Using non-participant observation to uncover mechanisms: insights from a realist evaluation

This article outlines how a realist evaluation of dementia care in hospitals used non-participant observation to support the refinement and testing of mechanisms likely to lead to the use of person-centred care. We found that comments and explanations of their actions from hospital staff during observation periods provided insights into the reasoning that generated their actions for care in real time. This informed subsequent data collection and analysis. Two worked examples of mechanisms first identified during non-participant observation demonstrate (1) how they were uncovered, and (2) how this informed research activities for theory refinement. Early, iterative engagement with the analytic process, primarily involving reflection and debate with the research team, maximised the potential of observation data to support surfacing underlying mechanisms, linking them to specific contexts and outcomes.Peer reviewedFinal Accepted Versio

Depression, anxiety, and within-person variability in adults aged 18 to 85 years

Mild depression and anxiety were investigated in relation to measures of within-person (WP) variability and mean RT from psychomotor, executive function, visual search, and word recognition tasks in a continuous age range (18 to 85 years, M = 50.33, SD = 20.37) of 300 community-dwelling adults. Structural equation modeling identified a significant Age x Depression interaction in relation to visual search for measures of WP variability but not for mean RT. Older more depressed adults exhibited greater variability. WP variability in executive function and other cognitive constructs covaried, and the significant Age x Depression interaction with visual search was accounted for by WP variability in executive control. The findings suggest that age-, and depression-related reductions in attentional resources may contribute to increased variability in visual search, and that variability in executive control may be the mechanism underlying these effects.This article may not exactly replicate the final version published in the APA journal. It is not the copy of record.This paper has not (yet) been published

Constraining recent lead pollution sources in the North Pacific using ice core stable lead isotopes

Trends and sources of lead (Pb) aerosol pollution in the North Pacific rim of North America from 1850 to 2001 are investigated using a high-resolution (subannual to annual) ice core record recovered from Eclipse Icefield (3017 masl; St. Elias Mountains, Canada). Beginning in the early 1940s, increasing Pb concentration at Eclipse Icefield occurs coevally with anthropogenic Pb deposition in central Greenland, suggesting that North American Pb pollution may have been in part or wholly responsible in both regions. Isotopic ratios (208Pb/207Pb and 206Pb/207Pb) from 1970 to 2001 confirm that a portion of the Pb deposited at Eclipse Icefield is anthropogenic, and that it represents a variable mixture of East Asian (Chinese and Japanese) emissions transported eastward across the Pacific Ocean and a North American component resulting from transient meridional atmospheric flow. Based on comparison with source material Pb isotope ratios, Chinese and North American coal combustion have likely been the primary sources of Eclipse Icefield Pb over the 1970–2001 time period. The Eclipse Icefield Pb isotope composition also implies that the North Pacific mid-troposphere is not directly impacted by transpolar atmospheric flow from Europe. Annually averaged Pb concentrations in the Eclipse Icefield ice core record show no long-term trend during 1970–2001; however, increasing 208Pb/207Pb and decreasing 206Pb/207Pb ratios reflect the progressive East Asian industrialization and increase in Asian pollutant outflow. The post-1970 decrease in North American Pb emissions is likely necessary to explain the Eclipse Icefield Pb concentration time series. When compared with low (lichen) and high (Mt. Logan ice core) elevation Pb data, the Eclipse ice core record suggests a gradual increase in pollutant deposition and stronger trans-Pacific Asian contribution with rising elevation in the mountains of the North Pacific rim

Setting priorities to inform assessment of care homes’ readiness to participate in healthcare innovation: a systematic mapping review and consensus process

© 2020 The Author(s). This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly citedOrganisational context is known to impact on the successful implementation of healthcare initiatives in care homes. We undertook a systematic mapping review to examine whether researchers have considered organisational context when planning, conducting, and reporting the implementation of healthcare innovations in care homes. Review data were mapped against the Alberta Context Tool, which was designed to assess organizational context in care homes. The review included 56 papers. No studies involved a systematic assessment of organisational context prior to implementation, but many provided post hoc explanations of how organisational context affected the success or otherwise of the innovation. Factors identified to explain a lack of success included poor senior staff engagement, non-alignment with care home culture, limited staff capacity to engage, and low levels of participation from health professionals such as general practitioners (GPs). Thirty-five stakeholders participated in workshops to discuss findings and develop questions for assessing care home readiness to participate in innovations. Ten questions were developed to initiate conversations between innovators and care home staff to support research and implementation. This framework can help researchers initiate discussions about health-related innovation. This will begin to address the gap between implementation theory and practice.Peer reviewe

First Steps Toward Change in Teacher Preparation for Elementary Science

Unless introductory undergraduate science classes for prospective elementary teachers actively incorporate the philosophy of inquiry-based learning called for in K-l2 science education refom little will change in elementary science education. Thus, at James Madison University, we have developed a new integrated science core curriculum called Understanding our World [1]. This course sequence was not only designed to fulfill general education science requirements. but also to focus on content areas our students will need to know as teachers. The objectives of these courses are based on the National Science Education Standards and Virginia’s Science Standards of Learning, including earth and space science, chemistry, physics, life sciences, and environmental science [2,3]. As an integrated package, this course sequence addresses basic science content, calculation skills, the philosophy and history of science, the process of how science is done, the role of science in society, and applications of computers and technology in science. Keeping in mind that students tend to teach in the same way they were taught, Understanding our World core classes embrace the concepts associated with reform in elementary math and science

"We Really Help, Taking Care of Each Other": Older Homeless Adults as Caregivers.

Objectives:Many older homeless adults maintain contact with family. We conducted a qualitative study examining the role of family caregiving for older homeless adults. Method:We conducted semi-structured qualitative interviews with a sample of 46 homeless participants who reported spending at least one night with a housed family member in the prior 6 months. Results:A total of 13 of 46 older adult participants provided caregiving. Themes included (a) the death of the care recipient led to the participant's homelessness; (b) feeling a duty to act as caregivers; (c) providing care in exchange for housing; (d) caregivers' ability to stay was tenuous; (e) providing care conflicted with the caregiver's needs; and (f) resentment when family was ungrateful. Discussion:In a sample of older homeless adults in contact with family, many provided caregiving for housed family. For some, caregiving precipitated homelessness; for others, caregiving provided temporary respite from homelessness, and for others, caregiving continued during homelessness

Discordant transmission of bacteria and viruses from mothers to babies at birth

BACKGROUND: The earliest microbial colonizers of the human gut can have life-long consequences for their hosts. Precisely how the neonatal gut bacterial microbiome and virome are initially populated is not well understood. To better understand how the maternal gut microbiome influences acquisition of the infant gut microbiome, we studied the early life bacterial microbiomes and viromes of 28 infant twin pairs and their mothers. RESULTS: Infant bacterial and viral communities more closely resemble those of their related co-twin than unrelated infants. We found that 63% of an infant\u27s bacterial microbiome can be traced to their mother\u27s gut microbiota. In contrast, only 15% of their viral communities are acquired from their mother. Delivery route did not determine how much of the bacterial microbiome or virome was shared from mother to infant. However, bacteria-bacteriophage interactions were altered by delivery route. CONCLUSIONS: The maternal gut microbiome significantly influences infant gut microbiome acquisition. Vertical transmission of the bacterial microbiome is substantially higher compared to vertical transmission of the virome. However, the degree of similarity between the maternal and infant gut bacterial microbiome and virome did not vary by delivery route. The greater similarity of the bacterial microbiome and virome between twin pairs than unrelated twins may reflect a shared environmental exposure. Thus, differences of the inter-generation transmissibility at birth between the major kingdoms of microbes indicate that the foundation of these microbial communities are shaped by different rules. Video Abstract

A Research-Based Curriculum for Teaching the Photoelectric Effect

Physics faculty consider the photoelectric effect important, but many erroneously believe it is easy for students to understand. We have developed curriculum on this topic including an interactive computer simulation, interactive lectures with peer instruction, and conceptual and mathematical homework problems. Our curriculum addresses established student difficulties and is designed to achieve two learning goals, for students to be able to (1) correctly predict the results of photoelectric effect experiments, and (2) describe how these results lead to the photon model of light. We designed two exam questions to test these learning goals. Our instruction leads to better student mastery of the first goal than either traditional instruction or previous reformed instruction, with approximately 85% of students correctly predicting the results of changes to the experimental conditions. On the question designed to test the second goal, most students are able to correctly state both the observations made in the photoelectric effect experiment and the inferences that can be made from these observations, but are less successful in drawing a clear logical connection between the observations and inferences. This is likely a symptom of a more general lack of the reasoning skills to logically draw inferences from observations.Comment: submitted to American Journal of Physic