Understanding childhood asthma in focus groups: perspectives from mothers of different ethnic backgrounds

BACKGROUND: Diagnosing childhood asthma is dependent upon parental symptom reporting but there are problems in the use of words and terms. The purpose of this study was to describe and compare understandings of childhood 'asthma' by mothers from three different ethnic backgrounds who have no personal experience of diagnosing asthma. A better understanding of parents' perceptions of an illness by clinicians should improve communication and management of the illness. METHOD: Sixty-six mothers living in east London describing their ethnic backgrounds as Bangladeshi, white English and black Caribbean were recruited to 9 focus groups. Discussion was semi-structured. Three sessions were conducted with each ethnic group. Mothers were shown a video clip of a boy with audible wheeze and cough and then addressed 6 questions. Sessions were recorded and transcribed verbatim. Responses were compared within and between ethnic groups. RESULTS: Each session, and ethnic group overall, developed a particular orientation to the discussion. Some mothers described the problem using single signs, while others imitated the sound or made comparisons to other illnesses. Hereditary factors were recognised by some, although all groups were concerned with environmental triggers. Responses about what to do included 'normal illness' strategies, use of health services and calls for complementary treatment. All groups were concerned about using medication every day. Expectations about the quality of life were varied, with recognition that restrictions may be based on parental beliefs about asthma, rather than asthma itself. CONCLUSION: Information from these focus groups suggests mothers know a great deal about childhood asthma even though they have no personal experience of it. Knowledge of how mothers from these ethnic backgrounds perceive asthma may facilitate doctor – patient communication with parents of children experiencing breathing difficulties

Identifying factors likely to influence compliance with diagnostic imaging guideline recommendations for spine disorders among chiropractors in North America: a focus group study using the Theoretical Domains Framework

Background: The Theoretical Domains Framework (TDF) was developed to investigate determinants of specific clinical behaviors and inform the design of interventions to change professional behavior. This framework was used to explore the beliefs of chiropractors in an American Provider Network and two Canadian provinces about their adherence to evidence-based recommendations for spine radiography for uncomplicated back pain. The primary objective of the study was to identify chiropractors’ beliefs about managing uncomplicated back pain without xrays and to explore barriers and facilitators to implementing evidence-based recommendations on lumbar spine xrays. A secondary objective was to compare chiropractors in the United States and Canada on their beliefs regarding the use of spine x-rays. Methods: Six focus groups exploring beliefs about managing back pain without x-rays were conducted with a purposive sample. The interview guide was based upon the TDF. Focus groups were digitally recorded, transcribed verbatim, and analyzed by two independent assessors using thematic content analysis based on the TDF. Results: Five domains were identified as likely relevant. Key beliefs within these domains included the following: conflicting comments about the potential consequences of not ordering x-rays (risk of missing a pathology, avoiding adverse treatment effects, risks of litigation, determining the treatment plan, and using x-ray-driven techniques contrasted with perceived benefits of minimizing patient radiation exposure and reducing costs; beliefs about consequences); beliefs regarding professional autonomy, professional credibility, lack of standardization, and agreement with guidelines widely varied (social/professional role & identity); the influence of formal training, colleagues, and patients also appeared to be important factors (social influences); conflicting comments regarding levels of confidence and comfort in managing patients without x-rays (belief about capabilities); and guideline awareness and agreements (knowledge). Conclusions: Chiropractors’ use of diagnostic imaging appears to be influenced by a number of factors. Five key domains may be important considering the presence of conflicting beliefs, evidence of strong beliefs likely to impact the behavior of interest, and high frequency of beliefs. The results will inform the development of a theorybased survey to help identify potential targets for behavioral-change strategies

A 12th century church dedicated to Theotokos. Our Lady of the Admiral in Palermo

Μη διαθέσιμη περίληψηno abstrac

Ernst Kitzinger Collection 1801-1965

The collection contains three circumcision registers (Mohelbuecher) with some entries from Prague, 1816 and Baiersdorf, 1819 and mostly from Munich, 1826-1885. In addition there is a ‘Memorbuch’ from Fuerth, Bavaria.The bulk of the collection pertains to the professional work of Ernst Kitzinger’s mother, Elisabeth Kitzinger, née Merzbacher. Notably, there is the correspondence from co-workers who died in Auschwitz together with the children in 1943. In addition there are family trees and documents concerning the Merzbacher and Strauss families.Rabbi Joseph Aub ; Education, primary and secondary;Abraham Merzbacher (1812-1885) was one of the leaders of the Munich Jewish community and an expert in numismatics, as was his son Eugen Merzbacher (1845-1903).Elisabeth Kitzinger, née Merzbacher (1881-1966) was the daughter of Eugen Merzbacher. She worked for Jewish welfare organizations in Munch as an organizer and director of ‘Israelitische Jugendhilfe Muenchen’, a home for Jewish youths. She emigrated to Palestine in 1939, to the United States in 1947, and died in Washington, D.C., on June 14, 1966.6-page inventory.Photographs removed to Photograph Collectiondigitize

H.P. L'Orange et P.J. Nordhagen. — Mosaics. [From Antiquity to the Early Middle Ages.]

Labande Edmond René, Kitzinger Ernst. H.P. L'Orange et P.J. Nordhagen. — Mosaics. [From Antiquity to the Early Middle Ages.]. In: Cahiers de civilisation médiévale, 12e année (n°47), Juillet-septembre 1969. pp. 321-322

H.P. L'Orange et P.J. Nordhagen. — Mosaics. [From Antiquity to the Early Middle Ages.]

Labande Edmond René, Kitzinger Ernst. H.P. L'Orange et P.J. Nordhagen. — Mosaics. [From Antiquity to the Early Middle Ages.]. In: Cahiers de civilisation médiévale, 12e année (n°47), Juillet-septembre 1969. pp. 321-322