The Validation of Speech Corpora

1.2 Intended audience........................

New cultural competences needed for healthcare teams as a priority in treatment of chronic diseases

Technological changes and higher prevalence of chronic diseases require changing patients’ and healthcare professionals’ position with more participation in healthcare organization, and more implication in their relationships. Based on the Canadian ‘patient-as-partner in healthcare’ approach, our aims were to identify and categorize cultural values underlying this term in Luxembourg, and to characterize a set of cultural competencies needed for its practical application. Method: A qualitative study using a semi-directive guide developed within an INTERREG project was conducted among 30 healthcare professionals. A categorical thematic content analysis was realized using N'Vivo software. Results: For some professionals, the word ‘partner’ is not appropriate in Luxembourgish, but they defined it as a companion who engages in a mutual cooperation, structured collaboration and sharing of information with a common goal: Quality of healthcare. For others, a ‘partner’ is an associate who takes part in decision making, discussions, negotiations and evaluations. This partner approach would allow processes of change, bringing autonomy (surveillance, self-education, and monitoring treatment) to the patients, provided that professionals partly cede their traditional power. Trust and respect would be the main start of this process. Difficulties in communication and relationships would arise when helping the patients understand their disease, adhering to instructions, and giving a balanced place to the information found on Internet. Conclusion: This ‘collaborative accompaniment’ appears to allow decisional balance, an interdisciplinary method which requires training for all partners (physicians GP or specialists, patients and psychologist) and not only case-managers to help patients acquire self-efficacy for behavioral changes

Generation of Patients-as-Partner Items Through a Qualitative Data Analysis : Initial Item Reduction

Health psychology aspires to find ways for evaluating the Patient as a Partner. The Montréal model, proposes a verbal and conceptual interpretation. Developed by a University of Montréal research team, this approach advances that patients should play an active role in the healthcare process. Quantitative assessments employing a methodological framework involving a qualitative approach do not exist. Our study aimed at analyzing a procedure for generating patient as a partner related items and to elaborate their classification. Five semi-structured focus groups with 20 chronic disease patients and 15 professionals (doctors, nurses) were conducted. A qualitative analysis, combining inductive (data abstraction was conducted from specific to general), and deductive (guided by a predefined protocol) methods was employed to create a flexible framework of analysis. A thematic categorical content analysis of the transcriptions was conducted. Verbatim were extracted and classified into categories. Cluster analysis using Sorensen’s coeffient was performed with the software N’Vivo 12. Sorensen’s similarity analysis helped to structure a conceptual framework for the assessment of patient as partner at the doctor patient interaction level. The content of each category was verfied through consensus by multidisciplinary experts, who formulated items to capture the overall patient as partner experience. Our list of items constituted fundamental dimensions of partnership, constituting a first classification and a basis for the development of a routine clinical assessment tool. This process should guarantee that the items are acceptable, comprehensive and relevant (reflecting the lived experience of the participants) ensuring a validity of the future questionnaire

Mieux situer la place de l’Approche Patient Partenaire de Soins en Grande Région

Nos résultats appellent également à un développement de la culture de l’approche patient-partenaire de soins. Même si ce genre de démarche, favorisant l’implication du patient, est recommandé depuis de nombreuses années, c’est tout le paradigme de l’organisation des systèmes de santé qui doit évoluer en parallèle à l’évolution des besoins sanitaires. Ce paradigme touche aux valeurs, aux représentations de ce que constitue l’acte même de soigner. L’exploration menée auprès des professionnels de santé et des patients révèle des envies d’évolution des pratiques de soins et de la relation soignant-soigné. Cependant, ces volontés sont freinées par des ambiguïtés sur le concept même du patient-partenaire de soins, une connaissance et des compétences limitées en matière d’approche patient-partenaire de soins et des éléments de contexte de travail qui rendent cette évolution impossible. Le point positif est la mise en évidence d’une volonté commune d’évoluer vers un patient plus acteur dans les soins, plus autonome, avec une série d’avantages perçus. On peut dire qu’il existe un décalage important entre la vision souhaitée et ce qui est actuellement possible. Notre projet a permis d’observer une volonté affichée d’évoluer vers davantage d’engagement du patient dans la relation de soin et dans les structures de soins de santé. Le développement attendu passera par une approche systémique de l’engagement tant sur des aspects micro (de la relation de soin) méso (dans la coordination des structures de soins) et macro (avec l’engagement des politiques de santé). Le développement doit s’appuyer sur les initiatives existantes : en ce sens le projet Interreg est une belle façon de promouvoir les échanges de bonnes pratiques au service de cet engagement du patient

Experiential Learning Through Participatory Action Research in an Interdisciplinary Leadership Training Program

Background: Experience in multidisciplinary collaboration among healthcare providers, leaders in public health, and educators is essential to effectively address the diverse needs of children with intellectual and developmental disabilities (I/DD) and their families. Purpose: We describe three participatory action research (PAR) projects from an interdisciplinary training program, which used experiential learning to enhance leadership competencies and promote inclusive services. Trainees report their leadership growth as providers and advocates for children with I/DD using experiential learning through PAR. Approach: Trainees discuss their engagement with organizations serving children with I/DD and ways that experiential learning supported leadership skill development, commitment to inclusive person- and family-centered practices, and contributions to disability advocacy and support programs. Conclusion: PAR is a beneficial experiential learning approach to foster interdisciplinary collaboration through inclusive community engagement. Related training programs may adopt a similar approach to build leadership skills among professionals in health care, public health, and education, and promote optimal health outcomes for children with I/DD

An open label randomized multicentre phase IIIb trial comparing parenteral substitution versus best supportive nutritional care in subjects with pancreatic adenocarcinoma receiving 5-FU plus oxaliplatin as 2nd or higher line chemotherapy regarding clinical benefit - PANUSCO

<p>Abstract</p> <p>Background</p> <p>Pancreatic cancer is an extremely aggressive malignancy. Subjects are afflicted with a variety of disconcerting symptoms, including profound cachexia. Recent data indicate that the outcome of oncological patients suffering from cancer cachexia could be improved by parenteral nutrition and that parenteral nutrition results in an improvement of quality of life and in prolonged survival.</p> <p>Currently, there is no recommendation of routine use of parenteral nutrition. Furthermore, there is no clear recommendation for 2^ndline therapy (or higher) for pancreatic adenocarcinoma but often asked for.</p> <p>Methods/Design</p> <p>PANUSCO is an open label, controlled, prospective, randomized, multicentre phase IIIb trial with two parallel arms. All patients will be treated with 5-fluorouracil, folinic acid and oxaliplatin on an outpatient basis at the study sites. Additionally, all patients will receive best supportive nutritional care (BSNC). In the experimental group BSNC will be expanded with parenteral nutrition (PN). In contrast, patients in the control group obtain solely BSNC. Parenteral nutrition will be applied overnight and at home by experienced medical staff.</p> <p>A total of 120 patients are planned to be enrolled. Primary endpoint is the comparison of the treatment groups with respect to event-free survival (EFS), defined as the time from randomization till time to development of an event defined as either an impairment (change from baseline of at least ten points in EORTC QLQ-C30, functional domain total score) or withdrawal due to fulfilling the special defined stopping criteria for chemotherapy as well as for nutritional intervention (NI) or death from any cause (whichever occurs first).</p> <p>Discussion</p> <p>The aim of this clinical trial is to evaluate whether parenteral nutrition in combination with defined 2^ndline or higher chemotherapy has an impact on quality of life for patients suffering from pancreatic adenocarcinoma.</p> <p>Trial registration</p> <p>Current Controlled Trials ISRCTN60516908.</p

Core Values that Influence the Patient—Healthcare Professional Power Dynamic: Steering Interaction towards Partnership

Healthcare has long been marked by the authoritative-physician–passive-patient interaction, with patients seeking help and physicians seeking to restore patients back to health. However, lobalisation, social movements, and technological advancements are transforming the nature of this relationship. We aim to identify core values that influence the power dynamic betweenpatients and healthcare professionals, and determine how to steer these interactions towards partnership, a more suitable approach to current healthcare needs. Patients with physical chronic diseases (10 men, 18 women) and healthcare professionals (11 men, 12 women) were interviewed, sessions transcribed, and the framework method used to thematically analyse the data. Validation was done through analyst triangulation and member check recheck. Core values identified as influencing the patient-healthcare professional power dynamic include: (A) values that empower patients (acceptance of diagnosis and autonomy); (B) values unique to healthcare professionals (HCPs) (acknowledging patients experiential knowledge and including patients in the therapeutic process); and (C) shared capitals related to their interactions (communication, information sharing and exchange, collaboration, and mutual commitment). These interdependent core values can be considered prerequisites to the implementation of the patient-as-partner approach in healthcare. Partnership would imply a paradigm shift such that stakeholders systematically examine each other’s perspective, motivations, capabilities, and goals, and then adapt their interactions in this accord, for optimal outcome

Initial State Dependence of the Breakup of Weakly Bound Carbon Isotopes

The one-neutron nuclear breakup from the Carbon isotopes $^{19}$C and $^{17}$C, is calculated as an example of application of the theory of transfer to the continuum reactions in the formulation which includes spin coupling. The effect of the energy sharing between the parallel and transverse neutron momentum distributions is taken into account thus resulting in a theory which is more general than sudden eikonal approaches. Both effects are necessary to understand properly the breakup from not too weakly bound $l_i>1$ orbitals. Breakup which leaves the core into an excited state below particle threshold is also considered. The core-target interaction is treated in the smooth cut-off approximation. By comparing to presently available experimental data we show how to make some hypothesis on the quantum numbers and occupancy of the neutron initial state. Possible ambiguities in the interpretation of inclusive cross sections are discussed.Comment: 22 RevTeX pages,3 ps figures. Phys. Rev. C, accepte