Analysis of mental imagery in grade one.

Thesis (Ed.M.)--Boston Universit

Challenges in Communication about Covid Medical Risks: : A Speculative Educational Template

The most recent descriptions of how the pandemic is playing out in medical offices and hospitals describe scenarios that are truly unprecedented. The impact of COVID-19 on individuals sick enough to seek professional health care highlights the importance of communication skills in explaining potential risks. Clinicians need to be sophisticated in thinking about how to approach each patient. We propose an educational framework for pre-service and in-service health care professionals to improve communication skills during this crisis. To assist Covid patients and their family members, clinicians need to be mindful of the ways that the likelihood of serious impact and consequences of treatments are perceived by each patient and their loved ones. The four-quadrant scheme we offer is a way to help providers orient themselves to their task and prepare to speak effectively about medical choices related to Covid. It is obvious that most situations demand more than one type of communication competency, but the focus here is on what might be advisable as the primary or “lead” skill. Thinking through what would be the preferred “leading” strategies is crucial for clinicians aiming to help COVID-19 patients think about the risks they are facing. Addressing the psychological state of each individual patient is vital. The most important element in managing COVID-19 is to empower patients with the appropriate information and emotional support. Additionally, we hope this model will inspire health professions faculty to think in new ways about teaching and coaching options in the practice-based learning of communication skills

Unmet care needs in people living with advanced cancer: a systematic review

Purpose: The support needs of cancer patients vary according to the phase of their cancer journey. Recent developments in healthcare are such that the advanced cancer phase is increasingly experienced as a chronic illness phase, with consequent changes in patient support needs. Understanding these needs, and identifying areas of unmet need, can enable us to develop services that are more adequate to the task of supporting this population. Methods: We conducted a systematic search of four electronic databases to identify studies examining the unmet needs of people living with advanced cancer. Relevant data were extracted and synthesised; meta-analyses were conducted to obtain pooled estimates for prevalence of needs. Results: We identified 23 studies (4 qualitative) for inclusion. Unmet needs were identified across a broad range of domains, with greatest prevalence in informational (30–55 %), psychological (18–42 %), physical (17–48 %), and functional (17–37 %) domains. There was considerable heterogeneity amongst studies in terms of methods of assessment, coding and reporting of needs, respondent characteristics, and appraised study quality. Conclusions: Heterogeneity made it difficult to compare across studies and inflated confidence intervals for pooled estimates of prevalence—we need standardised and comprehensive approaches to assessment and reporting of unmet needs to further our understanding. Nonetheless, the review identified prominent needs across a range of (interacting) experiential domains. Moreover, by focussing on unmet needs for support, we were able to extrapolate potential implications for service development

Minority Women in the Healthcare Workforce in New England

Research on health disparities affecting people of color typically focuses on their health status, health treatment and health outcomes with a particular emphasis on the relatively high rates of morbidity and mortality from selected diseases for ethnic and racial minority groups. This fact sheet offers a different but related focus on gender and race/ethnicity in the health care workforce. Our rationale is that the Sullivan Commission on Diversity in the Healthcare Workforce concluded that the lack of minority doctors, nurses and dentists is a significant cause of racial/ethnic health disparities and that the ability to recruit, train and retain minority health care professionals is critical in any effort to reduce health disparities in the future

Identifying innovation in higher education elearning strategies

There are many case studies of individual Higher Education Institutions (HEIs) devising distinctive eLearning strategies, reported by the HEI itself, journalists, or research observatories. An extraordinarily wide range of university-level eLearning programmes are rapidly becoming available from large numbers of HEIs across Europe, and there are strong attempts being made to identify and disseminate case studies of innovative eLearning practices (e.g. MENON, 2006). However, the vital research goal of obtaining more systematic evidence across countries in relation to HEIs' innovations in eLearning strategies represents a particular challenge for collectors of case studies, especially given the diverse processes in different countries for measuring pedagogical value and cost-effectiveness. By contrast, there are typically several reports a year of large-scale attempts to survey HEIs in relation to eLearning, sponsored, for example, by EU programmes or industry groups. Yet the factors that determine educational effectiveness are not, so far, well understood; and consequently it can be difficult to develop reliable quantitative survey items that simultaneously enable valid and insightful comparisons between essentially qualitative eLearning strategies. Moreover, such quantitative evidence is not collected systematically by the typical HEI; when collected, such evidence is commercially sensitive; and it is not easy for researchers to obtain independently of the HEI. So, claims are made, for example, that European universities plan to 'expand their use of eLearning' (BBC News, 2005), but it is not at all clear what measures of expansion are appropriate, and what kinds of strategies are associated with such expansion. The two-year research study described here attempted a mixed-method approach to the problem of identifying examples of innovation in relation to the eLearning strategies developed by HEIs. Where possible the study estimated the impact of the implemented eLearning programmes, but the emphasis was on illuminating a range of innovative eLearning strategy cases, rather than necessarily determining best practice. Two key research questions asked by the study are: 1. How can innovation in Higher Education eLearning strategies be identified? 2. What factors are critical to the success of these strategies? This research did not set out to obtain, directly, insight into why eLearning has not been more widely adopted by HEIs, why various eLearning projects have failed, why some eLearning projects have achieved less success than anticipated, or why some eLearning projects have achieved success more slowly than anticipated. However, by researching innovation, the challenges faced by the innovators, and how strategies needed to change over time, it is anticipated that the findings from this study might indirectly illuminate these crucial questions. It is not possible within the space available here to do more than outline the methodology and highlight a few key findings: fuller reports are available on the project website www.spi.pt/innounilearning

Improved standardization of transcribed digital specimen data

There are more than 1.2 billion biological specimens in the world's museums and herbaria. These objects are particularly important forms of biological sample and observation. They underpin biological taxonomy but the data they contain have many other uses in the biological and environmental sciences. Nevertheless, from their conception they are almost entirely documented on paper, either as labels attached to the specimens or in catalogues linked with catalogue numbers. In order to make the best use of these data and to improve the findability of these specimens, these data must be transcribed digitally and made to conform to standards, so that these data are also interoperable and reusable. Through various digitization projects, the authors have experimented with transcription by volunteers, expert technicians, scientists, commercial transcription services and automated systems. We have also been consumers of specimen data for taxonomical, biogeographical and ecological research. In this paper, we draw from our experiences to make specific recommendations to improve transcription data. The paper is split into two sections. We first address issues related to database implementation with relevance to data transcription, namely versioning, annotation, unknown and incomplete data and issues related to language. We then focus on particular data types that are relevant to biological collection specimens, namely nomenclature, dates, geography, collector numbers and uniquely identifying people. We make recommendations to standards organizations, software developers, data scientists and transcribers to improve these data with the specific aim of improving interoperability between collection datasets.Peer reviewe

The fostering of innovative eLearning strategies in European higher education

Although there are strong attempts being made by various European observatories and European Commission programmes to identify and disseminate innovative eLearning practices (MENON, 2006), the factors that determine educational effectiveness are, as yet, not well understood. In particular, while an extraordinarily wide range of university-level eLearning programmes are rapidly becoming available from large numbers of Higher Education Institutions (HEIs) across Europe, the sharing of good practice requires detailed accounts of successful innovative eLearning strategies. There are many relevant checklists and sets of principles described in EU websites (e.g. elearningeurope.info, 2006) and in the academic literature (e.g. Conole et al, 2004), but it is often only through thoroughly appreciating what others have done that such abstract guidance come alive. However, it can still be difficult for HEIs to learn from others. While there are many media reports of innovation, these typically have to omit the level of detail that would enable optimal understanding by those HEIs wishing to apply such innovations in their own contexts. Meanwhile, case studies presented at conferences and in the academic literature can provide the necessary level of detail, but it can be difficult to collate such case studies into a form that facilitates consistent descriptions across the diversity of European HEIs. By identifying the various eLearning programmes applied by HEIs in a number of EU member states and conducting a detailed assessment of a sample of eLearning strategies found to be effective supporters of higher education requirements, the EC-funded InnoUniLearning project is disseminating a range of eLearning strategy case studies. Where possible this project is estimating the potential impact of the implemented eLearning programmes, but more importantly it will identify and detail the strategies applied by leading institutions and well-known success stories, as well as those institutions that have applied new and innovative eLearning programmes. It is hoped that the dissemination of these case studies will be of assistance to HEIs across Europe in implementing eLearning strategies that meet their own particular curricular and cohort requirements. The study is concentrating on illuminating a range of successful eLearning strategy cases, rather than necessarily determining best practice, which could be argued an impossible task at the moment because of a lack of learner feedback. Nevertheless, most, if not all, organisations that have implemented eLearning have gone through a period of adjustment in order to obtain an eLearning programme that is cost-efficient and effective; so capturing something of the challenges overcome by the HEIs leading this field should assist the wider EU higher education community. This paper describes background and the methodological approach of the two-year study and some preliminary results, which will be elaborated in the conference presentation

Childhood abuse and the content of delusions

Original article can be found at: http://www.sciencedirect.com/science/journal/01452134 Copyright Elsevier Ltd.We aimed to investigate possible associations between histories of childhood abuse and the content of delusions for individuals with psychotic disorders. 39 participants with a psychotic disorder including one or more delusional beliefs successfully completed structured interviews about childhood trauma, delusional beliefs and associated anomalous perceptual experiences including hallucinations. The presence of hallucinations was predicted by greater physical abuse. Greater abuse in general was associated with delusions involving ‘special abilities’ (grandiosity) and, at trend levels, with those involving ‘defective self’. Though preliminary, these results suggest that further investigation is warranted. The presence and nature of abuse may be relevant to delusional presentations and should form an essential part of clinical assessment of psychotic disorder.Peer reviewe

Milestone 3.2 - DiSSCo Digital Maturity Self -Assessment Tool - Design Blueprint

This Milestone 3.2 report for DiSSCo Prepare Work Package 3 Task 3.1 sets out the initial design blueprint for a DiSSCo Digital Maturity Self-Assessment Tool, building on the analyses in the Milestone 3.1 report ‘Improving Digital Capability - Case Studies and Analysis’ (Hardy et al, Dec 2020) and in the Milestone 3.3. Report, including consideration of two existing tools in our sector. This tool is intended to support teams, institutions and national nodes in developing organisational readiness for provision of the DiSSCo services and data, helping them to identify and target areas for improvement. The aim is for this to tie in to future provision of training and support, as well as helping to identify the gaps at aggregate level where that training may be most useful. In addition , we believe there is a case for a platform that can support both this and the related Task 7.3 Policy Tool, such that these or other tools are consistent for users and can interact with one another where relevant, avoiding any duplication. This blueprint is intended for wider discussion among the DiSSCo members, so that tool content can be developed in more detail as part of the Deliverable for this Taskinfo:eu-repo/semantics/publishedVersio

How do hospital professionals involved in a randomised controlled trial perceive the value of genotyping vs. PCR-ribotyping for control of hospital acquired C. difficile infections?

Background: Despite scientific advances in typing of C. difficile strains very little is known about how hospital staff use typing results during periods of increased incidence (PIIs). This qualitative study, undertaken alongside a randomised controlled trial (RCT), explored this issue. The trial compared ribotyping versus more rapid genotyping (MLVA or multilocus variable repeat analysis) and found no significant difference in post 48 hour cases (C difficile transmissions). Methods: In-depth qualitative interviews with senior staff in 11/16 hospital trusts in the trial (5 MLVA and 6 Ribotyping). Semi-structured interviews were conducted at end of the trial period. Transcripts were content analysed using framework analysis supported by NVivo-8 software. Common sub-themes were extracted by two researchers independently. These were compared and organised into over-arching categories or ‘super-ordinate themes’. Results: The trial recorded that 45% of typing tests had some impact on infection control (IC) activities. Interviews indicated that tests had little impact on initial IC decisions. These were driven by hospital protocols and automatically triggered when a PII was identified. To influence decision-making, a laboratory turnaround time < 3 days (ideally 24 hours) was suggested; MLVA turnaround time was 5.3 days. Typing results were predominantly used to modify initiated IC activities such as ward cleaning, audits of practice or staff training; major decisions (e.g. ward closure) were unaffected. Organisational factors could limit utilisation of MLVA results. Results were twice as likely to be reported as ‘aiding management’ (indirect benefit) than impacting on IC activities (direct effect). Some interviewees considered test results provided reassurance about earlier IC decisions; others identified secondary benefits on organisational culture. An underlying benefit of improved discrimination provided by MLVA typing was the ability to explore epidemiology associated with CDI cases in a hospital more thoroughly. Conclusions: Ribotyping and MLVA are both valued by users. MLVA had little additional direct impact on initial infection control decisions. This would require reduced turnaround time. The major impact is adjustments to earlier IC measures and retrospective reassurance. For this, turnaround time is less important than discriminatory power. The potential remains for wider use of genotyping to examine transmission routes