37 research outputs found

    Going by the moon and the stars: Stories of two Russian Mennonite women

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    The stories of women\u27s religious lives are essential to understanding religion. This thesis records and interprets two Russian Mennonite women\u27s religious lives, using methods of feminist ethnography. The first chapter is a video which presents Agatha Janzen and Katja Enns talking about their childhoods in the Soviet Union in the 1920s and 305, their flight to Germany during World War ll, and their subsequent emigration and life in Canada. Chapter 2 tells and interprets Agatha\u27s and Katja\u27s experiences of marriage during the war, and the effect of their status as widow (Agatha) and single mother (Katja) upon their entry into the Canadian Mennonite church. Chapter 3 discusses the structure and content of the women\u27s stories about the war, and the ways they have integrated their war stories into their religious life. Chapter 4 considers the ways Agatha and Katja are Mennonite today, looking especially at the role of prayer, preaching, and personal relationships in their lives. The last chapter discusses the process of deciding what is religious about a life, the merits and tensions of feminist ethnography, and the implications of video for life history. Reflections on the effects of this work on Kalja, Agatha, and me conclude the study

    A novel preference-informed complementary trial (PICT) design for clinical trial research influenced by strong patient preferences

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    Background: Patients and their families often have preferences for medical care that relate to wider considerations beyond the clinical effectiveness of the proposed interventions. Traditionally, these preferences have not been adequately considered in research. Research questions where patients and families have strong preferences may not be appropriate for traditional randomized controlled trials (RCTs) due to threats to internal and external validity, as there may be high levels of drop-out and non-adherence or recruitment of a sample that is not representative of the treatment population. Several preference-informed designs have been developed to address problems with traditional RCTs, but these designs have their own limitations and may not be suitable for many research questions where strong preferences and opinions are present. Methods: In this paper, we propose a novel and innovative preference-informed complementary trial (PICT) design which addresses key weaknesses with both traditional RCTs and available preference-informed designs. In the PICT design, complementary trials would be operated within a single study, and patients and/or families would be given the opportunity to choose between a trial with all treatment options available and a trial with treatment options that exclude the option which is subject to strong preferences. This approach would allow those with strong preferences to take part in research and would improve external validity through recruiting more representative populations and internal validity. Here we discuss the strengths and limitations of the PICT design and considerations for analysis and present a motivating example for the design based on the use of opioids for pain management for children with musculoskeletal injuries. Conclusions: PICTs provide a novel and innovative design for clinical trials with more than two arms, which can address problems with existing preference-informed trial designs and enhance the ability of researchers to reflect shared decision-making in research as well as improving the validity of trials of topics with strong preferences

    Computed-Tomography Body Composition Analysis Complements Pre-Operative Nutrition Screening in Colorectal Cancer Patients on an Enhanced Recovery after Surgery Pathway

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    Pre-operative nutrition screening is recommended to identify cancer patients at risk of malnutrition, which is associated with poor outcomes. Low muscle mass (sarcopenia) and lipid infiltration to muscle cells (myosteatosis) are similarly associated with poor outcomes but are not routinely screened for. We investigated the prevalence of sarcopenia and myosteatosis across the nutrition screening triage categories of the Patient-Generated Subjective Global Assessment Short Form (PG-SGASF) in a pre-operative colorectal cancer (CRC) cohort. Data were prospectively collected from patients scheduled for surgery at two sites in Edmonton, Canada. PG-SGASF scores ≥ 4 identified patients at risk for malnutrition; sarcopenia and myosteatosis were identified using computed-tomography (CT) analysis. Patients (n = 176) with a mean age of 63.8 ± 12.0 years, 52.3% male, 90.3% with stage I–III disease were included. Overall, 25.2% had PG-SGASF score ≥ 4. Sarcopenia alone, myosteatosis alone or both were identified in 14.0%, 27.3%, and 6.4% of patients, respectively. Sarcopenia and/or myosteatosis were identified in 43.4% of those with PG-SGASF score < 4 and in 58.5% of those with score ≥ 4. Overall, 32.9% of the cohort had sarcopenia and/or myosteatosis with PG-SGASF score < 4. CT-defined sarcopenia and myosteatosis are prevalent in pre-operative CRC patients, regardless of the presence of traditional nutrition risk factors (weight loss, problems eating); therefore, CT image analysis effectively adds value to nutrition screening by identifying patients with other risk factors for poor outcomes

    Going by the moon and the stars. : Stories of two russian mennonite women.

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    Canadaviii, 151 p.; 23 cm
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