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"Little, Emily"
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Trojan horse : how the Greeks won the war
Recounts how the Greeks used a wooden horse to win the Trojan War.
Book
Cultural Variation in Triadic Infant-Caregiver Object Exploration
Two studies examined the extent to which the type of triadic interaction pervasive in Western populations (i.e., shared visual attention and ostensive pedagogical cues) was representative of infant–caregiver object exploration in a non-Western indigenous community. Caregivers in the United States and Vanuatu interacted with infants and a novel object for 3 min. In Study 1 (N = 116, Mage = 29.05), Ni-Van caregivers used more physical triadic engagement and U.S. caregivers used more visual triadic engagement. In Study 2 (N = 80, Mage = 29.91), U.S. caregivers were more likely than Ni-Van caregivers to transmit an action and to use visual cues while interacting with their child. These studies demonstrate that the Western model of early social learning is not universal.
Journal Article
الكتاب الكبير للحشرات الكبيرة والصغيرة أيضا
هذا الكتاب مخصص للأطفال يستهدف الطفولة المبكرة وتعمل علي اسثمار الطفل في بناء المهارات المختلفة المرتبطة بالخيال والابتكار وقوة الشخصية والبحث عن حلول إبداعية ويستمد الطفل الكثير من العلم والمعرفة والمعلومات من المنهج السلوكي التربوي رائع يعلم الطفل كيف يستخلص من مشكلاته وكيف يبني شخصيته بشكل مميز ويعطي المربي حلولا لحل مشكلات أبنه تعنيه عن تجاوز الأزمة وإنهائها.
BOOK
Mother–Infant Physical Contact Predicts Responsive Feeding among U.S. Breastfeeding Mothers
Responsive feeding—initiating feeding in response to early hunger cues—supports the physiology of lactation and the development of infant feeding abilities, yet there is a dearth of research examining what predicts responsive feeding. In non-Western proximal care cultures, there is an association between responsive feeding and mother–infant physical contact, but this has not been investigated within Western populations. In two studies, we tested whether mother–infant physical contact predicted feeding in response to early hunger cues versus feeding on a schedule or after signs of distress among U.S. breastfeeding mothers. With an online questionnaire in Study 1 (n = 626), physical contact with infants (via co-sleeping and babywearing) predicted increased likelihood of self-reported responsive feeding. Mothers who reported responsive feeding were more likely to exclusively breastfeed for the first six months, breastfeed more frequently throughout the day, and had a longer planned breastfeeding duration than mothers who reported feeding on a schedule or after signs of infant distress. In Study 2 (n = 96), a three-day feeding log showed that mother–infant physical contact predicted feeding in response to early hunger cues but mother–infant proximity (without physical contact) did not. In sum, our results demonstrate that physical contact with infants may shape breastfeeding behavior among U.S. mothers, highlighting a connection between social interaction and infant nutrition that warrants further investigation.
Journal Article
Effectiveness and utilization of a cognitive screening program for primary geriatric care
Background
Effective detection of cognitive impairment in the primary care setting is limited by lack of time and specialized expertise to conduct detailed objective cognitive testing and few well-validated cognitive screening instruments that can be administered and evaluated quickly without expert supervision. We therefore developed a model cognitive screening program to provide relatively brief, objective assessment of a geriatric patient’s memory and other cognitive abilities in cases where the primary care physician suspects but is unsure of the presence of a deficit.
Methods
Referred patients were tested during a 40-min session by a psychometrist or trained nurse in the clinic on a brief battery of neuropsychological tests that assessed multiple cognitive domains. Short questionnaires covering subjective cognitive complaints, symptoms of depression, and medical history were also administered. Results were conveyed to a dementia specialist who reviewed them and returned their judgement of the validity of the cognitive complaint to the primary care provider. Retrospective medical records review was carried out for a random (stratified) half of the sample to determine how screening results were utilized. Screening tests were repeated after two years in a subset of 69 patients.
Results
The 638 patients screened (mean age = 75.9 years; mean education = 14.9 years; 58% women) were classified by screening as having normal cognition (
n
= 177), depression (with possible cognitive changes;
n
= 115), mild cognitive impairment (MCI;
n
= 107), or dementia (
n
= 239). Classification accuracy was shown by high agreement with the eventual clinical diagnosis in the medical record (69%; Cohen’s Kappa = .38;
p
< .001; 77% if MCI and dementia were collapsed; Cohen’s Kappa = .58;
p
< .001) and longitudinal decline in cognitive test scores only in those initially classified as having MCI or dementia. Medical records documented discussion of screening results with the patient in 69% of cases (80% if MCI or dementia was detected) and often referral to a specialist (62%), new brain imaging (54%), or change in medication (58%) when screening indicated potential cognitive impairment.
Conclusion
The cognitive screening program was well accepted by primary care providers as an efficient and effective way to evaluate concerns about cognitive decline in older adults.
Journal Article
Communicating patient-reported outcome scores using graphic formats: results from a mixed-methods evaluation
Background Patient-reported outcomes (PROs) promote patient-centered care by using PRO research results (\"group-level data\") to inform decision making and by monitoring individual patient's PROs (\"individual-level data\") to inform care. We investigated the interpretability of current PRO data presentation formats. Method This cross-sectional mixed-methods study randomized purposively sampled cancer patients and clinicians to evaluate six group-data or four individual-data formats. A self-directed exercise assessed participants' interpretation accuracy and ratings of ease-of-understanding and usefulness (0 = least to 10 = most) of each format. Semi-structured qualitative interviews explored helpful and confusing format attributes. Results We reached thematic saturation with 50 patients (44 % < college graduate) and 20 clinicians. For grouplevel data, patients rated simple line graphs highest for ease-of-understanding and usefulness (median 8.0; 33 % selected for easiest to understand/most useful) and clinicians rated simple line graphs highest for ease-of-understanding and usefulness (median 9.0, 8.5) but most often selected line graphs with confidence limits or norms (30 % for each format for easiest to understand/most useful). Qualitative results support that clinicians value confidence intervals, norms, and p values, but patients find them confusing. For individual-level data, both patients and clinicians rated line graphs highest for ease-of-under-standing (median 8.0 patients, 8.5 clinicians) and usefulness (median 8.0, 9.0) and selected them as easiest to understand (50, 70 %) and most useful (62, 80 %). The qualitative interviews supported highlighting scores requiring clinical attention and providing reference values. Conclusions This study has identified preferences and opportunities for improving on current formats for PRO presentation and will inform development of best practices for PRO presentation. Both patients and clinicians prefer line graphs across group-level data and individual-level data formats, but clinicians prefer greater detail (e.g., statistical details) for group-level data.
Journal Article
An exploration of perinatal healthcare providers’ perspectives on respectful maternity care in the United States: a scoping review
Background
Maternal mortality and morbidity rates in the United States (US) among racially minoritized populations have continued to worsen over the past decade. Reviews have examined the perinatal healthcare experiences and outcomes of Black individuals in the US. However, few reviews have examined perinatal healthcare providers’ experiences practicing in the US healthcare system. The purpose of this review was to comprehensively assess the current evidence and knowledge gaps related to perinatal healthcare providers’ perspectives on providing respectful maternity care to Black patients.
Method
A literature search was conducted via PubMed, Embase, Web of Science, and CINAHL using appropriate search terms. This scoping review was conducted in accordance with the Preferred Reporting Items for Systematic Review and Meta-analysis extension for Scoping Reviews guidelines and by the Joanna Briggs Institute enhanced scoping review framework.
Results
The first and second database searches yielded 764 and 819 articles respectively (2013–2023). An updated search yielded a total of 1,592 articles (2013–2024). Thirty-nine studies met full text review, 14 studies were ultimately included in this review (11 qualitative, two quantitative, and one mix-method). Thematic synthesis of studies in this review yielded a six-component typology of providers’ views and experiences on respectful maternity care in the US. The themes were (1) being free from harm and mistreatment such as physical and verbal abuse; (2) developing rapport between providers and women; (3) meeting professional standards of care such as seeking consent and not performing procedures against patients’ wishes; (4) avoiding discrimination based on age, race/ethnicity, and medical conditions, and low socioeconomic status; (5) health system constraints and facilitators; and (6) macro-level, external constraints, and facilitators.
Conclusion
Findings from this review showed that providers’ descriptive narratives mirrors the body of evidence on individual pregnant women’s accounts of mistreatment while navigating perinatal care. However, none of the fourteen studies focused on providers admitting to their own practices that are or could be deemed disrespectful. Future research on the topic of this scoping review would benefit from looking at perinatal care providers’ willingness to admit to and be accountable for their disrespectful practices. More research is necessary to fully understand and disrupt dehumanizing perinatal care practices.
Registration
This review has been registered with the Open Science Framework (
https://doi.org/10.17605/OSF.IO/DQXG2
).
Journal Article
A cognitive screening program in community‐based medical clinics to facilitate Latino participation in Alzheimer's disease research
INTRODUCTION Relatively low rates of Latino participation in Alzheimer's disease and related dementias (ADRD) research makes it difficult to determine whether identified disease mechanisms, risk factors, or novel treatments generalize to this population. METHODS We introduced ADRD research opportunities through a model cognitive screening program in primary care and neurology specialty care clinics in areas with high proportions of Latino residents. RESULTS Out of 523 Latino adults (mean age = 72.1 years, mean education = 6.8 years, 62.1% female, 88.1% tested in Spanish), 520 allowed the use of screening data for research, and high percentages agreed to a research registry with contact about ADRD research opportunities (primary care: 91.9%, neurology: 86.6%). Registrants supported 368 referrals to 45 studies (21% successfully recruited). Thirty‐one individuals participated in ≥1 study, producing 79 enrollments across 15 ADRD studies. DISCUSSION Results demonstrate that combining a needed clinical service with recruitment efforts can enhance participation of older Latino adults in ADRD research. Highlights Older Latinos (>99%) allowed the use of cognitive screening data for research purposes. Primary care (91%) and neurology (87%) patients allowed ADRD research solicitation. Twenty‐one percent of referrals of those agreeing to contact (79/368) led to research recruitment. Thirty‐one participants accounted for 79 distinct enrollments across 15 ADRD studies. Combining clinical service with recruitment enhances Latino research participation.
Journal Article
Perinatal risk and the cultural ecology of health in Bihar, India
The objective of the current study is to examine the cultural ecology of health associated with mitigating perinatal risk in Bihar, India. We describe the occurrences, objectives and explanations of health-related beliefs and behaviours during pregnancy and postpartum using focus group discussions with younger and older mothers. First, we document perceived physical and supernatural threats and the constellation of traditional and biomedical practises including taboos, superstitions and rituals used to mitigate them. Second, we describe the extent to which these practises are explained as risk-preventing versus health-promoting behaviour. Third, we discuss the extent to which these practises are consistent, inconsistent or unrelated to biomedical health practises and describe the extent to which traditional and biomedical health practises compete, conflict and coexist. Finally, we conclude with a discussion of the relationships between traditional and biomedical practises in the context of the cultural ecology of health and reflect on how a comprehensive understanding of perinatal health practises can improve the efficacy of health interventions and improve outcomes. This article is part of the theme issue ‘Ritual renaissance: new insights into the most human of behaviours’.
Journal Article