scholarly journals A qualitative exploration of the patient experience of erosive and non-erosive hand osteoarthritis

2021 ◽  
Vol 5 (1) ◽  
Author(s):  
Charlotte Panter ◽  
Pamela Berry ◽  
Deven Chauhan ◽  
Sofia Fernandes ◽  
Sally Gatsi ◽  
...  
Keyword(s):  
Content Validity ◽  
Small Sample Size ◽  
The United States ◽  
Small Sample ◽  
Hand Osteoarthritis ◽  
Structured Interviews ◽  
Time Data ◽  
Erosive Disease ◽  
Concept Elicitation ◽  
Improve Measurement

Abstract Background Many patients with hand osteoarthritis (HOA) experience reduced health-related quality of life. This study sought to better understand the disease and treatment experience of individuals with HOA, explore any differences in experiences between erosive and non-erosive HOA sub-types, and evaluate content validity of the Michigan Hand Outcomes Questionnaire (MHQ) in HOA. Methods Thirty subjects from the United States (n = 15 erosive HOA; n = 15 non-erosive HOA) participated in semi-structured interviews: concept elicitation explored symptoms/impacts important to patients; cognitive interviews assessed understanding and relevance of the MHQ. A sub-sample participated in real-time data capture (RTDC) activities via a smartphone/tablet app over 7 days. Verbatim transcripts were coded using Atlas.ti software and thematically analyzed. Concept saturation and MHQ content validity were evaluated. Results Most participants reported experiencing pain, swelling and stiffness, symptoms that most commonly had a direct impact on physical functioning. Substantial impacts on activities of daily living, emotional functioning, sleep and work were also reported. RTDC findings corroborated concept elicitation findings. There were no notable differences between erosive and non-erosive HOA, except nodules were reported more frequently in erosive disease. Most participants used analgesic treatments, but effects were short-lived. Pain was the symptom most frequently reported as most bothersome and important to treat. Concept saturation was achieved. MHQ items and instructions were well understood and relevant to most participants; stiffness and swelling were reported as important symptoms not included in the MHQ. Conclusions This study characterizes key symptoms of HOA which are burdensome for patients and not well controlled by current therapies, highlighting an unmet treatment need. Although the study is limited by a small sample size that may not be representative of the broader erosive and non-erosive HOA population, concept saturation was achieved, and our findings suggest that disease experience is similar for patients with erosive and non-erosive HOA. Evaluation of stiffness and swelling items in conjunction with the MHQ may enhance relevance and improve measurement precision to assess important domains of HQRoL in an HOA population.

Individuals' waste separation practice in a relationship with social bonds: a case study of Hanoi, Vietnam

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Thi Kim Nhung Nguyen
Keyword(s):  
Social Bonds ◽  
Small Sample Size ◽  
Influential Factors ◽  
Small Sample ◽  
Household Waste ◽  
Mixed Method Research ◽  
Structured Interviews ◽  
Content Type ◽  
Sociological Approach ◽  
Waste Separation

PurposeThe paper aims to ascertain whether residents in Nguyen Du ward still sort their waste at source following the end of the 3R project that ended in 2009. Additionally, this paper aims to explore the relationship between waste separation practices and social bonds.Design/methodology/approachThe Travis Hirschi theory of social control was applied, together with the mixed method research design which included a structured questionnaire survey. Twelve semi-structured interviews were also conducted with residents and the data processed by SPSS software, using Chi-Square test, Independent-Samples t-test and Pearson's correlation analysis.FindingsA proportion of respondents has continued practicing waste separation since the 3R project ended. The study also indicated that the greater the involvement in family and neighborhood activities the more the participants were likely to practice waste separation.Research limitations/implicationsThe small sample size limits the extent to which the most influential factors can be determined and therefore the degree to which the findings can be generalized.Practical implicationsThe study includes implications for rerunning the waste separation programs for households as together with community campaigns to improve individuals' attachment and commitment and thus their participation in pro-environmental behaviors.Originality/valueTo the author’s knowledge, this is the first study to take a sociological approach to investigate factors affecting household waste separation, which has attracted little attention in previous studies. Useful information is also provided to local authorities for a policy-making process to implement effective domestic waste policies.

Trends in glassy cell cervical cancer in the United States from 1973-2015: Analysis based on SEER database.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e17502-e17502
Author(s):  
Anahat Kaur ◽  
Shuai Wang ◽  
Tarek N. Elrafei ◽  
Lewis Steinberg ◽  
Abhishek Kumar
Keyword(s):  
United States ◽  
Cervical Cancer ◽  
Overall Survival ◽  
Cell Carcinoma ◽  
Small Sample Size ◽  
Black Population ◽  
The United States ◽  
Small Sample ◽  
Cervix Uteri ◽  
Kaplan Meier

e17502 Background: Glassy cell carcinoma of cervix (GCCC) is a rare histological subtype of cervical cancer which has historically been associated with rapidly progressive disease, early development of metastases and overall poor prognosis. We attempt to define real-world trends in GCCC in the United States based on data from SEER (Surveillance, Epidemiology and End Results) database. Methods: We extracted data from the US National Cancer Institute's SEER 2018 dataset using ICD-O code for ‘Cervix Uteri Glassy Cell Carcinoma’. All patients who were diagnosed between 1973-2015 were included. Statistical analysis was done using SPSS 26. Kaplan Meier curve was used for survival analysis. Results: Data for a total of 57 patients with GCCC was available from 1975 to 2017. Median age at diagnosis was 38 years (range 30.5-44.5). Increased frequency of cases was noted in white females (77.2%) as compared to black population (22.2%). Most cases initially presented with localized or regional spread (47.4% and 40.4% respectively) with distant metastasis seen in only 10.5% patients. Data analysis revealed that 63.2% patients had Grade III poorly differentiated carcinoma, 66.7% received radiation therapy, 57.9% underwent chemotherapy and 59.6% had cancer direceted surgery performed. Calculated mean overall survival was 121.9 months. We were unable to calculate 5 year and 10 year median overall survival due to small sample size and censored data. Conclusions: GCCC is a rare histologic type of cervical cancer that presents at a younger age, is more frequently seen in white females and is commonly associated with localized or regional spread at time of initial presentation.[Table: see text]

Exploring the Relationship between Demographic Isolation and Professional Experiences of Black and Latinx Teachers

2021 ◽  
Author(s):  
Susan Kemper Patrick ◽  
Francisco Arturo Santelli
Keyword(s):  
Small Sample Size ◽  
The United States ◽  
Black Teachers ◽  
Small Sample ◽  
Continuous Measure ◽  
Professional Experiences ◽  
Workplace Experiences ◽  
Perceived Satisfaction ◽  
Ordinal Measure ◽  
Qualitative Work

Educational leaders throughout the United States have repeatedly emphasized the importance of increasing the number of Black and Latinx teachers in American schools. Prior qualitative work suggests that Black and Latinx teachers who are demographically isolated in their schools often report negative experiences. Drawing on theories of proportional representation in organizations, we use Tennessee statewide survey and administrative data to examine whether self-reported professional experiences of Black and Latinx teachers are different when they are demographically isolated. We estimate models using two measures of demographic isolation: a continuous measure and a theoretically generated ordinal measure. We find that, for Black teachers, the percentage of Black teachers in the school is positively associated with teachers’ perceived satisfaction and support and with the frequency of collaboration. There is also some evidence of threshold effects of demographic isolation for Black teachers, as Black teachers in schools in which at least 60% of fellow teachers are Black report significantly higher satisfaction and support than other Black teachers. Our models do not find any associations between isolation and professional experience for Latinx teachers, but a small sample size and lack of variation in demographic isolation among Latinx teachers makes it difficult to estimate these associations. Our findings suggest that both ordinal and continuous measures of demographic isolation may be useful when examining relationships between demographic isolation and workplace experiences. Because we study factors linked to turnover in prior research, these analyses can contribute to the broader discussion about the retention of Black and Latinx teachers.

‘There is no sincerer love than the love of food’ (George Bernard Shaw, 1903): The meaning of food and its uses in prison subculture

2018 ◽  
Vol 16 (2) ◽  
pp. 127-146 ◽  
Author(s):  
Tomer Einat ◽  
Moran Davidian
Keyword(s):  
Small Sample Size ◽  
Food Products ◽  
Analysis Data ◽  
Small Sample ◽  
Structured Interviews ◽  
Maximum Security ◽  
Maximum Security Prison ◽  
The Social ◽  
Bernard Shaw

This study examines the ways in which the prison service handles food and analyses the uses and meanings of food in prison subculture. Using semi-structured interviews and content analysis, data were collected and analysed from 20 ex-prisoners who were incarcerated in maximum-security prison facilities for a period of three years or more. Our main findings are that, according to the interviewees’ testimonies, (a) the Israel Prison Service (IPS) makes manipulative and abusive use of food in order to perpetuate its power; and (b) food serves as a means to determine the relationship between prisoners and staff, govern social status or rejection in the prison subculture, or pass the time. We have four main conclusions. First, the IPS nutrition policy differentiates and discriminates among prisoners and clearly violates the basic human rights of prisoners, thus suggesting an abuse of power. Second, the IPS’s use of food as a tool for punishing or rewarding introduces and perpetuates inequalities and encourages the illegal prison trade in food and food products. Third, cooking in prison, especially in light of its illegality, constitutes a symbolic expression of resistance to the institution and a meaningful way of coping with boredom. Lastly, food and its possession in prison serve as very powerful tools for constructing and perpetuating exploitation and unequal power relations among prisoners. Although the study suffers from two limitations – the validity of the adolescents’ responses and the small sample size – its findings lead us to propose that an improvement in the food products that are accessible to prisoners and permission to cook in their cells are inexpensive and legitimate means of bettering both the prisoners’ quality of life and the social atmosphere in prison.

Exploring digital servitization trajectories within product–service–software space

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Juliana Hsuan ◽  
Marin Jovanovic ◽  
Diego Honorato Clemente
Keyword(s):  
Small Sample Size ◽  
Small Sample ◽  
Software Systems ◽  
Structured Interviews ◽  
Content Type ◽  
Digital Ecosystem ◽  
Product Service ◽  
Practical Implications ◽  
Mapping Exercise

PurposeThis study shows various pathways manufacturers can take when embarking on digital servitization (DS) journeys. It builds on the DS and modularity literature to map the strategic trajectories of product–service–software (PSSw) configurations.Design/methodology/approachThe study is exploratory and based on the inductive theory building method. The empirical data were gathered through a workshop with focus groups of 15 servitization manufacturers (with 22 respondents), an on-site workshop (in-depth case study), semi-structured interviews, observations and document study of archival data.FindingsThe DS trajectories are idiosyncratic and dependent on design architectures of PSSw modules, balancing choices between standardization and innovation. The adoption of software systems depends on the maturity of the industry-specific digital ecosystem. Decomposition and integration of PSSw modules facilitate DS transition through business model modularity. Seven testable propositions are presented.Research limitations/implicationsWith the small sample size from different industries and one in-depth case study, generalizing the findings was not possible.Practical implicationsThe mapping exercise is powerful when top management from different functional departments can participate together to share their expertise and achieve consensus. It logs the “states” that the manufacturer undergoes over time.Originality/valueThe Digital Servitization Cube serves as a conceptual framework for manufacturers to systematically map and categorize their current and future PSSw strategies. It bridges the cross-disciplinary theoretical discussion in DS.

Impact of race on biomarker testing among HER2- advanced breast cancer (ABC) patients (pts) in the United States: Results from a real-world study.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 10598-10598
Author(s):  
Reshma L. Mahtani ◽  
Alexander Niyazov ◽  
Katie Lewis ◽  
Lucy Massey ◽  
Alex Rider ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Targeted Therapies ◽  
Small Sample Size ◽  
The United States ◽  
Small Sample ◽  
Access To Treatment ◽  
History Of ◽  
Biomarker Testing ◽  
Abstract Data ◽  
The Impact

10598 Background: African Americans (AA) have the highest breast cancer (BC) mortality rate. Access to treatment is a known contributing factor. In the past 4 years, several targeted therapies for HER2- BC have become available which require testing for specific biomarkers. This study assessed the impact of race on biomarker testing rates in HER2- ABC pts receiving treatment in the US. Methods: Oncologists were recruited to abstract data from medical charts for the next 8-10 pts receiving treatment with HER2- ABC during Sept 2019-Apr 2020. Pts records were stratified by race and categorized into 3 mutually exclusive cohorts [White/Caucasian (White), AA, Other]. The other race cohort was excluded from this analysis due to small sample size. Differences in pt demographics/clinical characteristics were analyzed via Fisher’s exact tests. Testing rates for actionable biomarkers (i.e. BRCA1/2, PIK3CA, PD-L1) were compared between White and AA pts utilizing logistic regressions controlling for age, known family history of a BRCA-related cancer, hormone receptor (HR) status and practice setting (academic vs. community). Further analyses by age will be presented. Results: This analysis included 378 pts records, provided by 40 oncologists. Mean age was 64 years; 77% had HR+/HER2- ABC; 20% had advanced triple negative breast cancer (TNBC), 3% had ABC with an unknown HR status. Compared to White pts, AA pts were significantly more likely to have advanced TNBC (27% vs. 18%, p<0.05). Compared to White pts, AA pts had significantly lower BRCA1/2 mutation (mut) testing rates (Table). Numerically lower rates of PIK3CAmut and PD-L1 testing were observed among AA pts (Table). BRCA1/2mut positivity rate (germline [g] and/or somatic [s]) was higher among AA vs. White pts (30% vs. 22%). Positivity rate for PIK3CAmut was lower for AA vs. White pts (8% vs. 11%). Conclusions: A higher than expected BRCA1/2mut positivity rate was observed than previously reported in the literature. This is likely because this analysis included s BRCA1/2mut and represented a high risk pt population. Across all biomarkers assessed, AA pts had lower testing rates than White pts. This suggests racial disparities in testing rates of actionable biomarkers. Consistent with guidelines, and with the increased availability of targeted therapies, focused efforts should be developed to increase biomarker testing in AA pts. Funding: Pfizer Biomarker Testing Rates by Race.[Table: see text]

Extra care housing: exploring motivations, expectations and perceptions

2020 ◽  
Vol 23 (1) ◽  
pp. 15-26
Author(s):  
Michael James Buckland ◽  
Anthea Tinker
Keyword(s):  
Social Life ◽  
Housing Association ◽  
Small Sample Size ◽  
Well Being ◽  
Small Sample ◽  
Structured Interviews ◽  
Content Type ◽  
High Expectations ◽  
Health And Social Care ◽  
Extra Care Housing

Purpose The purpose of this paper is to explore and compare the motivations and expectations that older people have when choosing to move into either a private or housing association (HA) extra care housing (ECH) scheme, and any effects this had on its residents. Design/methodology/approach This qualitative study is based on findings from four HA schemes in Tower Hamlets, London, and one private scheme in Warwickshire. Eight semi-structured interviews were conducted with five women and three men of varying backgrounds, from schemes managed by different associations and companies. Interview transcripts were coded and analysed thematically. Findings All residents moved into ECH in response to deteriorating health. However, almost all residents had felt obliged to move by others, generally their children. Few residents had any expectations of ECH on arrival, but many developed high expectations of an increased sense of independence and security and of an improved social life. ECH appeared to be beneficial for residents’ health and well-being. Research limitations/implications The inability to recruit an equal number of people from HA and private scheme, alongside the small sample size, may compromise the external validity of any conclusions drawn from any comparisons. Practical implications This research identifies a lack of knowledge about ECH among the general population and offers insight into areas of poor management within ECH schemes which could be improved. Social implications Inadequacies in the ECH model could be attributed to failures in the current health and social care system. Differences between expectations and perceptions of HA vs private schemes should be acknowledged and responded to. Originality/value This is a rare example of research exploring the relationships between ECH residents’ motivations and expectations (Hillcoat-Nallétamby and Sardani, 2019), and between those in HA vs private schemes.

Negative effects of self-help materials: three explorative studies

2015 ◽  
Vol 8 ◽  
Author(s):  
Mark Papworth ◽  
Aileen Ward ◽  
Karen Leeson
Keyword(s):  
Best Practice ◽  
Clinical Presentation ◽  
Small Sample Size ◽  
Postal Survey ◽  
Small Sample ◽  
Small Scale ◽  
Structured Interviews ◽  
Negative Effects ◽  
Self Help ◽  
Training Need

AbstractWithin the field of adult mental health, self-help is now a pivotal treatment modality. However, earlier research indicates that some individuals react negatively to this. Through three, small-scale studies, this paper explores both clinicians’ experience of harm in patients as a response to self-help materials as well as patients’ own reports. In Study 1, a postal survey was administrated to clinicians; in Study 2, semi-structured interviews were conducted with clinicians; and in Study 3, patients were sent a postal survey. Over 18% of clinicians indicated that they had experienced self-help materials resulting in harm to patients. The interviews uncovered four main themes: the patients’ clinical presentation, how the materials were presented within the therapeutic contact, certain personality characteristics in patients, and the characteristics of some materials. Between 12% and 24% of patients reported experience of negative effects (depending upon how this is defined), although the latter finding is limited by a small sample size. Proposals are made that are linked to best practice and it is suggested that there is a generic training need for clinicians in materials’ use.

scholarly journals Internship and Private Fellowship: Why is it Difficult for Companies to Find Suitable Candidates?

2015 ◽  
Vol 1 (1) ◽  
pp. 179-187
Author(s):  
Bogdan Rusu
Keyword(s):  
Role Models ◽  
Engineering Students ◽  
Small Sample Size ◽  
Critical Mass ◽  
Small Sample ◽  
Self Report ◽  
Structured Interviews ◽  
Group Discussions ◽  
Self Confidence ◽  
A Company

AbstractThis exploratory study aims to identify the factors that prevent companies to find suitable candidates for private fellowships and internships: what students believe to be the causes, how would they explain these and which stakeholders should be involved to eliminate them. Data collection based on a sample of 18 engineering students that attended a company presentation inviting applications for private fellowship and student practice. Opinions were expressed in writing prior to structured interviews and group discussions. Limitations to this study are the relatively small sample size (n =18) and reliance on self-report measures. Information related causes were perceived by the students to lead their decisions, followed by lack of self-confidence of successful application for the grant. Respondents were classified in „Doers”, „Wishers “and „Lagers”. Universities must reinvent themselves in order to provide students with better knowledge and confidence on the job market, measured through a larger number of doers, which could become role models for wishers. Such process may generate a “critical mass” or tipping point in the transformation of a significant number of “wishers and lagers”. Whilst some of the students’ opinions are subjective, cooperation between universities and companies must continue to improve in order to enhance learning and better prepare students for their future careers.

ID: 76: AVOIDING TRANSTHORACIC ECHOCARDIOGRAPHY (TTE) AND TRANSESOPHAGEAL ECHOCARDIOGRAPHY (TEE) FOR PATIENTS WITH VARIABLE BODY MASS INDEXES (BMI) IN INFECTIVE ENDOCARDITIS

2016 ◽  
Vol 64 (4) ◽  
pp. 916.3-917
Author(s):  
R Sogomonian ◽  
H Alkhawam ◽  
N Vyas ◽  
J Jolly ◽  
A Ashraf ◽  
...  
Keyword(s):  
Infective Endocarditis ◽  
Transesophageal Echocardiography ◽  
Body Mass ◽  
Sensitivity And Specificity ◽  
Transthoracic Echocardiography ◽  
Small Sample Size ◽  
The United States ◽  
Small Sample ◽  
Blood Cultures ◽  
True Negative

BackgroundEchocardiography has been a popular modality used to aid in the diagnosis of infective endocarditis (IE) with the modified Dukes' criteria. We evaluated the necessity between the uses of either a transthoracic echocardiography (TTE) or transesophageal echocardiography (TEE) in patients with a body mass index (BMI) greater than or equal to 25 kg/m2 and less than 25.MethodsA single-centered, retrospective study of 198 patients between the years of 2005 and 2012 diagnosed with IE based on modified Dukes' criteria. Patients were required to be above the age of 18, undergone an echocardiogram study and had blood cultures to be included in the study.This study was conducted at a major hospital in one of the most diverse communities in the United States, providing a cultural and epidemiologically significant advantage. An approved chart analysis using QuadraMed Computerized Patient Record (QCPR) was retrospectively accessed with data-input and calculations formulated in computerized software.ResultsAmong 198 patients, two echocardiographic groups were evaluated as 158 patients obtained a TTE, 143 obtained a TEE, and 103 overlapped with TEE and TTE. 167 patients were included in the study as 109 (65%) were discovered to have native valve vegetations on TEE and 58 (35%) with TTE. TTE findings were compared to TEE results for true negative and positives to isolate valvular vegetations Overall sensitivity of TTE was calculated to be 67% with a specificity of 93%. Patients were further divided into two groups with the first group having a BMI less than or equal to 25 kg/m2 and the subsequent group with a BMI<25. Patients with a BMI less than or equal to 25 that underwent a TTE study had a sensitivity and specificity of 54% and 92, respectively. On the contrary, patients with a BMI<25 had a TTE sensitivity and specificity of 78% and 95, respectively. Furthermore, we obtained the sensitivities of specific valves diseased from vegetations, visualized by TTE (figure 1). Lastly, we were able to demonstrate a correlation between the different modalities of echocardiography used to the specific organism identified on blood cultures (figure 2).ConclusionCalculating a BMI in patients with suspicion for IE may provide benefit in reducing further diagnostic imaging. Our study demonstrated that patients having a BMI <25 kg/m2 with a negative TTE should refrain from further diagnostic studies with TEE, given the findings of increased sensitivities (figure 3). Patients with a BMI less than or equal to 25 may proceed directly to a TEE, possibly avoiding an additional study with a TTE given the low sensitivities identified in this population. Clinicians should be aware that this study has several limitations, one of which a small sample size that may be increased with a multi-centered study. Further investigations with a larger population may improve and possibly provide similar findings, reinforcing the study.

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