Translation, cultural adaptation to Brazil and validation of the venous leg ulcer quality of life questionnaire (VLU-QoL-Br)

Objetivo:traduzir o instrumento Venous legulcer quality of life questionnaire (VLU-QoL), adaptá-lo culturalmente para o português do Brasil e validá-lo com pacientes do Hospital das Clínicas da Faculdade de Medicina de Botucatu (FMB) da Universidade Estadual Paulista (Unesp). Métodos:o questionário foi traduzido por um tradutor profissional e por dois dermatologistas especialistas na área de úlceras venosas (UV), sendo reformulado em reunião com os três tradutores. O constructo (VLU-QoL-Br) foi submetido a pré-entrevista com 10 portadores de UV para a adaptação da linguagem. Posteriormente, foi aplicado em pacientes do HC-Unesp, e como teste-reteste para verificação de sua reprodutibilidade. Resultados:foram avaliados 82 pacientes, sendo 56 (68%) do sexo feminino. A idade média foi de 67,3 anos. O questionário foi traduzido, adaptado e aplicado aos pacientes. O constructo apresentou alta consistência interna (alfa= 0,94) e adequada correlação item-total. Quando avaliados os 32 retestes, observou-se correlação intraclasse para concordância de 0,78 (p < 0,01), indicando boa reprodutibilidade do constructo. A análise fatorial confirmatória corroborou as dimensões do questionário original: atividades, psicológico e sintomas. Escores do VLU-QoL-Br se associaram, independentemente, à área total das úlceras e a menor escolaridade dos sujeitos (p < 0,01). Conclusão:a tradução, a adaptação e a validação do questionário VLU-Qol-Br demonstrou boa performance psicométrica, permitindo seu uso clínico no Brasil. É importante avaliar seu desempenho em outras regiões e em diferentes amostras de indivíduos.

Possibilidades de atividades de comunicação emocional entre bebês: um estudo à luz da teoria histórico-cultural

Pós-graduação em Educação - FFC

Promoting Higher Education: The Latino Achievement Mentoring Program (LAMP)

Statistics suggest that Latino youths are at risk for academic underachievement and withdrawal. Culturally sensitive approaches to supporting school achievement based on the needs of Latino youth and their families must be developed. In response to these needs, the Latino Research Initiative (LRI), a collaborative group with members from the University of Nebraska-Lincoln (UNL) and the Hispanic Community Center (HCC) created the Latino Achievement Mentoring Program (LAMP). LAMP is a culturally appropriate mentoring program designed to promote school success and post-secondary opportunities for Latino youths. This program provides Latino youths with positive role models and information and guidance about academic life and future school success. Finally, because of the cultural significance of family members among many Latinos, LAMP activities are developed and implemented such that the mentees' family members are involved. This presentation will report the first-year activities of the initial mentor and men tee pairs, with particular emphasis on educational outreach and academic development of the program. Evaluation data will be presented for the first cohort of mentees, including academic information, teacher reports and self-measure findings. LAMP activities aimed at promoting academic success will also be presented. Finally, the experiences of the mentors will briefly be reported.

Physical education and quality of life: reflections and perspectives

The study of the quality of life of individuals has become a prominent issue for contemporary society. However, research involving quality of life should consider that this is a complex issue that involves objective and subjective aspects, living conditions, lifestyles and multidimensional factors. There is a widespread idea in society that physical activity, exercise, sports and related activities can have a positive impact on improving the quality of life of the population. However, in several studies, this relationship is examined from the biological point of view, which considers only health indicators. Such practices are being studied in the area of Physical Education in various perspectives, such as biological, psychological, social, and cultural. Therefore, Physical Education should seek to produce knowledge that meets the scientific principles, and look for evidence that effectively clarifies the dynamics of this relationship. In this sense, methodological rigor, particularly the conceptual definition, is essential for a better understanding of the results and of which generalizations are actually likely to e proved. In addition, it is necessary to identify the possibilities and limitations of quantitative evaluations, qualitative evaluations and possible combinations.

Skin and mucosa care in systemic sclerosis - patients' and family caregivers' experiences and expectations of a specific education programme: a qualitative study

BACKGROUND Skin and mucosal manifestations such as skin thickening, pruritus, reduced microvascular circulation, digital lesions, appearance-related changes, and dryness of the eyes and mucosa are common in systemic sclerosis (SSc). A specific skin and mucosa care education programme for patients and their family caregivers should increase their self-efficacy and improve coping strategies. AIMS The aims of this qualitative study were to explore the participants' experiences of both everyday life with skin and mucosal manifestations and the programme itself, while identifying unmet needs for programme development. METHODS Narrative interviews were conducted with eight SSc patients and two family caregivers of individuals with SSc. Using qualitative content analysis techniques, the transcribed interviews were systematically summarized and categories inductively developed. RESULTS The findings illustrated participants' experiences of skin and mucosal symptoms and revealed them to be experts in finding the right therapy mix alone (before diagnosis) and also in collaboration with health professionals (after diagnosis). Participants emphasized that the programme gave them useful education on skin and mucosa care. They described how they had to cope alone with the lack of information on pathophysiology, people's reactions, and the impact on their family and working lives. Nevertheless, participants said that they maintained a positive attitude by not dwelling on future disabilities. CONCLUSIONS Patients and family caregivers benefited from the individualized and SSc-specific education on skin and mucosa care. Future improvements to the programme should focus on imparting understandable information on SSc pathophysiology, dealing with disfigurement and seeking reliable disease information, as well as facilitating peer support.

NARRATIVAS DE EXPERIÊNCIAS VIVIDAS POR DOCENTES E DISCENTES COM USO DE TECNOLOGIA DE INFORMAÇÃO E COMUNICAÇÃO – TDIC NA EDUCAÇÃO BÁSICA

Vivemos um período de transformações políticas, econômicas, sociais e culturais que, a todo instante, nos impõe desafios. Neste contexto, nas últimas décadas, o uso da tecnologia tem sido ampliado na realização de diversas atividades cotidianas, na divulgação de informações, na comunicação, como forma de expressão e organização da sociedade. A escola, enquanto instituição social, precisa reconhecer esta nova realidade, esta diferente possibilidade de aquisição e transformação de saber, para que possa intervir, ressignificar e redirecionar sua ação, a fim de atender as demandas de seu tempo. O objetivo geral desta pesquisa, a partir da apresentação e análise de experiências realizadas com o uso de Tecnologias da Informação e Conhecimento, é o de refletir sobre como inserir estas ferramentas no processo de ensinar e aprender na escola a partir da visão de professores e alunos, visando a formação integral do educando. Deste modo, no desenvolvimento, entendemos como necessário conhecer e considerar o contexto histórico, bem como as perspectivas relacionadas a escola e seus protagonistas (professores e estudantes) na chamada Sociedade da Informação e do Conhecimento. Ressaltamos a importância do docente (sua formação) e seu papel de mediador nos processos de aprendizagem, assim como a recepção à tecnologia, observando função e espaço de atuação desta. Destacamos experiências com a utilização de TDIC, realizada por professores e alunos, como a produção de game, revistas científicas, escrita de histórias, produções artísticas, blogs, vlogs, discussões em grupos presentes em redes sociais. A metodologia utilizada nesta pesquisa é qualitativa, na modalidade de pesquisa-ação e narrativa, em função do envolvimento com o grupo e com as atividades desenvolvidas, nas quais os participantes compartilham com o pesquisador suas histórias pessoais e de aprendizagem relacionadas às ações ou às atividades que realiza, fornecendo informações e indícios relevantes sobre o seu processo de formação ao longo do tempo. A revisão de literatura foi realizada por meio de análise bibliográfica e documental em livros, teses, dissertações, periódicos específicos sobre o assunto, além de artigos publicados na Internet. A coleta de dados foi realizada a partir de conversas informais, entrevistas semiestruturadas e filmagem dos relatos. A análise foi realizada a partir da abordagem hermenêutico-fenomenológica, que busca descrever e interpretar fenômenos da experiência humana, a fim de investigar a essência por meio da identificação de temas. Os resultados apontam para a necessidade e possibilidade da ampliação da utilização de TDIC como recurso no processo de ensino e aprendizagem, por meio de formação, diálogo, interação, intencionalidade, expectativas, esperança e seus desdobramentos.

The experiences of South Asian university students in the British education system and in their search for work

This research aimed to provide a comparative analysis of South Asian and White British students in their academic attainment at school and university and in their search for employment. Data were gathered by using a variety of methodological techniques. Completed postal questionnaires were received from 301 South Asian and White British undergraduates from 12 British universities, who were in their final year of study in 1985. In depth interviews were also conducted with 49 graduates who were a self selected group from the original sample. Additional information was also collected by using diary report forms and by administering a second postal questionnaire to selected South Asian and White British participants. It was found that while the pre-university qualifications of the White British and South Asian undergraduates did not differ considerably, many members in the latter group had travelled a more arduous path to academic success. For some South Asians, school experiences included the confrontation of racist attitudes and behaviour, both from teachers and peers. The South Asian respondents in this study were more likely than their White British counterparts, to have attempted some C.S.E. examinations, obtained some of their `O' levels in the Sixth Form and retaken their `A' levels. As a result the South Asians were on average older than their White British peers when entering university. A small sample of South Asians also found that the effects of racism were perpetuated in higher education where they faced difficulty both academically and socially. Overall, however, since going to university most South Asians felt further drawn towards their `cultural background', this often being their own unique view of `Asianess'. Regarding their plans after graduation, it was found that South Asians were more likely to opt for further study, believing that they needed to be better qualified than their White British counterparts. For those South Asians who were searching for work, it was noted that they were better qualified, willing to accept a lower minimum salary, had made more job applications and had started searching for work earlier than the comparable White British participants. Also, although generally they were not having difficulty in obtaining interviews, South Asian applicants were less likely to receive an offer of employment. In the final analysis examining their future plans, it was found that a large proportion of South Asian graduates were aspiring towards self employment.

Patients’ and physicians’ experiences of atrial fibrillation and anticoagulation therapy:a qualitative journey

Background: Oral anticoagulation (OAC) reduces stroke risk in patients with atrial fibrillation (AF) however it is often underutilized and sometimes refused by patients. This programme of work included a meta-synthesis and two inter-linking studies aiming to explore patients’ and physicians’ experiences of AF and OAC. Methods: A meta-synthesis of qualitative evidence was conducted which informed the empirical work. Semi-structured individual interviews were utilised. Study 1: Three AF patient sub-groups were interviewed; accepted (n=4), refused (n=4), or discontinued (n=3) warfarin. Study 2: Four physician sub-groups (n=4 each group) prescribing OAC to AF patients were interviewed: consultant cardiologists, consultant general physicians, general practitioners and cardiology registrars. Data was analysed using interpretative phenomenological analysis. Results: Study 1: Three over-arching themes comprised patients’ experiences: (1) the initial consultation, (2) life after the consultation, and (3) patients’ reflections. Patients commented on the relief and reassurance experienced during the consultation but they perceived the decision making process mostly led by the physician. Lack of education and take-home materials distributed during the initial consultation was highlighted. Patients who had experienced stroke themselves or were caregivers, were more receptive to education aimed towards stroke risk reduction rather than bleeding risk. Warfarin monitoring was challenging for patients, however some patients perceived it as beneficial as it served to enhance patient-physician relationship. Study 2: Two over-arching themes emerged from physicians’ experiences: (1) communicating information and (2) challenges with OAC prescription for AF. Physicians’ approach to the consultation style shifted through a continuum of compliance-adherence-concordance during the consultation. They aimed for concordance, however challenges such as time and the perceived patient trust in them as the expert, led to physicians adopting a paternalistic approach. Physicians also pointed out challenges associated with guideline adherence and the need to adopt a multi-disciplinary approach, where other health professionals could provide on-going education. Conclusion: This programme of work has illustrated the benefit of taking an in depth phenomenological approach to understanding the lived experience of the physician-patient consultation. Together with the meta-synthesis, this work has strengthened the evidence base and demonstrated that there is a need to target patients' and physicians' ability to communicate with each other in a comprehensible way.

The experiences of con sultations on oral anticoagula-tion for AF:the importance of qualitative research incardiovascular sciences

Objectives: Multiple-perspective qualitative designs can aid researchersto develop a more multifaceted account of a phenomenon and as aform of triangulation of data. Two interlinking studies aimed toexplore patients’ and physicians’ experiences of atrial fibrillation (AF)and warfarin.Methods: Audio-recorded semistructured individual interviews wereused. Study 1: Three AF patient subgroups were interviewed (n = 11);accepted, refused, or discontinued warfarin. Study 2: Four physiciansubgroups (n = 16): consultant cardiologists, consultant general physi-cians, general practitioners, and cardiology registrars. Data was ana-lyzed using interpretative phenomenological analysis, a qualitativemethodology.Results: Study 1: Three overarching themes comprised patients’ experi-ences: the initial consultation, life after the consultation, and patients’reflections. Patients commented on the reassurance experienced duringthe consultation, but they perceived the decision-making processmostly led by the physician. Lack of education and take-home materi-als during the initial consultation were highlighted. Patients’ uptake ofinformation was influenced by past experiences and knowledge ofstroke and/or bleeding. Study 2: Two overarching themes covered phy-sicians’ experiences: communicating information and challenges withwarfarin prescription for AF. Physicians’ approach to the consultationstyle shifted through a continuum of compliance-adherence-concor-dance during the consultation. Time and the perceived patient trust inthem as the expert led to physicians to adopt a paternalistic approach.Guideline adherence and the need to adopt a multidisciplinaryapproach were pointed out as current challenges.Conclusion: There is a need to target patients’ and physicians’ abilityto communicate with each other in a comprehensible way. This projecthas illustrated the benefit of using a qualitative approach to under-stand the lived experience of the physician–patient consultation.Disclosure of Interest: None declare

“I Am Not Stupid, I Just Don’t…”- A Qualitative Study of Expatriates’ Cross-Cultural Experiences

This qualitative study explored the unique experiences of expatriates in adjusting to cross-cultural situations and confronting challenges in global journeys. Personal narratives written by previous or current expatriates were collected as qualitative data and content analysis was conducted. The results clarified three themes contributing to the complex process of cross-cultural adaptation.

Crossing boundaries to education: Haitian transnational families and the quest to raise the family up

Nearly 175, 000 Haitian immigrants have settled in South Florida since the 1970s. Their lives are often lived transnationally with persistent connections and obligations to family members in Haiti. Yet, traditional theories of immigrant assimilation focus on the integration of immigrants into host countries, giving little consideration to relationships and activities that extend into migrants' countries of origin. Conversely, studies of transnational families do not explicitly address incorporation into the receiving country. This dissertation, through the experiences of Haitian immigrants in South Florida, reveals a transnational quest "to raise the family up" through migration, remittances, and the pursuit of higher levels of education. I argue that familial duties and obligations, which have cultural foundations in the Haitian lakou, structure the activities of Haitian transnational families as they pursue socioeconomic advancement through migration and education. With the support of transnational families, many students cross boundaries to academic achievement and improve their opportunities for socioeconomic mobility in the US. With higher levels of education, these individuals contributed to a more favorable incorporation into the United States for their extended families, as well. The data were collected through participant observation and 78 in-depth interviews documenting the migration histories of 27 Haitian immigrant families in South Florida. This dissertation contributes to the existing literature on Haitian immigrants in the United States and to an understanding of the transnational dimensions of immigrant incorporation more broadly.

Understandings of transnational families in debates on Migration and development

International migration sets in motion a range of significant transnational processes that connect countries and people. How migration interacts with development and how policies might promote and enhance such interactions have, since the turn of the millennium, gained attention on the international agenda. The recognition that transnational practices connect migrants and their families across sending and receiving societies forms part of this debate. The ways in which policy debate employs and understands transnational family ties nevertheless remain underexplored. This article sets out to discern the understandings of the family in two (often intermingled) debates concerned with transnational interactions: The largely state and policydriven discourse on the potential benefits of migration on economic development, and the largely academic transnational family literature focusing on issues of care and the micro-politics of gender and generation. Emphasizing the relation between diverse migration-development dynamics and specific family positions, we ask whether an analytical point of departure in respective transnational motherhood, fatherhood or childhood is linked to emphasizing certain outcomes. We conclude by sketching important strands of inclusions and exclusions of family matters in policy discourse and suggest ways to better integrate a transnational family perspective in global migration-development policy.

No second chance: junior neonatal nurses' experiences of caring for babies at the end-of-life and their families

Death of an infant is acutely stressful for parents and professionals. Little is known about junior nurses' experiences providing end-of-life care in Neonatal units (NNU). This study aimed to better understand junior nurses' experiences providing end-of-life care in NNU. Neonatal nurses (n = 12) with less than 3 years experience participated in a focus group. Nominal Group Technique (NGT) was used to build consensus around the challenges faced, alongside suggested developments in improving future care provision. Primary analysis involved successive rounds of ranking and decision-making whilst secondary analysis involved thematic analysis. All issues, whether environmental, professional or social appeared driven by an awareness on the part of nurses, that there was no ‘second chance’ which created a huge pressure to ‘get if right’ for the infants and families. Regarding future care 2 areas of improvement identified were ‘Education and Training’ and Support. This paper unpacks these findings making recommendations for practice.

No second chance: the experiences of junior neonatal nurses in providing end-of-life care for babies and families in the NNU

Background

An infant’s death is acutely stressful for parents and professionals. Little is known about junior nurses’ experiences providing end-of-life care in Neonatal Units (NNU).

Objectives

To better understand junior nurses’ experiences providing end-of-life care in NNU, the study explored the challenges and opportunities inherent in their practice relating to providing such care to babies and their families.

Methods

Neonatal nurses (n=12) with less than 3 years’ experience who were undergoing a neonatal education programme participated. Two focus groups were convened each with 6 nurses. The Ethics Committee at the relevant University approved the study. Nominal Group Technique (NGT) was used in the focus groups to build consensus around the challenges faced by junior nurses, alongside suggested developments in improving future care provision. Primary analysis involved successive rounds of ranking and decision making whilst secondary analysis involved thematic analysis.

Results

The study identified the pressures these nurses felt in having only one chance to ‘get it right’ for the infants and their families. They perceived the need for further ‘education and training’ highlighting that improved education provision would include both additional courses and internal training sessions. Greater ‘support’ from mentors themselves more experienced in this aspect of care within the NNU was identified as important in addressing issues around confidence building and skill development.

Conclusions

The results highlight junior nurses’ need for specific education and mentorship around end-of-life care for babies. This presentation will outline the implications for practice, education and further research.

Negotiating Community and Nation in Chợ Lớn: Nation-building, Community-building and Transnationalism in Everyday Life during the Republic of Việt Nam, 1955-1975

Thesis (Ph.D.)--University of Washington, 2016-06