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In the emotionally intense field of healthcare, the ability to peacefully inhabit one's body, maintain good boundaries, and be fully present during care is essential. This study aimed to validate the recently developed Mindful Self-Care Scale (MSCS) among hospice and healthcare professionals and develop a brief version of the 33-item MSCS.
A sample of hospice and healthcare professionals from all 50 states (n = 858) was used. A confirmatory factor analysis was run using a rigorous methodology for validation and item reduction to develop a brief version of the 33-item MSCS. The brief MSCS (B-MSCS) was developed by identifying items for exclusion through examination of conceptual overlap, descriptive statistics by detecting sources of improvement model fit using confirmatory factor analysis. Model modifications were done sequentially and with regard to theoretical considerations.
The existing model, 33-item MSCS with six subscales, had good fit to the data with all indicators in acceptable ranges (chi-square/df = 3.08, df (480), p < 0.01, root mean square error of approximation = 0.059, comparative fit index = 0.915, Tucker and Lewis's index of fit = 0.907). Nine items were excluded on the basis of very low loadings and conceptual and empirical overlap with other items.
Significance of results
The final 24-item, B-MSCS model was consistent with the original conceptual model and had a closer fit to the data (chi-square/df = 1.85, df (215), p < 0.01, root mean square error of approximation = 0.041, comparative fit index = 0.961, Tucker and Lewis's index of fit = 0.955). In addition, the reliability, construct, and concurrent validity of the MSCS and B-MSCS were in the acceptable and good ranges, respectively. Mean and standard deviation of the MSCS and B-MSCS scores were similar; B-MSCS mean scores well approximated the MSCS scores. Informal mindful self-care, in the process of everyday life, was practiced more regularly and associated with increased wellness and reduced burnout risk than formal mind-body practices.
Conceptual models (CMs) are useful tools for researchers and health technology assessment bodies to understand the interplay among environmental characteristics (e.g., health care system), patient characteristics, health behaviors, and patient outcomes. The objective of this pilot study was to elicit perspectives of patients with atrial fibrillation (AF) and health care providers (HCPs) to develop a patient-centered CM of the AF patient experience in a US-based sample.
We developed two preliminary versions of the Andersen model of healthcare utilization (standard and patient-friendly versions) based on the published literature and the help of a patient advisor. For example, instead of describing “predisposing characteristics,” the patient-friendly CM describes, “what is it about me, or other afib patients that could impact disease or outcomes;” “enabling resources” is swapped for “helpful resources,” and “perceived need” is changed to “what impacts whether I believe I need to be treated”. Five patients from an online patient community and 10 HCPs from the University of Maryland Medical System provided feedback on the preliminary models. Audio recordings of interviews were transcribed verbatim, analyzed, and findings incorporated into a revised CM.
Interviewee additions under “what impacts whether I believe I need to be treated” included: absence of symptoms and fear of experiencing an AF episode; under “helpful resources” suggested additions include resources for navigating insurer formulary/benefits. Suggested additional outcomes of interest include anxiety, bruising, and shortness-of-breath. While patients found the patient-friendly version easy to understand, HCPs required explanation of standard-version headers, for example ‘predisposing characteristics’ and ‘enabling resources’, which had been adapted in the patient-friendly version.
Soliciting input from stakeholders ensures CMs are pragmatic, reflect the real-world experiences of patients and HCPs, and incorporate variables or other considerations not currently described in published literature. Researchers can utilize CMs to aid in selection of variables for observational studies.
Dementia can interfere with the maintenance of social interactions. The ability to participate in social interactions is one of the elements that enables good social health (Hubert et al., 2011), and having dementia does not automatically eliminates the person's opportunity to have good social health (Vernooij-Dassen and Jeon, 2016). We highlighted in a previous study that people with dementia who did not know each other interacted spontaneously when they were in a stimulating social interaction setting (Mabire et al., 2016). However, a lack of activity and social interaction in nursing homes is still a widespread issue (Harper Ice, 2002). Stimulation of social interactions is rarely used as an intervention and social interactions are seldomly used as social health related outcomes.
The present study aimed to identify themes emerging from an inclusive therapeutic recreational camp experience for children with disabilities who attended a 10-day summer camp. Concept mapping was used to analyse the experience of 42 participants. Results emerged with seven themes: Personal Growth; Nurturing Relationships; Non-judgmental Environment and Attitude; Traditional/Classic Camp Fun; Beneficial and Unique Opportunities; Learning/Thinking with Structures and Rules; and Independence and Recognition. Results suggested that children with disabilities experienced positive personal growth and learned new skills from an integrated, therapeutic camp. These children benefited from the social and psychological aspects of the camp experience, as well as the learned skillset and behaviours. Clinical implications and future research directions are also discussed.
We report three cases of an abnormal finding of duplicated left pulmonary artery: two of these occurring in children with Kabuki syndrome and configuring the setting of a pseudo-pulmonary sling without any clinical or cardiac cross-sectional evidence of tracheal compression. The other case instead represents duplicated left pulmonary artery with pulmonary sling caused by the retro-tracheal course of the lower left pulmonary artery associated with “Christmas Tree” arrangement of the tracheo-bronchial system.
In both patients with pseudo-pulmonary sling and Kabuki syndrome, the abnormal finding was incidental during echocardiographic examination and neither of the patients required surgical repair for the condition. To the best of our knowledge, they represent the third and fourth cases in which such an anomaly of the pulmonary artery branches not forming a sling is seen in association with Kabuki syndrome. Another case represents our second experience and the second case reported in literature with duplicated left pulmonary artery in the setting of a complex tracheal anatomy. In this symptomatic patient, surgical repair of atrial septal defect and relief of the vascular ring were indicated, and the surgical repair was performed successfully at the age of 3 years.
An Upper Palaeolithic engraving of a female figure has recently been discovered on the base of a naturally hollowed limestone slab possibly used as a bowl or lamp, found in the cave of Courbet (Penne-Tarn, France) and preserved in the British Museum. The slab, decorated on the dished side with linear incisions, and the female figure are described in detail. The occurrence of a female engraving on a utilised slab is found to be unique to date but the relationship of the figure to the support is questioned and discussed. The female engraving is compared with others known from Germany, as well as Quercy and Périgord, France. On the basis of these comparisons and radiocarbon age estimates, the engraved slab is attributed to Magdalenian VI.
Very high surface area nanostructured metal electrodes are of interest as efficient current collectors. For thin film devices, the nanostructured metal can be grown in place using electrodeposition or electroless deposition. For larger devices metal electrodes structured at more than one length scale are desirable. Self-assembling surfactant templates are a versatile method of generating a range of nanostructures. As we report here, electrodeposition of nickel, cobalt and copper from liquid crystalline solutions of Triton X-100 produces a number of nanostructures, with significant surface area increases. Electrodeposition into templates with microstructure has proven more demanding. Oil-in-water Microemulsions of Tween surfactants and soy oil, produce micrometer scale structures, however measured nickel surface area does not scale with sample thickness. The method is also not robust, and was found to give microstructures only for nickel and cobalt. Experiments show that under our conditions a combination of nickel metal, nickel acetate and nickel/detergent microstructures are formed.
Tricolored Blackbird Agelaius tricolor is a rapidly declining species largely endemic to California and forms larger breeding colonies than any other extant North American landbird following the extinction of Passenger Pigeon Ectopistes migratorius. We present information on its distribution, breeding habitat and changes in global population size using data collected since the 1930s. We also present data on reproductive success at 103 colonies between 1992 and 2003. While possibly once the most abundant bird throughout much of its range, it declined by over 50% between the 1930s and early 1990s, and by a further c. 56% between 1994 and 2000. The global population is now smaller than the historic size of some individual breeding colonies. Reproductive success was significantly higher in upland non-native vegetation (primarily Himalayan blackberry Rubus discolor) than in native emergent cattail Typha spp. and bulrush Scirpus spp. marshes, its likely predominant historic breeding habitat. Contemporary losses of important upland nesting substrate, combined with low reproductive success in native habitats and complete breeding failure in harvested agricultural fields, are the most likely causes of recent declines. Recovery of this species presents possible conflicts in conservation policy because successful reproduction now largely depends on invasive non-native plants and the willingness of farmers to delay harvest or to lose portions of their crops.
This paper was written for a special issue of the Ekaterinburg Architecton devoted to the rich Constructivist heritage of that hitherto closed city beyond the Urals. Docomomo-Russia has an active working party there, but the combination of public poverty and vigorous real-estate pressures is making the fate of these buildings uncertain. This paper sought to offer some fundamental structuring ideas to the debate. We publish it here to stimulate discussion of problems also current elsewhere, but the author stresses that it should be read with its original purpose and audience in mind.