Formative research methods to understand patient and provider responses to heart attack symptoms

Formative research is often required for program planning, and for reducing uncertainty about generalizability of program effects. This article describes and justifies methods of formative research conducted for the REACT study (Rapid Early Action for Coronary Treatment), a multi-center collaborative randomized community trial aimed at reducing patient delay in seeking care for acute myocardial infarction (AMI). Formative research cast light on patient and community members’ decision-making process in seeking help for AMI, as well as barriers and facilitators of this process. Investigators at all five REACT Field Centers participated in the formative research. The process consisted of: (1) developing a common theoretical framework for the study intervention; (2) conducting a literature review and qualitative research to identify and address gaps in knowledge; and (3) developing a common protocol for the REACT study that accommodated the diversity of the target communities in terms of services, resources, history, and ethnicity. Analysis employed triangulation, defined as an explicit search for heterogeneous data sources to reduce uncertainty about forces at work and opportunities for intervention across settings and populations. Because the collection and interpretation of data went in stages, staff of several REACT Field Centers had independent input to the overall synthesis, then shared and revised the results. Advantages and limitations of this approach are discussed.     

Vocal determinants of first impressions of young children

Audiotapes of the voices of77 preschool children were prepared. Subjects listened to the tapes, and then provided their impressions of the competence, leadership, dominance, warmth, and honesty of the children. Judgments of the voices' babyishness and attractiveness were also obtained. Perceivers reliably discriminated the children's voices along the dimensions of babyishness and attractiveness. Moreover, analyses revealed that the previously documented impact of these characteristics on first impressions of adults extends to impressions of young children. The similarity of the effects of these characteristics on impressions formed about children to those revealed for adults suggests that vocal qualities may have an impact on personality development via a process of self-fulfilling prophecy.     

Having a say in health: involving young people with a chronic illness or physical disability in local health services development

Increasing attention is being paid to involving users in local NHS service development, and to involving young people as users in their own right. However, we know little about the views and experiences of young participants, especially those with a chronic illness or physical disability, which could inform more effective approaches to their involvement. The paper reports on research investigating the views of young patients and staff who have taken part in NHS service development projects, and suggests a range of issues for consideration when involving young patients in future. Copyright © 2002 John Wiley & Sons, Ltd.     

The Pune Slum Census: creating a socio-economic and spatial information base on a GIS for integrated and inclusive city development

Urban planning systems rarely include the poor. Cities are growing and so is the urban population. Pune is a large city in Western Maharashtra. According to the National Census, 2001, the population of the Pune urban agglomeration is 3.5 million and it is (in some estimates) to reach nearly 6 million by 2021.¹ Out of this, the city of Pune has a 2.5 million people living in it. Forty percent and above of the population live in slums. One of the biggest shortfalls of Pune's urban planning is that it still fails to include the poor in mainstream policies. The reason is that the poor are hardly known about, in fact, even government authorities are unaware about how many poor people there are in Pune. This attitude, and the fact that Shelter Associates (SA) work is closely connected with the poor regarding basic services and housing, started the development of a slum database by SA. Finally, the Pune Municipal Corporation asked us to make a complete census of the slum dwellers in the year 2000. That gave rise to a detailed survey of Pune's slum dwellers, to become, amongst other things, the first ever spatial and socio-economic census processed and analysed on a geographical information system (GIS). The Pune Slum Census has built upon this experience and expanded the communities’ information base, and has created a methodology which the city can use to work on detailed urban planning using a GIS and with the slum database as the base. This article focuses on the Pune Slum Census in progress.     

Engaging Indigeneity in Development Policy

This article explores how development programming in rural poverty and the environment can work with indigenous peoples. It draws on research conducted in Asia and Latin America to suggest how indigeneity can be understood as specific kinds of marginalisation intersecting with self‐identification and recognition as indigenous. Current obstacles to effective engagement with indigenous peoples are outlined, and suggestions are offered for pro‐actively addressing their experience. Two critical areas where there are opportunities for donors to support indigenous peoples' priorities include ‘FPIC’ (Free Prior and Informed Consent) and a careful consideration of the implications of niche‐market engagement.     

Career Counseling in a Volatile Job Market: Tiedeman's Perspective Revisited

This article explores implications of Tiedeman's original theory for career counselors. Some components of the theory seem to be compatible with existing volatile job market conditions. Notions of career path recycling, development in reverse, nonlinear progress, and parallel streams in career development are explored. Suggestions are made for counseling interventions and future research using this perspective.     

The Time Squeeze: Parental Statuses and Feelings About Time With Children

Policy makers, parents, and the public are concerned with perceived declines in parents’ time with children. Data from two national surveys (N = 1,159 and N = 821) used in this study show that nearly half of parents report feeling too little time with children. Work hours are strongly related to these feelings, even controlling for time spent with children, and explain why fathers more than mothers feel time strain. For fathers, those whose youngest child is an adolescent feel more strain than similarly situated mothers. Controlling for work hours, single parents are not more likely than married parents to feel that they spend insufficient time with children.     

Discovering Spatio-Temporal Models of the Spread of West Nile Virus

Emerging infectious diseases are characterized by complex interactions among disease agents, vectors, wildlife, humans, and the environment. Since the appearance of West Nile virus (WNV) in New York City in 1999, it has infected over 8,000 people in the United States, resulting in several hundred deaths in 46 contiguous states. The virus is transmitted by mosquitoes and maintained in various bird reservoir hosts. Its unexpected introduction, high morbidity, and rapid spread have left public health agencies facing severe time constraints in a theory-poor environment, dependent largely on observational data collected by independent survey efforts and much uncertainty. Current knowledge may be expressed as a priori constraints on models learned from data. Accordingly, we applied a Bayesian probabilistic relational approach to generate spatially and temporally linked models from heterogeneous data sources. Using data collected from multiple independent sources in Maryland, we discovered the integrated context in which infected birds are plausible indicators for positive mosquito pools and human cases for 2001 and 2002.