Talking about Height and Quality of Life: A Content-Analysis of Focus Group Discussions with Short-Statured Children and Their Parents in the US

Background: To understand what life is like for US children with a diagnosis of Growth Hormone Deficiency or Idiopathic Short Stature, the impact of short stature on Health related Quality of Life (HrQoL) was qualitatively examined and needs for care from the young patients and their parents perspective were identified. Methods: Focus group discussions with 26 American-English speaking and nine American-Spanish speaking children and their parents were conducted, transcribed verbatim and subsequently qualitatively analyzed by two independent raters, using an existing coding guideline, based on the multidimensional HrQoL concept and a special software (VERBI-Software MAXQDA 10). Results: A total of 1313 statements for the English-speaking and 447 statements for the Spanish-speaking families were categorized. In the US, the strongest frequency of mention was found for the HrQoL dimension “Social” across respondents, followed by “Treatment” and “Emotion”. Conclusion: Conducting and analyzing data generated from focus groups ensure that young patients’ experiences of disease are represented in the measure of outcomes for use in clinical trials and patient care.

Barriers and facilitators to mexican-american participation in clinical trials: physician and patient focus group perspectives

Racial/ethnic minority populations are under- represented in clinical trials and Hispanic participation rates are particularly low. This study assessed barriers and facilitators to clinical trials participation by Medicaid eligible Mexican- Americans and their serving physicians. Qualitative data from two focus groups conducted among Mexican-American Medicaid eligible patients and four physician focus groups were analyzed. Mexican-American patients have a basic understanding of clinical trials. While most are open to participating in clinical research, not speaking English, time, and transportation were identified as barriers. Physicians believe that desperation and financial need are the primary patient motivators for participation. Barriers to physician recruitment and referral include: lack of information about clinical trials, concern that study participation may not be in the patient’s best interest, and lack of staffing and time to conduct trials. Ample opportunities exist to engage providers and patients in future efforts to increase Mexican-American patient recruitment into clinical trials.

Risks and Influences of Climate Hazards for Agro-Pastoral Development and Strategies Adopted by Agro-Pastoralist Communities in the Bougouni District, Mali

In the southwest of Mali, pastoral resources play an important role in the production and reproduction of livestock. These pastoral resources are very sensitive to climatic hazards and negatively affected their availability in quantity and quality. The main objective of this study was to analyze the risks and influences of climate hazards on pastoral resources and the strategies taken by agropastoralists to cope with them. To achieve this objective, meteorological data trends from 1950 to 2022 were analyzed. The socio-economic data were collected through a semi-structured survey administered to 404 head households, from focus groups through discussion with local stakeholders by using climatic risks matrix. The results obtained indicate a concordance between agropastoralists perception on climate change and meteorological observations concerning the decrease of rainfall (−213 mm;63.3%), the increase of maximum and minimum temperature (+1.33˚C, +1.24˚C;93.1%), and the increase of wind speed (+0.59 m/s;97%) over the past 70 years. Respondents noted a deterioration in the conditions of pastoral resources due to climatic hazards compared to the last 40 years (44.8% for watering points;23.5% for pastures;63.1% for salty lands). Agro pastoralists have adopted measures that allow them to be resilient. These include the collection and storage of crop residues (49.5%), regular watering of animals (39.6%), changing of animals rhythms driving (35.9%), protection of pruning species (31.7%), and concerted reforestation (37.9%). Climatic risk-related hazards constitute a real threat to pastorals resources in the district of Bougouni.

Working experiences of nursing aides in nursing homes:A qualitative study

Objective:To examine how nursing aides in nursing homes perceived their caring work.Methods:Twenty-four nursing aides from one public and one private nursing home in Fuzhou,Fujian Province,China were selected and interviewed in focus groups.Phenomenological analysis was performed.Results:Two themes(positive and negative working experiences)and six sub-themes were drawn:companionship,happiness,trust,achievement,hard work,and grievance.Conclusion:A reasonable work arrangement,positive psychological intervention,and the strengthening of professional,medical and social supports are recommended to improve the work quality and satisfaction of nursing aides in elderly homes.

Intensive Care Nurses’Experiences of Caring for Intubated Patients under Light Sedation:A Qualitative Study

Introduction: Previous studies have shown that a light sedation level is beneficial for intubated patients in the Intensive care unit (ICU). Aim: This study aimed to describe intensive care nurses’ experiences of caring for intubated patients under light sedation. Methods: This study was an explorative descriptive qualitative study. Data were collected from 12 intensive care nurses by three focus group interviews and analyzed using qualitative content analysis. Findings: Five categories emerged from the data: 1) the importance of verbal communication and the nurses’ presence, 2) feelings of frustration and heavy workload, 3) assessment of patients’ pain and anxiety, 4) the nurses’ desire for the development of guidelines, and 5) being inspired by the care. Conclusion: The study found that intensive care nurses were positive towards light sedation care but the organization of care did not support them as the patients cared for with light sedation treatments demanded their physical presence at patients’ bed site.

Expectations of survivors towards disaster nurses in Indonesia:A qualitative study

Objective: This study aims to explore the expectations of survivors towards disaster nurses.Methods: The study used qualitative content analysis.Data were collected in 2017 through three focus group discussions with 21 survivors and in-depth interviews with three community leaders;the respondents had experienced one of the following events: a) an earthquake in Padang 2009,b) a volcanic eruption in Yogyakarta 2010,and c) flooding in Jakarta 2014.Results: Four themes represented survivors' expectations of what nurses can do in responding to a disaster,including: a) provision of direct nursing care,b) provision of information of health service access,c) provision of resources through cross-sector coordination,and d) disaster preparedness activities for the community.Conclusions: This study suggests the importance of disaster nurses having the competency to update information regarding healthcare access,particularly the utilization of health insurance and providing culturally competent care to the survivors.Disaster nurses are also expected to be able to train the community and families about preparedness-related activities.Besides,these disaster nurses should improve their competency in disaster risk reduction.More broadly,such nurses should have the ability to advocate and coordinate with the local government and other stakeholders regarding access to healthcare services and continuous rapid assessment,so that survivors receive immediate and appropriate treatment.

Development and validation of a rapid psychosocial well-being screening tool in patients with metastatic breast cancer

Objective The aim of this study was to develop and validate a rapid psychosocial well-being screening tool for metastatic breast cancer patients(MBC-PsySoc-Well-being).Methods Applying a mixed method approach,the study was conducted in two phases.Phase 1,a focus group method was employed for item development,and three focus group sessions were conducted,with patients,caregivers,and medical professionals,respectively.Phase 2,validity and reliability testing were performed.Five experts reviewed items for content validity.Construct validity,criterion-related validity,internal consistency,and test-retest reliability were conducted among a sample of 53 patients with metastatic breast cancer.Results Six themes were qualitatively analyzed based on focus group participants’responses.Eight items were then developed based on these themes.The index of Item-Objective Congruence scored by the experts ranged from 0.6 to 1.0.An exploratory factor analysis yielded three factors:Being curious and active in information seeking,Enthusiasm to return to a normal life,and Adjusting to positive lifestyle.The total scores of MBC-PsySoc-Well-being and the European Organization for Research and Treatment of Cancer’s Quality of Life Core Questionnaire(EORTC QLQ-C30)were moderately correlated(r=0.404,P=0.003).Cronbach’sαcoefficient of the overall scale was 0.686.Pearson correlation coefficients of items between two tests within 14-day ranged from 0.410 to 0.673.Conclusion This study represents an initiative to develop a rapid psychosocial well-being screening tool for patients with metastatic breast cancer.The results from validity and reliability testing indicate that the scale is moderately suitable for application to patients with metastatic breast cancer.However,a larger scale study should be further administered to confirm the validity and reliability of the measurement.

Vegetables, Herbs and Spices: The Importance of Family and Tasting

Objective: To explore why and how consumers utilize vegetables, herbs and spices. Methods: Focus groups were conducted with adult participants (n = 54) to determine attitudes, self-efficacy, and behaviors related to liking and usage of vegetables, herbs and spices as well as strategies to increase vegetable intake. Results: Seasonal availability, and family-centered memories and practices were motivation for vegetable intake. A diverse number of vegetables (n = 39) were listed as favorites based on taste and versatility, but seasonings were not commonly included in responses regarding preparation. Participants felt that vegetable dish names should reflect ingredients explicitly;that seasonings enhanced vegetable flavors;and that salt and pepper were most commonly used seasonings. The preferred strategy to increase vegetable consumption was through tasting or sampling opportunities;seasoning use was not mentioned. However, participants perceived that suggestions or demonstrations on how to prepare vegetables at home would be helpful. Personal gardens were mentioned frequently, but were not connected to strategies for increasing intake. Conclusions and Implications: Vegetable intake has a family focus that should be emphasized to increase intake. Efforts to increase intake could emphasize flavor and versatile preparation methods through tasting opportunities or educational demonstrations.

Improving Clinical Laboratory Quality through Reduction of Tests’ Turnaround Time in Democratic Republic of the Congo: Key Strategies

In Democratic Republic of the Congo (DRC), the laboratory TAT is significantly very long and do not comply with either international standards or the suggestions of customers. However, there is neither a national nor a local strategy to improve the laboratory TAT. The aim of the present study is to develop practical management strategies to shorten clinical laboratory tests’ TAT. This was a qualitative study conducted in Kinshasa. Focus groups and Lean tools were used respectively to generate a wide range of views from a variety of laboratory staff and to eliminate several form of waste in the laboratory flow process. Based on the identified root causes of delay, focus groups participants reported that there is a lot of scope for the improvement of TAT in DRC. Consistent attendance and punctuality are essential. The hospital management should implement the Laboratory Information Systems (LIS) and install Middleware. Total laboratory automation, inventory system for all reagents and supplies used in the laboratory, expansion of the sampling area, sufficient number of high-power machine and a clear job description are indispensable. LIS, 3.5 mL BD vacutainer BarricorTM tube and point-of-care testing (POCT) are necessary for workflow improvement. A reduction of 312 minutes was achieved by eliminating or decreasing non-value-added activities. Applying the suggested key strategies, and particularly the new workflow process, is a basis for improving the laboratory tests’ TAT. The algorithm presented can be easily implemented in other laboratories that face this type of problem.

“With This Disease, You Take Whatever Chances There Are”—A Study on Socio-Cultural and Psychological Aspects of Experiments Regarding Huntington’s Disease

Although relatively rare, Huntington’s disease (HD) has fatal consequences. There is no cure for the disease, which leads to an early death. Worldwide, scientists are trying to develop therapeutic methods that could cure the disease, including new molecular gene therapeutic methods. At Lund University, research on HD is now about to step from animal models to trials with humans. The project is special in its design since it involves both medical studies and socio-cultural and psychological research to explore and meet the many challenges that experimental trials with HD patients give rise to. The aim of the present study was to investigate the viewpoints of individuals affected by HD on the issues of participation and exerting influence if taking part in a medical study on gene therapy that has not previously been tested on humans. A total of 16 participants, recruited through the national association for HD and through the neurological clinic at Lund University in Sweden, took part in a focus group or in a survey study. A thematic analysis, to explore the transcribed text from the focus groups as well as from the written mail responses, was conducted by means of Nvivo, a program for qualitative data analysis. Results showed three main themes expressing reasons for participation: participation as a last resort, as an activity of hope, and as a way to take responsibility for the development of a cure that will benefit future generations. The responses relating to the question about affected individuals’ view of exerting influence resulted in two themes. The first theme was having a voice when researchers design experiments, which may give a sense of receiving respect. The second was that influence is an essential part of the information process before agreeing to take part in an experimental trail.

Bloodletting puncture in the treatment of acute ischemic stroke:protocol for a mixed-method study of a multi-center randomized controlled trial and focus group

This study is to investigate the effectiveness and safety of bloodletting puncture(BP)for acute ischemic stroke(AIS)when used in combination with standard treatment,as well as the patients'feelings and attitudes toward the treatment.This is a mixed method research which includes a multi-center,superiority,randomized controlled clinical trial,and focus group interview.A total of 360 AIS participants will be enrolled.They will be randomized into one of the following two groups for 7 d:(a)BP with standard treatment group(n=180);(b)standard treatment group(n=180).The primary outcome will be National Institute of Health stroke scale(NIHSS)score at day 7 after treatment.Secondary outcomes will be changes of Glasgow Coma Scale score,NIHSS score,mRS and Traditional Chinese Medicine syndrome score from baseline to 7,14,and 30 d after treatment,recurrence rate and all-cause mortality rate within 30 d,and the safety assessments.The focus group will be conducted with a purposive sample of 1-2 acupuncturists and 1-2 patients respectively at each center at 7 and 30 d after treatment.We designed a mixed method study to evaluate the effect of BP,an acupuncture therapy for patients with AIS.If the findings of this study confirm the effectiveness of BP to reduce the NIHSS score and other related outcomes and patients are willing to accept the therapy,we believe this study will help the implementation of this therapy in clinical practice,and provide new evidence for the treatment of AIS.

Perceptions and barriers that influence the ability to provide appropriate incontinence care in nursing home residents: Statements from nursing staff

Urinary incontinence is a common medical condition among nursing home residents. Urinary incontinence in older people has a multifactorial etiology and is therefore more difficult to assess and treat than urinary incontinence in younger people. Previous research has shown that incontinence care in nursing home residents often is inadequate and little systematized. The aim of this study was to identify perceptions and barriers that influence the ability of the nursing staff to provide appropriate incontinence care. This was a qualitative study using focus-group methodology. Data were collected from three focus-group interviews with 15 members of the nursing staff from six different units in a nursing home. The focus-group interviews were recorded on tape, transcribed verbatim and analyzed according to qualitative content analysis. Three topics and eight categories were identified. The first topic, Perceptions and barriers associated with residents, consisted of one category: “physical and cognitive problems”. The second topic, Perceptions and barriers associated with nursing staff, consisted of three categories: “lack of knowledge”, “attitudes and beliefs” and “lack of accessibility”. The third topic, Perceptions and barriers associated with organizational culture, consisted of four categories: “rigid routines”, “lack of resource”, “lack of documentation” and “lack of leadership”. The findings from this study show that there are many barriers that might influence the possibilities of nursing staff to provide appropriate incontinence care to residents in nursing homes. However, it can nevertheless seem like opinions and the attitude of nursing staff, together with a lack of knowledge about UI, are the most important barriers to provide appropriate incontinence care.

Nursing Staff’s Experiences of Providing Toilet Assistance to Elderly Nursing Home Residents with Urinary Incontinence

Introduction: Urinary incontinence is a common condition among elderly. It affects their daily life and quality of life. Toilet assistance may decrease urinary incontinence episodes among elderly. Many nursing home residents do not receive the available evidence-based toilet assistance they need. Aim: The aim of the present study was to describe nursing staff members’ experiences of providing toilet assistance to elderly nursing home residents with urinary incontinence. Design: A descriptive design with a qualitative content analysis method was used. Method: Four nurses and seven auxiliary nurses were interviewed in three homogenous focus groups. Data were collected during spring 2015. Results: The most essential opportunity factor for good toilet assistance was the nursing staff’s attitude and behavior regarding the elderly’s need to visit the lavatory. This resulted in individual toilet assistance in which the elderly’s integrity and needs were cared for. Functioning routines and sufficient staff availability were crucial in determining whether the elderly could visit the lavatory. Other enabling factors for good toilet assistance were information and education of staff. The main obstructing factors for good toilet assistance were the elderly’s decreased cognitive ability, negative attitudes toward receiving toilet assistance and lack of communication and co-operation between professionals with regard to prescribing and fastening individual incontinence aids. Conclusion: Providing toilet assistance is a considerable nursing intervention for elderly to help them regain continence or contain incontinence, whenever possible. Person-centered incontinence care is important for developing and adjusting toilet assistance based on each older person’s individual needs.

Harmonic Energy Transfer for Extreme Waves in Current

Ning et al. （2015） developed a 2D fully nonlinear potential model to investigate the interaction between focused waves and uniform currents. The effects of uniform current on focusing wave crest, focal time and focal position were given. As its extension, harmonic energy transfer for focused waves in uniform current is studied using the proposed model by Ning et al. （2015） and Fast Fourier Transformation （FFT） technique in this study. It shows that the strong opposing currents, inducing partial wave blocking and reducing the extreme wave crest, make the nonlinear energy transfer non-reversible in the focusing and defocusing processes. The numerical results also provide an explanation to address the shifts of focal points in consideration of the combination effects of wave nonlinearity and current.

A Frame Work of Multistage Decision Making

This research has objective to analyze some tools which are used to support decision maker to make a decision in multi stage and systematic way. And also in making decision, there are a qualitative type and quantitative type. In order to get an optimum decision making, the decision maker needs systematic way. There is the frame work which is based on combination of some existing methods and challenges emerging in organizational activities, including social organizations as well as business organisations. To formulate the framework, this research conducted focus group discussion consisting of some organizational managers as participants. There are five components of proposed frame work： （1） Criteria Identification through Focus Group Discussion （FGD）; （2） Criteria Selection; （3） Focus Group for Criteria Verification; （4） Multicriteria Decision Making based Analytic Hierarchy Process （AHP）; and （5） Impact Analysis. This research resulted in an effective approach of decision making which allows decision maker to have objective and rational reason in each step of its decision-making process. Strength of the proposed framework is to provide rational and objective approach in group decision making. However, it takes longer time to conduct decision making due to more steps and participants involved. As a conclusion, the proposed research has been successful in establishing a multi stage and rational decision-making process.

An investigation on traditional Chinese medicine in Dublin Ireland

The traditional Chinese medicine chain arrived in Ireland in 2005. This study focused on the standardization and adaptation of TCM companies and the customer profile in Irish market. The objective of this research dissertation is to find that how TCM is learned in Irish market and how it faces different cultures.

The Use and Misuse of Mobile Phones in the Maternity Ward—A Threat to Patient Safety?

An important task for the midwife is following up mother-child interaction to facilitate mother-infant attachment. The aim of this study was to explore midwives’ perceptions of parents’ use of mobile phones in the maternity ward. The research question was: Is the use of mobile phones in the maternity ward a threat to patient safety? Two focus group interviews exploring midwives’ perceptions (n = 10) of parent’ use of mobile phones during and after the birth were conducted in January 2016. Systematic text condensation was used to analyse the data, revealing three themes pertaining to safety concerns: Interrupted communication due to parents’ excessive use of mobile phones during labour and postnatally, Unsafe care caused by lack of attention to the newborn baby’s signals as a result of being disturbed by the mobile phone and Unsafe care because of parents interrupting their conversation with the midwife by answering the mobile, acting in a disrespectful manner and failing to pay attention. The midwives’ descriptions of parents’ use of mobile phones in the maternity ward included reflections on mobile phone usage as a permanent phenomenon. They were concerned that parents’ use of mobile phones in the maternity ward could negatively affect the attachment process and considered that it interrupted their work. In conclusion, there is a need for increased awareness of parents’ use of mobile phones in the maternity ward. Further research is required to gain greater insight into the consequences of mobile phone use in order to promote patient safety by ensuring effective communication between parents and midwives. In addition, research is needed to explore the safety discourse, clinical risks and/or health problems involved in the development of infant-parent attachment in newborn babies.

Experiences of Being Non-Smoking among Adolescents in a Smoking Context

Introduction: A study among Greenlandic 13-year-old showed that 68 percent for boys and 55 percent for girls, and at age 15, 46 percent of the boys and 32 percent of the girls were non-smokers. A literature review showed that the behaviour of parents and peers, attitudes and expectations were crucial factors for the smoking habits of adolescents. Young adults would more likely start smoking if their parents, older siblings and/or friends were smokers. Parental support has been proven to be a preventive factor against smoking, especially if the school and leisure centers get involved. Group pressure, directly or indirectly, is often described as the most important reason why adolescents start smoking. The purpose was to study why some adolescents choose to be smoke-free in a society where the norm is to smoke. Methods: Adolescents who were non-smokers were interviewed in focus groups. The material was analysed using content analysis. Results: The contents analysis of the text resulted in eleven categories. Based on these, four themes were developed. These themes covered areas on the reasons for being smoke-free;how the smoke-free adolescents generally felt about smokers from a society or environment perspective, and also specifically from an individual perspective, such as how smokers took up space and did not show any consideration. There was a feeling among non-smokers of not belonging and of ambivalence, as well as a perspective of the future for adolescents in Greenland and an uncertainty about what would be required for a smoke-free environment. Conclusions: In a context where the norm is to smoke, the adolescents need to make a conscious choice to be smoke-free, and there were different reasons for this choice. This choice means becoming an outsider in their group of peers as well as the overall social culture. Smokers were seen as taking up too much space, as their needs ruled and this was deemed inconsiderate.

Lack of Consensus and Dense Content in Informational Letters on Benign Gynecological Surgery

Objective: This study maps the contents of departmental informational letters and explores whether the national GynOp letters live up to the patients’ expectations and needs. Introduction: Patients who are well informed before undergoing surgery experience reduced stress and increased understanding of the postoperative process. Although providing patients with written information before gynecological surgery is widely used and assumed important, no study has investigated what information patients truly need. Methods: In 2014, all 59 gynecological departments in Sweden were asked to provide the information letter they send to patients before hysterectomy on benign indication. 32 letters were analyzed using frequency analysis. In addition, three focus groups were conducted and these data were submitted to Qualitative Content Analysis. Results: The analysis of the information letters showed great variation and discrepancy in pre-operative information. The analysis of the focus groups resulted in the theme You can’t see the forest for the trees, reflecting that, the women found it very difficult to identify the most important information among the massive amount information received. Conclusions: The informational letters did not meet the patients’ expectations and needs. Practice implications: This study could serve as a foundation for the content of informational letters.

NUMERICAL SIMULATION OF PROPAGATION AND BREAKING PROCESSES OF A FOCUSED WAVES GROUP

A two-dimensional numerical wave flume is developed to study the focused waves group propagation and the consequent breaking processes. The numerical model is based on the Reynolds-Averaged Navier-Stokes （PANS） equations, with the standard k - c turbulence model to simulate the turbulence effects. To track the complicated and broken free-surface, the Volume Of Fluid （VOF） method is employed. The numerical model combines the ＂Partial Cell Treatment （PCT）＂ method with the ＂Locally Relative Stationary （LRS）＂ concept to treat the moving wave paddle so that various waves can be generated directly in a fixed Cartesian grid system. The theoretical results of the linear and nonlinear waves are used to validate the numerical wave flume firstly, and then a plunging breaking wave created by a focused waves group is simulated. The numerical results are compared to the experimental data and other simulation results, with very good agreements. The turbulence intensity, the flow field and the energy dissipation in the breaking processes are analyzed based on the numerical results. It is shown that the present numerical model is efficient and accurate for studying the waves group generation, the waves packet propagation, and the wave breaking processes.