Resilience research and policy/practice discourse in health, social, behavioral, and environmental sciences over the last ten years.
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BACKGROUND: Resilience research has gained increased scientific interest and political currency over the last ten years. OBJECTIVE: To set this volume in the wider context of scholarly debate conducted in previous special theme issue and/or special section publications of refereed journals on resilience and related concepts (1998-2008). METHOD: Peer reviewed journals of health, social, behavioral, and environmental sciences were searched systematically for articles on resilience and/or related themes published as a set. Non-English language publications were included, while those involving non-human subjects were excluded. RESULTS: A total of fifteen journal special issues and/or special sections (including a debate and a roundtable discussion) on resilience and/or related themes were retrieved and examined with the aim of teasing out salient points of direct relevance to African social policy and health care systems. Viewed chronologically, this series of public discussions and debates charts a progressive paradigm shift from the pathogenic perspectives on risk and vulnerability to a clear turn of attention to health-centered approaches to building resilience to disasters and preventing vulnerability to disease, social dysfunction, human and environmental resource depletion. CONCLUSION: Resilience is a dynamic and multi-dimensional process of adaptation to adverse and/or turbulent changes in human, institutional, and ecological systems across scales, and thus requires a composite, multi-faceted Resilience Index (RI), in order to be meaningfully gauged. Collaborative links between interdisciplinary research institutions, policy makers and practitioners involved in promoting sustainable social and health care systems are called for, particularly in Africa. (+info)
Teaching dental students how to deliver bad news: S-P-I-K-E-S model.
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Delivering bad news has traditionally been associated with life-threatening illness, the imminence of death, or communicating about the death of a loved one to a family member. The delivery of bad news in dentistry is rarely about life-threatening circumstances. However, the impact of the bad news such as the loss of an anterior tooth can be devastating for the patient. This article outlines the S-P-I-K-E-S protocol and discusses the teaching aims and methodology in applying the model in an undergraduate dental program in Ireland. (+info)
Defining behavior-environment interactions: translating and developing an experimental and applied behavior-analytic vocabulary in and to the national language.
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Interdisciplinary direct observation: impact on precepting, residents, and faculty.
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BACKGROUND: Direct observation of residents for training and assessment is a core recommendation in medical education policy initiatives. Limited research exists about the impact of direct observation on precepting, and we are unaware of any research examining the impact of interdisciplinary precepting on trainees or preceptors. Over the past 3 years we have implemented an Interdisciplinary Direct Observation Precepting Model (IDOPM). Residents are directly observed via closed-circuit television by a behavioral scientist and family physician team. METHODS: Surveys and focus groups were used to examine the impact of the IDOPM. Authors analyzed survey responses and focus group transcripts using an immersion/crystallization approach to arrive at themes. RESULTS: Between February and June 2009, 24 residents, 14 physician faculty, and eight behavioral science faculty members participated in 19 IDOPM clinics. Eighty-two percent of residents and 95% of faculty responded to surveys. Key findings were (1) Residents and faculty report addressing topics that are not usually discussed in traditional precepting, including communication skills, time management, electronic medical record use, responding to emotional complexity, and physical exam skills, (2) The model reinforced a biopsychosocial approach to care, (3) Residents report ambivalent feelings about being observed, and (4) Faculty value the team approach to strengthen training and promote faculty development. CONCLUSIONS: The IDOPM addresses many core skills that are overlooked in traditional precepting encounters. Interdisciplinary direct observation may strengthen faculty ability to provide formative competency assessment in preparing residents to work in the complex world of primary care. (+info)
The summer institute in clinical dental research methods: still going and growing after twenty years.
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The first Summer Institute in Clinical Dental Research Methods, a faculty development program at the University of Washington, was offered in the summer of 1992 for sixteen participants. The primary objective of the program was to give clinical faculty members in dentistry an introduction to and an understanding of the fundamental principles and methods used in good clinical research. In the twentieth offering of the institute in 2011, there were thirty-five participants, and over the twenty institutes, there has been a cumulative total of 463 participants who have come from thirty U.S. states as well as forty-three countries outside the United States. The curriculum has expanded from the initial offering of biostatistics, clinical epidemiology, behavioral research methods, and ethics in clinical research to now include clinical trials, grantsmanship, data analysis, an elective in molecular biology, and a team project that provides participants with hands-on experience in research proposal development as members of an interdisciplinary team. Enrollment has doubled since the first year, yet exit evaluations of the program content have remained consistently high (rated as very good to excellent). One of the indicators of program quality is that at least 50 percent of recent participants indicated that they attended because the program was recommended by colleagues who had attended. There seems to be an ever-increasing pool of dental faculty members who are eager to learn more about clinical research methodology through the institute despite the intensive demands of full-time participation in a six-week program. (+info)
Translational research and behavioral sciences in developmental medicine: metabolic conditions of pregnancy versus autism spectrum disorders.
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Recently, scientific literature informed that metabolic conditions in pregnant women may be associated with increased risk for autism and other neurodevelopmental disorders in their offspring. In a cohort study of more than 1000 children between the ages of 2 and 5 years, those who had mothers classified as having "metabolic conditions" (which included diabetes, hypertension, and obesity) during pregnancy were at a significantly higher risk for developing an autism spectrum disorder (ASD) and neurodevelopmental delays. In addition, mothers with obesity were 1.6 times more likely to have a child with ASD and more than twice as likely to have a child with other developmental problems. In the United States, the prevalence of obesity among women of childbearing age is 34%. Moreover, with obesity rates rising steadily, these results appear to raise serious public health implications. The main objective of this Editorial is to propagate the health care improvement based on the translation research approach from basic behavioral sciences and relevant integrative neuroscience to pressing clinical issues that include an understanding of the etiology and assessment of disorders, and the assessment of functioning and development of innovative and culturally appropriate preventive treatment. Behavioral interventions for weight management in pregnancy may include the Transtheoretical Model (TTM) employed in obese pregnant women and then, the comparison with elements of the ecological model. A comparative effectiveness design is to test the effect of tailoring while including one of the most important predictors of screening-physician recommendation: after careful selection of analyzed behaviors from the TTM approach. However, there is also a risk that the evidence may not be conclusive for sustained weigh loss as a primary outcome of the proposed intervention, although the TTM in combination of physical activity and diet tended to produce significant results. Therefore, physicians might use the TTM to convince pregnant women to regulate weight and educate future parents on how to deal with autism at an early age of their children using watchful waiting management. (+info)