230 research outputs found

    Implementing and evaluating Care and Support Planning : a qualitative study of health professionals’ experiences in public polyclinics in Singapore

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    Funding. The PACE-D programme is funded by Singapore’s Ministry of Health. This study was funded by the Centre for Chronic Disease Prevention and Management of the National University Health System, Singapore. SM was supported by a Wellcome Trust Institutional Strategic Support Fund flexible returners award (University of Aberdeen, RG13795-18). VAE’s contribution was also supported by a Wellcome Trust Collaborative Award: This research was funded in whole, or in part, by the Wellcome Trust [209811/Z/17/Z]. For the purpose of open access, the author has applied a CC BY public copyright licence to any Author Accepted Manuscript version arising from this submission. Acknowledgements We are extremely grateful to the health professionals who took part in interviews for this study and allowed observation of their team huddles. We also thank LIM Mui Eng and ANG Shu Lin for supporting the recruitment of health professionals and arrangement of interviews, Monica ASHWINI for arranging transcription and discussion of patients’ experiences of PACE-D, Matthavi SENGUTTUVAN for contributions to early analytic discussions, Marlie FERENCZI and LOY En Yun for support with grant administration, data sharing agreements and helpful suggestions, and the Year of Care Partnerships team, especially Lindsay OLIVER and Nick LEWIS-BARNED for training health professionals and trainers in Singapore and for ongoing advice and support, including helpful comments on a draft of this manuscript.Peer reviewedPublisher PD

    Theoretical and Empirical Foundations of Divorce Education: Connecting Program Theory and Curricular Content

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    Many parent and family education programs lack a clearly articulated program theory that is solidly founded in the social science literature and used to guide rigorous evaluation. This article describes the program theory for Parents Forever, a divorce education program developed by the Minnesota Extension to serve divorcing parents. The Parents Forever program theory is theoretically based and empirically-informed. The program theory is based on three significant frameworks, which serve as the theoretical foundation for the program: human ecosystems, life course development, and family resilience. These theories are explored and discussed. Three primary change mechanisms relevant for divorcing families serve as the empirical foundation of the program. Parent-child and coparent relationships are commonly addressed in divorce education programs; however, the inclusion of parental self-care as the third mechanism to promote family resilience is a unique contribution of Parents Forever. Relevant concepts derived from the empirical literature related to these three mediators are presented. Connections between the curricular content and program theory (i.e., theoretical framework and three change mechanisms) are made explicit, and program theory is used to demonstrate the unique contribution that Parents Forever makes to the field of divorce education

    Specific Image Characteristics Influence Attitudes about Chimpanzee Conservation and Use as Pets

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    Chimpanzees are endangered in their native Africa but in the United States, they are housed not only in zoos and research centers but owned privately as pets and performers. In 2008, survey data revealed that the public is less likely to think that chimpanzees are endangered compared to other great apes, and that this is likely the result of media misportrayals in movies, television and advertisements. Here, we use an experimental survey paradigm with composite images of chimpanzees to determine the effects of specific image characteristics. We found that those viewing a photograph of a chimpanzee with a human standing nearby were 35.5% more likely to consider wild populations to be stable/healthy compared to those seeing the exact same picture without a human. Likewise, the presence of a human in the photograph increases the likelihood that they consider chimpanzees as appealing as a pet. We also found that respondents seeing images in which chimpanzees are shown in typically human settings (such as an office space) were more likely to perceive wild populations as being stable and healthy compared to those seeing chimpanzees in other contexts. These findings shed light on the way that media portrayals of chimpanzees influence public attitudes about this important and endangered species

    ‘C’était moi mais ce n’était pas moi’: portrayal of the disabled body in Catherine Breillat’s Abus de faiblesse (2013)

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    Writer/director Catherine Breillat’s most recent film, Abus de faiblesse (2013), explores an important moment of bodily transition: the change from able to disabled body. This semi-autobiographic film follows the story of film director Maud (Breillat’s alter ego), who forms a destructive relationship with a conman, Vilko, after she suffers a disabling stroke. This film shows consistency with Breillat’s previous work in its exploration of the constructed nature of the female body onscreen. In the past the filmmaker has portrayed moments of trauma and transition (such as childbirth, loss of virginity or rape) to subvert processes of objectification. The article argues that Abus de faiblesse challenges and subverts representation of the post-menopausal and disabled body onscreen. The film interrogates binary oppositions such as able/disabled and independence/dependency to challenge representations of the disabled body as ‘other’. With reference to scholarly work on disability and the ageing female body, the article suggests that Maud’s sadomasochistic relationship with Vilko is driven by a quest to retain her subjectivity after her stroke. The article demonstrates that the film dissects the feared and the unknown territory of the ageing female body

    A peer-led intervention to promote sexual health in secondary schools: the STASH feasibility study

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    Background: Young people report higher levels of unsafe sex and have higher rates of sexually transmitted infections than any other age group. Schools are well placed to facilitate early intervention, but more effective approaches are required. Peer-led approaches can augment school-based education, but often fail to capitalise on mechanisms of social influence. The potential of using social media in sexual health has not been tested in school settings. Objectives: Finalise the design of the Sexually Transmitted infections And Sexual Health (STASH) intervention; assess the recruitment and retention of peer supporters, and acceptability to participants and stakeholders; assess the fidelity and reach, in addition to the barriers to and facilitators of, implementation; refine programme theory; understand the potential of social media; determine design parameters for a future randomised controlled trial, including economic evaluation; and establish whether or not progression criteria were met. Design: This was a feasibility study comprising intervention development and refinement of the STASH pilot and non-randomised feasibility trial in six schools. Control data were provided by students in the year above the intervention group. Setting: Secondary schools in Scotland. Participants: Students aged 14–16 years, teachers and intervention delivery partners. Interventions: The STASH intervention was adapted from A Stop Smoking In Schools Trial (ASSIST) (an effective peer-led smoking intervention). Based on diffusion of innovation theory, the STASH study involves peer nomination to identify the most influential students, with the aim of recruiting and training 15% of the year group as peer supporters. The peer supporters deliver sexual health messages to friends in their year group via conversations and use of Facebook (www.facebook.com; Facebook, Inc., Menlo Park, CA, USA) to share varied content from a curated set of web-based resources. Peer supporters are given support themselves via follow-up sessions and via trainer membership of Facebook groups. Main outcome measures: The primary outcome was whether or not progression criteria were met in relation to intervention acceptability and feasibility. The study also piloted indicative primary outcomes for a full-scale evaluation. Data sources: Peer supporter questionnaire; observations of activities; interviews with trainers, teachers, peer supporters and students; monitoring log of peer supporter activities (including on Facebook and meeting attendance); questionnaire to control year group (baseline characteristics, social networks, mediators and sexual health outcomes); baseline and follow-up questionnaire (approximately 6 months later) for intervention year group. Results: A total of 104 students were trained as peer supporters (just over half of those nominated for the role by their peers). Role retention was very high (97%). Of 611 students completing the follow-up questionnaire, 58% reported exposure to STASH study activities. Intervention acceptability was high among students and stakeholders. Activities were delivered with good fidelity. The peer supporters were active, representative of their year group and well connected within their social network. Carefully managed social media use by peer supporters augmented conversations. A primary outcome of ‘always safer sex’ was identified, measured as no sex or always condom use for vaginal or anal sex in the last 6 months. The intervention cost £42 per student. Six progression criteria were met. A seventh criterion (regarding uptake of role by peer supporters) was not. Limitations: Small feasibility study that cannot comment on effectiveness. Conclusions: The STASH intervention is feasible and acceptable within the context of Scottish secondary schools. The results support continuation to a full-scale evaluation. Future work: Small-scale improvements to the intervention, refinement to programme theory and funding sought for full-scale evaluation. Trial registration Current Controlled Trials ISRCTN97369178. Funding: This project was funded by the National Institute for Health Research (NIHR) Public Health Research programme and will be published in full in Public Health Research; Vol. 8, No. 15. See the NIHR Journals Library website for further project information

    The beginning of time? Evidence for catastrophic drought in Baringo in the early nineteenth century

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    New developments in the collection of palaeo-data over the past two decades have transformed our understanding of climate and environmental history in eastern Africa. This article utilises instrumental and proxy evidence of historical lake-level fluctuations from Baringo and Bogoria, along with other Rift Valley lakes, to document the timing and magnitude of hydroclimate variability at decadal to century time scales since 1750. These data allow us to construct a record of past climate variation not only for the Baringo basin proper, but also across a sizable portion of central and northern Kenya. This record is then set alongside historical evidence, from oral histories gathered amongst the peoples of northern Kenya and the Rift Valley and from contemporary observations recorded by travellers through the region, to offer a reinterpretation of human activity and its relationship to environmental history in the nineteenth century. The results reveal strong evidence of a catastrophic drought in the early nineteenth century, the effects of which radically alters our historical understanding of the character of settlement, mobility and identity within the Baringo–Bogoria basin
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