Mental health nurses’ attitudes, behaviour, experience and knowledge regarding adults with a diagnosis of borderline personality disorder: systematic, integrative literature review

Aims and objectives To establish whether mental health nurses responses to people with borderline personality disorder are problematic and, if so, to inform solutions to support change. Background There is some evidence that people diagnosed with borderline personality disorder are unpopular among mental health nurses who respond to them in ways which could be counter-therapeutic. Interventions to improve nurses’ attitudes have had limited success. Design Systematic, integrative literature review. Methods Computerised databases were searched from inception to April 2015 for papers describing primary research focused on mental health nurses’ attitudes, behaviour, experience, and knowledge regarding adults diagnosed with borderline personality disorder. Analysis of qualitative studies employed metasynthesis; analysis of quantitative studies was informed by the theory of planned behaviour. Results Forty studies were included. Only one used direct observation of clinical practice. Nurses’ knowledge and experiences vary widely. They find the group very challenging to work with, report having many training needs, and, objectively, their attitudes are poorer than other professionals’ and poorer than towards other diagnostic groups. Nurses say they need a coherent therapeutic framework to guide their practice, and their experience of caregiving seems improved where this exists. Conclusions Mental health nurses’ responses to people with borderline personality disorder are sometimes counter-therapeutic. As interventions to change them have had limited success there is a need for fresh thinking. Observational research to better understand the link between attitudes and clinical practice is required. Evidence-based education about borderline personality disorder is necessary, but developing nurses to lead in the design, implementation and teaching of coherent therapeutic frameworks may have greater benefits. Relevance to clinical practice There should be greater focus on development and implementation of a team-wide approach, with nurses as equal partners, when working with patients with borderline personality disorder.

Designing the Spectator Experience

Interaction is increasingly a public affair, taking place in our theatres, galleries, museums, exhibitions and on the city streets. This raises a new design challenge for HCI, questioning how a performer s interaction with a computer experienced is by spectators. We examine examples from art, performance and exhibition design, comparing them according to the extent to which they hide, partially reveal, transform, reveal or even amplify a performerts manipulations. We also examine the effects of these manipulations including movements, gestures and utterances that take place around direct input and output. This comparison reveals four broad design strategies: `secretive,' where manipulations and effects are largely hidden; `expressive,' where they are revealed, enabling the spectator to fully appreciate the performer's interaction; `magical,' where effects are revealed but the manipulations that caused them are hidden; and finally `suspenseful,' where manipulations are apparent, but effects only get revealed when the spectator takes their turn.

Associations between patient factors and medication adherence: a Jordanian experience

Objective: To explore the effect of patient characteristics and health beliefs on their medication adherence. Methods: Patients (n=167) with chronic conditions (mean age 58.9; SD=13.54, 53% males) were recruited from March 2009- to March 2010 using a cross sectional study design. Data collected included patients’ demographics, medical conditions, medications therapeutic regimen, frequency of physician visits and health beliefs. Patient self-reported adherence to medications was assessed by the researcher using a validated and published scale. Treatment related problems (TRPs) were evaluated for each patient by competent clinical pharmacists. Associations between patient characteristics/health beliefs with adherence were explored. Results: About half of the patients (46.1%) were non-adherent. A significant association was found between lower adherence and higher number of disease states (p<0.001), higher number of medications (p=0.001), and higher number of identified TRPs (p = 0.003). Patient adherence was positively affected by older age, higher educational level, and higher number of physician visits per month, while it was negatively affected by reporting difficulties with getting prescription refills on time. Conclusion: This study identified different factors that may negatively affect adherence, including higher number of medications and disease states, higher number of identified TRPs and inability to getting prescription refills on time. Hence, more care needs to be provided to patients with complex therapeutic regimens in order to enhance adherence.

`Electronic Publishing' -- Practice and Experience

Electronic Publishing -- Origination, Dissemination and Design (EP-odd) is an academic journal which publishes refereed papers in the subject area of electronic publishing. The authors of the present paper are, respectively, editor-in-chief, system software consultant and senior production manager for the journal. EP-odd's policy is that editors, authors, referees and production staff will work closely together using electronic mail. Authors are also encouraged to originate their papers using one of the approved text-processing packages together with the appropriate set of macros which enforce the layout style for the journal. This same software will then be used by the publisher in the production phase. Our experiences with these strategies are presented, and two recently developed suites of software are described: one of these makes the macro sets available over electronic mail and the other automates the flow of papers through the refereeing process. The decision to produce EP-odd in this way means that the publisher has to adopt production procedures which differ markedly from those employed for a conventional journal.

Design de interfaces dinâmicos em sistemas de gestão de conteúdos

Relatório de Estágio para a obtenção do grau de Mestre na área de Educação e Comunicação Multimédia

A rewarding experience? Exploring how crowdfunding is affecting music industry business models.

This paper provides an exploratory study of how rewards-based crowdfunding affects business model development for music industry artists, labels and live sector companies. The empirical methodology incorporated a qualitative, semi-structured, three-stage interview design with fifty seven senior executives from industry crowdfunding platforms and three stakeholder groups. The results and analysis cover new research ground and provide conceptual models to develop theoretical foundations for further research in this field. The findings indicate that the financial model benefits of crowdfunding for independent artists are dependent on fan base demographic variables relating to age group and genre due to sustained apprehension from younger audiences. Furthermore, major labels are now considering a more user-centric financial model as an innovation strategy, and the impact of crowdfunding on their marketing model may already be initiating its development in terms of creativity, strength and artist relations.

Searching for knowledge in the belly of the beast: diversity, social equity and the African graduate student mother's experience in US higher education

Diversity has become a buzz word in public discourse and in educational circles. Higher education institutions in the US have increasingly used this word as a cornerstone of their mission statements and have made increasing efforts to attract students from different backgrounds. As part of the increase in diversity efforts among US colleges, is a significant rise in the number of international students. Attracting international students has become a priority for U.S. universities regardless of size or location. This study examines the intersection between the structure of American educational environment and the blended identities of African Graduate Student Mothers. Within the context of contemporary diversity efforts in US educational institutions, this study examines both the structural environments and the socio-cultural constructs that affect the experiences of African graduate student mothers. Based on a qualitative research interview design, a total of nineteen African graduate student mothers at a Mid-Western University in the US were interviewed individually and in groups over a six weeks period. Results from this study show that apart from the difficult and often dehumanizing treatment African student mothers endure from immigration and consular officials in their various countries and ports of entry, they often find themselves at the margins of their various programs and departments with very little support if any. This is because most of them enroll into graduate programs after arriving as dependants of their spouses; a process that does not allow them to negotiate for departmental commitments and support prior to their arrival. Not only do these women face racial discrimination from white professors, staff and fellow students, but they also experience discrimination and hostilities from African Americans and other minority groups who see them as threats to the limited resources that are often set aside for minority groups in such institutions.

The Impact of a Simulated Clinical Experience on CEGEP Nursing Students’ Perceptions of Self-Efficacy and Achievement

Abstract : Providing high-quality clinical experiences to prepare students for the complexities of the current health-care system has become a challenge for nurse educators. Additionally, there are concerns that the current model of clinical practice is suboptimal. Consequently, nursing programs have explored the partial replacement of traditional in-hospital clinical experiences with a simulated clinical experience. Despite research demonstrating numerous benefits to students following participation in simulation activities, insufficient research conducted within Québec exists to convince the governing bodies (Ordre des infirmières et des infirmiers du Québec, OIIQ; Ministère de L’Éducation supérieur, de la Recherche, de la Science et de la Technologie) to fully embrace simulation as part of nurse training. The purpose of this study was to examine the use of a simulated clinical experience (SCE) as a viable, partial pedagogical substitute for traditional clinical experience by examining the effects of a SCE on CEGEP nursing students’ perceptions of self-efficacy (confidence), and their ability to achieve course objectives. The findings will contribute new information to the current body of research in simulation. The specific case of obstetrical practice was examined. Based on two sections of the Nursing III-Health and Illness (180-30K-AB) course, the sample was comprised of 65 students (thirty-one students from section 0001 and thirty-four students from section 0002) whose mean age was 24.8 years. With two sections of the course available, the opportunity for comparison was possible. A triangulation mixed method design was used. An adapted version of Ravert’s (2004) Nursing Skills for Evaluation tool was utilized to collect data regarding students’ perceptions of confidence related to the nursing skills required for care of mothers and their newborns. Students’ performance and achievement of course objectives was measured through an Objective Structured Clinical Examination (OSCE) consisting of three marked stations designed to test the theoretical and clinical aspects of course content. The OSCE was administered at the end of the semester following completion of the traditional clinical experience. Students’ qualitative comments on the post -test survey, along with journal entries served to support the quantitative scale evaluation. Two of the twelve days (15 hours) allocated for obstetrical clinical experience were replaced by a SCE (17%) over the course of the semester. Students participated in various simulation activities developed to address a range of cognitive, psychomotor and critical thinking skills. Scenarios incorporating the use of human patient simulators, and designed using the Jeffries Framework (2005), exposed students to the care of families and infants during the perinatal period to both reflect and build upon class and course content in achievement of course objectives and program competencies. Active participation in all simulation activities exposed students to Bandura’s four main sources of experience (mastery experiences, vicarious experiences, social persuasion, and physiologic/emotional responses) to enhance the development of students’ self-efficacy. Results of the pre-test and post-test summative scores revealed a statistically significant increase in student confidence in performing skills related to maternal and newborn care (p < .0001) following participation in the SCE. Confidence pre-test and post-test scores were not affected by the students’ section. Skills related to the care of the post-partum mother following vaginal or Caesarean section delivery showed the greatest change in confidence ratings. OSCE results showed a mean total class score (both sections) of 57.4 (70.0 %) with normal distribution. Mean scores were 56.5 (68.9%) for section 0001 and 58.3 (71.1%) for section 0002. Total scores were similar between sections (p =0.342) based on pairwise comparison. Analysis of OSCE scores as compared to students’ final course grade revealed similar distributions. Finally, qualitative analysis identified how students’ perceived the SCE. Students cited gains in knowledge, development of psychomotor skills and improved clinical judgement following participation in simulation activities. These were attributed to the « hands on » practice obtained from working in small groups, a safe and authentic learning environment and one in which students could make mistakes and correct errors as having the greatest impact on learning through simulation.

An interpretative phenomenological analysis of the lived experience of suicidal behaviour

Background: In Scotland, suicide prevention is a major public health challenge, with two people, on average, dying every day due to suicide. Any efforts to prevent suicide should be aided by research. Existing research on suicide is dominated by quantitative research that has largely focused on providing explanatory accounts of suicidal phenomena. Research providing rich and detailed accounts of suicidal behaviour among individuals who have directly experienced it is growing but remains relatively embryonic. This study sought to supplement existing understanding of attempted suicide specifically by exploring the processes, meaning and context of suicidal experiences among individuals with a history of attempted suicide. Methods: The study used a retrospective qualitative design with semi-structured in-depth interviews. Participants were patients (n=7) from a community mental health service in Glasgow, Scotland who had attempted suicide within the previous 12-month period. The interviews were transcribed verbatim and were analysed for recurrent themes using interpretative phenomenological analysis (IPA). Results: Three super-ordinate themes, each with inter-related sub-themes, emerged from the analysis. 1) “Intentions”: This theme explored different motives for suicide, including providing relief from upsetting feelings; a way of establishing control; and a means of communicating with others. 2) “The Suicidal Journey”: This theme explored how individuals’ thinking can change when they are suicidal, including feeling overwhelmed by a build-up of distress and a narrowing of their perspective. 3) “Suicidal Dissonance”: This theme explored how people can feel conflicted about suicide and can be fearful of the consequences of their suicidal behaviour. Conclusion: Participants’ accounts were dominated by experience of significant adversity and psychological suffering. These accounts provided valuable insights into the suicidal process, highlighting implications for clinical practice and future research.

Applying Platform Design to Improve Product-Service Systems Collaborative Development

Part 3: Product-Service Systems

A MORE COMPLETE STREET A STREET FOR EVERYONE TO ENJOY, NORTH EAST STREET, FREDERICK, MARYLAND – A DESIGN INVESTIGATION OF DIFFERENT STREET DESIGN THEORIES

This design-research thesis suggests that the improvement of North East Street performances by using Complete Streets, Green Street, Place Making and Context Sensitive Solution principles and practices. Heavily used by a variety of users, often conflicting with one another, University of Maryland Campus Drive would benefit from a major planning and design amelioration to meet the increasing demands of serving as a city main street. The goal of this thesis project is to prioritize the benefits for pedestrians in the right-of-way and improve the pedestrian experience. This goal also responds to the recent North East Street Extension Phrase I of economic renaissances. The goal of this design-research thesis will be achieved focusing on four aspects. First, the plans and designs will suggest to building mixed use blocks, increase the diversity of street economic types and convenience of people’s living. Second, design and plans will propose bike lanes, separate driving lanes from sidewalks and bike lanes by street tree planters, and narrow driving lanes to reduce vehicular traffic volume and speed in order to reduce pedestrian and vehicle conflicts. Third, plans and designs will introduce bioswales, living walls and raingardens to treat and reuse rain water. Finally, the plans and designs will seek to preserve local culture and history by adding murals and farmers market. The outcome of the design-research thesis project is expected to serve as an example of implementing Complete Streets, Green Street, Place Making and Context Sensitive Solution principles and practices in urban landscape, where transportation, environment and social needs interact with each other.

A HUMAN-CENTERED APPROACH TO IMPROVING THE USER EXPERIENCE OF SOFTWARE UPDATES

Software updates are critical to the security of software systems and devices. Yet users often do not install them in a timely manner, leaving their devices open to security exploits. This research explored a re-design of automatic software updates on desktop and mobile devices to improve the uptake of updates through three studies. First using interviews, we studied users’ updating patterns and behaviors on desktop machines in a formative study. Second, we distilled these findings into the design of a low-fi prototype for desktops, and evaluated its efficacy for automating updates by means of a think-aloud study. Third, we investigated individual differences in update automation on Android devices using a large scale survey, and interviews. In this thesis, I present the findings of all three studies and provide evidence for how automatic updates can be better appropriated to fit users on both desktops and mobile devices. Additionally, I provide user interface design suggestions for software updates and outline recommendations for future work to improve the user experience of software updates.

Design gráfico alternativo

Dissertação de Mestrado para obtenção do grau de Mestre em Design de Comunicação, apresentada na Universidade de Lisboa - Faculdade de Arquitectura

Co-creation of tourism experience: attention, involvement and memorability

Tese de Doutoramento, Turismo, Faculdade de Economia, Universidade do Algarve, 2016

Adaptive lighting design as a holistic approach to public lighting

Dissertação para obtenção do grau de Doutor em Design, apresentada na Universidade de Lisboa - Faculdade de Arquitetura.