52 resultados para schizophrenia, auditory hallucinations, life-world, experience

em Deakin Research Online - Australia


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Couples on their honeymoon represent a vital part of the tourism market. Since the destination decision for honeymooners is a joint decision, paired in-depth interviews were conducted with ten British couples to explore their honeymoon destination decision making. The themes that arose from this qualitative study were consistent with more general studies on destination choice, including: culture, natural environment, and accommodation. New themes developed from the research included familiarity, romance, and budget. The results indicate that couples were more likely to stretch their budget for a honeymoon, or appear to be less concerned about the cost of their trip, as many see it as a once in a lifetime experience. This indicates that this valuable segment ofthe market should be further explored.

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Heideggerian phenomenology is expounded here as a qualitative methodology of value in researching "how things really are" in organisational life. It is a methodology, and a philosophy, which recognises a priori the value ofthe subjective, lived experience of the informant, and the physical, sociological and psychological phenomena that come together to create their life-world. In this paper, the authors present cases where this methodology successfully revealed the respondents' reality. Stories about working in teams and being downsized are shared to demonstrate the ability of Heideggerian phenomenology to reveal how life really is in organisations.

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Motor neurone disease (MND) is an uncommon neurodegenerative disease that is terminal and has an insidious onset. With no known cause or cure, the disease triggers progressive death of motor neurones that causes increasing difficulties with mobility, communication, breathing and nutrition. Most research focuses on the disease process, but little is known of the illness experience from the perspective of those diagnosed with the disease. The aim of this study was to explore what it is like to live with MND and how people with the disease negotiate with others to exercise choice over the way they live. A grounded theory methodology was used to explore the life world of people diagnosed and living with MND. Data were collected via in-depth interviews, their stories and photographs, poems and books participants identified as important and fieldnotes. The textual data were analysed using constant comparative analysis. The majority of participants experienced difficulty with verbal communication. Some invited a third person to interpret their speech and others used assistive technologies such as Lightwriters and computers. Analysis revealed three constructs that, together, told the story of the MND illness experience. First, was the “diagnosis story” that described the devastating process of repeated tests had on the participants, shattering their trust in the competence of the health care system. The second construct revealed the process of living with MND as cyclical and repetitive requiring constant decision-making to adapt to the ongoing changes connected with the disease. The core theme and basic social process of “maintaining personal integrity” evolved as the third construct. This process underpinned and explained participants’ decision-making. Finally a substantive theory was conceptualised as the illness experience: “maintaining personal integrity in the face of ongoing change and adaptation”. This theory illustrates that the basic social process of maintaining personal integrity is central to decision and choice making while living with MND. The findings have implications for people with MND, their carers, health professionals and service providers. Recommendations include improved counselling services for people at the time of diagnosis; the introduction of nurse specialists to support health professionals, people diagnosed with the disease and their families; open, accessible, realistic health and funding policies.

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Research on social inclusion often focuses on social exclusion. However, in order to gain greater insights into ways to facilitate social change, it is equally important to research the social inclusion of those normally excluded. Indeed, while one important purpose of studying disabilism is to catalogue and critique all its forms, another critical purpose is to better understand how disabilism can be resisted and/or ameliorated at individual and/or societal levels. Thus, it is equally important to understand when, why and how disabilism does not negatively impact the lives of people with impairments as well as when it does. This paper presents a single case study of Lynette, a young woman with a severe visual impairment who has a life-changing experience in an inclusive environment. In particular, it explores the impact of exclusive and inclusive contexts on Lynette's identity development as she transitions to adulthood. By juxtaposing Lynette's experiences of exclusion with those of inclusion, it highlights contexts in which there is a critical mass of people with impairments living alongside able-bodied people as a possible antecedent/impetus for greater social inclusion of people with impairments in society more generally.

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BACKGROUND: Clozapine is an effective treatment for a proportion of people with schizophrenia (SZ) who are resistant to the beneficial effects of other antipsychotic drugs. However, anything from 40-60 % of people on clozapine experience residual symptoms even on adequate doses of the medication, and thus could be considered 'clozapine resistant'. Agents that could work alongside clozapine to improve efficacy whilst not increasing the adverse effect burden are both desired and necessary to improve the lives of individuals with clozapine-resistant SZ. N-Acetylcysteine (NAC) is one such possible agent. Previous research from our research group provided promising pilot data suggesting the efficacy of NAC in this patient population. The aim of the study reported here is to expand this work by conducting a large scale clinical trial of NAC in the treatment of clozapine-resistant SZ.

METHODS: This study is an investigator initiated, multi-site, randomised, placebo-controlled trial. It aims to include 168 patients with clozapine-resistant SZ, divided into an intervention group (NAC) and a control group (placebo). Participants in the intervention group will receive 2 g daily of NAC. The primary outcome measures will be the negative symptom scores of the Positive and Negative Syndrome Scale (PANSS). Secondary outcome measures will include: changes in quality of life (QoL) as measured by the Lancashire Quality of Life Profile (LQoLP) and cognitive functioning as measured by the total score on the MATRICS. Additionally we will examine peripheral and cortical glutathione (GSH) concentrations as process outcomes.

DISCUSSION: This large scale clinical trial will investigate the efficacy of NAC as an adjunctive medication to clozapine. This trial, if successful, will establish a cheap, safe and easy-to-use agent (NAC) as a 'go to' adjunct in patients that are only partly responsive to clozapine.

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Heideggerian phenomenology is expounded here as a qualitative methodology of value in researching "how things really are" in organizational life. It is a methodology, and a philosophy, that recognizes a priori the value of the subjective, lived experience of the individual, and the physical, sociological, and psychological phenomena that come together to create a life-world. In this paper, the authors present three cases where this methodology successfully revealed the employee's reality. Stories about working in teams, being downsized, and having an unseen chronic illness at work are shared to demonstrate the ability of Heideggerian phenomenology to reveal how life really is in organizations. The benefit for HR practitioners and managers is an increased understanding of and, hence, ability to address these sensitive and often unspoken aspects of organizational life.

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This paper describes and analyzes the necessary misreadings of Giorgio Agamben’s account of ‘bare life’ in a recent performance in Melbourne, Australia. The ‘Bare Life’ project deals with Australia’s treatment of asylum seekers with reference to Agamben’s work on sovereign power and uses the on-line second life world as both a metaphor for the refugee’s desire for a new life, and a literal site of performance. The development showing explored the interactions between live performance and second life avatars in real time. This paper deals with the philosophical, ethical and practical problems that emerged during the development, and argues that the ‘misreading’ is an inevitable, but useful part of finding ways to embody philosophical and political ideas in performance.

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In 2008, the Australian Federal Minister for Ageing identified the importance of promoting social engagement amongst older Australians who frequently rely on community arts organizations to enhance quality of life, specifically in health, happiness and community. The arts are identified as a powerful catalyst in building strong communities that have the potential for connection, caring and social development. Greater active engagement in performing arts by older people is positively related to enhanced individual and community well-being. Our research study, Wellbeing and ageing: community, diversity and the arts (begun in 2008), explores cultural diversity and complexity within older Australian society through an examination of engagement with a community choir. In 2009 data were collected via semi-structured interviews that were analysed using Interpretative Phenomenological Analysis which utilises a phenomenological approach that explores personal experience in the participant’s life-world. Our research study focuses on one community choir, the Bosnian Behar Choir, in Victoria, Australia, as a lens through which to explore active ageing. Three significant issues were identified from this research which will be reported under the themes of well-being, community and cultural diversity. The Bosnian Behar Choir demonstrates how community music making can enhance well-being and positive ageing in contemporary Australia.

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The promotion of social engagement amongst older Australians is a national priority. Music is a powerful social mechanism that allows individuals and communities to affirm identity, gain a sense of belonging, and share history and culture. Community choir membership offers older people opportunities to connect with others and share a sense of purpose that can enhance their sense of well-being and potentially reduce their experience of social isolation. This paper explores the understandings of well-being, positive ageing and community music making held by members of three choirs in Victoria; Australia. The choirs selected for this discussion are the Coro Furlan, the Skylarkers and the Bosnian Behar Choir. Data have been collected via semi-structured interview with members of the three choirs and analyzed using interpretative Phenomenological Analysis which employs a phenomenological approach that explores personal experience in the participant's life-world. analysis of the combined data identified two broad common themes: First is the personal impact that choir membership has for the individual which includes the building of friendships and opportunities to learn and share music. The second theme concerns the contribution that the choir can make to others in their local community. Thus older singers are provided with a way to be both engaged, validated and appreciated by their contemporary society. Choir participation is an effective way for individuals to express themselves, engage with each other, improve their quality of life, transmit cultural heritage, and build community.

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With escalating health expenditure and a shrinking purse, there is increased focus on the cost efficacy of still patented versus generic medications in general, and for atypical antipsychotics in particular. In a recent BMC Medicine article, Godman and colleagues presented data indicating poor uptake of the off patent atypical antipsychotic risperidone, arguing for authorities to mandate its greater use. This is under the assumption of clinical equivalence of atypical antipsychotics. This commentary argues that there are clinically meaningful differences between atypical antipsychotics and important inter-individual heterogeneity in clinical response and tolerability. Access to a broad range of atypical antipsychotics enables clinicians to tailor care, taking consideration of differential efficacy and adverse effects profile in order to meet the needs of individual patients with improved real world effectiveness of treatment. Restriction of agent choice risks detracting from optimal clinical care, with possible poorer outcomes and greater costs of care. A balance between encouraging use of cheapest in class agent and allowing access to various atypical agents for tailored care is likely to produce optimal health outcomes.Please see related article: http://www.biomedcentral.com/1741-7015/12/98.

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My thesis examines the link between families, harm and knowledge in a society where knowledge is increasingly the central organising principle (Bohme 1997: 449-450; Stehr 1994: 6), and represents the capacity for action (Stehr 1994: 8). I observed as a consultant in the 1990s that practitioners in family work were able to articulate what works but often unable to articulate why and therefore unable easily to replicate what works. This time coincided with increasing commentary on complexities of living, capacity of families to cope, identification of the scale of family harm, and use of the term 'the knowledge society'. My aim is to identify why what works, works with families exhibiting harmful behaviours and families acquiring knowledge from learning everyday life skills so as to lead less harmful and more fulfilling lives. And by such explanations inform, replicate and scale up practice to benefit more families exhibiting harm. I conceptualise the outcome as a sequence of family, community and policy work in an ecological framework (Bronfenbrenner 1979) within a knowledge society. My method was a year-long action research project with a family support service in New South Wales. I engaged in reflective practice with workers, and a parallel literature review that supported additional reflective practice. I found growing complexity of life requires growing knowledge. I found a distinction between everyday and abstract life worlds, and with families principally acting in the everyday life world. It is a world from which some families and their members seek to escape, often by means of harmful behaviours of neglect, abuse and violence. I substantiated the link that the family support service of my study sees between relationships, behaviours and affects; and I linked this in turn with its therapeutic engagement of the whole family — adults and children, male and female, victims and perpetrators. This engagement involves a process of learning (Rogers 1967: 280) to acquire fulfilling behaviours. It is a process of adult and experiential learning of relationship skills, drawing on under-used reserves of families. Relationship skills form a basis of acquiring other life skills since most require relationships with others to perform life skills. Combining the sequence of family, community and policy work with workers engaging in reflective practice of their work creates capacity for community institutions to replicate and scale up what works and why. Understanding this sequence may assist community institutions to inform policymakers of benefits common to all policy interests of such replication and scaling up. I conceptualise a policy framework of families and knowledge in a knowledge society and two lower level frameworks of process and content of life skills. Implications of these for practice, policy, and theory include a greater distinction between everyday and abstract knowledge and skills; recognition of a sequential process of information, learning, and knowledge; and inclusiveness and fluidity in learning in diverse adult learning settings and in family support professions.

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This study explores the defining moments in six men’s lives. The empirical dimension of the research is built around the personal narratives these men tell of their lives across a series of four interviews. The central research theme is the notion of the defining moment as a key element in the processes of establishing how men understand and interpret the events and incidents that have shaped their lives. In the context of this study, the defining moment is seen as the moment or period in time when an individual gives definition to a specific event or experience, as a transition point with (potentially) life-altering consequences. Some of the thematic structures presented include relationships with significant adults (parents, teachers), masculinity, self-harm, schooling, mental illness, isolation, loneliness, stress and relationships with peers. In my pursuit of a methodology that could accommodate the aims of this study, I explored the process of meaning through the qualitative paradigm. Drawing on the principles of qualitative research, as applied through narrative inquiry, I deployed a semi-structured interview format to collect the lived experiences of participants. By privileging the stories that individuals tell of their experiences, the narrative method recognises that data are inexorably located in the contextual and contingent. The experiences and narratives that are presented in this thesis are built around the authentic voices of participants. The study presents a warrant for working with men’s defining moments to disrupt, alter and redefine their attitudes and behaviours in order to improve their lives. Based on the insights gleaned through this study, I argue that there are defining times/points in people’s lives where their experiences can be life altering. When these experiences involve uncertainty, anxiety, stress and other pernicious effects, their longer-term consequences can be devastating. The study confirms existing research, that men are reluctant to seek help or reveal their insecurities during such times, therefore making them particularly vulnerable to defining moments. The conclusion of this thesis establishes some broad recommendations pertaining to working effectively with men and their defining moments. I focus particular attention on the place of schooling and education in helping individuals recognise and respond to the early symptoms of what is potentially a life-altering experience. Schools and, by association, teachers need to be actively and strategically involved in this process. To this end, I argue the need for targeted interventions that are both sensitive and timely. In their engagements with young males, parents, teachers, coaches and mentors need to be particularly attuned to their silent screams for help.

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Since the late 1980s, representations of Japanese national identity and Japanese old age have been deconstructed. Images of the resilience of traditional cultural and social institutions are shown to have over-emphasized social and cultural homogeneity, elided social differentiation and inequality and minimized the significance of historical transformation. Key institutions of the postwar modernization project, including the patriarchal seniority system and household structure, are being transformed through globalization and feminization. This thesis focuses on the problem of representing individual and collective ageing in Japan in the context of modernization. Research is focussed on the contradictions, within essentialist representations of Japanese collective and individual identity, between socially constructed policy forms of old age and collective identities. Contemporary trends towards individualization and diversification of identities, and discourses on the ageing/information society, indicate cultural distance between an instrumentally rational administration and the life world of old people. Research explores the concept of embodiment through its significance in debates on postmodernization of the lifecourse in accordance with the structural shifts towards a postindustrial structure. This study examines representations of old age in broader social and cultural processes. Images of the social and cultural trajectory of the lifecourse draw attention to the embodiment of individual identities and ultimately generational cultures in contemporary social and cultural spaces. This research is the result of analyses of old age, which have been informed by postmodern theory. It in turn informs sociological theorizations of cultural representations of old age in contemporary societies.