Miracle-dz/UniFAR-FTUs huggingface dataset:
Strengths and Challenges in the Use of Interpretive Description: Reflections Arising From a Study of the Moral Experience of Health Professionals in Humanitarian Work

Interpretive description is a qualitative research methodology aligned with a constructivist and naturalistic orientation to inquiry. The aim of interpretive description, a relatively new qualitative methodology, is to generate knowledge relevant for the clinical context of applied health disciplines. To date there has been little discussion in the literature of the particular merits and limitations of this methodological framework. In this article I draw on my experience of using interpretive description as methodology for an inquiry into the moral experience of clinicians in humanitarian work. I identify and discuss strengths and challenges that can arise in the application of interpretive description. Strengths identified include a coherent logic and structure, an orientation toward the generation of practice-relevant findings, and attention to disciplinary biases and commitments. Challenges include limited resources for situating the methodology, challenges in employing a lesser-known methodology, and uncertainty regarding the degree of interpretation to seek.
“I’ve Never Not Had it So I Don’t Really Know What it’s Like Not to”: Nondifference and Biographical Disruption Among Children and Young People With Cystic Fibrosis

The relevance of biographical disruption and loss of self for children and young people is unclear, particularly in cases of congenital illness such as cystic fibrosis, where no prior period of wellness, stability, or perceived normality might exist. We explored the meaning, importance, and forms of maintenance of ideas of normality among 32 children and young people with cystic fibrosis. We examine the ways in which normalcy is produced, maintained, and threatened, and discuss the implications for the applicability and relevance of these traditional sociological concepts. Analysis of children’s and young people’s accounts resulted in a conceptualization of four forms of normalcy based on personal and social definitions and audiences. Biographical disruption appeared relevant but in a more nuanced form than its usual conceptualization when applied to adult populations. Maintaining normality within the family resulted in continual biographical revision in anticipation of future illness trajectory and life course.
The Role of Creative Expression in Diabetes: An Exploration Into the Meaning-Making Process

In this narrative exploration of meaning making through the use of creative arts, we recorded the experiences of 8 women with type 1 diabetes. Through a conceptual framework of creative expression as a way of knowing, we designed this study to evoke affective and metaphorical connections to the meaning of diabetes. The initial narrative interview findings reflected the experience of the participants, with three primary themes emerging: experiencing negative emotions about diabetes, putting a positive “spin” on the negative as a way to make meaning, and resisting against diabetes and the medical approach. During the creative arts process, we encouraged further exploration into the meaning-making process using imagery and photographs created by the participants. Final interview findings addressed the need for moving beyond numbers, and attention to the meaning-making process in patient care.
Metasynthesis of the Hope Experience of Family Caregivers of Persons With Chronic Illness

The purpose of this metasynthesis was to describe the hope experience of family caregivers of persons with chronic illness. Fourteen studies were included in the metasynthesis. All studies described the importance of hope to the family caregivers of relatives with chronic illness regardless of age, relationship, or setting. Several derived themes arose from the metasynthesis, including (a) transitional refocusing from a difficult present to a positive future, (b) dynamic possibilities within uncertainty, (c) pathways of hope, and (d) hope outcomes. Hope was defined as transitional dynamic possibilities within uncertainty. A new conceptual model of hope was developed that provides a foundation for future research and practice. The metasynthesis findings indicate factors influencing hope have a role in assessing hope and differing pathways of hope provide a foundation for future hope interventions.
Respiratory rate assessment from photoplethysmographic imaging

We present a study investigating the suitability of a respiratory rate estimation algorithm applied to photoplethysmographic imaging on a mobile phone. The algorithm consists of a cascade of previously developed signal processing methods to detect features and extract respiratory induced variations in photoplethysmogram signals to estimate respiratory rate. With custom-built software on an Android phone (Camera Oximeter), contact photoplethysmographic imaging videos were recorded using the integrated camera from 19 healthy adults breathing spontaneously at respiratory rates between 6 and 40 breaths/min. Capnometry was simultaneously recorded to obtain reference respiratory rates. Two hundred and ninety-eight Camera Oximeter recordings were available for analysis. The algorithm detected 22 recordings with poor photoplethysmogram quality and 46 recordings with insufficient respiratory information. Of the 232 remaining recordings, a root mean square error of 5.9 breaths/min and a median absolute error of 2.3 breaths/min was obtained. The study showed that it is feasible to estimate respiratory rates by placing a finger on a mobile phone camera, but that it becomes increasingly challenging at respiratory rates higher than 20 breaths/min.
Social Performance and Secret Ritual: Battling Against Obsessive-Compulsive Disorder

This autoethnography offers an account of my experience with mental illness and provides an analysis of the performative aspects of obsessive-compulsive disorder (OCD). OCD is a genetic disorder triggered by environmental stressors involving a chemical imbalance in the brain. The resulting biologically altered state leaves individuals to steer themselves among and between “appropriate” performance and secret rituals. Analyzing my own communication practices through a performance lens highlights the importance of image management for people struggling with disability. In telling my own story, this article provides readers an in-depth look at OCD as a traumatic brain disorder whose sufferers rely on communicative performance to maintain their public and private identities, and as a disease that impedes social life for its sufferers. Implications of this account for those struggling with mental disability and for practitioners aiming to help them are discussed.
Errores en el pabellón quirúrgico: cambiando la práctica perioperatoria

Como marco introductorio, el siguiente grafico muestra que tan riesgosa es la atencion en salud comparada con otras actividades. En el eje de las abscisas aparece el numero de eventos necesarios, en distintas actividades, para que se presente una victima fatal y en el de ordenadas, el numero de vidas perdidas por ano. Del grafico resulta evidente que la atencion en salud es la mas peligrosa de todas estas actividades: los vuelos aereos planificados, los ferrocarriles europeos y las plantas nucleares se enmarcan dentro de las actividades clasificadas como ultra seguras, es decir, causantes de menos de una muerte por cada 100.000 personas expuestas; la manufactura quimica, los vuelos charter y el conducir son actividades de riesgo regulado, mientras que el salto bungee, el montanismo y la atencion en salud son peligrosas, esta ultima con el mayor numero de vidas perdidas por ano (Fig.1).
Issues of Expressed Stigma of HIV/AIDS Among Professionals in Southern Sudan

HIV-related stigma continues to be a significant barrier to HIV testing, treatment, and care. Understanding the factors that underlie this stigma could help remove barriers to HIV/AIDS intervention. We identified these factors among nurses as well as community leaders in Lui, Southern Sudan. Participants included health workers at a local hospital, a women’s group, local market traders, religious leaders, and teachers. We categorized the responses generated from group interaction forums as concerns, fears, and perceptions. We found that stigma persisted not only toward people with conspicuous signs of full-blown AIDS, but also toward community programs, like voluntary counseling and testing centers. Future interventions, including delabeling the counseling and testing centers and demonstrating the efficacy of highly active antiretroviral therapy, will be critical in reducing the stigma of HIV/AIDS in communities.
Five-Year-Old Children’s Tuning-In and Negotiation Strategies in an Immunization Situation

In this article, we have explored 5-year-old children’s expressions when they as actors took part in an immunization situation in the Primary Child Health Care (PCHC) service in Sweden. Although children’s health and development are the main concern in the PCHC service, their perspectives in such a setting have not been explored fully. To capture children’s perspectives we used a hermeneutic design and video observations. The findings revealed children as competent and active participants, contributing to the construction of the PCHC situation in mutuality with the nurse and the parent. The conceptualization of children’s expressions and actions revealed how they influenced and dealt with a PCHC situation by using strategies of tuning-in, affirmative negotiation, and delaying negotiation. Understanding children’s actions will assist nurses to act with sensitivity when they encounter and support children.
Discourses of Depression of Australian General Practitioners Working With Gay Men

The data for this article are from a primary health care project on HIV and depression, in which the prevalence, nature, clinical management, and self-management of depression among homosexually active men attending high-HIV-caseload general practice clinics were investigated. One of the qualitative arms consisted of in-depth interviews with general practitioners (GPs) with high caseloads of gay men. The approach to discourse analysis was informed by Halliday’s systemic functional linguistics. GPs constructed three discourses of depression: engaging with psychiatric discourse, engaging with the patient’s world, and engaging with social structures. When GPs drew on the discourse of psychiatry, this discourse was positioned as only one possible construction of depression. This discourse was also contextualized in the social lives of gay men, and it was explicitly challenged and rejected. Engaging with their patients’ social world was considered vital for recognizing depression in gay men. Finally, the GPs’ construction of depression was inextricably linked to social disadvantage and marginalization. Depression is highly heterogeneous and constructed in terms of social relationships rather than as an independent entity that resides in the individual. There is a synergy between GPs’ constructions of depression and men’s experiences of depression, which differs from conventional medical views, and which enables GPs to be highly effective in dealing with the mental health issues of their gay patients.
DNA Watermarking Using Codon Postfix Technique

DNA watermarking is a data hiding technique that aims to protect the copyright of DNA sequences and ensures the security of private genetic information. In this paper, we proposed a novel DNA watermarking technique that can be used to embed binary bits into real DNA sequences. The proposed technique mutates the codon postfix according to the embedded bit. Our method was tested for a sample set of DNA sequences and the extracted bits showed robustness against mutation. Furthermore, the proposed DNA watermarking method proved to be secured, undetectable, resistance, and preservative to biological functions.
Accuracy of 3 Brief Screening Questions for Detecting Partner Violence in the Emergency Department

Objective. —To devise a brief screening instrument to detect partner violence and to partially validate this screen against established instruments. Design. —Prospective survey. Setting. —Two urban, hospital-based emergency departments. Participants. —Of 491 women presenting during 48 randomly selected 4-hour time blocks, 322 (76% of eligible patients) participated. Respondents had a median age of 36 years; 19% were black, 45% white, and 30% Hispanic, while 6% were of other racial or ethnic groups; 54% were insured. Interventions. —We developed a partner violence screen (PVS), consisting of 3 questions about past physical violence and perceived personal safety. We administered the PVS and 2 standardized measures of partner violence, the Index of Spouse Abuse (ISA) and the Conflict Tactics Scale (CTS). Main Outcome Measures. —Sensitivity, specificity, and predictive values of the PVS were compared with the ISA and the CTS as criterion standards. Results. —The prevalence rate of partner violence using the PVS was 29.5% (95% confidence interval [CI], 24.6%-34.8%). For the ISA and CTS, the prevalence rates were 24.3% (95% CI, 19.2%-30.1%) and 27.4% (95% CI, 21.7%-33.6%), respectively. Compared with the ISA, the sensitivity of the PVS in detecting partner abuse was 64.5%; the specificity was 80.3%. When compared with the CTS, sensitivity of the PVS was 71.4%; the specificity was 84.4%. Positive predictive values ranged from 51.3% to 63.4%, and negative predictive values ranged from 87.6% to 88.7%. Overall, 13.7% of visits were the result of acute episodes of partner violence. Conclusion. —Three brief directed questions can detect a large number of women who have a history of partner violence.
MHC molecule expression in laryngeal epithelium of patients with laryngopharyngeal reflux compared to normal subjects

Objectives. We recently demonstrated an increase in the MHC-associated molecule, β-2-microglobulin in laryngeal epithelium from patients with laryngopharyngeal reflux (LPR). This could not be accounted for by an increase in MHC Class I, particularly in the superficial layers where Class I is weakly expressed. We hypothesised that this reflected an increase in CD1d, a non-classical MHC molecule. Methods. Posterior laryngeal biopsies were obtained from 10 controls and 11 LPR patients. Multicolour immunofluorescence microscopy was used to measure expression of CD1d, CD161 (NK/NKT marker), CD4/8 T-cells, macrophage, neutrophil and eosinophil antigens. Two-way analysis of variance and unpaired T-tests were performed on transformed data. Results. Expression of CD1d increased from basal to superficial layers, and was marginally raised in LPR (P = 0.067), whilst CD161 increased significantly (P = 0.02). While CD161(+) cells were distributed throughout the epithelium, CD8(+) T-cells were localised to the deep, MHC class I-expressing layers. EMBP was significantly reduced in LPR (P = 0.01). Conclusions. CD1d and MHC class I exhibit reciprocal expression patterns, which are reflected by the distribution of cells expressing their respective ligands (NKT cells and CD8(+) T-cells). An increase in CD1d in LPR may be responsible for the increase in β-2-microglobulin observed, and is associated with a significant increase in NKT-cells. The CD1d-NKT cell axis may be a crucial part of maintaining tolerance in the laryngeal mucosa and changes in this system may be responsible for the persistence of inflammation in LPR.
Sanitoriums and the Canadian Colonial Legacy

Sanitoriums served a much-needed purpose in the age prior to antituberculosis drugs: They removed the infected patient from wider society and created an environment that promoted recovery. We aimed to (a) describe sanitoriums from the perspective of a First Nations reserve community in northern Canada and (b) understand the impact of the sanitorium experience at a community level. Semistructured interviews (n = 15) were conducted in a First Nations reserve community with a high incidence of tuberculosis. Purposive and snowball sampling were used to obtain the sample. Data collection and analysis were iterative, using qualitative content analysis. Participants described the exclusion resulting within and because of sanitoriums. Exclusion within sanitoriums was categorized into (a) the exclusion of Aboriginal culture and practices of healing from the treatment of tuberculosis and (b) the internal exclusion, in which members of the community internally labeled the healed individual postsanitorium as an outsider.
Anti β2 glycoprotein I antibodies: detection and association with thrombosis

Summary. It has been demonstrated that antiphospholipid antibodies (aPL) recognize epitopes formed by anionic phospholipids and protein cofactors. β2 glycoprotein I (β2GPI) is accepted as the cofactor of anticardiolipin antibodies (aCL). In the present study we explored the presence and clinical associations of anti β2GPI antibodies of IgG isotype (aβ2GPI‐IgG), measured by ELISA. We studied sera from 169 patients with aCL and/or lupus anticoagulant (LA), including 52 patients with systemic lupus erythematosus and 49 with primary antiphospholipid syndrome (PAPS). We found 31.9% positive sera for aβGPI‐IgG in the whole population and 48.6% in the aCL‐IgG(+) group. There was a good correlation between the titre of aCL‐IgG and the optical density for aβGPI‐IgG (r= 0.69, P <0.01). The presence of aβ2GPI‐IgG was associated with the presence of aCL‐IgG (P <0.0001) and LA (P <0.0005). However, none of 23 LA (+) patients without aCL had aβ2GPI‐IgG.
Rescue workers' reactions following the hyatt hotel disaster

Abstract The collapse of the skywalks at the Hyatt-Regency Hotel in Kansas City was one of the most traumatic man-made disasters in this country's history. The workers and volunteers who participated in the rescue activities were exposed to numerous stressors that made them at risk for physical and emotional sequelae. The purpose of this study was to describe the physical and emotional reactions and the help-seeking behaviors of these rescue workers. Findings support the need for more primary prevention services for rescure workers.
Facilitating Communication About Sexual Health Between Aging Women and Their Health Care Providers

Many women experience changes in sexual health as they age, and discussing these changes with health care providers is an essential component of optimal health management. The purpose of this study was to understand aging women’s perspectives about communicating with providers about sexual health. We used the integrative model of behavioral prediction as a theoretical lens to explore women’s attitudes, perceived norms, and perceived self-efficacy that promote or inhibit the likelihood of communicating about sexual health. In this theory-based qualitative study, we interviewed 28 community-dwelling older women in the Midwestern United States. Through thematic analysis, we identified both positive and negative attitudes about communicating with providers. Women seemed most inclined to discuss sexual health if they perceived that important patient–provider conditions, such as trust and rapport, were in place. Despite situational obstacles and perceived norms, these women held strong beliefs about their abilities to discuss sexual health topics with providers.
Daughters who care

The study is a comparison ofthe extent of selfreported ill health in adults, and of ill health in children as reported by the "mother figure", between two deprived areas of Belfast, the Divis Flats and the Twinbrook Estate. The study was undertaken at the request of residents in Divis in order to determine whether the bad housing conditions in the Flats had an adverse effect on health independent of that of socioeconomic deprivation. The main result was that, indeed, respiratory conditions and psychological distress in both children and adults, and diarrhoea and vomiting in children, were reported more frequently in the Divis Flats than in the Twinbrook area. However, at the time the survey was commissioned, four of the original twelve blocks in the Divis Flats had been demolished, and the remaining eight were to be refurbished. This was contrary to the wishes of the residents, who wanted to be rehoused. As the data were selected by interview, and the interviewers were mostly local women, the potential for interviewer bias was substantial, although interviewer training (of an unspecified type) was carried out. Respondent bias is also likely to have been a significant problem, since a much higher proportion of residents in the Divis Flats than in the Twinbrook area reported that they thought that the housing defects had an impact on their health. The authors make reference to other studies where self reported measures of ill health and ofhousing defects have been found to be in reasonable agreement with other sources of information, but these validation studies cannot be taken as applicable in the present context. Positive features ofthe study are that the response rate was high, 85% or more in both areas, and that potential confounding variables such as income and smoking behaviour were considered. 203
Seeing in Different Ways

In this article we explore the value of using visual data in a study on medical expert judgment to better understand medical experts’ conceptualizations of complex, challenging situations. We use examples from a larger study on medical expertise in which rich pictures and interviews were used. The three stories presented in this article belong to experts in the domain of surgery. The stories are used to show the ways in which rich pictures can capture and elucidate potentially hidden aspects of the influence of the context in surgical experts’ judgment during challenging operations. We suggest that incorporating visual representations such as rich pictures as research data can aid in understanding previously unarticulated constructions of medical expertise. We conclude that when the researcher strives for capturing complexity, visual methods have the potential to help medical experts deflect from their tendency to simplify descriptions of accounts and to meaningfully engage these individuals in the research process.
Barriers to Male Involvement in Antenatal Care in Rural Mozambique

Low rates of antenatal care (ANC) service uptake limit the potential impact of mother-to-child HIV-prevention strategies. Zambézia province, Mozambique, has one of the lowest proportions of ANC uptake among pregnant women in the country, despite the availability of free services. We sought to identify factors influencing ANC service uptake (including HIV counseling and testing) through qualitative methods. In addition, we encouraged discussion about strategies to improve uptake of services. We conducted 14 focus groups to explore community views on these topics. Based on thematic coding of discourse, two main themes emerged: (a) gender inequality in decision making and responsibility for pregnancy and (b) community beliefs that uptake of ANC services, particularly, if supported by a male partner, reflects a woman’s HIV-positive status. Interventions to promote ANC uptake must work to shift cultural norms through male partner participation. Potential strategies to promote male engagement in ANC services are discussed.