Factors influencing European consumer uptake of personalised nutrition: results of a qualitative analysis

The aim of this research was to explore consumer perceptions of personalised nutrition and to compare these across three different levels of ‘‘medicalization’’: lifestyle assessment (no blood sampling); phenotypic assessment (blood sampling); genomic assessment (blood and buccal sampling). The protocol was developed from two pilot focus groups conducted in the UK. Two focus groups (one comprising only ‘‘older’’ individuals between 30 and 60 years old, the other of adults 18–65 yrs of age) were run in the UK, Spain, the Netherlands, Poland, Portugal, Ireland, Greece and Germany (N = 16). The analysis (guided using grounded theory) suggested that personalised nutrition was perceived in terms of benefit to health and fitness and that convenience was an important driver of uptake. Negative attitudes were associated with internet delivery but not with personalised nutrition per se. Barriers to uptake were linked to broader technological issues associated with data protection, trust in regulator and service providers. Services that required a fee were expected to be of better quality and more secure. An efficacious, transparent and trustworthy regulatory framework for personalised nutrition is required to alleviate consumer concern. In addition, developing trust in service providers is important if such services to be successful.

Targeting medication non-adherence behavior in selected autoimmune diseases: a systematic approach to digital health program development

Background 29 autoimmune diseases, including Rheumatoid Arthritis, gout, Crohn’s Disease, and Systematic Lupus Erythematosus affect 7.6-9.4% of the population. While effective therapy is available, many patients do not follow treatment or use medications as directed. Digital health and Web 2.0 interventions have demonstrated much promise in increasing medication and treatment adherence, but to date many Internet tools have proven disappointing. In fact, most digital interventions continue to suffer from high attrition in patient populations, are burdensome for healthcare professionals, and have relatively short life spans. Objective Digital health tools have traditionally centered on the transformation of existing interventions (such as diaries, trackers, stage-based or cognitive behavioral therapy programs, coupons, or symptom checklists) to electronic format. Advanced digital interventions have also incorporated attributes of Web 2.0 such as social networking, text messaging, and the use of video. Despite these efforts, there has not been little measurable impact in non-adherence for illnesses that require medical interventions, and research must look to other strategies or development methodologies. As a first step in investigating the feasibility of developing such a tool, the objective of the current study is to systematically rate factors of non-adherence that have been reported in past research studies. Methods Grounded Theory, recognized as a rigorous method that facilitates the emergence of new themes through systematic analysis, data collection and coding, was used to analyze quantitative, qualitative and mixed method studies addressing the following autoimmune diseases: Rheumatoid Arthritis, gout, Crohn’s Disease, Systematic Lupus Erythematosus, and inflammatory bowel disease. Studies were only included if they contained primary data addressing the relationship with non-adherence. Results Out of the 27 studies, four non-modifiable and 11 modifiable risk factors were discovered. Over one third of articles identified the following risk factors as common contributors to medication non-adherence (percent of studies reporting): patients not understanding treatment (44%), side effects (41%), age (37%), dose regimen (33%), and perceived medication ineffectiveness (33%). An unanticipated finding that emerged was the need for risk stratification tools (81%) with patient-centric approaches (67%). Conclusions This study systematically identifies and categorizes medication non-adherence risk factors in select autoimmune diseases. Findings indicate that patients understanding of their disease and the role of medication are paramount. An unexpected finding was that the majority of research articles called for the creation of tailored, patient-centric interventions that dispel personal misconceptions about disease, pharmacotherapy, and how the body responds to treatment. To our knowledge, these interventions do not yet exist in digital format. Rather than adopting a systems level approach, digital health programs should focus on cohorts with heterogeneous needs, and develop tailored interventions based on individual non-adherence patterns.

Investigation of institutional investors’ responsible investment practices in UK

The focus of Corporate Governance is shifting from the role of directors to active ownership. Based on their fiduciary duty to other shareholders, it is believed that institutional investors have an important role to play in this regard. However, the Pension Funds and the Sovereign Wealth Organisations are not driven by the same set of objectives. In addition, Environmental Social and Governance (ESG) issues in investment decision-making are now becoming more important and they are capable of becoming the mainstream in the future. However, there are widespread variations in perception of fiduciary responsibilities, ESG issues appraisal, as well as the strategies adopted by institutional investors on shareholder engagement as responsible investors. Responsible Investment market is largely driven by institutional investors and they are expected to continue to lead the way. This research work investigates the role of the main asset owners and their advisors in responsible investment practices in the UK. It adopts a qualitative approach using semi-structured interviews, questionnaire and meetings observations. Gathered data is analysed using grounded theory and the findings highlight the perception of the various investor groups to corporate governance. The research work contributes to the body of knowledge by assessing the corporate governance perspectives of the various classes of institutional investors which may have practical implications for other countries.

Caught in the eye of the storm: a qualitative study of views and experiences of planned drug holidays from methylphenidate in child and adolescent ADHD treatment

Background: Attention deficit hyperactivity disorder (ADHD) can be treated with stimulant medication such as methylphenidate. Although effective, methylphenidate can cause serious side-effects, including suppressed appetite, growth retardation and sleep problems. A drug holiday is a deliberate interruption of pharmacotherapy for a defined period of time and for a specific clinical purpose, for example for appeasing side-effects. Whilst some international guidelines recommend introducing drug holidays in ADHD treatment, this is not practised routinely. Our aim was to examine the views and experiences of planned drug holidays from methylphenidate with adults who have responsibility for treatment decisions in children and adolescents with ADHD. Method: In-depth interviews were carried out. Child and Adolescent Mental Health Services (CAMHS) practitioners (n=8), General Practitioners (n=8), teachers (n=5), and mothers of children with ADHD (n=4) were interviewed in a UK setting. Interview transcripts were analysed using grounded theory. Results: Methylphenidate eases the experience of the child amid problems at home and at school and once started is mostly continued long-term. Some families do practise short-term drug holidays at weekends and longer-term ones during school holidays. The decision to introduce drug holidays is influenced by the child’s academic progress, the parents’ ability to cope with the child, as well as medication beliefs. Trialling a drug holiday is thought to allow older children to self-assess their ability to manage without medication when they show signs of wanting to discontinue treatment prematurely. Conclusions: Planned drug holidays could address premature treatment cessation by enabling adolescents to assess repercussions under medical supervision.

På gott och ont : En kvalitativ studie om ungdomars upplevelser av vistelsen på HVB-hemmet Närsjögläntan

Syftet med denna uppsats är att undersöka hur ungdomar som varit placerade på Närsjögläntans HVB-hem har upplevt sin vistelse och vilka implikationer som vistelsen medfört. Våra frågeställningar berör hur ungdomar ha upplevt tiden på Närsjögläntan, hur livet efter placeringen ser ut och hur de lyckats att anpassa sig till livet utanför institutionen samt hur ungdomarnas liv såg ut innan placeringen på Närsjögläntan i förhållande till livet efteråt.Den empiriska undersökningen har utförts genom ostrukturerade kvalitativa intervjuer med fem respondenter. Vår forskningsansats grundar sig i hermeneutiken och vår undersöknings- och analysmetod influeras av grounded theory. Våra teoretiska perspektiv utgår från E. Goffmans teori om totala institutioner och G. H. Meads socialisationsteori.De slutsatser vi drar utifrån denna studie är att ungdomarna upplever att Närsjögläntan i allmänhet och personalen i synnerhet har haft en stor betydelse för deras förbättrade livssituation och självbild efter placeringen. Dock framgår att livssituationen efter vistelsen innefattar viss kvarvarande problematik som till viss del är beroende av negativa konsekvenser som institutionsvistelsen fört med sig.

Kinesiska affärsetableringar i Sverige : Kartläggning över områden som förbättrar chanserna att lyckas

Aim and starting point: The aim of the Bachelor thesis is to examine and define the paramount knowledge Chinese businessmen need in order to succeed with their establishment in Sweden. The authors also seek to answer what incentives attract Chinese businessmen to come to Sweden, as well as how Chinese establishments in Sweden can be predicted to appear in the future. Results/conclusions: The study outlines key areas in which Chinese businessmen should have knowledge in order to succeed with their establishment in Sweden. The results also gives an indication on how Chinese business establishments in Sweden will appear in the future, into which areas the Chinese mainly invest/establish in, as well as why and how these are done. On the basis of this material the authors generate proposals for educational packages which among others can be sold to Chinese businessmen. Knowledge overview: Here relevant theory connected to the area of study is presented. The knowledge overview presents the Swedish in relation to the Chinese perspective in areas such as: culture, hierarchy, relations, Face, communication, HRM, education, CSR and labour law. The knowledge overview can itself contribute to fostering an understanding of differences between Sweden and China. Method: The area of research has been accessed by a combination of methods. The study is both deductive and explorative. The main channel of information and data collection are in-depth interviews which are used as a deductive starting point, an expert investigation and as a Grounded Theory. As a complement the authors have also conducted a delphi study in which an expert panel answered questions concerning the future of Chinese establishments in Sweden. The deductive and explorative parts have been analyzed individually and have each generated a conclusion. These conclusions have then been interwoven in a synthesis that highlights and creates new knowledge.

Naturvetenskapliga begrepp i vardagliga samtal : En observationsstudie med fokus på lärande samtal i förskolan

Syftet med studien är att undersöka hur vardagliga situationer kan nyttjas för naturvetenskapligt lärande i förskolan. Den har genomförts med hjälp av observationer av samtal. Det observerade naturvetenskapliga innehållet har genererat en ”lokal teori”, (Grounded Theory), med fokus på använda ord och omnämnda begrepp. Resultatet visar att barnen har en uppfattning om flera naturvetenskapliga begrepp och generellt ett rikt ordförråd för samtal om naturvetenskapliga fenomen. Vissa begrepp har barnen till synes en lägre grad av förståelse för och vissa begrepp är de väl bekanta med men har inget specifikt ord för. Det finns också olika sätt att förklara naturvetenskapliga fakta, vilka inte alltid motsvarar frågeställarens, barnets och/eller pedagogens, förväntningar. De huvud­sakliga slutsatser som har dragits är följande: även om ett barns ordförråd för att beskriva naturvetenskapliga fenomen är rikt ger det inte automatiskt en god begreppsbildning, det informella samtalet är en viktig resurs i barnens lärande samt att det är viktigt att använda rätt förklaringsmodell vid varje tillfälle.

Viktordningen : ett analytiskt perspektiv

The weight order – an analytical perspective This article is an outline of a critically oriented and empirically grounded theory of the weight order, as a complement to theories of more widely recognized and studied ordering systems. We 1) expose the weight orders “absent presence” in humanistic and social science-oriented research treating overweight and fatness as a personal or social problem, 2) outline the contours and characteristics of this specific ordering system, and 3) suggest a set of sensitizing concepts for analysis of this ordering system. Two primary forms of activity, maintaining order and putting in order, are analysed. The first is making thin people into order and overweight people into disorder, and thus maintains order in the weight order. The other, putting in order, covers different activities supposed to make sure that people keep their bodies thin or try to become thin. These ordering activities meet resistance when overweight people stop dieting and/or define overweight as a personal choice and themselves as good enough, or even healthy and beautiful. We call these forms of resistance alternative weight-doings.  

‘Being in a womb’ or ‘playing musical chairs’ : the impact of place and space on infant feeding in NICUs

Background: Becoming a parent of a preterm baby requiring neonatal care constitutes an extraordinary life situation in which parenting begins and evolves in a medical and unfamiliar setting. Although there is increasing emphasis within maternity and neonatal care on the influence of place and space upon the experiences of staff and service users, there is a lack of research on how space and place influence relationships and care in the neonatal environment. The aim of this study was to explore, in-depth, the impact of place and space on parents’ experiences and practices related to feeding their preterm babies in Neonatal Intensive Care Units (NICUs) in Sweden and England. Methods: An ethnographic approach was utilised in two NICUs in Sweden and two comparable units in England, UK. Over an eleven month period, a total of 52 mothers, 19 fathers and 102 staff were observed and interviewed. A grounded theory approach was utilised throughout data collection and analysis. Results: The core category of ‘the room as a conveyance for an attuned feeding’ was underpinned by four categories: the level of ‘ownership’ of space and place; the feeling of ‘at-homeness’; the experience of ‘the door or a shield’ against people entering, for privacy, for enabling a focus within, and for regulating socialising and the; ‘window of opportunity’. Findings showed that the construction and design of space and place was strongly influential on the developing parent-infant relationship and for experiencing a sense of connectedness and a shared awareness with the baby during feeding, an attuned feeding. Conclusions: If our proposed model is valid, it is vital that these findings are considered when developing or reconfiguring NICUs so that account is taken of the influences of spatiality upon parent’s experiences. Even without redesign there are measures that may be taken to make a positive difference for parents and their preterm babies.

Partnerlös och Barnfri : Friheten och ensamheten med singelskap

Med denna uppsats har vi velat ta reda på hur singlar över 30 år upplever sitt singelskap samt hur de förhåller sig till att inleda partnerskap och att skaffa barn. Singel är ett begrepp som inrymmer många olika aspekter och perspektiv. Genom individuella intervjuer har vi tagit del av 4 kvinnliga singlar och 4 manliga singlars egna upplevelser, alla är över 30 år och bosatta i mellan Sverige. Vi har analyserat det empiriska materialet vi fått fram med hjälp av vår teoretiska utgångspunkt som berör modernitetens samhälle där individen skapar sin självidentitet och livsstil utifrån sin kontext. Singlarna har givit oss en bild av deras liv och deras inställning till den norm om parrelationer och att skaffa barn som finns i vårt samhälle. Det empiriska materialet vi fått tillgång till har tolkats och analyserats med hjälp av Grounded theory. Vårt resultat visar på individens strävan efter känslan av frihet och oberoende. Singlarna är nöjda över sin livsstil men uppger att det kan finnas en saknad av någon ibland. En ambivalens uppstår mellan deras känsla av frihet till den ensamhet de kan uppleva. Upplevelsen av singelskapet och synen på partnerskap och barn mellan män och kvinnor visar sig inte vara så olik.

Nuets förnöjsamhet : en grundad teori om livsval och överlevnadsstrategier

Contentment in the moment ”Contentment in the moment” is a classic grounded theory exploring safety and contentment within a small community in northern Norway. The purpose of the study was to explore the village’s everyday life from a participant’s perspective and to develop an understanding of their living conditions. We found different survival strategies, which have their roots in the village’s history of poverty, isolation and harsh climate. Today these strategies have changed from a matter of life and death to a modern psychosocial foundation of contentment. The study is based on four and a half years of observations, in-depth interviews and informal but focused conversations with people living in Polarfjorden. The data was analysed using the constant comparative method of classic grounded theory. In this article we further relate our work to more general sociological theory, more specifically to Charles Tilly’s work on reason and routines.

Struggling with daily life and enduring pain : a qualitative study of women's experiences with pelvic girdle pain during pregnancy

Background. Few studies have investigated the experiences of living with pelvic girdle pain (PGP) and its impact on pregnant women’s lives. To address this gap in knowledge, this study investigates the experiences of women living with PGP during pregnancy. Methods. A purposive sample, of nine pregnant women with diagnosed PGP, were interviewed about their experiences. Interviews were recorded, transcribed to text and analysed using a Grounded Theory approach. Results. The core category that evolved from the analysis of experiences of living with PGP in pregnancy was “struggling with daily life and enduring pain”. Three properties addressing the actions caused by PGP were identified: i) grasping the incomprehensible; ii) balancing support and dependence and iii) managing the losses. These experiences expressed by the informants constitute a basis for the consequences of PGP: iv) enduring pain; v) being a burden; vi) calculating the risks and the experiences of the informants as vii) abdicating as a mother. Finally, the informants’ experiences of the consequences regarding the current pregnancy and any potential future pregnancies is presented in viii) paying the price and reconsidering the future. A conceptual model of the actions and consequences experienced by the pregnant informants living with PGP is presented. Conclusions. PGP during pregnancy greatly affects the informant’s experiences of her pregnancy, her roles in relationships, and her social context. For informants with young children, PGP negatively affects the role of being a mother, a situation that further strains the experience. As the constant pain disturbs most aspects of the lives of the informants, improvements in the treatment of PGP is of importance as to increase the quality of life. This pregnancy-related condition is prevalent and must be considered a major public health concern during pregnancy.

Tough, sensitive and sincere : how adolescent boys manage masculinities and emotions

This study aimed to explore adolescent boys’ views of masculinity and emotion management and their potential effects on well-being. Interviews with 33 adolescent boys aged 16–17 years in Sweden were analysed using grounded theory. We found two main categories of masculine conceptions in adolescent boys: gender-normative masculinity with emphasis on group-based values, and non-gender-normative masculinity based on personal values. Gender-normative masculinity comprised two seemingly opposite emotional masculinity orientations, one towards toughness and the other towards sensitivity, both of which were highly influenced by contextual and situational group norms and demands, despite their expressions contrasting each other. Non-gender-normative masculinity included an orientation towards sincerity emphasising the personal values of the boys; emotions were expressed more independently of peer group norms. Our findings suggest that different masculinities and the expression of emotions are strongly intertwined and that managing emotions is vital for well-being.

Understanding the "black box" of a health-promotion program : keys to enable health among older persons aging in the context of migration

Although the need to make health services more accessible to persons who have migrated has been identified, knowledge about health-promotion programs (HPPs) from the perspective of older persons born abroad is lacking. This study explores the design experiences and content implemented in an adapted version of a group-based HPP developed in a researcher-community partnership. Fourteen persons aged 70-83 years or older who had migrated to Sweden from Finland or the Balkan Peninsula were included. A grounded theory approach guided the data collection and analysis. The findings showed how participants and personnel jointly helped raise awareness. The participants experienced three key processes that could open doors to awareness: enabling community, providing opportunities to understand and be understood, and confirming human values and abilities. Depending on how the HPP content and design are being shaped by the group, the key processes could both inhibit or encourage opening doors to awareness. Therefore, this study provides key insights into how to enable health by deepening the understanding of how the exchange of health-promoting messages is experienced to be facilitated or hindered. This study adds to the scientific knowledge base of how the design and content of HPP may support and recognize the capabilities of persons aging in the context of migration.

A crise da região cacaueira e os desafios para o desenvolvimento local

Dissertação apresentada ao Programa de Mestrado em Administração da Universidade Municipal de São Caetano do Sul - USCS