The person within: parents and professionals’ views about the practitioner’s role in a parenting program

Practitioners’ characteristics and actions influence the implementation of evidence-based programs, but little is known about the practitioner’s role in the implementation of parent-based programs. The present qualitative study is the first to explore the perceptions of parents and professionals regarding the practitioners’ characteristics and actions which influence the implementation of a parent program directed at children’s behavior problems. Using thematic analysis, data were examined from eight focus groups comprising 24 parents and 19 practitioners who have participated in the Incredible Years parent group program (IYPP). The analysis identified three groups of practitioners’ characteristics perceived to impact the implementation of the IYPP: inferred interpersonal characteristics (genuine interest; empathy and warmth; positive regard; humbleness); inferred intrapersonal characteristics (objectivity; flexibility; well-being; reflexiveness) and objective characteristics (similar age; being a parent; clinical professional background; professional experience with children and the IYPP). These personal characteristics are perceived as serving to underpin practitioners’ actions, and an integrated framework model is proposed where specific practitioners’ actions are understood in relation to personal characteristics. Inferred characteristics are perceived as determinants in the intervention process while objective characteristics are seen as facilitators of parent engagement in the earliest stages of intervention. Finally, most of the characteristics and actions perceived as relevant in this study are contemplated in the IYPP model; however, the practitioners’ intrapersonal well-being, self-reflexiveness and genuineness emerged as characteristics which may merit further consideration. The results from this study suggest that in the IYPP the person of the practitioner may indeed be worthy of more critical examination.info:eu-repo/semantics/publishedVersio

A Qualitative Evidence Synthesis Protocol

Nursing Bedside Handover (NBH) is acknowledged as a nursing practice implemented at the patient’s bedside to improve communication safety during the shift change, but it is vulnerable due to inconsistent application among nurses. This synthesis of qualitative evidence aims to review and synthesize the perceptions and experiences of nurses regarding the factors that, in their perspective, influence NBH practice. We will follow the thematic synthesis methodology of Thomas and Harden and the Enhancing Transparency in Reporting the Synthesis of Qualitative Research (ENTREQ) Statement guidelines. A search will be conducted through the databases of MEDLINE, CINAHL, Web of Science, and Scopus, and we will follow the three-step search process to identify primary studies with qualitative or mixed-method research designs and projects of quality improvement. The screening and selection of the studies will be carried out by two independent reviewers. We will use the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) to report the screening, search, and selection of studies. To assess its methodological quality, two reviewers will independently use the CASM Tool. The extracted data will be reviewed, categorized, and summarized in tabular and narrative formats. The findings obtained will allow us to inform future research and change management led by nurse managers.info:eu-repo/semantics/publishedVersio

Can health care providers recognise a fibromyalgia personality?

OBJECTIVES: To determine if experienced health care providers (HCPs) can recognise patients with fibromyalgia (FM) based on a limited set of personality items, exploring the existence of a FM personality. METHODS: From the 240-item NEO-PI-R personality questionnaire, 8 HCPs from two different countries each selected 20 items they considered most discriminative of FM personality. Then, evaluating the scores on these items of 129 female patients with FM and 127 female controls, each HCP rated the probability of FM for each individual on a 0-10 scale. Personality characteristics (domains and facets) of selected items were determined. Scores of patients with FM and controls on the eight 20-item sets, and HCPs’ estimates of each individual’s probability of FM were analysed for their discriminative value. RESULTS: The eight 20-item sets discriminated for FM, with areas under the receiver operating characteristic curve ranging from 0.71-0.81. The estimated probabilities for FM showed, in general, percentages of correct classifications above 50%, with rising correct percentages for higher estimated probabilities. The most often chosen and discriminatory items were predominantly of the domain neuroticism (all with higher scores in FM), followed by some items of the facet trust (lower scores in FM). CONCLUSIONS: HCPs can, based on a limited set of items from a personality questionnaire, distinguish patients with FM from controls with a statistically significant probability. The HCPs’ expectation that personality in FM patients is associated with higher levels for aspects of neuroticism (proneness to psychological distress) and lower scores for aspects of trust, proved to be correct.info:eu-repo/semantics/publishedVersio

A comprehensive assessment of the transcriptome of cork oak (Quercus suber) through EST sequencing

Background: Cork oak (Quercus suber) is one of the rare trees with the ability to produce cork, a material widely used to make wine bottle stoppers, flooring and insulation materials, among many other uses. The molecular mechanisms of cork formation are still poorly understood, in great part due to the difficulty in studying a species with a long life-cycle and for which there is scarce molecular/genomic information. Cork oak forests are of great ecological importance and represent a major economic and social resource in Southern Europe and Northern Africa. However, global warming is threatening the cork oak forests by imposing thermal, hydric and many types of novel biotic stresses. Despite the economic and social value of the Q. suber species, few genomic resources have been developed, useful for biotechnological applications and improved forest management. Results: We generated in excess of 7 million sequence reads, by pyrosequencing 21 normalized cDNA libraries derived from multiple Q. suber tissues and organs, developmental stages and physiological conditions. We deployed a stringent sequence processing and assembly pipeline that resulted in the identification of ~159,000 unigenes. These were annotated according to their similarity to known plant genes, to known Interpro domains, GO classes and E.C. numbers. The phylogenetic extent of this ESTs set was investigated, and we found that cork oak revealed a significant new gene space that is not covered by other model species or EST sequencing projects. The raw data, as well as the full annotated assembly, are now available to the community in a dedicated web portal at http://www.corkoakdb.org. Conclusions: This genomic resource represents the first trancriptome study in a cork producing species. It can be explored to develop new tools and approaches to understand stress responses and developmental processes in forest trees, as well as the molecular cascades underlying cork differentiation and disease response.Peer Reviewe

Evaluating the methodological approaches of cross-cultural adaptation of the bedside handover attitudes and behaviours questionnaire into portuguese

Nurse managers need culturally adapted assessment instruments to support the implementation of change to Nursing Bedside Handover (NBH) in healthcare institutions. This study aimed to cross-culturally adapt the Bedside Handover Attitudes and Behaviours (BHAB) questionnaire to the Portuguese context and evaluate the methodological approaches used for this purpose. To guide this study, we followed a guideline for cross-cultural translation and adaptation measurement instruments in healthcare. The results of the content validity testing suggested that the BHAB questionnaire is a valid instrument for use in the Portuguese context. To obtain these results we showed 1) using of a new methodological approach, the dual focus, to resolve the divergences and ambiguities in the translators’ committee and the multi-professional committee; 2) the lack of a conceptual definition of the construct of the instrument as a requirement to retain items with I-CVI <0.70 after validity relevance pretesting and 3) the cognitive debriefing and relevance pretesting as methodological approaches which can be used alone or together to reinforce the evaluation of cultural relevance of the items. We concluded there is a need for guidelines to support the decision-making process of healthcare researchers with comprehensive information about the different methodological approaches they can follow.info:eu-repo/semantics/publishedVersio

A questionnaire for listening to students’ voices in the assessment of teaching quality in a classical medical school

and assess its reliability by using it with a sample of first-year medical students. Principal components analysis with varimax orthogonal rotation resulted in the development of a 12-item, two-component tool, adequate for use in lectures and smallgroup sessions. The two components were named ‘curriculum’ and ‘relationship’. The Cronbach coefficient alpha values indicated high reliability and internal consistency. According to the results obtained this teaching quality scale is a reliable measure and may be useful in identifying themes in disciplines and among teachers that may benefit from some professional development. Amongst its advantages is that it can be used with an optical reading tool

Bioestratigrafía y paleogeografía del Oligoceno-Mioceno del borde SO de la fosa de Ciudad Rodrigo

[ES] Durante el Oligoceno y Mioceno Inferior se depositó la Formación Arcosas de la Alamedilla (Fig. 5) en el borde meridional de la Fosa de Ciudad Rodrigo (Fig. 1). Esta unidad es el resultado del desmantelamiento de un área madre granitoide, fundamentalmente, ubicada al S, SO y N, por sistemas fluviales de baja sinuosidad (Fig. 6). El análisis polínico (Lám. 1) sugiere la existencia de un clima templado con carácter estacional. Al observar la evolución de las asociaciones florísticas, a lo largo de la columna estratigráfica se aprecia un paulatino reemplazamiento de los taxones arbóreos por los herbáceos (Fig. 3). Este hecho implicaría una progresiva degradación de la cobertera vegetal arbórea causada por una tendencia del clima a la aridez, en consecuencia, el carácter estacional del clima se va acentuando con el paso del tiempo. La conjunción de los estudios palinológicos, estratigráficos y sedimentológicos (Fig. 5), indica que durante la sedimentación de la Formación Arcosas de La Alamedilla, el paisaje fue abierto (Fig. 6) recorrido por sistemas fluviales trenzados de arenas muy proximales y condicionados por un clima estacional.[EN] During the Oligocene and Early Miocene the Arcosas de la Alamedilla Formation (Fig. 5) was deposited on the southern egde of the Ciudad Rodrigo trough (Fig. 1). This unit is the result of a dismanteling of a granitoid source areas present day situated to the S, SW and N by large ephemeral low-sinuosity fluvial systems (Fig. 5). Pollen analysis (plate 1) suggests the existence of a temperate climate with a seasonal nature. On considering the evolution of the floristic associatgions through the stratigraphie section stratigraphie a gradual replacement of the tree taxa by those of herbaceous species may be observed (Fig. 3). This would imply a progressive degradation of the tree covering caused by a trend of the climate towards arid conditions; consequently, the seasonal character of the climate would have become more pronounced with time. Joint palynological, stratigraphie and sedimentological studies (Fig. 5) show that during the sedimentation of the Arcosas de la Alamedilla Formation the landscape was opened (Fig. 6), covered by braided fluvial systems of proximal sands and governed by a seasonal temperate climate

Therapist Factors Matter: A Systematic Review of Parent Interventions Directed at Children's Behavior Problems

The present review systematically explored research examining the relationship between therapist-related factors and the outcomes of parent interventions directed at children's behavior problems. A systematic search of the literature was conducted with online scientific databases, parenting programs, web sites, and bibliographic references of the selected articles, according to PRISMA guidelines. A total of 24 quantitative studies met the inclusion criteria. Although some methodological limitations were identified with respect to the measurement of therapist factors, the reviewed research strongly suggests that the therapist plays a critical role in parent interventions directed at behavior problems. In particular, many parent outcomes are found to be related to the parent-therapist alliance, the therapist's fidelity to the intervention, specific therapist's in-session actions, and the therapist's personal variables. The parent-therapist alliance and therapist fidelity to the intervention consistently relate to changes in parenting practices, and alliance additionally relates to fewer perceived barriers to participation in treatment, more treatment acceptability, and greater parenting satisfaction and self-efficacy. In addition, specific in-session therapist interpersonal actions relate to parents' engagement and satisfaction, while both the therapist's interpersonal actions and more active skills relate to parent change. Therapist's personal variables have been scarcely or poorly studied to date, but the results found justify the need to develop further research in this area. In conclusion, more attention should be given to the role of the therapist when implementing parenting programs directed at behavior problems, and more and better research is needed that can overcome the methodological limitations identified

Médicos do Futuro - A selecção dos alunos de Medicina em Portugal e os desafios do médico do séc. XXI

Não tem resumo.1. Enquadramento do estudo empírico A sociedade moderna espera do médico, competências que ultrapassam largamente as do mero perito técnico (“Medical Expert”). O médico deve ser capaz de compreender o sofrimento alheio sem se deixar dominar por ele, de apaziguar o sofrimento para além da medicação, de transmitir confiança, empatia e esperança, de manter o sangue frio sob stresse, de se bater pelo seu doente e pela Saúde em geral, de utilizar responsavelmente os recursos sociais, entre muitas outras competências. A classe médica abraça, desde sempre, estes princípios e assume as exigências éticas e sociais que lhe estão subjacentes, como testemunha o juramento de Hipócrates. Esta assumpção é, em tempos mais recentes, reiterada pelo eco global com que foram acolhidos os papéis atribuídos ao Médico no projecto CanMeds: Medical expert, Communicator, Collaborator, Manager, Health advocate, Schollar, Professional (cf. http://rcpsc.medical.org/canmeds/ ). Um pouco por todo o mundo, curricula de pré- e pós-graduação em medicina vão sendo modificados para integrar objectivos claros em todas estas dimensões

Do Parents Perceive Practitioners to Have a Specific Role in Change? A Longitudinal Study Following Participation in an Evidence-Based Program

Little attention has been given to the role of practitioners in evidence-based parenting programs and to the evaluation that parents make of their importance in the process of change. This study aims to explore the role that parents assign to the facilitators of the Incredible Years (IY) program in enabling long-term life changes, as well as the association between parents' evaluation of the practitioners' skills and specific changes perceived after the intervention. In this longitudinal study, we applied 1 survey to 80 community parents who had participated in an IY group 2 years before, and we retrieved archival data to assess changes in parents' ratings of sense of competence and in children's behaviors immediately after the end of the intervention. Two years after the intervention, parents perceived significant improvements, especially in their parenting and their children's behaviors, and they recognized that their IY practitioners had played a significant role in these life changes. Parents who attributed a greater role to the practitioners' skills reported a greater number of improvements in parental sense of competence and in children's behaviors. The practitioners' skills relating more broadly to these specific changes are the practitioners' sensitivity and flexibility towards parents' needs and the practitioners' ability to clearly share knowledge with parents. The practitioner's assigned role when implementing an evidence-based parenting program seems to go far beyond the mere conveyance of the program's specific contents and methods and deserves to be researched further