Earlier Qualitative Study Research Articles

Experiences of living with idiopathic pulmonary fibrosis in relation to physical activity - “How the hills became steeper and steeper”: a qualitative interview study

IntroductionIdiopathic pulmonary fibrosis (IPF) is a progressive disease presenting with symptoms like dyspnoea, dry cough, and fatigue, which affect physical function and quality of life. No earlier qualitative studies have investigated physical activity in IPF. This study aims to explore experiences of living with IPF in relation to physical activity.Materials and methodsQualitative interviews were conducted with 14 participants living with IPF. The participants were 77 years old (range: 56–86) and diagnosed with IPF between 2 and 9 years ago. The analysis was performed by qualitative content analysis according to Graneheim and Lundman.ResultsThe results indicated that life and one’s ability to be physically active is affected by IPF. Despite this, it seems possible to navigate past obstacles, which was illustrated by an overall theme: “My life is constrained, but I am hanging on”. Two major categories cover topics of IPF being a life changing diagnosis with changes in self-image and changed future plans regarding physical activity, as well as life. Physical activity was perceived to be challenging, yet in many ways used as a strategy, developed to manage life.ConclusionsIPF affects physical activity as well as life, from onset onwards. By developing strategies for facilitating physical activity as well as identifying barriers, it seems possible to maintain an active life despite the disease. The healthcare system needs to create support systems that meet different needs during different phases of the disease.Trial registration“FoU in Sweden” Research and Development in Sweden (id: 227081).

소크라테스 대화법 관련 교육연구 현황 분석

Objectives This study aims to analyze the current state of educational research related to the Socratic Dialogue method, particularly in the context of the upcoming implementation of the revised 2022 curriculum.
 Methods The study involved analyzing 130 scholarly articles and thesis related to the Socratic method in education, published between 2015 and December 2022. Initially, the research classified by the types of studies according to school grades and research methods to analyze their current state. For a more comprehensive analysis, the study further categorized research types based on content, examining the status of applied subjects, research topics, and the use of literature and models.
 Results Firstly, the research types were predominantly literature studies. In particular, literature studies were prevalent in joint or elementary and high school-targeted research, while quantitative studies were common for early childhood and qualitative studies for middle school. Secondly, out of 130 studies related to the Socratic method, 72 were classified as basic research, mainly focusing on ‘general education’ and ‘moral’ subjects. In practical research, ‘moral’ and ‘philosophy’ subjects were commonly applied, especially ‘philosophical (community of inquiry activities)’ for early childhood education. Thirdly, upon reviewing the literature and models used in the research, basic research most frequently utilized ‘Dialogues’, focusing on educational implications like ‘teaching methods’⋅’teacher's role’⋅‘educational objectives’⋅‘content’. They emphasized educational objectives such as ‘truth-seeking’⋅‘knowledge’⋅‘unity of knowledge and action’⋅‘wisdom’, using key concepts from the ‘Dialogues’ and frequently analyzing the Elenchos method of Socratic dialogue. In practical research, over 50% reported results from conducting philosophical inquiry community activities.
 Conclusions This study is significant as it reviews the current state of educational research related to the Socratic method since the 2015 curriculum revision, in anticipation of the implementation of the revised 2022 curriculum (in 2024). It provides foundational research material for the qualitative improvement of subsequent studies and suggests future directions.

Exploring Life-Course Trajectories in Local Spatial Contexts Across Sweden

This article explores typical life-course trajectories based on annual observations of educational participation, employment, and establishing a family from age sixteen to age thirty. Using latent class analysis, we identify seven different trajectory classes that capture the different life courses experienced by individuals born in 1986. Examples of trajectory classes are (1) an early partner and childbearing trajectory; (2) a trajectory that mixes employment and a long postsecondary education into the later twenties; and (3) a trajectory involving low activity, very little employment, very little postsecondary education, and not starting a family. The classes identified correspond closely to trajectories found in earlier qualitative studies using life-history interviews, but in contrast to these studies that each encompass a few dozen individuals or less, our approach identifies trajectories for the individuals of an entire birth cohort. This allows for analysis of the geographical distribution of trajectories across regions, municipality types, and neighborhoods. Individuals following long postsecondary education trajectories were heavily concentrated in metropolitan areas and university towns. At the same age, individuals following early childbearing trajectories were concentrated instead in peripheral, rural areas. Individuals from nonmetropolitan areas also tend to follow more gender-polarized trajectories. Moreover, we find that there is more trajectory-based segregation at age thirty than at age fifteen. Theoretically, our study gives support to the idea that places are structured on the basis of life-course trajectories. Local context influences how individuals are linked into different trajectories and, at the same time, the spatial sorting of trajectories will shape local contexts.

텍스트 마이닝을 통한 언해본 <태상감응편> 감응담의 메시지 분석

This study aims to analyze the message of Taesanggameung-pyeon published by the Joseon royal family in the 19th century through text mining. As it was issued by the state, the text of Taesanggameung-pyeon occupies a special position. In addition, the title and genre regulation of the book constitute a superficial message centered on “Taoism, the transcendental, good and evil, and cause and effect.” Superficial messages may trigger cognitive bias in the reading process. Data mining enables a new interpretation of texts that are prone to cognitive biases in that it treats fine-scale text information, which is easy to miss by human attention, as having the same value as information in units that human cognition readily understands. In this article, frequency analysis of vocabulary, visualization of vocabulary characteristics, and topic-oriented visualization were conducted to determine the actual message delivered to the readers of Taesang󰠀gameung-pyeon, which has a strong superficial message. For the linguistic approach and visualization, quantitative analysis techniques such as word cloud, TF-IDF, word2Vec, K-means clustering, and topic modeling were used. Following text mining focused on the vocabulary used in Taesanggameung-pyeon, the ethics emphasized in Taesanggameung- pyeon is not religion-specific, but has general applicability, and the desire that the Gam Eung Story satisfies is a transcendent desire. Rather, it was confirmed that it was a desire to make up for worldly and everyday shortcomings. This affords new insights in that it is distinct from the results of earlier qualitative studies.

How patients with borderline personality disorder experience the skill opposite action in the context of dialectical behavior therapy-A qualitative study.

Dialectical behavior therapy (DBT) is currently the most researched therapy method to treat borderline personality disorder (BPD). A major component of DBT is learning and practicing specific skills to regulate emotions. Qualitative studies found that patients perceived DBT skills as helpful in dealing with emotions. However, DBT consists of more than 60 different skills, and earlier qualitative studies had a broad focus. The present study explores patients' experience with a specific skill, opposite action (OA). The skill is one of the major DBT skills assumed to play an important role in symptom improvement. OA means deliberately performing a behavior that is opposite to the emotional urge to act and is intended to weaken the original emotion. Qualitative data from semistructured interviews with 23 patients diagnosed with BPD receiving DBT were analyzed following qualitative content analysis procedures. The participants generally had a good understanding of the skill, although it was often mixed with other skills of DBT. Performing OA was perceived as exhausting. Adverse effects of OA, intense emotions and high distress were reported as barriers to OA use. However, participants named several factors that helped them overcome these barriers, including their thoughts and actions, support from others, and treatment elements. Participants described positive effects of OA such as positive emotional changes and a decrease in problem behavior and more freedom in everyday life. The findings of the study provide valuable information to optimize the delivery of OA and DBT and can help to improve treatment outcome for patients with BPD. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Environmental Displacement and Mental Well-Being in Banjarnegara, Indonesia.

Background:Residential moves (displacement) owing to climate- and weather-related disasters may significantly impact mental health. Despite the growing risk from climate change, health impacts of environmental-mobility remain understudied.Objectives:We assessed the effects of displacement on the association between landslides and changes in perceived mental well-being in Banjarnegara, Indonesia. We also investigated whether sociodemographics (age, sex, level of education, household-level income, or employment in agriculture) and landslide characteristics (number and severity of landslides) were associated with differing odds of relocation after experiencing landslides.Methods:In this cross-sectional study, we surveyed 420 individuals who experienced landslides between 2014 and 2018 to assess perceived changes in mental well-being, comparing after landslide exposure to before landslide exposure. We used a novel six-item measure that was created in collaboration with the local community to compare perceived changes between those who were displaced by landslides and those who were not displaced, using logistic and multinomial regressions adjusted for sociodemographic characteristics. We then assessed whether the odds of displacement differed based on sociodemographic characteristics and landslide exposure characteristics, using logistic regressions.Results:Those who were displaced were more likely than those who were not displaced to report perceived increases in economic stability [; 95% confidence interval (CI): 1.45, 6.46], optimism (; 95% CI: 1.87, 8.61), safety (; 95% CI: 1.44, 5.10), religiosity (; 95% CI: 1.03, 3.65), and closeness with community (; 95% CI: 1.10, 3.33) after landslides compared with before their first landslide during the study period. More frequent landslide exposures were associated with reduced odds of relocation, but more severe landslides were associated with increased odds of relocation.Discussion:These findings suggest that landslides affect the mental well-being not only of those who are displaced but also of those who are left behind. Further, this work supports the need for community-based participatory research to fully capture the health impacts of environmental mobility. https://doi.org/10.1289/EHP9391

Maternal health care professionals\u2019 experiences and views on the use of obstetric ultrasound in Rwanda: A cross-sectional study

BackgroundThis study, undertaken in Rwanda, aimed to investigate health professionals’ experiences and views on the following topics: current clinical guidelines for ultrasound from second trimester at the clinic, regional and national levels, and adherence to clinical guidelines; medically indicated ultrasound examinations; non-medical use of ultrasound including ultrasounds on maternal request; commercialisation of ultrasound; the value of ultrasound in relation to other clinical examinations in pregnancy; and ultrasound and medicalisation of pregnancy.MethodsA cross-sectional design was adopted. Health professionals providing antenatal care and delivery services to pregnant women in 108 health facilities were invited to complete a survey, which was developed based on the results of earlier qualitative studies undertaken as part of the CROss Country Ultrasound Study (CROCUS).ResultsNine hundred and seven health professionals participated: obstetricians/gynecologists (3.2%,) other physicians (24.5%), midwives (29.7%) and nurses (42.7%). Few physicians reported the existence of clinical guidelines at clinic, regional or national levels in Rwanda, and guidelines were moderately adhered to. Three obstetric ultrasound examinations were considered medically indicated in an uncomplicated pregnancy. Most participants (73.0%) were positive about obstetric ultrasound examinations on maternal request. Commercialisation was not considered a problem, and the majority (88.5%) agreed that ultrasound had contributed to medicalisation of pregnancy.ConclusionsFindings indicate that clinical guidelines for the use of obstetric ultrasound are limited in Rwanda. Non-medically indicated obstetric ultrasound was not considered a current problem at any level of the healthcare system. The positive attitude to obstetric ultrasound examinations on maternal request may contribute to further burden on a maternal health care system with limited resources. It is essential that limited obstetric ultrasound resources are allocated where they are most beneficial, and clearly stated medical indications would likely facilitate this.

Typological characteristics of interlanguage: Across native language types and L2 proficiency levels

Interlanguage studies have shifted over time from the early qualitative studies to quantitative studies of specific linguistic structures. However, the focus of these studies is usually on a partial aspect of an interlanguage instead of the whole system. Therefore, there remains a paucity of quantitative studies on interlanguage from the typological perspective. Based on a syntactically-tagged corpus that we built, and taking a quantitative linguistic metric, this paper reports the typological change in Chinese interlanguage from two native language backgrounds i.e., English and Japanese. The findings show that (1) the interlanguage of native English speakers and native Japanese speakers have the same preference for SV and VO; (2) interlanguage is a gradual developmental system, and the typological features of native language have an influence on the development of interlanguage typological features; (3) typological markedness between NL and TL affect the development of interlanguage's typological features, and experience with L2 can also influence L2 acquisition; (4) the dependency direction can be universally applicable as an indicator to investigate the overall development of interlanguage typology.

An instrument for measuring the influence of consumers' cultural values on functional food perception

PurposeThe purpose of the article is to develop an instrument for measuring the influence of consumers' cultural values on functional food perception.Design/methodology/approachThe study is quantitative in nature and builds on an earlier qualitative study that employed in-depth interviews, thematic analysis and constant comparative analysis to construct a survey instrument which initially had 53 items. The quantitative study involved an online survey that was conducted using this instrument, which resulted in 365 complete cases that included 173 Anglo-Australian, 102 Chinese and 90 Indian respondents living in Australia. The survey data were subjected to exploratory factor analysis using Principal axis factoring, with Promax rotation.FindingsThe research has validated that functional food perception is dependent upon consumers' cultural values. The results of the exploratory factor analysis provided a six-factor instrument with 32 items.Research limitations/implicationsOnly three ethnic groups were involved in this study and that is not entirely representative of Australia or other countries. The instrument, however, will allow researchers in the field of functional food to extend the research to other diverse communities.Practical implicationsThe instrument will further enable functional food producers and marketers to develop effective marketing strategies based on their knowledge of the influence of cultural values on functional food perception.Originality/valueThe instrument developed from this study, for measuring consumers' functional food perception based on cultural values, is the first of its kind.

Understanding Clinical Characteristics of Muscle Weakness.

BACKGROUND: Muscle weakness is a debilitating condition that can lead to frailty, falls, and functional decline. Muscle weakness is found across many diseases; therefore, understanding what constitutes this condition is paramount. The National Library of Medicine provides 2 definitions of muscle weakness, both from a disease perspective. These definitions are narrow and do not account for overlapping causes of muscle weakness. Nurses are holistic practitioners, so they need to understand the clinical characteristics of muscle weakness, regardless of underlying disease processes. METHODS: Secondary analysis of data from an earlier qualitative study. Using content analysis of transcripts of semistructured interviews with a multidisciplinary group of 12 experts in the management of muscle disorders, we identified characteristics of muscle weakness from the clinicians' perspectives. RESULTS: Muscle weakness has characteristics of debility, loss of function, and asymmetry. The characteristics of debility include lack of strength, atrophy, and fatigue. Muscle weakness does coexist with muscle tightness. CONCLUSIONS: The characteristics of muscle weakness identified in our study are markedly different from those included in National Library of Medicine definitions. As a condition, muscle weakness has both subjective and objective traits. Therefore, clinician assessment and patient input combined capture the comprehensive nature of muscle weakness. Nurses' awareness of what constitutes muscle weakness, regardless of diagnosis, is the first step in optimal management of this condition.

Climate change as an existential challenge: Exploring how emerging adults cope with ambivalence concerning climate-friendly food

This article focuses on the existential aspects of global climate change. Pessimism regarding this problem seems to be particularly common in emerging adulthood (the late teens and twenties). Research also shows that many in this age group feel ambivalent about different pro-environmental behaviors and that ambivalence is a disincentive to behave in an environmentally friendly way. This article’s aim is foremost theoretical, with a focus on living with ambivalence in a more or less “unsustainable” society that simultaneously puts pressure on the individual to live in a sustainable manner. Deploying existential theories and theories about ambivalence, the article argues that we cannot avoid ambivalence because of the complexity of climate change. Therefore, we should not focus foremost on getting rid of this feeling. Instead, it is crucial to look at how young people think about and cope with their ambivalence. An earlier qualitative study indicates that there are “negative” and “positive” ways to handle ambivalence seen from a behavioral perspective. We illustrate this with data from a quantitative pilot study with university students (n=261) regarding climate-friendly food choices. The results show that ambivalence and negative thinking patterns are negatively related to climate-friendly food choices, while the variable, positive thinking patterns, is significantly positively associated with and is the most potent predictor of these food choices. Furthermore, a theoretical model where ambivalence leads to negative thinking patterns, which then leads to less climatefriendly food choices, was supported in a mediation analysis. It is concluded that it is vital to discuss these thinking patterns in a critical way to promote coping strategies that can help the young face their ambivalence and be active despite it. In this regard, from a developmental psychological perspective, emergingadulthood is an ideal age period.

Understanding the work of case managers in Australian community aged care: a longitudinal time and motion study.

Objective The aim of this study was to quantify the work activities of community aged care case managers and assess changes following consumer-directed policy reforms. Methods A longitudinal, time and motion study was performed, with direct observation (n=339h) of case managers undertaking work in the office or in the community. We compared the distribution of proportions of time spent across seven broad work task categories during May-August 2014 (P1) and May-October 2016 (P2). Results Office time was primarily consumed by communication (43.7%) and documentation (33.3%) tasks. Documentation increased substantially from P1 to P2 (29.4% vs 37.0% respectively; P<0.001), with more time spent on the subtask of recording information (18.0% vs 24.5% respectively; P=0.039). Travel (45.9%) and communication (41.0%) accounted for most community time. Time in communication increased from P1 to P2 (37.3% vs 48.4% respectively; P=0.047), with more time allocated to client communication (14.6% vs 31.7%; P<0.001). Case managers spent 33.6% of community time in clients' homes (median 25.2min per client; 22.8 vs 30.1min in P1 and P2 respectively) and visited a median of two clients per day (3 vs 1 visits per day in P1 and P2 respectively). Conclusions This study provides the first quantification of task-time distribution among this workforce and how work patterns have changed during a time of significant policy reform and operational changes within the community aged care sector. What is known about the topic? Early qualitative studies gauging case managers' perceptions of the effect of consumer-directed care reforms on their work activities indicate an increase in time spent working directly with aged care clients. However, there is no existing quantitative evidence examining changes to case managers' work activities. What does this paper add? By capturing timed, multidimensional data, this study provides new quantitative evidence of how case managers distribute their time on work activities in office and community settings. Further, the results provide an indication of changes in work task-time distribution over a 2-year period when significant policy reforms and operational changes occurred. Amid a changing aged care landscape, how and with whom case managers spend their time was found to shift, with an increase in time spent recording information and communicating with clients identified. What are the implications for practitioners? This study demonstrates that direct observational studies provide important evidence of the ways in which policy and organisational changes affect community aged care case managers' work activities in practice. Triangulating this quantitative evidence with existing qualitative accounts of policy impact can further allow assessment of how complex reforms may affect everyday work. For policy makers and aged care organisations, such evidence can help discern whether policies and changes are having their desired effects, as well as providing insights as to why or why not.

Triaging the Terminally Ill—Development of the Responding to Urgency of Need in Palliative Care (RUN-PC) Triage Tool

ContextEvidence-based resource allocation is receiving increasing attention as we strive for equity, transparency, and cost-effectiveness across health care. In the context of finite resources, which of our patients with terminal illness should be prioritized for urgent palliative care? ObjectivesTo develop the scoring system for the novel Responding to Urgency of Need in Palliative Care triage tool. MethodsOnline international discrete choice experiment involving palliative care clinicians to establish the relative importance of seven key attributes of palliative care triage identified during an earlier qualitative study. ResultsParticipants (n = 772) were mainly female (79.9%) with a decade of clinical experience. All attributes contributed significantly (all P-values < 0.001) and independently to clinician assessment of urgency. This study found physical suffering (coefficient 3.45; 95% confidence interval: 3.24 to 3.66) was the most important determinant of urgency, followed by imminent dying (coefficient 1.56; 1.43 to 1.69), psychological suffering (coefficient 1.49; 1.37 to 1.60), caregiver distress (coefficient 1.47; 1.35 to 1.59), discrepancy between care needs and care arrangements (coefficient 1.14; 1.02 to 1.26), mismatch between current and desired site of care (coefficient 0.94; 0.85 to 1.03), and unmet communication needs (coefficient 0.84; 0.76 to 0.92). ConclusionPalliative care triage, which is complex and contextual, has been made more transparent through this discrete choice experiment. The Responding to Urgency of Need in Palliative Care triage tool provides an important step toward evidence-based assessment of priority for palliative care. Further research is underway to determine the validity of the tool in clinical practice and its impact on patient and caregiver outcomes.

The Endometriosis Impact Questionnaire (EIQ): a tool to measure the long-term impact of endometriosis on different aspects of women\u2019s lives

BackgroundEndometriosis is a chronic disease impacting on many aspects of a woman’s life. Because of the chronic and recurring nature, many of the impacts of endometriosis could be missed using existing questionnaires which focus on recent events. Therefore, a questionnaire with a long-term perspective is necessary. This study aimed to develop and evaluate a questionnaire to measure the long-term impact of endometriosis on different aspects of women’s lives.MethodsThrough a methodological design, phase 1 was qualitative and phase 2 was a cross-sectional study. The original 100 EIQ items were developed based on results from an earlier qualitative study and literature review. Through a process of assessing face and content validity this was reduced to 66 items. The psychometric properties of the final 63 item EIQ were evaluated through a web-based survey with data from 423 responders with a self-reported surgically-diagnosed endometriosis.ResultsParticipants were aged 16-58 years. Exploratory factor analysis of a 66-item EIQ was established with 423 responders. The final 63-item EIQ contained six dimensions including: 33-item physical-psychosocial; 3-item fertility; 7-item sexual; 11-item employment; 6-item educational; and 3-item lifestyle. Cronbach’s alpha of 0.99 for the whole 63-item EIQ, and 0.84 to 0.98 for the dimensions suggests a very good reliability. High positive correlations between the EIQ and the EHP-5 (altered recall period) indicated good evidence of concurrent validity. High intra-class correlations indicated very good test-retest reliability.ConclusionsThe EIQ, as a disease-specific questionnaire, could be used to provide a better understanding of the impact of endometriosis on different aspects of life, to better meet the needs of women. We recommend additional studies to establish validity evidence for the EIQ, including studies in other countries and languages.

Thermal stability of ultrafine grained AA8090 Al–Li alloy processed by repetitive corrugation and straightening

The thermal stability of an ultrafine-grained (UFG) AA8090 Al–Li alloy with an average grain size of 2μm is reported. The UFG structure was obtained by repetitive corrugation and straightening (RCS) process after 8 passes using optimized processing parameter conditions identified in the previous research, i.e., processing temperature 300°C; ram velocity 1.5mm/s using V-Grooved corrugating die profile (pitch 20mm, corrugating angle 30° and curve radius 2mm) and straightening by a flat die. The grain size distribution ranged from 200nm to 8μm. The average hardness of the RCS processed specimen had increased to a mean value of 104HV from an average value of 75HV in the parent material. The RCS processed specimens were annealed at different temperatures (T) for varying time periods (t) to investigate their thermal stability using hardness and microstructure changes as the quantitative measures. The microstructure analysis of the samples was done using electron backscattered diffraction (EBSD) analysis. The study was based on a full factorial design of experiments (DOE) and the results were analyzed using a TOPSIS optimization tool. The results prove that thermal stability is more influenced by temperature than the time of annealing, a known result based on earlier qualitative studies on conventional materials. The study also demonstrates that the material is fairly stable up to 300°C. The activation energy for grain growth is found to be 76kJ/mol in a range where the annealing time is 2–6h and the temperature range is 200–400°C.

Formal and Informal Work-Life Balance Practices of Athletic Trainers in Collegiate and University Settings.

Organizational policies for work-life balance exist, but little is known about athletic trainers' (ATs') awareness of and willingness to use them. To explore ATs' formal and informal work-life balance policies in the collegiate and university athletic training setting. Sequential mixed-methods study. Web-based survey. We sent 4673 e-mails to National Athletic Trainers' Association ATs (full-time employment for at least 1 year, nonacademic appointment); 1221 participants began our survey (access rate = 26.1%), and 783 completed the survey (64.1% completion rate). Demographics were as follows: men = 375 (48.0%) and women = 404 (51.7%); age = 36 ± 10 years; experience = 13 ± 9 years; years at current place of employment = 8 ± 8 years; and participants with children or minor dependents = 262 (33.5%). We created a 17-item instrument from an earlier qualitative study. A panel of experts (n = 3; employer, employee, and researcher) completed a content analysis. Variables of interest were confidence (scale = 1-4) and satisfaction (scale = 1-5) with policies. We used Pearson χ2 analyses to compare the effect of undergoing an orientation and the presence or absence of children on the main outcome measures. A majority of participants had experienced formal orientation through the human resources department (n = 522, 66.8%), the direct supervisor (n = 240, 30.7%), or a colleague (n = 114, 14.6%). However, many had received no orientation (n = 184, 23.6%). Those who had undergone orientation indicated greater confidence in knowing about (P < .001) and greater satisfaction with (P < .001) formal workplace policies and benefits. Those with children stated that they had greater confidence in knowing about (P < .001) and greater satisfaction with (P = .013) formal workplace policies and benefits. Those who had been oriented felt greater confidence in knowing about (P = .009) but no difference in satisfaction with (P = .060) informal workplace policies and benefits. We did not identify differences between those with and those without children regarding their confidence in knowing about (P = .653) or satisfaction with (P = .150) informal workplace policies and benefits. Athletic trainers in the collegiate and university setting were not confident in their knowledge of formal or informal work-life balance policies.

Search for Symbol Sense Behavior: Students in Upper Secondary Education Solving Algebraic Physics Problems

Students in upper secondary education encounter difficulties in applying mathematics in physics. To improve our understanding of these difficulties, we examined symbol sense behavior of six grade 10 physics students solving algebraic physic problems. Our data confirmed that students did indeed struggle to apply algebra to physics, mainly because they lacked both sufficient symbol sense behavior and basic algebraic skills. They used ad hoc strategies instead of correct, systematic rule-based procedures involving insight. These ad hoc strategies included the cross-multiplication, the numbering, and the permutation strategy. They worked only for basic formulas containing few variables. In problems with more variables, students got stuck. The latter two strategies substitute numbers for variables. The permutation strategy randomly checks several permutations to guess which one is correct. The numbering strategy substitutes numbers to check algebraic manipulations. Our results indicate insufficient focus on conceptual understanding of algebra in some mathematics textbooks, leading to reliance on poorly understood ad hoc strategies. Effective teaching of algebraic skills should not focus on either basic algebraic skills or on symbol sense behavior. Instead, both aspects should be taught in an integrated manner. Our operationalization of symbol sense behavior turned out to be very useful for analysis. In contrast to earlier qualitative studies, it provided us the opportunity to measure symbol sense behavior quantitatively. This operationalization should also be applicable to other science subjects. Furthermore, we discussed some implications of our results for curricula, teachers, science teacher educators, and textbook publishers aiming at successful application of mathematics in physics.

Complement C1q expression in Erythema nodosum leprosum.

Complement C1q is a soluble protein capable of initiating components of the classical pathway in host defence system. In earlier qualitative studies, C1q has been implicated in the pathogenesis of Erythema Nodosum Leprosum (ENL). However, little is known about the role of this complement in ENL reaction. In the present study we described the protein level of C1q production and its gene expression in the peripheral blood and skin biopsies in patients with ENL reaction and lepromatous leprosy (LL) patient controls before and after treatment. Thirty untreated patients with ENL reaction and 30 non-reactional LL patient controls were recruited at ALERT Hospital, Ethiopia. Peripheral blood and skin biopsies were obtained from each patient before and after treatment. The level of circulating C1q in the plasma was determined by enzyme-linked immunosorbent assay. The mRNA expression of the three C1q components, C1qA, C1qB, and C1qC in the peripheral blood and skin biopsies was determined by qPCR. Circulating C1q in the peripheral blood of untreated ENL patients was significantly decreased compared to LL patient controls. Untreated ENL patients had increased C1q gene expression in the peripheral blood compared to LL controls. Similarly, C1qA and C1qC gene expression were substantially increased in the skin biopsies of untreated ENL patients compared to LL controls. However, after treatment none of these genes show significant difference in both groups. In conclusion, while circulating C1q is inversely correlated with active ENL reactions, its gene expression is directly correlated with ENL. The decreased circulating C1q may suggest the utilization of C1q in immune-complex formation in these patients. Therefore, C1q could be a potential diagnostic marker for active ENL reactions as well as for monitoring ENL treatment.

Person-centredness in elder care: A secondary analysis of data from a study among home-dwelling men and women in the Faroe Islands.

As individuals in Western societies age, there is increasing demand for home-based care to help older people stay in their homes for as long as possible and provide services that ensure a person's quality of life in old age. Numerous attempts are made to develop a framework to secure quality of care. However, research has shown insufficient quality in care for older people. In this study, the purpose is to study how older people's experiences with home care reflect a person-centred approach to care. Data derived from an earlier study on ageing among home-dwelling men and women who are aged 67-91 and living in the Faroe Islands. Person-centredness as a concept is an often quoted, but ill-defined concept. Most studies concerning person-centred care are conducted within hospital wards or long-term care institutions. Empirical studies concerning home-dwelling older people receiving home care are scarce. The study is a secondary analysis of data from an earlier qualitative study. Latent thematic analysis was used which meant coding issues of potential interest and collecting these codes into themes. Three themes appeared to combine the initial codes: sense of involvement, sense of meaningfulness and contextual conditions. Overall, the analysis showed that the users were seldom involved in planning or scheduling the care they received. What they were offered did not always make sense to them or correspond to their needs or preferences. The number of interviews included was limited. However, findings from this study point at some possible barriers to successful implementation of person-centredness within elder care. Especially, contextual conditions seem to limit the facilitation of person-centred practices. Healthcare providers must take the user's preferences, resources and networks into consideration when coordinating and planning home care and, importantly, be open for negotiating needs. It is important to draw attention to the contrast between political intentions regarding elder care and the limited options for putting the intentions into practice.

Psychometric validation of the SF-36 Health Survey in light chain amyloidosis: results from community-based and clinic-based samples.

BackgroundLight chain (AL) amyloidosis, a rare and life-threatening protein misfolding disorder, causes organ damage and severely impacts health-related quality of life (HRQoL). No patient-reported outcome (PRO) HRQoL measure has been validated for use in an AL amyloidosis patient population, leaving a gap for researchers conducting observational studies and clinical trials for drug development. The SF-36 Health Survey (SF-36) has been the most frequently used PRO in AL amyloidosis studies to date, and early qualitative validation studies support its use in this population. The aim of this study was to assess the psychometric properties of the SF-36 among patients with AL amyloidosis.MethodsData from community-based (n=341) and clinic-based (n=1,438) observational studies were used to document the psychometric properties of the SF-36 in this disease population. Reliability was estimated using internal consistency (Cronbach’s alpha) and test–retest reliability (intraclass correlation). Convergent validity, known-groups validity, and the ability to detect change were assessed with available criterion variables.ResultsScale reliability (Cronbach’s alpha ≥0.780 for all scores) and test–retest reliability (intraclass correlation coefficients ≥0.731 for all) were acceptable. Scale convergent validity was supported by strong correlations with conceptually related measures. Mean SF-36 scores varied by response to treatment (P<0.05 for all scores) and a self-reported measure of disease severity (P<0.001 for all scores). Data indicate that the SF-36 is sensitive to changes in other measures over time.ConclusionThis study provided clear and consistent evidence of the psychometric properties of the SF-36 in both community-based and clinic-based samples of patients with AL amyloidosis.