Outsiders in the experts' world: a grounded theory study of consumers and the social world of health care

This article presents findings from a grounded theory study, which investigated interactions between health professionals and consumers. The authors used Corbin and Strauss's evolved version of grounded theory, which is underpinned by symbolic interactionism. The study sample included 23 consumers and nine health professionals. Data collection methods included demographic questionnaires, interviews, consumer diaries, digital storytelling, observations, and field notes. Data analysis was conducted using essential grounded theory methods. The resultant grounded theory consists of five categories: (a) Unexpected entrance, (b) Learning a new role, (c) Establishing a presence, (d) Confronting the dichotomy of "us and them," and (e) Tailored care. Findings suggest that despite consumers and health professionals' roles, consumers are outsiders in the social world of health care. Progress toward empowered consumers who are in control of their health and health care is slow and care that is truly consumer-centered is still the exception not the rule

Terminology used to describe health care teams: an integrative review of the literature

Purpose: Health systems around the world are struggling to meet the needs of aging populations and increasing numbers of clients with complex health conditions. Faced with multiple health system challenges, governments are advocating for team-based approaches to health care. Key descriptors used to describe health care teams include "interprofessional," "multiprofessional," "interdisciplinary," and "multidisciplinary." Until now there has been no review of the use of terminology relating to health care teams. The purpose of this integrative review is to provide a descriptive analysis of terminology used to describe health care teams. Methods: An integrative review of the literature was conducted because it allows for the inclusion of literature related to studies using diverse methodologies. The authors searched the literature using the terms interprofessional, multiprofessional, interdisciplinary, and multidisciplinary combined with “health teams” and “health care teams.” Refining strategies included a requirement that journal articles define the term used to describe health care teams and include a list of health care team members. The literature selection process resulted in the inclusion of 17 journal articles in this review. Results: Multidisciplinary is more frequently used than other terminology to describe health care teams. The findings in this review relate to frequency of terminology usage, justifications for use of specific terminology, commonalities and patterns related to country of origin of research studies and health care areas, ways in which terminology is used, structure of team membership, and perspectives of definitions used. Conclusion: Stakeholders across the health care continuum share responsibility for developing and consistently using terminology that is both common and meaningful. Notwithstanding some congruence in terminology usage, this review highlights inconsistencies in the literature and suggests that broad debate among policy makers, clinicians, educators, researchers, and consumers is still required to reach useful consensus

Diversity and abundance of photosynthetic sponges in temperate Western Australia

<p>Abstract</p> <p>Background</p> <p>Photosynthetic sponges are important components of reef ecosystems around the world, but are poorly understood. It is often assumed that temperate regions have low diversity and abundance of photosynthetic sponges, but to date no studies have investigated this question. The aim of this study was to compare the percentages of photosynthetic sponges in temperate Western Australia (WA) with previously published data on tropical regions, and to determine the abundance and diversity of these associations in a range of temperate environments.</p> <p>Results</p> <p>We sampled sponges on 5 m belt transects to determine the percentage of photosynthetic sponges and identified at least one representative of each group of symbionts using 16S rDNA sequencing together with microscopy techniques. Our results demonstrate that photosynthetic sponges are abundant in temperate WA, with an average of 63% of sponge individuals hosting high levels of photosynthetic symbionts and 11% with low to medium levels. These percentages of photosynthetic sponges are comparable to those found on tropical reefs and may have important implications for ecosystem function on temperate reefs in other areas of the world. A diverse range of symbionts sometimes occurred within a small geographic area, including the three "big" cyanobacterial clades, <it>Oscillatoria spongeliae</it>, "<it>Candidatus </it>Synechococcus spongiarum" and <it>Synechocystis </it>species, and it appears that these clades all occur in a wide range of sponges. Additionally, spongin-permeating red algae occurred in at least 7 sponge species. This study provides the first investigation of the molecular phylogeny of rhodophyte symbionts in sponges.</p> <p>Conclusion</p> <p>Photosynthetic sponges are abundant and diverse in temperate WA, with comparable percentages of photosynthetic to non-photosynthetic sponges to tropical zones. It appears that there are three common generalist clades of cyanobacterial symbionts of sponges which occur in a wide range of sponges in a wide range of environmental conditions.</p

Outsiders in the Experts' World: A Grounded Theory Study of Consumers and the Social World of Health Care

This article presents findings from a grounded theory study, which investigated interactions between health professionals and consumers. The authors used Corbin and Strauss's evolved version of grounded theory, which is underpinned by symbolic interactionism. The study sample included 23 consumers and nine health professionals. Data collection methods included demographic questionnaires, interviews, consumer diaries, digital storytelling, observations, and field notes. Data analysis was conducted using essential grounded theory methods. The resultant grounded theory consists of five categories: (a) Unexpected entrance, (b) Learning a new role, (c) Establishing a presence, (d) Confronting the dichotomy of "us and them," and (e) Tailored care. Findings suggest that despite consumers and health professionals' roles, consumers are outsiders in the social world of health care. Progress toward empowered consumers who are in control of their health and health care is slow and care that is truly consumer-centered is still the exception not the rule

Patterns of 'At Home' Alcohol-related Injury Presentations to Emergency Departments in Queensland from 2003-2012

Aim: This study sought to explore and describe the patterns and scale of 'at home' alcohol-related injury presentations to participating emergency departments (EDs) in Queensland from 2003 to 2012. Research Question: What were the patterns and scale of 'at home' alcohol-related injury presentations to EDs in Queensland from 2003 to 2012? Background: Australia has been identified as having one of the largest alcohol consumption rates in the world and a high proportion of patients present at EDs having sustained alcohol-related injuries. Despite a common perception that most alcohol-related injuries are sustained at licensed venues, many are sustained at 'other' locations, including 'at home'. Thus, it is important to assess the locations in which alcohol-related injuries are sustained. Methods: A retrospective observational study was conducted. Emergency department surveillance data from the Queensland Injury Surveillance Unit (QISU) were reviewed to identify alcohol-related presentations at EDs from 2003 to 2012 (n = 12,296 cases were identified). A Chi-square analysis was then undertaken to assess the involvement of alcohol in each injury and an analysis of variance (ANOVA) and post-hoc testing was used to determine mean differences among age groups and their associated presentations. Multiple logistic regression analyses were conducted to identify whether any significant associations existed between injury location, risk factors and demographic characteristics. P values o

Chemical and Synthetic Genetic Array Analysis Identifies Genes that Suppress Xylose Utilization and Fermentation in Saccharomyces cerevisiae

Though highly efficient at fermenting hexose sugars, Saccharomyces cerevisiae has limited ability to ferment five-carbon sugars. As a significant portion of sugars found in cellulosic biomass is the five-carbon sugar xylose, S. cerevisiae must be engineered to metabolize pentose sugars, commonly by the addition of exogenous genes from xylose fermenting fungi. However, these recombinant strains grow poorly on xylose and require further improvement through rational engineering or evolutionary adaptation. To identify unknown genes that contribute to improved xylose fermentation in these recombinant S. cerevisiae, we performed genome-wide synthetic interaction screens to identify deletion mutants that impact xylose utilization of strains expressing the xylose isomerase gene XYLA from Piromyces sp. E2 alone or with an additional copy of the endogenous xylulokinase gene XKS1. We also screened the deletion mutant array to identify mutants whose growth is affected by xylose. Our genetic network reveals that more than 80 nonessential genes from a diverse range of cellular processes impact xylose utilization. Surprisingly, we identified four genes, ALP1, ISC1, RPL20B, and BUD21, that when individually deleted improved xylose utilization of both S. cerevisiae S288C and CEN.PK strains. We further characterized BUD21 deletion mutant cells in batch fermentations and found that they produce ethanol even the absence of exogenous XYLA. We have demonstrated that the ability of laboratory strains of S. cerevisiae to utilize xylose as a sole carbon source is suppressed, which implies that S. cerevisiae may not require the addition of exogenous genes for efficient xylose fermentation

The Lantern Vol. 17, No. 1, Fall 1948

• In the Arms of the Sea • The Expressed Should Be Repressed • Puppy Love • Tommy • How to Eat a Ravioli Dinner • The Divine Blessing • On Thunder • There Is No Hell • Old Love Re-met • Autumn Eve • Dr. Cornelius Weygandthttps://digitalcommons.ursinus.edu/lantern/1046/thumbnail.jp

The Lantern Vol. 17, No. 1, Fall 1948

• In the Arms of the Sea • The Expressed Should Be Repressed • Puppy Love • Tommy • How to Eat a Ravioli Dinner • The Divine Blessing • On Thunder • There Is No Hell • Old Love Re-met • Autumn Eve • Dr. Cornelius Weygandthttps://digitalcommons.ursinus.edu/lantern/1046/thumbnail.jp

Patient safety content and delivery in pre-registration nursing curricula: A national cross-sectional survey study

Background: Patient safety is a core principle of health professional practice and as such requires significant attention within undergraduate curricula. However, patient safety practice is complex requiring a broad range of skills and behaviours including the application of sound clinical knowledge within a range of health care contexts and cultures. There is very little research that explores how this is taught within Australian nursing curricula. Objectives: To examine how Australia nursing curricula address patient safety; identify where and how patient safety learning occurs; and describe who is responsible for facilitating this learning. Design and Setting: A cross-sectional descriptive study of nursing undergraduate curricula using a nine-item survey tool. Participants were key informants from 18 universities across seven Australian States and Territories. Conclusion: Although there is consensus in relation to the importance of patient safety across universities, and similarity in views about what knowledge, skills and attitudes should be taught, there were differences in: the amount of time allocated, who was responsible for the teaching and learning, and in which setting the learning occurred and was assessed. There was little indication of the existence of a systematic approach to learning patient safety, with most participants reporting emphasis on learning applied to infection control and medication safety. Wide variation across universities, was reported, particularly in terms of how teaching occured, in what setting and by whom. There was evidence of both integrated and explicit concentration on patient safety learning but also fragmentation. Little evidence of the systematic development of critical reasoning and patient safety knowledge and skills across the years of the nursing program and across the classroom/ laboratory and clinical environments was apparent

Incorporating cancer risk information into general practice: a qualitative study using focus groups with health professionals.

BACKGROUND: It is estimated that approximately 40% of all cases of cancer are attributable to lifestyle factors. Providing people with personalised information about their future risk of cancer may help promote behaviour change. AIM: To explore the views of health professionals on incorporating personalised cancer risk information, based on lifestyle factors, into general practice. DESIGN AND SETTING: Qualitative study using data from six focus groups with a total of 24 general practice health professionals from the NHS Nene Clinical Commissioning Group in England. METHOD: The focus groups were guided by a schedule covering current provision of lifestyle advice relating to cancer and views on incorporating personalised cancer risk information. Data were audiotaped, transcribed verbatim, and then analysed using thematic analysis. RESULTS: Providing lifestyle advice was viewed as a core activity within general practice but the influence of lifestyle on cancer risk was rarely discussed. The word 'cancer' was seen as a potentially powerful motivator for lifestyle change but the fact that it could generate health anxiety was also recognised. Most focus group participants felt that a numerical risk estimate was more likely to influence behaviour than generic advice. All felt that general practice should provide this information, but there was a clear need for additional resources for it to be offered widely. CONCLUSION: Study participants were in support of providing personalised cancer risk information in general practice. The findings highlight a number of potential benefits and challenges that will inform the future development of interventions in general practice to promote behaviour change for cancer prevention.This study was funded by an innovation grant from the Cancer Research UK — BUPA Foundation Fund (ref: C55650/A20818). Juliet Usher-Smith is supported by a National Institute for Health Research Clinical Lectureship. Barbora Silarova was supported by the Medical Research Council [MC_UU_12015/4]