Supporters' experiences of sensory characteristics of children with profound intellectual and multiple disabilities in after-school daycare centres: A qualitative study.

AIM: To examine how supporters working at after-school daycare centres, who are involved in the lives of children with profound intellectual and multiple disabilities in the community, pay attention to the sensory characteristics of these children and provide support. DESIGN: A qualitative descriptive design. METHODS: Data were collected through semi-structured interviews with 20 supporters in after-school daycare centres. Interview transcripts were analysed via qualitative content analysis. RESULTS: The participants' years of involvement in supporting children with profound intellectual and multiple disabilities ranged from 0.5 to 40 years, with an average of 9.8 years. Data were classified into 68 subcategories, 11 categories and three themes: understanding sensory characteristics and devising support, systematic support and challenges supporting the children. Supporters dealt with physical complications and cooperated with other caregivers to understand and respond to children's sensory characteristics. Difficulties dealing with sensory characteristics, challenges due to the supporters' own characteristics and challenges with the facility's infrastructure were identified. The findings could guide sensory characteristics considerations and support systems in after-school daycare facilities for children with profound intellectual and multiple disabilities. Both support content and challenges in supporting these children were identified.

Experience and Availability of Pelvic Binders at Swedish Trauma Units; A Nationwide Survey.

OBJECTIVE: To assess availability, experience, and knowledge about the Pelvic Circumferential Compression Device (PCCD) in Sweden. METHODS: A telephone interview with the current on-call trauma doctors at all trauma units in Sweden was conducted. After a short presentation and oral consent, the doctors were asked to answer four short questions. We asked the doctors to answer whether they knew if they had PCCDs available in their emergency room, how many times had they applied a PCCD, which is the correct level of application for a PCCD, and if a PCCD can stop arterial bleeding. RESULTS: The on-call trauma doctors at the nine University hospitals, twenty-two General hospitals and twenty-one District General hospitals, with response rate of 100%, were interviewed. Availability of PCCD was 85 % and there was no difference between hospital types (p=0.546). In all hospitals 29/52 (56%) of those interviewed had used a PCCD at least once. There were significantly more doctors that had used a PCCD at least once in the University hospitals (8/9), compared to General hospitals (13/22) and District General hospitals (8/21) (p=0.034). A total of 43/52 (83 %) doctors defined the greater trochanters as the correct level of application for a PCCD. No difference was found when comparing hospitals (p=0.208). Only 22/52 (42 %) of doctors answered that a PCCD could not stop an arterial bleeding. No difference was found between hospitals (p=0.665). CONCLUSION: Less than half of the doctors knew that a PCCD cannot stop arterial bleeding, while the majority knew the correct level of application of a PCCD.

Health Beliefs and Experiences of a Health Promotion Intervention Among Psychiatric Patients With Substance Use: An Interview Study.

We aimed to explore beliefs about physical health from the perspective of patients with concurrent mental illness and substance use and to explore how a health promotion intervention influenced their personal agency for changing health-related behaviour. Our findings were that patients' beliefs were focused on their present day state of health and that patients had strategies to normalize their health and health-related behaviour. Health promotion to this group of patients should be tailored to fit their particular beliefs. Health measurements were experienced as providing tangible insight into their health and appeared to prevent patients from minimizing physical health problems.

Reliability of Multiple Mini-Interviews and traditional interviews within and between institutions: a study of five California medical schools.

BACKGROUND: Many medical schools use admissions Multiple Mini-Interviews (MMIs) rather than traditional interviews (TIs), partly because MMIs are thought to be more reliable. Yet prior studies examined single-school samples of candidates completing either an MMI or TI (not both). Using data from five California public medical schools, the authors examined the within- and between-school reliabilities of TIs and MMIs. METHODS: The analyses included applicants interviewing at ≥1 of the five schools during 2011-2013. Three schools employed TIs (TI1, TI2, TI3) and two employed MMIs (MMI1, MMI2). Mixed linear models accounting for nesting of observations within applicants examined standardized TI and MMI scores (mean = 0, SD = 1), adjusting for applicant socio-demographics, academic metrics, year, number of interviews, and interview date. RESULTS: A total of 4993 individuals (completing 7516 interviews [TI = 4137, MMI = 3379]) interviewed at ≥1 school; 428 (14.5%) interviewed at both MMI schools and 687 (20.2%) at more than one TI school. Within schools, inter-interviewer consistency was generally qualitatively lower for TI1, TI2, and TI3 (Pearson's r 0.07, 0.13, and 0.29, and Cronbach's α, 0.40, 0.44, and 0.61, respectively) than for MMI1 and MMI 2 (Cronbach's α 0.68 and 0.60, respectively). Between schools, the adjusted intraclass correlation coefficient was 0.27 (95% CI 0.20-0.35) for TIs and 0.47 (95% CI 0.41-0.54) for MMIs. CONCLUSIONS: Within and between-school reliability was qualitatively higher for MMIs than for TIs. Nonetheless, TI reliabilities were higher than anticipated from prior literature, suggesting TIs may not need to be abandoned on reliability grounds if other factors favor their use.

[Current and future competencies for public health professionals]. / Identificación de las competencias actuales y futuras de los profesionales de la salud pública.

OBJECTIVES: To identify current and future competencies (managers and technicians) for public health professionals in Catalonia (Spain). METHODS: Qualitative research with a phenomenological approach. Between November 2009 and February 2010, 31 semistructured interviews were completed with public health professionals working in Catalonia. We purposely used a theoretical sample to include the maximum multiplicity of discourses. We conducted a thematic content analysis. RESULTS: We obtained a wide range of current professional competencies, as well as those required for the future, classified according to professional profile. The participants highlighted transversal competencies, such as the importance of sharing a general theoretical framework of the discipline and the institution. Among the most frequently reported competencies were knowledge management, communication skills, teamwork, multidisciplinary and intersectoral orientation, legal knowledge, computer skills and languages, particularly English. It was also important for individual professionals to have specific skills in their areas of activity. In terms of differences between managers and technicians, the study showed that technicians prioritize management skills concerning human and material resources, while managers emphasize organizational and professional public health expertise. CONCLUSIONS: There is a need for transversal and specific competencies in distinct areas. Public health is a multidisciplinary field, which collaborates with a wide range of professionals and organizations.

Development of a Korean Version of an Advance Directive Model via Cognitive Interview / 한국호스피스완화의료학회지

PURPOSE: The purpose of the study was to develop a feasible form of a Korean version of advance directives (K-AD). METHODS: Sixteen adults participated in this study: 10 aged 20~50 years and nine aged 65 years or older. Using a draft version of the K-AD, cognitive interview was conducted on the participants to establish a culturally acceptable form of advance directives whose directions can be understood and responded accordingly by the general population. RESULTS: Cognitive interviews revealed areas of concerns for the draft version of K-AD: lack of instructions or clarity for technical and medical terms, context complexity and inadequate response categories. The draft version was revised by rewording, offering examples and rearranging the context. Editorial style was added with appropriate uses of bold fonts, bullet-points and underlines to facilitate interviewees' cognitive responses. CONCLUSION: Study results feasibility of the revised version of the K-AD. Further study should be performed with a larger number of participants to develop a K-AD with an acceptable level of reliability and validity.