Storytelling in Focus Group Discussions: A Narrative Approach to Phenomena With Temporal Dimensions in Medical Education Research

People can express experiences, opinions, and perspectives in stories. In a story, the experiences can be relived and discovered independently of time and place. In medical education, it is a fundamental premise that time progresses, and it is within this temporal space that students learn, acquire competencies, and form identity. It is also within this space that much qualitative research is conducted. However, qualitative examinations at one point in time will result in only a snapshot of a dynamic phenomenon that evolves over time. Existing approaches to qualitative research are often inadequate to accommodate this dynamic development without applying a time- and cost-consuming design such as longitudinal investigations. The purpose of this paper is to present storytelling as a useful research approach to include temporal dimensions in cross-sectional qualitative data collection. We describe the background for the approach, argue for its use, and provide a practical example of storytelling with the use of a fictional character in online focus group discussions to explore a dynamic phenomenon in medical education research. Overall, storytelling offers a narrative approach to qualitative research that allows the researcher to explore phenomena across time and space. The approach has the advantage that it can be used in different formats both oral and written, digital or physical.</p

Follow-up after gestational diabetes:a qualitative study of perspectives from general practices

BACKGROUND: Women whose pregnancies are complicated by gestational diabetes mellitus (GDM) are approximately eight times more likely to develop type 2 diabetes mellitus (T2DM). Although regular participation in follow-up screening increases the chance of early detection of diabetes, participation rates are often suboptimal. A better understanding of general practice as a key contextual setting for screening could help inform the development and adoption of, for example, electronic reminder interventions to support women’s participation. AIM: To explore the perspectives of GPs and relevant staff members engaged in early detection of diabetes after gestational diabetes in order to identify barriers to and facilitators of follow-up screening. DESIGN & SETTING: A qualitative interview study undertaken in general practices in the North Denmark Region. METHOD: Based on a purposive sample strategy, 18 semi-structured interviews of 12 GPs and six staff members, who were either nurses or midwives, were analysed using a reflexive thematic analytical approach. RESULTS: The following three main themes were formulated: (1) challenges of addressing women’s risk; (2) prioritisation of early detection of diabetes; and (3) system influence on clinical procedures. CONCLUSION: Follow-up screening was facilitated by knowledge of guidelines. Professional collaboration and adaptation support were found to lead to successful implementation of guidelines in general practice. Supporting GPs and their staff’s reflection and discussion of ways to engage in communication and decisionmaking processes with women is, however, important; it was found to create an important barrier to follow-up screening. Overall, the findings can help inform the future development of interventions to increase uptake

Effect of an electronic reminder of follow-up screening after pregnancy complicated by gestational diabetes mellitus:a randomized controlled trial

AIM: To determine the effectiveness of despatching an electronic reminder of participation in screening for gestational diabetes. The reminder was sent to the women 1–8 years after delivery. METHODS: A registry-based, randomized controlled trial in the North Denmark Region among women with gestational diabetes. Randomization was made, which included seven groups stratified by the child’s birth year (2012–2018). The intervention group received standard care supplemented by an electronic reminder through a secure nationwide email system (n = 731), while the control group received only standard care (n = 732). The primary outcome was based on blood testing for diabetes (OGTT, HbA1c or fasting P-glucose). RESULTS: A total of 471 (32.1%) women participated in screening. The primary outcome was experienced by 257 women (35.1%) in the intervention group and 214 women (29.2%) in the control group. The effect of the reminder seemed to increase with recipient’s age, non-western origin, urban dwelling, and multiparity. Of those who participated in follow-up screening, 56 (3.8%) were diagnosed with type 2 diabetes. CONCLUSION: Electronic reminders, based on the principles of informed choice and patient-centred care, to women have been shown to support life-long participation in follow-up screening. Attempts to further stimulation of coverage could however be considered. TRAIL REGISTRATION: ISRCTN registry (22/04/2022, ISRCTN23558707)

Den overhalede tid – i anledning af en udstilling

Med udgangspunkt i billedkunstneren Jette Gejls udstilling om det historiske landbrugslands Danmark behandles og tematiseres forskellige måder at håndtere tid og tidslighed på (som f.eks. indbygget i erindringsbærende artefakter) i billedkunstneriske, filmiske og museale praksisser (f.eks. affektivt, nostalgisk eller mekanisk-positivistisk evolutionært)

Thrombin generation measured on ST Genesia, a new platform in the coagulation routine lab: Assessment of analytical and between-subject variation

Background: The thrombin generation (TG) assay, which measures global coagulation, has mainly been used as a research tool to investigate thrombotic and bleeding disorders. Recently, Diagnostica Stago launched the ST Genesia, a fully automated system to perform “routine version” of this assay. The objectives of this study were to evaluate the imprecision compared with the previous method, Thrombinoscope CAT, and to establish reference intervals. Methods: Thrombin generation was measured in platelet-poor citrated plasma from 20 normal controls (fresh and after freezing at −80°C up to 12–13 weeks) on CAT and ST Genesia in duplicate to estimate the total variation, and within and between variations. The reference intervals were estimated nonparametrically in 30 men, 30 women taking combined oral contraceptives (COCs), and 30 women not taking COCs. These were sampled in both Vacutainer and Monovette tubes (i.e., tubes with a high and minimal contact activation, respectively). Results: Freezing had minimal effects. Imprecision was comparable between the ST Genesia and CAT, with a strong correlation between the two methods. TG was higher when sampled in Vacutainer than in Monovette. We observed a distinct difference between women taking and not taking COCs, whereas men and women not taking COC were quite similar. Conclusions: Thrombin generation on ST Genesia showed an analytical variation similar to that of CAT. The results depended on the type of sample tubes; thus, reference intervals must be established for the collection tubes used in each laboratory. Furthermore, a considerable difference was observed between women using and not using COCs