First Nations peoples bring a particular history and cultural perspective to healing and well-being that significantly influences their health behaviors. The authors used grounded theory methods to describe and explain how ethnocultural affiliation and gender influence the process that 22 First Nations people underwent when making lifestyle changes related to their coronary artery disease (CAD) risk. The transcribed interviews revealed a core variable, meeting the challenge. Meeting the challenge of CAD risk management was influenced by intrapersonal, interpersonal (relationships with others), extrapersonal (i.e., the community and government), sociodemographic, and gendered factors. Salient elements for the participants included their beliefs about origins of illness, the role of family, challenges to accessing information, financial and resource management, and the gendered element of body image. Health care providers need to understand the historical, social, and culturally embedded factors that influence First Nations people's appraisal of their CAD.
Adaptive programming and management principles focused on learning, experimentation, and evidence-based decision making are gaining traction with donor agencies and implementing partners in international development. Adaptation calls for using learning to inform adjustments during project implementation. This requires information gathering methods that promote reflection, learning, and adaption, beyond reporting on pre-specified data. A focus on adaptation changes traditional thinking about program cycle. It both erases the boundaries between design, implementation, and evaluation and reframes thinking to consider the complexity of development problems and nonlinear change pathways.Supportive management structures and processes are crucial for fostering adaptive management. Implementers and donors are experimenting with how procurement, contracting, work planning, and reporting can be modified to foster adaptive programming. Well-designed monitoring, evaluation, and learning systems can go beyond meeting accountability and reporting requirements to produce data and learning for evidence-based decision making and adaptive management. It is important to continue experimenting and learning to integrate adaptive programming and management into the operational policies and practices of donor agencies, country partners, and implementers. We need to devote ongoing effort to build the evidence base for the contributions of adaptive management to achieving international development results.
Cutaneous sensory organs are characteristic of many squamate lineages. Such organs may occur on the surface of scales as button-like, circular protuberances set off from their surroundings by a noticeable boundary, often taking the form of a moat or furrow. They may be relatively unadorned, clad with the surface micro-ornamentation of the scales on which they are carried, or they may carry one or more bristles of varying length and surface ornamentation. Such bristles may extend away from the body of the organ to interface with the surrounding environment or to contact adjacent scales. Cutaneous sensory organs have been physiologically demonstrated to have a mechanoreceptive function but have also been posited to potentially be involved with additional sensory modalities. Their distribution and structure across the body surface has been shown to be unequal, with some regions being much more extensively endowed than others, indicative of regional differential sensitivity. The digits of Anolis (Iguania: Dactyloidae) carry adhesive toepads that are convergent with those of geckos (Gekkota). Geckos exhibit a high density of cutaneous sensory organs on their toepads and their form and distribution has been associated with the operation and control of the toepads during locomotion. Investigation of the form and topographical distribution of cutaneous sensory organs on the toepads of Anolis shows them to be convergent in these attributes with those of geckos and quite distinct from those of the ancestrally padless Iguana (Iguania: Iguanidae). Their location at scale margins and the direction of their bristles towards adjacent scales indicates that the cutaneous sensory organs play an important role in proprioception during toepad deployment in Anolis.
Participant attrition (withdrawal or loss after entering a study) is a major threat to the completion of valid studies. It can result in systematic error (selection bias), thus decreasing the statistical power of studies and limiting the generalisability of study findings. This paper demonstrates how key social exchange theory principles form the theoretical context for our practice, which, in turn enables us to form enduring relationships with study participants.
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