The Family Model - A transgenerational approach to mental health in families: personal, clinical, educational, research, systems and policy perspectives

The Family Model – A transgenerational approach to mental health in families This workshop will provide an overview on The Family Model (TFM) and its use in promoting and facilitating a trans­generational family focus in Mental Health services, over the past 10­ - 15 years. Each of the speakers will address a different perspective, including service user/consumer, clinical practice, education & training, research and policy. Adrian Falkov (chair) will provide an overview of TFM to set the scene and a ‘policy to practice’ perspective, based on use of TFM in Australia. Author: Heide Lloyd. The Family Model ­ A personal (consumer/patient) perspective | United Kingdom Heide will provide a description of her experiences as a child, adult, parent & grandparent, using TFM as the structure around which to ‘weave’ her story and demonstrate how TFM has assisted her in understanding the impact of symptoms on her & family and how she has used it in her management of symptoms and recovery (personal perspective). The Family Model ­ Education & training perspective ­ Marie Diggins | United Kingdom PhD Bente Weimand | Norway Authors: ­ Marie Diggins | United Kingdom PhD Bente Weimand | Norway This combined (UK & Norwegian) presentation will cover historical background to TFM and its use in eLearning (the Social Care Institute for Excellence)and a number of other UK initiatives, together with a description of the postgraduate masters course at the University Oslo/Akershus, using TFM. The Family Model ­ A research perspective PhD Anne Grant | Northern Ireland Author: PhD Anne Grant | Ireland Anne Grant will describe how she used TFM as the theoretical framework for her PhD looking at family focused (nursing) practice in Ireland. The Family Model ­ A service systems perspective ­ Mary Donaghy | Northern Ireland Authors: PhD Adrian Falkov | Australia ­ Mary Donaghy | N Ireland Mary Donaghy will discuss how TFM has been used to support & facilitate a cross service ‘whole of system’ change program in Belfast (NI) to achieve improved family focused practice. She will demonstrate its utility in achieving a broader approach to service design, delivery and evaluation.

Herd management and livestock productivity in the Altai region of Western Mongolia

This thesis analyses the influence of qualitative and quantitative herbage production on seasonal rangelands, and of herd and pasture use strategies on feed intake, body mass development and reproductive performance of sheep and goats in the Altai mountain region of Bulgan county (soum) in Khovd province (aimag). This westernmost county of Mongolia is characterized by a very poor road network and thus very difficult access to regional and national markets. The thesis explores in this localized context the current rural development, the economic settings and political measures that affect the traditional extensive livestock husbandry system and its importance for rural livelihoods. Livestock management practices still follow the traditional transhumant mode, fully relying on natural pasture. This renders animal feeding very vulnerable to the highly variable climatic conditions which is one of many reasons for gradually declining quantity and quality of pasture vegetation. Small ruminants, and especially goats, are the main important species securing economic viability of their owners’ livelihood, and they are well adapted to the harsh continental climate and the present low input management practices. It is likely that small ruminants will keep their vital role for the rural community in the future, since the weak local infrastructure and slow market developments currently do not allow many income diversification options. Since the profitability of a single animal is low, animal numbers tend to increase, whereas herd management does not change. Possibilities to improve the current livestock management and thus herders’ livelihoods in an environmentally, economically and socially sustainable manner are simulated through bio-economic modelling and the implications are discussed at the regional and national scale. To increase the welfare of the local population, a substantial infrastructural and market development is needed, which needs to be accompanied by suitable pasture management schemes and policies

The Effects of a Group-Based Approach to Parent-Mediated Early Behavioral Intervention for Very Young Children with or At-Risk for Autism

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

What do GPs and Bereaved Parents Think About Paediatric Oncologists and Palliative Care?

Aim The aim of the study was to examine the experiences of bereaved parents and general practitioners (GPs) following the death of a child with cancer within the family home. This presenta-tion focuses on one of the findings; the parent and GP views on the hospital consultants’ involvement in the palliative care. Design A community based qualitative study.Setting West Midlands region, UK. Participants Purposeful sample of 18 GPs and 11 bereaved families. The sample was drawn from the families and GPs of children who had been treated for cancer at a regional childhood cancer centre and who subsequently died within the family home. Methods One-to-one semi-structured tape-recorded interviews were undertaken with GPs and bereaved parents following the death at home of a child with cancer. GPs were contacted three months after the death of the child and the parents at six months. Thematic analysis of the transcriptions was undertaken. Findings Parents described feeling abandoned at the transition to palliation when management of care transferred to the GP. Families did not perceive a seamless service of medical care between hospital and community. Where offered consultant contact was valued by families and GPs. Text and email were used by families as a means of asking the consultant questions. The GPs lacked role clarity where the consultant continued involvement in the care. Conclusions The transition to palliation and the transfer of care to community services needs to be sensitively and actively man-aged for the family and the GP. Medical care between tertiary andprimary care should be seen as a continuum. Improving GP: consultant communication could aid role clarity, identify mecha-nisms for support and advice, and promote the active engagement of the GP in the care. Exploring opportunities for integrated con-sultant: GP working could maximise mutual learning and support and enhance care provision. The level, access and duration of ongoing contact between consultants and families/GPs require clarity.

A social-ecological impact assessment for public lands management: application of a conceptual and methodological framework

According to the U.S. National Environmental Policy Act of 1969 (NEPA), federal action to manipulate habitat for species conservation requires an environmental impact statement, which should integrate natural, physical, economic, and social sciences in planning and decision making. Nonetheless, most impact assessments focus disproportionately on physical or ecological impacts rather than integrating ecological and socioeconomic components. We developed a participatory social-ecological impact assessment (SEIA) that addresses the requirements of NEPA and integrates social and ecological concepts for impact assessments. We cooperated with the Bureau of Land Management in Idaho, USA on a project designed to restore habitat for the Greater Sage-Grouse (Centrocercus urophasianus). We employed questionnaires, workshop dialogue, and participatory mapping exercises with stakeholders to identify potential environmental changes and subsequent impacts expected to result from the removal of western juniper (Juniperus occidentalis). Via questionnaires and workshop dialogue, stakeholders identified 46 environmental changes and associated positive or negative impacts to people and communities in Owyhee County, Idaho. Results of the participatory mapping exercises showed that the spatial distribution of social, economic, and ecological values throughout Owyhee County are highly associated with the two main watersheds, wilderness areas, and the historic town of Silver City. Altogether, the SEIA process revealed that perceptions of project scale varied among participants, highlighting the need for specificity about spatial and temporal scales. Overall, the SEIA generated substantial information concerning potential impacts associated with habitat treatments for Greater Sage-Grouse. The SEIA is transferable to other land management and conservation contexts because it supports holistic understanding and framing of connections between humans and ecosystems. By applying this SEIA framework, land managers and affected people have an opportunity to fulfill NEPA requirements and develop more comprehensive management plans that better reflect the linkages of social-ecological systems.

Challenges Facing Long Term Foster Carers: Exploration of the Nature of Psychoanalytic Parent/Carer Support

This research study investigates the role and impact of psychoanalytically-informed short-term parent work with long-term foster carers of looked-after children, in support of the foster placement. The study reflects on the data gathered from four child assessments and five foster families seen by a psychoanalytic child psychotherapist for four sessions each. It draws on psychoanalytic ideas from a range of theoretical traditions, exploring such concepts as trauma, defences, compulsion to repeat, psychological-mindedness, ‘container/contained’ (Bion) and ‘holding environment’ (Winnicott). One distinctive contribution of this research is what it adds to our already existing understanding of the defences (or responses) aroused in the carer when faced with the intense and distressing affect associated with the child’s early trauma; and the impact of this legacy of trauma on the child, on the carer and on the wider Social Services system. Applying Grounded Theory and psychoanalytically-informed clinical case study methodology to the research material, the study breaks down the data analysis into seven stages of coding, from the initial reading of the data to the eventual development of two key hypotheses. One of the predominant themes that emerged from the analysis was the carer’s capacity to remain focused on the child’s emotional needs and how this in turn was linked to the direction of the therapist’s focus. The successive analyses of the data culminated in the hypothesis that the more the therapist focused on the carer and the carer’s emotional states in the course of the parent work, the more the carer was enabled to focus on the child’s emotional needs. As the system of categories emerged according to the themes exemplified in the sessions, a particular focus of analysis became the concept of psychologicalmindedness, considered under several sub-categories: displaying insightful comments; awareness of the child’s bodily states; awareness of the child’s affect; the carer’s ability to recognize the child’s defences; and the carer’s ability to make links between the child’s current difficulties and the child’s past experiences. Through this analysis it became apparent that degree of psychological-mindedness was closely linked to the individual carer’s capacity to metabolize the child’s distressed and distressing communication. This in turn led to a deeper exploration of the situations that were particularly challenging for the carers: i.e., instances when the child was compelled to repeat past traumatic emotional states and as a result was communicating intense distress. This exploration eventually generated the second hypothesis: that in reaction to the child’s distress, the response of each carer could be plotted somewhere along a spectrum, from either distancing themselves from the child’s emotional state to seeking excessive closeness with the child (merging). The next stage of the analysis developed four new categories of carer responses to the distressed child: identification and distancing from the child; identification and merging with the child; the category that describes the carer’s psychologicalmindedness as being ‘impaired’; and ‘good enough’ caring. This then led to an exploration of the carer’s own defences at these most challenging times. This research demonstrates clearly that even within the short space of four sessions of weekly psychoanalytic parent work, it is possible to achieve significant improvement in a carer’s capacity to bear the child’s compulsion to repeat early traumas, and to help the carers become more emotionally available to provide the child with effective psychological parenting at such difficult and challenging times. Key words: looked-after children; long-term foster carers; psychoanalytic short-term parent work; trauma; compulsion to repeat; psychological-mindedness; empathy; defences; psychoanalytically-informed clinical case study research methodology; Grounded Theory research methodology.

A qualitative study of the emotional coping and support needs of children living with a parent with a brain injury

Primary objective: To examine emotional coping and support needs in children of persons with acquired brain injury, with a view to understanding what interventions would be helpful for these children. Design: The study was qualitative, using a thematic analysis approach. Methods and procedure: Six children between 9 and 18 years of age, six parents (three with ABI), and three support workers were interviewed either at home or at a support centre, using a semi-structured interview guide. Results: Children reported using a variety of adaptive and maladaptive emotional coping strategies, but were consistent in expressing a need for credible validation, i.e. sharing experiences with peers. The results are presented under four overarching themes: difficulties faced; emotions experienced; coping strategies; and reported support needs. Conclusions: The results reveal an interaction between the child’s experiences of complex loss that is difficult to acknowledge, emotional distancing between parent and child, and the children’s need for credible validation. All children expressed a desire for talking to peers in a similar situation to themselves, but had not had this opportunity. Interventions should set up such peer interaction to create credible validation for the specific distress suffered by this population.

Ecology and physical condition of red deer in the Iberian Peninsula: implications for management

The red deer (Cervus elaphus) is currently one of the most widespread and abundant wild ungulates in the Iberian Peninsula and is extremely important both ecologically, as a key species for the functioning of the ecosystems, and economically, as a major game species. In Iberia, red deer populations are subjected to different management systems that may affect the physical condition of the individuals, with further consequences for population dynamics. Studies investigating the effects of management practices and environmental conditions on the performance of red deer are still rare regarding Mediterranean ecosystems. Much of the knowledge concerning the ecology of red deer and the impact of management on its physical condition is based on studies conducted in northern and central regions of Europe, where climatological features and management practices differ from those observed in the Mediterranean areas of Iberia. Studies on a biogeographical scale can provide important insights into the relationships between species and a particular environment and contribute to the development of more targeted and appropriate management practices. The optimisation of sampling procedures and the fine-tuning of pre-existing analytical techniques are also fundamental to a more cost-effective monitoring and, therefore, are of enormous value to wildlife managers. In this context, the main aims of this thesis were: 1) to optimise the procedures used to assess the physical condition of red deer; and 2) to identify relevant management and environmental factors affecting the nutritional condition and stress physiology of red deer in the Mediterranean ecosystems of Iberia, as well as any potential interactions between those factors. Two studies with a methodological focus, presented in the first part of the thesis, demonstrated that the physical condition of red deer can be evaluated more simply, using more cost- and time-effective procedures than those traditionally used: i) it was shown that only one kidney and its associated fat is enough to assess nutritional condition in red deer; and ii) the feasibility of using near infrared spectroscopy to predict the concentrations of stress hormone metabolites was demonstrated using faeces of red deer for the first time. Subsequently, two large-scale observational studies, conducted in representative red deer populations found in Mediterranean Iberia, highlighted the importance of considering seasonal environmental variations and variables related to hunting management practices to better understand the nutritional and physiological ecology of red deer. High population densities had adverse effects on the nutritional condition of the deer and were associated with increased stress levels in natural populations without supplementary feeding. Massive hunting events involving the use of hounds were also identified as a potential source of chronic stress in red deer. The research presented in this thesis has clear implications regarding the management and monitoring of red deer populations in Mediterranean environments and is intended to help wildlife managers to implement more effective monitoring programmes and sustainable management practices.

Childhood Attention Problems and the Development of Comorbid Symptoms at the Transition to High School: The Mediating Role of Parent and Peer Relationships

Children with Attention-Deficit/Hyperactivity Disorder (ADHD) are at increased risk for the development of depression and delinquent behavior. Children and adolescents with ADHD also experience difficulty creating/maintaining high quality friendships and parent-child relationships, and these difficulties may contribute to the development of co-morbid internalizing and externalizing symptoms in adolescence. However, there is limited research examining whether high quality friendships and parent-child relationships mediate the relation between ADHD and the emergence of these co-morbid symptoms at the transition to high school. This study examines the mediating role of relationship quality in the association between ADHD and depressive symptoms/delinquent behaviors at this developmentally significant transition point. Results revealed significant indirect effects of grade 6 attention problems on grade 9 depressive symptoms through friendship quality and quality of the mother-child relationship in grade 8. Interventions targeting parent and peer relationships may be valuable for youth with ADHD to promote successful transitions to high school.

BUILDING EFFICIENT AND COST-EFFECTIVE CLOUD-BASED BIG DATA MANAGEMENT SYSTEMS

In today’s big data world, data is being produced in massive volumes, at great velocity and from a variety of different sources such as mobile devices, sensors, a plethora of small devices hooked to the internet (Internet of Things), social networks, communication networks and many others. Interactive querying and large-scale analytics are being increasingly used to derive value out of this big data. A large portion of this data is being stored and processed in the Cloud due the several advantages provided by the Cloud such as scalability, elasticity, availability, low cost of ownership and the overall economies of scale. There is thus, a growing need for large-scale cloud-based data management systems that can support real-time ingest, storage and processing of large volumes of heterogeneous data. However, in the pay-as-you-go Cloud environment, the cost of analytics can grow linearly with the time and resources required. Reducing the cost of data analytics in the Cloud thus remains a primary challenge. In my dissertation research, I have focused on building efficient and cost-effective cloud-based data management systems for different application domains that are predominant in cloud computing environments. In the first part of my dissertation, I address the problem of reducing the cost of transactional workloads on relational databases to support database-as-a-service in the Cloud. The primary challenges in supporting such workloads include choosing how to partition the data across a large number of machines, minimizing the number of distributed transactions, providing high data availability, and tolerating failures gracefully. I have designed, built and evaluated SWORD, an end-to-end scalable online transaction processing system, that utilizes workload-aware data placement and replication to minimize the number of distributed transactions that incorporates a suite of novel techniques to significantly reduce the overheads incurred both during the initial placement of data, and during query execution at runtime. In the second part of my dissertation, I focus on sampling-based progressive analytics as a means to reduce the cost of data analytics in the relational domain. Sampling has been traditionally used by data scientists to get progressive answers to complex analytical tasks over large volumes of data. Typically, this involves manually extracting samples of increasing data size (progressive samples) for exploratory querying. This provides the data scientists with user control, repeatable semantics, and result provenance. However, such solutions result in tedious workflows that preclude the reuse of work across samples. On the other hand, existing approximate query processing systems report early results, but do not offer the above benefits for complex ad-hoc queries. I propose a new progressive data-parallel computation framework, NOW!, that provides support for progressive analytics over big data. In particular, NOW! enables progressive relational (SQL) query support in the Cloud using unique progress semantics that allow efficient and deterministic query processing over samples providing meaningful early results and provenance to data scientists. NOW! enables the provision of early results using significantly fewer resources thereby enabling a substantial reduction in the cost incurred during such analytics. Finally, I propose NSCALE, a system for efficient and cost-effective complex analytics on large-scale graph-structured data in the Cloud. The system is based on the key observation that a wide range of complex analysis tasks over graph data require processing and reasoning about a large number of multi-hop neighborhoods or subgraphs in the graph; examples include ego network analysis, motif counting in biological networks, finding social circles in social networks, personalized recommendations, link prediction, etc. These tasks are not well served by existing vertex-centric graph processing frameworks whose computation and execution models limit the user program to directly access the state of a single vertex, resulting in high execution overheads. Further, the lack of support for extracting the relevant portions of the graph that are of interest to an analysis task and loading it onto distributed memory leads to poor scalability. NSCALE allows users to write programs at the level of neighborhoods or subgraphs rather than at the level of vertices, and to declaratively specify the subgraphs of interest. It enables the efficient distributed execution of these neighborhood-centric complex analysis tasks over largescale graphs, while minimizing resource consumption and communication cost, thereby substantially reducing the overall cost of graph data analytics in the Cloud. The results of our extensive experimental evaluation of these prototypes with several real-world data sets and applications validate the effectiveness of our techniques which provide orders-of-magnitude reductions in the overheads of distributed data querying and analysis in the Cloud.

Use of sulfuryl fluoride in the management of strongly phosphine-resistant insect pest populations in bulk grain storages in Australia

Sulfuryl fluoride (SF), an effective structural fumigant, is registered recently as Profume™ for controlling insect pests of stored grains and processed commodities. Information on its effectiveness in disinfestation of bulk grain, however, is limited. The ongoing problem with the strong level of resistance to phosphine has been addressed recently through deployment of SF as a ‘resistance breaker’ in bulk storages in Australia. This paper discusses important results on the efficacy of SF against key phosphine- resistant insect pests, lesser grain borer, Rhyzopertha dominca, red flour beetle, Tribolium castaneum, rice weevil, Sitophilus oryzae and the rusty grain beetle, Cryptolestes ferrugineus. We have established CT (g-hm3) profiles for SF against these insect pests at two temperature regimes 25 and 30°C, that showed that both temperature and exposure period (t) has significant influence on the effectiveness of SF than the concentration. Over a seven days fumigation period, CTs of 800 and 400 g-hm3 achieved complete control of all the target pests, including the most strongly phosphine - resistant species, C. ferrugineus at 25 and 30°C, respectively. Results from four industry scale field trials involving currently registered rate of SF (1500 g-hm3) over 2–14 d exposure period, confirmed its effectiveness in achieving complete control of the target pest species. The assessment of postfumigation grain samples across all the test storages indicated that the reinfestation occurs after three months. Monitoring resistance to phosphine in C. ferrugineus over a six year period (2009–2015), showed a significant reduction in resistant populations after the introduction of SF into the fumigation strategy at problematic storage sites. Overall our research concludes that SF is a good candidate to be used as a ‘resistance breaker’ where phosphine resistance is prevalent.

Supporting self-management: development and evaluation of a digital resource for adults with asthma

The problem: Around 300 million people worldwide have asthma and prevalence is increasing. Support for optimal self-management can be effective in improving a range of outcomes and is cost effective, but is underutilised as a treatment strategy. Supporting optimum self-management using digital technology shows promise, but how best to do this is not clear. Aim: The purpose of this project was to explore the potential role of a digital intervention in promoting optimum self-management in adults with asthma. Methods: Following the MRC Guidance on the Development and Evaluation of Complex Interventions which advocates using theory, evidence, user testing and appropriate modelling and piloting, this project had 3 phases. Phase 1: Examination of the literature to inform phases 2 and 3, using systematic review methods and focussed literature searching. Phase 2: Developing the Living Well with Asthma website. A prototype (paper-based) version of the website was developed iteratively with input from a multidisciplinary expert panel, empirical evidence from the literature (from phase 1), and potential end users via focus groups (adults with asthma and practice nurses). Implementation and behaviour change theories informed this process. The paper-based designs were converted to the website through an iterative user centred process (think aloud studies with adults with asthma). Participants considered contents, layout, and navigation. Development was agile using feedback from the think aloud sessions immediately to inform design and subsequent think aloud sessions. Phase 3: A pilot randomised controlled trial over 12 weeks to evaluate the feasibility of a Phase 3 trial of Living Well with Asthma to support self-management. Primary outcomes were 1) recruitment & retention; 2) website use; 3) Asthma Control Questionnaire (ACQ) score change from baseline; 4) Mini Asthma Quality of Life (AQLQ) score change from baseline. Secondary outcomes were patient activation, adherence, lung function, fractional exhaled nitric oxide (FeNO), generic quality of life measure (EQ-5D), medication use, prescribing and health services contacts. Results: Phase1: Demonstrated that while digital interventions show promise, with some evidence of effectiveness in certain outcomes, participants were poorly characterised, telling us little about the reach of these interventions. The interventions themselves were poorly described making drawing definitive conclusions about what worked and what did not impossible. Phase 2: The literature indicated that important aspects to cover in any self-management intervention (digital or not) included: asthma action plans, regular health professional review, trigger avoidance, psychological functioning, self-monitoring, inhaler technique, and goal setting. The website asked users to aim to be symptom free. Key behaviours targeted to achieve this include: optimising medication use (including inhaler technique); attending primary care asthma reviews; using asthma action plans; increasing physical activity levels; and stopping smoking. The website had 11 sections, plus email reminders, which promoted these behaviours. Feedback during think aloud studies was mainly positive with most changes focussing on clarification of language, order of pages and usability issues mainly relating to navigation difficulties. Phase 3: To achieve our recruitment target 5383 potential participants were invited, leading to 51 participants randomised (25 to intervention group). Age range 16-78 years; 75% female; 28% from most deprived quintile. Nineteen (76%) of the intervention group used the website for an average of 23 minutes. Non-significant improvements in favour of the intervention group observed in the ACQ score (-0.36; 95% confidence interval: -0.96, 0.23; p=0.225), and mini-AQLQ scores (0.38; -0.13, 0.89; p=0.136). A significant improvement was observed in the activity limitation domain of the mini-AQLQ (0.60; 0.05 to 1.15; p = 0.034). Secondary outcomes showed increased patient activation and reduced reliance on reliever medication. There was no significant difference in the remaining secondary outcomes. There were no adverse events. Conclusion: Living Well with Asthma has been shown to be acceptable to potential end users, and has potential for effectiveness. This intervention merits further development, and subsequent evaluation in a Phase III full scale RCT.

Megabalanus azoricus (Pilsbry, 1916) : building a scientific basis for its management

Tese de Doutoramento, Biologia (Ciências do Mar), 5 de Julho de 2013, Universidade dos Açores.

Effects of trawling on sessile megabenthos in the Great Barrier Reef and evaluation of the efficacy of management strategies

A series of related research studies over 15 years assessed the effects of prawn trawling on sessile megabenthos in the Great Barrier Reef, to support management for sustainable use in the World Heritage Area. These large-scale studies estimated impacts on benthos (particularly removal rates per trawl pass), monitored subsequent recovery rates, measured natural dynamics of tagged megabenthos, mapped the regional distribution of seabed habitats and benthic species, and integrated these results in a dynamic modelling framework together with spatio-temporal fishery effort data and simulated management. Typical impact rates were between 5 and 25% per trawl, recovery times ranged from several years to several decades, and most sessile megabenthos were naturally distributed in areas where little or no trawling occurred and so had low exposure to trawling. The model simulated trawl impact and recovery on the mapped species distributions, and estimated the regional scale cumulative changes due to trawling as a time series of status for megabenthos species. The regional status of these taxa at time of greatest depletion ranged from ∼77% relative to pre-trawl abundance for the worst case species, having slow recovery with moderate exposure to trawling, to ∼97% for the least affected taxon. The model also evaluated the expected outcomes for sessile megabenthos in response to major management interventions implemented between 1999 and 2006, including closures, effort reductions, and protected areas. As a result of these interventions, all taxa were predicted to recover (by 2-14% at 2025); the most affected species having relatively greater recovery. Effort reductions made the biggest positive contributions to benthos status for all taxa, with closures making smaller contributions for some taxa. The results demonstrated that management actions have arrested and reversed previous unsustainable trends for all taxa assessed, and have led to a prawn trawl fishery with improved environmental sustainability. © 2015 International Council for the Exploration of the Sea 2015. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Management of presenteeism. The effects on productivity of a food processing company

Presenteeism consists in going to work without conditions to produce, which can have a much higher impact than absenteeism on the productivity of an organisation. Presenteeism translates in both physical as psychological perturbations. It is a difficult to quantify reality, as is its translation into direct and indirect costs within the organisation. Our goal was to analyse the effects of presenteeism on the productivity of a company in the food-procession sector through a descriptive and transversal study of exploratory nature. The Stanford Presenteeism Scale SPS-6 (validated by Ferreira et al, 2010) and a semi-structured interview were used. Most of the workers referred having already gone to work feeling ill at least two days in the last year, mentioning that their health condition affected their performance, made them feel desperate and lacking pleasure from work. Management mentioned that presenteeism has a direct impact on productivity without, however, being able to quantify the true costs. Presenteeism is a reality in organisational scenarios, exceling in the educational and health sectors. We underline the importance of making organisations aware of the psychosocial risks and the importance of having healthy leaderships, work stress control and the presence of clinical psychologists and professional coaches.