Providing a ‘whole-of-family’ approach to care: family-focused practices in mental health services

Introduction: Family members including children are all impacted by a family member’s mental illness. Although mental health services are increasingly encouraged to engage in family-focused practice, this is not a well-understood concept or practice in mental health care. Methods: An integrative review using systematic methods was conducted with international literature, with the aim of identifying concepts and practices of family-focused practice in child and youth and adult mental health services. Results: Findings from 40 peer-reviewed literature identified a range of understandings and applications of family-focused practice, including who comprises the ‘family’, whether the focus is family of origin or family of procreation or choice, and whether the context of practice is child and youth or adult. ‘Family’ as defined by its members forms the foundation for practice that aims to provide a whole-of-family approach to care. Six core practices comprise a family focus to care: assessment; psychoeducation; family care planning and goal-setting; liaison between families and services; instrumental, emotional and social support; and a coordinated system of care between families and services. Conclusion: By incorporating key principles and the core family-focused practices into their care delivery, clinicians can facilitate a whole-of-family approach to care and strengthen family members’ wellbeing and resilience, and their individual and collective health outcomes.

Digitally Mediated Political Participation: Understanding the Democratic Impact of Internet Diffusion in the Asian Media Systems

Thesis (Ph.D.)--University of Washington, 2016-08

Revealing Cultural Ecosystem Services through Instagram Images : The Potential of Social Media Volunteered Geographic Information for Urban Green Infrastructure Planning and Governance

With the prevalence of smartphones, new ways of engaging citizens and stakeholders in urban planning and govern-ance are emerging. The technologies in smartphones allow citizens to act as sensors of their environment, producing and sharing rich spatial data useful for new types of collaborative governance set-ups. Data derived from Volunteered Geographic Information (VGI) can support accessible, transparent, democratic, inclusive, and locally-based governance situations of interest to planners, citizens, politicians, and scientists. However, there are still uncertainties about how to actually conduct this in practice. This study explores how social media VGI can be used to document spatial tendencies regarding citizens’ uses and perceptions of urban nature with relevance for urban green space governance. Via the hashtag #sharingcph, created by the City of Copenhagen in 2014, VGI data consisting of geo-referenced images were collected from Instagram, categorised according to their content and analysed according to their spatial distribution patterns. The results show specific spatial distributions of the images and main hotspots. Many possibilities and much potential of using VGI for generating, sharing, visualising and communicating knowledge about citizens’ spatial uses and preferences exist, but as a tool to support scientific and democratic interaction, VGI data is challenged by practical, technical and ethical concerns. More research is needed in order to better understand the usefulness and application of this rich data source to governance.

No right to sext? A critical examination of media and legal debates about teenage girls' sexual agency in the digital age

Advances in digital photography and distribution technologies enable many people to produce and distribute images of their sex acts. When teenagers do this, the photos and videos they create can be legally classified as child pornography since the law makes no exception for youth who create sexually explicit images of themselves. The dominant discussions about teenage girls producing sexually explicit media (including sexting) are profoundly unproductive: (1) they blame teenage girls for creating private images that another person later maliciously distributed and (2) they fail to respect—or even discuss—teenagers’ rights to freedom of expression. Cell phones and the internet make producing and distributing images extremely easy, which provide widely accessible venues for both consensual sexual expression between partners and for sexual harassment. Dominant understandings view sexting as a troubling teenage trend created through the combination of camera phones and adolescent hormones and impulsivity, but this view often conflates consensual sexting between partners with the malicious distribution of a person’s private image as essentially equivalent behaviors. In this project, I ask: What is the role of assumptions about teen girls’ sexual agency in these problematic understandings of sexting that blame victims and deny teenagers’ rights? In contrast to the popular media panic about online predators and the familiar accusation that youth are wasting their leisure time by using digital media, some people champion the internet as a democratic space that offers young people the opportunity to explore identities and develop social and communication skills. Yet, when teen girls’ sexuality enters this conversation, all this debate and discussion narrows to a problematic consensus. The optimists about adolescents and technology fall silent, and the argument that media production is inherently empowering for girls does not seem to apply to a girl who produces a sexually explicit image of herself. Instead, feminist, popular, and legal commentaries assert that she is necessarily a victim: of a “sexualized” mass media, pressure from her male peers, digital technology, her brain structures or hormones, or her own low self-esteem and misplaced desire for attention. Why and how are teenage girls’ sexual choices produced as evidence of their failure or success in achieving Western liberal ideals of self-esteem, resistance, and agency? Since mass media and policy reactions to sexting have so far been overwhelmingly sexist and counter-productive, it is crucial to interrogate the concepts and assumptions that characterize mainstream understandings of sexting. I argue that the common sense that is co-produced by law and mass media underlies the problematic legal and policy responses to sexting. Analyzing a range of nonfiction texts including newspaper articles, talk shows, press releases, public service announcements, websites, legislative debates, and legal documents, I investigate gendered, racialized, age-based, and technologically determinist common sense assumptions about teenage girls’ sexual agency. I examine the consensus and continuities that exist between news, nonfiction mass media, policy, institutions, and law, and describe the limits of their debates. I find that this early 21st century post-feminist girl-power moment not only demands that girls live up to gendered sexual ideals but also insists that actively choosing to follow these norms is the only way to exercise sexual agency. This is the first study to date examining the relationship of conventional wisdom about digital media and teenage girls’ sexuality to both policy and mass media.

Sexuality in the media and emotional well-being among lesbian, gay, & bisexual adolescents

LGB teens’ feelings, desires, and physical attractions run contrary to the heteronormative standards of American society. As such, LGB youth often experience feelings of sadness and dejection that can lead to depression and suicidal tendencies (Russell & Joyner, 2001). Evaluating the factors that could possibly influence the emotional well-being of LGB youth would be an important undertaking given the hindrances LGB adolescents face during sexual socialization. The purpose of this dissertation was to study the portrayal of sexuality in media popular with LGB adolescents and to assess the relationship between media exposure and emotional well-being among LGB teens. In particular, this dissertation distinguished between mainstream media and gay- and lesbian-oriented (GLO) media. GLO media were defined as any media outlet specifically designed, produced, and marketed for gay and lesbian audiences. Two studies were conducted to serve as the initial investigation in a program of research that will be designed to better understand the role of media in the lives of LGB individuals. The first study of this dissertation was a content analysis of the television programs, films, songs, and magazines most popular with LGB teens as determined by self-reports of media consumption in a survey of media use. A total of 96 media vehicles composed the content analysis sample, including 48 television programs, 22 films, 25 musical artists, and 6 magazines. Using a coding scheme that was adapted from previous media sex research, Study 1 measured the frequency of sexual instances as well as the type, nature, and source characteristics for each sexual instance. Results of the content analysis suggest that heterosexuality reigns supreme in mainstream media. When LGB sexuality is depicted in mainstream media, it is often sanitized. LGB sexual talk is rarely sexual; rather it is primarily about the social or cultural components of being lesbian, gay, or bisexual. LGB sexual behavior is also rare in mainstream media, which tend to depict LGB individuals as non-sexually as possible. LGB sexuality in mainstream media exists, but is more about proclaiming LGB identity than actually living it. GLO media depicted LGB sexuality more frequently than mainstream media did. GLO media often depict LGB sexuality in a more realistic manner. LGB sexual talk is about LGB identity, as well as the relational and sexual aspects of being a sexual minority. LGB sexual behavior is commonplace in GLO media, depicting LGB individuals as sexual beings. LGB sexuality in GLO media is prevalent and relatively authentic. The second study was a survey that assessed the relationship between media exposure (both mainstream media and GLO media) and LGB teens’ emotional well-being, considering self-discrepancy as an important mediating variable in that relationship. Study 2 also considered age, sex, and sexual identity commitment as possible moderating variables in the relationship between media exposure and emotional well-being. In Study 2, emotional well-being was defined as lower levels of dejection-related emotions. LGB adolescents (N = 573) completed a questionnaire that was used to investigate the relationships between media exposure and emotional well-being. Results of the survey indicated that mainstream media exposure was not significantly associated with dejection-related emotions. In contrast, GLO media exposure was negatively related to feelings of dejection even when controlling for age, sex, race, perceived social support, school climate, religiosity, geographical location, sexuality of peers, and motivation for viewing LGB inclusive media content. Neither age nor sex moderated the relationships between media exposure variables and dejection, but sexual identity commitment did act as a moderator in the relationship between GLO media exposure and dejection. The negative relationship between GLO media exposure and dejection was stronger for participants lower in sexual identity commitment than for participants higher in sexual identity commitment. In addition, the magnitude of discrepancies between the actual self and the ideal self mediated the relationship between GLO media exposure and dejection for LGB adolescents low in sexual identity commitment. However, self-discrepancy did not mediate the relationship between GLO media exposure and dejection for LGB teens highly committed to their sexual identities. Results of both the content analysis and the survey are discussed in terms of implications for theory and method. Practical implications of this dissertation’s findings are also discussed, as well as directions for future research.

“English Language Learning Strategies used by the Foreign Language Department Seminar Students Year 2006 with Either Above Eight Grade or Below it Obtained in Their Studies in the Basic Skills Area.

Nowadays language communication plays an important role in the world. For the technological explosion in the 20th century, the electronic mass media collapsed space and time barriers in human communication, enabling people to interact and live on a global scale. In this sense, the earth has been turned into a village by the electronic mass media. It not only changes the distance between countries, societies, but also shortens it between people. It means that the technological advancement makes the earth become a village. Since the distance between people is shortened, language communication becomes more important than before. To enhance language abilities, people can apply many different types of language learning strategies according to the learning styles that they have in order to learn the target language. In the Foreign Language Department of University of El Salvador Seminar students year 2006 apply different language learning strategies which make some of them get a grade either above eight or below it. To understand learning strategies, people can go back to basic term, strategy. This word comes from the ancient Greek term strategia meaning generalship or the art of war. A different, but related, word is tactics, which are tools to achieve the success of strategies. The two expressions share some basic implied characteristics: planning, competition, conscious manipulation, and movement toward a goal.

Avian flu: the creation of expectations in the interplay between science and the media

This paper examines the emerging cultural patterns and interpretative repertoires in reports of an impending pandemic of avian flu in the UK mass media and scientific journals at the beginning of 2005, paying particular attention to metaphors, pragmatic markers ('risk signals'), symbolic dates and scare statistics used by scientists and the media to create expectations and elicit actions. This study complements other work on the metaphorical framing of infectious disease, such as foot and mouth disease and SARS, tries to link it to developments in the sociology of expectations and applies insights from pragmatics both to the sociology of metaphor and the sociology of expectations.

Estimated Disability-adjusted Life Years Averted By Long-term Provision Of Long Acting Contraceptive Methods In A Brazilian Clinic.

What is the contribution of the provision, at no cost for users, of long acting reversible contraceptive methods (LARC; copper intrauterine device [IUD], the levonorgestrel-releasing intrauterine system [LNG-IUS], contraceptive implants and depot-medroxyprogesterone [DMPA] injection) towards the disability-adjusted life years (DALY) averted through a Brazilian university-based clinic established over 30 years ago. Over the last 10 years of evaluation, provision of LARC methods and DMPA by the clinic are estimated to have contributed to DALY averted by between 37 and 60 maternal deaths, 315-424 child mortalities, 634-853 combined maternal morbidity and mortality and child mortality, and 1056-1412 unsafe abortions averted. LARC methods are associated with a high contraceptive effectiveness when compared with contraceptive methods which need frequent attention; perhaps because LARC methods are independent of individual or couple compliance. However, in general previous studies have evaluated contraceptive methods during clinical studies over a short period of time, or not more than 10 years. Furthermore, information regarding the estimation of the DALY averted is scarce. We reviewed 50 004 medical charts from women who consulted for the first time looking for a contraceptive method over the period from 2 January 1980 through 31 December 2012. Women who consulted at the Department of Obstetrics and Gynaecology, University of Campinas, Brazil were new users and users switching contraceptive, including the copper IUD (n = 13 826), the LNG-IUS (n = 1525), implants (n = 277) and DMPA (n = 9387). Estimation of the DALY averted included maternal morbidity and mortality, child mortality and unsafe abortions averted. We obtained 29 416 contraceptive segments of use including 25 009 contraceptive segments of use from 20 821 new users or switchers to any LARC method or DMPA with at least 1 year of follow-up. The mean (± SD) age of the women at first consultation ranged from 25.3 ± 5.7 (range 12-47) years in the 1980s, to 31.9 ± 7.4 (range 16-50) years in 2010-2011. The most common contraceptive chosen at the first consultation was copper IUD (48.3, 74.5 and 64.7% in the 1980s, 1990s and 2000s, respectively). For an evaluation over 20 years, the cumulative pregnancy rates (SEM) were 0.4 (0.2), 2.8 (2.1), 4.0 (0.4) and 1.3 (0.4) for the LNG-IUS, the implants, copper IUD and DMPA, respectively and cumulative continuation rates (SEM) were 15.1 (3.7), 3.9 (1.4), 14.1 (0.6) and 7.3 (1.7) for the LNG-IUS, implants, copper IUD and DMPA, respectively (P < 0.001). Over the last 10 years of evaluation, the estimation of the contribution of the clinic through the provision of LARC methods and DMPA to DALY averted was 37-60 maternal deaths; between 315 and 424 child mortalities; combined maternal morbidity and mortality and child mortality of between 634 and 853, and 1056-1412 unsafe abortions averted. The main limitations are the number of women who never returned to the clinic (overall 14% among the four methods under evaluation); consequently the pregnancy rate could be different. Other limitations include the analysis of two kinds of copper IUD and two kinds of contraceptive implants as the same IUD or implant, and the low number of users of implants. In addition, the DALY calculation relies on a number of estimates, which may vary in different parts of the world. LARC methods and DMPA are highly effective and women who were well-counselled used these methods for a long time. The benefit of averting maternal morbidity and mortality, child mortality, and unsafe abortions is an example to health policy makers to implement more family planning programmes and to offer contraceptive methods, mainly LARC and DMPA, at no cost or at affordable cost for the underprivileged population. This study received partial financial support from the Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP), grant # 2012/12810-4 and from the National Research Council (CNPq), grant #573747/2008-3. B.F.B., M.P.G., and V.M.C. were fellows from the scientific initiation programme from FAPESP. Since the year 2001, all the TCu380A IUD were donated by Injeflex, São Paulo, Brazil, and from the year 2006 all the LNG-IUS were donated by the International Contraceptive Access Foundation (ICA), Turku, Finland. Both donations are as unrestricted grants. The authors declare that there are no conflicts of interest associated with this study.

The right to screens: from media education to educommunication in Brazil

Social organizations, local governments and the media in Brazil are confronting them, selves over the need for an oversight board to guarantee quality television programming, and establishing a system to determine which television programs are appropriate for which television time slots. Across Brazil, a representative body of children and young adults have determined that the right to receive quality programming is not currently being met. Children of the new generation see themselves as having a right to access new technologies which enable them to produce their own messages according to their own creativity, interests, and social participation. This new generation wants to go beyond education in order to watch and conquer their ""right to screens"".

Adherence to cervical and breast cancer programs is crucial to improving screening performance

Introduction: Cervical and breast cancer are the most common malignancies among women worldwide. Effective screening can facilitate early detection and dramatically reduce mortality rates. The interface between those screening patients and patients most needing screening is complex, and women in remote areas of rural counties face additional barriers that limit the effectiveness of cancer prevention programs. This study compared various methods to improve compliance with mass screening for breast and cervical cancer among women in a remote, rural region of Brazil. Methods: In 2003, a mobile unit was used to perform 10 156 mammograms and Papanicolaou smear tests for women living in the Barretos County region of Sao Paulo state, Brazil (consisting of 19 neighbouring cities). To reach the women, the following community outreach strategies were used: distribution of flyers and pamphlets; media broadcasts (via radio and car loudspeakers); and community healthcare agents (CHCAs) making home visits. Results: The most useful intervention appeared to be the home visits by healthcare agents or CHCAs. These agents of the Family Health Programme of the Brazilian Ministry of Health reached an average of 45.6% of those screened, with radio advertisements reaching a further 11.9%. The great majority of the screened women were illiterate or had elementary level schooling (80.9%) and were of 'poor' or 'very poor' socioeconomic class (67.2%). Conclusions: Use of a mobile screening unit is a useful strategy in developing countries where local health systems have inadequate facilities for cancer screening in underserved populations. A multimodal approach to community outreach strategies, especially using CHCAs and radio advertisements, can improve the uptake of mass screening in low-income, low-educational background female populations.

The Emergence of Family Nursing in Brazil

A family perspective has been influencing Brazilian nursing practice and research, in particular in the past decade. Despite this development, there is evidence from research and from nurses` narratives that nurses still experience serious challenges in providing nursing care to families in Brazil. These challenges are analyzed and strategies are offered to support nurses in Brazil to ""think family"" and stimulate advanced practice in family nursing.

Evaluation of two semi-selective media to detect Curtobacterium flaccumfaciens pv. flaccumfaciens in bean seeds

Evaluation of two semi-selective media to detect Curtobacterium flaccumfaciens pv. flaccumfaciens in bean seeds This study aimed to compare the effectiveness of the semi-selective MSCFF and modified CNS culture media in detecting Curtobacterium flaccumfaciens pv. flaccumfaciens (Cff) in bean seeds, using the streak and spread plate techniques. Four 500 g subsamples, obtained from two samples of bean seeds, were immersed in 600 mL of sterile distilled water for 18 h at 5 degrees C. Suspensions were picked and transferred to plates with both culture media. Plates were then incubated at 28 degrees C, and bacterial growth on both media was evaluated 72 and 144 hours later, compared to the growth of a Cff reference strain. Both media revealed the presence of Cff colonies. Typical colonies were isolated for PCR analyses and pathogenicity tests on tobacco leaves. A characteristic Cff growth on MSCFF medium was observed for the seed samples, for the two plate techniques used, in both evaluations. On the modified CNS culture medium, the bacterial growth was only detected in seed samples after 144 hours of incubation, regardless of the plate technique used. The results showed Cff grew faster on the MSCFF semi-selective culture medium. Bacterial isolates tested were identified as Cff by both PCR analyses and a positive tobacco hypersensitivity reaction.

Perceived self-other differences in persuasibility: the effects of interpersonal and group-based similarity

Two experiments examined the effects of interpersonal and group-based similarity on perceived self-other differences in persuasibility (i.e. on third-person effects, Davison, 1983). Results of Experiment 1 (N=121), based on experimentally-created groups, indicated that third-person perceptions with respect to the impact of televised product ads were accentuated when the comparison was made with interpersonally different others. Contrary to predictions, third-person perceptions were not affected by group-based similarity (i.e. ingroup or outgroup other). Results of Experiment 2 (N = 102), based an an enduring social identity, indicated that both interpersonal and group-based similarity moderated perceptions of the impact on self and other of least-liked product ads. Overall, third-person effects were more pronounced with respect to interpersonally dissimilar others. However, when social identity was salient, information about interpersonal similarity of the target did not affect perceived self-other differences with respect to ingroup targets. Results also highlighted significant differences in third-person perceptions according to the perceiver's affective evaluation of the persuasive message. (C) 1998 John Wiley & Sons, Ltd.

A numerical study of pore-fluid, thermal and mass flow iu fluid-saturated porous rock basins

We present a numerical methodology for the study of convective pore-fluid, thermal and mass flow in fluid-saturated porous rock basins. lit particular, we investigate the occurrence and distribution pattern of temperature gradient driven convective pore-fluid flow and hydrocarbon transport in the Australian North West Shelf basin. The related numerical results have demonstrated that: (1) The finite element method combined with the progressive asymptotic approach procedure is a useful tool for dealing with temperature gradient driven pore-fluid flow and mass transport in fluid-saturated hydrothermal basins; (2) Convective pore-fluid flow generally becomes focused in more permeable layers, especially when the layers are thick enough to accommodate the appropriate convective cells; (3) Large dislocation of strata has a significant influence off the distribution patterns of convective pore;fluid flow, thermal flow and hydrocarbon transport in the North West Shelf basin; (4) As a direct consequence of the formation of convective pore-fluid cells, the hydrocarbon concentration is highly localized in the range bounded by two major faults in the basin.