Interview schedule development for a Sequential explanatory mixed method design: complementary-alternative medicine (CAM) study among Indonesian psychologists

Sequential explanatory mixed method design is the most frequently applied in both health and social sciences literature. It is denoted by ‘QUAN → qual’ which represents the quantitative study occurs first and has greater weight in addressing the study’s aims, and the qualitative study follows to explain quantitative results. Despite the extensive use of sequential explanatory design, there are limited references to this design. Therefore, this methodological paper attempts to fill the gap by providing an illustration in developing a sequential explanatory interview schedule based on complementary-alternative medicine (CAM) study among clinical psychologists in Indonesia. The most important step to develop sequential explanatory interview schedule was the construction of aspects and questions that were immensely grounded on the most notable quantitative results. In this study, eight aspects of interview schedule were constructed after analyses of the nationwide survey. The interview schedule then piloted among participants with fairly similar characteristics to the participants in the main interviews. This process enhanced the quality of questions through feedback from participants and improved the interviewer’s skills through familiarization with questions. It is expected that this reflection report could be adopted as a practical guideline in developing interview schedule for sequential explanatory mixed method design, particularly in the field of psychology.     

The case of vegetovascular dystonia: inventing the most common Soviet disease

ABSTRACT

The paper considers the case of vegetovascular dystonia, one of the most typical and common “Soviet” diseases. This syndrome emerged in Soviet medicine after World War II, and very quickly become a popular diagnosis among physicians. The author describes how the construct of vegetovascular dystonia was formed and developed, what changes it underwent, and what affected those changes. The concept and history of vegetovascular dystonia can provide an understanding of Soviet medicine and health science in general.     

Bioecological Implications of Narrative Exposure Therapy in Low‐Resource Settings: Individual,Family, Community,and Socio‐Political Contexts

Traumatic stress can have detrimental effects on individuals, families, and communities. Narrative exposure therapy (NET) is an evidence‐based intervention for decreasing individuals’ post‐traumatic stress disorder (PTSD) symptoms and has been tested in some of the most challenging contexts, such as in post‐conflict refugee camps. Although the focus of NET is on reducing individual PTSD symptoms, the impact of NET can be seen beyond the individual level. The purpose of this paper is to examine some of the ecological implications of using NET with trauma‐affected populations in low‐resource settings. We describe the implications of NET at the family, community, and sociopolitical levels using several case examples. Finally, we outline limitations and future directions for improving the delivery of NET in settings with limited resources.     

An intuitive risk factors search algorithm: usage of the Bayesian network technique in personalized medicine

The article focuses on the application of the Bayesian networks (BN) technique to problems of personalized medicine. The simple (intuitive) algorithm of BN optimization with respect to the number of nodes using naive network topology is developed. This algorithm allows to increase the BN prediction quality and to identify the most important variables of the network. The parallel program implementing the algorithm has demonstrated good scalability with an increase in the computational cores number, and it can be applied to the large patients database containing thousands of variables. This program is applied for the prediction for the unfavorable outcome of coronary artery disease (CAD) for patients who survived the acute coronary syndrome (ACS). As a result, the quality of the predictions of the investigated networks was significantly improved and the most important risk factors were detected. The significance of the tumor necrosis factor-alpha gene polymorphism for the prediction of the unfavorable outcome of CAD for patients survived after ACS was revealed for the first time.     

以服务基层为导向的全科医学人才培养模式的探索

当前，我国基层卫生技术人员队伍建设相对滞后，已经成为制约基层卫生机构发展的瓶颈。医学院校充分发挥人才培养职能，积极探索符合基层医疗服务特点的全科医生培养模式，对推动我国基层医疗卫生服务质量的提高，促进我国医药卫生体制改革的深化具有重要作用。本文对现阶段我国全科医学人才培养中存在的问题进行了分析，介绍了开展全科医学教育的重要意义，并结合辽宁医学院的工作实践，提出了以服务基层为导向的全科医学人才培养的建议和措施。     

培养医学生阅读风格促进中华医药传统文化教育

阅读从来就是培养文化和传承文化的重要途径，阅读风格的培养是涵养医学人文品格的重要内容。重构大学生阅读兴趣，提升医学生阅读层次，通过漫阅读、深阅读、精阅读、动阅读等多元形式，引导大学生在书籍的海洋里涵养身心，以提高医学生全面素质，培养医学人文精神，传承中华医药传统文化。     

Social work stories: situated views and larger visions in disciplinary scholarship and education

ABSTRACT

This paper is about the changing imaginations of social work in an increasingly entangled world. It is also about the ways in which literatures shared across time and space encourage us to identify with larger collectivities. My central argument is that if social work is to find a larger vision in the wake of the failure of a range of modern progress narratives, we must engage differently with the challenge posed by multiplying and sometimes conflicting knowledge communities. Thinking with contemporary debates in transdisciplinary critical social theory, I nominate and explore a number of alternative heuristics—‘generational problematic,’ ‘translational space,’ and ‘imagined communities’—in support of future work on the uneven temporal and spatial communities of affiliation that reproduce and change what social work is, or could be, about. I conclude with theoretical suggestions, and some thoughts toward how social work education might better support incoming generations to locate themselves within the broader life-course of the discipline and profession.     

Development of predictive signatures for treatment selection in precision medicine with survival outcomes

For survival endpoints in subgroup selection, a score conversion model is often used to convert the set of biomarkers for each patient into a univariate score and using the median of the univariate scores to divide the patients into biomarker‐positive and biomarker‐negative subgroups. However, this may lead to bias in patient subgroup identification regarding the 2 issues: (1) treatment is equally effective for all patients and/or there is no subgroup difference; (2) the median value of the univariate scores as a cutoff may be inappropriate if the sizes of the 2 subgroups are differ substantially. We utilize a univariate composite score method to convert the set of patient's candidate biomarkers to a univariate response score. We propose applying the likelihood ratio test (LRT) to assess homogeneity of the sampled patients to address the first issue. In the context of identification of the subgroup of responders in adaptive design to demonstrate improvement of treatment efficacy (adaptive power), we suggest that subgroup selection is carried out if the LRT is significant. For the second issue, we utilize a likelihood‐based change‐point algorithm to find an optimal cutoff. Our simulation study shows that type I error generally is controlled, while the overall adaptive power to detect treatment effects sacrifices approximately 4.5% for the simulation designs considered by performing the LRT; furthermore, the change‐point algorithm outperforms the median cutoff considerably when the subgroup sizes differ substantially.     

Development of the Emergency Department Senior Abuse Identification (ED Senior AID) tool

Emergency departments (EDs) are an important health care setting for the identification of elder abuse (EA). Our objective was to develop an ED-based tool to identify EA. The initial tool included a brief cognitive assessment, questions to detect multiple domains of EA, and a physical examination. Refinement of the tool was based on input from clinical experts and nurse and patient feedback. The revised tool, which included 15 questions about EA, was then tested in an academic ED. We calculated the inter-rater reliability, sensitivity, and specificity of individual EA questions. Among ED patients age≥65 (N = 259), 17 (7%) screened positive for suspicion of EA. We identified a combination of six questions that cover the included domains of EA, demonstrated good or excellent inter-rater reliability, and had a sensitivity and specificity of 94% (95% confidence interval (CI) 71–100%) and 90% (95% CI 85–93%), respectively. These results inform a proposed screening tool for multisite validation testing.     

专家系统驱动的技治主义运动式治理——基于F市创建禁毒示范城市的转译社会学解释

地方政府的治理创新正在出现一种新的趋势：在“稳中求进”的政治考虑下,结合技术治理与运动式治理以实现特定的目标。借鉴拉图尔转译社会学理论,对F市“创城”过程中专家系统的转译行为进行研究发现,转译行动的实施赋予了专家系统行动者的身份,由此编织起的行动者网络能够实现治理资源的流动并促进治理效能的提升,从而形成技治主义运动式治理。作为技治主义运动式治理范式的“创城”是在转译行动建构下的内部转型与外部适配的过程。此种寓技术治理于运动式治理的范式并非简单的要素叠加,而是受到了专家系统的行动建构,将技术与政治进行了结构性整合,以使其匹配现阶段社会治理的总体目标。现实的合理性与治理的有效性是采取这一模式的根本原因。