ensuring appropriate referral of complex patients to nurse case managers responsibility. Clearer role description and benefit realisation of the nurse case managers could be achieved by interventions that are interprofessional and focus on the tasks that matter from a collaborative perspective. This could lead

  13. Genome wide single cell analysis of chemotherapy resistant metastatic cells in a case of gastroesophageal adenocarcinoma

    International Nuclear Information System (INIS)

    Hjortland, Geir Olav; Fodstad, Oystein; Smeland, Sigbjorn; Hovig, Eivind; Meza-Zepeda, Leonardo A; Beiske, Klaus; Ree, Anne H; Tveito, Siri; Hoifodt, Hanne; Bohler, Per J; Hole, Knut H; Myklebost, Ola

    2011-01-01

    Metastatic progression due to development or enrichment of therapy-resistant tumor cells is eventually lethal. Molecular characterization of such chemotherapy resistant tumor cell clones may identify markers responsible for malignant progression and potential targets for new treatment. Here, in a case of stage IV adenocarcinoma of the gastroesophageal junction, we report the successful genome wide analysis using array comparative genomic hybridization (CGH) of DNA from only fourteen tumor cells using a bead-based single cell selection method from a bone metastasis progressing during chemotherapy. In a case of metastatic adenocarcinoma of the gastroesophageal junction, the progression of bone metastasis was observed during a chemotherapy regimen of epirubicin, oxaliplatin and capecitabine, whereas lung-, liver and lymph node metastases as well as the primary tumor were regressing. A bone marrow aspirate sampled at the site of progressing metastasis in the right iliac bone was performed, and single cell molecular analysis using array-CGH of Epithelial Specific Antigen (ESA)-positive metastatic cells, and revealed two distinct regions of amplification, 12p12.1 and 17q12-q21.2 amplicons, containing the KRAS (12p) and ERBB2 (HER2/NEU) (17q) oncogenes. Further intrapatient tumor heterogeneity of these highlighted gene copy number changes was analyzed by fluorescence in situ hybridization (FISH) in all available primary and metastatic tumor biopsies, and ErbB2 protein expression was investigated by immunohistochemistry. ERBB2 was heterogeneously amplified by FISH analysis in the primary tumor, as well as liver and bone metastasis, but homogenously amplified in biopsy specimens from a progressing bone metastasis after three initial cycles of chemotherapy, indicating a possible enrichment of erbB2 positive tumor cells in the progressing bone marrow metastasis during chemotherapy. A similar amplification profile was detected for wild-type KRAS, although more heterogeneously

  14. Students’ Learning Experiences from Didactic Teaching Sessions Including Patient Case Examples as Either Text or Video: A Qualitative Study

    DEFF Research Database (Denmark)

    Pedersen, Kamilla; Holdgaard, Martin Møller; Paltved, Charlotte

    2017-01-01

    OBJECTIVES: The aim of this study was to explore medical students' learning experiences from the didactic teaching formats using either text-based patient cases or video-based patient cases with similar content. The authors explored how the two different patient case formats influenced students' ...... unintended stigma and influence an authoritative approach in medical students towards managing patients in clinical psychiatry....

  15. Schema therapy for patients with chronic depression: a single case series study.

    Science.gov (United States)

    Malogiannis, Ioannis A; Arntz, Arnoud; Spyropoulou, Areti; Tsartsara, Eirini; Aggeli, Aikaterini; Karveli, Spyridoula; Vlavianou, Miranda; Pehlivanidis, Artemios; Papadimitriou, George N; Zervas, Iannis

    2014-09-01

    This study tested the effectiveness of schema therapy (ST) for patients with chronic depression. Twelve patients with a diagnosis of chronic depression participated. The treatment protocol consisted of 60 sessions, with the first 55 sessions offered weekly and the last five sessions on a biweekly basis. A single case series A-B-C design, with 6 months follow-up was used. Baseline (A) was a wait period of 8 weeks. Baseline was followed by introduction to ST and bonding to therapist (phase B) with individually tailored length of 12-16 sessions, after which further ST was provided (phase C) up to 60 sessions (included the sessions given as introduction). Patients were assessed with Hamilton Rating Scale for Depression three times during baseline, at the end of phase B, then every 12 weeks until the end of treatment and at 6 months follow-up. Secondary outcome measures were the Hamilton Rating Scale for Anxiety and the Young Schema Questionnaire. At the end of treatment 7 patients (approximately 60%) remitted or satisfactorily responded. The mean HRSD dropped from 21.07 during baseline to 9.40 at post-treatment and 10.75 at follow-up. The effects were large and the gains of treatment were maintained at 6-month follow-up. Only one patient dropped out for reasons not related to treatment. The lack of control group, the small sample and the lack of a multiple baseline case series. This preliminary study supports the use of ST as an effective treatment for chronic depression. Copyright © 2014 Elsevier Ltd. All rights reserved.

  16. Single-port Access Subtotal Laparoscopic Hysterectomy: A Prospective Case-Control Study.

    Science.gov (United States)

    Angioni, Stefano; Pontis, Alessandro; Pisanu, Adolfo; Mereu, Liliana; Roman, Horace

    2015-01-01

    The objective was to evaluate the perioperative outcomes, safety, and patient acceptance of single-port access laparoscopic subtotal hysterectomy (SPAL-SH) in comparison with conventional multiport access laparoscopic subtotal hysterectomy (MPAL-SH). Case-control study. Canadian Task Force Classification II-2. The study was conducted at university hospitals in Cagliari, Italy, and Rouen, France. Sixty-one women with metrorrhagia, abnormal uterine bleeding with uterine myomas, or symptomatic adenomyosis were included in the study. Thirty-one patients underwent SPAL-SH, and 30 patients underwent conventional MPAL-SH. We analyzed the data to compare the outcomes of SPAL-SH versus MPAL-SH. Patients in the SPAL-SH group had longer operative times than those in the MPAL-SH group (p < .001) but shorter hospital stays (p < .001). Postoperative pain immediately after surgery, after 6 hours, and after 24 hours were lower in the SPAL-SH group (p < .001). The SPAL-SH group reported significantly higher cosmetic satisfaction at 1, 4, and 24 weeks after surgery (p < .01). We conclude that SPAL-SH is a feasible and safe alternative to standard MPAL-SH in selected patients. Ongoing refinement of the surgical technique and instrumentation is likely to expand its role in gynecologic surgery in the future. In addition, SPAL-SH has a definite benefit in relation to body image and cosmesis. Copyright © 2015 AAGL. Published by Elsevier Inc. All rights reserved.

  17. Effects of arm training with the robotic device ARMin I in chronic stroke: three single cases.

    Science.gov (United States)

    Nef, Tobias; Quinter, Gabriela; Müller, Roland; Riener, Robert

    2009-01-01

    Several clinical studies on chronic stroke conducted with end-effector-based robots showed improvement of the motor function in the affected arm. Compared to end-effector-based robots, exoskeleton robots provide improved guidance of the human limb and are better suited to train task-oriented movements with a large range of motions. To test whether intensive arm training with the arm exoskeleton ARMin I is feasible with chronic-stroke patients and whether it improves motor function in the paretic arm. Three single cases with chronic hemiparesis resulting from unilateral stroke (at least 14 months after stroke). A-B design with 2 weeks of multiple baseline measurements (A), 8 weeks of training (B) with repetitive measurements and a follow-up measurement 8 weeks after training. The training included shoulder and elbow movements with the robotic rehabilitation device ARMin I. Two subjects had three 1-hour sessions per week and 1 subject received five 1-hour sessions per week. The main outcome measurement was the upper-limb part of the Fugl-Meyer Assessment (FMA). The ARMin training was well tolerated by the patients, and the FMA showed moderate, but significant improvements for all 3 subjects (p arm exoskeleton is feasible with chronic-stroke patients. Moderate improvements were found in all 3 subjects, thus further clinical investigations are justified. Copyright 2009 S. Karger AG, Basel.

  18. Immediate single tooth replacement with subepithelial connective tissue graft using platform switching implants: a case series.

    Science.gov (United States)

    Chung, Seunghwan; Rungcharassaeng, Kitichai; Kan, Joseph Y K; Roe, Phillip; Lozada, Jaime L

    2011-10-01

    This case series evaluated the facial gingival stability following single immediate tooth replacement in conjunction with subepithelial connective tissue graft (SCTG). Implant success rate and peri-implant tissue response were also reported. Ten patients (6 male, 4 female), with a mean age of 52.1 (range = 22.7 to 67.1) years, underwent immediate implant placement and provisionalization with SCTG and were evaluated clinically and radiographically at presurgery (T0), at the time of immediate tooth replacement and SCTG (T1), and 3 months (T2), 6 months (T3), and 12 months (T4) after surgery. Data were analyzed using the Friedman and Wilcoxon signed-ranks tests at the significance level of α = .05. At 1 year, 9 of 10 implants remained osseointegrated with the overall mean marginal bone change of -0.31 mm and a mean facial gingival level change of -0.05 mm. The modified plaque index scores showed that patients were able to maintain a good level of hygiene throughout the study. The papilla index score indicated that at T4, more than 50% of the papilla fill was observed in 89% of all sites. When proper 3-dimensional implant position is achieved and bone graft is placed into the implant-socket gap, favorable success rate and peri-implant tissue response of platform switching implants can be achieved following immediate tooth replacement in conjunction with subepithelial connective tissue graft.

  19. Virtual agent-mediated appraisal training: a single case series among Dutch firefighters.

    Science.gov (United States)

    Beer, Ursula M; Neerincx, Mark A; Morina, Nexhmedin; Brinkman, Willem-Paul

    2017-01-01

    Background : First responders are a prime example of professionals that are at a high risk of being exposed to traumatic experiences. Reappraisal as a coping strategy might help first responders to better cope with their emotional responses to traumatic events. Objective : This study investigated the effects of repeated sessions of a digital reappraisal training among seven firefighters. The training consisted of four sessions supported by a virtual agent, conducted at home or at work, over a two-week period in a single case series. Method : Sixteen data points were collected from each participant in the eight days pre- and post-training. Results : Significantly more themes were used at post-training than at pre-training, implying more flexibility and confirming the main hypothesis of the study. Negative side effects were not reported during or in the week after the training. Conclusions : More controlled studies into the short- and long-term effects of a training of this nature are needed. Furthermore, it provides a reference for developers in this field.

  20. Imagery Rescripting for Body Dysmorphic Disorder: A Multiple-Baseline Single-Case Experimental Design.

    Science.gov (United States)

    Willson, Rob; Veale, David; Freeston, Mark

    2016-03-01

    Individuals with body dysmorphic disorder (BDD) often experience negative distorted images of their appearance, and research suggests these may be linked to memories of adverse events such as bullying or teasing. This study evaluates imagery rescripting (ImR) as an intervention for BDD. In this article, we present a multiple-baseline single-case experimental design testing imagery rescripting as a brief, stand-alone intervention, with six individuals with BDD that related to aversive memories. The impact of the intervention was assessed by self-reported daily measures of symptom severity (preoccupation with appearance, appearance-related checking behaviors, appearance-related distress, and strength of belief that their main problem is their appearance) and standardized clinician ratings of BDD severity (Yale-Brown Obsessive Compulsive Scale modified for BDD). Four out of six of the participants responded positively to the intervention, with clinically meaningful improvement in symptomatology. Overall response was rapid; improvements began within the first week post-ImR intervention. From a small sample it is cautiously concluded that imagery rescripting may show promise as a module in cognitive-behavioral therapy for BDD, and is worthy of further investigation. Copyright © 2015. Published by Elsevier Ltd.

  1. Single-case experimental designs to assess intervention effectiveness in rehabilitation: A practical guide.

    Science.gov (United States)

    Krasny-Pacini, Agata; Evans, Jonathan

    2017-12-15

    Single-case experimental designs (SCED) are experimental designs aiming at testing the effect of an intervention using a small number of patients (typically one to three), using repeated measurements, sequential (±randomized) introduction of an intervention and method-specific data analysis, including visual analysis and specific statistics. The aim of this paper is to familiarise professionals working in different fields of rehabilitation with SCEDs and provide practical advice on how to design and implement a SCED in clinical rehabilitation practice. Research questions suitable for SCEDs and the different types of SCEDs (e.g., alternating treatment designs, introduction/withdrawal designs and multiple baseline designs) are reviewed. Practical steps in preparing a SCED design are outlined. Examples from different rehabilitation domains are provided throughout the paper. Challenging issues such as the choice of the repeated measure, assessment of generalisation, randomization, procedural fidelity, replication and generalizability of findings are discussed. Simple rules and resources for data analysis are presented. The utility of SCEDs in physical and rehabilitation medicine (PRM) are discussed. Copyright © 2018 Elsevier Masson SAS. All rights reserved.

  2. Systematic review of sensory integration therapy for individuals with disabilities: Single case design studies.

    Science.gov (United States)

    Leong, H M; Carter, Mark; Stephenson, Jennifer

    2015-12-01

    Sensory integration therapy (SIT) is a controversial intervention that is widely used for people with disabilities. Systematic analysis was conducted on the outcomes of 17 single case design studies on sensory integration therapy for people with, or at-risk of, a developmental or learning disability, disorder or delay. An assessment of the quality of methodology of the studies found most used weak designs and poor methodology, with a tendency for higher quality studies to produce negative results. Based on limited comparative evidence, functional analysis-based interventions for challenging behavior were more effective that SIT. Overall the studies do not provide convincing evidence for the efficacy of sensory integration therapy. Given the findings of the present review and other recent analyses it is advised that the use of SIT be limited to experimental contexts. Issues with the studies and possible improvements for future research are discussed including the need to employ designs that allow for adequate demonstration of experimental control. Copyright © 2015 Elsevier Ltd. All rights reserved.

  3. A case of a resectable single hepatic epithelioid hemangioendothelioma with characteristic imaging by ADC map.

    Science.gov (United States)

    Okano, Hiroshi; Nakajima, Hideki; Tochio, Tomomasa; Suga, Daisuke; Kumazawa, Hiroaki; Isono, Yoshiaki; Tanaka, Hiroki; Matsusaki, Shimpei; Sase, Tomohiro; Saito, Tomonori; Mukai, Katsumi; Nishimura, Akira; Matsushima, Nobuyoshi; Baba, Youichirou; Murata, Tetsuya; Hamada, Takashi; Taoka, Hiroki

    2015-12-01

    A 47-year-old woman with a single-nodule hepatic tumor was referred to our hospital. She had no symptoms. The tumor was located at the surface of the right lobe of the liver; it showed peripheral low signal intensity on a magnetic resonance imaging apparent diffusion coefficient (ADC) map, and an influx of blood flow into the peripheral area of the tumor at the early vascular phase on perflubutane microbubble (Sonazoid(®)) contrast-enhanced (CE) ultrasonography. Since we suspected a malignant tumor, the patient underwent surgical resection. The hepatic tumor was resected curatively. Pathological examination revealed that the tumor was composed of epithelioid cells with an epithelioid structure and/or cord-like structure. Immunohistochemical staining was positive for cluster of differentiation 34 and factor VIII-related antigen. Based on the above, a final diagnosis of hepatic epithelioid hemangioendothelioma (EHE) was made. Hepatic EHE is a rare hepatic tumor: only a few cases of hepatic EHE with curative resection have been reported. We were unable to reach a diagnosis of hepatic EHE by imaging studies; however, an ADC map was useful in showing the malignant potential of the tumor, and CE ultrasonography was useful in revealing the peripheral blood flow of the tumor. When an unusual hepatic mass is encountered, hepatic EHE should be kept in mind, and the mass should be inspected with more than one imaging modality, including an ADC map, in the process of differential diagnosis.

  4. Single-Case Research Methods: History and Suitability for a Psychological Science in Need of Alternatives.

    Science.gov (United States)

    Hurtado-Parrado, Camilo; López-López, Wilson

    2015-09-01

    This paper presents a historical and conceptual analysis of a group of research strategies known as the Single-Case Methods (SCMs). First, we present an overview of the SCMs, their history, and their major proponents. We will argue that the philosophical roots of SCMs can be found in the ideas of authors who recognized the importance of understanding both the generality and individuality of psychological functioning. Second, we will discuss the influence that the natural sciences' attitude toward measurement and experimentation has had on SCMs. Although this influence can be traced back to the early days of experimental psychology, during which incipient forms of SCMs appeared, SCMs reached full development during the subsequent advent of Behavior Analysis (BA). Third, we will show that despite the success of SCMs in BA and other (mainly applied) disciplines, these designs are currently not prominent in psychology. More importantly, they have been neglected as a possible alternative to one of the mainstream approaches in psychology, the Null Hypothesis Significance Testing (NHST), despite serious controversies about the limitations of this prevailing method. Our thesis throughout this section will be that SCMs should be considered as an alternative to NHST because many of the recommendations for improving the use of significance testing (Wilkinson & the TFSI, 1999) are main characteristics of SCMs. The paper finishes with a discussion of a number of the possible reasons why SCMs have been neglected.

  5. Case Study: Physical Capacity and Nutritional Status Before and After a Single-Handed Yacht Race.

    Science.gov (United States)

    Ghiani, Giovanna; Magnani, Sara; Doneddu, Azzurra; Sainas, Gianmarco; Pinna, Virginia; Caboi, Marco; Palazzolo, Girolamo; Tocco, Filippo; Crisafulli, Antonio

    2017-12-18

    During solitary sailing the sailor is exposed to sleep deprivation and difficulties in consuming regular meals. Sailor weight loss is often reported. In the present case study we describe changes in the physical capacity and the nutritional status of an athlete attempting a single-handed yacht race around the globe. An Italian male ocean racer (GM) asked for our help to reach an optimum level of physical and nutritional preparation. We planned his diet after assessing his anthropometric parameters and body composition as well as his usual energy intake and nutritional expenditure. The diet consisted in 120 meals stored in sealed plastic bags. Before his departure, GM performed two incremental exercise tests (cycle- and arm crank- ergometry) to assess his physical capacity. Cardiac functions were also estimated by Doppler echocardiography. All measures and exercise tests were repeated 10 days after GM finished the race, which lasted 64 days. Anthropometric measures did not change significantly, with the exception of Arm Fat Area and Thigh Muscle area, which decreased. There were evident increments in maximum oxygen intake and maximum workload during arm cranking after the race. On the contrary, maximum oxygen uptake and maximum workload decreased during cycling. Finally, End Diastolic and Stroke Volume decreased after the race. It was concluded that nutritional counseling was useful to avoid excessive changes in the nutritional status and body composition due to 64 days of solitary navigation. However, a reduction in physical leg capacity and cardiovascular functions secondary to legs disuse were present.

  6. A Single-Case Study of Resiliency After Extreme Incest in an Old Order Amish Family.

    Science.gov (United States)

    McGuigan, William M; Stephenson, Sarah J

    2015-01-01

    This exploratory research brief presents a single case study of the resiliency of "Mary B." She grew up in an Old Order Amish family where isolation, secrecy, and patriarchy masked repeated sexual assaults by her older brothers that began at age 7. By the age of 20, Mary alleged she had been raped on more than 200 separate occasions by members of her Amish family. After years of pleading with her mother and church officials to intervene, she sought therapy outside the Amish community. This led to three of her brothers being incarcerated. Her family disowned her and she was banned from the Amish community, leaving with an 8th grade education and little more than the clothes she was wearing. In less than 2 years, Mary had moved to a new town, completed her GED, obtained a car and driving license, maintained a small home, and worked as a certified nursing assistant. She consented to tape recorded interviews and completed several quantitative diagnostic measures. Scores on the diagnostic measures placed her within the normal range on self-esteem, competency, depression, stress, social support, and life skills. Analysis of interviews revealed Mary rebounded from her past by reframing her experiences. Themes identified within the interviews supported 6 of the 7 types of resiliencies (insight, independence, initiative, relationships, humor, and morality) outlined in the therapeutic Challenge Model.

  7. “REPRESENTATION, PROJECTION AND COCHLEAR IMPLANT: A SINGLE CASE STUDY”

    Directory of Open Access Journals (Sweden)

    Carmela Mento

    2014-06-01

    Full Text Available From the psychological point of view hearing is an essential sensory modality for the human species, because it contributes to the formation of the first relational connections and emotions. It is important to make a diagnosis early to intervene and limit negative effects.  Deafness is a particular phenomenon (onset, types,  in this paper we undertake a thorough descriptive analysis on all aspects of deafness, in particular the use of a prosthetic device known as cochlear implant.  We have deepened personality variables in a single case with the use of Rorschach Test and Draw-a-person-Test.  We aimed to study, with the clinical interpretation of instruments, which personality variables could be involved in hearing loss condition and Cochlear Implant (CI.  This observational study highlights the psychological dynamics that should be taken into account by operators team, in order to improve the quality of life of these patients and increase their long-term therapeutic outcome.

  8. Bit and Power Allocation in Constrained Multicarrier Systems: The Single-User Case

    Directory of Open Access Journals (Sweden)

    Theodore Antonakopoulos

    2007-09-01

    Full Text Available Multicarrier modulation is a powerful transmission technique that provides improved performance in various communication fields. A fundamental topic of multicarrier communication systems is the bit and power loading, which is addressed in this article as a constrained multivariable nonlinear optimization problem. In particular, we present the main classes of loading problems, namely, rate maximization and margin maximization, and we discuss their optimal solutions for the single-user case. Initially, the classical water-filling solution subject to a total power constraint is presented using the Lagrange multipliers optimization approach. Next, the peak-power constraint is included and the concept of cup-limited waterfilling is introduced. The loading problem is also addressed subject to the integer-bit restriction and the optimal discrete solution is examined using combinatorial optimization methods. Furthermore, we investigate the duality conditions of the rate maximization and margin maximization problems and we highlight various ideas for low-complexity loading algorithms. This article surveys and reviews existing results on resource allocation in constrained multicarrier systems and presents new trends in this area.

  9. An introduction to modeling longitudinal data with generalized additive models: applications to single-case designs.

    Science.gov (United States)

    Sullivan, Kristynn J; Shadish, William R; Steiner, Peter M

    2015-03-01

    Single-case designs (SCDs) are short time series that assess intervention effects by measuring units repeatedly over time in both the presence and absence of treatment. This article introduces a statistical technique for analyzing SCD data that has not been much used in psychological and educational research: generalized additive models (GAMs). In parametric regression, the researcher must choose a functional form to impose on the data, for example, that trend over time is linear. GAMs reverse this process by letting the data inform the choice of functional form. In this article we review the problem that trend poses in SCDs, discuss how current SCD analytic methods approach trend, describe GAMs as a possible solution, suggest a GAM model testing procedure for examining the presence of trend in SCDs, present a small simulation to show the statistical properties of GAMs, and illustrate the procedure on 3 examples of different lengths. Results suggest that GAMs may be very useful both as a form of sensitivity analysis for checking the plausibility of assumptions about trend and as a primary data analysis strategy for testing treatment effects. We conclude with a discussion of some problems with GAMs and some future directions for research on the application of GAMs to SCDs. (c) 2015 APA, all rights reserved).

  10. Lexicalization errors in writing arabic numerals: a single-case study.

    Science.gov (United States)

    Noël, M P; Seron, X

    1995-11-01

    This paper presents a single-case study of a patient suffering from several impairments in number processing. The main focus of the paper is to describe and interpret the patient's errors in verbal to arabic transcoding. The errors were of the syntactical type and consisted of partial lexicalizations appearing mainly in response to items with Thousand in sum relationships and less frequently with Hundred in sum relationships. The Discussion section compares three models in their ability to account for the patient's dissociation. It was suggested that models such as that of McCloskey, Caramazza, and Basili (1985), postulating a semantic representation for numbers built up on a base-ten system, are unable to account for the patient's errors. By contrast, Power et al.'s perspective (Power & Longuet-Higgins, 1978; Power & Dal Martello, 1990), which posits a semantic representation of numbers reflecting the structure of the verbal numeral system, could provide an economical interpretation for the dissociation observed between the mastery of sum and product relationships. Similarly, the asemantic transcoding model developed by Deloche and Seron (1987) gives a valid account for the patient's profile.

  11. Preoperative therapeutic neuroscience education for lumbar radiculopathy: a single-case fMRI report.

    Science.gov (United States)

    Louw, Adriaan; Puentedura, Emilio J; Diener, Ina; Peoples, Randal R

    2015-01-01

    Therapeutic neuroscience education (TNE) has been shown to be effective in the treatment of mainly chronic musculoskeletal pain conditions. This case study aims to describe the changes in brain activation on functional magnetic resonance imaging (fMRI) scanning, before and after the application of a newly-designed preoperative TNE program. A 30-year-old female with a current acute episode of low back pain (LBP) and radiculopathy participated in a single preoperative TNE session. She completed pre- and post-education measures including visual analog scale (VAS) for LBP and leg pain; Oswestry Disability Index (ODI); Fear Avoidance Beliefs Questionnaire (FABQ); Pain Catastrophizing Scale (PCS) and a series of Likert-scale questions regarding beliefs and attitudes to lumbar surgery (LS). After a 30-minute TNE session, ODI decreased by 10%, PCS decreased by 10 points and her beliefs and attitudes shifted positively regarding LS. Immediately following TNE straight leg raise increased by 7° and forward flexion by 8 cm. fMRI testing following TNE revealed 3 marked differences compared to pre-education scanning: (1) deactivation of the periaqueductal gray area; (2) deactivation of the cerebellum; and (3) increased activation of the motor cortex. The immediate positive fMRI, psychometric and physical movement changes may indicate a cortical mechanism of TNE for patients scheduled for LS.

  12. Masked Visual Analysis: Minimizing Type I Error in Visually Guided Single-Case Design for Communication Disorders.

    Science.gov (United States)

    Byun, Tara McAllister; Hitchcock, Elaine R; Ferron, John

    2017-06-10

    Single-case experimental designs are widely used to study interventions for communication disorders. Traditionally, single-case experiments follow a response-guided approach, where design decisions during the study are based on participants' observed patterns of behavior. However, this approach has been criticized for its high rate of Type I error. In masked visual analysis (MVA), response-guided decisions are made by a researcher who is blinded to participants' identities and treatment assignments. MVA also makes it possible to conduct a hypothesis test assessing the significance of treatment effects. This tutorial describes the principles of MVA, including both how experiments can be set up and how results can be used for hypothesis testing. We then report a case study showing how MVA was deployed in a multiple-baseline across-subjects study investigating treatment for residual errors affecting rhotics. Strengths and weaknesses of MVA are discussed. Given their important role in the evidence base that informs clinical decision making, it is critical for single-case experimental studies to be conducted in a way that allows researchers to draw valid inferences. As a method that can increase the rigor of single-case studies while preserving the benefits of a response-guided approach, MVA warrants expanded attention from researchers in communication disorders.

  13. Art therapy may reduce psychopathology in schizophrenia by strengthening the patients' sense of self: a qualitative extended case report.

    Science.gov (United States)

    Teglbjaerg, Hanne Stubbe

    2011-01-01

    Many forms of artistic expression and art therapy are widely used in psychiatric treatment, but we lack an understanding of how artistic expression may interfere with psychopathology. Art therapy inspired by the Expressive Arts was offered for 1 year to two groups of outpatients. One group consisted of patients with severe schizophrenia and the other group of 5 nonpsychotic psychiatric patients with depression and/or personality disorders. The course of therapy was described systematically, and the experience of each patient was examined using interviews and written evaluations before and after therapy and at a 1-year follow-up. A qualitative analysis was done to determine how art therapy affects the psychopathology of the patients. The patients used the art therapy in many different ways. The most important benefit of the art therapy was a strengthening of the patients' sense of self. This was accomplished by engagement in the artistic process and by aesthetic reflections on the painted images. The stronger sense of self diminished the tension arising from interpersonal contact, boosting their self-esteem and thereby improving their social competences. All patients reported a very good outcome, and the qualitative analysis showed that the positive effect of art therapy is mainly due to a strengthening of the patients' minimal sense of self. Copyright © 2011 S. Karger AG, Basel.

  14. A qualitative study of primary care professionals' views of case finding for depression in patients with diabetes or coronary heart disease in the UK.

    Science.gov (United States)

    Maxwell, Margaret; Harris, Fiona; Hibberd, Carina; Donaghy, Eddie; Pratt, Rebekah; Williams, Chris; Morrison, Jill; Gibb, Jennifer; Watson, Philip; Burton, Chris

    2013-04-04

    Routinely conducting case finding (also commonly referred to as screening) in patients with chronic illness for depression in primary care appears to have little impact. We explored the views and experiences of primary care nurses, doctors and managers to understand how the implementation of case finding/screening might impact on its effectiveness. Two complementary qualitative focus group studies of primary care professionals including nurses, doctors and managers, in five primary care practices and five Community Health Partnerships, were conducted in Scotland. We identified several features of the way case finding/screening was implemented that may lead to systematic under-detection of depression. These included obstacles to incorporating case finding/screening into a clinical review consultation; a perception of replacing individualised care with mechanistic assessment, and a disconnection for nurses between management of physical and mental health. Far from being a standardised process that encouraged detection of depression, participants described case finding/screening as being conducted in a way which biased it towards negative responses, and for nurses, it was an uncomfortable task for which they lacked the necessary skills to provide immediate support to patients at the time of diagnosis. The introduction of case finding/screening for depression into routine chronic illness management is not straightforward. Routinized case finding/screening for depression can be implemented in ways that may be counterproductive to engagement (particularly by nurses), with the mental health needs of patients living with long term conditions. If case finding/screening or engagement with mental health problems is to be promoted, primary care nurses require more training to increase their confidence in raising and dealing with mental health issues and GPs and nurses need to work collectively to develop the relational work required to promote cognitive participation in case

  15. Validity of the diagnosis of a single depressive episode in a case register

    DEFF Research Database (Denmark)

    Bock, Camilla; Bukh, Jens Drachmann; Vinberg, Maj

    2009-01-01

    sampled from the register and diagnosed according to an interview using the Schedules for Clinical Assessment in Neuropsychiatry (SCAN). RESULTS: A total of 75.4% of 399 patients with a register diagnosis of a single depressive episode also got this diagnosis according to the SCAN interview (82......ABSTRACT: OBJECTIVE: To validate the ICD-10 diagnosis of a single depressive episode as used in daily clinical psychiatric practice and as recorded in the Danish Psychiatric Central Research Register. METHODS: Patients discharged with a diagnosis of a single depressive episode were consecutively.......8% for severe type of a single depression, 76.0% for moderate type of a single depression and 65.2% for mild type of a single depression). CONCLUSION: The ICD-10 diagnosis of a single depressive episode can be used in daily clinical practice with sufficient precision. The validity of the diagnosis is highest...

  16. Towards personalized integrated dementia care: a qualitative study into the implementation of different models of case management

    NARCIS (Netherlands)

    van Mierlo, L.D.; Meiland, F.J.M.; van Hout, H.P.J.; Dröes, R.M.

    2014-01-01

    Background: The aim of this process evaluation was to provide insight into facilitators and barriers to the delivery of community-based personalized dementia care of two different case management models, i.e. the linkage model and the combined intensive case management/joint agency model. These two

  17. The wavefield of acoustic logging in a cased hole with a single casing—Part II: a dipole tool

    Science.gov (United States)

    Wang, Hua; Fehler, Michael

    2018-02-01

    The acoustic method, being the most effective method for cement bond evaluation, has been used by industry for more than a half century. However, the methods currently used are almost always focused on the first arrival (especially for sonic logging), which has limitations. We use a 3-D finite-difference method to numerically simulate the wavefields from a dipole source in a single-cased hole with different cement conditions. By using wavefield snapshots and dispersion curves, we interpret the characteristics of the modes in the models. We investigate the effect of source frequency, the thickness and location of fluid columns on different modes. The dipole wavefield in a single-cased hole consists of a leaky P (for frequency >10 kHz) from formation, formation flexural, and also some casing modes. Depending on the mode, their behaviour is sometimes sensitive to the existence of fluid between the cement and formation and sometimes sensitive to the existence of fluid between the casing and cement. The formation S velocity can be obtained from the formation flexural mode at low frequency. However, interference from high-order casing modes makes the leaky P invisible and P velocity determination difficult when the casing is not well cemented. The dispersion curve of the formation flexural mode is sensitive to the fluid thickness when fluid exists only at the interface between casing and cement. The fundamental casing dipole mode is only sensitive to the total fluid thickness in the annulus between casing and formation. Either the arrival time or amplitude of the high-order casing dipole mode is sensitive to the fluid column when the fluid column is next to the casing. We provide a table that summarizes the ability of different modes to detect fluid columns between various layers of casing, cement and formation. Based on the results, we suggest a data processing flow for field application, which will highly improve cement evaluation.

  18. Single Restorations in the Resorbed Posterior Mandible Supported by 6-mm Implants : A 1-Year Prospective Case Series Study

    NARCIS (Netherlands)

    Gulje, Felix L.; Raghoebar, Gerry M.; Vissink, Arjan; Meijer, Henny J. A.

    2015-01-01

    PurposeThe aim of this prospective case series study was to assess the clinical performance of single restorations in the posterior mandible supported by 6-mm implants. Materials and MethodsTwenty-one consecutive patients with one or more missing premolars or molars in the posterior mandible and

  19. The Influence of Visual Word Form in Reading: Single Case Study of an Arabic Patient with Deep Dyslexia

    Science.gov (United States)

    Boumaraf, Assia; Macoir, Joël

    2016-01-01

    Deep dyslexia is a written language disorder characterized by poor reading of non-words, and advantage for concrete over abstract words with production of semantic, visual and morphological errors. In this single case study of an Arabic patient with input deep dyslexia, we investigated the impact of graphic features of Arabic on manifestations of…

  20. An Aggregate Study of Single-Case Research Involving Aided AAC: Participant Characteristics of Individuals with Autism Spectrum Disorders

    Science.gov (United States)

    Ganz, Jennifer B.; Earles-Vollrath, Theresa L.; Mason, Rose A.; Rispoli, Mandy J.; Heath, Amy K.; Parker, Richard I.

    2011-01-01

    Individuals with autism spectrum disorders (ASD) who cannot speak at all or not intelligibly are frequently taught to use aided augmentative and alternative communication (AAC). The majority of the research on the use of AAC with individuals with ASD has been single-case research studies. This investigation involved a meta-analysis of the…

  1. Meta-Analysis of Single-Case Design Research on Self-Regulatory Interventions for Academic Performance

    Science.gov (United States)

    Perry, Valerie; Albeg, Loren; Tung, Catherine

    2012-01-01

    The current study examined the effects of self-regulatory interventions on reading, writing, and math by conducting a meta-analysis of single-case design research. Self-regulatory interventions have promise as an effective approach that is both minimally invasive and involves minimal resources. Effects of the interventions were analyzed by…

  2. Promoting Positive Behavior Using the Good Behavior Game: A Meta-Analysis of Single-Case Research

    Science.gov (United States)

    Bowman-Perrott, Lisa; Burke, Mack D.; Zaini, Samar; Zhang, Nan; Vannest, Kimberly

    2016-01-01

    The Good Behavior Game (GBG) is a classroom management strategy that uses an interdependent group-oriented contingency to promote prosocial behavior and decrease problem behavior. This meta-analysis synthesized single-case research (SCR) on the GBG across 21 studies, representing 1,580 students in pre-kindergarten through Grade 12. The TauU effect…

  3. Single-case effect size calculation: comparing regression and non-parametric approaches across previously published reading intervention data sets.

    Science.gov (United States)

    Ross, Sarah G; Begeny, John C

    2014-08-01

    Growing from demands for accountability and research-based practice in the field of education, there is recent focus on developing standards for the implementation and analysis of single-case designs. Effect size methods for single-case designs provide a useful way to discuss treatment magnitude in the context of individual intervention. Although a standard effect size methodology does not yet exist within single-case research, panel experts recently recommended pairing regression and non-parametric approaches when analyzing effect size data. This study compared two single-case effect size methods: the regression-based, Allison-MT method and the newer, non-parametric, Tau-U method. Using previously published research that measured the Words read Correct per Minute (WCPM) variable, these two methods were examined by comparing differences in overall effect size scores and rankings of intervention effect. Results indicated that the regression method produced significantly larger effect sizes than the non-parametric method, but the rankings of the effect size scores had a strong, positive relation. Implications of these findings for research and practice are discussed. Copyright © 2014 Society for the Study of School Psychology. Published by Elsevier Ltd. All rights reserved.

  4. Collaboration between non-governmental organizations and public services in health – a qualitative case study from rural Ecuador

    Directory of Open Access Journals (Sweden)

    Olivia Biermann

    2016-11-01

    Full Text Available Background: Non-governmental organizations (NGOs have a key role in improving health in low- and middle-income countries. Their work needs to be synergistic, complementary to public services, and rooted in community mobilization and collective action. The study explores how an NGO and its health services are perceived by the population that it serves, and how it can contribute to reducing barriers to care. Design: A qualitative exploratory study was conducted in remote Ecuador, characterized by its widespread poverty and lack of official governance. An international NGO collaborated closely with the public services to deliver preventative and curative health services. Data were collected using focus group discussions and semistructured interviews with purposively sampled community members, healthcare personnel, and community health workers based on their links to the health services. Conventional qualitative content analysis was used, focusing on manifest content. Results: Emerging themes relate to the public private partnership (PPP, the NGO and its services, and community participation. The population perceives the NGO positively, linking it to healthcare improvements. Their priority is to get services, irrespective of the provider's structure. The presence of an NGO in the operation may contribute to unrealistic expectations of health services, affecting perceptions of the latter negatively. Conclusions: To avoid unrealistic expectations and dissatisfaction, and to increase and sustain the population's trust in the organization, an NGO should operate in a manner that is as integrated as possible within the existing structure. The NGO should work close to the population it serves, with services anchored in the community. PPP parties should develop a common platform with joint messages to the target population on the provider's structure, and regarding partners’ roles and responsibilities. Interaction between the population and the providers

  5. Hearing the voices of service user researchers in collaborative qualitative data analysis: the case for multiple coding.

    Science.gov (United States)

    Sweeney, Angela; Greenwood, Kathryn E; Williams, Sally; Wykes, Til; Rose, Diana S

    2013-12-01

    Health research is frequently conducted in multi-disciplinary teams, with these teams increasingly including service user researchers. Whilst it is common for service user researchers to be involved in data collection--most typically interviewing other service users--it is less common for service user researchers to be involved in data analysis and interpretation. This means that a unique and significant perspective on the data is absent. This study aims to use an empirical report of a study on Cognitive Behavioural Therapy for psychosis (CBTp) to demonstrate the value of multiple coding in enabling service users voices to be heard in team-based qualitative data analysis. The CBTp study employed multiple coding to analyse service users' discussions of CBT for psychosis (CBTp) from the perspectives of a service user researcher, clinical researcher and psychology assistant. Multiple coding was selected to enable multiple perspectives to analyse and interpret data, to understand and explore differences and to build multi-disciplinary consensus. Multiple coding enabled the team to understand where our views were commensurate and incommensurate and to discuss and debate differences. Through the process of multiple coding, we were able to build strong consensus about the data from multiple perspectives, including that of the service user researcher. Multiple coding is an important method for understanding and exploring multiple perspectives on data and building team consensus. This can be contrasted with inter-rater reliability which is only appropriate in limited circumstances. We conclude that multiple coding is an appropriate and important means of hearing service users' voices in qualitative data analysis. © 2012 John Wiley & Sons Ltd.

  6. Single Case Method in Psychology: How to Improve as a Possible Methodology in Quantitative Research.

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    Krause-Kjær, Elisa; Nedergaard, Jensine I

    2015-09-01

    Awareness of including Single-Case Method (SCM), as a possible methodology in quantitative research in the field of psychology, has been argued as useful, e.g., by Hurtado-Parrado and López-López (IPBS: Integrative Psychological & Behavioral Science, 49:2, 2015). Their article introduces a historical and conceptual analysis of SCMs and proposes changing the, often prevailing, tendency of neglecting SCM as an alternative to Null Hypothesis Significance Testing (NHST). This article contributes by putting a new light on SCM as an equally important methodology in psychology. The intention of the present article is to elaborate this point of view further by discussing one of the most fundamental requirements as well as main characteristics of SCM regarding temporality. In this respect that; "…performance is assessed continuously over time and under different conditions…" Hurtado-Parrado and López-López (IPBS: Integrative Psychological & Behavioral Science, 49:2, 2015). Defining principles when it comes to particular units of analysis, both synchronic (spatial) and diachronic (temporal) elements should be incorporated. In this article misunderstandings of the SCM will be adduced, and further the temporality will be described in order to propose how the SCM could have a more severe usability in psychological research. It is further discussed how to implement SCM in psychological methodology. It is suggested that one solution might be to reconsider the notion of time in psychological research to cover more than a variable of control and in this respect also include the notion of time as an irreversible unity within life.

  7. 'Silk Road', the virtual drug marketplace: a single case study of user experiences.

    Science.gov (United States)

    Van Hout, Marie Claire; Bingham, Tim

    2013-09-01

    The online promotion of 'drug shopping' and user information networks is of increasing public health and law enforcement concern. An online drug marketplace called 'Silk Road' has been operating on the 'Deep Web' since February 2011 and was designed to revolutionise contemporary drug consumerism. A single case study approach explored a 'Silk Road' user's motives for online drug purchasing, experiences of accessing and using the website, drug information sourcing, decision making and purchasing, outcomes and settings for use, and perspectives around security. The participant was recruited following a lengthy relationship building phase on the 'Silk Road' chat forum. The male participant described his motives, experiences of purchasing processes and drugs used from 'Silk Road'. Consumer experiences on 'Silk Road' were described as 'euphoric' due to the wide choice of drugs available, relatively easy once navigating the Tor Browser (encryption software) and using 'Bitcoins' for transactions, and perceived as safer than negotiating illicit drug markets. Online researching of drug outcomes, particularly for new psychoactive substances was reported. Relationships between vendors and consumers were described as based on cyber levels of trust and professionalism, and supported by 'stealth modes', user feedback and resolution modes. The reality of his drug use was described as covert and solitary with psychonautic characteristics, which contrasted with his membership, participation and feelings of safety within the 'Silk Road' community. 'Silk Road' as online drug marketplace presents an interesting displacement away from 'traditional' online and street sources of drug supply. Member support and harm reduction ethos within this virtual community maximises consumer decision-making and positive drug experiences, and minimises potential harms and consumer perceived risks. Future research is necessary to explore experiences and backgrounds of other users. Copyright © 2013

  8. The Circle Of Security Parenting and parental conflict: a single case study

    Directory of Open Access Journals (Sweden)

    Chiara ePazzagli

    2014-08-01

    Full Text Available The Circle of Security Parenting (COS-P is an early attachment based intervention that can be used with groups, dyads, and individuals. Created in the USA and now used in many countries, COS-P is a visually based approach that demonstrates its central principles through videos of parent/child interactions. The core purpose of the COS-P is to provide an opportunity for caregivers to reflect on their child’s needs and on the challenges each parent faces in meeting those needs. Even though there is a wide range of clinical settings in which child/parent attachment is an important component of assessment there is limited empirical data on when and how attachment based interventions are appropriate for specific clinical profiles and contexts. The aim of this paper is to present a clinical application of COS-P in order to explore and reflect on some specific therapeutic tasks where it works and on some clinical indicators and contexts appropriate for its application. A single case study of a father, M. (43 yrs. old in conflict for the custody of his 5yrs old daughter is reported. The Adult Attachment Projective Picture System (AAP, the Parenting Stress Index, the Strengths and Difficulties Questionnaire, and the Parental Alliance Measure, were administered pre- and post-intervention. The clinical significance analysis method revealed that numerous changes occurred in the father. The AAP showed improvements in the level of agency of self. M. made gains in his capacity to use internal resources and to increase his agency of self. M. was classified as recovered in his perception of the child’s functioning and as improved in his parenting stress and parenting alliance with the mother. Considerations on specific contexts and clinical indicators for the application of COS-P are proposed.

  9. Radiation treatment for medulloblastoma. A review of 64 cases at a single institute

    International Nuclear Information System (INIS)

    Liu Yueping; Gao Li; Xu Guozhen; Yi Junhin; Liu Xinfan; Li Yexiong

    2005-01-01

    Although the optimal treatment mode for medulloblastoma is frequently discussed, results based on large series of cases, especially those treated in Asia, have rarely been reported. Our purpose was to evaluate the efficacy of postoperative radiation therapy, and to identify prognostic factors, in a relatively large cohort of patients with limited-stage medulloblastoma treated at a single institute in China. Between January 1996 and April 2001, 69 patients with Chang stage M0/M1 medulloblastoma were referred to our hospital for radiation therapy after total or subtotal resection of the primary tumor. All patients received 30 Gy to the craniospinal axis followed by a 20-25 Gy boost to the posterior fossa (median fraction, 1.8 Gy). Sixty-four patients were followed for a median period of 38.5 months. The rates of 3-year and 5-year overall survival were 68.8% and 55.7%, respectively; corresponding disease-free survival were 57.8% and 51.4%, respectively. Patients who had received radiation treatment within 25 days after resection had a greater probability of 3-year survival (81.5% versus 59.5%; P=0.11) and 3-year disease-free survival (74.1% versus 46.0%; P=0.03) than patients who began radiation treatment later. No relationship was found between survival and age, sex or tumor size. This regimen was comparatively ineffective in preventing recurrence of postoperative medulloblastoma; however, we found that the interval between surgery and radiation is a significant prognostic factor for disease-free survival. (author)

  10. Cardiac rehabilitation in a pediatric patient with heart retransplantation. A single case study.

    Science.gov (United States)

    Chang, K-V; Chiu, H-H; Wang, S-S; Lan, C; Chen, S-Y; Chou, N-K; Wu, M-H; Lai, J-S

    2014-04-01

    Cardiac rehabilitation (CR) after heart transplantation is known to benefit physical capacity in adults, but the advantages of CR on pediatric patients with heart retransplantation remain undetermined. The purpose of the present study was to report the effect of structured CR for a boy receiving heart transplantations twice. Single case study. Inpatient and outpatient rehabilitation department. A pediatric patient underwent heart transplantation due to dilated cardiomyopathy at 13.6 year-old and retransplantation owing to severe cardiac allograft vasculopathy at 16.2 year-old. CR was arranged after both transplantations. Bicycle or treadmill exercises were conducted three times weekly with the intensity adjusted to the ventilatory threshold. Serial cardiopulmonary exercise tests were performed to evaluate the sequential cardiorespiratory function changes using the peak oxygen uptake (VO₂peak) as the primary outcome. The patient had undergone 10 times of exercise tests during rehabilitation. The VO₂peak increased from 12.27 to 15.63 mL·kg-1·min-1 within 6 months after the primary transplantation. However, the VO₂peak dropped intensively after a rejection episode and failed to improve since the development of cardiac allograft vasculopathy. Following retransplantation, the VO₂peak appeared worse initially but increased gradually with rehabilitation. One year subsequent to retransplantation, the VO₂peak reached 17.7 mL·kg-1·min-1 with a 7.22 mL·kg-1·min-1 improvement compared with his baseline value. Structured CR improves aerobic capacity of a pediatric patient with heart retransplantation. CR is safe and beneficial for pediatrics with heart retransplantation. Cardiopulmonary exercise testing can be considered as an adjuvant tool for detecting rejection or cardiac allograft vasculopathy in pediatric heart transplantation recipients.

  11. The feasibility of single port laparoscopic cholecystectomy: a pilot study of 20 cases

    OpenAIRE

    Rao, Prashanth P.; Bhagwat, Sonali M.; Rane, Abhay; Rao, Pradeep P.

    2008-01-01

    Introduction. Laparoscopic cholecystectomy has become the gold standard for symptomatic cholelithiasis 1. Traditionally done through four ports, three and two port surgeries have been described. We present a novel technique of single port cholecystectomy using the R-PortR (Advanced Surgical Concepts). Materials and methods. The R-PortR is a Tri-port that allows the ingress of three 5 mm instruments through a single port. Twenty patients with symptomatic cholelithiasis were subjected to single...

  12. Qualitative Comparison of Graph-Based and Logic-Based Multi-Relational Data Mining: A Case Study

    National Research Council Canada - National Science Library

    Ketkar, Nikhil S; Holder, Lawrence B; Cook, Diane J

    2005-01-01

    The goal of this paper is to generate insights about the differences between graph-based and logic-based approaches to multi-relational data mining by performing a case study of the graph-based system...

  13. Gender and Leadership Styles in Single-Sex Academic Institutions

    Science.gov (United States)

    Taleb, Hanan M.

    2010-01-01

    Purpose: This paper aims to investigate the relationship between gender and female leadership styles in a single-sex academic institution in Saudi Arabia. Design/methodology/approach: Essentially, a qualitative research approach that utilised a single case-study methodology was adopted. As part of this research, seven in-depth semi-structured…

  14. Qualitative Identification of Fentanyl Analogs and Other Opioids in Postmortem Cases by UHPLC-Ion Trap-MSn.

    Science.gov (United States)

    Shoff, Elisa N; Zaney, M Elizabeth; Kahl, Joseph H; Hime, George W; Boland, Diane M

    2017-07-01

    Since 2013, the Miami-Dade County Medical Examiner Department has experienced an increase in the number of opioid-related deaths. The majority of cases coincided with the introduction of fentanyl into the local heroin supply. From 2014 to 2015, Miami-Dade County experienced a near 600% increase in fentanyl-related deaths, followed by an additional 200% increase in 2016. In 2015, two novel fentanyl analogs were identified in medical examiner cases: beta-hydroxythiofentanyl and acetyl fentanyl. In 2016, four additional fentanyl analogs emerged: para-fluoroisobutyryl fentanyl, butyryl fentanyl, furanyl fentanyl and carfentanil, as well as the synthetic opioid U-47700. In order to address this epidemic, a method was developed and validated to identify 44 opioid-related and analgesic compounds in postmortem samples using ultra high performance liquid chromatography ion trap mass spectrometry with MSn capabilities. The limit of detection for all compounds ranged from 0.1 to 5 ng/mL, with a majority having MS3 spectral fragmentation. Blood, urine, liver or brain specimens from ~500 postmortem cases were submitted for analysis based on case history and/or initial screening results. Of those cases, 375 were positive for illicit fentanyl and/or one or more fentanyl analogs. Due to the potency of these compounds, they were almost always included in the cause of death. Worth emphasizing and extremely alarming is the detection of carfentanil in 134 cases, 104 of which were initially missed by gas chromatography mass spectrometry. By incorporating this sensitive, highly specific, and evolving screening procedure into the workflow, the toxicology laboratory continues to effectively assist the medical examiners in determining the cause and manner of death of decedents in Miami-Dade County. © The Author 2017. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  15. GIS-Based Fast Moving Landslide Risk Analysis Model Using Qualitative Approach: A Case Study of Balakot, Pakistan

    Directory of Open Access Journals (Sweden)

    Abdul Salam Soomro

    2011-04-01

    Full Text Available The innovation of this research is the development of new model called fast moving landslide risk analysis model by modifying one of the previous prominent landslide risk algorithms focusing on the fast moving type of the landslides (such as mudslides, mud flows, block slide, rock fall and topple based on the qualitative approach using Heuristic method in GIS (Geographical Information Systems. The different event controlling parameters and criteria were used for fast moving landslide predictive risk model. The pair wise comparison method was used in which the parameters of landslide hazard and vulnerability were compared by their assigned weights. The drawback of the used approach was justified by the standard value of consistency ratio, which proved the assigned weight of the parameters as reasonable and consistent. The model was validated by using the occurred landslides inventory data and correlation coefficient test, which showed the positive relationship between the landslide risk predicted regions and the occurred landslides locations. The various landslide events occurred on 8th October, 2005 were accumulated as landslide inventory by the interpretation of satellite imagery. The validation of the model was justified by using one of the statistical two paired, \\"t\\" test, and the amount of the predicted risk in the different regions. It is believed that this modified model will prove beneficial to the decision makers in future.

  16. An Integrated Strategy for Global Qualitative and Quantitative Profiling of Traditional Chinese Medicine Formulas: Baoyuan Decoction as a Case

    Science.gov (United States)

    Ma, Xiaoli; Guo, Xiaoyu; Song, Yuelin; Qiao, Lirui; Wang, Wenguang; Zhao, Mingbo; Tu, Pengfei; Jiang, Yong

    2016-12-01

    Clarification of the chemical composition of traditional Chinese medicine formulas (TCMFs) is a challenge due to the variety of structures and the complexity of plant matrices. Herein, an integrated strategy was developed by hyphenating ultra-performance liquid chromatography (UPLC), quadrupole time-of-flight (Q-TOF), hybrid triple quadrupole-linear ion trap mass spectrometry (Qtrap-MS), and the novel post-acquisition data processing software UNIFI to achieve automatic, rapid, accurate, and comprehensive qualitative and quantitative analysis of the chemical components in TCMFs. As a proof-of-concept, the chemical profiling of Baoyuan decoction (BYD), which is an ancient TCMF that is clinically used for the treatment of coronary heart disease that consists of Ginseng Radix et Rhizoma, Astragali Radix, Glycyrrhizae Radix et Rhizoma Praeparata Cum Melle, and Cinnamomi Cortex, was performed. As many as 236 compounds were plausibly or unambiguously identified, and 175 compounds were quantified or relatively quantified by the scheduled multiple reaction monitoring (sMRM) method. The findings demonstrate that the strategy integrating the rapidity of UNIFI software, the efficiency of UPLC, the accuracy of Q-TOF-MS, and the sensitivity and quantitation ability of Qtrap-MS provides a method for the efficient and comprehensive chemome characterization and quality control of complex TCMFs.

  17. Provider perspectives on drug-resistant tuberculosis and human immunodeficiency virus care in South Africa: a qualitative case study.

    Science.gov (United States)

    Daftary, A; Padayatchi, N

    2016-11-01

    To examine influences on health care workers' (HCWs') capacity to deliver health care for multi- and/or extensively drug-resistant tuberculosis (MDR/XDR-TB) and human immunodeficiency virus (HIV) infection in South Africa. Qualitative data were collected via group and individual interviews with a purposive sample of 17 HCWs at a centralised, tertiary TB facility and analysed using grounded theory. Four themes were identified: 1) personal infection control practices among HCWs may be weakened by a workplace culture comprising low motivation, disparate risk perceptions and practices across workforce hierarchies, physical discomfort, and problems managing patients with treatment-induced hearing loss. 2) Patient-provider interactions are likely stronger among nurses, and in HIV vs. MDR/XDR-TB service delivery, due to greater attention to patient empowerment and support. Stigma associated with MDR/XDR-TB, considered worse than HIV, may be perpetuated within non-specialised facilities less familiar with MDR/XDR-TB. 3) HCWs who struggle with the daily tedium of MDR/XDR-TB treatment supervision are becoming increasingly supportive of treatment literacy and self-administration. 4) Effective integration of HIV and MDR/XDR-TB services may be impeded by administrative restrictions, workplace norms and provider mindsets. Comprehensive, decentralised management of MDR/XDR-TB and HIV coinfection requires the creation of patient-provider trust and treatment literacy in MDR/XDR-TB programmes, and defying workplace norms that could provoke nosocomial TB exposure and fragmented service provision.

  18. Bilateral single-port thoracoscopic extended thymectomy for management of thymoma and myasthenia gravis: case report

    Directory of Open Access Journals (Sweden)

    Francesco Paolo Caronia

    2016-11-01

    Full Text Available Abstract Background Video-assisted thoracoscopy is become a widely accepted approach for the resection of anterior mediastinal masses, including thymoma. The current trend is to reduce the number of ports and minimize the length of incisions to further decrease postoperative pain, chest wall paresthesia, and length of hospitalization. Herein, we reported an extended resection of thymoma in a patient with myasthenia gravis through an uniportal bilateral thoracoscopic approach. Case presentation A 74 years old woman with myasthenia gravis was referred to our attention for management of a 3.5 cm, well capsulate, thymoma. All laboratory and cardio-pulmonary tests were within normal; thus, she was scheduled for thymoma resection through an uniportal bilateral thoracoscopic approach. Under general anaesthesia and selective intubation, the patient was placed in a 60° right lateral decubitus. A 3 cm skin incision was performed in the fourth right intercostal space and, through that a 30° video-camera and working instruments were inserted without rib spreading. After complete dissection of the thymus and mediastinal fat, the contralateral pleura was opened, and, through that the specimen was pushed into the left pleural cavity. Then, the patient was placed in the left lateral decubitus. Similarly to the right side procedure, a 3-cm incision was performed in the fourth left intercostal space to complete thymic dissection and retrieve the specimen. No intraoperative and post-operative complications were found. The patient was discharged four days later. Pathological examination revealed a type A thymoma (Masaoka stage I. No recurrence was found at 18 months of follow-up Conclusions Bilateral single-port thoracoscopy is an available procedure for management of thymoma associated with myasthenia gravis. The less post-operative pain, the reduction of hospital stay and the better esthetic results are all potential advantages of this approach over

  19. Integrating Qualitative and Quantitative Methods in Participatory Modeling to Elicit Behavioral Drivers in Environmental Dilemmas: the Case of Air Pollution in Talca, Chile.

    Science.gov (United States)

    Meinherz, Franziska; Videira, Nuno

    2018-04-10

    The aim of this paper is to contribute to the exploration of environmental modeling methods based on the elicitation of stakeholders' mental models. This aim is motivated by the necessity to understand the dilemmas and behavioral rationales of individuals for supporting the management of environmental problems. The methodology developed for this paper integrates qualitative and quantitative methods by deploying focus groups for the elicitation of the behavioral rationales of the target population, and grounded theory to code the information gained in the focus groups and to guide the development of a dynamic simulation model. The approach is applied to a case of urban air pollution caused by residential heating with wood in central Chile. The results show how the households' behavior interrelates with the governmental management strategies and provide valuable and novel insights into potential challenges to the implementation of policies to manage the local air pollution problem. The experience further shows that the developed participatory modeling approach allows to overcome some of the issues currently encountered in the elicitation of individuals' behavioral rationales and in the quantification of qualitative information.

  20. Qualitative analysis of round-table discussions on the business case and procurement challenges for hospital electronic prescribing systems.

    Directory of Open Access Journals (Sweden)

    Kathrin M Cresswell

    Full Text Available There is a pressing need to understand the challenges surrounding procurement of and business case development for hospital electronic prescribing systems, and to identify possible strategies to enhance the efficiency of these processes in order to assist strategic decision making.We organized eight multi-disciplinary round-table discussions in the United Kingdom. Participants included policy makers, representatives from hospitals, system developers, academics, and patients. Each discussion was digitally audio-recorded, transcribed verbatim and, together with accompanying field notes, analyzed thematically with NVivo9.We drew on data from 17 participants (approximately eight per roundtable, six hours of discussion, and 15 pages of field notes. Key challenges included silo planning with systems not being considered as part of an integrated organizational information technology strategy, lack of opportunity for interactions between customers and potential suppliers, lack of support for hospitals in choosing appropriate systems, difficulty of balancing structured planning with flexibility, and the on-going challenge of distinguishing "wants" and aspirations from organizational "needs".Development of business cases for major investments in information technology does not take place in an organizational vacuum. Building on previously identified potentially transferable dimensions to the development and execution of business cases surrounding measurements of costs/benefits and risk management, we have identified additional components relevant to ePrescribing systems. These include: considerations surrounding strategic context, case for change and objectives, future service requirements and options appraisal, capital and revenue implications, timescale and deliverability, and risk analysis and management.

  1. Qualitative analysis of round-table discussions on the business case and procurement challenges for hospital electronic prescribing systems.

    Science.gov (United States)

    Cresswell, Kathrin M; Slee, Ann; Coleman, Jamie; Williams, Robin; Bates, David W; Sheikh, Aziz

    2013-01-01

    There is a pressing need to understand the challenges surrounding procurement of and business case development for hospital electronic prescribing systems, and to identify possible strategies to enhance the efficiency of these processes in order to assist strategic decision making. We organized eight multi-disciplinary round-table discussions in the United Kingdom. Participants included policy makers, representatives from hospitals, system developers, academics, and patients. Each discussion was digitally audio-recorded, transcribed verbatim and, together with accompanying field notes, analyzed thematically with NVivo9. We drew on data from 17 participants (approximately eight per roundtable), six hours of discussion, and 15 pages of field notes. Key challenges included silo planning with systems not being considered as part of an integrated organizational information technology strategy, lack of opportunity for interactions between customers and potential suppliers, lack of support for hospitals in choosing appropriate systems, difficulty of balancing structured planning with flexibility, and the on-going challenge of distinguishing "wants" and aspirations from organizational "needs". Development of business cases for major investments in information technology does not take place in an organizational vacuum. Building on previously identified potentially transferable dimensions to the development and execution of business cases surrounding measurements of costs/benefits and risk management, we have identified additional components relevant to ePrescribing systems. These include: considerations surrounding strategic context, case for change and objectives, future service requirements and options appraisal, capital and revenue implications, timescale and deliverability, and risk analysis and management.

  2. Down the local: A qualitative case study of daytime drinking spaces in the London Borough of Islington.

    Science.gov (United States)

    Thompson, Claire; Milton, Sarah; Egan, Matt; Lock, Karen

    2018-02-01

    Recognising the lack of research on daytime drinking practices in areas with managed night-time economies (NTEs), this qualitative study explores the phenomena in the London Borough of Islington; a rapidly gentrifying area with a highly regulated night-time economy (NTE). The objectives were to (i) Characterise the daytime drinking spaces of the local alcohol environment and (ii) Theorise the ways in which these spaces, and the practices and performativities within them, are situated within broader social and economic trends. Adopting a legitimate peripheral participation approach to data collection, 39 licensed premises were visited in Islington and on-site observations carried out between the hours of 12 pm and 6 pm using a semi-structured observation guide. Observations were written-up into detailed fieldnotes, uploaded to NVivo and subject to a thematic analysis. The daytime on-premises alcohol environment was characterised by two main trends: the decline of traditional pubs and a proliferation of hybrid establishments in which alcohol was framed as part of a suite of attractions. The consumption trends that the latter exemplify are implicated in processes of micro-cultural production and 'hipster capitalism'; and it is via this framing that we explore the way the diverse local drinking spaces were gendered and classed. Hybrid establishments have been regarded as positive in terms of public health, crime and safety. However, they could also help introduce drinking within times and contexts where it was not previously present. The intersection of an expanding hipster habitus with Local Authority efforts to tackle 'determined drunkenness' create very particular challenges. The operating practices of hybrid venues may feed into current alcohol industry strategies of promoting 'new moments' in which consumers can drink. They blur the divisions between work and play and produce temporal and classed divisions of drinking. Copyright © 2017 Elsevier B.V. All rights

  3. Perspectives on econometric modelling to inform policy: a UK qualitative case study of minimum unit pricing of alcohol.

    Science.gov (United States)

    Katikireddi, Srinivasa V; Bond, Lyndal; Hilton, Shona

    2014-06-01

    Novel policy interventions may lack evaluation-based evidence. Considerations to introduce minimum unit pricing (MUP) of alcohol in the UK were informed by econometric modelling (the 'Sheffield model'). We aim to investigate policy stakeholders' views of the utility of modelling studies for public health policy. In-depth qualitative interviews with 36 individuals involved in MUP policy debates (purposively sampled to include civil servants, politicians, academics, advocates and industry-related actors) were conducted and thematically analysed. Interviewees felt familiar with modelling studies and often displayed detailed understandings of the Sheffield model. Despite this, many were uneasy about the extent to which the Sheffield model could be relied on for informing policymaking and preferred traditional evaluations. A tension was identified between this preference for post hoc evaluations and a desire for evidence derived from local data, with modelling seen to offer high external validity. MUP critics expressed concern that the Sheffield model did not adequately capture the 'real life' world of the alcohol market, which was conceptualized as a complex and, to some extent, inherently unpredictable system. Communication of modelling results was considered intrinsically difficult but presenting an appropriate picture of the uncertainties inherent in modelling was viewed as desirable. There was general enthusiasm for increased use of econometric modelling to inform future policymaking but an appreciation that such evidence should only form one input into the process. Modelling studies are valued by policymakers as they provide contextually relevant evidence for novel policies, but tensions exist with views of traditional evaluation-based evidence. © The Author 2013. Published by Oxford University Press on behalf of the European Public Health Association.

  4. Perspectives on econometric modelling to inform policy: a UK qualitative case study of minimum unit pricing of alcohol

    Science.gov (United States)

    Bond, Lyndal; Hilton, Shona

    2014-01-01

    Background: Novel policy interventions may lack evaluation-based evidence. Considerations to introduce minimum unit pricing (MUP) of alcohol in the UK were informed by econometric modelling (the ‘Sheffield model’). We aim to investigate policy stakeholders’ views of the utility of modelling studies for public health policy. Methods: In-depth qualitative interviews with 36 individuals involved in MUP policy debates (purposively sampled to include civil servants, politicians, academics, advocates and industry-related actors) were conducted and thematically analysed. Results: Interviewees felt familiar with modelling studies and often displayed detailed understandings of the Sheffield model. Despite this, many were uneasy about the extent to which the Sheffield model could be relied on for informing policymaking and preferred traditional evaluations. A tension was identified between this preference for post hoc evaluations and a desire for evidence derived from local data, with modelling seen to offer high external validity. MUP critics expressed concern that the Sheffield model did not adequately capture the ‘real life’ world of the alcohol market, which was conceptualized as a complex and, to some extent, inherently unpredictable system. Communication of modelling results was considered intrinsically difficult but presenting an appropriate picture of the uncertainties inherent in modelling was viewed as desirable. There was general enthusiasm for increased use of econometric modelling to inform future policymaking but an appreciation that such evidence should only form one input into the process. Conclusion: Modelling studies are valued by policymakers as they provide contextually relevant evidence for novel policies, but tensions exist with views of traditional evaluation-based evidence. PMID:24367068

  5. "There are too many, but never enough": qualitative case study investigating routine coding of clinical information in depression.

    Science.gov (United States)

    Cresswell, Kathrin; Morrison, Zoe; Kalra, Dipak; Sheikh, Aziz

    2012-01-01

    We sought to understand how clinical information relating to the management of depression is routinely coded in different clinical settings and the perspectives of and implications for different stakeholders with a view to understanding how these may be aligned. Qualitative investigation exploring the views of a purposefully selected range of healthcare professionals, managers, and clinical coders spanning primary and secondary care. Our dataset comprised 28 semi-structured interviews, a focus group, documents relating to clinical coding standards and participant observation of clinical coding activities. We identified a range of approaches to coding clinical information including templates and order entry systems. The challenges inherent in clearly establishing a diagnosis, identifying appropriate clinical codes and possible implications of diagnoses for patients were particularly prominent in primary care. Although a range of managerial and research benefits were identified, there were no direct benefits from coded clinical data for patients or professionals. Secondary care staff emphasized the role of clinical coders in ensuring data quality, which was at odds with the policy drive to increase real-time clinical coding. There was overall no evidence of clear-cut direct patient care benefits to inform immediate care decisions, even in primary care where data on patients with depression were more extensively coded. A number of important secondary uses were recognized by healthcare staff, but the coding of clinical data to serve these ends was often poorly aligned with clinical practice and patient-centered considerations. The current international drive to encourage clinical coding by healthcare professionals during the clinical encounter may need to be critically examined.

  6. “There Are Too Many, but Never Enough": Qualitative Case Study Investigating Routine Coding of Clinical Information in Depression

    Science.gov (United States)

    Cresswell, Kathrin; Morrison, Zoe; Sheikh, Aziz; Kalra, Dipak

    2012-01-01

    Background We sought to understand how clinical information relating to the management of depression is routinely coded in different clinical settings and the perspectives of and implications for different stakeholders with a view to understanding how these may be aligned. Materials and Methods Qualitative investigation exploring the views of a purposefully selected range of healthcare professionals, managers, and clinical coders spanning primary and secondary care. Results Our dataset comprised 28 semi-structured interviews, a focus group, documents relating to clinical coding standards and participant observation of clinical coding activities. We identified a range of approaches to coding clinical information including templates and order entry systems. The challenges inherent in clearly establishing a diagnosis, identifying appropriate clinical codes and possible implications of diagnoses for patients were particularly prominent in primary care. Although a range of managerial and research benefits were identified, there were no direct benefits from coded clinical data for patients or professionals. Secondary care staff emphasized the role of clinical coders in ensuring data quality, which was at odds with the policy drive to increase real-time clinical coding. Conclusions There was overall no evidence of clear-cut direct patient care benefits to inform immediate care decisions, even in primary care where data on patients with depression were more extensively coded. A number of important secondary uses were recognized by healthcare staff, but the coding of clinical data to serve these ends was often poorly aligned with clinical practice and patient-centered considerations. The current international drive to encourage clinical coding by healthcare professionals during the clinical encounter may need to be critically examined. PMID:22937106

  7. Parental decision-making on utilisation of out-of-home respite in children's palliative care: findings of qualitative case study research - a proposed new model.

    Science.gov (United States)

    Ling, J; Payne, S; Connaire, K; McCarron, M

    2016-01-01

    Respite in children's palliative care aims to provide a break for family's from the routine of caring. Parental decision-making regarding the utilisation of out-of-home respite is dependent on many interlinking factors including the child's age, diagnosis, geographical location and the family's capacity to meet their child's care needs. A proposed model for out-of-home respite has been developed based on the findings of qualitative case study research. Utilising multiple, longitudinal, qualitative case study design, the respite needs and experiences of parents caring for a child with a life-limiting condition were explored. Multiple, in-depth interviews were undertaken with the parents identified by a hospital-based children's palliative care team. Data were analysed using thematic analysis. Each individual case consists of a whole study. Cross-case comparison was also conducted. Nine families were recruited and followed for two years. A total of 19 in-depth interviews were conducted with mothers and fathers (one or both) caring for a child with a life-limiting condition in Ireland. Each family reported vastly different needs and experiences of respite from their own unique perspective. Cross-case comparison showed that for all parents utilising respite care, regardless of their child's age and condition, home was the location of choice. Many interlinking factors influencing these decisions included: past experience of in-patient care, and trust and confidence in care providers. Issues were raised regarding the impact of care provision in the home on family life, siblings and the concept of home. Respite is an essential element of children's palliative care. Utilisation of out-of-home respite is heavily dependent on a number of interlinked and intertwined factors. The proposed model of care offers an opportunity to identify how these decisions are made and may ultimately assist in identifying the elements of responsive and family-focused respite that are important

  8. Child Care Choices and Children's Cognitive Achievement: The Case of Single Mothers

    OpenAIRE

    Raquel Bernal; Michael P. Keane

    2011-01-01

    We evaluate the effect of child care versus maternal time inputs on child cognitive development using single mothers from the NLSY79. To deal with nonrandom selection of children into child care, we exploit the exogenous variation in welfare policy rules facing single mothers. In particular, the 1996 welfare reform and earlier state-level policy changes generated substantial increases in their work/child care use. We construct a comprehensive set of welfare policy variables and use them as in...

  9. Absent right coronary artery: A case of single coronary artery or congenital ostial atresia?

    Science.gov (United States)

    Gupta, Mohit D; Girish, M P; Vignesh, Vickram; Narang, Poonam; Trehan, Vijay; Tyagi, Sanjay

    2015-12-01

    Atresia of the right coronary artery ostium is a rare anatomic variant of the coronary circulation. It is often difficult to differentiate from single coronary artery. Its presence unassociated with any other anomaly has never been described in an adult individual. We report this unusual anomaly and discuss its anatomical and pathophysiological significance and possible ways to differentiate from single coronary artery. Copyright © 2015 Cardiological Society of India. Published by Elsevier B.V. All rights reserved.

  10. Single-port access laparoscopic surgery for rectal cancer: initial experience with 10 cases

    DEFF Research Database (Denmark)

    Bulut, Orhan; Nielsen, Claus B; Jespersen, Niels

    2011-01-01

    Single-port access laparoscopic surgery is emerging as a method to improve the morbidity and cosmetic benefits of conventional laparoscopic surgery and minimize the surgical trauma. However, the feasibility of this procedure in rectal surgery has not yet been determined.......Single-port access laparoscopic surgery is emerging as a method to improve the morbidity and cosmetic benefits of conventional laparoscopic surgery and minimize the surgical trauma. However, the feasibility of this procedure in rectal surgery has not yet been determined....

  11. Dementia case-finding in hospitals: a qualitative study exploring the views of healthcare professionals in English primary care and secondary care.

    Science.gov (United States)

    Burn, Anne-Marie; Fleming, Jane; Brayne, Carol; Fox, Chris; Bunn, Frances

    2018-03-17

    In 2012-2013, the English National Health Service mandated hospitals to conduct systematic case-finding of people with dementia among older people with unplanned admissions. The method was not defined. The aim of this study was to understand current approaches to dementia case-finding in acute hospitals in England and explore the views of healthcare professionals on perceived benefits and challenges. Qualitative study involving interviews, focus groups and thematic content analysis. Primary care and secondary care across six counties in the East of England. Hospital staff involved in dementia case-finding and primary care staff in the catchment areas of those hospitals. We recruited 23 hospital staff and 36 primary care staff, including 30 general practitioners (GPs). Analysis resulted in three themes: (1) lack of consistent approaches in case-finding processes, (2) barriers between primary care and secondary care which impact on case-finding outcomes and (3) perceptions of rationale, aims and impacts of case-finding. The study shows that there were variations in how well hospitals recorded and reported outcomes to GPs. Barriers between primary care and secondary care, including GPs' lack of access to hospital investigations and lack of clarity about roles and responsibilities, impacted case-finding outcomes. Staff in secondary care were more positive about the initiative than primary care staff, and there were conflicting priorities for primary care and secondary care regarding case-finding. The study suggests a more evidence-based approach was needed to justify approaches to dementia case-finding. Information communicated to primary care from hospitals needs to be comprehensive, appropriate and consistent before GPs can effectively plan further investigation, treatment or care. Follow-up in primary care further requires access to options for postdiagnostic support. There is a need to evaluate the outcomes for patients and the economic impact on health and care

  12. Applying Multiple Computerized Text-Analytic Measures to Single Psychotherapy Cases

    Science.gov (United States)

    MERGENTHALER, ERHARD; KÄCHELE, HORST

    1996-01-01

    The authors applied five different computer-assisted measures for the analysis of textual data to the transcripts of two brief psychotherapies. The five measures involved different computational procedures and were derived from different theoretical backgrounds. The two cases when compared did not show uniform results in their trends over time for any one method. However, examination and comparison of the five measurements for each case yielded convergent phenomena, which could then be validated by other data available for these cases. PMID:22700302

  13. Girl Talk: A Qualitative Study of Girls Talking about the Meaning of Their Lives in an Urban Single-Sex Elementary School

    Science.gov (United States)

    Ridenour, Carolyn S.; Hassell Hughes, Sheila

    2016-01-01

    The suburban-urban achievement gap (diminishing until the 1980s) has stopped its narrowing trend, and single-sex schools are proliferating as a reform model, especially in urban areas. In this study researchers interviewed eight elementary school girls (in an all-girls school) three times over 2 years, and the resulting 23 transcripts were…

  14. Pictorial mnemonic-strategy interventions for children with special needs: Illustration of a multiply randomized single-case crossover design.

    Science.gov (United States)

    Hwang, Yooyeun; Levin, Joel R; Johnson, Evan W

    2016-01-25

    An innovative single-case crossover design containing multiple forms of randomization was implemented with eight participants in seven weekly sessions, during which instruction was given in the use of two different pictorial mnemonic (memory-enhancing) strategies: one designed to improve the children's learning of the dates of various inventions and the other designed to improve the children's acquisition of unfamiliar vocabulary items. A composite randomization statistical test revealed that when compared with the children's own preferred learning methods, the mnemonic-strategy approach produced the predicted facilitation effects. At the same time, it was evident that mnemonic instruction enhanced children's performance to a greater extent on the vocabulary task than on the inventions task. In-depth examination of both individual student performance profiles and the tasks/procedures were conducted, yielding recommendations and challenges for follow-up single-case intervention research on the topic.

  15. Qualitative relation between heavy metal concentration in soil and agricultural products: a Chinese peri-urban case study

    Science.gov (United States)

    Kikuchi, Ryunosuke; Ferreira, Carla Sofia; Dinis Ferreira, Antonio

    2017-04-01

    A peri-urban area refers to a transition or interaction zone, where urban and rural activities are juxtaposed, and landscape features are subject to rapid modifications, mainly due to human activities. It is reported that peri-urban areas which might include valuable protected areas (e.g. forested hills, preserved woodlands, prime agricultural lands, etc.) can provide essential life support services for urban residents. A peri-urban area is not only a zone experiencing the immediate impacts of land demands from urban growth and pollution, but it is also a wider market-related zone of influence, recognized for the supply of agricultural and natural resource products. It is reported that China's environmental crisis is one of the most pressing challenges to emerge from the country's rapid industrialization; therefore a field study was carried out to investigate the qualitative relation of soil property with vegetable agricultural products in the Chinese peri-urban area located in Luoyang city (34°37'N and 112°27'E). Soil, water and plant (e.g. squash, Cucurbita maxima) samples were taken over the study site, and heavy metal concentrations were analyzed. All the soil samples showed Cd concentrations exceeded the permissible level established by Chinese guidelines for soil quality (0.3 mg/kg). The contents of Zn, Pb and Cu also surpassed the Chinese guideline levels (Zn = 250 mg/kg, Pb = 50 mg/kg and Cu = 100 mg/kg) in several soil samples. Although the sampled plants contained some degree of all the heavy metals, only the Al concentration was high in the Cucurbita maxima samples (317 mg/kg), which is a specie of cultivated squash. Considering the world market and the global trade of agricultural products, it can be said that the food risk associated with farm products containing Al is not local but global. It is concluded that an environmental contamination of the peri-urban areas may lead to the threat to food security.

  16. Immediate Nonfunctional Loading of Two Single-Maxillary Postextractive Implants: 6-Year Postloading Results of Two Case Reports

    Directory of Open Access Journals (Sweden)

    Vincenzo Ariano

    2016-01-01

    Full Text Available Objectives. The aim of the study was to evaluate and compare crestal bone loss of single-maxillary immediate postextractive implants and immediate nonfunctional loading (INFL during 72 months of follow-up. Material and Methods. Two single titanium implants (Certain Prevail, Biomet 3I, USA were placed in two patients using INFL technique. Implant stability and crestal bone level were measured on periapical radiographs at 1, 3, and 6 months after surgery. Results. All osseointegrated implants were clinically successful after 6 years of functional loading. Conclusion. Within the limit of the present case report, the paper supports the concept that INFL of single dental implant can be a successful treatment procedure.

  17. Modelling of marketing strategies for the single markets vs marketing strategy for the global market: Case study mobiExplore

    OpenAIRE

    Mate Perisic; Maljic Vinko; Neven Seric

    2010-01-01

    A successful treating of a single, national, market through new challenges of marketing management is notably different than treating of the global market. The paper provides the case study of Gideon Multimedia, IT firm from Croatia. The company’s main product is mobiExplore, touristic guide platform for mobile phones. The application could be adapted to different marketplaces - global and national, for different countries. Because of different dynamic of the growth of national mobile markets...

  18. The promise of mobile technologies and single case designs for the study of individuals in their natural environment.

    Science.gov (United States)

    Vilardaga, Roger; Bricker, Jonathan; McDonell, Michael

    2014-04-01

    Mobile technologies are growing rapidly around the world to broad demographics of society. These technologies hold great promise for their integration with Single Case Designs (SCDs) and the study of individuals in their natural environment. This paper discusses the theoretical, methodological and analytic implications of these tools for the advancement of the contextual behavioral etiology of behavioral disorders, and their remediation. We hope this paper will highlight the scientific advantages of combining mobile technologies and SCDs and encourage their adoption among CBS scientists.

  19. A systematic review and qualitative analysis to inform the development of a new emergency department-based geriatric case management model.

    Science.gov (United States)

    Sinha, Samir K; Bessman, Edward S; Flomenbaum, Neal; Leff, Bruce

    2011-06-01

    We inform the future development of a new geriatric emergency management practice model. We perform a systematic review of the existing evidence for emergency department (ED)-based case management models designed to improve the health, social, and health service utilization outcomes for noninstitutionalized older patients within the context of an index ED visit. This was a systematic review of English-language articles indexed in MEDLINE and CINAHL (1966 to 2010), describing ED-based case management models for older adults. Bibliographies of the retrieved articles were reviewed to identify additional references. A systematic qualitative case study analytic approach was used to identify the core operational components and outcome measures of the described clinical interventions. The authors of the included studies were also invited to verify our interpretations of their work. The determined patterns of component adherence were then used to postulate the relative importance and effect of the presence or absence of a particular component in influencing the overall effectiveness of their respective interventions. Eighteen of 352 studies (reported in 20 articles) met study criteria. Qualitative analyses identified 28 outcome measures and 8 distinct model characteristic components that included having an evidence-based practice model, nursing clinical involvement or leadership, high-risk screening processes, focused geriatric assessments, the initiation of care and disposition planning in the ED, interprofessional and capacity-building work practices, post-ED discharge follow-up with patients, and evaluation and monitoring processes. Of the 15 positive study results, 6 had all 8 characteristic components and 9 were found to be lacking at least 1 component. Two studies with positive results lacked 2 characteristic components and none lacked more than 2 components. Of the 3 studies with negative results demonstrating no positive effects based on any outcome tested, one

  20. Epistaxis as a Common Presenting Symptom of Glanzmann’s Thrombasthenia, a Rare Qualitative Platelet Disorder: Illustrative Case Examples

    Directory of Open Access Journals (Sweden)

    Michael Recht

    2017-01-01

    Full Text Available Children often present to emergency departments (EDs with uncontrollable nose bleeding. Although usually due to benign etiologies, epistaxis may be the presenting symptom of an inherited bleeding disorder. Whereas most bleeding disorders are detected through standard hematologic assessments, diagnosing rare platelet function disorders may be challenging. Here we present two case reports and review diagnostic and management challenges of platelet function disorders with a focus on Glanzmann’s thrombasthenia (GT. Patient 1 was a 4-year-old boy with uncontrolled epistaxis. His medical history included frequent and easy bruising. Previous laboratory evaluation revealed only mild microcytic anemia. An otolaryngologist stopped the bleeding, and referral to a pediatric hematologist led to the definitive diagnosis of GT. Patient 2 was a 2.5-year-old girl with severe epistaxis and a history of milder recurrent epistaxis. She had a bruise on her abdomen with a palpable hematoma and many scattered petechiae. Previous assessments revealed no demonstrable hemostatic anomalies. Platelet aggregation studies were performed following referral to a pediatric hematologist, leading to the diagnosis of GT. As evidenced by these cases, the ED physician may often be the first to evaluate severe or recurrent epistaxis and should recognize indications for coagulation testing and hematology consultation/referral for advanced hematologic assessments.

  1. Meta-Analysis of Behavioral Self-Management Interventions in Single-Case Research

    Science.gov (United States)

    Briesch, Amy M.; Briesch, Jacquelyn M.

    2016-01-01

    The current study meta-analyzed 47 single-subject studies of behavioral self-management interventions that were published between 1971 and 2011. In addition to obtaining an overall measure of effect across all self-management studies (f = 0.93), analyses were conducted to assess whether treatment effectiveness was moderated by factors such as…

  2. A Behavioral Analysis of Figurative Language in Psychotherapy: One Session in a Single Case Study.

    Science.gov (United States)

    Pollio, Howard R.; Barlow, Jack M.

    Assuming that all problem solving has both its rational and poetic aspects and that the solution to a problem is often found in the poetic well before it surfaces in the rational, this study examined in detail the ebb and flow of figurative language as it occurred in the course of a single, highly successful hour of gestalt therapy involving both…

  3. The Impact of Psychotherapeutic Reiki on Anxiety and Mindfulness: A Single-Case Design

    Science.gov (United States)

    Webster, Lindsay C.

    2016-01-01

    Reiki healing is one of several complementary and integrative therapies becoming increasingly prevalent in mental health counseling. It has been identified in the medical field for its usefulness in treating anxiety, depression, distress, and pain but has rarely been studied for its counseling impact on client wellness. I conducted single-case…

  4. Eleven Cases of Angioedema with Eosinophilia Treated in a Single Hospital in Japan

    Directory of Open Access Journals (Sweden)

    Shinichiro Nakachi

    2012-01-01

    Conclusions: AE developed in Japanese young females and likely showed a single course. In AE, the count of eosinophil of 104/μL was observed. Only eosinophil count increased among leukocyte series. Serum C- reactive protein and IgE levels remained almost normal. The eosinophil count in AE patients will return to the normal level within 8 weeks even without corticosteroid therapy.

  5. A case of effective single-session treatment for attention deficit and learning problems in a routine clinical practice: the value of a transdiagnostic approach to case formulation.

    Science.gov (United States)

    Whitefield-Alexander, Victoria; Edwards, David

    2009-06-01

    This article reports a systematic clinical case study of the psychological assessment and treatment of Daniel (9), a coloured South African boy with a diagnosis of attention deficit hyperactivity disorder (ADHD) (inattentive type). The case is of scientific interest because: (1) there was only a single treatment session, in which contingency management training was delivered to Daniel's parents and teacher; (2) there was evidence for the effectiveness of the intervention immediately and at two-year follow-up; (3) it documents the transportability to a South African context of an intervention developed by overseas research; (4) it documents the central role of case formulation in the delivery of effective psychological interventions; and (5) although Daniel met the criteria for ADHD, he also displayed symptoms of depression and social anxiety and the case supports the use of a transdiagnostic approach to case formulation. The conscientiousness with which his parents and teachers applied the programme was a major factor in the effectiveness of the intervention, and such rapid impact would not be possible where parents and teachers are unavailable or not co-operative. The publication of systematic case studies such as this one is important for the development of a local evidence-based practice in South Africa.

  6. Stability of equilibrium solutions of Hamiltonian systems with n-degrees of freedom and single resonance in the critical case

    Science.gov (United States)

    dos Santos, Fabio; Vidal, Claudio

    2018-04-01

    In this paper we give new results for the stability of one equilibrium solution of an autonomous analytic Hamiltonian system in a neighborhood of the equilibrium point with n-degrees of freedom. Our Main Theorem generalizes several results existing in the literature and mainly we give information in the critical cases (i.e., the condition of stability and instability is not fulfilled). In particular, our Main Theorem provides necessary and sufficient conditions for stability of the equilibrium solutions under the existence of a single resonance. Using analogous tools used in the Main Theorem for the critical case, we study the stability or instability of degenerate equilibrium points in Hamiltonian systems with one degree of freedom. We apply our results to the stability of Hamiltonians of the type of cosmological models as in planar as in the spatial case.

  7. Using Qualitative Research to Inform Development of Professional Guidelines: A Case Study of the Society of Critical Care Medicine Family-Centered Care Guidelines.

    Science.gov (United States)

    Coombs, Maureen A; Davidson, Judy E; Nunnally, Mark E; Wickline, Mary A; Curtis, J Randall

    2017-08-01

    To explore the importance, challenges, and opportunities using qualitative research to enhance development of clinical practice guidelines, using recent guidelines for family-centered care in the ICU as an example. In developing the Society of Critical Care Medicine guidelines for family-centered care in the neonatal ICU, PICU, and adult ICU, we developed an innovative adaptation of the Grading of Recommendations, Assessments, Development and Evaluations approach to explicitly incorporate qualitative research. Using Grading of Recommendations, Assessments, Development and Evaluations and the Council of Medical Specialty Societies principles, we conducted a systematic review of qualitative research to establish family-centered domains and outcomes. Thematic analyses were undertaken on study findings and used to support Population, Intervention, Comparison, Outcome question development. We identified and employed three approaches using qualitative research in these guidelines. First, previously published qualitative research was used to identify important domains for the Population, Intervention, Comparison, Outcome questions. Second, this qualitative research was used to identify and prioritize key outcomes to be evaluated. Finally, we used qualitative methods, member checking with patients and families, to validate the process and outcome of the guideline development. In this, a novel report, we provide direction for standardizing the use of qualitative evidence in future guidelines. Recommendations are made to incorporate qualitative literature review and appraisal, include qualitative methodologists in guideline taskforce teams, and develop training for evaluation of qualitative research into guideline development procedures. Effective methods of involving patients and families as members of guideline development represent opportunities for future work.

  8. Abdominal ectopic pregnancy after in vitro fertilization and single embryo transfer: a case report and systematic review.

    Science.gov (United States)

    Yoder, Nicole; Tal, Reshef; Martin, J Ryan

    2016-10-19

    Ectopic pregnancy is the leading cause of maternal morbidity and mortality during the first trimester and the incidence increases dramatically with assisted-reproductive technology (ART), occurring in approximately 1.5-2.1 % of patients undergoing in-vitro fertilization (IVF). Abdominal ectopic pregnancy is a rare yet clinically significant form of ectopic pregnancy due to potentially high maternal morbidity. While risk factors for ectopic pregnancy after IVF have been studied, very little is known about risk factors specific for abdominal ectopic pregnancy. We present a case of a 30 year-old woman who had an abdominal ectopic pregnancy following IVF and elective single embryo transfer, which was diagnosed and managed by laparoscopy. We performed a systematic literature search to identify case reports of abdominal or heterotopic abdominal ectopic pregnancies after IVF. A total of 28 cases were identified. Patients' ages ranged from 23 to 38 (Mean 33.2, S.D. = 3.2). Infertility causes included tubal factor (46 %), endometriosis (14 %), male factor (14 %), pelvic adhesive disease (7 %), structural/DES exposure (7 %), and unexplained infertility (14 %). A history of ectopic pregnancy was identified in 39 % of cases. A history of tubal surgery was identified in 50 % of cases, 32 % cases having had bilateral salpingectomy. Transfer of two embryos or more (79 %) and fresh embryo transfer (71 %) were reported in the majority of cases. Heterotopic abdominal pregnancy occurred in 46 % of cases while 54 % were abdominal ectopic pregnancies. Our systematic review has revealed several trends in reported cases of abdominal ectopic pregnancy after IVF including tubal factor infertility, history of tubal ectopic and tubal surgery, higher number of embryos transferred, and fresh embryo transfers. These are consistent with known risk factors for ectopic pregnancy following IVF. Further research focusing on more homogenous population may help in better characterizing

  9. Single Nucleotide Polymorphism-Based Analysis of Cell-Free Fetal DNA in 3000 Cases from Germany and Austria.

    Science.gov (United States)

    Eiben, B; Krapp, M; Borth, H; Kutur, N; Kreiselmaier, P; Glaubitz, R; Deutinger, J; Merz, E

    2015-07-01

    Data from 3 008 patients, who underwent single-nucleotide-polymorphism (SNP)-based noninvasive prenatal testing (NIPT) are presented. The PanoramaTM test (Natera, San Carlos, CA) was used to analyze cell-free fetal DNA from maternal blood for trisomies 21, 18, and 13, triploidy and sex-chromosome aneuploidies. In 2 942 (97.8%) cases, a result was obtained. The average fetal fraction was 10.2%. A high-risk result for fetal aneuploidy was made for 65 (2.2%) cases. In 59 (90.8%) of these cases, invasive testing confirmed the aneuploidy. There were 6 false-positive cases. In the false-positive group, the fetal fraction was significantly lower. The overall positive predictive value was 90.8%. No false-negative cases were reported but many patients in this study have not delivered yet. Therefore, exact data cannot be given for potential false-negative cases. SNP-based NIPT is a reliable screening method for evaluating the risk of aneuploidies of chromosomes 21, 18 and 13. By using NIPT, the number of invasive procedures may be reduced significantly compared to maternal age and first-trimester screening.

  10. Analysis and meta-analysis of single-case designs with a standardized mean difference statistic: a primer and applications.

    Science.gov (United States)

    Shadish, William R; Hedges, Larry V; Pustejovsky, James E

    2014-04-01

    This article presents a d-statistic for single-case designs that is in the same metric as the d-statistic used in between-subjects designs such as randomized experiments and offers some reasons why such a statistic would be useful in SCD research. The d has a formal statistical development, is accompanied by appropriate power analyses, and can be estimated using user-friendly SPSS macros. We discuss both advantages and disadvantages of d compared to other approaches such as previous d-statistics, overlap statistics, and multilevel modeling. It requires at least three cases for computation and assumes normally distributed outcomes and stationarity, assumptions that are discussed in some detail. We also show how to test these assumptions. The core of the article then demonstrates in depth how to compute d for one study, including estimation of the autocorrelation and the ratio of between case variance to total variance (between case plus within case variance), how to compute power using a macro, and how to use the d to conduct a meta-analysis of studies using single-case designs in the free program R, including syntax in an appendix. This syntax includes how to read data, compute fixed and random effect average effect sizes, prepare a forest plot and a cumulative meta-analysis, estimate various influence statistics to identify studies contributing to heterogeneity and effect size, and do various kinds of publication bias analyses. This d may prove useful for both the analysis and meta-analysis of data from SCDs. Copyright © 2013 Society for the Study of School Psychology. Published by Elsevier Ltd. All rights reserved.

  11. Single metastasis of myxoid liposarcoma from the thigh to thyroid gland: a case report.

    Science.gov (United States)

    Urakawa, Hiroshi; Nakanishi, Kenichi; Arai, Eisuke; Ikuta, Kunihiro; Hamada, Shunsuke; Ota, Takehiro; Ishiguro, Naoki; Nishida, Yoshihiro

    2018-03-27

    Thyroid metastasis of soft tissue sarcoma is very rare, and the diagnosis is especially difficult when only a single lesion is present. A 50-year-old man was diagnosed with myxoid liposarcoma of the right thigh and treated with wide resection. Two and a half years after the surgery, a growing low-density area was incidentally observed in the right lobe of his thyroid gland on follow-up chest computed tomography. Fine needle aspiration biopsy was performed twice, and the thyroid mass was suspected of being a sarcoma metastasis. He was treated by hemithyroidectomy, and the lesion was pathologically confirmed as a metastasis of myxoid liposarcoma. We experienced single thyroid gland metastasis in patients with myxoid liposarcoma in whom a growing mass is observed in the thyroid gland after radical surgery of the primary site.

  12. Single hydration of the peptide bond: the case of the Vince lactam.

    Science.gov (United States)

    Écija, Patricia; Basterretxea, Francisco J; Lesarri, Alberto; Millán, Judith; Castaño, Fernando; Cocinero, Emilio J

    2012-10-18

    2-Azabicyclo[2.2.1]hept-5-en-3-one (ABH or Vince lactam) and its monohydrated complex (ABH···H(2)O) have been observed in a supersonic jet by Fourier transform microwave spectroscopy. ABH is broadly used in the synthesis of therapeutic drugs, whereas the ABH···H(2)O system offers a simple model to explain the conformational preferences of water linked to a constrained peptidic bond. A single predominant form of the Vince lactam and its singly hydrated complex have been detected, determining the rotational constants, centrifugal distortion constants, and nuclear quadrupole coupling tensor. The monohydrated complex is stabilized by two hydrogen bonds (C═O···H-O and N-H···O) closing a six-membered ring. The complexation energy has been estimated to be ∼10 kJ mol(-1) from experimental results. In addition, the observed structure in the gas phase has been compared with solid-phase diffraction data. The structural parameters and binding energies of ABH···H(2)O have also been compared with similar molecules containing peptide bonds. Ab initio (MP2) and density functional (M06-2X and B3LYP) methods have supported the experimental work, describing the rotational parameters and conformational landscape of the title compound and its singly hydrated complex.

  13. [Quality evaluation of decoction of single medicinal herb--a case of Lonicerae Japinicae Flos].

    Science.gov (United States)

    Dai, Yun-Tao; Li, Qi; Fan, Zi-Quan; Wang, Dan-Dan; Dong, Qing; Tong, Jia-Yu; Takehisa, Tomada; Chen, Shi-Lin

    2017-03-01

    Decoction of single medicinal herb is a reference for the standardization of different dosage form of Chinese medicine and it provides a new direction for solving the problems existing in the quality of Chinese medicinal granules such no uniform dosage forms and no clear quality standard. There are few reports on the idea, method and preparation of single herb standard decoction. Our country is in urgent need of that information in order to improve the consistency and stability of traditional Chinese medicine products. Here, Lonicerae Japinicae Flos was selected as an example to elucidate the preparation and quality evaluation of Chinese single herbal medicine decoction. Twelve batches of representative Lonicerae Japinicae Flos were collected, UPLC fingerprints were established, and the chemical structures of main peaks were identified with UPLC-QTOF-MS and standard compounds. The main components in the decoction are organic acids and iridoids. The extract rate of the standard decoction was (34.2±2.9)% and the transfer rate is (78.6±8.4)% in the form of chlorogenic acid, within the range of 75%-125% of mean. This paper established a method for the quality evaluation of standard decoction of Lonicerae Japinicae Flos and provided reference for the quality control method of terminal products from decoction of Lonicerae Japinicae Flos. Copyright© by the Chinese Pharmaceutical Association.

  14. Comparing a single case to a control group - Applying linear mixed effects models to repeated measures data.

    Science.gov (United States)

    Huber, Stefan; Klein, Elise; Moeller, Korbinian; Willmes, Klaus

    2015-10-01

    In neuropsychological research, single-cases are often compared with a small control sample. Crawford and colleagues developed inferential methods (i.e., the modified t-test) for such a research design. In the present article, we suggest an extension of the methods of Crawford and colleagues employing linear mixed models (LMM). We first show that a t-test for the significance of a dummy coded predictor variable in a linear regression is equivalent to the modified t-test of Crawford and colleagues. As an extension to this idea, we then generalized the modified t-test to repeated measures data by using LMMs to compare the performance difference in two conditions observed in a single participant to that of a small control group. The performance of LMMs regarding Type I error rates and statistical power were tested based on Monte-Carlo simulations. We found that starting with about 15-20 participants in the control sample Type I error rates were close to the nominal Type I error rate using the Satterthwaite approximation for the degrees of freedom. Moreover, statistical power was acceptable. Therefore, we conclude that LMMs can be applied successfully to statistically evaluate performance differences between a single-case and a control sample. Copyright © 2015 Elsevier Ltd. All rights reserved.

  15. An Unusual Occurrence of Multiple Dental Anomalies in a Single Nonsyndromic Patient: A Case Report

    Directory of Open Access Journals (Sweden)

    N. B. Nagaveni

    2012-01-01

    Full Text Available Dental anomalies are the formative defects caused by genetic disturbances or environmental factors during tooth morphogenesis. Simultaneous occurrence of various multiple anomalies has been reported previously, particularly in cases of chromosomal abnormalities that often manifest with multisystem involvement. Very few cases of multiple anomalies have been documented in patients with no known generalized abnormalities. The present paper shows an unusual occurrence of a combination of dental anomalies like mandibular canine transmigration, taurodontism in permanent mandibular molars, congenital agenesis of 14 numbers of permanent teeth excluding third molars, canine impaction, primary molars with pyramidal roots, midline diastema and generalized microdontia in an apparently normal 13-year-old Indian girl.

  16. Spondylodiscitis by drug-multiresistant bacteria: a single-center experience of 25 cases.

    Science.gov (United States)

    Shiban, Ehab; Janssen, Insa; Wostrack, Maria; Krieg, Sandro M; Horanin, Monika; Stoffel, Michael; Meyer, Bernhard; Ringel, Florian

    2014-12-01

    Although the incidence of pyogenic spinal infections is increasing, the ideal treatment of spondylodiscitis is still a controversially discussed issue. Furthermore, the proportion of multiresistant bacteria in spondylodiscitis is increasing, and treatment recommendations or reported results are missing for this especially difficult subset of patients. The aim of this study is to evaluate the surgical outcome and the postoperative antibacterial treatment regime. Retrospective case series. Patients treated for a spondylodiscitis from multiresistant bacteria at our department between 2006 and 2011. Data were gathered through review of patients' case notes, relevant imaging, and electronic records. Magnetic resonance imaging of the whole spine including gadolinium (Gd)-enhanced T1 sequences and computed tomography scans of the affected regions were obtained in all cases. C-reactive protein (CRP) and complete blood cell count were analyzed in all cases using routine laboratory techniques. Neurologic deficits were classified according to the American Spinal Injury Association (ASIA) impairment scale. Twenty-five patients were identified (15 gram-positive and 10 gram-negative drug-multiresistant bacteria). The mean age at presentation was 66 years, and 14 patients were male (56%). All patients presented with pain, and a neurologic deficit was present in 11 (44%) cases. An epidural abscess was found in 11 (44%) cases. At admission, CRP was elevated in all cases with a mean of 13±9.2 mg/dL. The main source of infection was previous spine surgery (36%). All patients in this series underwent surgical debridement of the infection and instrumentation of the spine. Postoperative intravenous antibiotics were administered for 19±8.6 days followed by 3±0.3 months of oral antibiotic therapy. Eradication of the infection was achieved ultimately in all surviving patients. Out of 11 patients with neurologic deficits, 4 had a full recovery, 4 improved incompletely, and 3 remained

  17. Service learning can make occupation-based practice a reality: a single case study.

    Science.gov (United States)

    Vroman, Kerryellen; Simmons, C Douglas; Knight, Jessica

    2010-07-01

    ABSTRACT Service learning is philosophically congruent with the objectives of progressive occupational therapy curricula. This article presents a case-based research study that examined the attributes and outcomes of a service-learning course that included Level I fieldwork. Analysis of the case study identified three themes: (a) the translation of theory to practice, (b) the value of contextual learning, and (c) the gestalt of occupational awareness. Service learning can be considered a pedagogical [2] model that promotes the synthesis of conceptual models to clinical practice. Furthermore, it enables students to develop a professional and personal philosophy of occupation earlier in their careers.

  18. An Examination of Fluoxetine for the Treatment of Selective Mutism Using a Nonconcurrent Multiple-Baseline Single-Case Design Across 5 Cases.

    Science.gov (United States)

    Barterian, Justin A; Sanchez, Joel M; Magen, Jed; Siroky, Allison K; Mash, Brittany L; Carlson, John S

    2018-01-01

    This study examined the utility of fluoxetine in the treatment of 5 children, aged 5 to 14 years, diagnosed with selective mutism who also demonstrated symptoms of social anxiety. A nonconcurrent, randomized, multiple-baseline, single-case design with a single-blind placebo-controlled procedure was used. Parents and the study psychiatrist completed multiple methods of assessment including Direct Behavior Ratings and questionnaires. Treatment outcomes were evaluated by calculating effect sizes for each participant as an individual and for the participants as a group. Information regarding adverse effects with an emphasis on behavioral disinhibition and ratings of parental acceptance of the intervention was gathered. All 5 children experienced improvement in social anxiety, responsive speech, and spontaneous speech with medium to large effect sizes; however, children still met criteria for selective mutism at the end of the study. Adverse events were minimal, with only 2 children experiencing brief occurrences of minor behavioral disinhibition. Parents found the treatment highly acceptable.

  19. A qualitative case study of instructional support for web-based simulated laboratory exercises in online college chemistry laboratory courses

    Science.gov (United States)

    Schulman, Kathleen M.

    This study fills a gap in the research literature regarding the types of instructional support provided by instructors in online introductory chemistry laboratory courses that employ chemistry simulations as laboratory exercises. It also provides information regarding students' perceptions of the effectiveness of that instructional support. A multiple case study methodology was used to carry out the research. Two online introductory chemistry courses were studied at two community colleges. Data for this study was collected using phone interviews with faculty and student participants, surveys completed by students, and direct observation of the instructional designs of instructional support in the online Blackboard web sites and the chemistry simulations used by the participating institutions. The results indicated that the instructors provided multiple types of instructional support that correlated with forms of effective instructional support identified in the research literature, such as timely detailed feedback, detailed instructions for the laboratory experiments, and consistency in the instructional design of lecture and laboratory course materials, including the chemistry lab simulation environment. The students in one of these courses identified the following as the most effective types of instructional support provided: the instructor's feedback, opportunities to apply chemistry knowledge in the chemistry lab exercises, detailed procedures for the simulated laboratory exercises, the organization of the course Blackboard sites and the chemistry lab simulation web sites, and the textbook homework web sites. Students also identified components of instructional support they felt were missing. These included a desire for more interaction with the instructor, more support for the simulated laboratory exercises from the instructor and the developer of the chemistry simulations, and faster help with questions about the laboratory exercises or experimental

  20. Self-destruction by multiple methods during a single episode: a case ...

    African Journals Online (AJOL)

    Results: Three different methods of suicide were apparent in this instance: hanging, leaping down the cliff and drowning as was evidenced by the autopsy and positive diatom test. The complexity of this case was the planned protection against the failure of one method employed to commit suicide. The methods used were ...

  1. Thirty-eight cases of acute pancreatitis in pregnancy: a 6-year single center retrospective analysis.

    Science.gov (United States)

    Zhang, Dong-lin; Huang, Yi; Yan, Li; Phu, Amy; Ran, Xiao; Li, Shu-sheng

    2013-06-01

    Thirty-eight pregnant inpatients with acute pancreatitis (AP) were retrospectively reviewed from 2006 to 2012 in our hospital. The incidence of pregnancy-associated AP was 2.27‰. Most (78.95%) of the attack occurred in the third trimester. The median of APACHE II score was 6 and severe AP accounted for 31.58% (12 cases). Primary diseases were absent in most cases (57.89%). The most common clinical presentations were abdominal pain (89.47%) and vomiting (68.42%). Pleural effusion and ascites were found only in the third trimester. Elevated white blood cell count, amylase and lipase were commonly found in biochemical examinations. Eleven cases required intensive care in ICU and 21 cases received caesarean section. There were 2 maternal deaths and 12 fetal losses including 4 abortions. It is concluded that AP is a rare entity in pregnancy. The incidence of pancreatitis increases with the gestational age. However, the severity is not necessarily related with the pregnancy trimesters. The diagnosis is based on clinical presentations, laboratory tests and imaging examinations. Although the treatment strategy of a pregnant woman with pancreatitis is similar to the general non-pregnant patient with AP, a multidisciplinary team consisting of gastroenterologist, gastrointestinal surgeon, radiologist, obstetrician, and ICU doctor should be set up.

  2. Behavioral Experiments in the Treatment of Paranoid Schizophrenia: A Single Case Study

    Science.gov (United States)

    Hagen, Roger; Nordahl, Hans M.

    2008-01-01

    Since the first description of cognitive therapy of paranoid delusions appeared in the literature, the empirical support for cognitive behavioral therapy in treating psychotic symptoms has been widely established. The aim of the present case study is to show how the behavioral experiment can be used as a powerful tool to change delusional thinking…

  3. Single-Case Analysis to Determine Reasons for Failure of Behavioral Treatment via Telehealth

    Science.gov (United States)

    Schieltz, Kelly M.; Romani, Patrick W.; Wacker, David P.; Suess, Alyssa N.; Huang, Pei; Berg, Wendy K.; Lindgren, Scott D.; Kopelman, Todd G.

    2018-01-01

    Functional communication training (FCT) is a widely used and effective function-based treatment for problem behavior. The purpose of this article is to present two cases in which FCT was unsuccessful in reducing the occurrence of problem behavior displayed by two young children with an autism spectrum disorder. Both children received the same…

  4. Posterior cranial fossa single-hole arteriovenous fistulae in children: 14 consecutive cases

    International Nuclear Information System (INIS)

    Yoshida, Y.; Weon, Y.C.; Sachet, M.; Mahadevan, J.; Alvarez, H.; Rodesch, G.; Lasjaunias, P.

    2004-01-01

    We report 14 consecutive children with 23 posterior cranial fossa arteriovenous fistula (AVF); six had multifocal lesions, involving the supratentorial brain in three and the spinal cord in one. There were two boys and four girls with a family history compatible with hereditary haemorrhagic telangiectasia. The diagnosis was made in infancy in eight cases and in a further six before the age of 12 years; mean age at diagnosis was 3.5 years. The male-to-female ratio was 1.8:1. Presenting features were macrocrania in four cases, haemorrhage or headache in three and nonhaemorrhagic neurological deficits or and cardiac overload in two. Dominant supply to the symptomatic fistula arose from the posterior inferior cerebellar artery in five cases, anterior inferior cerebellar artery in two and the upper basilar artery system in seven. All children were primarily treated by transarterial embolisation. We treated thirteen children (93%) by transarterial embolisation alone; one older child with a history of haemorrhage also underwent radiosurgery. We obtained 100% exclusion of the fistula(e) in six children, 95-80% in five, 80-50% in one and <50% in one. Of the incompletely treated cases, three had conservative management, and two with 80% and one with 60% reduction of their lesion are scheduled for elective treatment; two partially treated case died. There was no morbidity due to the endovascular procedures. Follow-up since referral is 6 months-10 years (mean 4.5 years). Ten children are neurologically normal, two have persistent (pre-existing) neurological deficits and two are dead. (orig.)

  5. Public engagement with information on renewable energy developments: The case of single, semi-urban wind turbines.

    Science.gov (United States)

    Parks, J M; Theobald, K S

    2013-01-01

    This paper explores perceptions of public engagement with information on renewable energy developments. It draws on a case study of proposals by a major supermarket chain to construct single wind turbines in two semi-urban locations in the UK, analysing data from interviews with key actors in the planning process and focus groups with local residents. The paper concludes that key actors often had high expectations of how local people should engage with information, and sometimes implied that members of the public who were incapable of filtering or processing information in an organised or targeted fashion had no productive role to play in the planning process. It shows how the specific nature of the proposals (single wind turbines in semi-urban locations proposed by a commercial private sector developer) shaped local residents' information needs and concerns in a way that challenged key actors' expectations of how the public should engage with information.

  6. Laparoendoscopic Single-Site Surgery (LESS for a Large Ovarian Tumour: First Clinical Case Report

    Directory of Open Access Journals (Sweden)

    Yao Dong Chua

    2011-01-01

    Main Outcome Measure(s. Conversion to standard laparoscopic technique or laparotomy, estimated blood loss, operative time , extent of scarring, occurrence of intra- and perioperative surgical complications, technical adequacy, and clinical outcome. Result(s. No conversion to standard laparoscopic technique or laparotomy, and no intraoperative or postoperative complications were observed. Total operative time was 99 minutes. The patient was discharged home on postoperative day one. Conclusion(s. Laparoendoscopic single-site bilateral salpingo-oophorectomy of a large ovarian tumour is feasible with standard laparoscopic instruments. It is safe and effective, with good results in terms of excellent cosmesis and minimal postoperative pain.

  7. Rehabilitation of a Distressed Single Storied Building Founded on Expansive Soil: A Case Study

    Science.gov (United States)

    Pakrashi, Somdev

    2017-12-01

    A single storied building was constructed on strip foundation system—on a subsoil, with high expansivity, without taking necessary precautions and it suffered extensive cracks and damages in roof slab, beams, columns and brick walls, subsidence /upheavals in floors etc. within 2/3 years of its construction and consequently it had to be abandoned. The study examines the reasons for the severe damages, cracks etc. and also suggests remediation by ground improvement and other necessary measures that were actually taken up, to rehabilitate the highly distressed and abandoned building within a reasonably short period of time—at a reasonable cost.

  8. The role of economic evaluation in the decision-making process of family physicians: design and methods of a qualitative embedded multiple-case study

    Science.gov (United States)

    Lessard, Chantale; Contandriopoulos, André-Pierre; Beaulieu, Marie-Dominique

    2009-01-01

    Background A considerable amount of resource allocation decisions take place daily at the point of the clinical encounter; especially in primary care, where 80 percent of health problems are managed. Ignoring economic evaluation evidence in individual clinical decision-making may have a broad impact on the efficiency of health services. To date, almost all studies on the use of economic evaluation in decision-making used a quantitative approach, and few investigated decision-making at the clinical level. An important question is whether economic evaluations affect clinical practice. The project is an intervention research study designed to understand the role of economic evaluation in the decision-making process of family physicians (FPs). The contributions of the project will be from the perspective of Pierre Bourdieu's sociological theory. Methods/design A qualitative research strategy is proposed. We will conduct an embedded multiple-case study design. Ten case studies will be performed. The FPs will be the unit of analysis. The sampling strategies will be directed towards theoretical generalization. The 10 selected cases will be intended to reflect a diversity of FPs. There will be two embedded units of analysis: FPs (micro-level of analysis) and field of family medicine (macro-level of analysis). The division of the determinants of practice/behaviour into two groups, corresponding to the macro-structural level and the micro-individual level, is the basis for Bourdieu's mode of analysis. The sources of data collection for the micro-level analysis will be 10 life history interviews with FPs, documents and observational evidence. The sources of data collection for the macro-level analysis will be documents and 9 open-ended, focused interviews with key informants from medical associations and academic institutions. The analytic induction approach to data analysis will be used. A list of codes will be generated based on both the original framework and new themes

  9. Elective gastropexy with a reusable single-incision laparoscopic surgery port in dogs: 14 cases (2012-2013).

    Science.gov (United States)

    Stiles, Mandy; Case, J Brad; Coisman, James

    2016-08-01

    OBJECTIVE To describe the technique, clinical findings, and short-term outcome in dogs undergoing laparoscopic-assisted incisional gastropexy with a reusable single-incision surgery port. DESIGN Retrospective case series. ANIMALS 14 client-owned dogs. PROCEDURES Medical records of dogs referred for elective laparoscopic gastropexy between June 2012 and August 2013 were reviewed. History, signalment, results of physical examination and preoperative laboratory testing, surgical procedure, duration of surgery, postoperative complications, duration of hospital stay, and short-term outcome were recorded. All patients underwent general anesthesia and were positioned in dorsal recumbency. After an initial limited laparoscopic exploration, single-incision laparoscopic-assisted gastropexy was performed extracorporeally in all dogs via a conical port placed in a right paramedian location. Concurrent procedures included laparoscopic ovariectomy (n = 4), gastric biopsy (2), and castration (7). Short-term outcome was evaluated. RESULTS Median duration of surgery was 76 minutes (range, 40 to 90 minutes). Intraoperative complications were minor and consisted of loss of pneumoperitoneum in 2 of 14 dogs. A postoperative surgical site infection occurred in 1 dog and resolved with standard treatment. Median duration of follow-up was 371 days (range, 2 weeks to 1.5 years). No dogs developed gastric dilation-volvulus during the follow-up period, and all owners were satisfied with the outcome. CONCLUSIONS AND CLINICAL RELEVANCE Results suggested that single-incision laparoscopic-assisted gastropexy with a reusable conical port was feasible and effective in appropriately selected cases. Investigation of the potential benefits of this reusable port versus single-use devices for elective gastropexy in dogs is warranted.

  10. An Exploration of How U.S. Army Officers Attending the U.S. Army Command and General Staff College Decide Whether or Not to Attend Graduate School: A Qualitative Case Study

    Science.gov (United States)

    Vance, Charles David

    2013-01-01

    This qualitative case study explored how U.S. Army Command and General Staff College (CGSC) students decided whether or not to attend graduate school. The focus was on how U.S. Army students made their decision. The purpose of the study was to illuminate the issues related to this decision in adult development, adult learning, career decision…

  11. Benefits of a single payment system: case study of Abu Dhabi health system reforms.

    Science.gov (United States)

    Vetter, Philipp; Boecker, Klaus

    2012-12-01

    In 2005 leaders in the wealthy Emirate of Abu Dhabi inherited an health system from their predecessors that was well-intentioned in its historic design, but that did not live up to aspirations in any dimension. First, the Emirate defined a vision to deliver "world-class" quality care in response to citizen's needs. It has since introduced tiered mandatory health insurance for all inhabitants linked to a single standard payment system, which generates accurate data as an invaluable by-product. A newly created independent health system regulator monitors these data and licenses, audits, and inspects all health service professionals, facilities, and insurers accordingly. We analyse these health system reforms using the "Getting Health Reform Right" framework. Our analysis suggests that an integrated set of reforms addressing all reform levers is critical to achieving the outcomes observed. The reform programme has improved access, by giving all residents health cards. The approximate doubling of demand has been matched by flexible supply, with the private sector adding 5 new hospitals and 93 clinics to the health system infrastructure since 2006. The focus on reliable raw-data flows through the single standard payment system functions as a motor for improvement services, innovation, and investment, for instance by allowing payers to 'pay for quality', which may well be applicable in other contexts. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  12. Megalourethra: a case report managed with a single intrauterine bladder aspiration.

    Science.gov (United States)

    Asma, Basha; Jumana, Baramki

    2012-02-01

    Congenital megalourethra is a rare mesenchymal anomaly of the male urethra, characterised by severe dilatation of the penile urethra due to congenital absence of the corpus spongiosum and/or corpus cavernosum. Postnatal complications include voiding and erectile dysfunction as well as renal insufficiency and pulmonary hypoplasia. We present a unique case of congenital megalourethra diagnosed prenatally in the early second trimester. The parents opted to continue pregnancy and vaginal delivery of a live neonate occurred with a favourable outcome.

  13. Long-lasting changes in brain activation induced by a single REAC technology pulse in Wi-Fi bands. Randomized double-blind fMRI qualitative study.

    Science.gov (United States)

    Rinaldi, Salvatore; Mura, Marco; Castagna, Alessandro; Fontani, Vania

    2014-07-11

    The aim of this randomized double-blind study was to evaluate in healthy adult subjects, with functional magnetic resonance imaging (fMRI), long lasting changes in brain activation patterns following administration of a single, 250 milliseconds pulse emitted with radio-electric asymmetric conveyer (REAC) technology in the Wi-Fi bands. The REAC impulse was not administered during the scan, but after this, according to a protocol that has previously been demonstrated to be effective in improving motor control and postural balance, in healthy subjects and patients. The study was conducted on 33 healthy volunteers, performed with a 1.5 T unit while operating a motor block task involving cyclical and alternating flexion and extension of one leg. Subsequently subjects were randomly divided into a treatment and a sham treatment control group. Repeated fMRI examinations were performed following the administration of the REAC pulse or sham treatment. The Treated group showed cerebellar and ponto-mesencephalic activation components that disappeared in the second scan, while these activation components persisted in the Sham group. This study shows that a very weak signal, such as 250 milliseconds Wi-Fi pulse, administered with REAC technology, could lead to lasting effects on brain activity modification.

  14. Early Loading of Single-Piece Implant for Partially Edentulous Posterior Arch: A Prospective One-Year Case Report

    Directory of Open Access Journals (Sweden)

    Amol Beldar

    2013-01-01

    Full Text Available Implant therapy is now well established, and there is an increasing need for shorter rehabilitation time. Original prerequisites of osseointegration have been reassessed to satisfy continuously increasing patient's expectation of reduced treatment time, improved esthetics, and increased comfort. Shorter healing time may be appropriate in some circumstances, and examples of early loading have been reported in animal and human studies. However, to date there are insufficient data to determine a universally acceptable opinion on early loading of implants for single-tooth replacement. This case report involves early loading, combined with construction of a restoration, inserted directly after 6 weeks of implant surgery and followup of one year.

  15. Early Loading of Single-Piece Implant for Partially Edentulous Posterior Arch: A Prospective One-Year Case Report

    Science.gov (United States)

    Beldar, Amol; Bhongade, Manohar L.; Byakod, Girish; Buregoni, Chandrashekar

    2013-01-01

    Implant therapy is now well established, and there is an increasing need for shorter rehabilitation time. Original prerequisites of osseointegration have been reassessed to satisfy continuously increasing patient's expectation of reduced treatment time, improved esthetics, and increased comfort. Shorter healing time may be appropriate in some circumstances, and examples of early loading have been reported in animal and human studies. However, to date there are insufficient data to determine a universally acceptable opinion on early loading of implants for single-tooth replacement. This case report involves early loading, combined with construction of a restoration, inserted directly after 6 weeks of implant surgery and followup of one year. PMID:23710375

  16. Studies on water turbine runner which fish can pass through: In case of single stage axial runner

    International Nuclear Information System (INIS)

    Shimizu, Yukimari; Maeda, Takao; Nagoshi, Osamu; Ieda, Kazuma; Shinma, Hisako; Hagimoto, Michiko

    1994-01-01

    The relationship between water turbine runner design and operation and the safe passage of fish through the turbine is studied. The kinds of fish used in the tests are a dace, a sweet fish and a small salmon. A single stage axial runner is used. The velocity and pressure distributions were measured inside the turbine casing and along the casing wall. Many pictures showing fish passing through the rotating runner were taken and analyzed. The swimming speed of the fish was examined from video recordings. Fish pass through the runner more rapidly when they can determine and choose the easier path. Injury and mortality of fish are affected by the runner speed and the location of impact of the runner on the fish body

  17. LH-RH agonists modulate amygdala response to visual sexual stimulation: a single case fMRI study in pedophilia.

    Science.gov (United States)

    Habermeyer, Benedikt; Händel, Nadja; Lemoine, Patrick; Klarhöfer, Markus; Seifritz, Erich; Dittmann, Volker; Graf, Marc

    2012-01-01

    Pedophilia is characterized by a persistent sexual attraction to prepubescent children. Treatment with anti-androgen agents, such as luteinizing hormone-releasing hormone (LH-RH) agonists, reduces testosterone levels and thereby sexual drive and arousal. We used functional magnetic resonance imaging (fMRI) to compare visual erotic stimulation pre- and on-treatment with the LH-RH agonist leuprolide acetate in the case of homosexual pedophilia. The pre-treatment contrasts of the erotic pictures against the respective neutral pictures showed an activation of the right amygdala and adjacent parahippocampal gyrus that decreased significantly under treatment with leuprolide acetate. Our single case fMRI study supports the notion that anti-androgens may modify amygdala response to visual erotic stimulation, a hypothesis that should be further examined in larger studies.

  18. The IHO as Actor The case of cannabis and the Single Convention on Narcotic Drugs 1961

    Directory of Open Access Journals (Sweden)

    James H. Mills

    2016-12-01

    Full Text Available After the Second World War the United Nations (UN assumed the role of the League of Nations in formulating and operating the international regulatory framework for narcotic drugs. It gathered masses of information from across countries and continents while acting as both a forum and an agent for the emergence of agreed approaches to a heterodox array of substances. This article will examine the story of the inclusion of cannabis in the 1961 Single Convention on Narcotic Drugs. It will argue that in the years after 1945, it was officials at the UN and the WHO that played crucial roles in shaping opinions of the drug and in securing its place in the Convention.

  19. Immediate provisional restoration of a single-tooth implant in the esthetic zone: A case report

    Directory of Open Access Journals (Sweden)

    Po-Sung Fu

    2011-02-01

    Full Text Available Immediate implant restoration of single implants may demonstrate a positive effect on peri-implant soft tissue. Placement of a provisional restoration following implant surgery can create soft tissue contours that resemble normal gingival topography before placement of the definitive prosthesis. This article describes a staged approach of the mandibular permanent right central incisor, which was congenital missing. The proper space for restoration of the missing incisor was created through orthodontic treatment. The scheduled implant site was reconstructed using autogenous bone harvested from the chin region. After a healing period of four months, an implant was installed with the connection of a fixed provisional crown to a prefabricated temporary abutment. The soft tissue around the implant healed according to the contours of the provisional restoration and the emergence profile was used to duplicate the definitive restoration. Peri-implant esthetics was achieved through the staged approach and immediate restoration of the implant.

  20. Nano-modified adhesive by graphene: the single lap-joint case

    Energy Technology Data Exchange (ETDEWEB)

    Silva Neto, Almir; Cruz, Diego Thadeu Lopes da; Avila, Antonio Ferreira, E-mail: aavila@netuno.lcc.ufmg.b [Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG (Brazil). Dept. de Engenharia Mecanica

    2013-11-01

    This paper addresses the performance study on, low viscosity, nano-modified adhesives by graphene. For achieving this goal, single-lap joints following ASTM D 5868-01 were manufactured and tested. X-ray diffraction, scanning electron microscopy and nanoindentation were employed for graphene based nanostructures characterization. The increase on joint strength was around 57% when compared against the control group. Furthermore, all failures for the nano-modified adhesive were cohesive failure for the carbon fibre/epoxy composites indicating that the adhesive was tested. X-ray diffractions signatures indicate formation of nano-structures with 17-19 nm diameters. Moreover, nanoindentation tests revealed a homogeneous dispersion of graphene. (author)

  1. How market-oriented education policies might influence young people's health: development of a logic model from qualitative case studies in English secondary schools.

    Science.gov (United States)

    Bonell, Chris; Fletcher, Adam; Sorhaindo, Annik; Wells, Helene; McKee, Martin

    2012-07-01

    School systems are increasingly typified by diversity of provision, parental choice and publication of performance data. Schools shape their students' lifestyles and health, but the effects of 'marketisation' are under-researched. The authors use qualitative data to develop a logic model regarding such effects. Case studies in seven English secondary schools, interviews with 103 students and 39 staff. 'Parental choice' was associated with dispersal of students' friendship groups on transition to secondary school, reduced social support and emotional harms. 'Choice' meant some schools were regarded as 'dumping grounds' for socially disadvantaged students, creating potentially violent environments where students engaged in risk behaviours such as substance use to facilitate protective bonds with peers. Schools focused strongly on academic attainment, reflecting external pressures from the school inspectorate and performance league tables. Some schools sought to improve their league table position by targeting resources on 'key marginal' students on the threshold of passing five exams, the key metric. Less-academic students commonly became disengaged, engaging in various health risk behaviours as alternative status markers. The exam-focused environment aroused anxiety among high and low attainers, some using substances as self-medication. Schools also de-prioritised health education and sport in this performance-driven context. Our logic model aims to guide further research on how marketisation might affect young people health behaviours.

  2. Single Nanorod Devices for Battery Diagnostics: A Case Study on LiMn 2 O 4

    KAUST Repository

    Yang, Yuan

    2009-12-09

    This paper presents single nanostructure devices as a powerful new diagnostic tool for batteries with LiMn2O4 nanorod materials as an example. LiMn2O4 and Al-doped LiMn2O4 nanorods were synthesized by a two-step method that combines hydrothermal synthesis of β-MnO2 nanorods and a solid state reaction to convert them to LiMn2O4 nanorods. λ-MnO2 nanorods were also prepared by acid treatment of LiMn2O4 nanorods. The effect of electrolyte etching on these LiMn2O 4-related nanorods is investigated by both SEM and single-nanorod transport measurement, and this is the first time that the transport properties of this material have been studied at the level of an individual singlecrystalline particle. Experiments show that Al dopants reduce the dissolution of Mn3+ ions significantly and make the LiAl 0.1Mn1.9O4 nanorods much more stable than LiMn2O4 against electrolyte etching, which is reflected by the magnification of both size shrinkage and conductance decrease. These results correlate well with the better cycling performance of Al-doped LiMn 2O4 in our Li-ion battery tests: LiAl0.1Mn 1.9O4 nanorods achieve 96% capacity retention after 100 cycles at 1C rate at room temperature, and 80% at 60 °C, whereas LiMn 2O4 shows worse retention of 91% at room temperature, and 69% at 60 °C. Moreover, temperature-dependent I - V measurements indicate that the sharp electronic resistance increase due to charge ordering transition at 290 K does not appear in our LiMn2O4 nanorod samples, suggesting good battery performance at low temperature. © 2009 American Chemical Society.

  3. Case Management in Primary Care for Frequent Users of Health Care Services With Chronic Diseases: A Qualitative Study of Patient and Family Experience.

    Science.gov (United States)

    Hudon, Catherine; Chouinard, Maud-Christine; Diadiou, Fatoumata; Lambert, Mireille; Bouliane, Danielle

    2015-11-01

    Although case management (CM) is increasingly being implemented to address the complex needs of vulnerable clienteles, few studies have examined the patient experience of CM. This study aimed to examine the experience of patients and their family members with care integration as part of a primary care CM intervention. Patients in the study were frequent users of health care services who had chronic diseases. A descriptive, qualitative approach was conducted involving 25 patients and 8 of their family members. Data were collected through in-depth interviews of the patients and 2 focus groups of family members and were analyzed thematically. While some participants did not fully understand the CM intervention and a few believed that it involved too many appointments, the CM nurses were patients' preferred contact with primary care. The nurses actively involved the patients in developing and carrying out their individualized services plans (ISPs) with other health care partners. Patients felt that their needs were taken into consideration, especially regarding access to the health care system. The case manager facilitated access to information as well as communication and coordination among health care and community partners. This improved communication comforted the patients and nurtured a relationship of trust. Participants were actively involved in decision-making. Their ISPs helped them know where they were going and improved transitions between services. The experience of patients and family members was overall very positive regarding care integration. They reported improved access, communication, coordination, and involvement in decision-making as well as better health care transitions. © 2015 Annals of Family Medicine, Inc.

  4. Weight Loss in Advanced Chronic Kidney Disease: Should We Consider Individualised, Qualitative, ad Libitum Diets? A Narrative Review and Case Study

    Directory of Open Access Journals (Sweden)

    Irene Capizzi

    2017-10-01

    Full Text Available In advanced chronic kidney disease, obesity may bring a survival advantage, but many transplant centres demand weight loss before wait-listing for kidney graft. The case here described regards a 71-year-old man, with obesity-related glomerulopathy; referral data were: weight 110 kg, Body Mass Index (BMI 37 kg/m2, serum creatinine (sCr 5 mg/dL, estimated glomerular filtration rate (eGFR 23 mL/min, blood urea nitrogen (BUN 75 mg/dL, proteinuria 2.3 g/day. A moderately restricted, low-protein diet allowed reduction in BUN (45–55 mg/dL and good metabolic and kidney function stability, with a weight increase of 6 kg. Therefore, he asked to be enrolled in a weight-loss program to be wait-listed (the two nearest transplant centres required a BMI below 30 or 35 kg/m2. Since previous low-calorie diets were not successful and he was against a surgical approach, we chose a qualitative, ad libitum coach-assisted diet, freely available in our unit. In the first phase, the diet is dissociated; he lost 16 kg in 2 months, without need for dialysis. In the second maintenance phase, in which foods are progressively combined, he lost 4 kg in 5 months, allowing wait-listing. Dialysis started one year later, and was followed by weight gain of about 5 kg. He resumed the maintenance diet, and his current body weight, 35 months after the start of the diet, is 94 kg, with a BMI of 31.7 kg/m2, without clinical or biochemical signs of malnutrition. This case suggests that our patients can benefit from the same options available to non-CKD (chronic kidney disease individuals, provided that strict multidisciplinary surveillance is assured.

  5. Radiotherapy of Painful Vertebral Hemangiomas: The Single Center Retrospective Analysis of 137 Cases

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    Miszczyk, Leszek, E-mail: leszek@io.gliwice.pl [Radiotherapy Department, Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Gliwice Branch, Gliwice (Poland); Tukiendorf, Andrzej [Cardiff Research Consortium, The MediCentre Eastgate House, Cardiff, South Glamorgan (United Kingdom)

    2012-02-01

    Purpose: An evaluation of dose-response relationship and an attempt to define predictive factors. Methods and Materials: A total of 137 cases of painful vertebral hemangioma irradiations (101 patients). Fraction dose (fd) varied from 2 to 15 Gy (123 fractionated and 14 radiosurgical treatments), and total dose (TD) from 8 to 30 Gy (111 cases irradiated with fd of 2 GY to TD of 24 Gy). We evaluated pain relief, changes in analgesic requirements, and reossification. Results: Means of pain relief 1, 6, 12, and 18 months after radiotherapy (defined as a decrease of primary pain level expressed in percent) were 60.5%, 65.4%, 68.3%, and 78.4%, respectively. Proportion of patients with no need for analgesics and patients using tramadol were 39%, 40%, 44%, 57%, and 20%, 17%, 22%, and 11% in these times. The proportion of patients experiencing complete/partial pain relief changed from 36/48% 1 month, to 64/22% 1.5 years after radiotherapy. No impact of radiotherapy on reossification was found. The positive impact of fd and TD increase for analgesics uptake reduction and pain relief was found. An increase of the fd by 1 Gy results in 27% chance of analgesics uptake reduction and 3.8% reduction of pain, whereas 14% analgesics uptake reduction and 2.2% of pain reduction in case of the TD. The predictive factors improving results were found: female gender, older age, better performance states (the chance of the lower analgesic treatment decreases over 2.5 times in comparison to the higher Zubrod degree), bigger Hb concentration, shorter symptoms duration and lower analgesics uptake before radiotherapy. Conclusions: The obtained data support the efficacy of radiotherapy in improving pain secondary to vertebral hemangioma, with the degree of pain amelioration being related to increasing fd and TD. The positive predictive factors were defined: female gender, older age, better performance status, increased Hb concentration, shorter symptoms duration, and lower analgesics uptake

  6. Radiotherapy of Painful Vertebral Hemangiomas: The Single Center Retrospective Analysis of 137 Cases

    International Nuclear Information System (INIS)

    Miszczyk, Leszek; Tukiendorf, Andrzej

    2012-01-01

    Purpose: An evaluation of dose–response relationship and an attempt to define predictive factors. Methods and Materials: A total of 137 cases of painful vertebral hemangioma irradiations (101 patients). Fraction dose (fd) varied from 2 to 15 Gy (123 fractionated and 14 radiosurgical treatments), and total dose (TD) from 8 to 30 Gy (111 cases irradiated with fd of 2 GY to TD of 24 Gy). We evaluated pain relief, changes in analgesic requirements, and reossification. Results: Means of pain relief 1, 6, 12, and 18 months after radiotherapy (defined as a decrease of primary pain level expressed in percent) were 60.5%, 65.4%, 68.3%, and 78.4%, respectively. Proportion of patients with no need for analgesics and patients using tramadol were 39%, 40%, 44%, 57%, and 20%, 17%, 22%, and 11% in these times. The proportion of patients experiencing complete/partial pain relief changed from 36/48% 1 month, to 64/22% 1.5 years after radiotherapy. No impact of radiotherapy on reossification was found. The positive impact of fd and TD increase for analgesics uptake reduction and pain relief was found. An increase of the fd by 1 Gy results in 27% chance of analgesics uptake reduction and 3.8% reduction of pain, whereas 14% analgesics uptake reduction and 2.2% of pain reduction in case of the TD. The predictive factors improving results were found: female gender, older age, better performance states (the chance of the lower analgesic treatment decreases over 2.5 times in comparison to the higher Zubrod degree), bigger Hb concentration, shorter symptoms duration and lower analgesics uptake before radiotherapy. Conclusions: The obtained data support the efficacy of radiotherapy in improving pain secondary to vertebral hemangioma, with the degree of pain amelioration being related to increasing fd and TD. The positive predictive factors were defined: female gender, older age, better performance status, increased Hb concentration, shorter symptoms duration, and lower analgesics uptake

  7. Twin-twin Transfusion Syndrome with a Single Ectopic Kidney in a Twin Donor. Case Presentation

    OpenAIRE

    Gerardo Rogelio Robaina Castellanos; Solangel de la Caridad Riesgo Rodríguez; Esther María Tristá Ricardo

    2016-01-01

    Twin-twin Transfusion Syndrome presents more frequently in diamniotic monochromic twins. In advanced stages and without prenatal intervention, is associated to high rates of peri natal mortality and neurological sequel in the survivors. It is presented a case of a pair of twins with severe depression at birth in which it was diagnosed a Twin-twin Transfusion Syndrome, later confirmed with the presence of anemia in the donor twin and polycythemia in the receptor twin. Both twins had an unfavou...

  8. [Development of lipoma following a single cupping massage - a case report].

    Science.gov (United States)

    Schumann, Stefan; Lauche, Romy; Hohmann, Claudia; Zirbes, Thomas; Dobos, Gustav; Saha, Felix Joyonto

    2012-01-01

    The cupping massage is a form of bloodless cupping. This type of cupping is particularly used to treat muscular tension and musculoskeletal pain, such as chronic neck pain; however the data records on mechanisms and potential side effects are not satisfactory. In a study on the effectiveness of cupping massage in patients with chronic neck pain, one patient showed a formation of a lipoma in the cupping area after the first treatment session. Because of the short time interval between therapy and development of the lipoma, a primary cause is not realistic. This adverse event has not been described in the literature before, and the present report describes the case in summary.

  9. Shower emboli and digital necrosis after a single corticosteroid injection for trigger thumb: case report.

    Science.gov (United States)

    Park, Jonathan; Dumanian, Gregory A

    2009-02-01

    Local corticosteroid injection into the hand is the preferred initial step in the management of trigger finger owing to its safety and efficacy. We report the case of a patient with shower emboli and digital necrosis after a local corticosteroid injection for the treatment of trigger thumb. Given the patient's subsequent negative hypercoagulability workup, we suspect that the patient's symptoms resulted from the injection of steroids into the princeps pollicis artery, with subsequent retrograde flow into multiple other arteries of the hand. The patient was managed conservatively and ultimately her symptoms resolved. No new areas of digital necrosis have appeared in 8 years of follow-up.

  10. Pneumococcal polyarticular septic arthritis after a single infusion of infliximab in a rheumatoid arthritis patient: a case report

    Directory of Open Access Journals (Sweden)

    Hayashi Masatoshi

    2012-03-01

    Full Text Available Abstract Introduction We present a case of Streptococcus pneumoniae polyarticular septic arthritis in a patient with rheumatoid arthritis receiving a single infusion of infliximab. Case presentation A 38-year-old Japanese man with a 5-year history of seronegative rheumatoid arthritis had previously received sulphasalazine and methotrexate therapies and was on regular low-dose prednisolone therapy. Despite these treatments, his disease activity remained high and infliximab was introduced in addition to methotrexate, prednisolone, and folic acid. However, he was admitted to hospital with a fever of 40.6°C, chills, and polyarthralgia eight days after the first infusion of infliximab. His joints were swollen, painful, and warm. Laboratory data showed marked acute inflammation. He was diagnosed with bacterial septic polyarthritis, and emergency surgical joint lavage and drainage was performed at the knees along with needle aspiration and lavage of the ankles and right wrist. He was then given intravenous antibiotic therapy for 31 days. He made a good recovery and was discharged on day 37. Conclusions We believe this is the first reported case of severe pneumococcal septic arthritis requiring hospitalization in a patient treated with infliximab. S. pneumonia is now a well-recognized but uncommon cause of polyarticular septic arthritis that can lead to cessation of therapy, as in our patient's case.

  11. A 23-year, single-center, retrospective analysis of 36 cases of acute pancreatitis in pregnancy.

    Science.gov (United States)

    Xu, Qiuxiang; Wang, Sumei; Zhang, Zhenyu

    2015-08-01

    To assess the incidence, causes, clinical characteristics, and outcomes of cases of acute pancreatitis in pregnancy (APIP). A retrospective review was conducted of the medical records of pregnant women who were diagnosed with APIP at any point during pregnancy, labor, or the puerperium and attended Beijing Chaoyang Hospital, China, between January 1, 1991, and March 31, 2014. Among 34 292 pregnant women admitted to the center during the study period, 36 patients were diagnosed with APIP. The condition developed during the second (9 [25%] cases) and third (22 [61%]) trimesters. The underlying cause was hypertriglyceridemia for 14 (39%) patients and biliary diseases for 7 (19%). Severe acute pancreatitis was significantly more common among patients with hypertriglyceridemia (11/14 [79%]) than among those without hypertriglyceridemia (6/22 [27%]; P=0.006). Additionally, complications were recorded for more patients with hypertriglyceridemia (11 [79%]) than those without hypertriglyceridemia (4 [18%]; Ppancreatitis (8/17 [47%]) than among those with mild acute pancreatitis (3/19 [16%]; P=0.039). No maternal deaths and only two perinatal deaths were recorded. The overall incidence of APIP was low; however, hypertriglyceridemia was associated with poor outcomes. Early diagnosis and prompt treatment should be implemented to improve maternal and fetal prognosis and decrease mortality. Copyright © 2015 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

  12. Cytotoxic chemotherapy for pregnancy-associated breast cancer: single institution case series.

    Science.gov (United States)

    Morris, Patrick G; King, Fionnuala; Kennedy, M John

    2009-12-01

    Pregnancy-associated (PA) breast cancer is a rare disease state that poses unique management challenges, specifically controlling the cancer and maximizing the survival of the expectant mother balanced with the health and safety of the developing fetus. As more women delay pregnancy into their 30s and 40s it is expected that this may become a more important clinical problem in the future. Existing data on PA-breast cancer comes from case series using older chemotherapy drugs. A review of practice was carried out to assess current experience with PA-breast cancer, particularly relating to current cytotoxic drugs and targeted agents. The St James's Hospital breast cancer registry, a prospectively maintained database, was used to identify cases of PA-breast cancer over a 6.5-year period and a chart review carried out. Chemotherapy administered during pregnancy, breast cancer specific outcomes, and fetal outcomes were assessed. Five patients were identified with PA-breast cancer; median age 34 years (range 28-35). The median gestation at presentation was 18 weeks (range 14-29). Four women received chemotherapy during pregnancy; three received doxorubicin and cyclophosphamide (AC) and one paclitaxel. These agents were generally well tolerated. At median gestation of 36 weeks (range 35-40 weeks) four elective caesareans and one spontaneous delivery occurred. There were no fetal abnormalities. Common cytotoxics can safely be delivered in pregnancy. Further research on newer therapies such as trastuzumab is needed.

  13. [Trans-Arterial Chemoembolization Therapy for Giant Cholangiocellular Carcinoma - A Single Case Report].

    Science.gov (United States)

    Yamashiro, Keita; Hori, Astushi; Yuki, Takeo; Ohira, Ryosuke; Hori, Shinichi

    2016-11-01

    Here, we report a case of cholangiocellular carcinoma that was successfully treated with chemotherapy using a selective intra-arterial infusion technique. A 65-year-old man presented to our hospital to obtain a second opinion regarding his disease. The patient was diagnosed with cholangiocellular carcinoma. The giant tumor was located in the porta hepatis. Some small nodules that were considered to be metastatic lesions were also observed in the surroundingarea. The tumor was judged by the primary physician to be too large for surgical treatment. Consequently, it was decided to treat the patient with trans-arterial chemoembolization(TACE)by selectingintra -arterial infusion of 5-FU, epirubicin(EPI), and mitomycin C prior to EPI-loaded HepaSphere(super-absorbent polymer microsphere)embolization, combined with concurrent systemic gemcitabine chemotherapy. After 5 sessions of the above treatment, the primary lesion reduced dramatically in size. In addition, the levels of CEA and CA19-9 decreased from 34.2 to 2.6 ng/mL and 1,540 to 149 U/mL, respectively. Although the patient's initial life expectancy was only 3 to 6 months, his life expectancy was extended to as longas 26 months followingthe initiation of TACE. This case suggests that treatment with TACE together with systemic chemotherapy can be a powerful therapeutic option for patients with inoperable cholangiocellular carcinoma.

  14. Why Public Comments Matter: The Case of the National Institutes of Health Policy on Single Institutional Review Board Review of Multicenter Studies.

    Science.gov (United States)

    Ervin, Ann-Margret; Taylor, Holly A; Ehrhardt, Stephan; Meinert, Curtis L

    2018-03-06

    In 2014, the National Institutes of Health (NIH) requested public comments on a draft policy requiring NIH-funded, U.S.-based investigators to use a single institutional review board (sIRB) for ethical review of multicenter studies. The authors conducted a directed content analysis and qualitative summary of the comments and discuss how they shaped the final policy. Two reviewers independently assessed support for the policy from a review of comments responding to the draft policy in 2016. A reviewer conducted an open text review to identify prespecified and additional comment themes. A second researcher reviewed 20% of the comments; discrepancies were resolved through discussion. The NIH received 167 comments: 65% (108/167) supportive of the policy, 23% (38/167) not supportive, and 12% (21/167) not indicating support. Clarifications or changes to the policy were suggested in 102/167 comments (61%). Criteria for selecting sIRBs were addressed in 32/102 comments (31%). Also addressed were IRB responsibilities (39/102; 38%), cost (27/102; 26%), the role of local IRBs (14/102; 14%), and allowable policy exceptions (19/102; 19%). The NIH further clarified or provided additional guidance for selection criteria, IRB responsibilities, and cost in the final policy (June 2016). Local IRB reviews and exemptions guidance were unchanged. In this case study, public comments were effective in shaping policy as the NIH modified provisions or planned supplemental guidance in response to comments. Yet critical knowledge gaps remain and empirical data are necessary. The NIH is considering mechanisms to support the establishment of best practices for sIRB implementation.

  15. Generation of national political priority for surgery: a qualitative case study of three low-income and middle-income countries.

    Science.gov (United States)

    Dare, Anna J; Bleicher, Josh; Lee, Katherine C; Elobu, Alex E; Kamara, Thaim B; Liko, Osborne; Luboga, Samuel; Danlop, Akule; Kune, Gabriel; Hagander, Lars; Leather, Andrew J M; Yamey, Gavin

    2015-04-27

    Surgical conditions exert a major health burden in low-income and middle-income countries (LMICs), yet surgery remains a low priority on national health agendas. Little is known about the national factors that influence whether surgery is prioritised in LMICs. We investigated factors that could facilitate or prevent surgery from being a health priority in three LMICs. We undertook three country case studies in Papua New Guinea, Uganda, and Sierra Leone, using a qualitative process-tracing method. In total 72 semi-structured interviews were conducted between March and June, 2014, in the three countries. Interviews were designed to query informants' attitudes, values, and beliefs about how and why different health issues, including surgical care, were prioritised within their country. Informants were providers, policy makers, civil society, funders, and other stakeholders involved with health agenda setting and surgical care. Interviews were analysed with Dedoose, a qualitative data analysis tool. Themes were organised into a conceptual framework adapted from Shiffman and Smith to assess the factors that affected whether surgery was prioritised. In all three countries, effective political and surgical leadership, access to country-specific surgical disease indicators, and higher domestic health expenditures are facilitating factors that promote surgical care on national health agendas. Competing health and policy interests and poor framing of the need for surgery prevent the issue from receiving more attention. In Papua New Guinea, surgical care is a moderate-to-high health priority. Surgical care is embedded in the national health plan and there are influential leaders with surgical interests. Surgical care is a low-to-moderate health priority in Uganda. Ineffectively used policy windows and little national data on surgical disease have impeded efforts to increase priority for surgery. Surgical care remains a low health priority in Sierra Leone. Resource constraints

  16. The nursing contribution to chronic disease management: a case of public expectation? Qualitative findings from a multiple case study design in England and Wales.

    Science.gov (United States)

    Wilson, Patricia Mary; Brooks, Fiona; Procter, Susan; Kendall, Sally

    2012-01-01

    The global response to the rise in prevalence of chronic disease is a focus on the way services are managed and delivered, in which nurses are seen as central in shaping patient experience. However, there is relatively little known on how patients perceive the changes to service delivery envisaged by chronic care models. The PEARLE project aimed to explore, identify and characterise the origins, processes and outcomes of effective chronic disease management models and the nursing contributions to the models. Design, settings and participants Case study design of seven sites in England and Wales ensuring a range of chronic disease management models. Participants included over ninety patients and family carers ranging in age from children to older people with conditions such as diabetes, respiratory disease, epilepsy, or coronary heart disease. Semi-structured interviews with patients and family carers. Focus groups were conducted with adolescents and children. A whole systems approach guided data collection and data were thematically analysed. Despite nurses' role and skill development and the shift away from the acute care model, the results suggested that patients had a persisting belief in the monopoly of expertise continuing to exist in the acute care setting. Patients were more satisfied if they saw the nurse as diagnostician, prescriber and medical manager of the condition. Patients were less satisfied when they had been transferred from an established doctor-led to nurse-led service. While nurses within the study were highly skilled, patient perception was guided by the familiar rather than most appropriate service delivery. Most patients saw chronic disease management as a medicalised approach and the nursing contribution was most valued when emulating it. Patients' preferences and expectations of chronic disease management were framed by a strongly biomedical discourse. Perceptions of nurse-led chronic disease management were often shaped by what was

  17. Effect of Maitland mobilization and exercises for the treatment of shoulder adhesive capsulitis: a single-case design.

    Science.gov (United States)

    Maricar, N; Shacklady, C; McLoughlin, L

    2009-04-01

    The purpose of this single-case design (ABCBC) was to investigate the response of shoulder motions, pain, and function to two commonly used physiotherapy management approaches. An individual with stage three shoulder adhesive capsulitis was treated with exercise (phase B) and exercise plus mobilization (phase C). Initially, a "baseline" phase (phase A) when treatment had not started was established for comparison. Two types of Maitland "accessory" glenohumeral mobilization techniques, anteroposterior mobilization in shoulder flexion and longitudinal caudad in shoulder abduction, were evaluated during phase C. The Shoulder Pain and Disability Index (SPADI) was used to monitor pain and functional disability, and four shoulder movements (flexion, abduction, internal, and external rotations) were measured. The results were evaluated by using single-case design analysis method of Split Middle Technique and visual observation. The SPADI scores deteriorated in phase A but improved in phase B1, C1, and B2. All four shoulder movements improved under both management approaches, although more gain in motion was observed when mobilizations were added to an exercise program. The exercise plus mobilization intervention shows promise as a cost-effective management. The deterioration in shoulder motion, pain, and function observed in phase A may suggest benefit of an earlier physiotherapy intervention.

  18. Spontaneous Resolution of Vesicoureteral Reflux (VUR in Iranian Children, a Single Center Experience in 533 Cases

    Directory of Open Access Journals (Sweden)

    M Sharifian

    2012-05-01

    Full Text Available

    Background and Objectives

    Experience with vesicoureteral reflux (VUR differs in different centers and there are lots of controversies surrounding this issue. The aim of this study was to evaluate Spontaneous resolution and prognosis of the disease among Iranian children.

     

    Methods

    In this case series study, 1278 children with urinary tract infection and visited at pediatric nephrology clinic in Tehran, Iran during 1999-2007 were studied. Primary VUR was found in 533 Patients. Following the diagnosis, the patients received prophylactic antibiotic and were annually followed with radionucleo cystography (RNC. Patients underwent surgery in case the medical treatment failed (breakthrough infection or new renal scar formation.

     

    Results

    533 patients with VUR were studied. Patients’ mean age with VUR was 3.7±2.4 years (range: 2 days to 18 years old. During an average follow-up duration of 3.3+2.2 years, spontaneous resolution was observed in 40% of 279 patients who had follow-up RNCs. The mean interval between VUR diagnosis and spontaneous resolution was 1.5+ 1 years (range: 2 months to 6 years. The resolution rate was decreased with increment of reflux grade so that for grades I to V, VUR was resolved in 63%, 57%, 27%, 22% and 10% of the cases, respectively. Anti reflux surgery was performed in 27(10% of patients during follow-up.

     

    Conclusion

    Based on the excellent results obtained from clinical therapy using low dose antibiotics, it is recommended that VUR grades 1 to 4 be managed medically with low-dose oral antibiotic prophylaxis and close follow-ups.

  19. Adult bacterial myositis: report of a single-center series of 26 cases

    Directory of Open Access Journals (Sweden)

    Fernando Gallucci

    2016-09-01

    Full Text Available Bacterial infections involving muscle are quite uncommon and generally require specific predisposing factors. Bacterial myositis is more rarely described in the typical kind of patients observed in Internal Medicine (presence of multiple co-morbidities, partial/limited immune-deficiency, advanced age. Twenty-six patients suffering from bacterial myositis (8 women and 18 men; mean age 58.5 years, range 27-82 observed in a single Internal Medicine Unit were reported. Muscles involved were ileopsoas, thigh, paravertebral, gluteus, calf, forearm and rectus abdomen. Simultaneous presence of arthritis was registered in 17 patients and all patients presented relevant comorbidity. Main cultured bacteria were Staphylococcus aureus, Escherichia coli, other Gram-negative bacteria, Streptococcus spp. Multi-drug-resistance was observed in 14 out 26 (53.8%. Computed tomography, ultrasound and magnetic resonance imaging were utilized for diagnostic purposes. Antibiotic treatment was administered to all patients. Surgical debridement and drainage were performed in 12 patients; 7 patients were treated with percutaneous aspiration and drainage. At discharge, relevant functional impairment was present in 17 patients (65.3%. Four patients died (in-hospital mortality 7.6%, global mortality at three months 15.3%. Management of bacterial myositis is difficult and its prognosis is poor. In the near future, this demanding infection will be more frequently observed in Internal Medicine setting as comorbidity, which is very often the main characteristic of these patients.

  20. ACUTE APPENDICITIS IN A SINGLE AND MULTIPLE PREGNANCY – A STUDY OF TWO CASES

    Directory of Open Access Journals (Sweden)

    Olga Adamczyk-Gruszka

    2013-11-01

    Full Text Available Appendicitis during pregnancy is a diagnostic and therapeutic problem. Removal of the appendix due to acute inflammation is one of the most difficult surgeries performed when immediate indications are concerned. Diagnosis and a decision on eligibility for the surgery are based on clinical criteria, subjective data from an interview and physical examination. The reason for great diagnostic difficulties and the not-so-rare mistakes in diagnosis of pregnant women is the anatomy of the abdominal cavity altered by the uterus during pregnancy. Some of the symptoms of appendicitis may be mistakenly interpreted as symptoms occurring typically in pregnancy. In pregnant women, the decision on eligibility for surgery is of special importance, because one must take into consideration the threat to foetal health. The diagnostic difficulties of differentiating this affliction in different trimesters of pregnancy in single and twin pregnancies have been discussed in the paper. An assessment was made of the influence of surgical treatment on further development of the pregnancy and development of the foetuses. Both pregnancies ended in Caesarean sections. The first one in the 37th week due to obstetric indications – a twin pregnancy with breech presentation of the first foetus; the second one in the 37th week with a simultaneous removal of the appendix.

  1. The measurement of the vertical component of hydraulic conductivity in single-cased and uncased boreholes

    International Nuclear Information System (INIS)

    Black, J.H.; Noy, D.J.; Brightman, M.A.

    1987-01-01

    The project aimed to assess the different existing methods of measuring vertical hydraulic conductivity in single boreholes by carrying out some actual field testing. A review of existing techniques for both field practice and analysis of the results is reported. After consideration of the various techniques a combination method of testing is proposed. A set of equipment to carry out this combination of tests was designed and built. The uncased testing revealed that it was possible to derive a value for vertical hydraulic conductivity. The doublet method, however, was not particularly successful and numerical simulation was cumbersome. The type-curve approach of appraising whether or not analysis concepts were appropriate proved the most robust method. It is clear that reconnaissance measurements of environmental pressure are very useful in defining where detailed testing should take place. The second phase of testing through perforations proved very difficult. There were many problems associated with location both of the wireline testing system within the borehole and especially of the previous measurements. However, analysis of the results in terms of skin indicated that the perforations produced a negative skin. The measurement of vertical hydraulic conductivity cannot at the moment be regarded as routine

  2. Current trend of annotating single nucleotide variation in humans--A case study on SNVrap.

    Science.gov (United States)

    Li, Mulin Jun; Wang, Junwen

    2015-06-01

    As high throughput methods, such as whole genome genotyping arrays, whole exome sequencing (WES) and whole genome sequencing (WGS), have detected huge amounts of genetic variants associated with human diseases, function annotation of these variants is an indispensable step in understanding disease etiology. Large-scale functional genomics projects, such as The ENCODE Project and Roadmap Epigenomics Project, provide genome-wide profiling of functional elements across different human cell types and tissues. With the urgent demands for identification of disease-causal variants, comprehensive and easy-to-use annotation tool is highly in demand. Here we review and discuss current progress and trend of the variant annotation field. Furthermore, we introduce a comprehensive web portal for annotating human genetic variants. We use gene-based features and the latest functional genomics datasets to annotate single nucleotide variation (SNVs) in human, at whole genome scale. We further apply several function prediction algorithms to annotate SNVs that might affect different biological processes, including transcriptional gene regulation, alternative splicing, post-transcriptional regulation, translation and post-translational modifications. The SNVrap web portal is freely available at http://jjwanglab.org/snvrap. Copyright © 2014 Elsevier Inc. All rights reserved.

  3. Erica the Rhino: A Case Study in Using Raspberry Pi Single Board Computers for Interactive Art

    Directory of Open Access Journals (Sweden)

    Philip J. Basford

    2016-06-01

    Full Text Available Erica the Rhino is an interactive art exhibit created by the University of Southampton, UK. Erica was created as part of a city wide art trail in 2013 called “Go! Rhinos”, curated by Marwell Wildlife, to raise awareness of Rhino conservation. Erica arrived as a white fibreglass shell which was then painted and equipped with five Raspberry Pi Single Board Computers (SBC. These computers allowed the audience to interact with Erica through a range of sensors and actuators. In particular, the audience could feed and stroke her to prompt reactions, as well as send her Tweets to change her behaviour. Pi SBCs were chosen because of their ready availability and their educational pedigree. During the deployment, ‘coding clubs’ were run in the shopping centre where Erica was located, and these allowed children to experiment with and program the same components used in Erica. The experience gained through numerous deployments around the country has enabled Erica to be upgraded to increase reliability and ease of maintenance, whilst the release of the Pi 2 has allowed her responsiveness to be improved.

  4. Five Simultaneous Primary Tumors in a Single Patient: A Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Casey W. Williamson

    2015-10-01

    Full Text Available Multiple primary malignancies (MPMs are present when a patient is diagnosed with more than one primary malignancy and when each tumor is histologically unrelated to the others. MPMs are considered synchronous when they present within 6 months of one another. Here, we report the case of a 57-year-old woman with a past medical history significant for melanoma in 1988, who presented in 2014 with 5 distinct tumors within 4 months: malignant melanoma of the right popliteal fossa, invasive lobular breast carcinoma, diffuse large B cell lymphoma, nodular lymphocyte predominant Hodgkin lymphoma, and a giant cell tumor of tendon sheath/pigmented villonodular synovitis. We discuss her treatment and also present a brief review of the literature. The incidence of MPMs appears to be on the rise, which demands an interdisciplinary, multimodal, and personalized approach to care.

  5. Deletion of a single-copy DAAM1 gene in congenital heart defect: a case report

    Directory of Open Access Journals (Sweden)

    Bao Bihui

    2012-08-01

    Full Text Available Abstract Background With an increasing incidence of congenital heart defects (CHDs in recent years, genotype-phenotype correlation and array-based methods have contributed to the genome-wide analysis and understanding of genetic variations in the CHD population. Here, we report a copy number deletion of chromosomal 14q23.1 in a female fetus with complex congenital heart defects. This is the first description of DAAM1 gene deletion associated with congenital heart anomalies. Case Presentation Compared with the control population, one CHD fetus showed a unique copy number deletion of 14q23.1, a region that harbored DAAM1 and KIAA0666 genes. Conclusions Results suggest that the copy number deletion on chromosome 14q23.1 may be critical for cardiogenesis. However, the exact relationship and mechanism of how DAAM1 and KIAA0666 deletion contributes to the onset of CHD is yet to be determined.

  6. Early management of mesenteric cyst prevents catastrophes: A single centre analysis of 17 cases

    Directory of Open Access Journals (Sweden)

    Prakash Advait

    2010-01-01

    Full Text Available Background: Mesenteric cysts are rare intra-abdominal masses in the paediatric age group with varied presentation, ranging from an asymptomatic mass to acute abdomen. This study reviews our experience in the diagnosis and treatment of 17 mesenteric cysts in our centre, with especial reference to acute abdominal symptoms. Patients and Methods: Seventeen patients (age less than 10 years with mesenteric cysts were managed in our hospital. The age ranged from 15 days to 10 years. Patients were admitted with acute or chronic symptoms. They were evaluated with complete history, clinical examination, blood investigations and radiological investigations (x-ray abdomen erect, ultrasound abdomen (USG and computed tomography (CT scan in selected cases to reach a provisional diagnosis. The diagnosis was proven on laparotomy and histologically confirmed. Results: The main presenting symptoms were abdominal pain or lump. The most common mode of presentation was acute small intestinal obstruction. USG was not conclusive in all. Abdominal CT scan with intravenous contrast was diagnostic in nine patients. Five patients had volvulus on exploration. Cysts were located in small intestinal mesentery in 14 cases and three were in the sigmoid mesentery. Seven patients had complete excision, intestinal resection was required in four and marsupialisation with cauterisation of margins was done in six patients. Histologically, all were lymphangiomatous mesenteric cysts. Conclusion: The diagnosis of mesenteric cysts should be kept in mind in any patient presenting with acute abdominal symptoms. Small bowel volvulus with mesenteric cyst constituted a significant number in children with acute abdominal symptoms. Early diagnosis and treatment yields excellent outcome.

  7. Evaluating statistical and clinical significance of intervention effects in single-case experimental designs: an SPSS method to analyze univariate data

    NARCIS (Netherlands)

    Maric, Marija; de Haan, Else; Hogendoorn, Sanne M.; Wolters, Lidewij H.; Huizenga, Hilde M.

    2015-01-01

    Single-case experimental designs are useful methods in clinical research practice to investigate individual client progress. Their proliferation might have been hampered by methodological challenges such as the difficulty applying existing statistical procedures. In this article, we describe a

  8. Evaluating statistical and clinical significance of intervention effects in single-case experimental designs: An SPSS method to analyze univariate data

    NARCIS (Netherlands)

    Maric, M.; de Haan, M.; Hogendoorn, S.M.; Wolters, L.H.; Huizenga, H.M.

    2015-01-01

    Single-case experimental designs are useful methods in clinical research practice to investigate individual client progress. Their proliferation might have been hampered by methodological challenges such as the difficulty applying existing statistical procedures. In this article, we describe a

  9. Retrospective evaluation of borderline ovarian tumors: single center experience of 183 cases.

    Science.gov (United States)

    Gungor, Tayfun; Cetinkaya, Nilufer; Yalcin, Hakan; Ozdal, Bulent; Ozgu, Emre; Baser, Eralp; Uygur, Dilek; Caglar, Mete; Sirvan, Levent; Erkaya, Salim

    2015-01-01

    Borderline ovarian tumors (BOTs) constitute about a quarter of epithelial ovarian malignancies and require different treatment approaches. The present study aims to document the experience of a single center on the treatment outcome of women who had conservative or comprehensive surgery for BOTs. One hundred eighty-three patients with BOTs, diagnosed and/or treated in our center between January of 2000 and March of 2013, were reviewed retrospectively. The mean age at diagnosis was 40.6 years old (range 17-78). Ninety-five patients (51 %) were ≤40 years. Comprehensive surgical staging and fertility sparing surgery were performed in 49 % (n = 91) and 48 % of patients (n = 89) respectively. A hundred and forty-seven patients had stage IA disease (80 %). The most common type of BOT was serous in histology with 18 % bilateralism. CA-125 and CA-199 levels were increased in 29 (19 %) and 15 (10 %) patients with stage IA disease. Non-invasive tumor implants were diagnosed in 9 patients (4 %) and uterine involvement was 2 % among BOT patients that underwent hysterectomies. The mean post-operative follow-up period was 20.4 months (range 6-78 months). Disease recurrence was seen in 5 patients indicating overall recurrence rate of 2.7 %. In our study, we evaluated a large data pool of 183 patients diagnosed with borderline epithelial ovarian tumors. BOTs have a relatively better prognosis than invasive epithelial ovarian cancer. Surgery with proper staging is the cornerstone of treatment. Patients with BOTs at the early stage can undergo fertility sparing surgery with close follow-up.

  10. Bilateral single-port thoracoscopic extended thymectomy for management of thymoma and myasthenia gravis: case report.

    Science.gov (United States)

    Caronia, Francesco Paolo; Fiorelli, Alfonso; Arrigo, Ettore; Trovato, Sebastiano; Santini, Mario; Monte, Attilio Ignazio Lo

    2016-11-22

    Video-assisted thoracoscopy is become a widely accepted approach for the resection of anterior mediastinal masses, including thymoma. The current trend is to reduce the number of ports and minimize the length of incisions to further decrease postoperative pain, chest wall paresthesia, and length of hospitalization. Herein, we reported an extended resection of thymoma in a patient with myasthenia gravis through an uniportal bilateral thoracoscopic approach. A 74 years old woman with myasthenia gravis was referred to our attention for management of a 3.5 cm, well capsulate, thymoma. All laboratory and cardio-pulmonary tests were within normal; thus, she was scheduled for thymoma resection through an uniportal bilateral thoracoscopic approach. Under general anaesthesia and selective intubation, the patient was placed in a 60° right lateral decubitus. A 3 cm skin incision was performed in the fourth right intercostal space and, through that a 30° video-camera and working instruments were inserted without rib spreading. After complete dissection of the thymus and mediastinal fat, the contralateral pleura was opened, and, through that the specimen was pushed into the left pleural cavity. Then, the patient was placed in the left lateral decubitus. Similarly to the right side procedure, a 3-cm incision was performed in the fourth left intercostal space to complete thymic dissection and retrieve the specimen. No intraoperative and post-operative complications were found. The patient was discharged four days later. Pathological examination revealed a type A thymoma (Masaoka stage I). No recurrence was found at 18 months of follow-up CONCLUSIONS: Bilateral single-port thoracoscopy is an available procedure for management of thymoma associated with myasthenia gravis. The less post-operative pain, the reduction of hospital stay and the better esthetic results are all potential advantages of this approach over traditional technique. Obviously, our impression should be

  11. Efficacy of Dapsone in the Treatment of Pemphigus Vulgaris: A Single-Center Case Study.

    Science.gov (United States)

    Baum, Sharon; Debby, Assaf; Gilboa, Sarit; Trau, Henri; Barzilai, Aviv

    2016-01-01

    Pemphigus vulgaris (PV) is a chronic autoimmune blistering disease. Most patients require long-term therapy with systemic steroids, and a steroid-sparing agent is usually also utilized. Dapsone is a chemotherapeutic agent with anti-inflammatory properties that is used as a steroid-sparing agent in PV. The aim of the present study was to evaluate the efficacy of dapsone as an adjuvant therapy in patients with PV. A retrospective analysis of patients' files was performed. All 26 patients included in the study group were treated with dapsone as an adjuvant to systemic steroids for at least 3 consecutive months and were followed up during their dapsone treatment period. After 3 months of treatment with dapsone, 13 patients were in the consolidation phase, 4 patients demonstrated partial remission on minimal therapy, 7 patients demonstrated complete remission on minimal therapy, and 2 patients were defined as treatment failures. The trend of clinical improvement continued after 6 months of treatment and at the study end point. This retrospective case series, one of the largest reported, indicates that dapsone is efficacious and safe for patients with PV in whom it is well tolerated soon after the initiation of treatment. © 2016 S. Karger AG, Basel.

  12. Solid pseudopapillary tumors of the pancreas: 27 cases from a single institution

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    ZHOU Haiyang

    2013-01-01

    Full Text Available ObjectiveTo summarize the clinicopathologic features and treatment outcomes of solid pseudopapillary tumors (SPTs of the pancreas. MethodsTwenty-seven cases of SPT of the pancreas admitted for treatment to the Peking University Cancer Hospital between September 2008 and September 2012 were retrospectively analyzed. ResultsThe majority of the pancreatic SPT patients were young adults (median age: 29 years old and females (85.2%. All 27 patients were treated with surgical resection using pancreaticoduodenectomy (n=4, duodenum preserving pancreatic tumor resection (n=6, middle pancreatectomy (n=5, distal pancreatectomy (n=5, or distal pancreatectomy plus splenectomy (n=7. The minimum tumor diameter was 1.5 cm, the maximum diameter was 12.0 cm, and the average diameter was 5.4 cm. Twelve patients developed pancreatic leakage and pyrexia following the operation. One patient suffered splenic artery hemorrhage. All 27 patients survived and completed follow-up. Only one patient developed recurrence, which was treated by a second surgical resection, and all other patients showed no clinical signs of recurrence or metastasis. ConclusionSPT of the pancreas has uncertain malignant potential with good prognosis. Radical resection with preservation of the surrounding tissues is an effective and safe treatment for SPT.

  13. Single-centre experience on transthyretin familial amyloid polyneuropathy: case series and literature review.

    Science.gov (United States)

    Martens, Broes; De Pauw, Michel; De Bleecker, Jan L

    2018-03-09

    Familial amyloid polyneuropathy (FAP) is a most often length-dependent axonal neuropathy, often part of a multisystem disorder also affecting other organs, such as cardiac, gastrointestinal, genitourinary, renal, meningeal and eye tissue. It is most frequently the result of a mutation in the TTR gene, most commonly a p.Val50Met mutation. TTR-FAP is a rare autosomal dominant heritable disabling, heterogeneous disease in which early diagnosis is of pivotal importance when attempting treatment. This paper discusses the course of four Belgian FAP patients with different TTR mutations (p.Val48Met; p.Val52Ala; p.Ala59Val; p.Val50Met). We also review the diagnosis and differential diagnosis of TTR-FAP, diagnostic studies, follow-up, its current treatment and those in development, prognosis and the importance of genetic counseling. At first, TTR-FAP is often misdiagnosed as a chronic inflammatory demyelinating polyneuropathy or chronic idiopathic axonal polyneuropathy. Genetic testing is obligatory to confirm the diagnosis of TTR-FAP, except in familial cases. Biopsy samples are an asset in diagnosing TTR-FAP but can be falsely negative. At the moment, tafamidis meglumine is considered as first-line treatment in stage I neurological disease. Patients eligible for liver transplantation should be carefully selected when first-line therapy fails.

  14. Improving social cognition in people with schizophrenia with RC2S: two single-case studies

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    Elodie ePEYROUX

    2016-04-01

    Full Text Available Difficulties in social interactions are a central characteristic of people with schizophrenia, and can be partly explained by impairments of social cognitive processes. New strategies of cognitive remediation have been recently developed to target these deficits. The RC2S therapy is an individualized and partly computerized program through which patients practice social interactions and develop social cognitive abilities with simulation techniques in a realistic environment. Here we present the results of two case studies involving two patients with schizophrenia presenting with specific profiles of impaired social cognition. Each patient completed three baseline sessions, 14 treatment sessions, and three follow up sessions at the end of the therapy – and for one patient, another three sessions nine months later. We used a multiple baseline design to assess specific components of social cognition according to the patients’ profiles. Functioning and symptomatology were also assessed at the end of the treatment and six months later. Results highlight significant improvements in the targeted social cognitive processes and positive changes in functioning in the long term. The RC2S program seems thus to be a new useful program for social cognitive remediation in schizophrenia.

  15. Improving Social Cognition in People with Schizophrenia with RC2S: Two Single-Case Studies

    Science.gov (United States)

    Peyroux, Elodie; Franck, Nicolas

    2016-01-01

    Difficulties in social interactions are a central characteristic of people with schizophrenia, and can be partly explained by impairments of social cognitive processes. New strategies of cognitive remediation have been recently developed to target these deficits. The RC2S therapy is an individualized and partly computerized program through which patients practice social interactions and develop social cognitive abilities with simulation techniques in a realistic environment. Here, we present the results of two case-studies involving two patients with schizophrenia presenting with specific profiles of impaired social cognition. Each patient completed three baseline sessions, 14 treatment sessions, and 3 follow-up sessions at the end of the therapy – and for 1 patient, another 3 sessions 9 months later. We used a multiple baseline design to assess specific components of social cognition according to the patients’ profiles. Functioning and symptomatology were also assessed at the end of the treatment and 6 months later. Results highlight significant improvements in the targeted social cognitive processes and positive changes in functioning in the long term. The RC2S program seems, thus, to be a new useful program for social cognitive remediation in schizophrenia. PMID:27199776

  16. Minimally invasive spine surgery in lumbar spondylodiscitis: a retrospective single-center analysis of 67 cases.

    Science.gov (United States)

    Tschugg, Anja; Hartmann, Sebastian; Lener, Sara; Rietzler, Andreas; Sabrina, Neururer; Thomé, Claudius

    2017-12-01

    Minimally invasive surgical techniques have been developed to minimize tissue damage, reduce narcotic requirements, decrease blood loss, and, therefore, potentially avoid prolonged immobilization. Thus, the purpose of the present retrospective study was to assess the safety and efficacy of a minimally invasive posterior approach with transforaminal lumbar interbody debridement and fusion plus pedicle screw fixation in lumbar spondylodiscitis in comparison to an open surgical approach. Furthermore, treatment decisions based on the patient´s preoperative condition were analyzed. 67 patients with lumbar spondylodiscitis treated at our department were included in this retrospective analysis. The patients were categorized into two groups based on the surgical procedure: group (MIS) minimally invasive lumbar spinal fusion (n = 19); group (OPEN) open lumbar spinal fusion (n = 48). Evaluation included radiological parameters on magnetic resonance imaging (MRI), laboratory values, and clinical outcome. Preoperative MRI showed higher rates of paraspinal abscess (35.5 vs. 5.6%; p = 0.016) and multilocular location in the OPEN group (20 vs. 0%, p = 0.014). Overall pain at discharge was less in the MIS group: NRS 2.4 ± 1 vs. NRS 1.6 ± 1 (p = 0.036). The duration of hospital stay was longer in the OPEN than the MIS group (19.1 ± 12 days vs. 13.7 ± 5 days, p = 0.018). The open technique is effective in all varieties of spondylodiscitis inclusive in epidural abscess formation. MIS can be applied safely and effectively as well in selected cases, even with epidural abscess.

  17. Percutaneous Nephrolithotomy: Our Results of a Single-Centre Analysis in 2300 Cases

    Directory of Open Access Journals (Sweden)

    Akif Erbin

    2014-03-01

    Full Text Available Aim: In this study, we evaluated the results of 2300 patients who underwent percutaneous nephrolithotomy (PNL between March 2002 and April 2013. Methods: In our clinic, a total of 2300 PNL operations were performed between March 2002 - April 2013. Demographic characteristics (age, gender, body mass index, stone features (side, size, location, clinical characteristics of the urinary tract (renal anomaly, previous surgery, previous extracorporeal shock wave lithotripsy, operation parameters (duration of the intervention and fluoroscopy, number of access, location of access, transfusion, complications, post-operative data (length of hospital stay, transfusion, complications, stone-free were recorded on PNL forms. The data were analyzed retrospectively. Results: Of all the PNL operations, 1225 (53.2% were left-sided, 1074 (46.6% were right-sided and 1 was bilateral. The mean age of the subjects was 43.5 (7-83 years and the mean body mass index was 26.6 kg/m2 (12-51. A total of 46 (2% cases had renal anomalies. There were 16 patients with horseshoe kidney. More than one accesses was performed in 18.6% of the patient and intercostal access was done in 9.8%. Perioperative and post-operative transfusion rates were 1.4% and 2.9%, respectively. The mean stone size was 7.5±4.1 cm2. Stone-free (SF rate was 65.1% and success rate was 78.5%. Conclusion: With increasing experience and advances in endourology, PNL is being widely performed with low morbidity and high success in our country as in the world. (The Me­di­cal Bul­le­tin of Ha­se­ki 2013; 51: 19-24

  18. Traumatic spinal cord injury in Tianjin, China: a single-center report of 354 cases.

    Science.gov (United States)

    Zhou, Y; Wang, X-B; Kan, S-L; Ning, G-Z; Li, Y-L; Yang, B; Li, Y; Sun, J-C; Feng, S-Q

    2016-09-01

    Hospital-based retrospective study. The objective of this study was to describe the epidemiological profile of traumatic spinal cord injury (TSCI) in Tianjin Medical University General Hospital, China, from 2009 to 2014. Tianjin Medical University General Hospital. Hospital medical records of patients with TSCI admitted to hospital from 1 January 2009 to 31 December 2014 were reviewed. Collected variables included gender, age, marital status, ethnic group, occupation, etiology, neurological level of injury, American Spinal Injury Association (ASIA)-ISCoS impairment scale at admission, the severity, death and its cause, concomitant injuries and treatment choice. During the study period, 354 cases were identified. Male-to-female ratio was 2.34:1, with a mean age of 50.1±15.5 years. Falls (55.1%), comprising low falls and high falls (33.6% and 21.5%, respectively), were the leading cause, followed by motor vehicle collisions (MVCs) (35.9%). The most common injury site was the cervical spinal cord, especially C4-C6, accounting for 59.3%. Surgery was the major treatment choice (57.6%). The number of TSCI patients increased annually in our center. The mean age at the time of injury was older, and the proportion of males was higher. The leading two causes were falls and MVCs. The SCIs caused by MVCs were increasing. Peasants, workers and unemployed individuals were those at higher risk. Surgery was the major treatment choice. These data may be useful to implement those preventive strategies focused on the characteristics of different groups and pay more attention to high-risk populations.

  19. An intronic single-nucleotide polymorphism (rs13217795) in FOXO3 is associated with asthma and allergic rhinitis: a case-case-control study.

    Science.gov (United States)

    Amarin, Justin Z; Naffa, Randa G; Suradi, Haya H; Alsaket, Yousof M; Obeidat, Nathir M; Mahafza, Tareq M; Zihlif, Malek A

    2017-11-15

    Asthma and allergic rhinitis are respiratory diseases with a significant global burden. Forkhead box O3 (FOXO3) is a gene involved in the etiology of a number of respiratory diseases. The objective of this study is to assess the association of rs13217795, an intronic FOXO3 single-nucleotide polymorphism, with asthma and allergic rhinitis. In this case-case-control genetic association study, genotyping was conducted using the PCR-RFLP method. Genotype-based associations were investigated under the general, recessive, and dominant models of disease penetrance using binomial logistic regression; and, allele-based associations were tested using Pearson's chi-squared test. The final study population consisted of 94 controls, 124 asthmatics, and 110 allergic rhinitis patients. The general and recessive models of disease penetrance were statistically significant for both case-control comparisons. Under the general model, the odds of the asthma phenotype were 1.46 (0.64 to 3.34) and 3.42 (1.37 to 8.57) times higher in heterozygotes and derived allele homozygotes, respectively, compared to ancestral allele homozygotes. The corresponding odds ratios for the allergic rhinitis phenotype were 1.05 (0.46 to 2.40) and 2.35 (0.96 to 5.73), respectively. The dominant model of disease penetrance was not statistically significant. The minor allele in all study groups was the ancestral allele, with a frequency of 0.49 in controls. There was no deviation from Hardy-Weinberg equilibrium in controls. Both case-control allele-based associations were statistically significant. Herein we present the first report of the association between rs13217795 and allergic rhinitis, and the first independent verification of the association between rs13217795 and asthma. Marker selection in future genetic association studies of asthma and allergic rhinitis should include functional polymorphisms in linkage disequilibrium with rs13217795.

  20. Strengths, weaknesses, opportunities, and threats analysis of integrating the World Health Organization patient safety curriculum into undergraduate medical education in Pakistan: a qualitative case study

    Directory of Open Access Journals (Sweden)

    Samreen Misbah

    2017-12-01

    Full Text Available Purpose The purpose of this study was to conduct a strengths, weaknesses, opportunities, and threats (SWOT analysis of integrating the World Health Organization (WHO patient safety curriculum into undergraduate medical education in Pakistan. Methods A qualitative interpretive case study was conducted at Riphah International University, Islamabad, from October 2016 to June 2017. The study included 9 faculty members and 1 expert on patient safety. The interviews were audiotaped, and a thematic analysis of the transcripts was performed using NVivo software. Results Four themes were derived based on the need analysis model. The sub-themes derived from the collected data were arranged under the themes of strengths, weaknesses, opportunities, and threats, in accordance with the principles of SWOT analysis. The strengths identified were the need for a formal patient safety curriculum and its early integration into the undergraduate program. The weaknesses were faculty awareness and participation in development programs. The opportunities were an ongoing effort to develop an appropriate curriculum, to improve the current culture of healthcare, and to use the WHO curricular resource guide. The threats were attitudes towards patient safety in Pakistani culture, resistance to implementation from different levels, and the role of regulatory authorities. Conclusion The theme of patient safety needs to be incorporated early into the formal medical education curriculum, with the main goals of striving to do no harm and seeing mistakes as opportunities to learn. Faculty development activities need to be organized, and faculty members should to be encouraged to participate in them. The lack of a patient safety culture was identified as the primary reason for resistance to this initiative at many levels. The WHO curriculum, amended according to local institutional culture, can be implemented appropriately with support from the corresponding regulatory bodies.

  1. Strengths, weaknesses, opportunities, and threats analysis of integrating the World Health Organization patient safety curriculum into undergraduate medical education in Pakistan: a qualitative case study.

    Science.gov (United States)

    Misbah, Samreen; Mahboob, Usman

    2017-01-01

    The purpose of this study was to conduct a strengths, weaknesses, opportunities, and threats (SWOT) analysis of integrating the World Health Organization (WHO) patient safety curriculum into undergraduate medical education in Pakistan. A qualitative interpretive case study was conducted at Riphah International University, Islamabad, from October 2016 to June 2017. The study included 9 faculty members and 1 expert on patient safety. The interviews were audiotaped, and a thematic analysis of the transcripts was performed using NVivo software. Four themes were derived based on the need analysis model. The sub-themes derived from the collected data were arranged under the themes of strengths, weaknesses, opportunities, and threats, in accordance with the principles of SWOT analysis. The strengths identified were the need for a formal patient safety curriculum and its early integration into the undergraduate program. The weaknesses were faculty awareness and participation in development programs. The opportunities were an ongoing effort to develop an appropriate curriculum, to improve the current culture of healthcare, and to use the WHO curricular resource guide. The threats were attitudes towards patient safety in Pakistani culture, resistance to implementation from different levels, and the role of regulatory authorities. The theme of patient safety needs to be incorporated early into the formal medical education curriculum, with the main goals of striving to do no harm and seeing mistakes as opportunities to learn. Faculty development activities need to be organized, and faculty members should to be encouraged to participate in them. The lack of a patient safety culture was identified as the primary reason for resistance to this initiative at many levels. The WHO curriculum, amended according to local institutional culture, can be implemented appropriately with support from the corresponding regulatory bodies.

  2. Practice organisational characteristics can impact on compliance with the BTS/SIGN asthma guideline: qualitative comparative case study in primary care.

    Science.gov (United States)

    Wiener-Ogilvie, Sharon; Huby, Guro; Pinnock, Hilary; Gillies, John; Sheikh, Aziz

    2008-06-04

    Although the BTS-SIGN asthma guideline is one of the most well known and widely respected guidelines in the world, implementation in UK primary care remains patchy. Building on extensive earlier descriptive work, we sought to explore the way teamwork and inter-professional relationships impact on the implementation of the BTS-SIGN guideline on asthma in general practice. Qualitative comparative case study using nine in-depth interviews and 2 focus groups with general practitioners and practice nurses, involved in delivering asthma care. Participants were purposively recruited from practices in a Scottish health board with high and low compliance with the BTS-SIGN asthma guideline. There was a marked difference in the way respondents from practices with high compliance and respondents from practices with low compliance spoke about the value of guidelines and the challenges of implementing them. On both accounts, the former were more positive than the latter and were able to be more specific about the strategies they used to overcome barriers to implementation. We explored the reason for this difference in response and identified practice organisation, centring on delegation of work to nurses, as a factor mediating the practice's level of compliance. Effective delegation was underpinned by organisation of asthma work among practice members who have the appropriate level of skills and knowledge, know and understand each others' work and responsibilities, communicate well among themselves and trust each others' skills. It was the combination of these factors which made for successful delegation and guideline implementation, not any one factor in isolation. In our sample of practices, teamwork and organisation of care within practices appeared to impact on guideline implementation and further larger studies are needed to explore this issue further. Isolated interventions such as measures to improve staff's knowledge or increased clinical resource and time, which are

  3. Ethical challenges for international collaborative research partnerships in the context of the Zika outbreak in the Dominican Republic: a qualitative case study.

    Science.gov (United States)

    Canario Guzmán, Julio Arturo; Espinal, Roberto; Báez, Jeannette; Melgen, Ricardo Elias; Rosario, Patricia Antonia Pérez; Mendoza, Eddys Rafael

    2017-09-25

    The establishment of international collaborative research partnerships in times of infectious disease outbreaks of international importance has been considered an ethical imperative. Frail health research systems in low- and middle-income countries can be an obstacle to achieve the goal of knowledge generation and the search for health equity before, during and after infectious disease outbreaks. A qualitative case study was conducted to identify the challenges and opportunities facing the Dominican Republic with regards to developing international collaborative research partnerships in the context of the Zika outbreak and its ethical implications. Researchers conducted 34 interviews (n = 30 individual; n = 4 group) with 39 participants (n = 23 males; n = 16 females) representing the government, universities, international donor agencies, non-governmental organisations, community-based organisations and medical societies, in two metropolitan cities. Five international collaborative research projects related to the Zika virus were identified. Major ethical challenges were linked to the governance of health research, training of human resources, the institutionalisation of scientific activity, access to research funds and cultural aspects. Capacity-building was not necessarily a component of some partnership agreements. With few exceptions, local researchers were merely participating in data collection and less on defining the problem. Opportunities for collaborative work included the possibility of participation in international research consortiums through calls for proposals. The Dominican government and research stakeholders can contribute to the international response to the Zika virus through active participation in international collaborative research partnerships; however, public recognition of the need to embrace health research as part of public policy efforts is warranted. A working group led by the government and formed by national and

  4. The evolution of the national licensing system of health care professionals: a qualitative descriptive case study in Lao People's Democratic Republic.

    Science.gov (United States)

    Sonoda, Miwa; Syhavong, Bounkong; Vongsamphanh, Chanphomma; Phoutsavath, Phisith; Inthapanith, Phengdy; Rotem, Arie; Fujita, Noriko

    2017-08-07

    The introduction of a systematic framework for the licensing of health care professions, which is a crucial step in ensuring the quality of human resources for health (HRH), is still evolving in Lao People's Democraic Republic. The aim of this study was to review and document the evolution of Lao HRH policies and the development of its national licensing system. A qualitative descriptive case study methodology was applied to document and describe how Lao People's Democratic Republic laid the foundation for the development of a licensing system. The results demonstrate that Lao People's Democratic Republic is currently in the process of transitioning the focus of its HRH policies from the quantity and deployment of services to remote areas to improvements in the quality of services. The key events in the process of developing the licensing system are as follows: (1) the systematic development of relevant policies and legislation, (2) the establishment of responsible organizations and the assignment of responsible leaders, (3) the acceleration of development efforts in response to the Association of Southeast Asian Nations Mutual Recognition Arrangement for standard qualifications, (4) the strengthening of educational systems for fostering competent health care professionals, (5) the introduction of a 3-year compulsory service component in rural areas for newly recruited government servants, and (6) the introduction of a requirement to obtain a professional health care certificate to work in a private hospital. The Lao Ministry of Health (MOH) has endorsed a specific strategy for licensing to realize this system. The need for licensing systems has increased in recent years due to regional economic integration and a shift in policy toward achieving universal health coverage. A national licensing system would be a significant milestone in health system development, helping to ensure the competency of health care professionals by means of a national examination

  5. Reliability centered maintenance : a case study of railway transit maintenance to achieve optimal performance.

    Science.gov (United States)

    2010-12-01

    The purpose of this qualitative case study was to identify the types of obstacles and patterns experienced by a single heavy rail transit agency located in North America that embedded a Reliability Centered Maintenance (RCM) Process. The outcome of t...

  6. Capitalizing on technology for developing communication skills in autism spectrum disorder: a single case study.

    Science.gov (United States)

    Mohan, Veena; Kunnath, Suja Kurian; Philip, Vineetha Sara; Mohan, Lakshmi Santha; Thampi, Neethu

    2017-12-15

    In this case study, we discuss the application of a patient-centred clinical approach that led to the use of an assisted communication platform to combat severe communicative deficit in a child with autism spectrum disorder (ASD). Initial assessment at four years of age revealed that the patient had rudimentary communication skills, with significant sensory integration dysfunction manifested as oral, olfactory, and tactile seeking behaviours; self-stimulatory behaviour; and complete dependence on caregiver for activities of daily living. Intensive, multi-disciplinary intervention resulted in minimal improvement in communicative skills and sensory seeking over six months. Subsequently, a tailor-made picture-assisted communication training with the mother as the communication facilitator was adopted. This approach was abandoned due to the patient's poor response and mother's low acceptance of picture-based interaction. A preference for printed material was observed in the patient. Accordingly, further management was focused on employing a computer-based interactive platform that the patient was taught to use over the course of a few months as a part of augmentative and alternative communication (AAC) intervention program. This resulted in a remarkable improvement in the child's skills that now allowed for a better intentional communication of his thoughts and needs. This study highlights the importance of revisiting conventional rehabilitation strategies for communicative deficits and tailoring them according to the patient's needs and preferences. It also emphasises that besides excellent observation skills, clinicians must be willing to consider technology based approaches in patients responding poorly to traditional approaches in order to develop effective interventional programmes. Implication for Rehabilitation The current study highlights the importance of exploring the application of technology based intervention for building communication skills in the early

  7. Ensembles generated from crystal structures of single distant homologues solve challenging molecular-replacement cases in AMPLE.

    Science.gov (United States)

    Rigden, Daniel J; Thomas, Jens M H; Simkovic, Felix; Simpkin, Adam; Winn, Martyn D; Mayans, Olga; Keegan, Ronan M

    2018-03-01

    Molecular replacement (MR) is the predominant route to solution of the phase problem in macromolecular crystallography. Although routine in many cases, it becomes more effortful and often impossible when the available experimental structures typically used as search models are only distantly homologous to the target. Nevertheless, with current powerful MR software, relatively small core structures shared between the target and known structure, of 20-40% of the overall structure for example, can succeed as search models where they can be isolated. Manual sculpting of such small structural cores is rarely attempted and is dependent on the crystallographer's expertise and understanding of the protein family in question. Automated search-model editing has previously been performed on the basis of sequence alignment, in order to eliminate, for example, side chains or loops that are not present in the target, or on the basis of structural features (e.g. solvent accessibility) or crystallographic parameters (e.g. B factors). Here, based on recent work demonstrating a correlation between evolutionary conservation and protein rigidity/packing, novel automated ways to derive edited search models from a given distant homologue over a range of sizes are presented. A variety of structure-based metrics, many readily obtained from online webservers, can be fed to the MR pipeline AMPLE to produce search models that succeed with a set of test cases where expertly manually edited comparators, further processed in diverse ways with MrBUMP, fail. Further significant performance gains result when the structure-based distance geometry method CONCOORD is used to generate ensembles from the distant homologue. To our knowledge, this is the first such approach whereby a single structure is meaningfully transformed into an ensemble for the purposes of MR. Additional cases further demonstrate the advantages of the approach. CONCOORD is freely available and computationally inexpensive, so

  8. Bilateral Simultaneous Revision Total Knee Arthroplasty as a Single Staged Procedure: A Case Report and Review of Literature.

    Science.gov (United States)

    Vaishya, Raju; Agarwal, Amit Kumar; Jaiswal, Chirag; Vijay, Vipul; Vaish, Abhishek

    2017-03-23

    Bilateral revision total knee arthroplasty (TKA) is a surgical procedure, which is rarely done simultaneously as it is a difficult surgery and the safety of simultaneous bilateral single stage surgery remains unknown. We report a case of a 67-year-old woman who presented to us with bilateral painful and unstable TKA (right > left) of six months duration. The primary bilateral TKA were done 14 years ago. Bilateral simultaneous revision TKA was performed, using cemented, constrained, long-stem prostheses. The intraoperative and postoperative periods remained uneventful. At last follow-up at four years, she had a pain-free range of motion of up to 0-115°, and the patient had returned to the activities of daily living. She had stable knees with good function and no evidence of loosening or wear.

  9. Explaining variance and identifying predictors of children's communication via a multilevel model of single-case design research.

    Science.gov (United States)

    Ottley, Jennifer Riggie; Ferron, John M; Hanline, Mary Frances

    2016-06-01

    The purpose of this study was to explain the variability in data collected from a single-case design study and to identify predictors of communicative outcomes for children with developmental delays or disabilities (n = 4). Using SAS University Edition, we fit multilevel models with time nested within children. Children's initial levels of communication and teachers' frequency of strategy use when directed at the children predicted children's communicative outcomes. These results indicate that teachers' implementation of evidence-based communication strategies, when directed toward children with disabilities, and the interaction between their use of the strategies and children's initial levels of communication predict children's communicative outcomes. Implications for research and practice are provided.

  10. The Naso-labial and lateral forehead flaps as a single stage: A case report and review of literature

    Directory of Open Access Journals (Sweden)

    Adigun I

    2008-01-01

    Full Text Available We present here the case of a patient with a major traumatic nasal loses who had a near-total nasal reconstruction as a single-stage procedure. A 35 year-old civil servant who was involved in a road traffic injury about two years before presentation. He sustained extensive and multiple facial injuries with complete loss of nasal cover and lining. Reconstruction was performed by using superiorly based, bilateral, nasolabial flaps to line the floor and the nasal septum, and a paramedian forehead flap for skin cover. The patient did well postoperatively and was discharged home on the 7 th postoperative day. If the principles concerning cover, support, and lining are adhered to, excellent functional and aesthetic results can be achieved as we have obtained in our patient.

  11. Target-mediated drug disposition with drug-drug interaction, Part I: single drug case in alternative formulations.

    Science.gov (United States)

    Koch, Gilbert; Jusko, William J; Schropp, Johannes

    2017-02-01

    Target-mediated drug disposition (TMDD) describes drug binding with high affinity to a target such as a receptor. In application TMDD models are often over-parameterized and quasi-equilibrium (QE) or quasi-steady state (QSS) approximations are essential to reduce the number of parameters. However, implementation of such approximations becomes difficult for TMDD models with drug-drug interaction (DDI) mechanisms. Hence, alternative but equivalent formulations are necessary for QE or QSS approximations. To introduce and develop such formulations, the single drug case is reanalyzed. This work opens the route for straightforward implementation of QE or QSS approximations of DDI TMDD models. The manuscript is the first part to introduce DDI TMDD models with QE or QSS approximations.

  12. Radionuclide deflation effects at contaminated environmental area in case of single and steady discharges to the atmosphere

    International Nuclear Information System (INIS)

    Makhon'ko, K.P.

    1984-01-01

    The effects of wind generation of radioactive dust in the area contaminated as a result of single or steady radionuclide discharges to the atmosphere are considered. Calculations are given on changing in time of the deflation coefficient Ksub(α) cm -1 on the base of the radionuclides migration rate account into the depth from a surface dust-forming soil layer and irradiation dose for account of radionuclides penetrated by food chains and into respiratory organs as a result of dusting of the contaminated zone. It is shown that the deflation effects play an essential part in case of emergency discharges owing to the possibility of including radionuclides in food chains through plants. The numerical calculations are performed for 90 Sr and 137 Cs and for light and heavy natural deposit soils

  13. A methodology to compile food metrics related to diet sustainability into a single food database: Application to the French case.

    Science.gov (United States)

    Gazan, Rozenn; Barré, Tangui; Perignon, Marlène; Maillot, Matthieu; Darmon, Nicole; Vieux, Florent

    2018-01-01

    The holistic approach required to assess diet sustainability is hindered by lack of comprehensive databases compiling relevant food metrics. Those metrics are generally scattered in different data sources with various levels of aggregation hampering their matching. The objective was to develop a general methodology to compile food metrics describing diet sustainability dimensions into a single database and to apply it to the French context. Each step of the methodology is detailed: indicators and food metrics identification and selection, food list definition, food matching and values assignment. For the French case, nutrient and contaminant content, bioavailability factors, distribution of dietary intakes, portion sizes, food prices, greenhouse gas emission, acidification and marine eutrophication estimates were allocated to 212 commonly consumed generic foods. This generic database compiling 279 metrics will allow the simultaneous evaluation of the four dimensions of diet sustainability, namely health, economic, social and environmental, dimensions. Copyright © 2016 Elsevier Ltd. All rights reserved.

  14. Classifying the Progression of Ductal Carcinoma from Single-Cell Sampled Data via Integer Linear Programming: A Case Study.

    Science.gov (United States)

    Catanzaro, Daniele; Shackney, Stanley E; Schaffer, Alejandro A; Schwartz, Russell

    2016-01-01

    Ductal Carcinoma In Situ (DCIS) is a precursor lesion of Invasive Ductal Carcinoma (IDC) of the breast. Investigating its temporal progression could provide fundamental new insights for the development of better diagnostic tools to predict which cases of DCIS will progress to IDC. We investigate the problem of reconstructing a plausible progression from single-cell sampled data of an individual with synchronous DCIS and IDC. Specifically, by using a number of assumptions derived from the observation of cellular atypia occurring in IDC, we design a possible predictive model using integer linear programming (ILP). Computational experiments carried out on a preexisting data set of 13 patients with simultaneous DCIS and IDC show that the corresponding predicted progression models are classifiable into categories having specific evolutionary characteristics. The approach provides new insights into mechanisms of clonal progression in breast cancers and helps illustrate the power of the ILP approach for similar problems in reconstructing tumor evolution scenarios under complex sets of constraints.

  15. On Generalization in Qualitatively Oriented Research

    Directory of Open Access Journals (Sweden)

    Philipp Mayring

    2007-09-01

    Full Text Available In this article, I open a debate about the importance and possibilities of generalization in qualitative oriented research. Generalization traditionally is seen as a central aim of science, as a process of theory formulation for further applications. Others criticize the concept in general, either because of the insufficiency of inductive arguments (POPPER, 1959 or because of context specificity of all scientific findings (LINCOLN & GUBA, 1985. In this paper, I argue that generalization is necessary in qualitative research, but we have to differentiate different aims of generalization: laws, rules, context specific statements, similarities and differences, and procedures. There are different possibilities to arrive at a generalization: analysis of total population, falsification, random or stratified samples, argumentative generalization, theoretical sampling, variation, and triangulation. Depending on the type of research or research design some of those strategies of generalization can be important for qualitative oriented research. This is discussed especially in respect to single case analysis. URN: urn:nbn:de:0114-fqs0703262

  16. Translational Treatment of Aphasia Combining Neuromodulationand Behavioral Intervention for Lexical Retrieval: Implications from a Single Case Study

    Directory of Open Access Journals (Sweden)

    Elizabeth E. Galletta

    2015-08-01

    Full Text Available BackgroundTranscranial direct current stimulation (tDCS, a non-invasive method of brain stimulation, is an adjunctive research-therapy for aphasia. The concept supporting translational application of tDCS is that brain plasticity, facilitated by language intervention, can be enhanced by non-invasive brain stimulation. This study combined tDCS with an ecologically-focused behavioral approach that involved training nouns and verbs in sentences. MethodParticipant: A 43-year-old, right-handed male with fluent-anomic aphasia who sustained a single-left-hemisphere-temporal-parietal stroke was recruited. Treatment: Instrumentation included the Soterix Medical 1x1 Device. Anodal tDCS was applied over Broca’s area. Behavioral materials included: sentence production, naming in the sentence context, and implementation of a social-conversational-discourse treatment.Design and Procedures: The independent variable of this crossover case-study was tDCS, and the dependent variables were language and quality-of-life measures. In each session the subject received language treatment with the first twenty minutes additionally including tDCS. ResultsPerformance in naming nouns and verbs in single words and sentences were obtained. Verb production in the sentence context increased after active anodal tDCS and speech-language treatment. ConclusionAphasia treatment that involves naming in the sentence context in conjunction with translational application of tDCS may be a promising approach for language-recovery post stroke.

  17. Qualitative Economics

    DEFF Research Database (Denmark)

    Fast, Michael; Clark II, Woodrow W

                         This book is about science -- specifically, the science of economics. Or lack thereof is more accurate. The building of any science, let alone economics, is grounded in the understanding of what is beneath the "surface" of economics. Science, and hence economics, should...... be concerned with formulating ideas that express theories which produce descriptions of how to understand phenomenon and real world experiences.                       Economics must become a science, because the essence of economics in terms of human actions, group interactions and communities are in need...... of scientific inquiry. Academics and scholars need a scientific perspective that can hypothesize, theorize document, understand and analyze human dynamics from the individual to more societal interactions. And that is what qualitative economics does; it can make economics into becoming a science. The economic...

  18. Limitations of the equivalence between spatial and ensemble estimators in the case of a single-tone excitation.

    Science.gov (United States)

    Monsef, Florian; Cozza, Andrea

    2011-10-01

    The ensemble-average value of the mean-square pressure is often assessed by using the spatial-average technique, underlying an equivalence principle between spatial and ensemble estimators. Using the ideal-diffuse-field model, the accuracy of the spatial-average method has been studied theoretically forty years ago in the case of a single-tone excitation. This study is revisited in the present work on the basis of a more realistic description of the sound field accounting for a finite number of plane waves. The analysis of the spatial-average estimator is based on the study of its convergence rate. Using experimental data from practical examples, it is shown that the classical expression underestimates the estimator uncertainty even for frequencies greater than Schroeder's frequency, and that the number of plane waves may act as lower bound on the spatial-average estimator accuracy. The comparison of the convergence rate with an ensemble-estimator shows that the two statistics cannot be regarded as equivalent in a general case. © 2011 Acoustical Society of America

  19. Single-Session Hematoma Removal and Transcranial Coil Embolization for a Cavernous Sinus Dural Arteriovenous Fistula: A Technical Case Report.

    Science.gov (United States)

    Akamatsu, Yosuke; Sato, Kenichi; Endo, Hidenori; Matsumoto, Yasushi; Tominaga, Teiji

    2017-08-01

    Patients with cavernous sinus dural arteriovenous fistulas (CS dAVFs) with cortical venous varix are indicated for aggressive treatment because of the associated risk for intracranial hemorrhage. We present a case of surgical transvenous embolization in an 84-year-old woman with CS dAVF who presented with massive intracerebral hematoma. Cerebral angiograms revealed the dural AVF drained only into the superficial middle cerebral vein. Because an emergent mass reduction and prevention of rebleeding were necessary, single-session hematoma removal and transcranial embolization of a CS dAVF were performed in the neurosurgical operating room, using a mobile C-arm fluoroscopy. After the right frontotemporal craniotomy, intracerebral hematoma was removed and coil packing of the affected cavernous sinus was successfully performed via the dilated superficial middle cerebral vein. The transcortical vein approach enables occlusion of CS dAVF with isolated cortical venous drainage and may be a valuable alternative approach for some cases needed emergency craniotomy. Copyright © 2017 Elsevier Inc. All rights reserved.

  20. Single-session emotion regulation skills training to reduce aggression in combat veterans: A clinical innovation case study.

    Science.gov (United States)

    Miles, Shannon R; Thompson, Karin E; Stanley, Melinda A; Kent, Thomas A

    2016-05-01

    Posttraumatic stress disorder (PTSD) is common among returning veterans, and aggression frequently co-occurs with PTSD. Veterans with PTSD most commonly engage in impulsive aggression, or aggression that is emotionally charged, unplanned, and uncontrolled, rather than premeditated aggression, which is planned and controlled. Previous research demonstrated a variety of emotions can result in aggression, rather than the traditional conceptualization that only anger leads to aggression. In a veteran sample, deficiencies in the ability to regulate emotions (emotion dysregulation) mediated the relationship between PTSD and impulsive aggression. These results suggest that teaching veterans with PTSD and impulsive aggression how to regulate emotions may decrease aggression. The cases presented illustrate the use of an innovative, single-session emotion regulation treatment for combat veterans with PTSD. Two cases are presented to generate hypotheses on who might benefit from this treatment in the future. The two male veterans treated with this protocol differed in how frequently they used the emotion regulation skills after the treatment and in their treatment outcomes. Teaching veterans how to regulate their emotions in a condensed time frame may be beneficial for certain veterans, and further research on this brief treatment is warranted. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  1. Implementation of a collaborative care model for the treatment of depression and anxiety in a community health center: results from a qualitative case study

    Directory of Open Access Journals (Sweden)

    Eghaneyan BH

    2014-11-01

    Full Text Available Brittany H Eghaneyan,1 Katherine Sanchez,2 Diane B Mitschke2 1Department of Psychiatry, UT Southwestern Medical Center, Dallas, TX, USA; 2School of Social Work, The University of Texas at Arlington, Arlington, TX, USA Background: The collaborative care model is a systematic approach to the treatment of depression and anxiety in primary care settings that involves the integration of care managers and consultant psychiatrists, with primary care physician oversight, to more proactively manage mental disorders as chronic diseases, rather than treating acute symptoms. While collaborative care has been shown to be more effective than usual primary care in improving depression outcomes in a number of studies, less is known about the factors that support the translation of this evidence-based intervention to real-world program implementation. The purpose of this case study was to examine the implementation of a collaborative care model in a community based primary care clinic that primarily serves a low-income, uninsured Latino population, in order to better understand the interdisciplinary relationships and the specific elements that might facilitate broader implementation. Methods: An embedded single-case study design was chosen in order to thoroughly examine the components of one of several programs within a single organization. The main unit of analysis was semi-structured interviews that were conducted with seven clinical and administrative staff members. A grounded theory approach was used to analyze the interviews. Line-by-line initial coding resulted in over 150 initial codes, which were clustered together to rebuild the data into preliminary categories and then divided into four final categories, or main themes. Results: Four unique themes about how the implementation of a collaborative care model worked in this setting emerged from the interviews: organizational change, communication, processes and outcomes of the program, and barriers to

  2. Three independent one-dimensional margins for single-fraction frameless stereotactic radiosurgery brain cases using CBCT

    International Nuclear Information System (INIS)

    Zhang, Qinghui; Chan, Maria F.; Burman, Chandra; Song, Yulin; Zhang, Mutian

    2013-01-01

    Purpose: Setting a proper margin is crucial for not only delivering the required radiation dose to a target volume, but also reducing the unnecessary radiation to the adjacent organs at risk. This study investigated the independent one-dimensional symmetric and asymmetric margins between the clinical target volume (CTV) and the planning target volume (PTV) for linac-based single-fraction frameless stereotactic radiosurgery (SRS).Methods: The authors assumed a Dirac delta function for the systematic error of a specific machine and a Gaussian function for the residual setup errors. Margin formulas were then derived in details to arrive at a suitable CTV-to-PTV margin for single-fraction frameless SRS. Such a margin ensured that the CTV would receive the prescribed dose in 95% of the patients. To validate our margin formalism, the authors retrospectively analyzed nine patients who were previously treated with noncoplanar conformal beams. Cone-beam computed tomography (CBCT) was used in the patient setup. The isocenter shifts between the CBCT and linac were measured for a Varian Trilogy linear accelerator for three months. For each plan, the authors shifted the isocenter of the plan in each direction by ±3 mm simultaneously to simulate the worst setup scenario. Subsequently, the asymptotic behavior of the CTV V 80% for each patient was studied as the setup error approached the CTV-PTV margin.Results: The authors found that the proper margin for single-fraction frameless SRS cases with brain cancer was about 3 mm for the machine investigated in this study. The isocenter shifts between the CBCT and the linac remained almost constant over a period of three months for this specific machine. This confirmed our assumption that the machine systematic error distribution could be approximated as a delta function. This definition is especially relevant to a single-fraction treatment. The prescribed dose coverage for all the patients investigated was 96.1%± 5.5% with an extreme

  3. Qualitative-Based Methodology to Teaching Qualitative Methodology in Higher Education

    Science.gov (United States)

    Katz, Sara

    2015-01-01

    There is no defined theory for teaching Qualitative Inquiry, and very few studies have focused on the topic. This study is a qualitative case study focused on the Qualitative Methods course that I teach at a college of education in Israel. The aim of the study is to explore and describe the course, to provide a true picture of my pedagogy, and to…

  4. The web of silence: a qualitative case study of early intervention and support for healthcare workers with mental ill-health.

    Science.gov (United States)

    Moll, Sandra E

    2014-02-08

    There is a high rate of stress and mental illness among healthcare workers, yet many continue to work despite symptoms that affect their performance. Workers with mental health issues are typically ostracized and do not get the support that they need. If issues are not addressed, however, they could become worse and compromise the health and safety, not only of the worker, but his/her colleagues and patients. Early identification and support can improve work outcomes and facilitate recovery, but more information is needed about how to facilitate this process in the context of healthcare work. The purpose of this study was to explore the key individual and organizational forces that shape early intervention and support for healthcare workers who are struggling with mental health issues, and to identify barriers and opportunities for change. A qualitative, case study in a large, urban healthcare organization was conducted in order to explore the perceptions and experiences of employees across the organization. In-depth interviews were conducted with eight healthcare workers who had experienced mental health issues at work as well as eight workplace stakeholders who interacted with workers who were struggling (managers, coworkers, union leaders). An online survey was completed by an additional 67 employees. Analysis of the interviews and surveys was guided by a process of interpretive description to identify key barriers to early intervention and support. There were many reports of silence and inaction in response to employee mental health issues. Uncertainty in identifying mental health problems, stigma regarding mental ill health, a discourse of professional competence, social tensions, workload pressures, confidentiality expectations and lack of timely access to mental health supports were key forces in preventing employees from getting the help that they needed. Although there were a few exceptions, the overall study findings point to many barriers to supporting

  5. The web of silence: a qualitative case study of early intervention and support for healthcare workers with mental ill-health

    Science.gov (United States)

    2014-01-01

    Background There is a high rate of stress and mental illness among healthcare workers, yet many continue to work despite symptoms that affect their performance. Workers with mental health issues are typically ostracized and do not get the support that they need. If issues are not addressed, however, they could become worse and compromise the health and safety, not only of the worker, but his/her colleagues and patients. Early identification and support can improve work outcomes and facilitate recovery, but more information is needed about how to facilitate this process in the context of healthcare work. The purpose of this study was to explore the key individual and organizational forces that shape early intervention and support for healthcare workers who are struggling with mental health issues, and to identify barriers and opportunities for change. Methods A qualitative, case study in a large, urban healthcare organization was conducted in order to explore the perceptions and experiences of employees across the organization. In-depth interviews were conducted with eight healthcare workers who had experienced mental health issues at work as well as eight workplace stakeholders who interacted with workers who were struggling (managers, coworkers, union leaders). An online survey was completed by an additional 67 employees. Analysis of the interviews and surveys was guided by a process of interpretive description to identify key barriers to early intervention and support. Results There were many reports of silence and inaction in response to employee mental health issues. Uncertainty in identifying mental health problems, stigma regarding mental ill health, a discourse of professional competence, social tensions, workload pressures, confidentiality expectations and lack of timely access to mental health supports were key forces in preventing employees from getting the help that they needed. Although there were a few exceptions, the overall study findings point to

  6. Practice organisational characteristics can impact on compliance with the BTS/SIGN asthma guideline: Qualitative comparative case study in primary care

    Directory of Open Access Journals (Sweden)

    Gillies John

    2008-06-01

    Full Text Available Abstract Background Although the BTS-SIGN asthma guideline is one of the most well known and widely respected guidelines in the world, implementation in UK primary care remains patchy. Building on extensive earlier descriptive work, we sought to explore the way teamwork and inter-professional relationships impact on the implementation of the BTS-SIGN guideline on asthma in general practice. Methods Qualitative comparative case study using nine in-depth interviews and 2 focus groups with general practitioners and practice nurses, involved in delivering asthma care. Participants were purposively recruited from practices in a Scottish health board with high and low compliance with the BTS-SIGN asthma guideline. Results There was a marked difference in the way respondents from practices with high compliance and respondents from practices with low compliance spoke about the value of guidelines and the challenges of implementing them. On both accounts, the former were more positive than the latter and were able to be more specific about the strategies they used to overcome barriers to implementation. We explored the reason for this difference in response and identified practice organisation, centring on delegation of work to nurses, as a factor mediating the practice's level of compliance. Effective delegation was underpinned by organisation of asthma work among practice members who have the appropriate level of skills and knowledge, know and understand each others' work and responsibilities, communicate well among themselves and trust each others' skills. It was the combination of these factors which made for successful delegation and guideline implementation, not any one factor in isolation. Conclusion In our sample of practices, teamwork and organisation of care within practices appeared to impact on guideline implementation and further larger studies are needed to explore this issue further. Isolated interventions such as measures to improve staff

  7. Exploring drivers and challenges in implementation of health promotion in community mental health services: a qualitative multi-site case study using Normalization Process Theory.

    Science.gov (United States)

    Burau, Viola; Carstensen, Kathrine; Fredens, Mia; Kousgaard, Marius Brostrøm

    2018-01-24

    There is an increased interest in improving the physical health of people with mental illness. Little is known about implementing health promotion interventions in adult mental health organisations where many users also have physical health problems. The literature suggests that contextual factors are important for implementation in community settings. This study focused on the change process and analysed the implementation of a structural health promotion intervention in community mental health organisations in different contexts in Denmark. The study was based on a qualitative multiple-case design and included two municipal and two regional provider organisations. Data were various written sources and 13 semi-structured interviews with 22 key managers and frontline staff. The analysis was organised around the four main constructs of Normalization Process Theory: Coherence, Cognitive Participation, Collective Action, and Reflexive Monitoring. Coherence: Most respondents found the intervention to be meaningful in that the intervention fitted well into existing goals, practices and treatment approaches. Cognitive Participation: Management engagement varied across providers and low engagement impeded implementation. Engaging all staff was a general problem although some of the initial resistance was apparently overcome. Collective Action: Daily enactment depended on staff being attentive and flexible enough to manage the complex needs and varying capacities of users. Reflexive Monitoring: During implementation, staff evaluations of the progress and impact of the intervention were mostly informal and ad hoc and staff used these to make on-going adjustments to activities. Overall, characteristics of context common to all providers (work force and user groups) seemed to be more important for implementation than differences in the external political-administrative context. In terms of research, future studies should adopt a more bottom-up, grounded description of context

  8. "Souls of the ancestor that knock us out" and other tales. A qualitative study to identify demand-side factors influencing malaria case management in Cambodia.

    Science.gov (United States)

    O'Connell, Kathryn A; Samandari, Ghazaleh; Phok, Sochea; Phou, Mean; Dysoley, Lek; Yeung, Shunmay; Allen, Henrietta; Littrell, Megan

    2012-10-05

    Appropriate case management of suspected malaria in Cambodia is critical given anti-malarial drug resistance in the region. Improving diagnosis and the use of recommended malarial treatments is a challenge in Cambodia where self-treatment and usage of drug cocktails is widespread, a notable difference from malaria treatment seeking in other countries. This qualitative study adds to the limited evidence base on Cambodian practices, aiming to understand the demand-side factors influencing treatment-seeking behaviour, including the types of home treatments, perceptions of cocktail medicines and reasons for diagnostic testing. The findings may help guide intervention design. The study used in-depth interviews (IDIs) (N = 16) and focus group discussions (FGDs) (N = 12) with Cambodian adults from malaria-endemic areas who had experienced malaria fever in the previous two weeks. Data were analysed using NVivo software. Findings suggest that Cambodians initially treat suspected malaria at home with home remedies and traditional medicines. When seeking treatment outside the home, respondents frequently reported receiving a cocktail of medicines from trusted providers. Cocktails are perceived as less expensive and more effective than full-course, pre-packaged medicines. Barriers to diagnostic testing include a belief in the ability to self-diagnose based on symptoms, cost and reliance on providers to recommend a test. Factors that facilitate testing include recommendation by trusted providers and a belief that anti-malarial treatment for illnesses other than malaria can be harmful. Treatment-seeking behaviour for malaria in Cambodia is complex, driven by cultural norms, practicalities and episode-related factors. Effective malaria treatment programmes will benefit from interventions and communication materials that leverage these demand-side factors, promoting prompt visits to facilities for suspected malaria and challenging patients' misconceptions about the effectiveness

  9. “Souls of the ancestor that knock us out” and other tales. A qualitative study to identify demand-side factors influencing malaria case management in Cambodia

    Directory of Open Access Journals (Sweden)

    O’Connell Kathryn A

    2012-10-01

    Full Text Available Abstract Background Appropriate case management of suspected malaria in Cambodia is critical given anti-malarial drug resistance in the region. Improving diagnosis and the use of recommended malarial treatments is a challenge in Cambodia where self-treatment and usage of drug cocktails is widespread, a notable difference from malaria treatment seeking in other countries. This qualitative study adds to the limited evidence base on Cambodian practices, aiming to understand the demand-side factors influencing treatment-seeking behaviour, including the types of home treatments, perceptions of cocktail medicines and reasons for diagnostic testing. The findings may help guide intervention design. Methods The study used in-depth interviews (IDIs (N = 16 and focus group discussions (FGDs (N = 12 with Cambodian adults from malaria-endemic areas who had experienced malaria fever in the previous two weeks. Data were analysed using NVivo software. Results Findings suggest that Cambodians initially treat suspected malaria at home with home remedies and traditional medicines. When seeking treatment outside the home, respondents frequently reported receiving a cocktail of medicines from trusted providers. Cocktails are perceived as less expensive and more effective than full-course, pre-packaged medicines. Barriers to diagnostic testing include a belief in the ability to self-diagnose based on symptoms, cost and reliance on providers to recommend a test. Factors that facilitate testing include recommendation by trusted providers and a belief that anti-malarial treatment for illnesses other than malaria can be harmful. Conclusions Treatment-seeking behaviour for malaria in Cambodia is complex, driven by cultural norms, practicalities and episode-related factors. Effective malaria treatment programmes will benefit from interventions and communication materials that leverage these demand-side factors, promoting prompt visits to facilities for suspected

  10. A qualitative case study in the social capital of co-professional collaborative co-practice for children with speech, language and communication needs.

    Science.gov (United States)

    McKean, Cristina; Law, James; Laing, Karen; Cockerill, Maria; Allon-Smith, Jan; McCartney, Elspeth; Forbes, Joan

    2017-07-01

    Effective co-practice is essential to deliver services for children with speech, language and communication needs (SLCN). The necessary skills, knowledge and resources are distributed amongst professionals and agencies. Co-practice is complex and a number of barriers, such as 'border disputes' and poor awareness of respective priorities, have been identified. However social-relational aspects of co-practice have not been explored in sufficient depth to make recommendations for improvements in policy and practice. Here we apply social capital theory to data from practitioners: an analytical framework with the potential to move beyond descriptions of socio-cultural phenomena to inform change. Co-practice in a local authority site was examined to understand: (1) the range of social capital relations extant in the site's co-practice; (2) how these relations affected the abilities of the network to collaborate; (3) whether previously identified barriers to co-practice remain; (4) the nature of any new complexities that may have emerged; and (5) how inter-professional social capital might be fostered. A qualitative case study of SLCN provision within one local authority in England and its linked NHS partner was completed through face-to-face semi-structured interviews with professionals working with children with SLCN across the authority. Interviews, exploring barriers and facilitators to interagency working and social capital themes, were transcribed, subjected to thematic analysis using iterative methods and a thematic framework derived. We identified a number of characteristics important for the effective development of trust, reciprocity and negotiated co-practice at different levels of social capital networks: macro-service governance and policy; meso-school sites; and micro-intra-practitioner knowledge and skills. Barriers to co-practice differed from those found in earlier studies. Some negative aspects of complexity were evident, but only where networked

  11. Aulas de inglés inclusivas: requerimientos, implicaciones y limitaciones: -Un estudio de caso- Inclusive English classrooms: requirements, implications and limitations: -A qualitative case study-

    Directory of Open Access Journals (Sweden)

    Johanna Montaño Moreno

    Full Text Available Resumen Este artículo presenta los resultados de un estudio de caso que buscaba responder a las siguientes preguntas de investigación: ¿Cuáles son las percepciones que tiene la comunidad educativa de un centro educativo distrital acerca de la educación inclusiva en las aulas de inglés?, ¿Cuáles son los parámetros que esta escuela sigue para trabajar con aulas de inglés inclusivas? Y ¿Qué estrategias se utilizan en las aulas de inglés para responder a las necesidades individuales de los estudiantes? El estudio fue realizado durante ocho meses aproximadamente en el centro educativo en mención. Para realizar una descripción completa del proceso de inclusión en la institución se realizaron observaciones de clase, entrevistas a diferentes miembros de la comunidad educativa y se aplicaron cuestionarios a los estudiantes con necesidades educativas especiales y a sus docentes. Los hallazgos revelaron que aunque algunos pocos profesores utilizan estrategias personales para responder a las necesidades individuales de los estudiantes, hay aún muchos obstáculos que se constituyen en una barrera para el desarrollo exitoso de un proceso de inclusión y carencias que se deben atender y suplir.Abstract This article presents the results of a qualitative case study which attempted to answer the following research questions: What are the perceptions that the educational community has of inclusive education in the English language classrooms? What are the parameters that this school follows in order to work with inclusive English classrooms? And what strategies are being used in the classrooms in order to respond to students'individual needs? The study was developed approximately during eight months in a public school in Bogota. Class observations and interviews to different members of the educational community were done and questionnaires to teachers and students with special educational needs were applied in order to provide a thorough

  12. Facial gingival tissue stability after connective tissue graft with single immediate tooth replacement in the esthetic zone: consecutive case report.

    Science.gov (United States)

    Kan, Joseph Y K; Rungcharassaeng, Kitichai; Morimoto, Taichiro; Lozada, Jaime

    2009-11-01

    The present consecutive case report evaluated facial gingival tissue stability after immediate tooth replacement with connective tissue grafting in the esthetic zone. The implant success rate and peri-implant tissue response were also recorded. A total of 20 consecutive patients with a mean age of 52.3 years (range 28 to 71), who had undergone 20 single immediate tooth replacement with connective tissue grafting, were evaluated clinically and radiographically at the preoperative examination, immediately after implant placement and provisionalization with connective tissue grafting, and at the latest follow-up appointment. The data were analyzed using the t test and Wilcoxon signed rank test at a significance level of alpha = .05. At the preoperative examination, a thick gingival biotype was observed in 8 patients and a thin gingival biotype in 12. At a mean follow-up of 2.15 years (range 1 to 4), all implants were functioning and exhibited a thick biotype. At the latest follow-up appointment, no significant differences (P > .05) were found between the initially thick and thin gingival biotypes in the mean mesial marginal bone level changes (-0.53 versus -0.55 mm), the mean distal marginal bone level changes (-0.50 versus -0.44 mm), and the mean facial gingival level changes (+0.23 mm versus +0.06 mm). The frequency distribution of the papilla index score showed that peri-implant papillae were well preserved at the latest follow-up visit. With proper 3-dimensional implant positioning and bone grafting into the implant-socket gap, the facial gingival level can be maintained after connective tissue grafting with single immediate tooth replacement, regardless of the initial gingival biotype, indicating that the thin gingival biotype can be converted to the thick gingival biotype morphologically and behaviorally with this procedure. Nevertheless, careful patient selection and treatment planning, as well as immaculate execution by skillful clinicians, are required to

  13. Neuromuscular Control Mechanisms During Single-Leg Jump Landing in Subacute Ankle Sprain Patients: A Case Control Study.

    Science.gov (United States)

    Allet, Lara; Zumstein, Franziska; Eichelberger, Patric; Armand, Stéphane; Punt, Ilona M

    2017-03-01

    Optimal neuromuscular control mechanisms are essential for preparing, maintaining, and restoring functional joint stability during jump landing and to prevent ankle injuries. In subacute ankle sprain patients, neither muscle activity nor kinematics during jump landing has previously been assessed. To compare neuromuscular control mechanisms and kinematics between subacute ankle sprain patients and healthy persons before and during the initial contact phase of a 25-cm single-leg jump. Case-control study. University hospital. Fifteen patients with grade I or II acute ankle sprains were followed up after 4 weeks of conservative management not involving physical therapy. Subjects performed alternately 3 single-leg forward jumps of 25 cm (toe-to-heel distance) barefoot. Their results were compared with the data of 15 healthy subjects. Electromyographic (EMG) activity of the musculus (m.) gastrocnemius lateralis, m. tibialis anterior, and m. peroneus longus as well as kinematics for ankle, knee, and hip joint were recorded for pre-initial contact (IC) phase, post-initial contact phase, and reflex-induced phase. The results showed that EMG activity of the 3 muscles did not differ between ankle sprain patients (n = 15) and healthy persons (n = 15) for any of the analyzed time intervals (all P > .05). However, during the pre-IC phase, ankle sprain patients presented less plantar flexion, as well as during the post-IC phase after jump landing, compared to healthy persons (P ankle joint can lead to neuromuscular control mechanism disturbances through which functional instability might arise. III. Copyright © 2017 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

  14. Descriptive Analysis of Right and Left-sided Traumatic Diaphragmatic Injuries; Case Series from a Single Institution

    Science.gov (United States)

    Al-Thani, Hassan; Jabbour, Gaby; El-Menyar, Ayman; Abdelrahman, Husham; Peralta, Ruben; Zarour, Ahmad

    2018-01-01

    Objective: To investigate the presentation, management and outcomes of left and right-sided traumatic diaphragmatic injury (TDI) in a single level I trauma center. Methods: This cross-sectional study was conducted during a 7-year period from 2008 to 2015 in a level I trauma center in Qatar. We included all the patients who presented with TDIs during the study period. Data included demographics, mechanism of injury, associated injuries, initial vitals, emergency department disposition, length of ICU and hospital stay, ventilator days, management, and outcomes. The variables were analyzed and compared for patients with left (LTDI) and right (RTDI). Results: A total of 52 TDI cases (79% LTDI and 21% RTDI) were identified with a mean age of 31±11. LTDI patients were more likely to have higher Injury severity scores (p=0.50) and greater AAST organ injury scoring (p=0.661 for all) than RTDI patients. Surgical repair was performed for 85% LTDI vs. 73% RTDI (p=0.342). Recurrent DIs was reported only in LTDI (5.1% vs. 0.0%; p=0.911). Twelve patients died (9 LTDI and 3 RTDI), of them 5 had associated head injury. Conclusion: This single-institution study confirms that LTDI are more commonly diagnosed than RTDI. Exploratory laparotomy is the most frequent procedure considered for the management of diaphragmatic injuries in the emergency settings. To improve outcomes in patients presenting with TDI, large prospective multicenter studies are needed to standardize the TDI management protocols including the diagnostic workup, timing of surgical intervention, and the most appropriate approach of treatment.  PMID:29379805

  15. A Restricted Open Configuration Interaction with Singles Method To Calculate Valence-to-Core Resonant X-ray Emission Spectra: A Case Study.

    Science.gov (United States)

    Maganas, Dimitrios; DeBeer, Serena; Neese, Frank

    2017-10-02

    In this work, a new protocol for the calculation of valence-to-core resonant X-ray emission (VtC RXES) spectra is introduced. The approach is based on the previously developed restricted open configuration interaction with singles (ROCIS) method and its parametrized version, based on a ground-state Kohn-Sham determinant (DFT/ROCIS) method. The ROCIS approach has the following features: (1) In the first step approximation, many-particle eigenstates are calculated in which the total spin is retained as a good quantum number. (2) The ground state with total spin S and excited states with spin S' = S, S ± 1, are obtained. (3) These states have a qualitatively correct multiplet structure. (4) Quasi-degenerate perturbation theory is used to treat the spin-orbit coupling operator variationally at the many-particle level. (5) Transition moments are obtained between the relativistic many-particle states. The method has shown great potential in the field of X-ray spectroscopy, in particular in the field of transition-metal L-edge, which cannot be described correctly with particle-hole theories. In this work, the method is extended to the calculation of resonant VtC RXES [alternatively referred to as 1s-VtC resonant inelastic X-ray scattering (RIXS)] spectra. The complete Kramers-Dirac-Heisenerg equation is taken into account. Thus, state interference effects are treated naturally within this protocol. As a first application of this protocol, a computational study on the previously reported VtC RXES plane on a molecular managanese(V) complex is performed. Starting from conventional X-ray absorption spectra (XAS), we present a systematic study that involves calculations and electronic structure analysis of both the XAS and non-resonant and resonant VtC XES spectra. The very good agreement between theory and experiment, observed in all cases, allows us to unravel the complicated intensity mechanism of these spectroscopic techniques as a synergic function of state polarization

  16. Being together – Exploring the modulation of affect in improvisational music therapy with a man in a persistent vegetative state – a qualitative single case study

    Directory of Open Access Journals (Sweden)

    Wolfgang Schmid

    2016-12-01

    Full Text Available This article explores the role of affective expression and modulation as a means of communication in improvisational music therapy with a 44-year-old man living in a persistent vegetative state. Within a practice-based approach two vignettes from music therapy illustrate the regulation of the intensity of affect in an interpersonal relationship. Perspectives from modern attachment theory, developmental psychology, and embodiment research will be introduced and discussed, to theoretically frame and embed the practical work. It is suggested that the bodily-emotional situatedness of the man and the music therapist form the area of exchange for a non-verbal, affect-driven communication. In this way, playing with the affect is the main topic for the encounter, promoting self-organizational processes in both individuals involved.

  17. Stakeholder Experiences of a Dual-Language International School: A Qualitative Case Study of a Private International School in Hong Kong

    Science.gov (United States)

    Fryer, Timothy

    2009-01-01

    Dual-language education has many different meanings and there is much variation to be found among international schools. Is it possible to combine both concepts to the satisfaction of all stakeholders? This article reports the findings of a qualitative study at a dual-language international school that examines the views of the students, parents…

  18. Effectiveness of a systematic approach to promote intersectoral collaboration in comprehensive school health promotion-a multiple-case study using quantitative and qualitative data.

    Science.gov (United States)

    Pucher, Katharina K; Candel, Math J J M; Krumeich, Anja; Boot, Nicole M W M; De Vries, Nanne K

    2015-07-05

    We report on the longitudinal quantitative and qualitative data resulting from a two-year trajectory (2008-2011) based on the DIagnosis of Sustainable Collaboration (DISC) model. This trajectory aimed to support regional coordinators of comprehensive school health promotion (CSHP) in systematically developing change management and project management to establish intersectoral collaboration. Multilevel analyses of quantitative data on the determinants of collaborations according to the DISC model were done, with 90 respondents (response 57 %) at pretest and 69 respondents (52 %) at posttest. Nvivo analyses of the qualitative data collected during the trajectory included minutes of monthly/bimonthly personal/telephone interviews (N = 65) with regional coordinators, and documents they produced about their activities. Quantitative data showed major improvements in change management and project management. There were also improvements in consensus development, commitment formation, formalization of the CSHP, and alignment of policies, although organizational problems within the collaboration increased. Content analyses of qualitative data identified five main management styles, including (1) facilitating active involvement of relevant parties; (2) informing collaborating parties; (3) controlling and (4) supporting their task accomplishment; and (5) coordinating the collaborative processes. We have contributed to the fundamental understanding of the development of intersectoral collaboration by combining qualitative and quantitative data. Our results support a systematic approach to intersectoral collaboration using the DISC model. They also suggest five main management styles to improve intersectoral collaboration in the initial stage. The outcomes are useful for health professionals involved in similar ventures.

  19. A Framework for Integrating Qualitative and Quantitative Data in Knowledge, Attitude, and Practice Studies: A Case Study of Pesticide Usage in Eastern Uganda.

    Science.gov (United States)

    Muleme, James; Kankya, Clovice; Ssempebwa, John C; Mazeri, Stella; Muwonge, Adrian

    2017-01-01

    Knowledge, attitude, and practice (KAP) studies guide the implementation of public health interventions (PHIs), and they are important tools for political persuasion. The design and implementation of PHIs assumes a linear KAP relationship, i.e., an awareness campaign results in the desirable societal behavioral change. However, there is no robust framework for testing this relationship before and after PHIs. Here, we use qualitative and quantitative data on pesticide usage to test this linear relationship, identify associated context specific factors as well as assemble a framework that could be used to guide and evaluate PHIs. We used data from a cross-sectional mixed methods study on pesticide usage. Quantitative data were collected using a structured questionnaire from 167 households representing 1,002 individuals. Qualitative data were collected from key informants and focus group discussions. Quantitative and qualitative data analysis was done in R 3.2.0 as well as qualitative thematic analysis, respectively. Our framework shows that a KAP linear relationship only existed for households with a low knowledge score, suggesting that an awareness campaign would only be effective for ~37% of the households. Context specific socioeconomic factors explain why this relationship does not hold for households with high knowledge scores. These findings are essential for developing targeted cost-effective and sustainable interventions on pesticide usage and other PHIs with context specific modifications.

  20. A Framework for Integrating Qualitative and Quantitative Data in Knowledge, Attitude, and Practice Studies: A Case Study of Pesticide Usage in Eastern Uganda

    Directory of Open Access Journals (Sweden)

    James Muleme

    2017-12-01

    Full Text Available Knowledge, attitude, and practice (KAP studies guide the implementation of public health interventions (PHIs, and they are important tools for political persuasion. The design and implementation of PHIs assumes a linear KAP relationship, i.e., an awareness campaign results in the desirable societal behavioral change. However, there is no robust framework for testing this relationship before and after PHIs. Here, we use qualitative and quantitative data on pesticide usage to test this linear relationship, identify associated context specific factors as well as assemble a framework that could be used to guide and evaluate PHIs. We used data from a cross-sectional mixed methods study on pesticide usage. Quantitative data were collected using a structured questionnaire from 167 households representing 1,002 individuals. Qualitative data were collected from key informants and focus group discussions. Quantitative and qualitative data analysis was done in R 3.2.0 as well as qualitative thematic analysis, respectively. Our framework shows that a KAP linear relationship only existed for households with a low knowledge score, suggesting that an awareness campaign would only be effective for ~37% of the households. Context specific socioeconomic factors explain why this relationship does not hold for households with high knowledge scores. These findings are essential for developing targeted cost-effective and sustainable interventions on pesticide usage and other PHIs with context specific modifications.

  1. Do cost savings from reductions in nosocomial infections justify additional costs of single-bed rooms in intensive care units? A simulation case study.

    Science.gov (United States)

    Sadatsafavi, Hessam; Niknejad, Bahar; Zadeh, Rana; Sadatsafavi, Mohsen

    2016-02-01

    Evidence shows that single-patient rooms can play an important role in preventing cross-transmission and reducing nosocomial infections in intensive care units (ICUs). This case study investigated whether cost savings from reductions in nosocomial infections justify the additional construction and operation costs of single-bed rooms in ICUs. We conducted deterministic and probabilistic return-on-investment analyses of converting the space occupied by open-bay rooms to single-bed rooms in an exemplary ICU. We used the findings of a study of an actual ICU in which the association between the locations of patients in single-bed vs open-bay rooms with infection risk was evaluated. Despite uncertainty in the estimates of costs, infection risks, and length of stay, the cost savings from the reduction of nosocomial infections in single-bed rooms in this case substantially outweighed additional construction and operation expenses. The mean value of internal rate of return over a 5-year analysis period was 56.18% (95% credible interval, 55.34%-57.02%). This case study shows that although single-patient rooms are more costly to build and operate, they can result in substantial savings compared with open-bay rooms by avoiding costs associated with nosocomial infections. Copyright © 2015 Elsevier Inc. All rights reserved.

  2. Using Voice Recognition Software to improve communicative writing and social participation in an individual with severe acquired dysgraphia: an experimental single case therapy study

    OpenAIRE

    Caute, A.; Woolf, C.

    2016-01-01

    Background\\ud Two previous single-case studies have reported that voice recognition software (VRS) can be a powerful tool for circumventing impaired writing in aphasia (Bruce et al, 2003; Estes & Bloom, 2011). However, these studies report mixed results regarding transfer of skills to functional tasks, such as emailing.\\ud \\ud Method\\ud A single-case therapy study was conducted with “Stephen”, a 63 -year old man with fluent aphasia and severe acquired dysgraphia and dyslexia limiting his soci...

  3. Self-Administered, Home-Based SMART (Sensorimotor Active Rehabilitation Training) Arm Training: A Single-Case Report.

    Science.gov (United States)

    Hayward, Kathryn S; Neibling, Bridee A; Barker, Ruth N

    2015-01-01

    This single-case, mixed-method study explored the feasibility of self-administered, home-based SMART (sensorimotor active rehabilitation training) Arm training for a 57-yr-old man with severe upper-limb disability after a right frontoparietal hemorrhagic stroke 9 mo earlier. Over 4 wk of self-administered, home-based SMART Arm training, the participant completed 2,100 repetitions unassisted. His wife provided support for equipment set-up and training progressions. Clinically meaningful improvements in arm impairment (strength), activity (arm and hand tasks), and participation (use of arm in everyday tasks) occurred after training (at 4 wk) and at follow-up (at 16 wk). Areas for refinement of SMART Arm training derived from thematic analysis of the participant's and researchers' journals focused on enabling independence, ensuring home and user friendliness, maintaining the motivation to persevere, progressing toward everyday tasks, and integrating practice into daily routine. These findings suggest that further investigation of self-administered, home-based SMART Arm training is warranted for people with stroke who have severe upper-limb disability. Copyright © 2015 by the American Occupational Therapy Association, Inc.

  4. Analyzing two-phase single-case data with nonoverlap and mean difference indices: Illustration, software tools, and alternatives

    Directory of Open Access Journals (Sweden)

    Rumen eManolov

    2016-01-01

    Full Text Available Two-phase single-case designs, including baseline evaluation followed by an intervention, represent the most clinically straightforward option for combining professional practice and research. However, unless they are part of a multiple-baseline schedule, such designs do not allow demonstrating a causal relation between the intervention and the behavior. Although the statistical options reviewed here cannot help overcoming this methodological limitation, we aim to make practitioners and applied researchers aware of the available appropriate options for extracting maximum information from the data. In the current paper, we suggest that the evaluation of behavioral change should include visual and quantitative analyses, complementing the substantive criteria regarding the practical importance of the behavioral change. Specifically, we emphasize the need to use structured criteria for visual analysis, such as the ones summarized in the What Works Clearinghouse Standards, especially if such criteria are complemented by visual aids, as illustrated here. For quantitative analysis, we focus on the Nonoverlap of all pairs and the Slope and level change procedure, as they offer straightforward information and have shown reasonable performance. An illustration is provided of the use of these three pieces of information: visual, quantitative, and substantive. To make the use of visual and quantitative analysis feasible, open source software is referred to and demonstrated. In order to provide practitioners and applied researchers with a more complete guide, several analytical alternatives are commented on pointing out the situations (aims, data patterns for which these are potentially useful.

  5. Innovative Single-Tooth Replacement with an Individual Root-Analog Hybrid Implant in the Esthetic Zone: Case Report.

    Science.gov (United States)

    Saeidi Pour, Reza; Randelzhofer, Peter; Edelhoff, Daniel; Prandtner, Otto; Rafael, Caroline Freitas; Liebermann, Anja

    The goal of this study was to explore an innovative approach to single-tooth replacement using an individually custom-fabricated, root-analog, hybrid dental implant, in the esthetic zone, to avoid the microgap and micromovements between the implant and abutment. Moreover, the use of burs to prepare the implant recipient site is not necessary in this technique, reducing the bone removal, heating, and trauma. The process requires capturing accurate root geometry through combined computer-aided design/computer-assisted manufacturing (CAD/CAM) and a three-dimensional (3D) visualization (digital volume tomography [DVT]) of the tooth in situ, which might result in reduced remodeling after insertion. A good esthetic and functional outcome was obtained. The use of a root-shaped tooth analog implant might be in selected cases a viable alternative to current threaded cylindrical and cone-shaped implants. The new concept avoids the microgap between the implant and the abutment and reduces the trauma to the tissue and bone.

  6. Single case design studies in music therapy: resurrecting experimental evidence in small group and individual music therapy clinical settings.

    Science.gov (United States)

    Geist, Kamile; Hitchcock, John H

    2014-01-01

    The profession would benefit from greater and routine generation of causal evidence pertaining to the impact of music therapy interventions on client outcomes. One way to meet this goal is to revisit the use of Single Case Designs (SCDs) in clinical practice and research endeavors in music therapy. Given the appropriate setting and goals, this design can be accomplished with small sample sizes and it is often appropriate for studying music therapy interventions. In this article, we promote and discuss implementation of SCD studies in music therapy settings, review the meaning of internal study validity and by extension the notion of causality, and describe two of the most commonly used SCDs to demonstrate how they can help generate causal evidence to inform the field. In closing, we describe the need for replication and future meta-analysis of SCD studies completed in music therapy settings. SCD studies are both feasible and appropriate for use in music therapy clinical practice settings, particularly for testing effectiveness of interventions for individuals or small groups. © the American Music Therapy Association 2014. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  7. On the Use of Dance as a Rehabilitation Approach for Children with Cerebral Palsy: A Single Case Study.

    Science.gov (United States)

    Morán Pascual, Patricia; Mortes Roselló, Esther; Domingo Jacinto, Amparo; Belda Lois, Juan Manuel; Bermejo, Ignacio; Medina, Enric; Barberà Guillem, Ricard

    2015-01-01

    Cerebral Palsy (CP) is the most common motor disability in childhood. It is a group of permanent disorders that affect child development causing disorders of movement and posture and activity limitations. The impairment of psychomotor skills of children with Cerebral Palsy is attributed to a permanent alteration occurred in non-progressive brain development of the fetus or nursing infant. Some motor related symptoms can be treated using proper physical therapy. However, one of the biggest problems of the usual physical therapy is adherence to therapy. Ballet can be an alternative or a complement to physiotherapy, with the added attraction of not being part of a to therapy, but a fun activity with the extra reward associated with the realization of an artistic activity. For some years the ballet is used as therapeutically valuable for both children with cerebral palsy: Intensive ballet training can generate changes in the sensorimotor cortex. Ballet is characterized by a complex process of movements that have to be in a musical rhythm (hence have to be precise), in which there is an overall coordination of the muscles. It is also a highly motivating and rewarding activity that allows many children with CP sharing the activities of their peers without special needs. Objective measurements of the Full Port de Bras movement has been chosen as an index of improvement. The results shows progressive improvements of the execution in a single case.

  8. Exposure-based cognitive behavioral therapy for irritable bowel syndrome. A single-case experimental design across 13 subjects.

    Science.gov (United States)

    Boersma, Katja; Ljótsson, Brjánn; Edebol-Carlman, Hanna; Schrooten, Martien; Linton, Steven J; Brummer, Robert J

    2016-11-01

    Irritable bowel syndrome (IBS) is a highly prevalent disorder with a significant impact on quality of life. The presence of psychological symptoms in IBS patients such as catastrophic worry and behavioral avoidance suggests the possible efficacy of cognitive behavioral interventions. Exposure-based cognitive behavioral therapy (CBT) has proven to be a promising approach but has only been investigated in a few studies and mainly via the Internet. Therefore, the aims of this study were to extend and replicate previous findings and to evaluate whether an individual, face-to-face, exposure-based CBT leads to improvement in gastrointestinal symptoms, pain catastrophizing, avoidance behavior and quality of life in IBS patients. Thirteen patients with IBS according to Rome III criteria participated in a single-case experimental study using a five-week baseline and a subsequent twelve-session intervention phase focusing on psycho-education, mindfulness and in vivo exposure. Standardized measurement of gastrointestinal symptoms, pain catastrophizing, avoidance behavior and quality of life was conducted weekly during baseline as well as intervention phase and at six-month follow-up. Results showed that over 70% of patients improved significantly on gastrointestinal symptoms, pain catastrophizing, and quality of life. Effects on avoidance behavior were modest. These results strengthen and extend earlier findings and provide further support for the efficacy of exposure-based strategies for IBS.

  9. Effects of tracking technology on daily life of persons with dementia: three experimental single-case studies.

    Science.gov (United States)

    Olsson, Annakarin; Engström, Maria; Åsenlöf, Pernilla; Skovdahl, Kirsti; Lampic, Claudia

    2015-02-01

    To investigate the effects of using tracking technology on independent outdoor activities and psychological well-being in 3 persons with dementia (PwDs) and their spouses. Three experimental single-case studies with an A1B1A2B2 design. The intervention entailed access to a passive positioning alarm and technical support. Continual daily measures of independent outdoor activities among PwDs' and spouses' worries about these activities were made during all phases. Access to a tracking technology consistently increased the independent outdoor activities of 2 PwDs. One of the spouses consistently reported decreased worry during B phases, another's worry decreased only in B2, and the third showed little variability in worrying across all phases. Tracking technology may support PwDs to engage in independent outdoor activities and decrease spouses' worries; however, randomized controlled group studies are needed to investigate whether these results can be replicated on a group level. © The Author(s) 2014.

  10. Evaluation of electrical aversion therapy for inappropriate sexual behaviour after traumatic brain injury: a single case experimental design study.

    Science.gov (United States)

    Ter Mors, Bert Jan; van Heugten, Caroline M; van Harten, Peter N

    2012-08-24

    Inappropriate sexual behaviour after acquired brain injury is a severe complication. Evidence for effective treatment is not available. Electrical aversion therapy (EAT) is a behavioural therapeutic option used in persons with intellectual disabilities, which might be suitable for brain-injured individuals for whom other therapies are not effective. The effect of EAT in brain injury has not been investigated previously. A single case experimental design was used. In an ABBA (baseline-treatment-treatment-withdrawal) design the frequency of the target behaviour (ie, inappropriate sexual behaviour) in a 40-year-old man was measured daily. A total of 551 measurements were recorded. A significant reduction of the target behaviour was seen after the first treatment phase (baseline 12.18 (2.59) vs 3.15 (3.19) mean target behaviours daily); this reduction remained stable over time. We conclude that EAT was effective in this patient with inappropriate sexual behaviour due to severe brain injury. EAT can therefore be considered in therapy resistant inappropriate sexual behaviour in brain-injured patients.

  11. Technology-based programs to improve walking behavior of persons with multiple disabilities: two single-case studies.

    Science.gov (United States)

    Lancioni, Giulio E; Singh, Nirbhay N; O'Reilly, Mark F; Sigafoos, Jeff; Alberti, Gloria; Boccasini, Adele; Oliva, Doretta; Buono, Serafino

    2013-01-01

    Assessing two technology-based programs for reducing toe walking and breaks during walking of two men with multiple disabilities, respectively. The men were involved in separate single-case studies, each of which was carried out according to an ABAB design. The technology included a microprocessor with specific software, optic sensors, and visual plus vibrotactile or auditory systems for presenting preferred stimuli. In Study I, the man received 1 s of preferred flickering lights and vibratory input for each step performed with the heel of the left foot touching the ground or coming close to it (i.e. within a 2-mm distance). In Study II, the other man received 10 s of preferred music anytime he crossed one of the small marks present along the travel routes. The B phases showed that (a) the man included in Study I increased the percentages of left- and right-foot steps performed with the heels touching or nearing the ground to above 85% and 70%, respectively, and (b) the man included in Study II walked with very few breaks. Technology-based programs can be highly effective in helping persons with multiple disabilities improve their walking behavior.

  12. Ovarian Low-grade Serous Carcinoma: A Clinicopathologic Study of 33 Cases With Primary Surgery Performed at a Single Institution.

    Science.gov (United States)

    Okoye, Ekene; Euscher, Elizabeth D; Malpica, Anais

    2016-05-01

    Ovarian low-grade serous carcinoma (LGSC) is an entity with distinct pathologic and clinical features. The number of studies on this type of tumor is limited. In this article, we present our experience with 33 cases of ovarian LGSC with primary surgical treatment at our institution. For comparison, a cohort of ovarian high-grade serous carcinoma (HGSC) was also studied. Clinical information was obtained from the patients' charts or from the treating physicians. Hematoxylin and eosin slides were reviewed of 28 available LGSCs, and the following parameters were recorded: presence/absence of a serous borderline tumor (SBT), presence/absence of micropapillary/cribriform pattern (MP/CP), architectural pattern in the invasive component, and presence/absence of desmoplasia or fibrosis. The incidence of ovarian LGSC was 4.7%. LGSC patients ranged in age from 19 to 79 years (mean, 52 y), with 21.2% younger than 40 years. HGSC patients ranged in age from 38 to 90 years (mean, 62 y), with 1.6% younger than 40 years. LGSCs were staged as follows: stage I (2), stage III (23), and stage IV (8). Twenty-eight of 33 LGSC cases had concurrent SBT, with this component accounting for >50% of the neoplasm in 15 cases. In addition, MP/CP was noted in 19 cases. Invasion patterns included micropapillae (93%), cribriform nests (74%), elongated papillae (26%), glandular (44.4%), medium-sized papillae (33.3%), solid nests (22.2%), macropapillae (19%), and single cells (19%). In addition, desmoplasia (44.4%) and fibrosis (37%) were noted. Follow-up data ranging from 13 to 195 months (median 61.2 mo) were available on 30/33 LGSC patients: 18 (60%) were dead of disease; 1 (3.3%) was dead of other cause; 5 (16.7%) were alive with disease; and 6 (20%) had no evidence of disease. Follow-up data from 1 to 169 months (median 48 mo) were available on 185 HGSC patients: 132 (71.4%) were dead of disease; 3 (1.6%) were dead of other cause; 21 (11.4%) were alive with disease; and 29 (15.7%) had no

  13. Deconstructing Cancer Patient Information Seeking in a Consumer Health Library Toward Developing a Virtual Information Consult for Cancer Patients and Their Caregivers: A Qualitative, Instrumental Case Study.

    Science.gov (United States)

    Papadakos, Janet; Trang, Aileen; Cyr, Alaina B; Abdelmutti, Nazek; Giuliani, Meredith E; Snow, Michelle; McCurdie, Tara; Pulandiran, Menaka; Urowitz, Sara; Wiljer, David

    2017-05-24

    Cancer patients and their caregivers want information about their disease and are interested in finding health information online. Despite the abundance of cancer information online, it is often fragmented, its quality is highly variable, and it can be difficult to navigate without expert-level knowledge of the cancer system. The Patient & Family Library at the Princess Margaret Cancer Centre offers a broad collection of high-quality cancer health information and staff are available to help patrons refine their questions and explore information needs that they may not have considered. The purpose of this research study was to deconstruct patrons' information-seeking behaviors in the library to assess the feasibility of replicating the services provided in the library through a Web app, extending the service beyond the walls of the cancer centre. The specific aims of this research were to understand (1) how patrons approach information seeking in the library (interface design), (2) how patrons communicate their informational needs (information categorization and metadata requirements), and (3) what resources are provided to address the patrons' information needs (collection development). We employed a qualitative, instrumental case study to deconstruct patrons' health information-seeking behavior. The study population included patients, the librarian, and library volunteers. Ethnographic observation was conducted at the library over 3 days and key informant interviews with library staff were conducted to address the first aim. A closed card-sorting activity was conducted to address the second aim and the library shift logs and Search Request Forms (SRFs) were reviewed to address the third aim. A total of 55 interactions were recorded during the ethnographic observation and nine semistructured interviews were conducted during the key informant interviews. Seven library patron personas were identified: (1) Newbie, (2) Seasoned, (3) Direct, (4) Window Shopper, (5

  14. A clinical case of single-stage correction of penetration combined orofacial defect with two microsurgical autografts

    Directory of Open Access Journals (Sweden)

    A. D. Kaprin

    2015-01-01

    Full Text Available After surgical treatment for locally advanced oral tumors with resection of soft tissues, mucosal membrane, and facial skeletal structures, there are penetration combined defects, removal of which is a challenge for reconstructive surgeons. Mandibular repair is one of the problems in the correction of combined oral defects. Surgeons use different grafts to remove mandibular defects. One-flap transplantation does not always solve all reconstruction problems and ensure the repair of the mucosal membrane, a soft-tissue component, skin integuments, and facial skeleton.The authors describe a clinical case of successful single-stage correction of penetration combined orofacial defect after resection of the tongue, mouth floor, en bloc resection of the lower jaw and mental soft tissues, bilateral cervical supramyochoroidal lymphadenectomy, stage LCL CM mandibular defect formation after J. Boyd, by using two microsurgical autografts (a peroneal skin-muscle-skin autograft and a radial skin-fascia one in a 39-year-old female patient clinically diagnosed with carcinoma of the left mandibular alveolar ridge mucosa, Stage IVA (T4аN0M0.The Department of Microsurgery, P.A. Herzen Moscow Oncology Research Institute, Ministry of Health of Russia, has gained experience in comprehensively correcting extensive combined maxillofacial defects with two or more grafts in 27 patients who underwent autografting with a total of 73 flaps. The most functionally incapacitating and life-incompatible defect was removed at Stage 1 of reconstructive treatment. Delayed reconstruction was made after a complex of specialized antitumor therapy and assessment of treatment results in the absence of progressive growth. A great problem during multi-stage defect correction is presented by the lack of recipient vessels after cervical lymphadenectomy, the presence of soft tissue scar changes, trismus, temporomandibular joint ankylosis, contractures and displacement of the edges of the

  15. Methodological and practical viewpoints of qualitative-driven mixed method design: the case of decentralisation of primary healthcare services in Nepal.

    Science.gov (United States)

    Regmi, Krishna

    2018-01-01

    Although considerable attention has been paid to the use of quantitative methods in health research, there has been limited focus on decentralisation research using a qualitative-driven mixed method design. Decentralisation presents both a problematic concept and methodological challenges, and is more context-specific and is often multi-dimensional. Researchers often consider using more than one method design when researching phenomena is complex in nature. Aim To explore the effects of decentralisation on the provision of primary healthcare services. Qualitative-driven mixed method design, employing three methods of data collections: focus group discussions (FGDs), semi-structured interviews (SSIs) and participant observations under two components, that is, core component and supplementary components were used. Four FGDs with health service practitioners, three FGDs with district stakeholders, 20 SSIs with health service users and 20 SSIs with national stakeholders were carried out. These were conducted sequentially. NVivo10, a data management program, was utilised to code the field data, employing a content analysis method for searching the underlying themes or concepts in the text material. Findings Both positive and negative experiences related to access, quality, planning, supplies, coordination and supervision were identified. This study suggests some evidence of the effects of decentralisation on health outcomes in general, as well as filling a gap of understanding and examining healthcare through a qualitative-driven mixed methods approach, in particular. Future research in the area of qualitative in-depth understanding of the problems (why decentralisation, why now and what for) would provoke an important data set that benefits the researchers and policy-makers for planning and implementing effective health services.

  16. Qualitative Methodology in Unfamiliar Cultures

    DEFF Research Database (Denmark)

    Svensson, Christian Franklin

    2014-01-01

    This case study discusses qualitative fieldwork in Malaysia. The trends in higher education led to investigating how and why young Indians and Chinese in Malaysia are using the university to pursue a life strategy. Given the importance of field context in designing and analysing research based...

  17. THE FUNCTION OF QUALITATIVE RESEARCH

    NARCIS (Netherlands)

    HEYINK, JW; TYMSTRA, T

    Due to the prevailing positivistic view on science, qualitative research has only a modest place within the social sciences. There is, however, a growing awareness that a purely quantitative approach is not always satisfactory. This is for instance the case in the field of research into the quality

  18. Case presentation of two patients using diagonal platform-switched double implants for maxillary single-first-molar replacement as the alternative of a single-tooth implant.

    Science.gov (United States)

    Hotta, Yasunori; Ito, Koji; Komatsu, Shinichi; Saito, Takashi

    2015-12-01

    A single-tooth implant restoration is generally performed for maxillary single-first-molar replacement. If the interdental space between the second premolar and the second molar is large enough, a double-implant placement can be performed to avoid creating mesiodistal cantilever and to distribute occlusal loading forces.If there is not adequate space for a double-implant placement to be performed mesiodistally along the crest of the alveolar ridge line, they should be placed along a diagonal line offset lingually to increase the space. This procedure has two primary advantages. First, greater stability is provided by a double-implant placement. Resistance to lateral forces (palatal-buccal) is much stronger than two implants placed along the alveolar crest ridge line. Residual palatal and buccal bone can provide support against occlusal forces, provided that there is adequate residual bone in these regions.If anatomical conditions are favorable, the placement of two diagonal implants in the palatal and buccal residual bones can be a rational procedure.We report on two typical patients. The progress of these patients was followed using computed tomography for 7 and 6 years, respectively.

  19. Coexistence of two talon cusps and two dens invaginatus in a single tooth with associated radicular cyst-a case report and review of literature.

    Science.gov (United States)

    Kasat, Vikrant O; Singh, Mukund; Saluja, Harish; Ladda, Ruchi

    2014-10-01

    Talon cusp (TC) and dens invaginatus (DI) are relatively rare developmental anomalies which affect the shape of teeth. TC is an additional cusp that projects predominately from the lingual surface of anterior teeth. DI is a deep surface invagination of the crown or root which is commonly detected on routine radiographic examination. Both of these anomalies are observed more frequently in permanent maxillary lateral incisor. Isolated cases of single TC and DI are extensively reported in dental literature. Occasionally two talon cusps (TCs) in the same tooth as well as double and triple invaginations in one tooth are reported separately. Coexistence of these two anomalies in a single tooth is considered extremely rare, but still there are few reported cases. However, coexistence of two TCs and double DI in a single tooth is not reported till date. We hereby report the first case of coexistence of two TCs and double DI in a single tooth of a 23 year old female and use of platelet-rich fibrin (PRF) in the management of associated radicular cyst. Also, literature on coexistence of these two anomalies in a single tooth is reviewed. Key words:Coexistence, dens invaginatus, radicular cyst, talon cusp.

  20. Adenoid cystic carcinoma of the head and neck: a single-center analysis of 105 consecutive cases over a 30-year period

    NARCIS (Netherlands)

    van Weert, S.; Bloemena, E.; van der Waal, I.; de Bree, R.; Rietveld, D.H.F.; Kuik, D.J.; Leemans, C.R.

    2013-01-01

    Background Adenoid cystic carcinoma is a rare salivary gland malignancy with a poor disease free survival due to frequent distant metastases and late local recurrences. Previous single-center reports on outcome mostly encompass small series. In this report a relative large series of 105 cases is