scholarly journals Developing a realist theory of psychosocial rehabilitation: the Clubhouse model

2021 ◽  
Author(s):  
Christina Mutschler ◽  
Jen Rouse ◽  
Kelly McShane ◽  
Criss Habal-Brosek
Keyword(s):  
Phase 1 ◽  
Psychosocial Rehabilitation ◽  
Theory Development ◽  
Realist Evaluation ◽  
Self Determination ◽  
Phase 2 ◽  
Two Phase ◽  
Realist Theory ◽  
Clubhouse Model ◽  
Two Phases

Background Psychosocial rehabilitation is a service that supports recovery from mental illness by providing opportunities for skill development, self-determination, and social interaction. One type of psychosocial rehabilitation is the Clubhouse model. The purpose of the current project was to create, test, and refine a realist theory of psychosocial rehabilitation at Progress Place, an accredited Clubhouse. Method Realist evaluation is a theory driven evaluation that uncovers contexts, mechanisms, and outcomes, in order to develop a theory as to how a program works. The current study involved two phases, encompassing four steps: Phase 1 included (1) initial theory development and (2) initial theory refinement; and Phase 2 included (3) theory testing and (4) refinement. Results The data from this two-phase approach identified three demi-regularities of recovery comprised of specific mechanisms and outcomes: the Restorative demi-regularity, the Reaffirming demi-regularity, and the Re-engaging demi-regularity. The theory derived from these demi-regularities suggests that there are various mechanisms that produce outcomes of recovery from the psychosocial rehabilitation perspective, and as such, it is necessary that programs promote a multifaceted, holistic perspective on recovery. Conclusions The realist evaluation identified that Progress Place promotes recovery for members. Additional research on the Clubhouse model should be conducted to further validate that the model initiates change and promotes recovery outcomes.

scholarly journals Developing a realist theory of psychosocial rehabilitation: the Clubhouse model

2021 ◽  
Author(s):  
Christina Mutschler ◽  
Jen Rouse ◽  
Kelly McShane ◽  
Criss Habal-Brosek
Keyword(s):  
Phase 1 ◽  
Psychosocial Rehabilitation ◽  
Theory Development ◽  
Realist Evaluation ◽  
Self Determination ◽  
Phase 2 ◽  
Two Phase ◽  
Realist Theory ◽  
Clubhouse Model ◽  
Two Phases

Background Psychosocial rehabilitation is a service that supports recovery from mental illness by providing opportunities for skill development, self-determination, and social interaction. One type of psychosocial rehabilitation is the Clubhouse model. The purpose of the current project was to create, test, and refine a realist theory of psychosocial rehabilitation at Progress Place, an accredited Clubhouse. Method Realist evaluation is a theory driven evaluation that uncovers contexts, mechanisms, and outcomes, in order to develop a theory as to how a program works. The current study involved two phases, encompassing four steps: Phase 1 included (1) initial theory development and (2) initial theory refinement; and Phase 2 included (3) theory testing and (4) refinement. Results The data from this two-phase approach identified three demi-regularities of recovery comprised of specific mechanisms and outcomes: the Restorative demi-regularity, the Reaffirming demi-regularity, and the Re-engaging demi-regularity. The theory derived from these demi-regularities suggests that there are various mechanisms that produce outcomes of recovery from the psychosocial rehabilitation perspective, and as such, it is necessary that programs promote a multifaceted, holistic perspective on recovery. Conclusions The realist evaluation identified that Progress Place promotes recovery for members. Additional research on the Clubhouse model should be conducted to further validate that the model initiates change and promotes recovery outcomes.

scholarly journals Is it Real? Qualitative Framing Analyses of the Depiction of Fibromyalgia in Newspapers and Health Websites

2013 ◽  
Vol 11 (3) ◽  
pp. 48-61 ◽  
Author(s):  
Joy L. Rodgers ◽  
Mari L. Zapata Ramos
Keyword(s):  
Medical Condition ◽  
Phase 1 ◽  
Media Representation ◽  
Mental Condition ◽  
Phase 2 ◽  
Ongoing Debate ◽  
Two Phase ◽  
Online Newspapers ◽  
Fda Approval ◽  
Two Phases

Purpose: This two-phase project employed qualitative framing analyses to explore how fibromyalgia has been framed in some of the top sources of U.S. health information and how these sources address treatments related to fibromyalgia. Methods: Phase 1 of the project examined 95 stories and articles published between January 1, 2007, and October 15, 2010, in eight elite U.S. newspapers and five mosttrafficked health websites to determine the dominant framing of fibromyalgia in each source. Phase 2 analyzed 146 stories and articles published between January 1, 2007, and May 15, 2013, in 15 topcirculation U.S. daily print and online newspapers and five popular health websites. Phase 2 was conducted to examine changes in the dominant framing of fibromyalgia since Phase 1, and identify new frames in the ongoing debate about whether fibromyalgia is a medical or mental condition. Results: Project findings suggest a lessening in the debate insofar as the overall media representation shifted from a depiction of fibromyalgia as a mental to a medical condition. Moreover, changes found between the two phases in the identification of the frames demonstrate the evolving public discussion surrounding fibromyalgia amid FDA approval of drugs specifically for the treatment of the condition. Conclusion: Thus, the marketing of fibromyalgia-specific drugs may be a factor contributing to the legitimization of the controversial condition.

Changes in the condition of dunlins and knots during short-term captivity

1984 ◽  
Vol 62 (9) ◽  
pp. 1724-1731 ◽  
Author(s):  
Nicholas C. Davidson
Keyword(s):  
Body Condition ◽  
Muscle Protein ◽  
Phase 1 ◽  
Phase 2 ◽  
Short Term ◽  
Two Phase ◽  
Constant Rate ◽  
In Captivity ◽  
Loss Of Mass ◽  
Two Phases

Dunlins, Calidris alpina, and knots, Calidris canutus, captured while roosting at Teesmouth in northeastern England, were held in captivity during ringing operations. During this time they lost up to 19% (dunlins) and 23% (knots) of their total mass. In dunlins, loss of mass occurred in two phases. During phase 1 (0–8 h after capture) mass was lost at a similar, declining, rate regardless of conditions or frequency of handling. During phase 2 (>8 h after capture), frequently handled birds continued to lose mass rapidly, but the mass of less disturbed birds decreased at a lower, constant, rate. Knots had a similar two-phase mass loss. Changes in body condition were analysed in less disturbed birds. During phase 1 much of the loss was due to dehydration. Fat catabolism began within 4 h of capture at a rate of 2.2 to 2.4 times basal metabolic rate (BMR) in dunlins and 2.4 times BMR in knots. Dunlins also lost lean dry muscle tissue concurrently and at a constant rate. After 24 h, dunlins had lost 27.4% of the protein reserve available in their pectoral muscles. The consequences of the stress of capture and handling on rates of loss of mass, particularly muscle protein, are discussed, as are the implications of short-term loss of mass for the accurate measurement of body condition in live and killed samples of birds.

Psychiatry Transcript Annotation: Process Study and Improvements

2021 ◽  
Vol 10 (1) ◽  
pp. 71-75
Author(s):  
Srinivasan Sridhar ◽  
Nazmul Kazi ◽  
Indika Kahanda ◽  
Bernadette McCrory
Keyword(s):  
Mental Health ◽  
Work Experience ◽  
Phase 1 ◽  
Kappa Statistics ◽  
Phase 2 ◽  
Rater Reliability ◽  
Standard Data ◽  
Annotation Process ◽  
Data Collection Process ◽  
Two Phases

Background: The demand for psychiatry is increasing each year. Limited research has been performed to improve psychiatrist work experience and reduce daily workload using computational methods. There is currently no validated tool or procedure for the mental health transcript annotation process for generating “gold-standard” data. The purpose of this paper was to determine the annotation process for mental health transcripts and how it can be improved to acquire more reliable results considering human factors elements. Method: Three expert clinicians were recruited in this study to evaluate the transcripts. The clinicians were asked to fully annotate two transcripts. An additional five subjects were recruited randomly (aged between 20-40) for this pilot study, which was divided into two phases, phase 1 (annotation without training) and phase 2 (annotation with training) of five transcripts. Kappa statistics were used to measure the inter-rater reliability and accuracy between subjects. Results: The inter-rater reliability between expert clinicians for two transcripts were 0.26 (CI 0.19 to 0.33) and 0.49 (CI 0.42 to 0.57), respectively. In the pilot testing phases, the mean inter-rater reliability between subjects was higher in phase 2 with training transcript (k= 0.35 (CI 0.052 to 0.625)) than in phase 1 without training transcript (k= 0.29 (CI 0.128 to 0.451)). After training, the accuracy percentage among subjects was significantly higher in transcript A (p=0.04) than transcript B (p=0.10). Conclusion: This study focused on understanding the annotation process for mental health transcripts, which will be applied in training machine learning models. Through this exploratory study, the research found appropriate categorical labels that should be included for transcripts annotation, and the importance of training the subjects. Contributions of this case study will help the psychiatric clinicians and researchers in implementing the recommended data collection process to develop a more accurate artificial intelligence model for fully- or semi-automated transcript annotation.

Endometrial Adenocarcinoma in SurePath™ Cervical Samples: Cytological Features Revisited

2016 ◽  
Vol 60 (1) ◽  
pp. 46-52 ◽  
Author(s):  
Nalini Gupta ◽  
John Crossley ◽  
Nick Dudding ◽  
John H.F. Smith
Keyword(s):  
Phase 1 ◽  
Endometrial Adenocarcinoma ◽  
Nuclear Chromatin ◽  
Phase 2 ◽  
Cervical Lesions ◽  
Two Phase ◽  
Endometrial Cells ◽  
Phase Study ◽  
Cytological Features ◽  
Liquid Based Cytology

Objective: The cytomorphological criteria of malignant endometrial lesions in cervical samples are less well described than those of cervical lesions. We wished to investigate if there were features in SurePath™ liquid-based cytology samples that would facilitate more accurate differentiation between benign and malignant endometrial cells. Study Design: This was a two-phase study, with a review of all SurePath™ samples reported as endometrial adenocarcinoma (n = 42) evaluating 12 cytological features in the first phase. In phase 2 (test set), all initial cases plus an additional 83 cases were reviewed using these 12 cytological features to predict the outcome. Results: Out of 12 cytological features evaluated in phase 1 (training set), nuclear chromatin pattern, apoptotic bodies and tingible body macrophages were found to be the most significant features determining malignant histological outcome. These 12 cytological features were re-evaluated in phase 2 (n = 125). Of 125 cases, 54 had a benign and 71 had a malignant or premalignant histological outcome, with a positive predictive value of 56.8%. Conclusion: Granular nuclear chromatin, tingible body macrophages and apoptosis in the background are the most significant factors in determining whether endometrial cells present in cervical samples represent malignancy or are benign. Using these features, relatively accurate predictions of endometrial pathology can be made.

scholarly journals Removal of organic matter from pre-treated domestic sewage in anaerobic biological reactor by a combined system of electrolytic and biological aerobic treatment

2019 ◽  
Vol 14 (4) ◽  
pp. 1
Author(s):  
Ariela Araujo Fonseca ◽  
Yovanka Pérez Ginoris ◽  
Norma Mendes Pinheiro Gontijo ◽  
Marco Antonio Almeida de Souza
Keyword(s):  
Organic Matter ◽  
Electric Current ◽  
Phase 1 ◽  
Zooplankton Community ◽  
Batch Reactors ◽  
Phase 2 ◽  
Combined System ◽  
Organic Matter Removal ◽  
Electrolytic Process ◽  
Two Phases

Biological processes are the most widespread methods for wastewater treatment. However, they are limited in their ability to degrade toxic and refractory pollutants, contaminants that electrochemical processes can remove. Therefore, this research explored the possibility of treating sewage by an anaerobic biological process followed by an aerobic system integrated to an electrolytic process. Three sequential batch reactors were operated in an automated way. Each of three reactors represented a process: aerobic biological treatment (BR); electrolytic treatment (ER); and a combination of both, the bio electrolytic reactor (BER). Two phases were ran with different electrodes: (Phase 1) stainless steel and (Phase 2) graphite. The electric current was varied from 0.001 to 0.100 A. COD, TS, SS, turbidity, and the zooplankton community were monitored. The highest organic matter removal efficiencies were 86%, 79% and 87% for BR, ER and BER, respectively. The best weekly BER efficiencies for COD removal were 90% and 98%, with current densities of 0.27 A/m2 (Phase 1) and 0.05 A/m2 (Phase 2). The main conclusions about bio electrolytic process were: (1) it did not achieve organic matter removal high enough to justify its application; (2) inert electrodes are the more indicated; and (3) the zooplankton community was affected by the electric current.

scholarly journals Factors Influencing International Board Certified Lactation Consultants to Continue Advancing Practice Beyond Certification: A Multinational Study

2018 ◽  
Vol 7 (4) ◽  
pp. 227-237 ◽  
Author(s):  
Karolyn Vaughan ◽  
Anne McMurray ◽  
Mary Sidebotham ◽  
Jennifer Gamble
Keyword(s):  
Phase 1 ◽  
Demographic Data ◽  
Phase 2 ◽  
Online Questionnaire ◽  
Optimal Care ◽  
Lifelong Learners ◽  
Lactation Consultant ◽  
Qualitative Understanding ◽  
Lactation Consultants ◽  
Two Phases

Background:Certification as a lactation consultant is based on practitioners having achieved a standard of knowledge indicative of their competence to practice by passing a psychometric examination. The underpinning principle of recertification programs is to support clinicians to become lifelong learners by progressively enhancing and advancing their knowledge and skills in line with contemporary evidence. The aim of this study was to investigate the factors that influence International Board Certified Lactation Consultants (IBCLCs) to advance their practice.Method:A mixed-methods study was conducted in two phases. Phase 1 included focus groups, interviews, and participants’ demographic data. Phase 2 comprised of an online questionnaire to IBCLCs. This approach was designed to provide a comprehensive qualitative understanding of the IBCLCs’ experiences, which was then triangulated with quantitative data from a significantly larger population of IBCLCs in Phase 2.Results:The findings are described in themes and subthemes. Participants in phase 2 (n = 3,946) reported being intrinsically motivated (93.3%, n = 3,631) and committed to providing evidence-based guidance and optimal care to support breastfeeding mothers. They identified various sources of continuing education, although attendance at conferences, peer support, and reflective sessions were the most common approaches to enhancing knowledge. They recognized that it was through extension of knowledge that they were able to advance their practice.Conclusion:This article identifies strategies that the managers, educators, and certification bodies can adopt to support the IBCLCs in continuing to advance their practice, which will ultimately improve breastfeeding outcomes for mothers.

scholarly journals Improving eye health using a child-to-child approach in Bariadi, Tanzania

2017 ◽  
Vol 76 (1) ◽  
Author(s):  
Ving F. Chan ◽  
Hasan Minto ◽  
Eden Mashayo ◽  
Kovin S. Naidoo
Keyword(s):  
Refractive Error ◽  
Phase 1 ◽  
Health Messages ◽  
Eye Drops ◽  
Vision Screening ◽  
Phase 2 ◽  
Eye Health ◽  
Knowledge And Practice ◽  
Two Phases

Purpose: Vision Champions (VC) are children trained to perform simple eye health screening and share eye health messages among their community. Our objectives were to assess the ability of VC in identifying and referring children and the community with refractive error and obvious ocular disease and to assess the change in knowledge and practice of eye healthseeking behaviour of the community 3 months after the introduction of the Vision Champion Programme.Methods: We purposively sampled 600 households and interviewed 1051 participants in two phases with a close-ended questionnaire. The numbers of children screened, referred by the VC and those who attended the Vision Centre were recorded. The percentage of people who answered the questions correctly were compared between Phase 1 (P1) and Phase 2 (P2).Results: The VC shared their eye health messages with 6311 people, screened 7575 people’s vision and referred 2433 people for further care. The community were more aware that using eye ointment not prescribed by doctors (P1 = 58.96% vs. P2 = 72.75%) can lead to blindness. Participants were more aware that they should not administer eye drops in stock (P1 = 44.18% vs. P2 = 61.37%) or received from a friend or relative (P1 = 53.23% vs. P2 = 72.35%) if their eyes are red and painful.Conclusion: Children have the potential to effectively share eye health messages and conduct simple vision screening for their families and peers. Efforts are needed to sensitise the community to improve the referral or follow-up rate.

The new Myopic Traction Maculopathy Staging System

2020 ◽  
pp. 112067212093059 ◽  
Author(s):  
Barbara Parolini ◽  
Michele Palmieri ◽  
Alessandro Finzi ◽  
Gianluca Besozzi ◽  
Angela Lucente ◽  
...  
Keyword(s):  
Macular Hole ◽  
Phase 1 ◽  
Staging System ◽  
Wide Field ◽  
Phase 2 ◽  
Macular Detachment ◽  
Myopic Traction Maculopathy ◽  
Fundus Photographs ◽  
Two Phases ◽  
Stage 1

Purpose: To describe a comprehensive OCT-based classification of myopic traction maculopathy (MTM). Methods: Two hundred eighty-one eyes with MTM (visited from 2006 to 2018), were retrospectively reviewed for age, best-corrected-visual-acuity (BCVA), axial length (AL), optical coherence tomography (OCT), and wide-field color fundus-photographs. The study was divided in two Phases. Phase 1: MTM types were categorized with OCT and correlated with age and BCVA. The type of staphyloma was described. Phase 2: the evolution of MTM was studied evaluating at least three OCT exams of each eye taken at different timings (interval between each exam: 1–10 years). Results: Phase 1: We identified, four MTM retinal stages (1. Inner/Outer Maculoschisis; 2. Predominantly outer Maculoschisis; 3. Maculoschisis-Macular Detachment; 4. Macular Detachment) and three foveal stages (a. Normal fovea; b. Inner Lamellar-Macular-Hole; c. Full-Thickness-Macular-Hole). Outer-Lamellar-Macular-Holes and epiretinal abnormalities were associated findings. Stages 1 to 2 were younger than stages 3 to 4 ( p < 0.05). BCVA in stages 1, 2 was similar, and higher than stages 3, 4 ( p < 0.02). About 14% of eyes had no staphyloma, 73% of eyes had staphyloma type 1 or 2. MTM stages were not correlated with AL. Phase 2: The retina could change in time from stage 1 to 4, or the fovea could change from stage a to c. Mean evolution time from stage 1 to 2, stage 2 to 3, and 3 to 4 were 20, 12, 3 months, respectively. BCVA decreased over time as stages increased ( p = 0.47). Conclusion: The MSS Table displays a new classification, the natural evolution, and practical insights for the management of MTM.

Oxygen delivery rate and sufficiency of oxygenation during ECMO in newborn baboons

1989 ◽  
Vol 66 (1) ◽  
pp. 210-216
Author(s):  
J. D. Cornish ◽  
D. R. Gerstmann ◽  
D. M. Null ◽  
M. D. Smith ◽  
T. J. Kuehl
Keyword(s):  
Phase 1 ◽  
Ductus Arteriosus ◽  
Serum Lactate ◽  
Papio Cynocephalus ◽  
Phase 2 ◽  
Primate Model ◽  
O2 Extraction ◽  
Two Phases ◽  
The Right ◽  
O2 Delivery

Minimum acceptable O2 delivery (DO2) during extracorporeal membrane oxygenation (ECMO) remains to be defined in a newborn primate model. The right atrium, carotid artery, and femoral artery were cannulated, and the ductus arteriosus, aorta, and pulmonary artery ligated in neonatal baboons (Papio cynocephalus) under a combination of ketamine, diazepam, and pancuronium. The internal jugular vein was also cannulated retrograde to the level of the occipital ridge. We measured hemoglobin, pH, arterial and venous PO2 (both from the pump circuit and from the cerebral venous site), serum lactate and bicarbonate concentrations, and pump flow, and we calculated hemoglobin saturations, (DO2), O2 consumption (VO2), systemic O2 extraction, and cerebral O2 extraction. Six baboons were studied during each of two phases of the experiment. In the first, flow rates were varied sequentially from 200 to 50 ml.kg-1.min-1 with saturation maximized. In the second, flow was maintained at 200 ml.kg-1.min-1 and saturation was reduced sequentially from 100 to 38%. VO2 fell significantly below baseline at a flow rate of 50 ml.kg-1.min-1 and a DO2 of 8 +/- 2 (SE) ml.kg-1.min-1 in phase 1 and at DO2 of 12 +/- 5 in phase 2. Both systemic and cerebral O2 extraction rose significantly at a flow of 100 ml.kg-1.min-1 and DO2 of 17 +/- 4 ml.kg-1.min-1 in phase 1, whereas neither rose with decreasing DO2 in phase 2. In fact, cerebral extraction fell significantly DO2 of 16 +/- 6 ml.kg-1.min-1.(ABSTRACT TRUNCATED AT 250 WORDS)

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