Patient Perspectives of Physicians\u27 Compliance Gaining Strategies

This research examined strategies used by physicians for compliance gaining and patient responses to those strategies. Respondents were surveyed regarding their expectations about strategies physicians would use to gain compliance with requests related to changing lifestyle behaviors and how the respondents anticipated they would respond to physicians. Findings revealed that patients did anticipate specific persuasive strategies from physicians and anticipated responding in specific ways. Most respondents expect expertise strategies from physicians and plan to comply. Expertise strategies, however, were also linked with patients who planned to defy or ignore their physicians’ requests. Findings suggest that future research into why patients who intend to comply do not follow through and what strategies may be more effective on patients who do not anticipate compliance would be valuable

Systems Thinking in a Second Grade Curriculum: Students Engaged to Address a Statewide Drought

Faced with issues, such as drought and climate change, educators around the world acknowledge the need for developing students’ ability to solve problems within and across contexts. A systems thinking pedagogy, which recognizes interdependence and interconnected relationships among concrete elements and abstract concepts (Meadows, 2008; Senge et al., 2012), has potential to transform the classroom into a space of observing, theorizing, discovering, and analyzing, thus linking academic learning to the real world. In a qualitative case study in one school located in a major metropolitan area in California, USA teachers and their 7- and 8-year-old students used systems thinking in an interdisciplinary project-based curriculum. Through reflection and investigations, students devised solutions and used innovative approaches to publicly engage peers and family members in taking action to address an environmental crisis

The applicability of measures of socioeconomic position to different ethnic groups within the UK

In this paper we seek to tease out differences in socioeconomic position between ethnic groups. There are 3 main reasons why conventional socioeconomic indicators and asset based measures may not be equally applicable to all ethnic groups: 1) Differences in response rate to conventional socioeconomic indicators 2) Cultural and social differences in economic priorities/opportunities 3) Differences in housing quality, assets and debt within socioeconomic strata

Emotional Freedom Techniques (Tapping) to Improve Wellbeing and Reduce Anxiety in Primary School Classrooms

The use of Emotional Freedom Techniques (EFT) as a class exercise was investigated to ascertain its effectiveness for student wellbeing. Although EFT has been validated in clinical settings, studies have not yet established whether this approach could be applied in classrooms to curb anxiety and improve wellbeing. A pragmatic, mixed methods study was conducted with 138 students in northern Australian primary schools. Student anxiety dissipated over two stages of intervention. Aside from class tapping sessions, students sometimes tapped surreptitiously, and teachers applied tapping for themselves on occasions. Students generally preferred a quieter, individual approach during class tapping sessions. Broader themes derived from student and teacher data suggested that tapping is a mechanism for change, the skills are transferable, and unsurprisingly, tapping is not always effective. EFT supports social and emotional learning and aligns with the Australian school curriculum. Findings suggest EFT used in classrooms can benefit students and teacher

Indigenous engagement in health: lessons from Brazil, Chile, Australia and New Zealand

Background: Given the persistence of Indigenous health inequities across national contexts, many countries have adopted strategies to improve the health of Indigenous peoples. Governmental recognition of the unique health needs of Indigenous populations is necessary for the development of targeted programs and policies to achieve universal health coverage. At the same time, the participation of Indigenous peoples in decision-making and program and policy design helps to ensure that barriers to health services are appropriately addressed and promotes the rights of Indigenous peoples to self-determination.&nbsp;Due to similar patterns of Indigenous health and health determinants across borders, there have been calls for greater global collaboration in this field. However, most international studies on Indigenous health policy link Anglo-settler democracies (Canada, Australia, Aotearoa/New Zealand and the United States), despite these countries representing a small fraction of the world&rsquo;s Indigenous people.Aim: This paper examines national-level policy in Australia, Brazil, Chile and New Zealand in relation to governmental recognition of differential Indigenous health needs and engagement with Indigenous peoples in health. The paper aims to examine how Indigenous health needs and engagement are addressed in national policy frameworks within each of the countries in order to contribute to the understanding of how to develop pro-equity policies within national health care systems.Methods: For each country, a review was undertaken of national policies and legislation to support engagement with, and participation of, Indigenous peoples in the identification of their health needs, development of programs and policies to address these needs and which demonstrate governmental recognition of differential Indigenous health needs. Government websites were searched as well as the following databases: Google, OpenGrey, CAB Direct, PubMed, Web of Science and WorldCat.Findings: Each of the four countries have adopted international agreements regarding the engagement of Indigenous peoples in health. However, there is significant variation in the extent to which the principles laid out in these agreements are reflected in national policy, legislation and practice. Brazil and New Zealand both have established national policies to facilitate engagement. In contrast, national policy to enable engagement is relatively lacking in Australia and Chile. Australia, Brazil and New Zealand each have significant initiatives and policy structures in place to address Indigenous health. However, in Brazil this is not necessarily reflected in practice and although New Zealand has national policies these have been recently reported as insufficient and, in fact, may be contributing to health inequity for Māori. In comparison to the other three countries, Chile has relatively few national initiatives or policies in place to support Indigenous engagement or recognise the distinct health needs of Indigenous communities.Conclusions: The adoption of international policy frameworks forms an important step in ensuring that Indigenous peoples are able to participate in the formation and implementation of health policy and programs. However, without the relevant principles being reflected in national legislature, international agreements hold little weight. At the same time, while a national legislative framework facilitates the engagement of Indigenous peoples, such policy may not necessarily translate into practice. Developing multi-level approaches that improve cohesion between international policy, national policy and practice in Indigenous engagement in health is therefore vital. Given that each of the four countries demonstrate strengths and weaknesses across this causal chain, cross-country policy examination provides guidance on strengthening these links.</div

The oral microbiome of denture wearers is influenced by natural dentition

Objectives: The composition of dental plaque has been well defined, whereas currently there is limited understanding of the composition of denture plaque and how it directly influences denture related stomatitis (DS). The aims of this study were to compare the microbiomes of denture wearers, and to understand the implications of these towards inter-kingdom and host-pathogen interactions within the oral cavity. Methods: Swab samples were obtained from 123 participants wearing either a complete or partial denture; the bacterial composition of each sample was determined using bar-coded illumina MiSeq sequencing of the bacterial hypervariable V4 region of 16S rDNA. Sequencing data processing was undertaken using QIIME, clustered in Operational Taxonomic Units (OTUs) and assigned to taxonomy. The dentures were sonicated to remove the microbial flora residing on the prosthesis, sonicate was then cultured using diagnostic colorex Candida media. Samples of unstimulated saliva were obtained and antimicrobial peptides (AMP) levels were measured by ELISA. Results: We have shown that dental and denture plaques are significantly distinct both in composition and diversity and that the oral microbiome composition of a denture wearer is variable and is influenced by the location within the mouth. Dentures and mucosa were predominantly made up of Bacilli and Actinobacteria. Moreover, the presence of natural teeth has a significant impact on the overall microbial composition, when compared to the fully edentulous. Furthermore, increasing levels of Candida spp. positively correlate with Lactobacillus spp. AMPs were quantified, though showed no specific correlations. Conclusions: This is the first study to provide a detailed understanding of the oral microbiome of denture wearers and has provided evidence that DS development is more complex than simply a candidal infection. Both fungal and bacterial kingdoms clearly play a role in defining the progression of DS, though we were unable to show a defined role for AMPs

Orthostatic Tremor is Responsive to Bilateral Thalamic Deep Brain Stimulation: Report of Two Cases Performed Asleep

Background: Orthostatic tremor (OT) is a hyperkinetic movement disorder characterized by rapid tremor in the lower extremities or trunk upon standing. Case Report: We report two patients presenting with OT, whose symptoms improved markedly following asleep bilateral thalamic deep brain stimulation (DBS) surgery. Discussion: Medically refractory OT can respond favorably to asleep bilateral DBS surgery similar to awake surgery, and may have the advantages of less psychological trauma to the patient, shorter procedure times, and less exposure to anesthesia

Hippocampal Contribution to Context Encoding across Development Is Disrupted following Early-Life Adversity

Context can drastically influence responses to environmental stimuli. For example, a gunshot should provoke a different response at a public park than a shooting range. Little is known about how contextual processing and neural correlates change across human development or about individual differences related to early environmental experiences. Children (N = 60; 8–19 years, 24 exposed to interpersonal violence) completed a context encoding task during fMRI scanning using a delayed match-to-sample design with neutral, happy, and angry facial cues embedded in realistic background scenes. Outside the scanner, participants completed a memory test for context-face pairings. Context memory and neural correlates of context encoding did not vary with age. Larger hippocampal volume was associated with better context memory. Posterior hippocampus was recruited during context encoding, and greater activation in this region predicted better memory for contexts paired with angry faces. Children exposed to violence had poor memory of contexts paired with angry faces, reduced hippocampal volume, and atypical neural recruitment on encoding trials with angry faces, including reduced hippocampal activation and greater functional connectivity between hippocampus and ventrolateral prefrontal cortex (vlPFC). Greater hippocampus-vlPFC connectivity was associated with worse memory for contexts paired with angry faces. Posterior hippocampus appears to support context encoding, a process that does not exhibit age-related variation from middle childhood to late adolescence. Exposure to dangerous environments in childhood is associated with poor context encoding in the presence of threat, likely due to greater vlPFC-dependent attentional narrowing on threat cues at the expense of hippocampus-dependent processing of the broader context

Systems Thinking in a Second Grade Curriculum: Students Engaged to Address a Statewide Drought

Faced with issues, such as drought and climate change, educators around the world acknowledge the need for developing students' ability to solve problems within and across contexts. A systems thinking pedagogy, which recognizes interdependence and interconnected relationships among concrete elements and abstract concepts (Meadows, 2008; Senge et al., 2012), has potential to transform the classroom into a space of observing, theorizing, discovering, and analyzing, thus linking academic learning to the real world. In a qualitative case study in one school located in a major metropolitan area in California, USA teachers and their 7- and 8-year-old students used systems thinking in an interdisciplinary project-based curriculum. Through reflection and investigations, students devised solutions and used innovative approaches to publicly engage peers and family members in taking action to address an environmental crisis

Agile software development in an earned value world: a survival guide

Agile methodologies are current best practice in software development. They are favored for, among other reasons, preventing premature optimization by taking a somewhat short-term focus, and allowing frequent replans/reprioritizations of upcoming development work based on recent results and current backlog. At the same time, funding agencies prescribe earned value management accounting for large projects which, these days, inevitably include substantial software components. Earned Value approaches emphasize a more comprehensive and typically longer-range plan, and tend to characterize frequent replans and reprioritizations as indicative of problems. Here we describe the planning, execution and reporting framework used by the LSST Data Management team, that navigates these opposite tensions