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Trust and Culture in Rural Research Design
Lacey Andrews,
Joy Butcher-Winfree,
Marianna Linz,
Todd Davies
Issue:
Volume 9, Issue 3, May 2021
Pages:
64-71
Received:
15 April 2021
Accepted:
5 May 2021
Published:
14 May 2021
Abstract: Background: Community isolation, poor economic conditions, intimate group structures and the natural terrain creates unique challenges in both the treatment and study of opioid use disorder (OUD). The maternal and neonatal consequences for OUD can be profoundly altered by co-occurring psychiatric conditions in the mother, a phenomenon that may be more profound in rural communities. Because of these unique issues, the level of direct interaction in a patient-centric rural research design is critical to the effectiveness of the study. Objective: We set out to test the hypothesis that maternal stress and psychological state has a prolonged developmental impact on prenatally exposed children in rural areas by reducing needed stimulation in the caretaking environment. The study quickly changed as we discovered the geographic isolation and health disparate nature of the community had an important implication for research design and data collection. Methods: We used a typical patient-centered study design method for an observational study in rural West Virginia. Results: Original concise designs created complications for participants leading to recruitment difficulties and poor retention. Patients were resistant to study participation related to culture and severe community health disparities that were not identified until the patient population became comfortable with the research team. Conclusion: Despite the cultural and genetic background similarities between patients in less isolated areas and the test site, the geographic isolation and health disparate nature of the community had a profound effect on the research design. The findings in this study suggest a reevaluation of approaches to conducting research in rural isolated areas.
Abstract: Background: Community isolation, poor economic conditions, intimate group structures and the natural terrain creates unique challenges in both the treatment and study of opioid use disorder (OUD). The maternal and neonatal consequences for OUD can be profoundly altered by co-occurring psychiatric conditions in the mother, a phenomenon that may be m...
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Twenty-Five Years of the Partners in Policymaking® Leadership Institute: A Longitudinal Survey of Tennessee Alumni
Bruce Lane Keisling,
Robert Zach DeBerry,
Alexandra Marie Vohs
Issue:
Volume 9, Issue 3, May 2021
Pages:
72-81
Received:
21 April 2021
Accepted:
30 April 2021
Published:
14 May 2021
Abstract: Partners in Policymaking® is a leadership and advocacy training program for adults with disabilities and family members of persons with disabilities. The Tennessee Council on Developmental Disabilities began implementing this intensive seven-weekend program in 1993. Objectives: The lasting influence of such a training program on the advocacy practices and leadership activities of graduates once they have completed the program has not been examined; this was the aim of the study. Methods: A follow-up survey seeking to quantify graduates’ current levels of advocacy, community involvement, accomplishments, and overall satisfaction with the training experience was created and sent to 361 graduates across a variety of formats; one hundred and thirty-five individuals completed the measure. Results: The findings suggest that program completion had a lasting impact on participants’ disability-related knowledge, advocacy, and self-assessed ability to create change in disability-related policy. Specifically, a majority of the graduates affirmed increases in leadership skills, leadership ability, and sense of empowerment. In addition, graduates reported increased feelings of connectedness to others with similar life experiences, with a majority even reporting increased quality of life due to participation. Conclusions: Use of a structured training program in leadership and advocacy to increase perceived self-efficacy in disability policy advocacy and leadership is supported. Graduates’ qualitative comments reveal enduring community activism and engagement in systems change, including statewide and national disability-related policy advocacy, years after completing the program.
Abstract: Partners in Policymaking® is a leadership and advocacy training program for adults with disabilities and family members of persons with disabilities. The Tennessee Council on Developmental Disabilities began implementing this intensive seven-weekend program in 1993. Objectives: The lasting influence of such a training program on the advocacy practi...
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Twenty Years of Deceased Organ Donation in Slovenia: Steps Towards Progress in Quality, Safety, and Effectiveness
Danica Avsec,
Jana Simenc
Issue:
Volume 9, Issue 3, May 2021
Pages:
82-88
Received:
29 March 2021
Accepted:
24 April 2021
Published:
21 May 2021
Abstract: The paper describes 20 years of the thriving evolution of the organ donation system in Slovenia. Even before the turn of the century, Slovenia was a pioneering country in South-East Europe in terms of the organizational, legislative, medical, and ethical development of donor and transplantation medicine. Real progress came in the year 2000 when the national donation and transplant competent organization the Slovenija-transplant (ST) institute was established, modern national legislation was introduced, and the country met the demanding entrance requirements to join Eurotransplant (ET), an international foundation for organ and tissue exchanges. Joining the ET led to improvements in numbers of organs procured from deceased donors, allowed better transplant treatment options for Slovenian patients (especially urgent, hyper sensibilized, etc.), reduced patient waiting lists, while the larger ‘pool’ of patients meant that a suitable match could be found for procured organs. Over the 20 years of deceased donation development, priorities have included assuring the quality, safety, and traceability of human organs, tissues, and cells within an efficient, transparent and ethical transplant system. Great attention has always been placed on frequent, open, transparent, and high-quality communication with the public. Entailing a retrospective study, the article presents analysis of key figures and quality indicators of the Slovenian deceased donation program for the period 2000–2019. Slovenia has stood out for its rate of consent for deceased donation (the 20-year average exceeds 75%), been a world leader in the number of heart transplants per million population (at around 11 heart transplants pmp), and has a consistent deceased donor rate (around 20–22 deceased donors pmp). In the challenging pandemic year of 2020, Slovenia once more demonstrated its quality and professionalism. It was one of the countries that best adapted to the crisis. With regular videoconferences on a daily/weekly basis that included professionals and the frequent alteration of safety protocols, the national deceased and transplantation programs were able to remain active and without drops in numbers. The quality of organs and safety for patients was not under threat. Statistics for 2020 show that even more deceased donors and transplantations were performed than in 2019. The article provides an example of good practice of adaptation of the world renowned “Spanish donation model” to suit a specific national context. The findings are useful and transferable to clinical settings in other smaller countries that still need to establish national organ and tissue donation programs. Unfortunately, in many countries around the world (even in Europe), transplant treatment is neither available nor accessible to many patients in need.
Abstract: The paper describes 20 years of the thriving evolution of the organ donation system in Slovenia. Even before the turn of the century, Slovenia was a pioneering country in South-East Europe in terms of the organizational, legislative, medical, and ethical development of donor and transplantation medicine. Real progress came in the year 2000 when the...
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Utilization of Iodized Salt and Associated Factors Among Pregnant Mothers in Kimbibit District, North Shoa Zone, Oromia Regional State, Ethiopia
Tola AberaTesema,
Haji Aman Deybasso,
Ebrahim Mohammed Gebaba
Issue:
Volume 9, Issue 3, May 2021
Pages:
89-99
Received:
3 May 2021
Accepted:
7 June 2021
Published:
21 June 2021
Abstract: Globally, it has been reported that 38% of people live in areas with iodine deficiency and are at risk of its complications. The main health concern of iodine deficiency during pregnancy is its negative effect on the brain and nervous system of unborn infants. Despite the national availability of iodized salt was 89%, adequate utilization of iodized salt is only 41.9%. Hence, this study was to assess utilization of iodized salt and factors associated among pregnant mothers in Kimbibit District. Community based cross-sectional study design was conducted. Simple random sampling technique was used to select a total sample of 555 pregnant mothers. Single population proportion formula and Stat. calc software were used to calculate the required sample size. Data were collected using interview administered pretested questionnaire and iodized salt test kit. Collected data were entered using Epi info 7 and then exported to SPSS 20 for further analyses. Descriptive statistics were used to describe important variables and binary logistic regression was used to identify candidate independent variables. P< 0.05 was used for testing significance and AOR with 95%CI was used to identify the strength of association between dependent and independent variables. From the total respondents, 48.1% (95%CI: 44.1%, 52.1%) of them adequately use iodized salt. Mother with formal education (AOR, 2.46; 95%CI: 1.70, 3.56), urban residents (AOR, 1.80; 95%CI: 1.14, 2.93), purchasing from open markets (AOR, 0.35; 95%CI: 0.23, 0.50), storing at sun light (AOR, 0.24; 95%CI: 0.13, 0.45) and storing more than two months (AOR, 0.64; 95%CI: 0.42, 0.98) were independent factors significantly affect adequate utilization of iodized salt. Utilization of iodized salt was low compared to the standard. Mother’s education, residence, place of purchase, place of storage and duration of storage were independent factors which significantly affect adequate utilization.
Abstract: Globally, it has been reported that 38% of people live in areas with iodine deficiency and are at risk of its complications. The main health concern of iodine deficiency during pregnancy is its negative effect on the brain and nervous system of unborn infants. Despite the national availability of iodized salt was 89%, adequate utilization of iodize...
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