scholarly journals Barriers to postpartum diabetes screening: a qualitative synthesis of clinicians’ views

2021 ◽  
pp. BJGP.2020.0928
Author(s):  
Georgina E. Lithgow ◽  
Jasper Rossi ◽  
Simon Griffin ◽  
Juliet Usher-Smith ◽  
Rebecca A. Dennison
Keyword(s):  
Synthesis Method ◽  
Qualitative Studies ◽  
System Level ◽  
Diabetes Screening ◽  
Qualitative Synthesis ◽  
Individual Level ◽  
Postpartum Screening ◽  
Critical Appraisal Skills ◽  
The Individual ◽  
Competing Priorities

Background: Gestational diabetes (GDM) is an important risk factor for developing type 2 diabetes (T2DM) later in life. Postpartum screening provides an opportunity for early detection and management of T2DM, but uptake is poor. Aim: To explore barriers to screening from clinicians’ perspectives to guide future interventions to increase uptake. Design and Setting: Systematic review and qualitative synthesis. Method: We assessed qualitative studies included in a previous review, then searched five electronic databases from 2013 to May 2019 for qualitative studies reporting clinicians’ perspectives on postpartum glucose screening after GDM. Study quality was assessed against the Critical Appraisal Skills Programmes checklist. Qualitative data from the studies were analysed using thematic synthesis. Results: We included nine studies, containing views from 187 clinicians from both community and hospital care. Three main themes were identified: difficulties in handover between primary and secondary care (ambiguous roles and communication difficulties), short-term focus in clinical consultations (underplaying risk so as not to overwhelm patients and competing priorities) and patient-centric barriers. Conclusion: We identified barriers to diabetes screening at both system and individual levels. At the system level, clarification of responsibility for testing among healthcare professionals and better systems for recall are needed. These could be achieved through registers, improved clinical protocols, and automatic flagging and prompts within electronic medical records. At the individual level, clinicians should be supported to prioritise the importance of screening within consultations and better educational resources made available for women. Making it more convenient for women to attend may also facilitate screening.

Adolescent Girls’ Perceptions of Physical Activity: A Systematic Review of Qualitative Studies

2018 ◽  
Vol 33 (5) ◽  
pp. 806-819 ◽  
Author(s):  
Méabh Corr ◽  
Jennifer McSharry ◽  
Elaine M. Murtagh
Keyword(s):  
Physical Activity ◽  
Adolescent Girls ◽  
Qualitative Studies ◽  
Future Research ◽  
Qualitative Synthesis ◽  
Prisma Statement ◽  
Study Characteristics ◽  
Critical Appraisal Skills ◽  
Societal Expectations ◽  
Competing Priorities

Objective: To synthesize evidence from qualitative studies relating to adolescent girls’ perceptions of physical activity participation. The protocol for this review is registered with PROSPERO (ID no. CRD42017054944). Data Source: PubMed, Sports Discus, Academic Search Complete, and Education Resources Information Centre. Inclusion and Exclusion Criteria: Studies reporting qualitative data that explored the views/opinions/perceptions of adolescent girls (>12 and <18 years old) published between 2001 and 2016 were included. Studies not in English, those focusing on school physical education or specific sports, and those including special populations were excluded. Extraction: Study characteristics and results were extracted to a form developed by the authors and managed using NVivo 10 (QSR International’s NVivo 10 software). Data were extracted by 1 reviewer, and a sample (25%) was checked by a second reviewer. Synthesis: Data were synthesized using a thematic network and managed using NVivo 10. The validity of the included studies was assessed using the “Critical Appraisal Skills Programme (2018)” checklist. The ENTREQ and PRISMA statement was followed when reporting this qualitative synthesis. Results: Of the 1818 studies identified in the search strategy, 24 met the inclusion criteria and were included in the analysis. Global themes were identified using a thematic network. These themes were “Gender Bias in Sport,” “Motivation and Perceived Competence,” “Competing Priorities during Adolescence,” and “Meeting Societal Expectations.” Conclusions: The results of this review provide insights into adolescent girls’ views on physical activity. Future research is needed to investigate the potential impact of alternative activity programs on adolescent girls with appropriate follow-up. Researchers and individuals working with young girls must consider the role of perceived motor competence in participation and how this can impact their perceptions.

scholarly journals System models for resilience in gerontology: application to the COVID-19 pandemic

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Katarzyna Klasa ◽  
Stephanie Galaitsi ◽  
Andrew Wister ◽  
Igor Linkov
Keyword(s):  
The Elderly ◽  
System Level ◽  
Improve Quality ◽  
Care Needs ◽  
Individual Level ◽  
Chronic Stressors ◽  
The World ◽  
Aging Adults ◽  
The Individual

AbstractThe care needs for aging adults are increasing burdens on health systems around the world. Efforts minimizing risk to improve quality of life and aging have proven moderately successful, but acute shocks and chronic stressors to an individual’s systemic physical and cognitive functions may accelerate their inevitable degradations. A framework for resilience to the challenges associated with aging is required to complement on-going risk reduction policies, programs and interventions. Studies measuring resilience among the elderly at the individual level have not produced a standard methodology. Moreover, resilience measurements need to incorporate external structural and system-level factors that determine the resources that adults can access while recovering from aging-related adversities. We use the National Academies of Science conceptualization of resilience for natural disasters to frame resilience for aging adults. This enables development of a generalized theory of resilience for different individual and structural contexts and populations, including a specific application to the COVID-19 pandemic.

The Gatekeeping of iNews.id about News on Worship in Mosques Due to the Covid-19 Pandemic

MEDIASI ◽  
2021 ◽  
Vol 2 (2) ◽  
pp. 100-107
Author(s):  
Shania Shaufa ◽  
Thalitha Sacharissa Rosyidiani
Keyword(s):  
Production Process ◽  
Media Coverage ◽  
System Level ◽  
Organizational Level ◽  
Online Media ◽  
Individual Level ◽  
The Public ◽  
The Social ◽  
The Media ◽  
The Individual

This article explains about online media iNews.id in implementing gatekeeping function. This study aims to find out how gatekeeping efforts iNews.id in the production process on the issue of preaching restrictions on worship in mosques during Ramadan in 2020. During the Covid-19 pandemic, the current media situation, especially in the midst of a crisis, encourages the public to become heavily dependent on media coverage. With a qualitative approach, researchers analyzed five levels of influence on the gatekeeping process in online media iNews.id. The results of this study show that factors that influence the way iNews.id in the production process of preaching restrictions on worship in mosques due to the Covid-19 pandemic are the individual level of media workers, the level of media routine, the organizational level, the extramedia level, and the social system level. The conclusions of this study state the most dominant levels is the organization level and the media routine level in the iNews.id.

Political Journalism

2018 ◽  
Author(s):  
Jesper Strömbäck ◽  
Adam Shehata
Keyword(s):  
System Level ◽  
Organizational Level ◽  
Strategic Game ◽  
Partisan Bias ◽  
Individual Level ◽  
Political Journalism ◽  
The Media ◽  
Media Systems ◽  
Conflict Framing ◽  
The Individual

Political journalism constitutes one of the most prominent domains of journalism, and is essential for the functioning of democracy. Ideally, political journalism should function as an information provider, watchdog, and forum for political discussions, thereby helping citizens understand political matters and help prevent abuses of power. The extent to which it does is, however, debated. Apart from normative ideals, political journalism is shaped by factors at several levels of analysis, including the system level, the media organizational level, and the individual level. Not least important for political journalism is the close, interdependent, and contentious relationship with political actors, shaping both the processes and the content of political journalism. In terms of content, four key concepts in research on political journalism in Western democratic systems are the framing of politics as a strategic game, interpretive versus straight news, conflict framing and media negativity, and political or partisan bias. A review of research related to these four concepts suggests that political journalism has a strong tendency to frame politics as a strategic game rather than as issues, particularly during election campaigns; that interpretive journalism has become more common; that political journalism has a penchant for conflict framing and media negativity; and that there is only limited evidence that political journalism is influenced by political or partisan bias. Significantly more important than political or partisan bias are different structural and situational biases. In all these and other respects, there are important differences across countries and media systems, which follows from the notion that political journalism is always influenced by the media systems in which it is produced and consumed.

Learning Identity, Flexibility, and Lifelong Experiential Learning

2019 ◽  
Author(s):  
Mai P. Trinh
Keyword(s):  
Experiential Learning ◽  
System Level ◽  
Global Learning ◽  
Lifelong Learners ◽  
Individual Level ◽  
Learning Flexibility ◽  
Learning Modes ◽  
Learning Identity ◽  
The Individual ◽  
Changing World

The world is changing faster than ever before. Recent advances in technology are constantly making old knowledge, skills, and abilities (KSAs) obsolete while also creating new KSAs and increasing the demand for jobs that have never existed before. These advances place tremendous pressure on people to learn, adapt, and innovate in order to keep up with these changes. Kolb’s Experiential Learning Theory (ELT) has been widely and effectively applied in various settings in the last four decades. This theory posits that learning is a proactive process, coming from the holistic integration of all learning modes in the human being: experiencing, reflecting, thinking, and acting. Learners must own and drive this process, because ownership of their own experiential learning process empowers learners to do far more than an external person—whether a parent, a teacher, or a friend—can accomplish. More than just a way to learn, experiential learning is a way of being and living that permeates all aspects of a person’s life. Given the demands of the fast-changing world we live in, what do individuals need to do to make sure they stay ahead of the change curve, remain fit with the changing environment, survive, and thrive? At the individual level, a number of important competencies need to be developed, including learning identity and learning flexibility. At the system level, learning and education as a whole must be treated differently. Education should be an abductive process in which learners are taught to ask different types of questions and then connect new knowledge with their own personal experiences. The outcome of education, likewise, should be adaptive and developmental. Instead of promoting global learning outcomes that every student needs to achieve, educators need to hold each student individually responsible for incrementally knowing more than he or she previously knew, and teach students not only how to answer questions but also how to ask good questions to extract knowledge from future unknown circumstances. Helping students foster a learning identity and become lifelong learners are among the most important tasks of educators in today’s fast-changing world.

Levels and sources of regime support in democracies and autocracies

2020 ◽  
pp. 93-157
Author(s):  
Marlene Mauk
Keyword(s):  
Structural Equation ◽  
System Level ◽  
Multilevel Structural Equation Modeling ◽  
Equation Modeling ◽  
Individual Level ◽  
Citizen Support ◽  
Autocratic Regimes ◽  
The Individual ◽  
Regime Support ◽  
Multilevel Structural Equation

This chapter presents the results of the empirical analysis of levels and sources of citizen support for democratic and autocratic regimes. The analysis proceeds in three steps. First, it compares the levels of regime support in democracies and autocracies. It shows that levels of citizen support, while varying considerably across individual countries, are roughly equal between democratic and autocratic regimes. Second, the analysis investigates the individual-level sources of regime support. It finds evidence that the same set of individual-level sources affect regime support in democracies and autocracies and that they do so in virtually the same way across regimes. Third, it addresses the system-level sources of regime support in democracies and autocracies. Using multilevel structural equation modeling, it observes effects of three of the four system-level sources in both types of regimes; yet, these system-level sources do not affect regime support in the same way in democracies as in autocracies.

Sources of regime support in democracies and autocracies

2020 ◽  
pp. 35-72
Author(s):  
Marlene Mauk
Keyword(s):  
Cultural Context ◽  
Value Orientations ◽  
Explanatory Model ◽  
Attitude Formation ◽  
Performance Evaluations ◽  
System Level ◽  
Individual Level ◽  
Regime Types ◽  
The Individual ◽  
Regime Support

This chapter develops an explanatory model of regime support applicable to both democracies and autocracies. The explanatory model includes both individual- and system-level determinants and explicates how these interact in shaping regime support. On the individual-level, it integrates culturalist and institutionalist explanations of support to arrive at five central sources of regime support: political value orientations, societal value orientations, incumbent support, democratic performance evaluations, and systemic performance evaluations. On the system level, it draws on social psychological theories of attitude formation and identifies four sources of regime support: macro-cultural context, macro-political context, actual systemic performance, and level of socioeconomic modernization. Recurring to the fundamental differences between democracies and autocracies, the explanatory model expects the individual-level processes forming regime support to be universal across regime types, but effects of system-level sources of regime support to vary between democracies and autocracies, due to indoctrination and propaganda distorting the attitude-formation process in autocracies.

scholarly journals From Mutual Hedging to All-Round Competition — The Strategic Transformation of Sino-US relations

2020 ◽  
Vol 12 (3) ◽  
pp. 88
Author(s):  
Yang Meijiao
Keyword(s):  
National Level ◽  
The United States ◽  
System Level ◽  
Asia Pacific ◽  
Individual Level ◽  
Pivot To Asia ◽  
Chinese Characteristics ◽  
Belt And Road ◽  
The Individual ◽  
Strategic Thought

Since the 21st century, the United States has gradually felt the insecurity brought by structural pressure, and then shifted its strategic focus to the Asia-Pacific region. The Obama administration put forward &quot;Pivot to Asia&quot;, and Trump has abandoned the legacy of the previous administration and constructed his own discourse system. He put forward the &quot;Indo-Pacific strategy&quot;, which has been expanded in both degree and contents. Meanwhile, China has taken a variety of corresponding strategies respectively. These include the&nbsp;Belt and Road Initiative and a community with a shared future for mankind and the strategic thought of major country diplomacy with Chinese characteristics. These two countries&rsquo; communicating model has changed from mutual hedging to all-round competition. With the change of US Asia Pacific (Indo-Pacific) strategy, this article uses the neoclassical realism theory to analyze them in detail, and analyzes the factors that influence the change of US strategies and the transformation of Sino-US relations from the system level, the national level and the individual level. Apart from that, their comprehensive competition has added challenges and difficulties to the construction of coordination, cooperation and stability.

scholarly journals Integration of Health Coaching Concepts and Skills into Clinical Practice Among VHA Providers: A Qualitative Study

2018 ◽  
Vol 7 ◽  
pp. 2164957X1875746 ◽  
Author(s):  
David A. Collins ◽  
Kirsten Thompson ◽  
Katharine A. Atwood ◽  
Melissa H. Abadi ◽  
David L. Rychener ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Qualitative Study ◽  
Health Coaching ◽  
System Level ◽  
Health Administration ◽  
Clinical Role ◽  
Individual Level ◽  
Positive Effects ◽  
Coaching Skills ◽  
The Individual

Background Although studies of health coaching for behavior change in chronic disease prevention and management are increasing, to date no studies have reported on what concepts and skills providers integrate into their clinical practice following participation in health coaching courses. The purpose of this qualitative study was to assess Veterans Health Administration (VHA) providers’ perceptions of the individual-level and system-level changes they observed after participating with colleagues in a 6-day Whole Health Coaching course held in 8 VHA medical centers nationwide. Methods Data for this study were from the follow-up survey conducted with participants 2 to 3 months after completing the training. A total of 142 responses about individual-level changes and 99 responses about system-level changes were analyzed using content analysis. Results Eight primary themes emerged regarding individual changes, including increased emphasis on Veterans’ values, increased use of listening and other specific health coaching skills in their clinical role, and adding health coaching to their clinical practice.Four primary themes emerged regarding system-level changes, including leadership support, increased staff awareness/support/learning and sharing, increased use of health coaching skills or tools within the facility, and organizational changes demonstrating a more engaged workforce, such as new work groups being formed or existing groups becoming more active. Conclusions Findings suggest that VHA providers who participate in health coaching trainings do perceive positive changes within themselves and their organizations. Health coaching courses that emphasize patient-centered care and promote patient–provider partnerships likely have positive effects beyond the individual participants that can be used to promote desired organizational change.

scholarly journals Barriers and Delays in Tuberculosis Diagnosis and Treatment Services: Does Gender Matter?

2014 ◽  
Vol 2014 ◽  
pp. 1-15 ◽  
Author(s):  
Wei-Teng Yang ◽  
Celine R. Gounder ◽  
Tokunbo Akande ◽  
Jan-Walter De Neve ◽  
Katherine N. McIntire ◽  
...  
Keyword(s):  
Gender Differences ◽  
Public Health Problem ◽  
System Level ◽  
Global Public Health ◽  
Community Members ◽  
Quantitative Evidence ◽  
Individual Level ◽  
Treatment Services ◽  
Quantitative Studies ◽  
The Individual

Background. Tuberculosis (TB) remains a global public health problem with known gender-related disparities. We reviewed the quantitative evidence for gender-related differences in accessing TB services from symptom onset to treatment initiation.Methods. Following a systematic review process, we: searched 12 electronic databases; included quantitative studies assessing gender differences in accessing TB diagnostic and treatment services; abstracted data; and assessed study validity. We defined barriers and delays at the individual and provider/system levels using a conceptual framework of the TB care continuum and examined gender-related differences.Results. Among 13,448 articles, 137 were included: many assessed individual-level barriers (52%) and delays (42%), 76% surveyed persons presenting for care with diagnosed or suspected TB, 24% surveyed community members, and two-thirds were from African and Asian regions. Many studies reported no gender differences. Among studies reporting disparities, women faced greater barriers (financial: 64% versus 36%; physical: 100% versus 0%; stigma: 85% versus 15%; health literacy: 67% versus 33%; and provider-/system-level: 100% versus 0%) and longer delays (presentation to diagnosis: 45% versus 0%) than men.Conclusions. Many studies found no quantitative gender-related differences in barriers and delays limiting access to TB services. When differences were identified, women experienced greater barriers and longer delays than men.

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