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Contextual factor

Ankeet Shah, Nima Nassiri, Siamak Daneshmand
PURPOSE OF REVIEW: Management of extraretroperitoneal (ERP) germ cell tumor (GCT) is a complex clinical scenario faced by urologic oncologists. This article reviews the indications and approach to management of ERP GCT masses. RECENT FINDINGS: ERP GCT management starts with chemotherapy, and for any residual masses, a careful consideration of surgical intervention versus salvage chemotherapy. Decision-making regarding residual ERP masses hinges on tumor markers, and also the anatomical location...
October 16, 2018: Current Opinion in Urology
Carol S Camlin, Janet Seeley
INTRODUCTION: Very few pragmatic and community-level effectiveness trials integrate the use of qualitative research over all stages of the trial, to inform trial design, implementation optimization, results interpretation and post-trial policy recommendations. This is despite the growing demand for mixed methods research from funding agencies and awareness of the vital importance of qualitative and mixed methods research for understanding trial successes and challenges. DISCUSSION: We offer examples from work we have been involved in to illustrate how qualitative research conducted within trials can reveal vital contextual factors that influence implementation and outcomes, can enable an informed adaptation of trials as they are being conducted and can lead to the formulation of theory regarding the social and behavioural pathways of intervention, while also enabling community engagement in trial design and implementation...
October 2018: Journal of the International AIDS Society
Farshad A Mansouri, Mark J Buckley
Psychophysical studies in humans indicate that the performance in various tasks is affected by contextual factors such as conflict level and error commission. It is generally believed that contextual factors influence the executive control processes and consequently modulate ongoing behaviour. Imaging studies suggest that dorsolateral prefrontal cortex and anterior cingulate cortex play crucial roles in mediating these context-dependent adjustments in executive control of behaviour. However, the underlying neuronal processes are to a great extent unknown...
2018: Advances in Neurobiology
Emily M Becker-Haimes, Kelsie H Okamura, Constance D Baldwin, Edward Wahesh, Christopher Schmidt, Rinad S Beidas
Reports on the behavioral health workforce highlight the need to enhance evidence-based capacity; evidence-based interventions incorporated into pre-service graduate curricula (coursework and fieldwork) are needed to meet this goal. Improving educational practices across pre-service settings will require understanding of and careful attention to the contextual factors that exert pressure on curricula. The authors believe efforts to change educational practices can be enhanced by application of implementation science principles...
October 18, 2018: Psychiatric Services: a Journal of the American Psychiatric Association
Jae Eun Shim, Seo-Jin Kim, Kirang Kim, Ji-Yun Hwang
Different contextual factors of a household and a community, such as access to resources and transportation, may influence the level of food insecurity. The objective of this study was to identify how food environmental factors and economic resources were related to food insecurity in Korean older adults residing in different contexts of rural areas. Face-to-face interviews with 248 older adults residing in land ( n = 149) and mountain ( n = 99) rural areas were performed. In both areas, risk of food insecurity was increased for households with limited community food accessibility measured by having difficulties in food purchasing due to food stores far from home...
October 16, 2018: Nutrients
Bushra Sabri
African immigrant women survivors of cumulative trauma are at high risk for HIV infection. This study aims to identify survivors' perceptions of (a) contextual (i.e., community, and relationship) and individual-level risk and protective factors for HIV among African immigrant women in the United States and (b) areas and strategies of HIV prevention intervention at contextual and individual levels. Qualitative data for this study were collected from African-born women (n = 39) in Maryland, Virginia, and Washington, DC, from February 2017 to March 2018...
October 2018: AIDS Education and Prevention: Official Publication of the International Society for AIDS Education
Marisa Felsher, Zsofia Szep, Douglas Krakower, Ana Martinez-Donate, Nguyen Tran, Alexis M Roth
The Health Belief Model has been useful for studying uptake of HIV prevention behaviors and has had limited application to understanding utilization of pre-exposure prophylaxis (PrEP), a biomedical strategy to reduce HIV acquisition. We recruited 90 persons undergoing HIV screening and educated them about PrEP. We followed up with 35 participants approximately 3 weeks later and quantitatively assessed PrEP uptake. No participant had initiated PrEP. We conducted in-depth interviews with 15 participants to explore situational factors impacting this decision...
October 2018: AIDS Education and Prevention: Official Publication of the International Society for AIDS Education
Stephen Barrett, Stephen Begg, Michael Kingsley
BACKGROUND: The high prevalence of non-communicable diseases places significant demands on the healthcare system. As a result, hospitals are seeking to broaden their role to include more integrated health promotion. Strong leadership at different levels of the organisation is required for the successful integration of health promotion in hospital settings. The status of surgeons within healthcare affords them significant influence over clinical practice, and by extension, institutional policy and practice...
October 16, 2018: BMC Health Services Research
Godswill N Osuafor, Sonto M Maputle, Natal Ayiga
BACKGROUND:  Sexual and reproductive decision-making has emerged as an important health indicator in family reproductive health issues. While there is evidence of male dominance in sexual and reproductive health decisions, the role of socio-demographic factors on women's decision to use contraception is not well understood. AIM:  This study aimed at exploring the socio-demographic factors associated with married women's decision-making to use contraception. SETTING:  The study was conducted in Mahikeng local municipality in the Modiri Molema District Municipality...
October 11, 2018: African Journal of Primary Health Care & Family Medicine
Elizabeth K Darling, Karen Marie Olsen Lawford, Kathi Wilson, Michelle Kryzanauskas, Ivy Lynn Bourgeault
INTRODUCTION: Little is known about the relationship between distance from hospital services and the outcomes of planned home births. We examined whether greater driving distance from a hospital with continuous cesarean capability was associated with a higher risk of adverse neonatal outcome among individuals who were planning to give birth at home. METHODS: Using an intention-to-treat analysis, we conducted a population-based cohort study of 11,869 individuals who planned to give birth at home in Ontario, Canada, between April 1, 2012, and March 31, 2015...
October 16, 2018: Journal of Midwifery & Women's Health
Apostolos Gkatzionis, Stephen Burgess
Background: Selection bias affects Mendelian randomization investigations when selection into the study sample depends on a collider between the genetic variant and confounders of the risk factor-outcome association. However, the relative importance of selection bias for Mendelian randomization compared with other potential biases is unclear. Methods: We performed an extensive simulation study to assess the impact of selection bias on a typical Mendelian randomization investigation...
October 15, 2018: International Journal of Epidemiology
Verena Menec, Cara Brown
This interpretive review examined the empirical evidence of the factors that facilitate or hinder the implementation of age-friendly community and city (AFCC) initiatives. Thirteen studies were included in the review. Findings show three themes: enablers (consisting of the subthemes of multilevel leadership and a common vision, effective governance and management, and diverse partnerships); process-related factors (e.g., linking to other strategies); and contextual factors (e.g., rural/urban). Moreover, several underlying influencers intersect with these themes, such as how age-friendliness is conceptualized...
October 15, 2018: Journal of Aging & Social Policy
Victoria Shepherd, Kerenza Hood, Mark Sheehan, Richard Griffith, Amber Jordan, Fiona Wood
BACKGROUND: Research involving adults lacking mental capacity relies on the involvement of a proxy or surrogate, although this raises a number of ethical concerns. Empirical studies have examined attitudes towards proxy decision-making, proxies' authority as decision-makers, decision accuracy, and other relevant factors. However, a comprehensive evidence-based account of proxy decision-making is lacking. This systematic review provides a synthesis of the empirical data reporting the ethical issues surrounding decisions made by research proxies, and the development of a conceptual framework of proxy decision-making for research...
October 15, 2018: AJOB Empirical Bioethics
J Kevin Dorsey, Austin M Beason, Steven J Verhulst
PROBLEM: The traditional clerkship model of brief encounters between faculty and students results in reduced meaningful learning opportunities due to the lack of a relationship that enables repeated observation, supervisor feedback, trust formation, and growth. INTERVENTION: Clinical clerkships at our institution were restructured to decrease fragmentation of supervision and foster an educational alliance between faculty and student. A mixed-methods approach was used to study the impact of this curriculum reform on the student experience in the obstetrics and gynecology clerkship...
October 15, 2018: Teaching and Learning in Medicine
Ana Oliveira, Raquel Martinho, Paula Serrão, Mónica Moreira-Rodrigues
Epinephrine (EPI) strengthens contextual fear memories by acting on peripheral β2 -adrenoceptors. Phenylethanolamine- N -methyltransferase-knockout (Pnmt-KO) mice are EPI-deficient mice and have reduced contextual fear learning. Our aim was to evaluate the molecular mechanisms by which peripheral EPI strengthens contextual fear memory and if a β2 -adrenoceptor antagonist can erase contextual fear memories. Pnmt-KO and wild-type (WT) mice were submitted to fear conditioning (FC) procedure after treatment with EPI, norepinephrine (NE), EPI plus ICI 118,551 (selective β2 -adrenoceptor antagonist), ICI 118,551 or vehicle (NaCl 0...
2018: Frontiers in Molecular Neuroscience
Torhild Holthe, Flavia Dias Casagrande, Liv Halvorsrud, Anne Lund
INTRODUCTION: The ageing population has been described as a grand societal challenge worldwide, and access to technology is one important strategy for meeting this challenge. The Assisted Living Project has a responsible research and innovation approach and includes older adults in evaluating sensor-based functions in assisted living facilities. The purpose of involving users in research is to enhance a wider dialogue about the values, methods, and purposes of the research project. METHODS: We carried out a feasibility study in order to inform the development and conduct of a pilot project with eight residents...
October 14, 2018: Disability and Rehabilitation. Assistive Technology
Kristine Bærøe
In this commentary on Williams and colleagues' paper, I will address some essential issues related to research on contextual factors that influence value decision-making in healthcare. Based on the presumption that scientific work requires coherence in its ontological, epistemological and methodological approaches, I identify some challenges in their text and reflect on how those challenges might be addressed. I recommend that more normative work be done to make this a comprehensive area of research and suggest that the fundamental premises structuring investigations in this field be explicitly clarified...
June 30, 2018: International Journal of Health Policy and Management
Stephen Maluka
BACKGROUND: In the attempt to move towards universal health coverage (UHC), many low- and middle-income countries (LMICs) are actively seeking to contract-out non-state providers (NSPs) to deliver health services to a specified population. Research on contracting-out has focused more on the impact of contracting-out than on the actual processes underlying the intervention and contextual factors that influence its performance. This paper reports on perceptions of stakeholders on contracting-out faith-based hospitals through service agreements (SAs) to provide primary healthcare services in Tanzania...
May 22, 2018: International Journal of Health Policy and Management
G D Sclar, G Penakalapati, B A Caruso, E A Rehfuess, J V Garn, K T Alexander, M C Freeman, S Boisson, K Medlicott, T Clasen
The WHO defines health not as the absence of disease but as a "state of complete physical, mental, and social well-being." To date, public health research on sanitation has focused mainly on the impact of sanitation on infectious diseases and related sequelae, such as diarrhea and malnutrition. This review focuses on the mental and social well-being implications of sanitation. We systematically searched leading databases to identify eligible studies. Qualitative studies were assessed using a 17-point checklist adapted from existing tools, while quantitative studies were assessed using the Liverpool Quality Appraisal Tool...
September 19, 2018: Social Science & Medicine
Chia-Yuan Yu, Ayoung Woo, Christopher Hawkins, Sara Iman
BACKGROUND: This study examined the association between residential segregation and obesity for Whites, African Americans, Hispanics, and Asians. This study considered 3 dimensions of residential segregation, isolation, dissimilarity, and concentration. METHODS: By combining individual-level data from the Behavioral Risk Factor Surveillance System and county-level data from the County Health Rankings and Roadmaps, the total sample size was 204,610 respondents (160,213 Whites, 21,865 African Americans, 18,027 Hispanics, and 4505 Asians) from 205 counties in the United States...
October 12, 2018: Journal of Physical Activity & Health
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