The lived experience of diagnosis delivery in motor neurone disease: A sociological-phenomenological study

Relatively few previous studies of individuals receiving a diagnosis of Motor Neurone Disease within the UK health care system have employed qualitative approaches to examine the diagnostic journey from a patient perspective. A qualitative sociological study was undertaken, involving interviews with 42 participants diagnosed with MND, to provide insight into their experiences of undergoing testing and receiving a diagnosis. Adopting a sociological-phenomenological perspective, this article examines key themes that emerged from participant accounts surrounding the lived experience of the diagnostic journey. The key themes that emerged were: The diagnostic quest; living with uncertainty; hearing bad news; communication difficulties; and a reified body of medical interest. In general, doctor-patient communication both at pre and post diagnosis was experienced as highly stressful, distressing and profoundly upsetting. Participants reported such distress as being due to the mode of delivery and communication strategies used by health professionals. We therefore suggest that professional training needs to emphasize the importance to health professionals of fostering greater levels of tact, sensitivity and empathy towards patients diagnosed with devastating, life-limiting illnesses such as MND.

A moving experience.

Eva Menkin, June 2003

Dining experience in elsewhere

Globalisation leads people getting a chance to move to a different place, to dine in a different context and to experience a different lifestyle. This paper evaluates the designs which offer dining experience in elsewhere, a changed context. A logical narrative review of literature has been conducted to clarify the patterns that restaurant practitioners, designers and social science researchers used for developing dining experience in elsewhere. The paper defines two hourglass balance pattern via food between diner and dining experience providers, as well as a set of interactive strategies in dining experience design. The former can be regarded as an example of the latter pattern. The findings indicate an empathetic setting design framework is needed in future research. This is the first paper that examines the dining experience in light of the atmosphere caused by people’s physical and psychological mobility flow in modern society. The findings provide an access to establish dining experience design framework in future research, that is, achieve various levels of diners’ needs in dining setting design by distributing the multisensory effects to activate diners’ involvement in the dining experience.

The experience of Indigenous students in a Bachelor of Nursing Program in Australia: cultural safety and decolonising nurse education

Background In Australia significant health inequalities, such as an 11year life expectancy gap, impact on the continent’s traditional owners, the Aboriginal peoples and Torres Strait Islanders. Evidence suggests links between improved Indigenous health and a greater proportion of Indigenous people employed in all sectors. Achieving a greater proportion of Indigenous people in health services and in the health education workforce, requires improved higher education completion rates. Currently Indigenous people are under-represented in higher education and attrition rates amongst those who do participate are high. We argue these circumstances make health and education matters of social justice, largely related to unexamined relations of power within universities where the pedagogical and social environment revolve around the norms and common-sense of the dominant culture. Project Research at Queensland University of Technology in 2010-2012, aimed to gain insights into attrition/retention in the Bachelor of Nursing. A literature review on Indigenous participation in higher education in nursing contextualised a mixed methods study. The project examined enrolment, attrition and success by an analysis of enrolment data from 1984-2012. Using Indigenous Research Assistants we then conducted 20 in-depth interviews with Indigenous students followed by a thematic analysis seeking to gain insights into the impact of students’ university experience on retention. Our findings indicate that cultural safety, mentorship, acceptance and support are crucial in student academic success. They also indicate that inflexible systems based on ethnocentric assumptions exacerbate the structural issues that impact on the students’ everyday life and are also part of the story of attrition. The findings reinforced the assumption that educational environments and processes are inherently cultural and political. This perspective calls into question the role of the students’ cultural experience at university in attrition rates. A partnership between the School of Nursing and the Indigenous Education Unit is working to better support Indigenous students.

Schoolman family papers, undated, 1889-1994

The Schoolman Papers reflect Dr. Albert P. and Mrs. Bertha Schoolmans' staunch dedication to Jewish education, Jewish causes, and Israel. Bertha Schoolman, a lifelong member of Hadassah, assisted thousands of Israeli youth as chairman of the Youth Aliyah Committee. Her diaries, photos, scrapbooks, and correspondence record her numerous visits to Israel on which she helped set up schools, met with Israeli dignitaries, and participated in Zionist Conferences and events. The collection includes a 1936 letter from Hadassah founder, Henrietta Szold, praising Mrs. Schoolman's work as well as a letter from the father of Anne Frank, thanking Mrs. Schoolman for naming a Youth Aliyah center the "Anne Frank Haven" after his later daughter.

Enterprise education: Learning through personal experience

This paper outlines the development of a reflective process through which student feelings are brought to the surface to advance their learning outcomes. A key notion in relation to the capacity of student development is the ability of students to alter their collective habits of thought and in turn the nature of the learning environment. The paper examines student reflection in the context of students' heightened awareness of self and their potential influence on their environment. The notion of 'surfacing feelings' is used to describe the outcome of individual and group reflection through which several parties become aware of the active reflections of individual students, thereby increasing the potential depth of overall reflection. Finally, the author considers the transferability of the ideas discussed to other educational contexts.

Working experience with a foundry solar furnace

Literature reveals that a low order priority has been given to foundry applications of the solar furnace for temperatures upto about 1000°C. In the present work, the performance of a solar furnace capable of melting small quantities of foundry-grade metals and alloys had been studied under various conditions. Crucibles of different materials and shapes were tried and the effect of having different heat-shield materials was also studied. Al---bronze crucible with cavity, and well-polished stainless stell heat-shield were found to be most effective in enhancing the efficiency of the furnace. Many important industrial applications of the present solar furnace, such as the recovery of metallic zinc from slags, had also been realised.

The open access advantage for researchers: Reflections on experience and challenges

This paper focuses on the advantages of Open Access, (OA) particularly from the point of view of individual researchers, research centres and disciplines, and institutions. The advantage described by the phrase “OA advantage”, is multifaceted. The experience of Queensland University of Technology in Australia in pioneering OA as preferred practice in an institution with a growing research profile and energy, has seen evidence of the OA advantage develop in the experience of our researchers. The University has witnessed the development of practical evidence about improved recognition and impact, and this has occurred in the context of sector wide activity and policy where fresh approaches and leadership will result in even greater rewards for researchers whose outputs are “in the open”.

The Mediated Immediacy : João Batista Libanio and the Question of Latin American Liberation Theology

This study is a systematic analysis of mediated immediacy in the production of the Brazilian professor of theology João Batista Libanio. He stresses both ethical mediation and the immediate character of the faith. Libanio has sought an answer to the problem of science and faith. He makes use of the neo-scholastic distinction between matter and form. According to St. Thomas Aquinas, God cannot be known as a scientific object, but it is possible to predicate a formal theological content of other subject matter with the help of revelation. This viewpoint was emphasized in neo-Thomism and supported by the liberation theologians. For them, the material starting point was social science. It becomes a theologizable or revealable (revelabile) reality. This social science has its roots in Latin American Marxism which was influenced by the school of Louis Althusser and considered Marxism a science of history . The synthesis of Thomism and Marxism is a challenge Libanio faced, especially in his Teologia da libertação from 1987. He emphasized the need for a genuinely spiritual and ethical discernment, and was particularly critical of the ethical implications of class struggle. Libanio s thinking has a strong hermeneutic flavor. It is more important to understand than to explain. He does not deny the need for social scientific data, but that they cannot be the exclusive starting point of theology. There are different readings of the world, both scientific and theological. A holistic understanding of the nature of religious experience is needed. Libanio follows the interpretation given by H. C. de Lima Vaz, according to whom the Hegelian dialectic is a rational circulation between the totality and its parts. He also recalls Oscar Cullmann s idea of God s Kingdom that is already and not yet . In other words, there is a continuous mediation of grace into the natural world. This dialectic is reflected in ethics. Faith must be verified in good works. Libanio uses the Thomist fides caritate formata principle and the modern orthopraxis thinking represented by Edward Schillebeeckx. One needs both the ortho of good faith and the praxis of the right action. The mediation of praxis is the mediation of human and divine love. Libanio s theology has strong roots in the Jesuit spirituality that places the emphasis on contemplation in action.

Q-evankeliumi ja psykohistoria : Uuden testamentin eksegetiikan väitöskirja

In the course of my research for my thesis The Q Gospel and Psychohistory, I moved on from the accounts of the Cynics ideals to psychohistorical explanations. Studying the texts dealing with the Cynics and the Q Gospel, I was amazed by the fact that these texts actually portrayed people living in greater poverty than they had to. I paid particular attention to the fact that the Q Gospel was born in traumatising, warlike circumstances. Psychiatric traumatology helped me understand the Q Gospel and other ancient documents using historical approaches in a way that would comply with modern behavioural science. Even though I found some answers to the questions I had posed in my research, the main result of my research work is the justification of the question: Is it important to ask whether there is a connection between the ethos expressed by means of the religious language of the Q Gospel and the predominantly war-related life experiences typical to Palestine at the time. As has been convincingly revealed by a number of studies, traumatic events contribute to the development of psychotic experiences. I approached the problematic nature, significance and complexity of the ideal of poverty and this warlike environment by clarifying the history of psychohistorical literary research and the interpretative contexts associated with Sigmund Freud, Jacques Lacan and Melanie Klein. It is justifiable to question abnormal mentality, but there is no reliable return from the abnormal mentality described in any particular text to the only affecting factor. The popular research tendency based on the Oedipus complex is just as controversial as the Oedipus complex itself. The sociological frameworks concerning moral panics and political paranoia of an outer and inner danger fit quite well with the construction of the Q Gospel. Jerrold M. Post, M.D., Professor of Psychiatry, Political Psychology and Interna-tional Affairs at George Washington University, and founder and director of the Center for the Analysis of Personality and Political Behavior for the Central Intelligence Agency, has focused on the role played by charisma in the attracting of followers and detailed the psychological styles of a "charismatic" leader. He wrote the books Political Paranoia and Leaders and Their Followers in a Dangerous World: the Psychology of Political Behavior among others. His psychoanalytic vocabulary was useful for my understanding of the minds and motivations involved in the Q Gospel s formation. The Q sect began to live in a predestined future, with the reality and safety of this world having collapsed in both their experience and their fantasies. The deep and clear-cut divisions into good and evil that are expressed in the Q Gospel reveal the powerful nature of destructive impulses, envy and overwhelming anxiety. Responsible people who influenced the Q Gospel's origination tried to mount an ascetic defense against anxiety, denying their own needs, focusing their efforts on another objective (God s Kingdom) and a regressive, submissive earlier phase of development (a child s carelessness). This spiritual process was primarily an ecclesiastic or group-dynamical tactic to give support to the power of group leaders.

Pyhä Teresa ja keskiajan mystiikan teoriat

In my dissertation I have studied St Teresa (1515-1582) in the light of medieval mystical theories. I have two main levels in my research: historical and theological. On the historical level I study St Teresa s personal history in the context of her family and the Spanish society. On the theological level I study both St Teresa s mysticism and her religious experience in the light of medieval mysticism. St Teresa wrote a book called Life , which is her narrative autobiography and story about her mystical spiritual formation. She reflected herself through biblical texts interpreting them in the course of the biblical hermeneutics like allegory, typology, tropology and anagogy. In addition to that she read others life stories from her period of time, but reflected herself only slightly through the sociological point of view. She used irony as a means to gain acceptance to her authority and motive to write. Her position has been described as a double bind because of writing at the request of educated men and to the non-educated women as she herself was uneducated. She used irony as a means to achieve valuation to women, to gain negative attributes connected to them and to gain authority to teach them mystical spirituality, the Bible and prayer. In this ironic tendency she was a feminist writer. In order to understand medieval mysticism I have written in the first chapter a review of the main trends in medieval mysticism in connection with the classical emotional theories. Two medieval mystical theories show an important role in St Teresa s mysticism. One is love mysticism and the other is the three partite way of mysticism (purification, illumination and union). The classic-philosophical emotional theories play a role in both patterns. The theory of love mysticism St Teresa interpreted in the traditional way stressing the spiritual meaning of love in connexion with God and neighbors. Love is an emotion, which is bound with other emotions, but all objects of love don t strengthen spiritual love. In the three partite way of mysticism purification means to find biblical values in life and to practice meditative self-knowledge theologically interpreted. In illumination human understanding has to be illuminated by God and united to mystical knowledge from God. St Teresa considered illumination a way to learn things. Illumination has also psychological aspects like recognition of many trials and pains, which come from life on earth. Theologically interpreted in illumination one should die to oneself, let oneself be transformed and renewed by God. I have also written a review of the modern philosophical discussion on personal identity where memory and mental experiences are important creators of personal identity. St Teresa bound medieval mystical teaching together with her personal religious experience. Her personal identity is by its character based on her narrative life story where mental experiences play important role. Previous researchers have labelled St Teresa as an ecstatic person whose experiences produced ecstatic phenomena to the mysticism. These phenomena combined with visions have in one respect made of her a person who has brought physical and visionary tendencies to theology. In spite of that she also represents a modern tendency trying to give words to experiences, which at first seem to be exceptional and extreme and which are easily interpreted as one-sided either physical or sexual or unsaid. In other respect I have stressed the personality of St Teresa that was represented as both strong and weak. The strong personality for her is demonstrated by religious faith and in its practice. The weak personality was for her a natural personal identity. St Teresa saw a unifying aspect in almost all. Firstly, her mysticism was aimed towards union with God and secondly, the unifying aspects and common rules in human relations in community life were central. Union with God is based on the fact that in a soul God is living in its centre, where God is present in the Trinitarian way. The picture of God in ourselves is a mirror but to get to know God better is to recognize his/her presence in us. When the soul recognizes itself as a dwelling place of God, it knows itself as God knows him/herself. There is equality between God and the soul. To be a Christian means to participate in God in his Trinitarian being. The participation to God is a process of divinization that puts a person into transformation, change and renewal. The unitive aspect concludes also knowledge of opposites between experience of community and solitude as well as community and separateness. As a founder of monasteries St Teresa practiced theology of poverty. She renewed the monastic life founding a rule called discalced that stressed ascetic tendencies. Supporters of her work were after the difficulties in the beginning both society and churchly leaders. She wrote about the monasteries including in her description at times seriousness at times humor and irony. Her stories are said to be picaresque histories that contain stories of ordinary laymen and many unexpected occasions. She exercised a kind of Bakhtinian dialogue in her letters. St Teresa stressed the virtues like sacrifice, determination and courage in the monastic life. Most of what she taught of virtues is based on biblical spirituality but there are also psychological tendencies in her writings. The theological pedagogical advice is mixed with psychology, but she herself made no distinction between different aspects in her teaching. To understand St Teresa and her mysticism is to recognize that she mixes her personal religious experience and mysticism, which widens mysticism to religious experience in a new way, although this corresponds also the very definition of mysticism. St Teresa concentrated on mental-spiritual experiences and the aim of her mystical teaching was to produce a human mind well cured like a garden that has God as its gardener.

A Soul for Europe? : Contributions of European Churches to the Forum of the Convention on the Future of Europe

The aim of this research was to study how European churches contributed to the shaping of the Constitutional Treaty during the work of the Convention on the future of Europe through the public discussion forum, established by the Convention for this specific purpose in the years 2002 2003. In particular, this study sought to uncover the areas of interest brought up by the churches in their contributions, the objectives they pursued, and the approaches and arguments they employed to reach those objectives. The data for this study comprised all official submissions by European churches and church alliances to the Forum, totalling 21 contributions. A central criterion for inclusion of the data was that the organization can reasonably be assumed to represent the official position of one or more Christian churches within the European Union before the 2004 expansion. The contributing churches and organizations represent the vast majority of Christians in Europe. The data was analyzed using primarily qualitative content analysis. The research approach was a combination of abductive and inductive inference. Based on the analysis a two-fold theoretical framework was adopted, focusing on theories of public religion, secularization and deprivatization of religion, and of legitimation and collective identity. The main areas of interest found in the contributions of the churches were the value foundation of the European Union, which is demanded to coherently permeate all policies and actions of the EU, and the social dimension of Europe, which must be given equal status to the political and economic dimensions. In both areas the churches claim significant experience and expertise, which they want to see recognized in the Constituional Treaty through a formally guaranteed status for churches and religious communities in the EU. In their contributions the churches show a strong determination to secure a significant role for both religion and religious communities in the public life of Europe. As for the role of religion, they point out to its potential as a motivating and cohesive force in society and as a building block for a collective European identity, which is still missing. Churches also pursue a substantial public role for themselves beyond the spiritual dimension, permeating the secular areas of the social, political and economic dimensions. The arguments in suppport of such role are embedded in their interest and expertise in spiritual and other fundamental values and their broad involvement in providing social services. In this context churches use expressions inclusive of all religions and convictions, albeit clearly advocating the primacy of Europe's Christian heritage. Based on their historical role, their social involvement and their spiritual mission they use the public debate on the Constitutional Treaty to gain formal legitimacy for the public status of religion and religious communities, both nationally and on a European level, through appropriate provisions in the constitutional text. In return they offer the European Union ways of improving its own legitimacy by reducing the democratic and ideological deficit of the EU and advancing the development a collective European identity.

The church must become the people of Soweto : Manas Buthelezi’s existential-Christocentric understanding of the church

The aim of this study has been to discern what Manas Buthelezi (1935-), a black South African Lutheran theologian and later also a bishop, regards as the requirements a church has to fulfill in order to be credible in the apartheid society. Buthelezi’s dissertation and several articles written between the years 1968 and 1993 are the sources of this study. Also the lectures held in Heidelberg in 1972 are referred to. Systematic analysis is the method used. The question of the credibility of the church is studied through three concepts that play an important role in Buthelezi’s ecclesiological thought, namely the wholeness of life, incarnation and liberation. The notion of the wholeness of life stems from the African tradition. Buthelezi takes the concept into the Christian church: the church should realize that God is the Creator of all life and Christ the lord of every aspect of human existence. Life is one entity coram Deo. However, the church is not to become the world; solidarity between the two must remain critical as the church is also called to play a prophetic role in the society. The church is in an open relationship with the world. It has a unique message of forgiveness and reconciliation. Nevertheless, the message is not a possession of the church but it is addressed to the whole world. The meaning of incarnation comes close to that of the wholeness of life. Following the example of Christ’s incarnation, the church must become human in the reality of the people. The church in Soweto is to become the people of Soweto, that is, the church must become as vulnerable as the people are. An incarnate church cannot be immune to the oppression that people experience, because the people are the church. The church is therefore bound to suffer. Buthelezi’s theology of the cross is pragmatic: the suffering of the church aims at the liberation of the oppressed. At times the physical presence of the church by the side of the suffering people is the only way to preach the incarnate gospel. In the South Africa of the late 1960s onwards the liberation of the oppressed black people was high on the agenda of Black Theology. As a leader of the early South African Black Theology, Buthelezi is concerned about the racial injustice in his country. He urges the churches to join the struggle against it as one people of God. The notions of liberation and the wholeness of life emerge in Buthelezi’s holistic understanding of liberation that involves the inner liberation of the black spirit and the liberation of the economic, social and political aspects of life. Interpreting Tillich’s correlation method in the South African situation, and also paralleling other liberation theologians, Buthelezi takes the existential situation of the people as the starting point for liberation. The gospel has to respond to the existential questions of people. The church is called to work for the liberation of society but it must also be liberated itself. Buthelezi initiated the LWF statement on the status confessionis in South Africa (1977). In line with the statement, he calls for church unity on the human level. For the unity to be true, it has to be experienced on the grassroots’ level. All the three concepts covered urge the church to come down from any ivory tower and out of any spiritual haven it might hide in. A lot of the credibility of the church derives from the behavior of the people. Buthelezi’s concentration on how the people who constitute the church should live their faith leaves less attention to how God constitutes the church. I have labeled Buthelezi’s understanding of the church existential-Christocentric due to the emphasis he lays on the need of the church to take the existential situation of the people seriously and on the other hand, on Christ as the exemplar for the church.

Dental Service Utilization, Dental Health Production and Equity in Dental Care: the Finnish Experience

This thesis is grounded on four articles. Article I generally examines the factors affecting dental service utilization. Article II studies the factors associated with sector-specific utilization among young adults entitled to age-based subsidized dental care. Article III explores the determinants of dental ill-health as measured by the occurrence of caries and the relationship between dental ill-health and dental care use. Article IV measures and explains income-related inequality in utilization. Data employed were from the 1996 Finnish Health Care Survey (I, II, IV) and the 1997 follow-up study included in the longitudinal study of the Northern Finland 1966 Birth Cohort (III). Utilization is considered as a multi-stage decision-making process and measured as the number of visits to the dentist. Modified count data models and concentration and horizontal equity indices were applied. Dentist s recall appeared very efficient at stimulating individuals to seek care. Dental pain, recall, and the low number of missing teeth positively affected utilization. Public subvention for dental care did not seem to statistically increase utilization. Among young adults, a perception of insufficient public service availability and recall were positively associated with the choice of a private dentist, whereas income and dentist density were positively associated with the number of visits to private dentists. Among cohort females, factors increasing caries were body mass index and intake of alcohol, sugar, and soft drinks and those reducing caries were birth weight and adolescent school achievement. Among cohort males, caries was positively related to the metropolitan residence and negatively related to healthy diet and education. Smoking increased caries, whereas regular teeth brushing, regular dental attendance and dental care use decreased caries. We found equity in young adults utilization but pro-rich inequity in the total number of visits to all dentists and in the probability of visiting a dentist for the whole sample. We observed inequity in the total number of visits to the dentist and in the probability of visiting a dentist, being pro-poor for public care but pro-rich for private care. The findings suggest that to enhance equal access to and use of dental care across population and income groups, attention should focus on supply factors and incentives to encourage people to contact dentists more often. Lowering co-payments and service fees and improving public availability would likely increase service use in both sectors. To attain favorable oral health, appropriate policies aimed at improving dental health education and reducing the detrimental effects of common risk factors on dental health should be strengthened. Providing equal access with respect to need for all people ought to take account of the segmentation of the service system, with its two parallel delivery systems and different supplier incentives to patients and dentists.

Achieving medium-high density in low scale development: The Queensland experience in innovative ‘fine-grained’ urbanism

Worldwide population growth and economic agglomeration is driving increasing urban density within larger metropolitan conurbations. Population growth and housing diversity and affordability issues in Queensland have seen an increasing demand for more diverse and higher density development. Under Queensland’s flexible planning regulatory provisions, a level of ‘medium’ to ‘high density’ is being achieved by a focus on fine-grained urban design, low scale development, lot diversity, and delivery of single dwelling products. This for Queensland (and Australia) has been an unprecedented innovation in urban and dwelling design. Dwellings are being delivered on lots with zero regulatory minimum sizes providing for a range of new products including ‘apartments on the ground’. This paper reviews recent and nascent demonstrations of EDQ’s fine-grained urbanism principles, identifiable with historical ‘vernacular suburbanism’. The paper introduces and defines a concept of a ‘natural density’ linking human scale built form with walkability. The paper challenges the notion that (sub)urban development, outside major city centres, needs to be of a higher scale to achieve density and diversity aspirations. ‘Natural density’ provides a means of achieving the increasing demand for more diverse and higher density development.