The role of cognitions and beliefs in trichotillomania: a qualitative study using interpretative phenomenological analysis

Trichotillomania (TTM) is characterised by the removal of one's hair, causing hair loss. Phenomenological research on TTM has investigated its associated behavioural and affective factors. Few studies have investigated the possible role of cognitions and beliefs, despite emerging support for cognitive therapies in treating this disorder. This study aimed to explore and describe the cognitions and beliefs that contribute to the onset and maintenance of hairpulling in TTM. Eight women with TTM participated in semi-structured, in-depth interviews to explore their experience of cognitions and beliefs before, during and after typical hairpulling episodes. Interviews were analysed using the qualitative method of Interpretative Phenomenological Analysis. Six superordinate themes of beliefs were identified as important: negative self-beliefs, control beliefs, beliefs about coping, beliefs about negative emotions, permission-giving beliefs, and perfectionism. These preliminary findings suggest that cognitions may play an important role in TTM phenomenology. Future quantitative research on the role of cognitions and beliefs in TTM in larger samples has the potential to advance cognitive-behavioural models and treatments of this poorly understood disorder.

Engaging patients and families in communication across transitions of care: an integrative review protocol

AIM: To describe an integrative review protocol to analyse and synthesize peer-reviewed research evidence in relation to engagement of patients and their families in communication during transitions of care to, in and from acute care settings.

BACKGROUND: Communication at transitions of care in acute care settings can be complex and challenging, with important information about patients not always clearly transferred between responsible healthcare providers. Involving patients and their families in communication during transitions of care may improve the transfer of clinical information and patient outcomes and prevent adverse events during hospitalization and following discharge. Recently, optimizing patient and family participation during care transitions has been acknowledged as central to the implementation of patient-centred care.

DESIGN: Integrative review with potential for meta-analysis and application of framework synthesis.

REVIEW METHOD: The review will evaluate and synthesize qualitative and quantitative research evidence identified through a systematic search. Primary studies will be selected according to inclusion criteria. Data collection, quality appraisal and analysis of the evidence will be conducted by at least two authors. Nine electronic databases (including CINAHL and Medline) will be searched. The search will be restricted to 10 years up to December 2013. Data analysis will include content and thematic analysis.

DISCUSSION: The review will seek to identify all types of patient engagement activities employed during transitions of care communication. The review will identify enablers for and barriers to engagement for patients, families and health professionals. Key strategies and tools for improving patient engagement, clinical communication and promoting patient-centred care will be recommended based on findings.

The burden of neck pain: its meaning for persons with neck pain and healthcare providers, explored by concept mapping

PURPOSE: To empirically define the concept of burden of neck pain. The lack of a clear understanding of this construct from the perspective of persons with neck pain and care providers hampers adequate measurement of this burden. An additional aim was to compare the conceptual model obtained with the frequently used Neck Disability Index (NDI). METHODS: Concept mapping, combining qualitative (nominal group technique and group consensus) and quantitative research methods (cluster analysis and multidimensional scaling), was applied to groups of persons with neck pain (n = 3) and professionals treating persons with neck pain (n = 2). Group members generated statements, which were organized into concept maps. Group members achieved consensus about the number and description of domains and the researchers then generated an overall mind map covering the full breadth of the burden of neck pain. RESULTS: Concept mapping revealed 12 domains of burden of neck pain: impaired mobility neck, neck pain, fatigue/concentration, physical complaints, psychological aspects/consequences, activities of daily living, social participation, financial consequences, difficult to treat/difficult to diagnose, difference of opinion with care providers, incomprehension by social environment, and how person with neck pain deal with complaints. All ten items of the NDI could be linked to the mind map, but the NDI measures only part of the burden of neck pain. CONCLUSION: This study revealed the relevant domains for the burden of neck pain from the viewpoints of persons with neck pain and their care providers. These results can guide the identification of existing measurements instruments for each domain or the development of new ones to measure the burden of neck pain.

Improving waste management in construction projects: an Australian study

Construction waste generation has been identified as one of the major issues in the construction industry due to its direct impacts on the environment as well as the efficiency of the construction industry. As the industry cannot continue to practice if the environmental resources on which it depends are depleted, the significance of waste management needs to be understood in order to encourage stakeholders to achieve related goals. Therefore, this research aims to determine effective approaches to eliminate and/or minimise waste generation in construction projects. Mixed methods were adopted by combining qualitative and quantitative research approaches. Interviews and a questionnaire survey were conducted as the primary data collection methods. The findings reveal twenty six critical solutions for waste management. Five factors of solutions for waste management were extracted from the exploratory factor analysis. These factors were: team building and supervision; strategic guidelines in waste management; proper design and documentation; innovation in waste management decisions; and lifecycle management. The evidence from this study suggests that both technologies and attitudinal approaches require improvement to eliminate/minimise waste generation in construction projects. Similarly, attention should be paid to being mindful of the environmental effects of waste generation and avoiding waste generation as early as possible in construction projects.

Adolescent energy drink consumption: An Australian perspective.

Caffeinated Energy Drinks (EDs) are not recommended for consumption by children, yet there is a lack of age-specific recommendations and restrictions on the marketing and sale of EDs. EDs are increasingly popular among adolescents despite growing evidence of their negative health effects. In the current study we examined ED consumption patterns among 399 Australian adolescents aged 12-18 years. Participants completed a self-report survey of consumption patterns, physiological symptoms, and awareness of current ED consumption guidelines. Results indicated that ED consumption was common among the sample; 56% reported lifetime ED consumption, with initial consumption at mean age 10 (SD = 2.97). Twenty-eight percent of the sample consumed EDs at least monthly, 36% had exceeded the recommended two standard EDs/day, and 56% of consumers had experienced negative physiological health effects following ED consumption. The maximum number of EDs/day considered appropriate for children, adolescents, and adults varied, indicating a lack of awareness of current consumption recommendations. These findings add to the growing body of international evidence of adolescent ED consumption, and the detrimental impact of EDs to adolescent health. Enforced regulation and restriction of EDs for children's and adolescents' consumption is urgently needed in addition to greater visibility of ED consumption recommendations.

Shining the light on the dark side of medical leadership - a qualitative study in Australia

Purpose The paper aims to explore the beliefs of doctors in leadership roles of the concept of "the dark side", using data collected from interviews carried out with 45 doctors in medical leadership roles across Australia. The paper looks at the beliefs from the perspectives of doctors who are already in leadership roles themselves; to identify potential barriers they might have encountered and to arrive at better-informed strategies to engage more doctors in the leadership of the Australian health system. The research question is: "What are the beliefs of medical leaders that form the key themes or dimensions of the negative perception of the 'dark side'?". Design/methodology/approach The paper analysed data from two similar qualitative studies examining medical leadership and engagement in Australia by the same author, in collaboration with other researchers, which used in-depth semi-structured interviews with 45 purposively sampled senior medical leaders in leadership roles across Australia in health services, private and public hospitals, professional associations and health departments. The data were analysed using deductive and inductive approaches through a coding framework based on the interview data and literature review, with all sections of coded data grouped into themes. Findings Medical leaders had four key beliefs about the "dark side" as perceived through the eyes of their own past clinical experience and/or their clinical colleagues. These four beliefs or dimensions of the negative perception colloquially known as "the dark side" are the belief that they lack both managerial and clinical credibility, they have confused identities, they may be in conflict with clinicians, their clinical colleagues lack insight into the complexities of medical leadership and, as a result, doctors are actively discouraged from making the transition from clinical practice to medical leadership roles in the first place. Research limitations/implications This research was conducted within the Western developed-nation setting of Australia and only involved interviews with doctors in medical leadership roles. The findings are therefore limited to the doctors' own perceptions of themselves based on their past experiences and beliefs. Future research involving doctors who have not chosen to transition to leadership roles, or other health practitioners in other settings, may provide a broader perspective. Also, this research was exploratory and descriptive in nature using qualitative methods, and quantitative research can be carried out in the future to extend this research for statistical generalisation. Practical implications The paper includes implications for health organisations, training providers, medical employers and health departments and describes a multi-prong strategy to address this important issue. Originality/value This paper fulfils an identified need to study the concept of "moving to the dark side" as a negative perception of medical leadership and contributes to the evidence in this under-researched area. This paper has used data from two similar studies, combined together for the first time, with new analysis and coding, looking at the concept of the "dark side" to discover new emergent findings.

Clinical research 5: quantitative data collection and analysis

This six-part research series is aimed at clinicians who wish to develop research skills, or who have a particular clinical problem that they think could be addressed through research. The series aims to provide insight into the decisions that researchers make in the course of their work, and to also provide a foundation for decisions that nurses may make in applying the findings of a study to practice in their own Unit or Department. The series emphasises the practical issues encountered when undertaking research in critical care settings; readers are encouraged to source research methodology textbooks for more detailed guidance on specific aspects of the research process.

A couple of points:

1. It is artificial to describe research as qualitative or quantitative. Studies often include both dimensions. However, for the purposes of this paper/series, this distinction is drawn for clarity of writing.

2. It is common practice for quantitative studies to refer to study ‘subjects’ and qualitative studies to refer to study ‘participants’. For ease of reading, the latter term will be used throughout this series.

Quantitative analysis of research mediums' consious experiences during a discarnate reading versus a control task : a pilot study

Mediums claim to be able to report accurate and specific information about the deceased loved ones (termed discarnates) of living people (termed sitters) even without any prior knowledge about the sitters or the discarnates and in the complete absence of any sensory feedback. Despite recent proof-focused experimental research investigating this phenomenon (e.g., Beischel & Schwartz, 2007), no published studies have attempted to quantify the phenomenological effects of discarnate readings. The aim of the present study was, thus, to investigate experimentally the phenomenological differences that arose psychologically in accordance with the demands of a discarnate reading task versus a control task. Seven mediums were administered counter-balanced sequences of a discarnate reading and control condition. The discarnate reading condition consisted of a phone reading including questions about a discarnate where only a blinded medium and a blinded experimenter were on the phone. The control condition consisted of a phone conversation between the medium and the same experimenter in which the medium was asked similar questions regarding a living person s/he (i.e., the medium) knew. Mediums’ phenomenology during each condition was retrospectively assessed using the Phenomenology of Consciousness Inventory (PCI). Phenomenology associated with the discarnate reading condition appeared to be significantly different from phenomenology associated with the control condition. Future research might use the PCI to address whether the phenomenology reported by mediums during discarnate readings is quantitatively different from their experiences during psychic telepathy readings for the living.

"Beyond number crunching" : applying qualitative techniques in sport marketing research

Valid and reliable research is pivotal to successful sport marketing strategy. Market research may be gathered via either quantitative or qualitative means. This paper explores the theoretical background and practical applications of qualitative research techniques. It explains the appropriate context for qualitative approaches, and discusses sampling procedures with particular emphasis on the powerful but simple technique known as theoretical sampling. In addition, it clarifies and explores data analysis procedures. The purpose of this paper is to provide sport market research practitioners with a model for implementing qualitative methodologies in sport marketing campaigns.

Children's perceptions of their home and neighborhood environments, and their association with objectively measured physical activity: A qualitative and quantitative study

Environmental factors may have an important influence on children’s physical activity, yet children’s perspectives of their home and neighborhood environments have not been widely assessed. The aim of this study was to investigate children’s perceptions of their environments, and to examine associations between these perceptions and objectively measured physical activity. The sample consisted of 147, 10-year-old Australian children, who drew maps of their home and neighborhood environments. A subsample of children photographed places and things in these environments that were important to them. The maps were analyzed for themes, and for the frequency with which particular objects and locations appeared. Physical activity was objectively measured using accelerometers. Six themes emerged from the qualitative analysis of the maps and photographs: the family home; opportunities for physical activity and sedentary pursuits; food items and locations; green space and outside areas; the school and opportunities for social interaction. Of the 11 variables established from these themes, one home and two neighborhood factors were associated with children’s physical activity. These findings contribute to a broader understanding of children’s perceptions of their environment, and highlight the potential importance of the home and neighborhood environments for promoting physical activity behavior.

Beliefs about genetically modified foods : a qualitative and quantitative exploration

This study is aimed to examine consumers' beliefs about genetically modified foods. Ten focus group interviews of community members and a random questionnaire-based mail survey of 500 Australian (Victorian) adults were conducted (58% response). Participants were generally negative about genetically modified foods, with concerns being raised about them being unnatural, difficult to identify, and having unknown long-term health and environmental effects. Many participants were unaware of or disagreed with the benefits of genetically modified foods that are promoted by its advocates and there were some misconceptions present. These findings provide information for both advocates and opponents of genetically modified foods and a basis for future larger-scale research.

Easier analysis and better reporting : modelling ordinal data in mathematics education research

This article presents an examination of the use of Rasch modelling in a major research project, 'Improving Middle Years Mathematics and Science' (IMYMS). It is unarguable that it is important to take students' perceptions, or views, into account when planning learning and teaching for them. The IMYMS student perceptions survey is an attempt to make visible these student viewpoints, and report them in a way that is accessible to teachers and researchers involved in the project. The project involves four clusters of schools from urban and regions of Victoria to investigate the role of mathematics and science knowledge and subject cultures in mediating change processes in the middle years of schooling. There are five secondary and twenty-eight primary schools. The project has generated both qualitative and quantitative data, with much of the qualitative data being ordinal in nature. Reporting the results of analyses for a range of audiences necessitates careful, well-designed report formats. Some useful new report formats based on Rasch modeling -the Modified Variable Map, the Ordinal Map, the Threshold Map, and the Annotated Ordinal Map - are illustrated using data from the IMYMS project. The Rasch analysis and the derived reporting formats avoid the pitfalls that exist when working with ordinal data and provide insights into the respondents' views about their experiences in schools unavailable by other approaches.

Research methodologies for planning ecotourism and nature conservation

Ecotourism is an important niche market in the world tourism industry. It is becoming increasingly popular as an alternative to mass tourism. The emergence of ecotourism was facilitated by the environmental damage associated with mass tourism. Ecotourism is defined in many ways and there is no consensus as to its exact meaning. However, a number of salient elements, such as environmental conservation, maintenance of biodiversity, a satisfying experience for the visitors, study and appreciation of nature and sustainable community development, are included in many definitions. Tourism creates negative environmental externalities in the form of environmental damage. Such adverse effects can have serious implications for the tourism industry because they damage the very natural resource that forms the raw material for ecotourism. Ecotourism ventures should thus be properly planned and implemented and carefully monitored. Proper planning of ecotourism is hampered by the paucity of relevant qualitative and quantitative information. The use of analytical tools such as the Contingent Valuation Method, carrying capacity, decision analysis techniques with which multiobjective and uncertain consequences can be analysed, and other management strategies, such as the Safe Minimum Standard, can be useful in enabling better planning of ecotourism. Ecotourism can thus enhance the opportunities for better management of natural resources while providing a satisfying experience for the visitor.