Overall, it is suggested that families positively perceive their experience with FCR, although more research is needed to determine if satisfaction is greater in FCR versus standard rounds as well as to better understand different perspectives of adolescent patients and non-English-speaking families.
HIV-related symbolic stigma arises from moralistic value judgements attached to people living with HIV and has negative consequences from both public health and human rights perspectives. Relatively little is known about cross-national variation in symbolic stigma. With the purpose of informing stigma reduction efforts within and across settings, we compared social representations of HIV in six African countries with estimated adult HIV prevalence rates ranging from 1 to 33%. Our study used a unique data source, namely a stratified random sample (n=586, ~5%) from 11,354 creative ideas contributed from six countries to a continent-wide HIV-related scriptwriting contest held between February and April2005. The narratives were written by equal numbers of males and females aged 10–24 in urban and rural areas of Swaziland, Namibia, Kenya, South-East Nigeria, Burkina Faso and Senegal. We combined three analytical approaches: descriptive statistics on certain quantifiable characteristics of the narratives, thematic data analysis, and a narrative-based approach. The association of HIV with outsiders (“othering”)and preoccupation with the circumstances of infection are more common in lower prevalence countries but vary substantially in tone depending on the sociocultural context. The highest proportion both of moralising narratives and of narratives with pessimistic outcomes come from South-East Nigeria and, to a lesser extent, from Kenya, countries with prevalence levels of 3.9 and 6.1% respectively, in which evangelical Christian movements, including Pentecostalism, have sizeable followings. The data provide a rare cross-cultural overview of symbolic stigma, identify country-specific needs, and point to strategies for future programming. Social representations from the highest prevalence countries, Swaziland and Namibia, and from lower prevalence Burkina Faso offer potential models for the framing of HIV in ways that serve to increase social proximity and counteract symbolic stigma.
CCAD is commonly related to trauma and presents with AIS. The majority of patients experience good clinical outcome. Recanalization of initial vessel occlusion occurs in half of cases at 2 years.
All of the graduate students in the School of Nursing take some of their Master of Science courses online. A group of six School of Nursing faculty members and a graduate student received funding to determine best practices in online courses. The group developed an evaluation rubric to measure quality in the graduate online curriculum. They then applied the rubric to the core courses which are primarily offered online and are required for all graduate nursing students. The project had a positive impact on faculty by offering a tool useful for online course evaluation and development. Additionally it brought to attention the needs of faculty member development in online education.
Despite the prominence of abstinence promotion in HIV prevention for young Africans, there is little documentation concerning its reception and interpretation. With the purpose of informing programmatic practice, we examined how young Africans from six countries with contrasting HIV prevalence rates make sense of abstinence. ‘Scenarios from Africa’ scriptwriting contests invite young people to contribute ideas for short films about HIV. Using thematic narrative-based approaches, we analyzed a stratified random sample of 586 (~5%) of these narratives written in 2005 by young women and men aged 10–24 years from Senegal, Burkina Faso, South-East Nigeria, Kenya, Namibia and Swaziland. Abstinence was considerably more prominent as a theme in the samples from SE Nigeria, Kenya and Swaziland. It was articulated in relation to conservative Christian sexual morality and in opposition to condom use with particular intensity in SE Nigeria, with stigmatising implications for non-abstainers. However, cross-national commonalities were more striking than differences. Examples of non-stigmatising pro-abstinence messaging highlighted the appeal of discourses of romantic love and future plans across countries and demographic characteristics. The analysis yielded contextual understanding, youth-driven ideas, and recommendations to inform comprehensive HIV prevention efforts.
Introduction: While family-centered rounds (FCR) have become increasingly important in pediatrics, there is often no training for residents on appropriate FCR practice. This curriculum was developed to address this identified gap in pediatric trainee education through a combination of didactic presentation, direct observation, and simulated FCR. Methods: Residents participated in a didactic presentation on key components of FCR and tenets of communication with families. A subset of residents participated in a simulated intervention in which they practiced an FCR encounter using a mock patient case and received immediate feedback from a multidisciplinary team. Following the simulation, residents completed follow-up surveys and focus group discussions to assess their experience and comfort. Resident trainees were observed and rated during FCR by trained parent advisors using a novel FCR checklist both before and after participation in the simulation. Results: This curriculum was implemented with 10 pediatric interns (intervention group). These residents demonstrated statistically significant improvements in the areas of greeting family by name and soliciting rounding preferences, enhancing family comfort in participating in FCR, and increasing family engagement in FCR. Compared to controls, intervention group residents had higher ratings on the majority of performance items. Resident-reported self-efficacy in conducting FCR increased following the intervention, and the feedback portion of the intervention was highly valued. Discussion: Simulation-based training is an effective model for teaching residents best practices in FCR with lasting impact on resident communication skills as seen in comparative analysis from before and after the intervention.
BACKGROUND: Neonatal seizures and antiseizure medications both have potentially serious consequences on the developing brain. As such, optimal treatment of neonatal seizures remains unclear. Moreover, little is known about parental experiences, concerns, or unanswered questions. We conducted an online survey to assess parental perspectives regarding neonatal seizures and their management, along with their suggestions for specific high priority research topics. METHODS: Parents whose children had neonatal seizures were recruited through social media support groups to complete an online survey. Respondents progressed through a tiered series of questions about their experiences with neonatal seizures and antiseizure medications. RESULTS: There were 126 eligible respondents. On a Likert scale, parents reported that neonatal seizures had a major effect on their families (median 10 of 10; interquartile range 3; n ¼ 85). They also reported that antiseizure medications had a significant impact on their families (median 7 of 10; interquartile range 5.5; n ¼ 75). The emotional impact of the uncertainty regarding seizures and medications was highlighted. Effects on neurodevelopment, continued seizures, and adverse effects of medications were some of the most commonly reported parental concerns and their highest priority research topics. CONCLUSIONS: Both neonatal seizures and the medications used to treat them contribute to parental worries and have major impact on families. Patient-centered outcomes research should focus on the riskebenefit ratio of neonatal seizures and antiseizure medication. The emotional impact on parents related to the uncertainty regarding both immediate and long-term neonatal seizure management is important to address in the clinical setting.
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