Experimenting with dialogic mentoring: a new model

Purpose – the purpose of this article is to explore mentoring as a dialogic practice. It develops Bokenko and Gantt's (2000) concept of dialogic mentoring to propose a new theorisation of mentoring as a relational, embodied, spatial affective, and ethical practice. Design/methodology/approach – the article reports on a mentoring project that took place in a post-1992 UK University which was seeking to enhance its research culture. This project used an innovative methodological approach in which mentor and mentee wrote and shared diary entries as means of building more effective and constructive mentoring experiences, and as a vehicle for reflexively analysing the mentoring process. Findings – the project outcomes were: first, a deepened appreciation and reflexive evaluation of the role played by dairies and writing in the enactment of dialogic mentoring; second, the development of a theoretical framework to enhance understanding of dialogic mentoring; and third, the generation of a dialogic mentoring model encompassing multiple dimensions of the process. Practical implications – the article provides insights to support methodological innovation in mentoring practice; it links mentoring practice with theory development to enhance mentor and mentee collaboration and reflexivity; it offers an example of good mentoring practice that could be scaled up within educational institutions wishing to enhance their research culture. Originality/ value – the article provides insights into a methodologically innovative mentoring practice to assist mentors and mentees in enhancing collaborative reflexivity during mentoring; it also proposes a new theorisation of mentoring practices. Keywords: mentoring; dialogue; reflexive; ethical; higher education Paper type: Research paper</p

Deference, Denial, and Exclusion: Men Talk about Contraception and Unintended Pregnancy

Individual in-depth interviews were conducted with 20 men, ages 21-48, who have fathered at least one unintended pregnancy. The goal of the interviews was to explore the experiences of these men with unintended pregnancy, their communication with partners and others, contraceptive beliefs and practices, their relationships with their partners, and the outcomes and consequences of the unintended pregnancies. This essay describes results derived from their comments regarding their contraceptive practices and the pregnancy-outcome decisions, with thematic analysis used to identify prominent themes from participant comments. Two strong themes, deference and denial, and one lesser theme, exclusion, emerged from participant responses. Discussion of the role of communication, the power of denial, and opportunities for further involvement of men in decision making relating to unintended pregnancy are presented

Doctors' knowledge of the law on withholding and withdrawing life-sustaining medical treatment

Objectives To examine the level of knowledge of doctors about the law on withholding and withdrawing life-sustaining treatment from adults who lack decision-making capacity, and factors associated with a higher level of knowledge. Design, setting and participants Postal survey of all specialists in emergency medicine, geriatric medicine, intensive care, medical oncology, palliative medicine, renal medicine and respiratory medicine on the AMPCo Direct database in New South Wales, Victoria and Queensland. Survey initially posted to participants on 18 July 2012 and closed on 31 January 2013. Main outcome measures Medical specialists’ levels of knowledge about the law, based on their responses to two survey questions. Results Overall response rate was 32%. For the seven statements contained in the two questions about the law, the mean knowledge score was 3.26 out of 7. State and specialty were the strongest predictors of legal knowledge. Conclusions Among doctors who practise in the end-of-life field, there are some significant knowledge gaps about the law on withholding and withdrawing life-sustaining treatment from adults who lack decision-making capacity. Significant consequences for both patients and doctors can flow from a failure to comply with the law. Steps should be taken to improve doctors’ legal knowledge in this area and to harmonise the law across Australia

Medical education and law: withholding/withdrawing treatment from adults without capacity

BACKGROUND - Law is increasingly involved in clinical practice, particularly at the end of life, but undergraduate and postgraduate education in this area remains unsystematic. We hypothesised that attitudes to and knowledge of the law governing withholding/withdrawing treatment from adults without capacity (the WWLST law) would vary and demonstrate deficiencies among medical specialists. AIMS - We investigated perspectives, knowledge and training of medical specialists in the three largest (populations and medical workforces) Australian states, concerning the WWLST law. METHODS - Following expert legal review, specialist focus groups, pre-testing and piloting in each state, seven specialties involved with end-of-life care were surveyed, with a variety of statistical analyses applied to the responses. RESULTS - Respondents supported the need to know and follow the law. There were mixed views about its helpfulness in medical decision-making. Over half the respondents conceded poor knowledge of the law; this was mirrored by critical gaps in knowledge that varied by specialty. There were relatively low but increasing rates of education from the undergraduate to continuing professional development (CPD) stages. Mean knowledge score did not vary significantly according to undergraduate or immediate postgraduate training, but CPD training, particularly if recent, resulted in greater knowledge. Case-based workshops were the preferred CPD instruction method. CONCLUSIONS - Teaching of current and evolving law should be strengthened across all stages of medical education. This should improve understanding of the role of law, ameliorate ambivalence towards the law, and contribute to more informed deliberation about end-of-life issues with patients and families

Doctors' perspectives on law and life-sustaining treatment: Survey design and recruitment strategies for a challenging cohort

Background - Palliative medicine and other specialists play significant legal roles in decisions to withhold and withdraw life-sustaining treatment at the end of life. Yet little is known about their knowledge of or attitudes to the law, and the role they think it should play in medical practice. Consideration of doctors’ views is critical to optimizing patient outcomes at the end of life. However, doctors are difficult to engage as participants in empirical research, presenting challenges for researchers seeking to understand doctors’ experiences and perspectives. Aims - To determine how to engage doctors involved in end-of-life care in empirical research about knowledge of the law and the role it plays in medical practice at the end of life. Methods - Postal survey of all specialists in palliative medicine, emergency medicine, geriatric medicine, intensive care, medical oncology, renal medicine, and respiratory medicine in three Australian states: New South Wales, Victoria, and Queensland. The survey was sent in hard copy with two reminders and a follow up reminder letter was also sent to the directors of hospital emergency departments. Awareness was further promoted through engagement with the relevant medical colleges and publications in professional journals; various incentives to respond were also used. The key measure is the response rate of doctors to the survey. Results - Thirty-two percent of doctors in the main study completed their survey with response rate by specialty ranging from 52% (palliative care) to 24% (medical oncology). This overall response rate was twice that of the reweighted pilot study (16%). Conclusions - Doctors remain a difficult cohort to engage in survey research but strategic recruitment efforts can be effective in increasing response rate. Collaboration with doctors and their professional bodies in both the development of the survey instrument and recruitment of participants is essential

The Mobility Assessment Course for the Diagnosis of Spatial Neglect: Taking a Step Forward?

This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.Spatial neglect after stroke can be a challenging syndrome to diagnose under standard neuropsychological assessment. There is now sufficient evidence that those affected might demonstrate neglect behavior in everyday settings despite showing no signs of neglect during common neglect tasks. This discrepancy is attributed to the simplified and unrealistic nature of common pen and paper based tasks that do not match the demanding, novel, and complex environment of everyday life. As such, increasing task demands under more ecologically valid scenarios has become an important method of increasing test sensitivity. The main aim of the current study was to evaluate the diagnostic utility of the Mobility Assessment Course (MAC), an ecological task, for the assessment of neglect. If neglect becomes more apparent under more challenging task demands the MAC could prove to be more diagnostically accurate at detecting neglect than conventional methods, particularly as the time from initial brain damage increases. Data collected by Guide Dogs of SA/NT were retrospectively analyzed. The Receiver Operating Characteristic (ROC) curve, a measure of sensitivity and specificity, was used to investigate the diagnostic utility of the MAC and a series of paper and pencil tests in 67 right hemisphere stroke survivors. While the MAC proved to be a more sensitive neglect test (74.2%) when compared to the Star Cancellation (43.3%) and Line Bisection (35.7%) tests, this was at the expense of relatively low specificity. As a result, the ROC curve analysis showed no statistically discernable differences between tasks (p > 0.12), or between subacute and chronic groups for individual tasks (p > 0.45). It is concluded that, while the MAC is an ecologically valid alternative for assessing neglect, regarding its diagnostic accuracy, there is currently not enough evidence to suggest that it is a big step forward in comparison to the accuracy of conventional tests

Modelling interactions of acid–base balance and respiratory status in the toxicity of metal mixtures in the American oyster Crassostrea virginica

Author Posting. © The Author(s), 2009. This is the author's version of the work. It is posted here by permission of Elsevier B.V. for personal use, not for redistribution. The definitive version was published in Comparative Biochemistry and Physiology - Part A: Molecular & Integrative Physiology 155 (2010): 341-349, doi:10.1016/j.cbpa.2009.11.019.Heavy metals, such as copper, zinc and cadmium, represent some of the most common and serious pollutants in coastal estuaries. In the present study, we used a combination of linear and artificial neural network (ANN) modelling to detect and explore interactions among low-dose mixtures of these heavy metals and their impacts on fundamental physiological processes in tissues of the Eastern oyster, Crassostrea virginica. Animals were exposed to Cd (0.001 – 0.400 μM), Zn (0.001 – 3.059 μM) or Cu (0.002 – 0.787 μM), either alone or in combination for 1 to 27 days. We measured indicators of acid-base balance (hemolymph pH and total CO2), gas exchange (Po2), immunocompetence (total hemocyte counts, numbers of invasive bacteria), antioxidant status (glutathione, GSH), oxidative damage (lipid peroxidation; LPx), and metal accumulation in the gill and the hepatopancreas. Linear analysis showed that oxidative membrane damage from tissue accumulation of environmental metals was correlated with impaired acid-base balance in oysters. ANN analysis revealed interactions of metals with hemolymph acid-base chemistry in predicting oxidative damage that were not evident from linear analyses. These results highlight the usefulness of machine learning approaches, such as ANNs, for improving our ability to recognize and understand the effects of sub-acute exposure to contaminant mixtures.This study was supported by NOAA’s Center of Excellence in Oceans and Human Health at HML and the National Science Foundation

Projects in Applied Data Science: Fall 2019

This document contains semester projects for students in CSCI 4381/7000 Data ScienceProjects. This course explores concepts and techniques for design, formulation and execution ofpractical, applied data science. Topics covered include experimental design, statistical analysisand predictive modeling, machine learning, data visualization, scientific writing and presentation.During the class, students selected a semester-long project to acquire, analyze, and understanddata in support of a research question. In addition to traditional lectures, students read anddiscussed published papers on data science topics, practiced skills in recitation sessions, andentertained guest lectures from expert data scientists in the field. Outside of these readings andrecitations, students were allowed to work on their projects exclusively and were supported withmeetings, peer-discussion and copyediting. In terms of the scope of the final product, undergraduate students were asked to perform aresearch or engineering task of some complexity while graduate students were additionallyrequired to perform a survey of related work, demonstrate some novelty in their approach, anddescribe the position of their contribution within the broader literature. All students whoperformed at or above these expectations were offered the opportunity to contribute their paperfor publication in this technical summary. The diversity of the papers herein is representative of the diversity of interests of the students inthe class. There is no common trend among the papers submitted and each takes a differenttopic to task. Students made use of open data or worked with organizations to acquire data.Several students pivoted their projects early on due to limitations and difficulties in data access--- a real-world challenge in practical data science. The projects herein range from analyzingtraffic in cities, restaurant trends and Facebook responses to smartphone accelerometer data,scaling laws in higher education, and bicycle trends in Boulder, Colorado. Analysis approachesare similarly varied: visualization, statistical analysis and modeling, machine learning,reinforcement learning, etc.. Most papers can be understood as exploratory data analysis,although some emphasize interactive visualization and others emphasize statistical modelingand prediction aimed at testing a well-defined research question. To inform the style of theirapproach, students read papers from a broad sampling of original research. They used thesereadings to build an understanding of approaches to presentation and analysis in the modernscientific literature. One paper was held out from this compendium so that it could be submittedfor publication to a peer-reviewed venue. Please direct questions/comments on individual papers to the student authors when contactinformation has been made available.</p

Feasibility and results of a randomised pilot-study of pre-discharge occupational therapy home visits

BACKGROUND: Pre-discharge home visits aim to maximise independence in the community. These visits involve assessment of a person in their own home prior to discharge from hospital, typically by an occupational therapist. The therapist may provide equipment, adapt the home environment and/or provide education. The aims of this study were to investigate the feasibility of a randomised controlled trial in a clinical setting and the effect of pre-discharge home visits on functional performance in older people undergoing rehabilitation. METHODS: Ten patients participating in an inpatient rehabilitation program were randomly assigned to receive either a pre-discharge home visit (intervention), or standard practice in-hospital assessment and education (control), both conducted by an occupational therapist. The pre-discharge home visit involved assessment of the older person's function and environment, and education, and took an average of 1.5 hours. The hospital-based interview took an average of 40 minutes. Outcome data were collected by a blinded assessor at 0, 2, 4, 8 and 12 weeks. Outcomes included performance of activities of daily living, reintegration to community living, quality of life, readmission and fall rates. RESULTS: Recruitment of 10 participants was slow and took three months. Observed performance of functional abilities did not differ between groups due to the small sample size. Difference in activities of daily living participation, as recorded by the Nottingham Extended Activities of Daily Living scale, was statistically significant but wide confidence intervals and low statistical power limit interpretation of results. CONCLUSION: Evaluation of pre-discharge home visits by occupational therapists in a rehabilitation setting is feasible, but a more effective recruitment strategy for a main study is favored by application of a multi-centre setting