scholarly journals Exploration of Psychological Resilience during a 25-Day Endurance Challenge in an Extreme Environment

2021 ◽  
Vol 18 (23) ◽  
pp. 12707
Author(s):  
David Harrison ◽  
Mustafa Sarkar ◽  
Chris Saward ◽  
Caroline Sunderland
Keyword(s):  
Focus Groups ◽  
Interpretative Phenomenological Analysis ◽  
Learning Experience ◽  
Extreme Environments ◽  
Extreme Environment ◽  
Psychological Resilience ◽  
Fast Marching ◽  
Long Distance ◽  
Team Members ◽  
Personal Qualities

Psychological resilience is the ability to use personal qualities to withstand pressure, consisting of the interaction between the individual and the environment over time. It is essential when operating in extreme environments which are typically characterised by a complex combination of stressors with increased elements of risk and adversity. Psychological resilience has never been investigated “live” (e.g., in the moment) throughout the duration of an extreme endurance challenge, despite anecdotal accounts of the need for resilience to successfully function in such environments. The aim of the study was to explore psychological resilience with challenge team members (n = 4, mean age = 46.0 years) involved in a 25-day extreme endurance challenge. The object of the challenge was to ‘TAB’ (Tactical Advance to Battle, fast marching with weighted packs) 100 peaks in the UK in 25 days and complete long-distance bike rides between base camps. A mixed-methods approach with a focus on qualitative methods was utilised. Specifically, individual reflective video diaries (n = 47) and focus groups (n = 4) were completed and analysed using interpretative phenomenological analysis (IPA). At the same time, the 10-item Connor Davidson Resilience Scale was employed to measure resilience, which highlighted the individualised and dynamic nature of resilience. Two superordinate themes were identified from the video diaries and focus groups, namely, the identification of the stressors within extreme environments and strategies to maintain functioning. Stressors were split into subordinate themes of significant and every day, and collectively, they created a cluster effect which contributed to pressure associated with operating in these environments. Challenge team members employed various strategies to maintain functioning, including using a challenge mindset to positively appraise pressure as a challenging learning experience. Further research should continue to develop an understanding of how participants completing challenges within extreme environments utilise and develop personal qualities to maintain functioning.

Behavioral Health Professionals’ Perceptions on Outcomes of Patient-Controlled Granular Information Sharing Study: Focus Groups and Survey (Preprint)

2020 ◽  
Author(s):  
Julia Ivanova ◽  
Tianyu Tang ◽  
Nassim Idouraine ◽  
Anite Murcko ◽  
Adela Grando ◽  
...  
Keyword(s):  
Focus Groups ◽  
Information Sharing ◽  
Behavioral Health ◽  
Health Professionals ◽  
Medical Information ◽  
Health Data ◽  
Health Record ◽  
Team Members ◽  
Patient Study ◽  
Actual Patient

BACKGROUND Granular information sharing studies rarely use actual patient electronic health record (EHR) information. In a previous study, behavioral health patients categorized their own EHR data into sensitive categories (e.g. mental health) and chose which care team members (e.g. pharmacists) should have access to those records. In this study, behavioral health professionals are provided access to the outcomes of a previous patient study to better understand the perspectives of health professionals on patient-controlled granular information sharing. OBJECTIVE Assess behavioral health professionals’: (1) perspectives on understanding and opinions about granular information sharing; (2) accuracy in assessing redacted medical information; (3) reactions to patient rationale for health data categorization, assignment of sensitivity, and sharing choices; and (4) recommendations on how to improve the process of granular health information sharing. METHODS Four two-hour focus groups and a pre- and post-survey were conducted at two integrated health facilities. During the focus groups, outcomes from a previous study on patients’ medical record sharing choices were shared. Thematic analysis and descriptive statistical analyses were conducted. RESULTS Twenty-eight professionals were initially unaware of or provided incorrect definitions of granular information sharing (56.0%). After having access to outcomes from a previous patient study, professionals increased their mixed perspectives (21.4% to 37.1%) on granular information sharing. A majority (81.3%) identified that key medical data had been redacted from the study case. Many (66.1%) stated they did not understand patient rationale for categorization or medical sharing preferences. Finally, participants recommended that a variety of educational approaches be incorporated to inform patients about granular information and health record sharing processes. CONCLUSIONS This study provides detailed insights from behavioral health professionals on patient-controlled granular information sharing. Health professionals accurately identified information gaps resulting from patient-directed data redaction, improved in their overall concept comprehension, underscored the fine line between patient safety and patient rights, and expressed a commitment to help patients appreciate the risks and benefits associated with granular information sharing. Outcomes will inform the development, deployment and evaluation of an electronic consent tool for granular health data sharing.

scholarly journals Understanding decisions about antibiotic prescribing in ICU: an application of the Necessity Concerns Framework

2021 ◽  
pp. bmjqs-2020-012479
Author(s):  
Alyssa M Pandolfo ◽  
Robert Horne ◽  
Yogini Jani ◽  
Tom W Reader ◽  
Natalie Bidad ◽  
...  
Keyword(s):  
Focus Groups ◽  
Antibiotic Prescribing ◽  
Negative Consequences ◽  
Out Of Hours ◽  
Team Members ◽  
Clinical Vignettes ◽  
Molecular Microbiology ◽  
Semistructured Interviews ◽  
Decision Making Processes ◽  
The Individual

BackgroundAntibiotics are extensively prescribed in intensive care units (ICUs), yet little is known about how antibiotic-related decisions are made in this setting. We explored how beliefs, perceptions and contextual factors influenced ICU clinicians’ antibiotic prescribing.MethodsWe conducted 4 focus groups and 34 semistructured interviews with clinicians involved in antibiotic prescribing in four English ICUs. Focus groups explored factors influencing prescribing, whereas interviews examined decision-making processes using two clinical vignettes. Data were analysed using thematic analysis, applying the Necessity Concerns Framework.ResultsClinicians’ antibiotic decisions were influenced by their judgement of the necessity for prescribing/not prescribing, relative to their concerns about potential adverse consequences. Antibiotic necessity perceptions were strongly influenced by beliefs that antibiotics would protect patients from deterioration and themselves from the ethical and legal consequences of undertreatment. Clinicians also reported concerns about prescribing antibiotics. These generally centred on antimicrobial resistance; however, protecting the individual patient was prioritised over these societal concerns. Few participants identified antibiotic toxicity concerns as a key influencer. Clinical uncertainty often complicated balancing antibiotic necessity against concerns. Decisions to start or continue antibiotics often represented ‘erring on the side of caution’ as a protective response in uncertainty. This approach was reinforced by previous experiences of negative consequences (‘being burnt’) which motivated prescribing ‘just in case’ of an infection. Prescribing decisions were also context-dependent, exemplified by a lower perceived threshold to prescribe antibiotics out-of-hours, input from external team members and local prescribing norms.ConclusionEfforts to improve antibiotic stewardship should consider clinicians’ desire to protect with a prescription. Rapid molecular microbiology, with appropriate communication, may diminish clinicians’ fears of not prescribing or of using narrower-spectrum antibiotics.

Collective soul: The spirituality of an interdisciplinary palliative care team

2006 ◽  
Vol 4 (1) ◽  
pp. 13-24 ◽  
Author(s):  
SHANE SINCLAIR ◽  
SHELLEY RAFFIN ◽  
JOSE PEREIRA ◽  
NANCY GUEBERT
Keyword(s):  
Health Care ◽  
Palliative Care ◽  
Focus Groups ◽  
Health Care Professionals ◽  
Palliative Care Team ◽  
Care Team ◽  
Cancer Center ◽  
Team Members ◽  
Spiritual Journeys ◽  
Common Goals

Objective:Although spirituality as it relates to patients is gaining increasing attention, less is known about how health care professionals (HCP) experience spirituality personally or collectively in the workplace. This study explores the collective spirituality of an interdisciplinary palliative care team, by studying how individuals felt about their own spirituality, whether there was a shared sense of a team spirituality, how spirituality related to the care the team provided to patients and whether they felt that they provided spiritual care.Methods:A qualitative autoethnographic approach was used. The study was conducted in a 10-bed Tertiary Palliative Care Unit (TPCU) in a large acute-care referral hospital and cancer center. Interdisciplinary team members of the TPCU were invited to participate in one-to-one interviews and/or focus groups. Five interviews and three focus groups were conducted with a total of 20 participants.Results:Initially participants struggled to define spirituality. Concepts of spirituality relating to integrity, wholeness, meaning, and personal journeying emerged. For many, spirituality is inherently relational. Others acknowledged transcendence as an element of spirituality. Spirituality was described as being wrapped in caring and often manifests in small daily acts of kindness and of love, embedded within routine acts of caring. Palliative care served as a catalyst for team members' own spiritual journeys. For some participants, palliative care represented a spiritual calling. A collective spirituality stemming from common goals, values, and belonging surfaced.Significance of results:This was the first known study that focused specifically on the exploration of a collective spirituality. The culture of palliative care seems to foster spiritual reflection among health care professionals both as individuals and as a whole. While spirituality was difficult to describe, it was a shared experience often tangibly present in the provision of care on all levels.

scholarly journals Should Interpretative Phenomenological Analysis (IPA) be Used With Focus Groups? Navigating the Bumpy Road of “Iterative Loops,” Idiographic Journeys, and “Phenomenological Bridges”

2020 ◽  
Vol 19 ◽  
pp. 160940692092160 ◽  
Author(s):  
Beverly Love ◽  
Arlene Vetere ◽  
Paul Davis
Keyword(s):  
Focus Groups ◽  
Group Dynamics ◽  
Lived Experiences ◽  
Interpretative Phenomenological Analysis ◽  
Phenomenological Analysis ◽  
Group Data ◽  
Focus Group Data ◽  
Thematic Approach ◽  
The Individual ◽  
Individual Voice

Interpretative phenomenological analysis (IPA) is a qualitative thematic approach developed within psychology underpinned by an idiographic philosophy, thereby focusing on the subjective lived experiences of individuals. However, it has been used in focus groups of which some have been critical because of the difficulties of extrapolating the individual voice which is more embedded within the group dynamics and the added complexity of multiple hermeneutics occurring. Some have adapted IPA for use with focus groups, while others provide scant regard to these philosophical tensions. This raises the question whether IPA should be used with focus group data. To address these concerns, this article will set out a step-by-step guide of how IPA was adapted for use with focus groups involving drug using offenders (including illustrative examples with participants’ quotes). A rationale of why it was important to use both focus groups and an IPA approach will be covered including the value, merits, and challenges this presented. An overview of how participants’ idiographic accounts of their drug use, relapse, and recovery were developed will be provided. This article will conclude with a suggested way forward to satisfy the theoretical tensions and address the question raised in the title.

scholarly journals EVALUATION OF ANTIMICROBIAL AND ANTIPROLIFERATIVE ACTIVITIES OF ACTINOBACTERIA ISOLATED FROM THE SALINE LAGOONS OF NORTHWEST PERU

2020 ◽  
Author(s):  
Rene Flores Clavo ◽  
Nataly Ruiz Quiñones ◽  
Álvaro Tasca Hernandez ◽  
Ana Lucia Tasca Gois Ruiz ◽  
Lucia Elaine de Oliveira Braga ◽  
...  
Keyword(s):  
Antibacterial Activity ◽  
Antiproliferative Activity ◽  
Extreme Environments ◽  
Extreme Environment ◽  
Small Cells ◽  
E Coli ◽  
The North ◽  
Salt Flats ◽  
Multiple Drugs ◽  
Antiproliferative Activities

AbstractThe unexplored saline lagoons of the north of Peru harbor a rich microbiome, due to reported studies of different extreme environments around the world. In these regions, there are several ecosystems and microhabitats not yet explored, and little is known about the diversity of actinobacteria and other microorganisms. We suggest that the endemic bacteria present in this extreme environment could be source of active molecules with anticancer, antimicrobial, antiparasitic properties. Using phenotypic and genotypic characterization techniques including the 16S rRNA were identified into the genera Streptomyces 39 (78%), Pseudonocardia 3 (6%), Staphylococcus 4 (8%), Bacillus 2 (4%), and Pseudomonas 2 (4%). All isolated bacteria for the genotypic data were preliminarily identified. Actinobacteria strains were found dominantly in both sites (Lagoon1-3 = 16 isolates and lagoon 4 = 12 isolates). Phylogenetic analysis revealed that 28 isolates were exclusively affiliated to eleven different clusters of Actinobacteria of the major genus Streptomyces. Three Streptomyces sp. strains M-92, B-146, and B-81, were tested for antibacterial and antiproliferative activities. The results showed antiproliferative activities against three tumor cell lines, U251 glioma; MCF7 breast; NCI-H460 lung non-small type of cells, and the antibacterial activity to Staphylococcus aureus ATCC 6538, E. coli ATCC 10536, and Acinetobacter baumanni AC-972 which is resistant to multiple drugs. The promising results belong to Streptomyces sp. B-81 strain in the R2A medium using a doxorubicin with control positive, the best result was from the latter (TGI = 0,57 µg/mL) for glioma; NCI-H460 lung of type non-small cells (TGI = 0,61 µg/mL), and breast cancer (TGI =0,80 µg/mL), this strain was selected to be fractionated because it had better antiproliferative and antibacterial activity, and its fractions were evaluated concerning antiproliferative activity against nine types of tumor cells and one non-tumor. The methanolic fraction showed a better result in the antiproliferative activity and was able to inhibit U251 (glioma) (TGI = 38.3 µg/mL), OVCAR-03 (ovary) (TGI = 62.1 µg/mL), and K562 (leukemia) (TGI = 81.5 µg/mL). The methanol 50% - acetate 50% fraction (Fraction 4) inhibited U251 (glioma) (TGI = 73.5 µg/mL) and UACC-62 (melanoma) (TGI = 89.4 µg/mL). Moreover, the UHPLC-MS/MS data and molecular networking of Streptomyces sp. B-81 isolate extract revealed the production cholic acid, Lobophorin A, Lobophorin B, Lobophorin E, Lobophorin K and compound 6. Extremophilic environments such as the Mórrope and Bayovar Salt Flats are promising sources of new bacteria with promising pharmaceutical potential; These compounds could be useful to treat various infectious diseases or even some type of cancer.

Involving international postgraduate students in university initiatives – a qualitative investigation into ‘UCL ChangeMakers’

2018 ◽  
Vol 4 (1) ◽  
Author(s):  
Anastasia Vikhanova ◽  
Vanessa Wedi
Keyword(s):  
Focus Groups ◽  
Student Learning ◽  
Learning Experience ◽  
Student Population ◽  
Qualitative Investigation ◽  
Postgraduate Students ◽  
University College ◽  
University College London ◽  
Enhance Student Learning ◽  
Collaborative Initiative

UCL ChangeMakers is the collaborative initiative launched in 2014 to enhance student learning experience in University College London (UCL), UK. Its aim is to enable students and staff to work together to make changes in the UCL community. In 2016/17, the UCL ChangeMakers initiative struggled to recruit projects from the postgraduate (PG) student population; however, postgrads are believed to have brought exceptionally valuable ideas into the initiative. The current study aimed to investigate the general image of the UCL ChangeMakers initiative among the UCL PG population and identify potential areas of improvement for attracting more PG students into the scheme. Two focus groups were conducted with current international PGs participating in the UCL ChangeMakers programme and international PGs from the general UCL population. The results included a discussion on current UCL PG ChangeMakers’ experiences, the image of the initiative among the general PG UCL population and suggestions for promotion of and improvements to the initiative. Furthermore, recommendations for postgraduate involvement in university initiatives were made.

Digital Experience Moving Toward Greater Learning Experience

2018 ◽  
pp. 126-143 ◽  
Author(s):  
Kit Wai Leong ◽  
Roslina Abdul Latif
Keyword(s):  
Learning Environment ◽  
Focus Groups ◽  
Learning Process ◽  
Learning Experience ◽  
Mediating Effect ◽  
Student Perspective ◽  
Learning Skills ◽  
New Development ◽  
The World ◽  
Vast Range

In this new millennium it is a challenge for educators to promote digital experiences that lead to effectiveness and holistic contribution in the learning process. This new development is also in line with the Taylor's University strategy plan 2012-2016, which promises a conducive and responsive learning environment that embraces technology. Hence, the main focus of this chapter is to evaluate the student perspective toward digital experience applied with the adoption of TIMES together with a vast range of tools and how the digital experience was preparing our students for success in the world beyond for the audio-visual production module. Focus groups were conducted to examine the feedback on digital experience for the duration of teaching the module. The results from the study imply that the digital experience has a positive and mediating effect on the learning experience for the students. The knowledge-rich ecology of ongoing participation, self-expression, and recognition in their learning skills also contributes to the ever on-going process of learning.

Multiple System Configurations in a 32-bit Extreme Environment

2012 ◽  
Vol 2012 (HITEC) ◽  
pp. 000301-000306 ◽  
Author(s):  
Michael C. Brown
Keyword(s):  
Error Detection ◽  
Extreme Environments ◽  
Extreme Environment ◽  
Silicon On Insulator ◽  
Cmos Process ◽  
System A ◽  
External Sources ◽  
System Configurations ◽  
Simple Systems ◽  
Computational Systems

Full computational systems are needed at extreme environments (to 300°C) to increase functionality and reduce cost in the ever advancing oil/gas, geothermal, aeronautic, and automotive industries. Commercially available electronic components are not available to build a reliable system. A single microcontroller device can be used in systems of varying complexity, from small, mid, large, and multiprocessor scale. The 32-bit microcontroller will use a low power silicon-on-insulator CMOS process to increase long term reliability. Communication ports are provided to allow for simple systems with a single processor to complex multiprocessor systems with multiple controlled devices and external memory. As no adequate non-volatile solution is available for extreme conditions, multiple boot options are available to load instructions from external sources. Fault tolerance should be provided by system error detection. Battery backup must be provided for program and data retention. The resulting microcontroller will allow a wide variety of extreme environment systems, from simple to complex.

Adaptive response of extreme epiphyte Tillandsia species (Bromeliaceae) is demonstrated by different sexual reproduction strategies in the Brazilian Chaco

2019 ◽  
Vol 192 (4) ◽  
pp. 840-854
Author(s):  
Aline C Gomes ◽  
Bruno H S Ferreira ◽  
Camila S Souza ◽  
Luan M M Arakaki ◽  
Camila Aoki ◽  
...  
Keyword(s):  
Breeding System ◽  
Reproductive Strategies ◽  
Extreme Environments ◽  
Extreme Environment ◽  
Floral Biology ◽  
Reproduction Strategies ◽  
Pollen Vectors ◽  
Self Compatibility ◽  
Floral Visitors ◽  
Selection For

Abstract Some epiphytes are adapted to extreme environments with the ability to survive drought as a result of their morphological (xeromorphism), anatomical (foliar trichomes or scales) and physiological features. In contrast to vegetative features, they may have diverse sexual reproductive strategies. Here we compared the flowering morphology, floral biology, breeding system and pollinators of Tillandsia duratii, T. loliacea and T. recurvifolia (Bromeliaceae) adapted to an extreme environment, the Brazilian Chaco. Tillandsia duratii and T. recurvifolia flower for 5–6 months, whereas T. loliaceae flowers for 11 months, mainly in the dry season, with low to high flowering overlap between them. Although these species generally show similar flowering morphology, they differ in size, colour, odour and/or floral functionality, suggesting non-sharing of pollinators among them. Bimodal pollination occurs in T. duratii (bees, moths other than hawkmoths) and T. recurvifolia (butterflies, hummingbirds); in T. loliacea, we recorded no floral visitors. Tillandsia recurvifolia is self-incompatible, has flowers which approach herkogamy and protandry, and depends on pollen vectors for fruit set. The other two species show reverse herkogamy, autonomous self-pollination and self-compatibility (mixed breeding system); therefore, pollinators are not required. The disparity in reproductive strategies among the three species suggests the possibility of selection for diverse modes of reproduction.

Microbial Ecology of Extreme Environments: Automobile Air Conditioning Systems

2000 ◽  
Vol 6 (S2) ◽  
pp. 658-659
Author(s):  
R.B. Simmons ◽  
L.J. Rose ◽  
S.A. Crow ◽  
D.G. Ahearn
Keyword(s):  
Air Conditioning ◽  
Hypersensitivity Pneumonitis ◽  
Extreme Environments ◽  
Sick Building Syndrome ◽  
Extreme Environment ◽  
The United States ◽  
Temperature Changes ◽  
Sick Building ◽  
Air Conditioning Systems ◽  
Automobile Air Conditioning

Automobile air conditioning systems (ACS) might be considered an extreme environment for many microorganisms. Organisms surviving and proliferating in these systems may be presented with temperature changes ranging from subzero to over 140°F, water activity from saturation to dryness and a nutrient complexity including varying levels of hydrocarbons. Microbial communities develop in ACS and sometimes proliferate to the extent of massive colonization and production of objectionable odors.In a few instances microorganisms emanating from ACS have been associated with hypersensitivity pneumonitis and other allergic reactions. Previously we demonstrated that foam insulation and glues, in particular, on ACS insulations were colonized by fungi such as Aspergillus, Aureobasidium, Cladosporium, and Penicillium. Such fungi often are implicated in colonization of similar substrates in buildings categorized with the sick building syndrome.A total of 42 ACS from the United States, Europe and Central America have been examined by cabin air sampling culture swab, direct microscopy or a combination of these techniques.

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