Becoming a mother: a study exploring occupational change in first-time motherhood

Having a first baby is considered a major life event, due to significant role change impacting on the ordinary and familiar activities the new mother performs every day. The aim of this study was to explore changes in the occupational lives of first time mothers. A concurrent nested strategy of enquiry was used. Quantitative data via the Modified Interest Checklist and the Role Checklist was nested within the predominantly qualitative data collection in the form of semi-structured interviews. Six first time mothers, who were two and a half years post motherhood and aged between 28 and 42 years, participated in this study. The findings indicate that 'new mothers' engaging in a balanced lifestyle pre-motherhood in the areas of self-care, leisure, productivity and rest experience a period of occupational disruption and occupational imbalance before adapting into motherhood through activities, tasks and finally occupations. These mothers' occupational lives are productivity dominant with most of their time being spent in paid employment and/or performing homecare/family care activities. Their occupational lives are also obligatory dominant, for example, they are performing activities they need to do to enable them to fulfil their role as mother, as opposed to activities they choose to do. Also evident is a daily process of change as individuals adapt into motherhood

Art Horne and Jane Chu in a Joint Recital

This is the program for the joint recital of senior tenor Art Horne and junior pianist Jane Chu. Melissa Stroud and the OBU Woodwind Ensemble directed by Ralph Rauch accompanied Horne. The recital took place on February 2, 1978, in the Mabee Fine Arts Center Recital Hall

From research to practice: The case of mathematical reasoning

Mathematical proficiency is a key goal of the Australian Mathematics curriculum. However, international assessments of mathematical literacy suggest that mathematical reasoning and problem solving are areas of difficulty for Australian students. Given the efficacy of teaching informed by quality assessment data, a recent study focused on the development of evidence-based Learning Progressions for Algebraic, Spatial and Statistical Reasoning that can be used to identify where students are in their learning and where they need to go to next. Importantly, they can also be used to generate targeted teaching advice and activities to help teachers progress student learning. This paper explores the processes involved in taking the research to practice

Measuring confidence after stroke

Introduction: Improving confidence following stroke has been cited as a research priority (Pollock et al 2012). It is difficult to measure a change in confidence levels without valid and reliable measures. This research aims to develop and conduct a psychometric evaluation of a self-reported, confidence after stroke measure [CaSM]. Methods: Items were generated from themes highlighted in the literature review, and from a qualitative interview study, exploring the meaning of confidence. The CaSM was piloted with expert groups to establish face and content validity. The CaSM was administered to a sample of stroke and healthy elderly people recruited from the community. Completed postal questionnaires were analysed for reliability (internal consistency and test-retest), construct validity (factor analysis) and convergent validity. A visual analogue scale, to correlate therapists opinion with CaSM scores was used to assess concurrent validity. Sensitivity to change was assessed by comparing change scores at three time points after a confidence intervention. Case vignettes were used with stroke clinical experts to detect a minimal clinically meaningful change score. Results: Stroke (n=101) and healthy elderly participants (n=101) were recruited. Using item reduction techniques, a 53 item scale was reduced to 27 items. Factor Analysis was used to derive a three factor solution, Self-Confidence, Positive Attitude and Social Confidence, which explained 52% of variance. There was good evidence for internal consistency (α=0.94) and good temporal stability (rs=0.85 p=0.001). There was a small positive correlation between the two variables when assessing concurrent validity (rs=0.18, n=31, p<0.34), and did not demonstrate statistical significance. Four points on the CaSM was recommended by clinical experts as being a clinically important change score. Conclusion: The 27 item CaSM [Appendix 1] was shown to be a valid and reliable measure. The CaSM was designed to be used to identify people with low confidence after stroke in order to facilitate appropriate treatment. The CaSM could be used in research, as a patient reported outcome measure to evaluate strategies to improve confidence after a stroke. Assessment of the CaSM’s ability to detect sensitivity to change needs further assessment

Medication nonadherence: health impact, prevalence, correlates and interventions

Nonadherence to medicines is a global problem compromising health and economic outcomes for individuals and society. This article outlines how adherence is defined and measured, and examines the impact, prevalence and determinants of nonadherence. It also discusses how a psychosocial perspective can inform the development of interventions to optimise adherence and presents a series of recommendations for future research to overcome common limitations associated with the medication nonadherence literature. Nonadherence is best understood in terms of the interactions between an individual and a specific disease/treatment, within a social and environmental context. Adherence is a product of motivation and ability. Motivation comprises conscious decision-making processes but also from more 'instinctive', intuitive and habitual processes. Ability comprises the physical and psychological skills needed to adhere. Both motivation and ability are influenced by environmental and social factors which influence the opportunity to adhere as well as triggers or cues to actions which may be internal (e.g. experiencing symptoms) or external (e.g. receiving a reminder). Systematic reviews of adherence interventions show that effective solutions are elusive, partly because few have a strong theoretical basis. Adherence support targeted at the level of individuals will be more effective if it is tailored to address the specific perceptions (e.g. beliefs about illness and treatment) and practicalities (e.g. capability and resources) influencing individuals' motivation and ability to adhere

A systematic review of the prevalence and determinants of nonadherence to phosphate binding medication in patients with end-stage renal disease

<p>Abstract</p> <p>Background</p> <p>Cardiovascular events are the leading cause of death in end stage renal disease (ESRD). Adherence to phosphate binding medication plays a vital role in reducing serum phosphorus and associated cardiovascular risk. This poses a challenge for patients as the regimen is often complex and there may be no noticeable impact of adherence on symptoms. There is a need to establish the level of nonadherence to phosphate binding medication in renal dialysis patients and identify the factors associated with it.</p> <p>Methods</p> <p>The online databases PsycINFO, Medline, Embase and CINAHL were searched for quantitative studies exploring predictors of nonadherence to phosphate binding medication in ESRD. Rates and predictors of nonadherence were extracted from the papers.</p> <p>Results</p> <p>Thirty four studies met the inclusion criteria. There was wide variation in reported rates of non-adherence (22–74% patients nonadherent, mean 51%). This can be partially attributed to differences in the way adherence has been defined and measured. Demographic and clinical predictors of nonadherence were most frequently assessed but only younger age was consistently associated with nonadherence. In contrast psychosocial variables (e.g. patients' beliefs about medication, social support, personality characteristics) were less frequently assessed but were more likely to be associated with nonadherence.</p> <p>Conclusion</p> <p>Nonadherence to phosphate binding medication appears to be prevalent in ESRD. Several potentially modifiable psychosocial factors were identified as predictors of nonadherence. There is a need for further, high-quality research to explore these factors in more detail, with the aim of informing the design of an intervention to facilitate adherence.</p

Measuring confidence after stroke

Introduction: Improving confidence following stroke has been cited as a research priority (Pollock et al 2012). It is difficult to measure a change in confidence levels without valid and reliable measures. This research aims to develop and conduct a psychometric evaluation of a self-reported, confidence after stroke measure [CaSM]. Methods: Items were generated from themes highlighted in the literature review, and from a qualitative interview study, exploring the meaning of confidence. The CaSM was piloted with expert groups to establish face and content validity. The CaSM was administered to a sample of stroke and healthy elderly people recruited from the community. Completed postal questionnaires were analysed for reliability (internal consistency and test-retest), construct validity (factor analysis) and convergent validity. A visual analogue scale, to correlate therapists opinion with CaSM scores was used to assess concurrent validity. Sensitivity to change was assessed by comparing change scores at three time points after a confidence intervention. Case vignettes were used with stroke clinical experts to detect a minimal clinically meaningful change score. Results: Stroke (n=101) and healthy elderly participants (n=101) were recruited. Using item reduction techniques, a 53 item scale was reduced to 27 items. Factor Analysis was used to derive a three factor solution, Self-Confidence, Positive Attitude and Social Confidence, which explained 52% of variance. There was good evidence for internal consistency (α=0.94) and good temporal stability (rs=0.85 p=0.001). There was a small positive correlation between the two variables when assessing concurrent validity (rs=0.18, n=31, p<0.34), and did not demonstrate statistical significance. Four points on the CaSM was recommended by clinical experts as being a clinically important change score. Conclusion: The 27 item CaSM [Appendix 1] was shown to be a valid and reliable measure. The CaSM was designed to be used to identify people with low confidence after stroke in order to facilitate appropriate treatment. The CaSM could be used in research, as a patient reported outcome measure to evaluate strategies to improve confidence after a stroke. Assessment of the CaSM’s ability to detect sensitivity to change needs further assessment

The frequency of "brilliant" and "genius" in teaching evaluations predicts the representation of women and African Americans across fields

Women and African Americans-groups targeted by negative stereotypes about their intellectual abilities-may be underrepresented in careers that prize brilliance and genius. A recent nationwide survey of academics provided initial support for this possibility. Fields whose practitioners believed that natural talent is crucial for success had fewer female and African American PhDs. The present study seeks to replicate this initial finding with a different, and arguably more naturalistic, measure of the extent to which brilliance and genius are prized within a field. Specifically, we measured field-by-field variability in the emphasis on these intellectual qualities by tallying-with the use of a recently released online tool-the frequency of the words "brilliant" and "genius" in over 14 million reviews on RateMyProfessors.com, a popular website where students can write anonymous evaluations of their instructors. This simple word count predicted both women's and African Americans' representation across the academic spectrum. That is, we found that fields in which the words "brilliant" and "genius" were used more frequently on RateMyProfessors.com also had fewer female and African American PhDs. Looking at an earlier stage in students' educational careers, we found that brilliance-focused fields also had fewer women and African Americans obtaining bachelor's degrees. These relationships held even when accounting for field-specific averages on standardized mathematics assessments, as well as several competing hypotheses concerning group differences in representation. The fact that this naturalistic measure of a field's focus on brilliance predicted the magnitude of its gender and race gaps speaks to the tight link between ability beliefs and diversity

Regaining Confidence after Stroke (RCAS): a feasibility randomised controlled trial (RCT)

Background: The Regaining Confidence after Stroke Course (RCAS) was designed to facilitate adjustment for people with stroke discharged from rehabilitation. The aim of the trial was to evaluate the feasibility of conducting a randomised trial to compare a RCAS course with usual care. The rates feasibility of screening and recruitment, rates of consent and retention, acceptability of outcome measures and the acceptability and fidelity of the intervention, were evaluated. Methods: Participants with stroke were recruited from hospital databases and community services and randomly assigned to the Regaining Confidence after Stroke (RCAS) course or usual care. The course comprised 11 weekly 2 hour sessions with 6-8 participants, delivered by two rehabilitation assistants. Carers were invited to attend three of the sessions. Sessions were video recorded. A six item checklist was developed from the manual content. Each item was rated as met, partially met, or not met. Fidelity was assumed if >75% of the criteria were met. Outcomes were assessed 3 and 6 months after randomisation. Semi-structured interviews, were conducted using open ended questions to assess the acceptability of the intervention. Results: Of 47 participants (mean age 66.9 years [SD 14.9]; 26 men) 22 were randomly allocated to the intervention and 25 to usual care. Participants attended a mean of 8.2 out of 11 sessions [SD 2.6]. Fidelity outcomes suggested that the content corresponded to the manual but further training of the therapist was needed. Interview findings indicated the intervention was acceptable and considered beneficial. At three months, 35 (78%) participants returned questionnaires and 30 (67%) at 6 months, but only 38(42 %) were fully completed. Conclusion: The results support the feasibility of conducting a randomised trial to evaluate the effectiveness of a RCAS course compared to usual care