scholarly journals Emotion transformation: a grounded theory for uncovering painful triggers and repairing relational connection for parents of autistic children

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Anna Robinson ◽  
Ennie Yong
Keyword(s):  
Grounded Theory ◽  
Parent Training ◽  
Process Model ◽  
Phase 1 ◽  
Transformation Process ◽  
Autistic Children ◽  
Phase 3 ◽  
Content Type ◽  
Three Phase ◽  
Model Phase

Purpose It is often voiced that parents of autistic children are the expert of their child, whereas parenting programmes target them as effective mediators for change. This paper aims to explore this unchallenged heuristic to develop an understanding of both emotional and relational needs of parents through trainers’ experiences of delivering emotion-focused and autism parent training. Design/methodology/approach This qualitative study used a constructivist approach of grounded theory to gain an in-depth understanding of trainers’ experiences from their encounters when delivering parent training. Six expert trainers were interviewed, and a two-phased coding of ground theory and an adapted thematic analysis was used. Findings An overarching theme emerged: emotion transformation from painful triggers, to enhanced attunement and relational repair. Four main themes containing 13 subthemes were identified. The interaction of these themes and subthemes are presented in a three-phase process model. Phase 1: uncovering painful emotions from a shared journey contained one theme: parent painful triggers. Phase 2: uncovering interpersonal rupture cycle contained one theme: relational rupture cycle within non-synchrony of attunement. Phase 3: parent–child relational repair contained two themes: repairing attachment bonds and therapist’s prizing stance. Social implications The authors challenge the parent as expert heuristic and propose that not all parents feel expert in neurotypical-neurodivergent intersubjectivity. The authors are curious to see whether trainers/therapists can guide parents through unprocessed emotions and non-synchrony of attunement to promote healing and relational repair, which requires further investigation. Originality/value To the best of the authors’ knowledge, this is the first emotion-transformation process model grounded in humanistic principles of relational acceptance and emotion theory. The authors propose that a focus on process rather than outcome is more likely to result in higher parenting self-efficacy.

scholarly journals Activity of Simulated Human Dosage Regimens of Meropenem and Vaborbactam against Carbapenem-Resistant Enterobacteriaceae in an In Vitro Hollow-Fiber Model

2017 ◽  
Vol 62 (2) ◽  
Author(s):  
Mojgan Sabet ◽  
Ziad Tarazi ◽  
Debora Rubio-Aparicio ◽  
Thomas G. Nolan ◽  
Jonathan Parkinson ◽  
...  
Keyword(s):  
Antibacterial Activity ◽  
Hollow Fiber ◽  
Phase 1 ◽  
Phase 3 ◽  
Fiber Model ◽  
Content Type ◽  
Development Of Resistance ◽  
Carbapenem Resistant ◽  
Dosage Regimens

ABSTRACT The objective of these studies was to evaluate the exposures of meropenem and vaborbactam that would produce antibacterial activity and prevent resistance development in carbapenem-resistant Klebsiella pneumoniae carbapenemase (KPC)-producing Enterobacteriaceae strains when tested at an inoculum of 108 CFU/ml. Thirteen K. pneumoniae isolates, three Enterobacter cloacae isolates, and one Escherichia coli isolate were examined in an in vitro hollow-fiber model over 32 h. Simulated dosage regimens of 1 to 2 g of meropenem with 1 to 2 g of vaborbactam, with meropenem administered every 8 h by a 3-h infusion based on phase 1 or phase 3 patient pharmacokinetic data, were studied in the model. A dosage of 2 g of meropenem in combination with 2 g of vaborbactam was bactericidal against K. pneumoniae, E. cloacae, and E. coli strains, with meropenem-vaborbactam MICs of up to 8 mg/liter. When the vaborbactam exposure was adjusted to the levels observed in patients enrolled in phase 3 trials (24-h free AUC, ∼550 mg · h/liter, versus 320 mg · h/liter in the phase 1 studies), 2 g of meropenem with 2 g of vaborbactam was also bactericidal against strains with meropenem-vaborbactam MICs of 16 mg/liter. In addition, this level of vaborbactam also suppressed the development of resistance observed using phase 1 exposures. In this pharmacodynamic model, exposures similar to 2 g of meropenem in combination with 2 g of vaborbactam administered every 8 h by a 3-h infusion in phase 3 trials produced antibacterial activity and suppressed the development of resistance against carbapenem-resistant KPC-producing strains of Enterobacteriaceae.

scholarly journals MP09: Canadian Community Utilization of Stroke Prevention Pilot Study-Emergency Department (C-CUSP ED)

CJEM ◽  
2017 ◽  
Vol 19 (S1) ◽  
pp. S68 ◽  
Author(s):  
R. Parkash ◽  
K. Magee ◽  
M. McMullen ◽  
M.B. Clory ◽  
M. D’Astous ◽  
...  
Keyword(s):  
Stroke Prevention ◽  
Phase 1 ◽  
Retrospective Chart Review ◽  
Phase 2 ◽  
Phase 3 ◽  
Three Phase ◽  
Rigorous Study ◽  
The Mean ◽  
Prior Risk

Introduction: Atrial fibrillation (AF) is the most common sustained arrhythmia affecting 1-2% of the population. Oral anticoagulation (OAC) reduces stroke risk by 60-80% in AF patients, but only 50% of indicated patients receive OAC. Many patients present to the ED with AF due to arrhythmia symptoms, however; lack of OAC prescription in the ED has been identified as a significant gap in the care of AF patients. Methods: This was a multi-center, pragmatic, three-phase before-after study, in three Canadian sites. Patients who presented to the ED with electrocardiographically (ECG) documented, nonvalvular AF and were discharged home were included. Phase 1 was a retrospective chart review to determine OAC prescription of AF patients in each ED; Phase 2 was a low-intensity knowledge translation intervention where a simple OAC-prescription tool for ED physicians with subsequent short-term OAC prescription was used, as well as an AF patient education package and a letter to family physicians; phase 3 incorporated Phase 2 interventions, but added immediate follow-up in a community AF clinic. The primary outcome of the study was the rate of new OAC prescriptions at ED discharge in AF patients who were OAC eligible and were not on OAC at presentation. Results: A total of 632 patients were included from June, 2015-November, 2016. ED census ranged from 30000-68000 annual visits. Mean age was 71±15, 67±12, 67±13 years, respectively. 47.5% were women, most responsible ED diagnosis was AF in 75.8%. The mean CHA2DS2-VASc score was 2.6±1.8, with no difference amongst groups. There were 266 patients eligible for OAC and were not on this at presentation. In this group, the prescription of new OAC was 15.8% in Phase 1 as compared to 54% and 47%, in Phases 2 and 3, respectively. After adjustment for center, components of the CHA2DS2-VASc score, prior risk of bleeding and most responsible ED diagnosis, the odds ratio for new OAC prescription was 8.0 (95%CI (3.5,18.3) p<0.001) for Phase 3 vs 1, and 10.0 (95%CI (4.4,22.9) p<0.001), for Phase 2 vs 1). No difference in OAC prescription was seen between Phases 2 and 3. Conclusion: Use of a simple OAC-prescription tool was associated with an increase in new OAC prescription in the ED for eligible patients with AF. Further testing in a rigorous study design to assess the effect of this practice on stroke prevention in the AF patients who present to the ED is indicated.

scholarly journals PSII-21 The Effect of Feeding a LucraFit® Feed Nursery Program without Lactose on Piglet Performance

2020 ◽  
Vol 98 (Supplement_3) ◽  
pp. 172-172
Author(s):  
Stacie Crowder ◽  
Terry Weeden ◽  
Clayton Hankins ◽  
Terry Meyer ◽  
Brenda de Rodas
Keyword(s):  
Negative Impact ◽  
Phase 1 ◽  
Initial Weight ◽  
Phase 3 ◽  
Time Period ◽  
Three Phase ◽  
Significant Difference ◽  
Period Data ◽  
Effect Of Feeding ◽  
D 43

Abstract The objective of this study was to evaluate the effect of feeding LucraFit® Feed nursery program without lactose on piglet performance. A total of 440 weanling pigs, initial weight of 5.76 ± 0.23 kg., were randomly assigned to either Control or LucraFit® Feed treatments with 11 replicates per treatment and 20 pigs per pen. Pigs were weighed at day 0, 8, 15, 21, 29, and 43 post-weaning with corresponding ADG, ADFI, and G:F calculated for each time period. Data was analyzed using the Mixed procedure of SAS. Pigs were fed a three-phase nursery program with 2.27, 5.44, and 13.19 kg/pig for phases 1-3 respectively. Control diets contained 12.5% lactose in phase 1, 5% lactose in phase 2, and 0% lactose in phase 3. LucraFit® Feed diets contained 0% lactose in all phases. LucraFit® Feed was added at 2.5% and 1.25% in phase 1 and 2 respectively. During d0 to 8, there was no significant difference in growth measurements. During d8 to 15, pigs fed LucraFit® Feed treatment had increased (P=0.039) ADG (0.296 vs 0.266 kg/d) and improved (P=0.035) G:F ratio (0.977 vs 0.923). During d15 to 21, ADG was not significantly different between treatments, however ADFI was tended to increase (P=0.061) with the LucraFit® Feed treatment (0.526 vs 0.497 kg/d) resulting in decreased (P=0.047) G:F ratio (0.783 vs 0.824). Through d21 to 43, LucraFit® Feed tended to improve (P=0.082) G:F ratio (0.676 vs 0.660). Overall (d0 to 43) G:F ratio tended to improve (P=0.082) with the LucraFit® Feed treatment (0.723 vs 0.709). No significant differences were observed in pig removals between treatments. Final (d 43) body weight was not significantly different between treatments. These results suggest that pigs can be started on a LucraFit® Feed nursery program with 0% lactose without having a negative impact on nursery performance.

A qualitative investigation of e-tail brand affect

2018 ◽  
Vol 36 (3) ◽  
pp. 365-380 ◽  
Author(s):  
Abhigyan Sarkar ◽  
Juhi Gahlot Sarkar ◽  
Sreejesh S. ◽  
Anusree M.R.
Keyword(s):  
Grounded Theory ◽  
Attachment Style ◽  
Process Model ◽  
Causal Process ◽  
Store Brand ◽  
Content Type ◽  
Grounded Theory Method ◽  
Brand Affect ◽  
Positive Word Of Mouth ◽  
Depth Interviews

Purpose The purpose of this paper is to qualitatively investigate various factors associated with e-tail store brand affect. Design/methodology/approach Data were collected by conducting semi-structured depth interviews following a storytelling approach. The data were coded using the grounded theory method. Findings Data analysis shows that anticipated service recovery, deal attractiveness and luxury e-tail brand image predict e-tail store brand affect. These predictors play their roles under the moderating influences of specific moderators. The desirable marketing outcomes of e-tail store brand affect are e-tail branded app usage, spreading positive word of mouth and secure attachment style toward e-tailer. Originality/value The value of this study lies in developing a grounded theory based causal process model that can provide managerial insights on how to enhance e-tail brand affect.

scholarly journals External Quality Assessment of Transporting Infectious Substances in Canada

1999 ◽  
Vol 10 (3) ◽  
pp. 246-251
Author(s):  
Shelley M Tiffin ◽  
Michael A Noble
Keyword(s):  
Phase 1 ◽  
Phase 3 ◽  
Laboratory Observation ◽  
Common Error ◽  
Absorbent Material ◽  
Dangerous Goods ◽  
Phase Study ◽  
Three Phase ◽  
Immunodeficiency Virus ◽  
Private Laboratory

OBJECTIVE: To determine the degree of compliance with Transport Canada’s Transportation of Dangerous Goods Regulations for transporting infectious substances in Canada.DESIGN: A three-phase study including observation of packages arriving at the British Columbia Centre for Disease Control (BCCDC) provincial laboratory; observation of requested samples of either anEscherichia coliculture or serum, not human immunodeficiency virus (HIV) or HbsAg positive, from laboratories; and a questionnaire concerning training and certification of packers in laboratories.RESULTS: During phase 1, 500 packages arriving at the BCCDC provincial laboratory were assessed. All arrived intact, with 384 (76.8%) in a firm outer package. Only 178 (35.6%) contained absorbent material. Six samples were known to contain human immunodefiency virus or hepatitis B; all were appropriately packaged. Of the remainder, 11 (2.2%) were considered overpackaged, 192 (38.4%) acceptably packaged and 191 (38.2%) inadequately packaged. In phase 2, 138 requested packages were assessed. All arrived intact, 132 (95.7%) in a firm outer package. Ninety-six (69.6%) contained absorbent material. Only six (4.3%) were considered inadequately packaged. In phase 3, 171 laboratories responded to a questionnaire. Fifty-nine were from small laboratories, 53 from intermediate laboratories and 23 from large laboratories. Most laboratories (55.4%) relied on in-house resources to train packers. Only 26 (15.3%) facilities had no certified packers, and 60.8% noted they had a formal copy of the regulations available in the laboratory. Laboratory characteristics associated with the likelihood of overpackaging included number of technologists (χ2=5.72; P=0.058), number of samples processed by laboratories (χ2=8.46; P=0.015) and being a private laboratory as opposed to being a hospital laboratory (Fisher Exact two-tailed 0.040).CONCLUSIONS: Canadian laboratories tend to package safely and within the acceptable range of regulation, although not within the precision of regulation. Most laboratories have trained and certified packers. The most common error is the use of outer packaging that is not firm. Larger laboratories tend to overpackage resulting in increased costs.

A NEW FUZZY APPROACH FOR PROJECT SELECTION WITH OUTSOURCING VIEWPOINT

2011 ◽  
Vol 08 (02) ◽  
pp. 227-251 ◽  
Author(s):  
MAHDI BASHIRI ◽  
HOSSEIN BADRI ◽  
JAFAR TALEBI
Keyword(s):  
Programming Model ◽  
Phase 1 ◽  
Fuzzy Topsis ◽  
Project Selection ◽  
Phase 2 ◽  
Fuzzy Approach ◽  
Topsis Method ◽  
Phase 3 ◽  
Contractor Selection ◽  
Model Phase

Nowadays most of the organizations tend to outsource their projects. In these cases, two major problems arise: project selection and contractor selection. There are many papers which have argued separately about project and contractor selections. In this paper, we propose a decision support system for selecting projects and related contractors. The proposed approach contains three phases including contractors' prequalification (Phase 1), computing success coefficient of each contractor in projects using fuzzy TOPSIS method (Phase 2), and selecting projects and assigning each project to the most appropriate contractor using a linear programming model (Phase 3). Finally, a numerical example is illustrated to show the application of the proposed method.

scholarly journals Lean Six Sigma implementation and sustainability roadmap for reducing medication errors in hospitals

2020 ◽  
Vol 33 (1) ◽  
pp. 33-55
Author(s):  
Yaifa Trakulsunti ◽  
Jiju Antony ◽  
Jacqueline Ann Douglas
Keyword(s):  
Case Studies ◽  
Medication Errors ◽  
Six Sigma ◽  
Phase 1 ◽  
Hospital Setting ◽  
Lean Six Sigma ◽  
Healthcare Sector ◽  
Phase 3 ◽  
Content Type ◽  
Key Characteristics

PurposeThe purpose of this study is to propose a Lean Six Sigma (LSS) roadmap to guide healthcare practitioners in the implementation of LSS along with a customized LSS tool kit for reducing medication errors.Design/methodology/approachThe authors initially critically reviewed several frameworks/roadmaps of Lean, Six Sigma and LSS which have been proposed in healthcare sector from the existing literature. This review has led to an understanding of key characteristics, limitations and reasons behind the development of such frameworks/roadmaps. A conceptual roadmap was developed and then validated by a number of LSS experts and a healthcare practitioner. Based on the previous studies and taking LSS experts’ opinions into account, a revised roadmap for reducing medication is presented.FindingsThe roadmap for LSS in reducing medication errors is developed. This roadmap includes three phases: Phase 1 cultural readiness for LSS employment in reducing medication errors; Phase 2 preparation, initialization and implementation; and Phase 3 sustainability.Research limitations/implicationsThe roadmap has been tested with only a handful of practitioners of LSS. Moreover, only two case studies have been carried out in a Thai hospital setting which followed the roadmap. In order to improve the validity of research, more case studies need to be executed and more people should be used for testing the roadmap with varied cultures.Originality/valueThis is the first attempt in the development of a LSS roadmap that healthcare practitioners can follow to reduce medication errors using LSS methodology and sustaining LSS in their organizations.

scholarly journals Efficacy and Cardiovascular Safety of Roxadustat for Treatment of Anemia in Patients with Non–Dialysis-Dependent CKD

2021 ◽  
Vol 16 (8) ◽  
pp. 1190-1200
Author(s):  
Robert Provenzano ◽  
Lynda Szczech ◽  
Robert Leong ◽  
Khalil G. Saikali ◽  
Ming Zhong ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Rescue Therapy ◽  
Cardiovascular Safety ◽  
Phase 3 ◽  
End Points ◽  
Content Type ◽  
Link Type ◽  
Three Phase ◽  
All Cause Mortality

Background and objectivesWe evaluated the efficacy and cardiovascular safety of roxadustat versus placebo by analyzing data pooled from three phase 3 studies of roxadustat in patients with non–dialysis-dependent CKD and CKD-related anemia.Design, setting, participants, & measurementsIn the three phase 3, double-blind studies of roxadustat versus placebo evaluating the treatment of CKD-related anemia in patients not requiring dialysis, the primary efficacy end point was mean change from baseline in hemoglobin averaged over weeks 28–52, regardless of rescue therapy. The primary cardiovascular safety end point was a composite measure of major adverse cardiovascular events (MACE; all-cause mortality, myocardial infarction, stroke). MACE plus (MACE+; MACE plus unstable angina and heart failure requiring hospitalization) and all-cause mortality were key secondary safety end points. These safety end points were adjudicated.ResultsA total of 4277 patients with non–dialysis-dependent CKD were randomized (roxadustat, n=2391; placebo, n=1886). Baseline characteristics were comparable between groups; the mean (SD) hemoglobin was 9.1 (0.7) g/dl and mean eGFR was 20 (12) ml/min per 1.73 m2. Patients treated with roxadustat versus those treated with placebo showed a mean change from baseline in hemoglobin averaged over weeks 28–52, regardless of rescue therapy, of 1.9 versus 0.2 g/dl, a treatment difference of 1.7 (95% confidence interval [95% CI], 1.7 to 1.8). Roxadustat reduced the need for red blood cell transfusion in the first 52 weeks versus placebo (6.1 versus 20.4 per 100 patient-exposure years, respectively; hazard ratio [HR], 0.26; 95% CI, 0.21 to 0.32). There were no increased risks of MACE (HR, 1.10; 95% CI, 0.96 to 1.27), MACE+ (HR, 1.07; 95% CI, 0.94 to 1.21), all-cause mortality (HR, 1.08; 95% CI, 0.93 to 1.26), or individual MACE+ components in patients treated with roxadustat versus those treated with placebo.ConclusionsRoxadustat was more effective than placebo at increasing hemoglobin in patients with non–dialysis-dependent CKD and anemia, while decreasing transfusion rate and being noninferior to placebo with respect to risk of MACE.Clinical Trial registry name and registration number:A Study of FG-4592 for the Treatment of Anemia in Chronic Kidney Disease Patients Not Receiving Dialysis, NCT01750190; Roxadustat in the Treatment of Anemia in Chronic Kidney Disease Patients Not Requiring Dialysis (ALPS), NCT01887600; Safety and Efficacy Study of Roxadustat to Treat Anemia in Patients With Chronic Kidney Disease (CKD), Not on Dialysis, NCT02174627

scholarly journals Social isolation and loneliness of UK veterans: a Delphi study

2020 ◽  
Vol 70 (6) ◽  
pp. 407-414 ◽  
Author(s):  
C Leslie ◽  
G McGill ◽  
M D Kiernan ◽  
G Wilson
Keyword(s):  
Social Isolation ◽  
Delphi Study ◽  
Phase 1 ◽  
Armed Forces ◽  
Phase 3 ◽  
Emotional Resilience ◽  
Mixed Methods Approach ◽  
Three Phase ◽  
The Military ◽  
The Impact

Abstract Background Evidence increasingly acknowledges the impact of social isolation and loneliness on the lives of military veterans and the wider Armed Forces Community. Aims The study gathered expert consensus to (i) understand if veterans are considered ‘unique’ in their experiences of social isolation and loneliness; (ii) examine perceived factors leading to social isolation and loneliness of veterans; (iii) identify ways to tackle veterans’ social isolation and loneliness. Methods This study adopted a three-phase Delphi method. Phase 1 utilized a qualitative approach and Phase 2 and Phase 3 utilized a mixed-methods approach. Results Several outcomes were identified across the three phases. Transition out of the military was viewed as a period to build emotional resilience and raise awareness of relevant services. It was also concluded that veterans would benefit from integrating into services within the wider community, and that social prescribing services could be a vehicle to link veterans to relevant services. Furthermore, access to, and the content of, programmes was also of importance. Conclusions These findings illustrate various important interventional aspects to consider when funding and implementing programmes focussed on tackling social isolation and loneliness.

scholarly journals THE SYSTEM OF EXERCISES AND TASKS TO BUILD THE LINGUISTIC COMPETENCE IN LATIN

2020 ◽  
pp. 32-44
Author(s):  
Viacheslav Shovkovyi ◽  
Tetiana Shovkova ◽  
Tamara Kavytska
Keyword(s):  
Procedural Knowledge ◽  
Phase 1 ◽  
Educational Process ◽  
Linguistic Competence ◽  
Phase 3 ◽  
Sound System ◽  
Analytical Skills ◽  
Three Phase ◽  
Analysis And Synthesis ◽  
Insight Into

Systematization of educational material in the form of exercises and tasks has been a relevant problem for learning any language, including a classical one. Exercises and tasks – the application of which in the educational process requires an appropriate sequencing and phasing – are given a significant role in building Latin linguistic competence (LLC) of Philology majors. Theoretically, however, the problem is underresearched in the Ukrainian context; the available research that gives insight into building of LLC focuses on modern languages and thus tends to integrate linguistic competence with communicative competence, which has no relevance to teaching Latin. Hence, the goal of this article is to outline the theoretical prerequisites and develop a scientifically sound system of exercises and tasks to build the LLK in Philology majors. The methodology of the research relies on critical analysis and synthesis of theoretical sources with further application of basic concepts in the process of designing the system of exercises and tasks. The review of literature on the problem under discussion has enabled the authors to conceptualise the content and building of the LLC from the standpoint of educational expediency. The three-phase model of building the specified competence is offered: Phase 1 – building of declarative and procedural knowledge; Phase 2 – building of phonetic, grammatical, and lexical skills; Phase 3 – development of phonetic, lexical, grammatical, and analytical abilities. The system of exercises and tasks involves three subsystems – phonetic exercises and tasks, grammatical exercises and tasks, lexical exercises and tasks. Each subsystem contains both the exercises to build relevant skills and the tasks aimed at enhancing analytical skills and critical thinking, which relate to the analysis of language material by integrating Latin with other disciplines the students major in.

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