The influence of culture on home-based family caregiving at end-of-life: A case study of Dutch reformed family care givers in Ontario, Canada

Families are facing increased pressure to provide care to their terminally-ill or dying kin in the home. It is known that balancing care with other personal and social roles can adversely affect family caregivers' (FCGs) health, yet access to supportive services which can mitigate burden is often inadequate. Cultural factors are known to shape the experience of caregiving; however, most research to date tends to neglect the experiences of FCGs from different cultural groups. This understanding is necessary to ensure that supportive services are both meaningful and culturally-appropriate. Using qualitative methods, we undertook longitudinal research with a sample of Dutch Reformed FCGs (n = 5) to understand their experiences of caregiving and bereavement. The results of the study are suggestive of a cultural specificity with respect to caregiving that impacts both responsibilities and reactions to care. Three themes were salient to this group as a cultural entity: cultural attitudes towards care, religious beliefs and coping, and c. ulturally-informed care-seeking behaviours. These three themes were seen to be a function of their religious and ethnic identities and were reinforced by ties to the communities in which they resided. Cultural identity provided a framework through which to understand and make sense of the experience, while group membership provided access to networks of informal support. This research contributes to the geographical literature on care/caregiving by providing insight into the social, cultural and religious context of informal family caregiving with a population who live in close geographic proximity. On a practical level, this case study indicates the importance of considering how these factors may operate in other settings in order to implement timely and appropriate interventions to better support FCGs who are caring for their terminally-ill loved-ones at home.

Predictors of PTSD Symptoms in Response to Psychosis and Psychiatric Admission

The experiences of psychosis and psychiatric admission have the potential to act as events precipitating posttraumatic stress disorder (PTSD) symptoms. Known risk factors for the development of PTSD symptoms in adults were identified. These included childhood trauma, current psychiatric symptoms, perceived coercion, and relationships with mental health service providers. These factors were analyzed to determine if they were important in the development of PTSD symptoms in response to psychosis and admission. We used a cross-sectional design with a sample of 47 participants recruited from a service in Northern Ireland who had experienced psychosis and been discharged from inpatient treatment within 12 months of data collection. The main outcome measure was the impact of events scale-revised. Data was subject to correlation analyses. A cut-off point of r = +/- 0.25 was used to select variables for inclusion in hierarchical regression analyses. Forty-five percent and 31% of the sample had moderate to severe PTSD symptoms related to psychosis and admission, respectively. The majority of participants identified positive symptoms and the first admission as the most distressing aspects of psychosis and admission. Childhood sexual and physical traumas were significant predictors of some PTSD symptoms. Strong association was found between current affective symptoms and PTSD symptoms. A reduced sense of availability of mental health service providers was also associated with PTSD symptoms and depression. Awareness of risk factors for the development of PTSD symptoms in response to admission and psychosis raises important issues for services and has implications for interventions provided.

Stability Analysis and Implementation of a Decentralized Formation Control Strategy for Unmanned Vehicles

This paper presents a new methodology for solving the multi-vehicle formation control problem. It employs a unique extension-decomposition-aggregation scheme to transform the overall complex formation control problem into a group of subproblems, which work via boundary interactions or disturbances. Thus, it is proved that the overall formation system is exponentially stable in the sense of Lyapunov, if all the individual augmented subsystems (IASs) are stable. Linear matrix inequality-based H8 control methodology is employed to design the decentralized formation controllers to reject the impact of the formation changes being treated as boundary disturbances and guarantee the stability of all the IASs, consequently maintaining the stability of the overall formation system. Simulation studies are performed to verify the stability, performance, and effectiveness of the proposed strategy.

A Preliminary Qualitative Investigation of Voice Hearing and Its Association with Dissociation in Chronic PTSD

Following on from a quantitative study, this research used a qualitative methodology to investigate the lived experience of 3 men with chronic posttraumatic stress disorder associated with the conflict in Northern Ireland who reported auditory hallucinations. Data analysis used the Framework method. Results showed that beliefs about voices, dissociation of identity and body, and interpersonal impact were central superordinate themes associated with auditory hallucinations in posttraumatic stress disorder. Central subordinate themes included feeling a lack of controllability over voices, experiencing them as ego-dystonic, and feeling an increased sense of isolation and shame because of their presence. Results provide an in-depth analysis of participants' lived experiences and enhance understanding of previous quantitative findings.

Decompressive hemicraniectomy following malignant middle cerebral artery infarctions:a mixed methods exploration of carer experience and level of burden

Purpose: This study explores the experiences and sense of burden of family carers of survivors of malignant middle cerebral artery infarctions who had undergone decompressive hemicraniectomy. To date, there have been no studies examining carer outcomes among this unique population. This study, taken alongside an already published study of survivor outcomes, provides a more holistic picture with regard to sequelae within the sample. Method: Six family carers completed the Sense of Competence Questionnaire and the Hospital Anxiety and Depression Scale. These results were compared with existing normative data. Carers also consented to a semi-structured interview. Interview data were examined using thematic content analysis. Consistent with the mixed methods design, quantitative and qualitative findings were integrated for further analysis. Results: While carers experienced many losses, their overall sense of burden was not outside 'Average' limits, nor did they experience clinically significant symptoms of depression. All carers identified methods of coping with the demands of caregiving. These included intrapersonal, interpersonal and practical strategies. All carers apart from one were able to identify areas of post-traumatic growth. Conclusion: Carers will benefit from information, support and care. In addition, problem solving skills are essential in managing the myriad difficulties that arise in the aftermath of stroke. [Box: see text].

Social Dance for Successful Aging:The Practice of Health, Happiness, and Social Inclusion Amongst Senior Citizens

This article presents findings from a qualitative study of social
dancing for successful aging amongst senior citizens in three locales:
in Blackpool (GB), around Belfast (NI), and in Sacramento (US). Social
dancers are found to navigate an intense space in society, one of
wellbeing accompanied by a beneficial sense of youthfulness. Besides
such renewal and self-actualisation, findings also attest to the perceived
social, psychological and health benefits of social dancing amongst senior
citizens. They also articulate three different social dancing practices:
social dance as tea dance (Sacramento), social dance as practice dance
(Blackpool), social dance as motility (Belfast and environs).

Are power laws that estimate fractal dimension a good descriptor of soil structure and its link to soil biological properties?

The study of interrelationships between soil structure and its functional properties is complicated by the fact that the quantitative description of soil structure is challenging. Soil scientists have tackled this challenge by taking advantage of approaches such as fractal geometry, which describes soil architectural complexity through a scaling exponent (D) relating mass and numbers of particles/aggregates to particle/aggregate size. Typically, soil biologists use empirical indices such as mean weight diameters (MWD) and percent of water stable aggregates (WSA), or the entire size distribution, and they have successfully related these indices to key soil features such as C and N dynamics and biological promoters of soil structure. Here, we focused on D, WSA and MWD and we tested whether: D estimated by the exponent of the power law of number-size distributions is a good and consistent correlate of MWD and WSA; D carries information that differs from MWD and WSA; the fraction of variation in D that is uncorrelated with MWD and WSA is related to soil chemical and biological properties that are thought to establish interdependence with soil structure (e.g., organic C, N, arbuscular mycorrhizal fungi). We analysed observational data from a broad scale field study and results from a greenhouse experiment where arbuscular mycorrhizal fungi (AMF) and collembola altered soil structure. We were able to develop empirical models that account for a highly significant and large portion of the correlation observed between WSA and MWD but we did not uncover the mechanisms that underlie this correlation. We conclude that most of the covariance between D and soil biotic (AMF, plant roots) and abiotic (C. N) properties can be accounted for by WSA and MWD. This result implies that the ecological effects of the fragmentation properties described by D and generally discussed under the framework of fractal models can be interpreted under the intuitive perspective of simpler indices and we suggest that the biotic components mostly impacted the largest size fractions, which dominate MWD, WSA and the scaling exponent ruling number-size distributions. (C) 2010 Elsevier Ltd. All rights reserved.

Power and the Construction of Independence in ICTD Organizations

How do powerful vested interests continue to influence ICT for development (ICTD) projects? In this paper, instead of adopting a macro-level analysis, I take an in-depth, ethnographic approach to focus on work practices at one NGO involved in producing information and communication technologies for use in developing countries. Staff decisions at this NGO were influenced by particular powerful organizations, and I draw on theoretical insights from organization studies in order to understand this. The approach yields surprising results. Staff members appeared able to "stand back" from the pressures coming from donors and other influential parties, and to critically reflect upon these. Paradoxically, rather than fueling resistance, this sense of independence appeared to reinforce dependency on these powerful organizations. Moreover, the fact that this NGO was engaged in ICTD work further heightened these effects. This study extends existing understandings of how power operates within ICTD organizations, by highlighting the ways in which a sense of independence can paradoxically exacerbate donor influence over work activities.

Bolivian health and social care professionals' experiences of decision-making in oncology and palliative care

In the UK, end-of-life care strategies recommend patients and families are involved in decision making around treatment and care. In Bolivia, such strategies do not exist, and access to oncology services depends on finance, geography, education and culture. Compared to more developed countries, the delivery of oncology services in Latin America may result in a higher percentage of patients presenting with advanced incurable disease. The objective of this study was to explore decision-making experiences of health and social care professionals who cared for oncology and palliative care patients attending the Instituto Oncológico Nacional, Cochabamba (Bolivia). Patients were predominantly from the Quechua tradition, which has its own ethnic diversity, linguistic distinctions and economic systems. Qualitative data were collected during focus groups. Data analysis was conducted using Interpretative Phenomenological Analysis. Three interrelated themes emerged: (i) making sense of structures of experience and relationality; (ii) frustration with the system; and (iii) the challenges of promoting shared decision making. The study uncovered participants' lived experiences, emotions and perceptions of providing care for Quechua patients. There was evidence of structural inequalities, the marginalisation of Quechua patients and areas of concern that social workers might well be equipped to respond to, such as accessing finances for treatment/care, education and alleviating psychological or spiritual suffering.

An exploratory study of specialist and generalist teachers: predicting self efficacy in delivering primary physical education.

We aimed to determine whether primary school teachers’ motivational regulations to exercise and self efficacy in delivering a physical education (PE) lesson are different based on prior PE training. Two groups of qualified primary school teachers were recruited; PE specialists and a group of generalist primary school teachers who also teach PE. All teachers completed the Behavioural Regulation in Exercise Questionnaire-2, International Physical Activity Questionnaire and the Teachers’ Sense of Efficacy Scale. PE specialists demonstrated significantly higher levels of intrinsic motivation towards exercise participation and took part in more physical activity in comparison to the generalist teachers. Regression analysis showed that being a PE specialist predicted higher scores in instructional strategies and classroom management in PE. Our findings support the useof Self Determination Theory concepts in understanding teacher’s exercise participation motivations. These findings have implications for the modelling role of teachers in encouraging children to be physically active.

Nurses' experiences providing palliative care to individuals living in rural communities aspects of the physical residential setting

Introduction: Efforts are needed to improve palliative care in rural communities, given the unique characteristics and inherent challenges with respect to working within the physical aspects of residential settings. Nurses who work in rural communities play a key role in the delivery of palliative care services. Hence, the purpose of this study was to explore nurses’ experiences of providing palliative care in rural communities, with a particular focus on the impact of the physical residential setting.

Methods: This study was grounded in a qualitative approach utilizing an exploratory descriptive design. Individual telephone interviews were conducted with 21 community nurses. Data were analyzed by thematic content analysis.

Results: Nurses described the characteristics of working in a rural community and how it influences their perception of their role, highlighting the strong sense of community that exists but how system changes over the past decade have changed the way they provide care. They also described the key role that they play, which was often termed a ‘jack of all trades’, but focused on providing emotional, physical, and spiritual care while trying to manage many challenges related to transitioning and working with other healthcare providers. Finally, nurses described how the challenges of working within the physical constraints of a rural residential setting impeded their care provision to clients who are dying in the community, specifically related to the long distances that they travel while dealing with bad weather.

Thermal properties, sizes, and size distribution of Jupiter-family cometary nuclei

We present results from SEPPCoN, an on-going Survey of the Ensemble Physical Properties of Cometary Nuclei. In this report we discuss mid-infrared measurements of the thermal emission from 89 nuclei of Jupiter-family comets (JFCs). All data were obtained in 2006 and 2007 using imaging capabilities of the Spitzer Space Telescope. The comets were typically 4-5 AU from the Sun when observed and most showed only a point-source with little or no extended emission from dust. For those comets showing dust, we used image processing to photometrically extract the nuclei. For all 89 comets, we present new effective radii, and for 57 comets we present beaming parameters. Thus our survey provides the largest compilation of radiometrically-derived physical properties of nuclei to date. We have six main conclusions: (a) The average beaming parameter of the JFC population is 1.03 ± 0.11, consistent with unity; coupled with the large distance of the nuclei from the Sun, this indicates that most nuclei have Tempel 1-like thermal inertia. Only two of the 57 nuclei had outlying values (in a statistical sense) of infrared beaming. (b) The known JFC population is not complete even at 3 km radius, and even for comets that approach to ˜2 AU from the Sun and so ought to be more discoverable. Several recently-discovered comets in our survey have small perihelia and large (above ˜2 km) radii. (c) With our radii, we derive an independent estimate of the JFC nuclear cumulative size distribution (CSD), and we find that it has a power-law slope of around -1.9, with the exact value depending on the bounds in radius. (d) This power-law is close to that derived by others from visible-wavelength observations that assume a fixed geometric albedo, suggesting that there is no strong dependence of geometric albedo with radius. (e) The observed CSD shows a hint of structure with an excess of comets with radii 3-6 km. (f) Our CSD is consistent with the idea that the intrinsic size distribution of the JFC population is not a simple power-law and lacks many sub-kilometer objects.

Varieties of Economic Crisis, Varieties of Ideational Change: How and Why Macroeconomic Policy and Financial Regulation Differ

One of the principal tasks facing post-crash academic political economy is to analyse patterns of ideational change and the conditions that produce such change. What has been missing from the existing literature on ideational change at times of crises however, is a sense of how processes of persuasive struggle, and how the success of those ‘norm entrepreneurs’ arguing for ideational change is shaped by two contextual variables: the most immediate material symptoms and problems that a crisis displays (the variety of crisis); and the institutional character of the policy subsystem that agents have to operate within to affect change. Introducing these two variables into our accounts of persuasive struggle and ideational change enables us to deepen our understanding of the dynamics of ideational change at times of crisis. The article identifies that a quite rapid and radical intellectual change has been evident in the field of financial regulation in the form of an embrace of a macroprudential frame. In contrast in the field of macroeconomic policy - both monetary and fiscal policy, many pre-crash beliefs remain prominent, there is evidence of ideational stickiness and inertia, and despite some policy experimentation, overarching policy frameworks and their rationales have not been overhauled. The article applies Peter Hall’s framework of three orders of policy changes to help illuminate and explain the variation in patterns of change in the fields of financial regulation and macroeconomic policy since the financial crash of 2008. The different patterns of ideational change in macroeconomic policy and financial regulation in the post-crash period can be explained by timing and variety of crisis; sequencing of policy change; and institutional political differences between micro policy sub systems and macro policy systems.

Consideration of coastal risk in the Irish spatial planning process

The vulnerability of coastal areas to associated hazards is increasing due to population growth, development pressure and climate change. It is incumbent on coastal governance regimes to address the vulnerability of coastal inhabitants to these hazards. This is especially so at the local level where development planning and control has a direct impact on the vulnerability of coastal communities. To reduce the vulnerability of coastal populations, risk mitigation and adaptation strategies need to be built into local spatial planning processes. Local government, however, operates within a complex hierarchal governance framework which may promote or limit particular actions. It is important, therefore, to understand how local coastal planning practices are shaped by national and supranational entities. Local governments also have to respond to the demands of local populations. Consequently, it is important to understand local populations’ perceptions of coastal risk and its management. Adopting an in-depth study of coastal planning in County Mayo, Ireland, this paper evaluates: (a) how European and national policies and legislation shape coastal risk management at local level; (b) the incorporation of risk management strategies into local plans; and (c) local perception of coastal risks and risk management. Despite a strong steer from supranational and national legislation and policy, statutory local plans are found to be lacking in appropriate risk mitigation or adaptation strategies. Local residents appear to be lulled into a sense of complacency towards these risks because of the low level of attention afforded to them by the local planning authorities. To avoid potentially disastrous consequences for local residents and businesses, it is imperative that this situation is redressed urgently. Based on our analysis, we recommend: the development and implementation of a national ICZM strategy, supported by detailed local ICZM plans; and obliging local government to address known risks in their plans rather than defer them to project level decision making.

Disordered Eating in first year university students: A qualitative study exploring student and support service needs

The paper reports on a qualitative study exploring disordered eating in younger first-year students studying for professional health care related degrees (n=12), and highlights a number of support mechanisms and services required for those students at risk.

Key issues emerging in relation to disordered eating included: concealment; lack of understanding to the nature/risks associated; its use as a stress coping mechanism; isolation; perception as mental health issues with attaching stigma and reticence to acknowledge; invisible experience; wariness of eating in more public refectories. Finally positivity about their arrival at university and that their experience with disordered eating could potentially add to their repertoire as future health care professionals.

Conclusion: The University could; further develop its outreach to new students with a more consistently supportive person-centred program including stress training and more support via student buddying; extend its program on positive mental health; greater awareness particularly the sub-clinical group; consider some small changes and adaptations to the refectory eating areas to better facilitate at- risk students. Finally the University could perhaps better use the first few months of student's arrival at university to help embed a program to develop a stronger sense of coherence and well-being.