A qualitative investigation of decision making during help-seeking for adult hearing loss

Objective: The Any Qualified Provider framework in the National Health Service has changed the way adult audiology services are offered in England. Under the new rules, patients are being offered a choice in geographical location and audiology provider. This study aimed to explore how choices in treatment are presented and to identify what information patients need when they are seeking help with hearing loss. Design: This study adopted qualitative methods of ethnographic observations and focus group interviews to identify information needed prior to, and during, help-seeking. Observational data and focus group data were analysed using the constant comparison method of grounded theory. Study sample: Participants were recruited from a community Health and Social Care Trust in the west of England. This service incorporates both an Audiology and a Hearing Therapy service. Twenty seven participants were involved in focus groups or interviews. Results: Participants receive little information beyond the detail of hearing aids. Participants report little information that was not directly related to uptake of hearing aids. Conclusions: Participant preferences were not explored and limited information resulted in decisions that were clinician-led. The gaps in information reflect previous data on clinician communication and highlight the need for consistent information on a range of interventions to manage hearing loss.

Munkapiac keresési súrlódásokkal (Job seeking on the labour market, with frictions)

A munkapiac különleges piac, jellegzetességeinek köszönhetően számos modell elemzi. Ezek közül a legismertebbek a keresési-párosítási modellek, amelyek több egymáshoz kapcsolódó kérdéskör vizsgálatára is alkalmasak. A modellcsalád által megmagyarázható munkapiaci jelenségek széles köre, a belőlük levonható következtetések, a modellek magyarázóképességéről folytatott vita egyaránt hozzájárult, hogy a modellek kidolgozói 2010-ben közgazdasági Nobel-emlékdíjban részesültek. Modelljük kiterjeszti a munkanélküliség természetes rátájának elméletét, képes a jóléti intézkedések és intézményrendszer beépítésére. A szerző e modellek elméleti előzményei, valamint egy alapmodell ismertetése után felvázolja az újabb generációs modellek alapvonásait, a hatékonyságelemzések tanulságait, az állami intézkedések vizsgálatának lehetőségeit, valamint a Shimer-kritika alapjait. / === / The labor market is a specialized market with characteristics that have produced several different models for analysing it. One of the best known is the search and matching model, which is suitable for analysis of several related issues. The broad range of labour market phenomena that can be described by this family of models, the conclusions to be drawn from them, and the debate on their explanatory capability have all contributed to the fact that three economists who made important contributions to developing them - P. A. Diamond, D. T. Mortensen and C. A. Pissar-ides - were awarded the Nobel Prize in Economics in 2010. The DMP model named after them expands the theory of the natural rate of unemployment and is capable of integrating the analysis of welfare measures and institutions. This paper follows up on the contribution of the Nobel Prize winners by examining the theoretical preliminaries of these models, a basic search and matching model, and by looking at the typical characteristics of a new generation of models, the lessons of efficiency analyses, the possibility of investigating the role of policy measures, and the foundations of Shimer's critique.

The solution-seeking behavior of small Hungarian enterprises between 2006 and 2010

This paper describes the results of an investigation into the finance-related innovative ability of Hungarian micro, small and medium sized enterprises (SMEs) by using two datasets (from 2006 and 2010). The author explored SMEs’ levels of openness to new financial solutions and identified features which influence their innovative solution-seeking behavior. Additionally, changes in innovation between 2006 and 2010 were analyzed according to the SME sector and whether there is a correlation between having an active solution seeking attitude and business performance was examined. The findings show that shared/multiple ownership in businesses (having interests in different enterprises simultaneously) has a significant positive effect on flexibility and innovative ability. However, the size of the business, industrial sector, type of ownership and market of the SME also have some effect. Furthermore, the hypothesis that an active solution-seeking attitude increases after-tax performance per employee was confirmed.

Florida International University Magazine Winter 2005: Seeking Enlightenment

Copy of Florida International University Magazine published Winter 2005 with a feature article on the new Center for the Study of Spirituality at Florida International University .

Swimming against the tide: A study of a youth enrichment program seeking to empower inner-city Black youth

Serious inequities in our K-12 public education system, particularly in regard to the quality of education in predominately Black inner-city schools, are well-documented in the literature (Freeman, 1998; Ross, 1998). Moreover, there is general agreement that the most effective means of ameliorating that situation is through well-thought-out after-school programs and partnership initiatives (Beck, 1993; Gardner et al., 2001). ^ The purpose of this qualitative study was to examine the programmatic interventions of a youth enrichment program for inner-city Black youth currently in place at the Overtown Youth Center (OYC) in Miami, Florida, in order to: (a) discern those factors that support its claim that it is making a difference in students’ lives, (b) explore how any such factors are implemented, and (c) determine whether its interventions have served to equalize the playing field for these youth. ^ Two primary methods of data collection were used for this study. The first was participant observation conducted over the course of two years through a partnership initiative established and led by this author. The second was through in-depth interviews of the Center’s founder, staff, and students. Secondary methods used were the recording of informal conversations and the analysis of written documents. ^ Analysis of the data yielded four features of the Center that are indispensible to the students’ growth. The center provides the youth with (a) physical and psychological safety, (b) supportive relationships, (c) exposure to cultural and educational opportunities, and (d) assistance in building self-esteem. ^ The most significant finding of the study was that OYC has been successful at making a difference in students’ lives and at increasing their aspirations to attend college. By addressing the full spectrum of their needs, the Center has given them many of the necessary tools with which to compete and thereby helped equalize their opportunities to succeed in school and in life. ^ The study also noted a number of challenges for the Center to examine. The main issues that need to be addressed more seriously are staff turnover, staff indifference, nepotism, inconsistent student attendance, and insufficient focus on racial issues and African-American-centered education. Meeting those challenges would engender even greater positive outcomes.^

University Policies that Increase· and/or Decrease Access for African- American Women Seeking Advanced Degrees

The policies of most universities show a lack of dedication in addressing the needs of their non-traditional graduate students, particularly African-American women seeking advanced degrees. As African-American women return to the academy to pursue doctoral degrees, universities must address the issues facing women in general and African-American women in particular.

A phenomenological perspective of the lived experiences of Jewish holocaust survivors seeking health care in the United States today

Seven Jewish Holocaust survivors were interviewed using a phenomenological method to determine the essence of the Jewish Holocaust survivor's experience with health care in the United States today. The transcriptions were analyzed using Colaizzi's approach to phenomenological research. This approach includes extraction of significant statements, from the transcriptions, that described the participant's health care behaviors and needs. Formulated meanings of the significant statements were then organized into six themes: Hiding and Avoidance, Self care, Fear/Trust Dichotomy, Security, Luck, and Need for Understanding. These six themes were forms of protection for the participants, which ultimately led to continued survival, the essence of their experience. Knowledge of their experience may direct the nurse in implementing creative and appropriate nursing interventions to provide comfort and assist the survivor with their needs in today's health care arena.

Unemployment office with unemployed seeking jobs

General note: Title and date provided by Bettye Lane.

Online information seeking by patients with bipolar disorder:results from an international multisite survey

Background: Information seeking is an important coping mechanism for dealing with chronic illness. Despite a growing number of mental health websites, there is little understanding of how patients with bipolar disorder use the Internet to seek information. Methods: A 39 question, paper-based, anonymous survey, translated into 12 languages, was completed by 1222 patients in 17 countries as a convenience sample between March 2014 and January 2016. All patients had a diagnosis of bipolar disorder from a psychiatrist. Data were analyzed using descriptive statistics and generalized estimating equations to account for correlated data. Results: 976 (81 % of 1212 valid responses) of the patients used the Internet, and of these 750 (77 %) looked for information on bipolar disorder. When looking online for information, 89 % used a computer rather than a smartphone, and 79 % started with a general search engine. The primary reasons for searching were drug side effects (51 %), to learn anonymously (43 %), and for help coping (39 %). About 1/3 rated their search skills as expert, and 2/3 as basic or intermediate. 59 % preferred a website on mental illness and 33 % preferred Wikipedia. Only 20 % read or participated in online support groups. Most patients (62 %) searched a couple times a year. Online information seeking helped about 2/3 to cope (41 % of the entire sample). About 2/3 did not discuss Internet findings with their doctor. Conclusion: Online information seeking helps many patients to cope although alternative information sources remain important. Most patients do not discuss Internet findings with their doctor, and concern remains about the quality of online information especially related to prescription drugs. Patients may not rate search skills accurately, and may not understand limitations of online privacy. More patient education about online information searching is needed and physicians should recommend a few high quality websites.

Facilitators and Barriers to Naloxone Kit Use Among Opioid-Dependent Patients Seeking Treatment at Medication Assisted Therapy Clinics in North Carolina, USA

Naloxone – an opioid antagonist that reverses the effects of opioids, including potential death from overdose – is increasingly being distributed in non-medical settings. We conducted a mixed methods study administering a survey to 100 treatment seekers and pursuing observant participation at four methadone/buprenorphine Medication Assisted Therapy (MAT) clinics in North Carolina, USA. Female participants were more likely to have gotten a kit and to carry it with them, whereas male participants were more likely to have witnessed an overdose and to have made use of naloxone. Men discussed the difficulties of carrying the naloxone kits, which are currently too large to fit in a pocket. Public health officials may be relieved to know that naloxone users intend to call emergency services.

Understanding Patients’ Needs and Healthcare Seeking Behavior in Rural Southern India: The Comparison of Providers through Patients’ Perceptions and Cost Issues

This study explores patients’ needs in rural Thanjavur, southern India through understanding how people with diabetes choose providers and perceive care-seeking experience. To measure perception, the study surveyed people regarding six common barriers to care-seeking behavior, selected from both literature and local expert interview. Ninety-one percent of the sampled population goes to public or private allopathic providers out of the six presented providers. The low socioeconomic group and people with more complications or comorbidities are more likely to go to private allopathic providers. What is more, there is no difference between public and private allopathic providers in patients’ perception of care except for perceived cost. Positive perceptions in both providers are very common except for perceptions in blood-sugar management, distance to facilities, and cost of care. Sixty-six percent of patients perceived their blood-sugar control to fluctuate or have no change versus improved control. Twenty-seven percent of patients perceived the distance to facilities as unreasonable, and sixty-two percent of patients perceived the cost as high for them. The results suggest that cost may affect low socioeconomic people’s choice of care significantly. However, for people in middle and higher socioeconomic groups, cost does not appear to be a major factor. For qualitative text analyses, physician’s behavior and reputation emerge as themes, which require further studies.

"On our way": identities and representations of African women seeking asylum in Ireland

This thesis provides the first explicit Postcolonial study of asylum in the Irish context that integrates Black Feminist analyses of intersectional identity with Postcolonial Feminist theories of representation. African women seeking asylum in the Republic of Ireland were key political instruments used by the state to re-draw racial lines. The study examines how, for a group of African women “On their Way” through asylum, identity and representation work hand in hand to force identities, subaltern spaces and bodies to occupy them. Rich biographical data is gathered through mixed art and drama methods over two intensive participatory research projects conducted in a small Irish city. Data analysis critically examines the poetics (practices that signify) and politics (the powers that govern these practices) and affective economies of global and local NGO visual representations, exposing how they consume, fragment, and appropriate African women’s identities and bodies. Though hypervisible, the women themselves “cannot speak”. The women in the study reported feeling “tired” and “used”. Asking “What work are they doing as they do asylum?” the study finds that black female identities and bodies are forced to perform political, cultural, emotional and material labour on their way through this context of Irish asylum. The author argues that Postcolonial Asylum is a performative encounter that re-scripts colonial race/class/gender discourse through a humanitarian alibi to naturalize European/white supremacy, reinscribe patriarchal power and justify racialised incarceration of bodies seeking asylum in the North. This study takes an interdisciplinary approach that centralizes Black and Postcolonial Feminist theory and innovates Participatory Art-Based Action methodology. Black and Postcolonial feminisms can recognize, theorize and replenish black female political and intellectual agency. Participatory Action research, if grounded in Black feminist epistemology and ethics, can allow participants to “speak back” to what is already said about them in spaces of convivial self-representation.

Help-seeking behaviors and mental well-being of first year undergraduate university students

University students demonstrate poor help-seeking behaviors for their mental health, despite often reporting low levels of mental well-being. The aims of this study were to examine the help-seeking intentions and experiences of first year university students in terms of their mental well-being, and to explore these students’ views on formal (e.g. psychiatrists) and informal (e.g. friends) help-seeking. Students from a university in the Republic of Ireland (n=220) completed an online questionnaire which focused on mental well-being and help-seeking behaviors. Almost a third of students had sought help from a mental health professional. Very few students reported availing of university/online supports. Informal sources of help were more popular than formal sources, and those who would avail and had availed of informal sources demonstrated higher well-being scores. Counselors were the source of professional help most widely used. General practitioners, chaplains, social workers, and family therapists were rated the most helpful. Those with low/average well-being scores were less likely to seek help than those with higher scores. Findings indicate the importance of enhancing public knowledge of mental health issues, and for further examination of students’ knowledge of help-seeking resources in order to improve the help-seeking behaviors and mental well-being of this population group.

Distributed Extremum-Seeking Control with Applications to High-Altitude Balloons

The real-time optimization of large-scale systems is a difficult problem due to the need for complex models involving uncertain parameters and the high computational cost of solving such problems by a decentralized approach. Extremum-seeking control (ESC) is a model-free real-time optimization technique which can estimate unknown parameters and can optimize nonlinear time-varying systems using only a measurement of the cost function to be minimized. In this thesis, we develop a distributed version of extremum-seeking control which allows large-scale systems to be optimized without models and with minimal computing power. First, we develop a continuous-time distributed extremum-seeking controller. It has three main components: consensus, parameter estimation, and optimization. The consensus provides each local controller with an estimate of the cost to be minimized, allowing them to coordinate their actions. Using this cost estimate, parameters for a local input-output model are estimated, and the cost is minimized by following a gradient descent based on the estimate of the gradient. Next, a similar distributed extremum-seeking controller is developed in discrete-time. Finally, we consider an interesting application of distributed ESC: formation control of high-altitude balloons for high-speed wireless internet. These balloons must be steered into a favourable formation where they are spread out over the Earth and provide coverage to the entire planet. Distributed ESC is applied to this problem, and is shown to be effective for a system of 1200 ballons subjected to realistic wind currents. The approach does not require a wind model and uses a cost function based on a Voronoi partition of the sphere. Distributed ESC is able to steer balloons from a few initial launch sites into a formation which provides coverage to the entire Earth and can maintain a similar formation as the balloons move with the wind around the Earth.

Understanding Suicide and Help-seeking in Urban and Rural Areas in Northern Ireland

Funded by HSC R&D Division, Public Health Agency Why did we start? Most people who complete suicide are in contact with their family doctors or other services in the months prior to death. A better understanding of the nature of these contacts and the various pathways experienced by suicidal people should reveal the gaps and barriers to effective service provision. We also need better information about the difficulties experienced by family carers, both prior to the death and afterwards. Of particular interest to policy makers in Northern Ireland was a concern that people from rural areas may be at increasing risk of suicide. We were commissioned by the Health and Social Care R&D Division of the Northern Ireland Public Health Agency to address the gaps in our understanding of suicide in NI. What did we do? We undertook a mixed methods study in which we examined the records of 403 people who took their own lives over a two-year period between March 2007 and February 2009. We linked these data to GP records and then examined help-seeking pathways of people and their contacts with services. We did in-depth face-to-face interviews with 72 bereaved relatives and friends who discussed their understanding of the events and circumstances surrounding the death, the experience of seeking help for the family member, the personal impact of the suicide, and use of support services. Additionally, we interviewed 19 General Practitioners about their experiences of managing people who died by suicide.