The experience of clients with anxiety of the “doing something different” task in solution focused brief therapy, and the development of my practice with them.

This thesis seeks to provide insight into the experience of four counselling clients experiencing anx- iety, and of the researcher, with the doing something different technique in solution focused brief therapy (SFBT). It is intended to provide the reader with a small amount of rich qualitative data, which they can incorporate into their own understanding of how counselling may be experienced. A case-study design within a qualitative framework was used to do this practice-based research. Data was analysed using Hatch’s (2002) method of inductive analysis. Key findings were: The do- ing something different task can be confusing, intimidating, and can give people “permission” to try to find solutions in new places, especially when they are “stuck” in non-useful attempted solutions. Themes regarding my development of skill with the task were around rationale for its use, verbal priming, scope of the task, presenting the task as “an experiment,” and seeking single or multiple ideas from clients for doing something different. I discuss how youth and anxiety may change the way clients identify exceptions (which in turn changes whether they are likely to be asked to try doing something different); the types of doing something different task they come up with; and the difficulty and effort involved in doing the task. I also discuss how the research impacted my practice: through direct acquisition of skill and knowl- edge around anxiety and the doing something different task; through reflexivity and skill transfer; and also through its personal effect on me as a researcher-counsellor

Twelve tips for adopting the virtual Nominal Group Technique (vNGT) in medical education research

Nominal Group Technique (NGT) is a structured approach to consensus development and data collection driven by problem-solving, idea inception and prioritisation. Challenges of the coronavirus disease 2019 (COVID-19) pandemic necessitated the development of a virtual (vNGT) model to recruit participants from diverse locations and time zones. Our reflections reveal the opportunities and challenges of using Zoom© for NGT sessions, resulting in more effective engagement and focus with fewer distractions compared to in-person meetings. The 12 tips provide practical suggestions for expanding the versatility of NGT in a virtual environment. These recommendations cover every aspect of the process, including the person, place, and object, from planning the sessions, and utilising technology resources effectively, to ensuring a seamless implementation to desirable outcomes. The paper strives to assist individuals in effectively using the online NGT as a substitute for in-person events, promoting effective management of remote participants even during unprecedented times of quarantine and physical distancing

Is Walk Score associated with hospital admissions from chronic diseases? Evidence from a cross-sectional study in a high socioeconomic status Australian city-state

Objectives: To explore patterns of non-communicable diseases (NCDs) in the Australian Capital Territory (ACT).To ascertain the effect of the neighbourhood built environmental features and especially walkability on health outcomes, specifically for hospital admissions from NCDs. Design: A cross-sectional analysis of public hospital episode data (2007–2013). Setting: Hospitalisations from the ACT, Australia at very small geographic areas. Participants: Secondary data on 75 290 unique hospital episodes representing 39 851 patients who were admitted to ACT hospitals from 2007 to 2013. No restrictions on age, sex or ethnicity. Main exposure measures: Geographic Information System derived or compatible measures of general practitioner access, neighbourhood socioeconomic status, alcohol access, exposure to traffic and Walk Score walkability. Main outcome measures: Hospitalisations of circulatory diseases, specific endocrine, nutritional and metabolic diseases, respiratory diseases and specific cancers. Results: Geographic clusters with significant high and low risks of NCDs were found that displayed an overall geographic pattern of high risk in the outlying suburbs of the territory. Significant relationships between neighbourhood walkability as measured by Walk Score and the likelihood of hospitalisation with a primary diagnosis of myocardial infarction (heart attack) were found. A possible relationship was also found with the likelihood of being hospitalised with 4 major lifestylerelated cancers. Conclusions: Our research augments the growing literature underscoring the relationships between the built environment and health outcomes. In addition, it supports the importance of walkable neighbourhoods, as measured by Walk Score, for improved health.Full Tex

A Mixed Methods Small Pilot Study to Describe the Effects of Upper Limb Training Using a Virtual Reality Gaming System in People with Chronic Stroke

Introduction. This small pilot study aimed to examine the feasibility of an upper limb rehabilitation system (the YouGrabber) in a community rehabilitation centre, qualitatively explore participant experiences, and describe changes after using it. Methods and Material. Chronic stroke participants attending a community rehabilitation centre in the UK were randomised to either a YouGrabber or a gym group and completed 18 training sessions over 12 weeks. The motor activity log, box and block, and fatigue severity score were administered by a blinded assessor before and after the intervention. Semistructured interviews were used to ascertain participants’ views about using the YouGrabber. Results. Twelve participants (6 females) with chronic stroke were recruited. All adhered to the intervention. There were no adverse events, dropouts, or withdrawal. There were no significant differences between the YouGrabber and gym groups although there were significant within group improvements on the motor activity log (median change: 0.59, range: 0.2–1.25; ) within the YouGrabber group. Participants reported that the YouGrabber was motivational but they expressed frustration with technical challenges. Conclusions. The YouGrabber appeared practical and may improve upper limb activities in people several months after stroke. Future work could examine cognition, cost effectiveness, and different training intensities

Pedagogical interventions and their influences on university-level students learning pharmacology-a realist review

IntroductionThe knowledge complexity and varied delivery formats in pharmacology education can leave students unprepared in essential pharmacotherapy skills. This significantly influences their ways of thinking and working in clinical environments, resulting in a challenging clinical transition. This need demands pedagogical innovations to strengthen pharmacology education and improve learners’ skills and competencies in pharmacotherapy. This evidence-based realist review aimed to examine the contextual factors and program theories or causal mechanisms crucial for effective pedagogical interventions in pharmacology, seeking to answer the question of ‘what works for whom, under what circumstances, how, and why’.MethodThe realist synthesis was initiated after retrieving data from Medline (OVID), Cochrane, EBSCO hosted ERIC, SCOPUS, and Embase (OVID) including other sources for additional records. The preliminary analysis enabled the establishment of context, mechanism, and outcome configurations (CMOC) and formulation and refinement of the initial program theory regarding the pedagogical interventions in pharmacology. Data synthesis iteration helped to identify the relevant context and unravel its relationships with underlying causal mechanisms through which said interventions generate outcomes of interest.ResultsA realist review analyzed 1,217 records and identified 75 articles examining a range of educational interventions from individual efforts to faculty-wide curriculum changes in pharmacology education. The key contexts for pharmacology education were troublesome content, traditional delivery methods, inadequate and limited opportunities for knowledge integration, and application. Active participation in interactive learning, along with enjoyment and motivation, was proposed as a causal mechanism for optimizing cognitive load and achieving positive outcomes. The outcomes of the review include subjective perceptions of improved confidence and satisfaction, objective measurements of high post-test scores.DiscussionPedagogical scaffolding in constructivist learning environments helps students overcome challenges in learning troublesome pharmacology knowledge. Considering the human cognitive system’s processing capacity, these interventions improve learning by effectively using cognitive resources. Innovations that focus on enhancing cognitive load through task construction can also promote positive emotional experiences in students, such as engagement and enjoyment, as explained by flow theory. A constructive learning environment, where the cognitive load is optimized and high flow is achieved, can maximize the impact of pedagogical interventions in pharmacology.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?RecordID=160441, PROSPERO (CRD42020160441)

Social Media Mining for Toxicovigilance: Automatic Monitoring of Prescription Medication Abuse from Twitter

Introduction Prescription medication overdose is the fastest growing drug-related problem in the USA. The growing nature of this problem necessitates the implementation of improved monitoring strategies for investigating the prevalence and patterns of abuse of specific medications. Objectives Our primary aims were to assess the possibility of utilizing social media as a resource for automatic monitoring of prescription medication abuse and to devise an automatic classification technique that can identify potentially abuse-indicating user posts. Methods We collected Twitter user posts (tweets) associated with three commonly abused medications (Adderall®, oxycodone, and quetiapine). We manually annotated 6400 tweets mentioning these three medications and a control medication (metformin) that is not the subject of abuse due to its mechanism of action. We performed quantitative and qualitative analyses of the annotated data to determine whether posts on Twitter contain signals of prescription medication abuse. Finally, we designed an automatic supervised classification technique to distinguish posts containing signals of medication abuse from those that do not and assessed the utility of Twitter in investigating patterns of abuse over time. Results Our analyses show that clear signals of medication abuse can be drawn from Twitter posts and the percentage of tweets containing abuse signals are significantly higher for the three case medications (Adderall®: 23 %, quetiapine: 5.0 %, oxycodone: 12 %) than the proportion for the control medication (metformin: 0.3 %). Our automatic classification approach achieves 82 % accuracy overall (medication abuse class recall: 0.51, precision: 0.41, F measure: 0.46). To illustrate the utility of automatic classification, we show how the classification data can be used to analyze abuse patterns over time. Conclusion Our study indicates that social media can be a crucial resource for obtaining abuse-related information for medications, and that automatic approaches involving supervised classification and natural language processing hold promises for essential future monitoring and intervention tasks

Working with and for social enterprises: the role of the volunteer ethnographer

Purpose – This paper considers the specific opportunities and challenges of engaging in ethnographic research with organisations in which the researcher participates as a volunteer ethnographer. Design/methodology/approach – The findings in this paper are based on four years of ethnographic research within a social enterprise. Findings – This paper finds that there are significant benefits of the role of the volunteer ethnographer and suggests ways to address some of the challenges. Research limitations/implications – As the field of social enterprise and ethnography grows and researchers engage with methodological discussions about participant observation, the authors suggest that attention should also be paid to the specifics of the role of the volunteer ethnographer. Originality/value – There is growing interest in the use of ethnography in social enterprises. This paper offers unique insight into how this methodology has been applied in the context of self-reliant groups and the importance of the engaging with discussion about the specific role of the volunteer ethnographer

Examining the correlates of adolescent food and nutrition knowledge

Food literacy is a set of skills and knowledge that are integral to diet. It is common among teenagers to not have basic food literacy skills needed to consume a healthy diet. This study examined: (1) the current state of food and nutrition knowledge among adolescents 13–19 years of age in the census metropolitan area of London, ON, Canada; and (2) correlates of food knowledge and nutrition knowledge among adolescents. Data for this study were drawn from baseline youth and parent survey data collected from a larger population health intervention study. Statistical analysis of the survey data indicates that higher parental education and higher median neighbourhood family income, the use of mobile health applications, liking to cook, as well as confidence in reading and understanding food labels were all consistently associated with increased food and nutrition knowledge. Findings may help guide future research towards optimal methods for delivering food literacy interventions to effectively educate teenagers. Results of this study may help guide policy makers, researchers, and public health professionals in developing appropriate food and nutrition programs and curriculums to combat the decline in food literacy skills

Mortuary Caves and the Dammar Trade in the Towuti–Routa Region, Sulawesi, in an Island Southeast Asian Context

Archaeological evidence from survey and cave excavation in the Towuti–Routa region of Sulawesi suggests the following sequence of late Holocene cultural change. Settled communities whose subsistence included an agricultural component had established themselves by the early centuries a.d. and began the use of caves for mortuary purposes. Extended inhumations are the oldest attested mortuary practice, overlapping in time with secondary burials in large earthenware jars dated to around a.d. 1000. The third, ethnohistorically described practice involved the surface disposal of the deceased, including the use of imported martavans for the elite, between approximately a.d. 1500 and 1900. This sequence of mortuary practices has not been documented elsewhere in Island Southeast Asia, although each practice has multiple parallels. The Towuti–Routa dammar trade, which was at its peak at the time of European contact, can perhaps account for the quantity of exotic items imported to the region but not the specifics of the mortuary practices