126 resultados para Marriage counseling


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The sharing economy or collaborative consumption based firms have the potential to disrupt long-standing traditional industries. However, little is known on the topic, specifically the role of design in these successful community-led, technology enable firms. It is the proposition of this research that the intrinsic innovation of collaborative consumption firms is not merely a technological one. With successful firms being identified by being able to marry both technological advancement and human insight on product meaning. Therefore, the authors suggest the use of design as an effective way to capitalise and build on product meaning, not only technological advancements in order to foster the growth of a community. To explore this further, the research team decided to investigate two fast growing examples of industry disrupting, sharing economy businesses; Airbnb and Uber. Of the two cases, the use of design was found to be more evident within, Airbnb, due to wide profession of using design techniques. Each case study has been mapped on Guenther’s (2012) framework of techno-economic innovation to help illustrate this marriage of innovation agendas. This paper explored the role of design in community-led companies by presenting an argument for why they have succeeded due to an understanding of human need and key market trends, instead of only technological innovation alone. Findings and implication of these case studies suggest the future role of design as a method to achieve this success. Built on the core tenants of design thinking, these techniques rationalise technology, human needs and business viability to product innovative solutions. Upon these findings, the research team has created a new framework for understanding community-led technology enabled companies, one that builds upon the work of Guenther’s (2012) model of enterprise design innovation. This paper is the first step in a new research agenda.

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Background Mild stroke survivors are generally discharged from acute care within a few days of the stroke event, often without rehabilitation follow-up. We aimed to examine the recovery trajectory for male patients and their wife-caregivers during the 12 months postdischarge. Methods A descriptive study was undertaken to examine functional outcomes, quality of life (QOL), depression, caregiver strain, and marital function in a prospective cohort of male survivors of mild stroke and their wife-caregivers during the 12 months postdischarge. Data from each point in time were summarized and repeated measures analyses undertaken. Logistic regression was used to determine which baseline demographic and biopsychosocial variables influenced or predicted marital functioning 1 year postdischarge. Results A total of 38 male patients (mean age 63.4 years) and their wife-caregivers (mean age 58.5 years) were examined. The median discharge National Institutes of Health Stroke Scale score was 1.5, modified Rankin Scale score was 1.0, Barthel Index was 100.0, and Stroke Impact Scale-16v2 score was 78.5. The patients' modified Rankin Scale (function) and QOL scores improved significantly over time (F (2) = 4.583, P = .017; and F (6) = 5.632, P < .001, respectively). However, the wife-caregiver QOL scores did not change. Multivariate analysis revealed overall worsening of depression for both the patient and wife-caregivers (F (6, 32) = 3.087, P = .017) and marital function (F (6, 32) = 3.961, P = .004), although the wife-caregivers' perceptions of caregiver strain improved (F (6, 32) = 3.923, P = .007). None of the measured variables were associated with marital functioning 1 year postdischarge. Conclusions Despite improvement in patients' functional status, other patient and wife-caregiver psychosocial outcomes during the 12 months postdischarge may be negatively affected. Thus, attention needs to focus on recovery beyond functional outcomes.

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BACKGROUND Motivational interviewing and stages of change are approaches to increasing knowledge and effecting behavioural change. This study examined the application of this approach on stroke knowledge acquisition and changing individual lifestyle risk factors in an outpatient clinic. METHODS RCT in which 200 participants were allocated to an education-counselling interview (ECI) or a control group. ECI group participants mapped their individual risk factors on a stage of change model and received an appointment to the next group lifestyle class. Participants completed a stroke knowledge questionnaire at baseline (T1), post-appointment, and three months (T3) post-appointment. Passive to active changes in lifestyle behaviour were self-reported at three months. RESULTS There was a statistically significant difference between groups from T1 toT3 in stroke knowledge (p < 0.001). While there was a significant shift from a passive to active stage of change for the overall study sample (p < 0.000), there was no significant difference between groups on the identified risk factors. CONCLUSIONS Although contact with patients in ambulatory clinical settings is limited due to time constraints, it is still possible to improve knowledge and initiate lifestyle changes utilizing motivational interviewing and a stage of change model. Stroke nurses may wish to consider these techniques in their practice setting.

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This issue on the genetics of brain imaging phenotypes is a celebration of the happy marriage between two of science's highly interesting fields: neuroscience and genetics. The articles collected here are ample evidence that a good deal of synergy exists in this marriage. A wide selection of papers is presented that provide many different perspectives on how genes cause variation in brain structure and function, which in turn influence behavioral phenotypes (including psychopathology). They are examples of the many different methodologies in contemporary genetics and neuroscience research. Genetic methodology includes genome-wide association (GWA), candidate-gene association, and twin studies. Sources of data on brain phenotypes include cortical gray matter (GM) structural/volumetric measures from magnetic resonance imaging (MRI); white matter (WM) measures from diffusion tensor imaging (DTI), such as fractional anisotropy; functional- (activity-) based measures from electroencephalography (EEG), and functional MRI (fMRI). Together, they reflect a combination of scientific fields that have seen great technological advances, whether it is the single-nucleotide polymorphism (SNP) array in genetics, the increasingly high-resolution MRI imaging, or high angular resolution diffusion imaging technique for measuring WM connective properties.

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This book provides the first comprehensive international coverage of key issues in mandatory reporting of child abuse and neglect. The book draws on a collection of the foremost scholars in the field, as well as clinicians and practice-based experts, to explore the nature, history, impact and justifiability of mandatory reporting laws, their optimal form, legal and conceptual issues, and practical issues and challenges for reporters, professional educators and governments. Key issues in non-Western nations are also explored briefly to assess the potential of socio-legal responses sex trafficking, forced child labour and child marriage. The book is of particular value to policy makers, educators and opinion leaders in government departments dealing with children, and to professionals and organisations who work with children. It is also intended to be a key authority for researchers and teachers in the fields of medicine, nursing, social work, education, law, psychology, health and allied health fields.

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This study qualitatively examined an 8 week group exercise and counseling intervention for breast and prostate cancer survivors. Groups exercised 3 days per week, 50 minutes per session,performing moderate intensity aerobic and resistance training. Groups also underwent 90 minute supportive group psychotherapy sessions once per week. Survivors discussed their experiences in focus groups post intervention. Transcripts were analyzed using interpretative phenomenological analysis. Survivors described how exercise facilitated counseling by creating mutual aid and trust, and counseling helped participants with self-identity, sexuality, and returning to normalcy. When possible, counselors and fitness professionals should create partnerships to optimally support cancer survivors.

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OBJECTIVE: To evaluate the effectiveness of a telephone-delivered behavioral weight loss and physical activity intervention targeting Australian primary care patients with type 2 diabetes. RESEARCH DESIGN AND METHODS: Pragmatic randomized controlled trial of telephone counseling (n = 151) versus usual care (n = 151). Reported here are 18-month (end-of-intervention) and 24-month (maintenance) primary outcomes of weight, moderate-to-vigorous-intensity physical activity (MVPA; via accelerometer), and HbA1c level. Secondary outcomes include dietary energy intake and diet quality, waist circumference, lipid levels, and blood pressure. Data were analyzed via adjusted linear mixed models with multiple imputation of missing data. RESULTS: Relative to usual-care participants, telephone counseling participants achieved modest, but significant, improvements in weight loss (relative rate [RR] -1.42% of baseline body weight [95% CI -2.54 to -0.30% of baseline body weight]), MVPA (RR 1.42 [95% CI 1.06-1.90]), diet quality (2.72 [95% CI 0.55-4.89]), and waist circumference (-1.84 cm [95% CI -3.16 to -0.51 cm]), but not in HbA1c level (RR 0.99 [95% CI 0.96-1.02]), or other cardio-metabolic markers. None of the outcomes showed a significant change/deterioration over the maintenance period. However, only the intervention effect for MVPA remained statistically significant at 24 months. CONCLUSIONS: The modest improvements in weight loss and behavior change, but the lack of changes in cardio-metabolic markers, may limit the utility, scalability, and sustainability of such an approach.

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This study examined the level, the prevalence of and the factors associated with depression among male casual laborers in Hanoi. Social mapping was done to recruit and interview 450 men aged over 18 years, mostly unskilled and unregistered laborers from 135 street venues across 13 districts of the city using a structured questionnaire. Most were from rural and mountainous provinces and did manual works such as motorbike taxi drivers, porters, construction workers, small traders and others in the current city. The prevalence of self-reported depressive symptoms (25 %) was high. Structural equation modeling showed that marriage, family separation and living with peers or partners were three significant distal risk factors, while illicit drug use and low social connectedness were proximal predictors of depression. Of all factors, social connectedness appeared to be the most important because it plays a mediating role. Drug use was an independent risk factor. This study provides a model to understand the mental health of male casual laborers and to develop culturally appropriate intervention programs for these men

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The rate of severe depression among women in single-parent and biological families and in a variety of stepfamilies was examined in a large community sample of 13,088 pregnant women in the United Kingdom. Compared with women in biological families and published population rates, women in single-parent families and step-families reported significantly elevated rates of depression. Family-type differences in several risk factors were examined, including cohabiting (vs. married) status, relationship history, and socioeconomic and psychosocial risks, such as crowding, social support, and stressful life events. Family-type differences in depression were mediated partly by differences in social support, stressful life events, and crowding, but a main effect of family type in predicting depression remained after statistically controlling for these risks.

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The nature of collective perception of prostitution is understudied in Canada. Except some rudimentary reports on the percentages of the key legal options, multivariate analysis has never been used to analyze the details of public opinion on prostitution. The current study explores the trend of public attitude toward prostitution acceptability in Canada over a 25-year span and examines the social determinants of the acceptability of prostitution, using structural equation modeling (SEM), which allows researchers to elaborate both direct and indirect effects (through mediating variables) on the outcome variable. Results show that the public has become more acceptant of prostitution over time. In addition, the less religious, less authoritarian, and more educated are more acceptant of prostitution than the more religious, more authoritarian, and less well educated. The effects of religiosity and authoritarianism mediate out the direct effects of age, gender, gender equality, marriage, marriage as an outdated institution, Quebec, race, and tolerance. The findings may serve as a reference point for the law reform regarding the regulation of prostitution in Canada.

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Objective To investigate the perspectives of general practitioners (GPs) on the practice of soliciting additional concerns (ACs) and the acceptability and utility of two brief interventions (prompts) designed to aid the solicitation. Methods Eighteen GPs participating in a feasibility randomised controlled trial were interviewed. Interviews were semi-structured and audio-recorded. Data were analysed using a Framework Approach. Results Participants perceived eliciting ACs as important for: reducing the need for multiple visits, identifying serious illness early, and increasing patient and GP satisfaction. GPs found the prompts easy to use and some continued their use after the study had ended to aid time management. Others noted similarities between the intervention and their usual practice. Nevertheless, soliciting ACs in every consultation was not unanimously supported. Conclusion The prompts were acceptable to GPs within a trial context, but there was disagreement as to whether ACs should be solicited routinely. Some GPs considered the intervention to aid their prioritisation efficiency within consultations. Practice implications Some GPs will find prompts which encourage ACs to be solicited early in the consultation enable them to better organise priorities and manage time-limited consultations more effectively.

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Attitudes, knowledge, and perceptions of an individual influence their behavior as well as culture of a society. The objective of the study was to understand the attitudes and knowledge of 584 Indian community members regarding child rights and their perceptions about whether selected child rights were secured in reality. Overall attitudes of vast majority (96 – 98%) of the participants towards child rights were found to be positive i.e., children should have rights in various respects except issue like right to meet others (Article 15 of CRC). Knowledge of majority of the participants about child rights related legislations was moderate and varied across the cities while participants were unanimous about poor lived experiences of child rights in reality. So far as attitude and perception are concerned about child rights, there was a significant difference in the distribution between cities (p<0.01). Overall, the Rights of Children to Free and Compulsory Education Act, 2009 had the highest awareness (91.3%, n=533), followed by the Child Labour (Prohibition and Regulation) Act, 1986 (89.7%, n=523) and the Prohibition of Child Marriage Act, 2006 (89.6%, n=523). Findings of the present study speak in favor of community awareness about child rights and penalties for violation of child rights.

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This article presents the attitudinal response of rural villagers in Papua New Guinea to mobile telephony, based on a threshold study made during the early stages of its adoption. The research indicates that the introduction of mobile telecommunications has generally been viewed positively, with mobile phones affording social interaction with loved ones. Nonetheless, negative concerns have been strongly felt, notably financial costs and anxiety about mobile phones aiding in the coordination of extramarital liaisons and criminal activities. The communities investigated previously had scant access to modern communication technologies, some still using traditional means such as wooden slit drums, known locally as garamuts. The expansion of mobile network coverage has introduced into communal village life the capability to communicate dyadically and privately at a distance. Investigation into the adoption of mobile phones thus promotes understanding about traditional means of communication and notions of public and private interactions.

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The voice of a traditional communication drum can be heard over great distances. Yet now in Papua New Guinea (PNG) it is hearing, by phone, the voice of a loved one who has moved far away from home for work, marriage or studies that brings the greatest delight. As recently as 2007, most areas of this Pacific island nation had no form of telephony available. Apart from radio, modern communication forms have been restricted predominantly to the urban areas where only a small percentage of the people reside. Landline telephones, television, Internet, facsimile machines and so on have never reached the majority of the inhabited areas...