Explanatory Statements Research Articles

2258 The need for delirium education and psychosocial care after discharge: a realist analysis of interviews with key stakeholders

Abstract Introduction There is limited understanding of long-term delirium care after discharge from hospital for older people. A realist approach was used to investigate the contextual factors and mechanisms of care that influence recovery from delirium. Realist evaluation is fundamentally theory-driven. A preliminary programme theory was used as the foundation for theory testing and refinement to develop the RecoverED intervention. Method Realist interviewing techniques were used to obtain real-world and lived experiences of delirium recovery and service use in the community for theory-building and testing. Semi-structured interviews were conducted with a purposive sample of people with delirium (N = 7), informal carers (N = 14), and healthcare professionals (N = 24). Data from the interviews were analysed using a deductive codebook of Context-Mechanism-Outcome (CMO) configurations. Open coding was also performed to identify inductive themes, which were then aggregated to elicit explanatory statements. Results There was support for a multicomponent delirium intervention including cognitive and physical rehabilitation, and psychosocial support. The analysis revealed the need for an additional component which focused on improving awareness and understanding about delirium among those with lived experience. In the context of insufficient knowledge about delirium, people experienced increased fear and anxiety among other negative outcomes. Offering a focused educational component as part of the intervention is expected to contribute to recovery outcomes. This was associated with CMOs identifying the need for positive relationships with staff, improving communication with staff and sense-making through staff emotional support. Conclusion(s) The preliminary programme theory was refined based on the realist analysis data. Additional components were included, one of which was targeted education for people with delirium and carers. Following a consultation with an expert panel, the intervention is being tested in a feasibility trial and process evaluation, which will analyse data from multiple sources using realist methods to further refine the intervention.

Peran Keikutsertaan Mahasiswa FISIP Universitas Teknologi Sumbawa dalam Organisasi terhadap Pola Pikir Kritis

This research discusses the influence of the participation of students from the Faculty of Social and Political Sciences, Sumbawa Technology University in organizations on critical thinking patterns. The problem formulation that will be discussed in this research is the role of participation in organizations in changing the critical thinking patterns of students at the Faculty of Social and Political Sciences. This research aims to determine the role of participation in organizations on changes in the critical thinking patterns of students at the Faculty of Social and Political Sciences. This research uses a descriptive qualitative research method, namely describing the data as it is and explaining the data or events with qualitative explanatory statements to obtain in-depth information, as well as data that contains significant meaning and can influence the research object. This research produced several results. Students get the opportunity to develop thinking patterns, analytical thinking skills, as well as communication and negotiation skills. The participation of students from the Faculty of Social and Political Sciences in student organizations that encourage debate and discussion activities provides important benefits. These discussions and debates train students in critical thinking, develop communication skills, and convey opinions clearly and persuasively.

Austeridade e financeirização: a construção do discurso reformista no campo previdenciário brasileiro

Abstract This article seeks to outline a panorama in the construction of reformist discourses in the Brazilian social security field after the 1988 Federal Constitution, unveiling the ideologies present in such discourses. The study conducted an analysis of the explanatory statements that justify constitutional amendment proposals submitted to the Brazilian parliament. The theoretical and methodological method was critical discourse analysis (CDA), seeking to answer to what extent the conceptions of austerity and financialization permeate the process of construction of the discourses that justify the proposition of the Brazilian social security reforms. The results indicate that capitalist ideologies guided by the logic of financialization and austerity appear in the construction of the reformist discourses, which demonstrates their influence on the authors and suggests the affiliation of the reforms to these hegemonic conceptions. It is concluded that CDA is an important tool to understand the processes that involve public policies, from its formulation to its evaluation.

Перерегистрация членов ВКП(б) как форма проверки их лояльности советской власти на примерах Краснодарского края. 1943-1944 гг.

The article is devoted to the disclosure of the activities of party organizations of the All-Union Communist Party of Bolsheviks in Kuban during the Great Patriotic War, mainly after the liberation of the Krasnodar region from the German invaders from January to autumn 1943. One of the tasks was to resume after the occupation the structure of party organizations of cities and districts. District committees of the All-Union Communist Party of Bolsheviks (b), party organizations at district executive committees, cells in organizations, institutions, enterprises, collective farms, village councils, primary party organizations in district departments of the NKGB and NKVD were being formed. The source base of the article was unpublished archival documents of 1943 - early 1944, stored in the Center for Documentation of Contemporary History of Krasnodar Region (CDCHKR) and representing a top-secret correspondence between the secretaries of the district party committees and the regional committee of the All-Union Communist Party of Bolsheviks (b). The main contents of the correspondence are materials of inspections of communists who, at the end of July and beginning of August 1942, when the unexpected and rapid attack of German troops on the cities and districts of the Kuban began, did not evacuate to the Soviet rear for various reasons. The stay of the Communists in the occupied territory became for them (as well as for the entire population, of which they were a part) a severe ordeal. Many were forced to conceal their affiliation with the All-Union Communist Party of Bolsheviks (Bolsheviks) and destroyed their party cards. Others took jobs in enterprises controlled by the German administration, and some took the path of cooperation with the Germans. Already after the expulsion of the Nazi troops, their allies and collaborators, they were re-registered in the party and were obliged to undergo humiliating inspection procedures. All of them, without exception, wrote explanatory statements about their stay in the occupation and their occupation in the enemy-occupied territory, were massively expelled from the Party for cowardice and loss or deliberate destruction of their Party card. As a rule, most of them had no real guilt. The article uses a micro-historical approach, where the object of study is local historical events, allowing a deeper understanding of the depth of drama in the lives of people of this difficult period, accused undeservedly of collaboration when the Soviet authorities were restoring the former order. In the course of checks on loyalty to the All-Union Communist Party of Bolsheviks (Bolsheviks) and the country, criminal acts of some Communists, which were not subject to forgiveness, also surfaced.

The Effect of the Abrogating and the Abrogated on the Explanatory Weightings According to the Scientists of Hilla

This research deals with the effect of the abrogating and abrogated in the interpretational preferences of the scholars of Hilla, after it was found that there is no sufficient evidence to determine the amount of abrogation in the Holy Qur’an, except in some resources, and this indicates that the issue is in dispute among the commentators, and the Scientists of Hilla had a clear impact on the interest in abrogation Qur’an and its definition and weighting between the explanatory statements that have been subjected to abrogation and criticize it. And we show that there is a difference in the number of abrogated in the Holy Qur’an by the Holy Qur’an, and Scientists of Hilla have a specific insight at identifying the abrogated with definitive evidence such as unanimity and the frequent text, given that the abrogated is like the Qur’an. Considering that the Qur’anic text is definitive, it is abrogated only by a definitive one.The research explained - in its three demands - that the preponderance of the scholars of al-Hilla with abrogation was based on the statements of the commentators and the most famous saying of abrogation and consider whether it was abrogated or not.

The social networks of hospital staff: A realist synthesis.

ObjectivesThe social ties people have with one another are known to influence behaviour, and how information is accessed and interpreted. It is unclear, however, how the social networks that exist in multi-professional health care workplaces might be used to improve quality in hospitals. This paper develops explanatory theory using realist synthesis to illuminate the details and significance of the social ties between health care workers. Specifically we ask: How, why, for whom, to what extent and in what context, do the social ties of staff within a hospital influence quality of service delivery, including quality improvement?MethodsFrom a total of 75 included documents identified through an extensive systematic literature search, data were extracted and analysed to identify emergent explanatory statements.ResultsThe synthesis found that within the hospital workforce, an individual’s place in the social whole can be understood across four identified domains: (1) social group, (2) hierarchy, (3) bridging distance and (4) discourse. Thirty-five context-mechanism-outcome configurations were developed across these domains.ConclusionsThe relative position of individual health care workers within the overall social network in hospitals is associated with influence and agency. As such, power to bring about change is inequitably and socially situated, and subject to specific contexts. The findings of this realist synthesis offer a lens through which to understand social ties in hospitals. The findings can help identify possible strategies for intervention to improve communication and distribution of power, for individual, team and wider multi-professional behavioural change in hospitals.

Prevalence of Oral Problems among Patients with Type II Diabetes Mellitus in the Selected Urban Area of Vellore City, Tamil Nadu

There is a rapid increase in diabetes mellitus worldwide causing premature deaths (1.6 million deaths in 2016) due to complications of the disease. India is said to have a greater number of diabetics, and diabetes remains one of the leading causes of death due to complications in India. Poor glycaemic control in patients not only affects their heart, kidneys, eyes and nerves but also affects the oral cavity. Periodontal disease is considered the sixth complication of diabetes mellitus, and it is seldom addressed. This study was conducted to assess the extent of oral problems amongst the clients with Type II diabetes mellitus in the selected urban area of Vellore district. A total of 150 samples were selected using simple random technique method. Informed consent was obtained from every subject, and the study was approved by the institutional review board. Data were collected using a structured pro forma, and a thorough oral examination was done to identify oral problems. The data were analysed using SPSS and were presented with explanatory statements in tables and graphs. The study findings revealed that the prevalence of periodontitis was high (64.7%) amongst the Type II diabetes mellitus and half of the subjects (53%) had one or the other oral problems such as calculus, stains dental caries, bleeding or swollen gum, gum recession and loose tooth or missing tooth. Regular dental check-up is mandatory for all diabetics, and oral health education is much required for better glycaemic control which will help to reduce the mortality rate and country's burden.

Автобиография Ю. В. Кнорозова: эволюция документа в личном деле исследователя

The publication characterizes autobiographies of the historian, ethnographer, linguist, “father” of the Russian school of Mayanism Yuri Valentinovich Knorozov (1922–99), that have been identified in the fonds of various institutions and departments: (State Archive of the Russian Federation (GARF), Scientific Archive of the Russian Ethnographic Museum (REM), Scientific Archive of the Museum of Anthropology and Ethnography of the Russian Academy of Sciences (MAE RAN). Autobiography is a “free” author's presentation (with fixed semantic accents, sometimes duplicating the data of personnel sheet) and a mandatory formal element of Soviet personnel management. The text of the autobiography was influenced by the document’s purpose: individual facts unfit for socially and ideologically correct biography were “hushed up” or otherwise carefully explained by the author. Drawing on Yu. V. Knorozov’s autobiographies written in different years and for different reasons (admission to graduate school, employment, dissertation defense, promotion to honorary titles), the article assesses how explanatory statements were changing textually. “Corrections” are considered using the example of specific facts: during the Great Patriotic War (from 1941 to February 1943), Yuri Knorozov, a student of the Kharkiv Pedagogical University, unfit for military service for health reasons, was in the territory occupied by the enemy. The article is accompanied by the publication of a detailed autobiography of Yuri Knorozov (1981) compiled on the occasion of his nomination as corresponding member of the Soviet Academy of Sciences in “General history” (ethnography). The autobiography text contains information on most important facts of Yuri Knorozov’s scientific biography, including his expeditions (field research), reports at foreign scientific events and participation in international scientific associations. The author concludes that it is more important to analyze not the content of the autobiography, but the socio-political circumstances and practices that determined its semantic framework.

Moving beyond the model as a copy problem: investigating the utility of teaching about structure-preserving transformations in the model-referent relationship

ABSTRACT An important research objective in modelling instruction is defining what students should learn about the model-referent relationship, as when unguided, they tend to errantly think of models as literal interpretations of their referents. Restating this problem we say students should learn about structure-preserving transformations between models and referents; including: what gets transformed, how it is transformed, and directions of information flow in transformation. To define what students should learn of this triumvirate, we introduce two explanatory statements: models are abstractions and models have transferability. We then investigated how readily students could learn about abstraction and transferability, and how this learning related to literal interpretation, by comparing pre- and posttest scores of modelling knowledge for students (n = 175) who participated in a modelling activity that provided experiences with abstraction and transferability. A control group (n=49) took identical tests but received no relevant instruction. Results showed that modelling students: (1) improved their capability to generate abstract models; (2) gained in their understanding that models represented their referents under transformation; and (3) consequently, did not think of models as literal interpretations. Lack of gains in the control ruled out a testing effect. We concluded that knowledge of structure-preserving transformations is a viable and valuable object of instruction.

Analytical chemistry students’ explanatory statements in the context of their corresponding lecture

Conceptually understanding chemistry requires the ability to transition among representational levels to use an understanding of submicroscopic entities and properties to explain macroscopic phenomena. Past literature describes student struggles with these transitions but provides limited information about upper-level post-secondary chemistry students’ abilities to transition among levels. This group is of particular interest as they are engaging in potentially their final training before entering a career as professional chemists, thus if students are likely to develop this skill during their formal education it should be manifest among this group. This study characterized analytical chemistry students’ responses to open-ended assessments on acid–base titrations and thin-layer chromatography for the use of sub-microscopic entities or properties to explain these macroscopic phenomena. Further, to understand whether explanatory statements were an expectation inherent in the instructional context of the setting, the analytical chemistry instructor's lectures on acid–base titrations and thin-layer chromatography were analyzed with the same framework. The analysis found that students seldom invoked explanatory statements within their responses and that congruence between lectures and responses to assessment was primarily limited to the use of macroscopic, descriptive terms. Despite the fact that the lecture in class regularly invoked explanatory statements in one context, this did not translate to student use of explanatory statements. To further test the hypothesis that analytical chemistry students struggle with explanatory statements, a follow-on study was also conducted among a second cohort of students reviewing their responses when specifically prompted to use sub-microscopic entities to explain a macroscopic phenomenon. The results suggest that fewer than half of the students showed proficiency on generating explanatory statements when explicitly prompted to do so. Instructional implications to promote explanatory statements are proposed in the discussion.

The Transformational Efficacy of Postgraduate Courses

Considerable literature exists pertaining to transformative education and academics seek to provide a transformative educational experience for students. The purpose of this research was to examine the perceptions of graduates from postgraduate teacher education courses concerning transformative efficacy with regard to the stated outcomes of the courses. The participants were Christian teachers and school principals from Christian schools across Australia who had graduated from accredited Master of Education or Master of Education (Leadership) courses. Data collection was by way of an online survey containing Likert scales and explanatory statements. The research found that most of the graduates identified transformation at a personal level, particularly in the theological and philosophical understandings that underpin classroom or school leadership practice in Christian schools. This enabled them to be able to critique the cultural artifacts with which educators must deal in their practice.

A worked example of initial theory-building: PARTNERS2 collaborative care for people who have experienced psychosis in England

In this article, we present an exemplar of the initial theory-building phase of theory-driven evaluation for the PARTNERS2 project, a collaborative care intervention for people with experience of psychosis in England. Initial theory-building involved analysis of the literature, interviews with key leaders and focus groups with service users. The initial programme theory was developed from these sources in an iterative process between researchers and stakeholders (service users, practitioners, commissioners) involving four activities: articulation of 442 explanatory statements systematically developed using realist methods; debate and consensus; communication; and interrogation. We refute two criticisms of theory-driven evaluation of complex interventions. We demonstrate how the process of initial theory-building made a meaningful contribution to our complex intervention in five ways. Although time-consuming, it allowed us to develop an internally coherent and well-documented intervention. This study and the lessons learnt provide a detailed resource for other researchers wishing to build theory for theory-driven evaluation.

Underlying mechanisms of complex interventions addressing the care of older adults with multimorbidity: a realist review

ObjectivesTo understand how and why effective multi-chronic disease management interventions influence health outcomes in older adults 65 years of age or older.DesignA realist review.Data sourcesElectronic databases including Medline and Embase...

Designing Effective Testimonial Pictorial Warning Labels for Tobacco Products

ABSTRACTWarning labels on tobacco products sometimes feature images and stories of real people whose health has been affected by smoking. We examined effects of some of the design elements that may contribute to the effectiveness of these testimonial pictorial warning labels (PWLs). Beginning with a testimonial PWL that contained an image of a person and a basic warning statement (e.g., “Smoking can kill you”), we examined the impact of adding: (a) text detailing the person’s name, age and health status (identifiers); and (b) explanatory statements that elaborated on the basic warning using a testimonial or non-testimonial message. In an online experiment, 1255 adult smokers in the United States were randomly assigned to one of six experimental conditions (2 [identifier: none/identifier] × 3 [explanatory statement: none/non-testimonial/testimonial]), or a control condition (text only warning labels that currently appear on packs in the United States). In each condition, participants were exposed to multiple labels each focused on a different health effect. Effectiveness was assessed using emotional responses, engagement and behavioral intentions measured immediately post-exposure, and quit attempts measured at five-week follow up. Testimonial PWLs were more effective than the text only labels. However, there was little evidence that adding identifiers or the explanatory statements enhanced effectiveness; rather, there was some evidence that testimonial explanatory statements reduced effectiveness. These findings suggest that the most effective design for testimonial PWLs may be to combine a basic warning statement with an image of a real person, without any additional textual components.

The genre effect

Abstract Some purport that literary fiction is determined by high inference demands. The subgenre of science fiction is often defined by story-world tropes that may reduce inferential demands. However, science fiction with high inference demands may also constitute literary fiction. Instead of inferential demands, it may be readers’ responses to setting that distinguishes science fiction and narrative realism. In two experiments, a story was manipulated for contemporary and science-fiction settings. Also, a version of each text with and without explanatory statements manipulated inference demand. Readers perceived the science-fiction text as lower in literary quality. For science fiction, readers also exerted less inference effort for theory of mind, but more for understanding the world. Regardless of inference effort, participants who read the story in the science-fiction world performed more poorly on comprehension. Readers’ expectations triggered by setting tropes seem to be particularly potent determinants of literary quality perceptions, inference effort, and comprehension.

Theism and Contrastive Explanation

I argue that there could not be grounds on which to introduce God into our ontology. My argument presupposes two doctrines. First, we should allow into our ontology only what figures in the best explanation of an event or fact. Second, explanation is contrastive by nature, in that the explanandum always consists in a contrast between a fact and a foil. I argue that God could not figure in true contrastive explanatory statements, because the omnipotence of God guarantees that for any true proposition p, God could have made it the case that ~p just as much as He could have made it the case that p.

Key performance indicators in Danish place and city branding – Proposal for a new brand strategy platform

The primary aim of this paper is to identify and analyze municipal performance strategies in Danish place and city branding and as a second aim also to analyze explanatory statements for the lack of data. Five municipalities had a performance management strategy with target setting and KPIs related to brand motives. KPIs were consistent with SMART criteria and directly related to brand motives. All first order indicators related to media and social media. Indicators relating to material impact within the municipality relied on available public statistics. Indicators for immaterial impact within or outside the municipality all require specific analysis. The explanatory statements can be aggregated into three main categories: Lack of funding and political support, uncertainty of methods, and the failing obligation for cities and municipalities to organize and publish data or other analytical information. Finally the aim is to propose a Brand Strategy Platform to support place and city brand investors in a more systematic approach to performance management.

“But I Wanted to Appear Happy”: How using Arts-Informed and Mixed Methods Approaches Complicate Qualitatively Driven Research on Culture Shock

The study of culture shock has been limited in terms of the use of mixed methods research and arts-informed approaches. The purpose of this research was to expand upon the understanding of culture shock through the use of a mixed methods research design that included arts-informed, qualitative, and quantitative procedures. This study used a concurrent parallel design where all three data types were collected simultaneously, analyzed separately, and then analyzed together. It is based on an information-rich sampling of 10 undergraduate students participating in a short-term study abroad program based in the United States of America that traveled to a South American country. All data were collected throughout the duration of the program: self-portraits and explanatory artist statements, open-ended reflective journals, and responses to a modified version of the Revised Sociocultural Adaptation Scale. The analyses of each of these sets of data (i.e., the initial analysis stage) revealed a complexity of emotions that students experienced as part of their culture shock, the impact of interacting with others, and their heightened experience of culture shock upon returning home. The integration of these findings resulted in a reconsideration of the qualitative data to highlight the importance of interactions with locals while abroad as being particularly important to alleviate culture shock. The article concludes by considering the implications of the arts-informed data and the use of a mixed methods research design for the interpretation of the qualitative data and for qualitative researchers in general.

The differential impact of monetary policy announcements and explanatory minutes releases on the Australian interest rate futures market

Unlike US and Continental European jurisdictions, Australian monetary policy announcements are not followed promptly by projections materials or comprehensive summaries that explain the decision process. This information is disclosed 2weeks later when the explanatory minutes of the Reserve Bank board meeting are released. This paper is the first study to exploit the features of the Australian monetary policy environment in order to examine the differential impact of monetary policy announcements and explanatory statements on the Australian interest rate futures market.We find that both monetary policy announcements and explanatory minutes releases have a significant impact on the implied yield and volatility of Australian interest rate futures contracts. When the differential impact of these announcements is examined using the full sample, no statistically significant difference is found. However, when the sample is partitioned based on stable periods and the Global Financial Crisis, a differential impact is evident. Further, contrary to the findings of Kim and Nguyen (2008), Lu et al. (2009), and Smales (2012a), the response along the yield curve, is found to be indifferent between the short and medium terms.

Prevalence and Factors Influencing Diabetic Foot Ulcer among Diabetic Patients Attending Arbaminch Hospital, South Ethiopia

Background: Diabetic foot ulcer is one of the long standing complications of diabetic mellitus with the life time risk up to 25%. In Africa in general, particularly in Ethiopia, there are limited epidemiological studies related to diabetic foot ulcer. Objective: The main objective of this study is to assess prevalence and factors influencing diabetic foot ulcer among diabetic patients attending Arbaminch hospital. Methods: A cross sectional study was conducted on 216 diabetic clients attending Arbaminch hospital from Feb10, 2013 to April 10, 2013. Subjects were identified using simple random sampling and data was collected by four trained diploma level nurses using interviewer administered questioner, record review check list and observation check lists. The data was coded and entered to Epidata version 3.1 and exported to SPSS version 16.0 for analysis. Descriptive analysis was done for sociodemographic variables, diabetic knowledge, diabetes self care practice and attitude and clinical factors. Binary logistic regression analysis was also done to identify independent factors associated with diabetic foot ulcer and significant factors was declared at p<0.05 with 95% confidence interval. Finally data was presented with explanatory statements, tables and graphs. Result: All of the study subjects were interviewed which gives 100% response rate with the mean ± SD age of 50.72 ± 13.39 years. Out of the total 216 study subjects , about 32(14.8%) has diabetic foot ulcer, 129(59.7%) were male, 61(28.2%) from rural, 132(61.11%) were overweight, 97(44.5%) have poor diabetic foot self care practice and 80(37%) of them have secondary education. rural residence (AOR=4.074, 95% CI 1.262-13.151), absence of co-morbidity (AOR=0.611, 95% CI 0.131-0.955), mean arterial blood pressure greater than 90(AOR=5.113, 95% CI 1.285-20.347), duration of diabetes for more than 10years (AOR=8.452, 95% CI 2.365-30.994), are independent factor associated with DFU. Conclusions and recommendations: Significant proportion of patients with diabetes developed diabetic foot ulcer. Rural residence; presence of co-morbidity; duration of diabetes, mean arterial blood pressure and occupation are factors associated with diabetic foot ulcer. In addition to regular diabetic care emphasis should be given on enhancing diabetic patient’s knowledge of self care practice and regular diabetic foot evaluation