Fostering Restoration The impact of love and second families in residential care

My Refuge House Ministry (MRH), a shelter for survivors of commercial sexual exploitation (CSE) and abuse in the Philippines, functioned under a Trauma Focused Cognitive Behavioural Therapy approach when it was founded in 2009. However, an assessment of their programmes in 2014 found that the girls felt uncomfortable with the counseling approach and trapped by the staff and shelter guidelines. As a result, MRH underwent a complete restructuring of their program in August of 2014, moving from a clinically focused approach to a strengths-based one, which was more culturally appropriate for the girls and staff members. Since its restructuring, MRH has developed a family-like environment between staff and girls, drawing upon their Filipino culture and way of life. The results have seen mutual growth in relationships between staff and girls and an increased level of respect between both parties. MRH has created a second family by advocating for a loving and caring atmosphere, which they believe to be the foundation for any healing environment. This paper describes why MRH operates from this approach, how this approach has been implemented, and the differences observed in the staff and girls since its introduction

“Not Being Able to Talk Was Horrid”: A Descriptive, Correlational Study of Communication During Mechanical Ventilation

Objectives: The purpose of this study was to describe the patient experience of communication during mechanical ventilation. Research methodology: This descriptive study is a secondary analysis of data collected to study the relationship between sedation and the MV patients’ recall of the ICU. Interviews, conducted after extubation, included the Intensive Care Experience Questionnaire. Data were analysed with Spearman correlation coefficients (rs) and content analysis. Setting: Participants were recruited from a medical-surgical intensive care unit in the Midwest United States. Results: Participants (n = 31) with a mean age of 65 ± 11.9 were on the ventilator a median of 5 days. Inability to communicate needs was associated with helplessness (rs = .43). While perceived lack of information received was associated with not feeling in control (rs = 41) and helplessness (rs = 41). Ineffective communication impacted negatively on satisfaction with care. Participants expressed frustration with failed communication and a lack of information received. They believed receipt of information helped them cope and desired a better system of communication during mechanical ventilation. Conclusion: Communication effectiveness impacts patients’ sense of safety and well-being during mechanical ventilation. Greater emphasis needs to be placed on the development and integration of communication strategies into critical care nursing practice

Environmental influences on children\u27s physical activity in early childhood education and care

Background: To examine the relationship between attributes of early childhood education and care (ECEC) settings and children\u27s physical activity and sedentary behavior. Methods: Cross-sectional study involving 490 children aged 2-5 years from 11 ECECs. The ECEC routine, size of the outdoor environment, and time spent in the outdoor environment were calculated for each center. Children\u27s physical activity and sedentary time were measured using accelerometers. Multivariate linear regressions were used to examine associations of the attributes of ECEC centers with the outcome variables, adjusting for the effects of center clustering and gender. Results: Children in ECECs that offered free routines (where children can move freely between indoor and outdoor environments) had lower levels of sedentary time (28.27 min/h vs 33.15 min/h; P = .001) and spent more time in total physical activity (7.99 min/h vs 6.57 min/h; P = .008) and moderate- to vigorous-intensity physical activity (9.49 min/h vs 7.31 min/h; P = .008). Children in ECECs with an outdoor environment \u3e400 m2 had less sedentary time (28.94 min/h vs 32.42 min/h; P = .012) than those with areas children

Social and Psychological Factors Associated with Health Care Transition for Young Adults Living with Sickle Cell Disease

Introduction: Due to advances in disease management, mortality rates in children with sickle cell disease (SCD) have decreased. However, mortality rates for young adults (YA) increased, and understanding of social and psychological factors is critical. The aim of this study was to explore factors associated with health care transition experiences for YA with SCD. Method: This was a qualitative descriptive study. A 45-minute semistructured interview was conducted with 13 YA (M = 21.5 years, SD = 1.73). Results: Results suggest that social and psychological factors and self-management experiences influence health care transition. Eight themes emerged: “need for accessible support”; “early assistance with goal setting”; “incongruence among expectations, experiences, and preparation”; “spiritual distress”; “stigma”; “need for collaboration”; “appreciation for caring providers”; and “feeling isolated.” Discussion: Consideration of cultural contexts will guide nurses in supporting health care transition. Designing culturally relevant interventions that address unique needs for YA living with SCD is warranted

Criminal Law and Procedure

This Article surveys recent developments in criminal procedure and law in Virginia. Because of space limitations, the authors have limited their discussion to the most significant appellate decisions and legislation

Criminal Law and Procedure

This article surveys recent developments in criminal law and procedure in Virginia. Because of space limitations, the authors have limited their discussion to the most significant appellate decisions and legislation

Finding qualitative research: an evaluation of search strategies

BACKGROUND: Qualitative research makes an important contribution to our understanding of health and healthcare. However, qualitative evidence can be difficult to search for and identify, and the effectiveness of different types of search strategies is unknown. METHODS: Three search strategies for qualitative research in the example area of support for breast-feeding were evaluated using six electronic bibliographic databases. The strategies were based on using thesaurus terms, free-text terms and broad-based terms. These strategies were combined with recognised search terms for support for breast-feeding previously used in a Cochrane review. For each strategy, we evaluated the recall (potentially relevant records found) and precision (actually relevant records found). RESULTS: A total yield of 7420 potentially relevant records was retrieved by the three strategies combined. Of these, 262 were judged relevant. Using one strategy alone would miss relevant records. The broad-based strategy had the highest recall and the thesaurus strategy the highest precision. Precision was generally poor: 96% of records initially identified as potentially relevant were deemed irrelevant. Searching for qualitative research involves trade-offs between recall and precision. CONCLUSIONS: These findings confirm that strategies that attempt to maximise the number of potentially relevant records found are likely to result in a large number of false positives. The findings also suggest that a range of search terms is required to optimise searching for qualitative evidence. This underlines the problems of current methods for indexing qualitative research in bibliographic databases and indicates where improvements need to be made

When to approach novel prey cues? Social learning strategies in frog-eating bats

Animals can use different sources of information when making decisions. Foraging animals often have access to both self-acquired and socially acquired information about prey. The fringe-lipped bat, Trachops cirrhosus, hunts frogs by approaching the calls that frogs produce to attract mates.We examined howthe reliability of self-acquired prey cues affects social learning of novel prey cues. We trained bats to associate an artificial acoustic cue (mobile phone ringtone) with food rewards. Bats were assigned to treatments in which the trained cue was either an unreliable indicator of reward (rewarded 50% of the presentations) or a reliable indicator (rewarded 100% of the presentations), and they were exposed to a conspecific tutor foraging on a reliable (rewarded 100%) novel cue or to the novel cue with no tutor. Bats whose trained cue was unreliable and who had a tutor were significantly more likely to preferentially approach the novel cue when compared with bats whose trained cue was reliable, and to bats that had no tutor. Reliability of self-acquired prey cues therefore affects social learning of novel prey cues by frog-eating bats. Examining when animals use social information to learn about novel prey is key to understanding the social transmission of foraging innovations. © 2013 The Author(s) Published by the Royal Society

Validation of text-mining and content analysis techniques using data collected from veterinary practice management software systems in the UK

Electronic patient records from practice management software systems have been used extensively in medicine for the investigation of clinical problems leading to the creation of decision support frameworks. To date, technologies that have been utilised for this purpose such as text mining and content analysis have not been employed significantly in veterinary medicine.The aim of this research was to pilot the use of content analysis and text-mining software for the synthesis and analysis of information extracted from veterinary electronic patient records. The purpose of the work was to be able to validate this approach for future employment across a number of practices for the purposes of practice based research. The approach utilised content analysis (Prosuite) and text mining (WordStat) software to aggregate the extracted text. Text mining tools such as Keyword in Context (KWIC) and Keyword Retrieval (KR) were employed to identify specific occurrences of data across the records. Two different datasets were interrogated, a bespoke test dataset that had been set up specifically for the purpose of the research, and a functioning veterinary clinic dataset that had been extracted from one veterinary practice.Across both datasets, the KWIC analysis was found to have a high level of accuracy with the search resulting in a sensitivity of between 85.3–100%, a specificity of between 99.1–99.7%, a positive predictive value between 93.5–95.8% and a negative predictive value between 97.7–100%. The KR search, based on machine learning, was utilised for the clinic-based dataset and was found to perform slightly better than the KWIC analysis.This study is the first to demonstrate the application of content analysis and text mining software for validation purposes across a number of different datasets for the purpose of search and recall of specific information across electronic patient records. This has not been demonstrated previously for small animal veterinary epidemiological research for the purposes of large scale analysis for practice-based research. Extension of this work to investigate more complex diseases across larger populations is required to fully explore the use of this approach in veterinary practice