The experiences of living with a person with an eating disorder: the impact on the carers

Using a combination of focus groups and individual in-depth interviews, the experience of living with a person with an eating disorder was explored in 24 carers. Attention was given to the progression of the disorder to understand its impact upon the family throughout the stages of the illness. Caring for a person with an eating disorder impacted upon the primary carer and the family throughout the course of the illness. Despite this, the impact on the carers was seldom acknowledged and the needs of these carers and their families were unrecognized and neglected by health professionals.

Healthy eating, activity and obesity prevention: a qualitive study of parent and child perceptions in Australia

Preventative health strategies incorporating the views of target participants have improved the likelihood of success. This qualitative study aimed to elicit child and parent views regarding social and environmental barriers to healthy eating, physical activity and child obesity prevention programmes, acceptable foci, and appropriate modes of delivery. To obtain views across a range of social circumstances three demographically diverse primary schools in Victoria, Australia were selected. Children in Grades 2 (aged 7–8 years) and 5 (aged 10–11 years) participated in focus groups of three to six children. Groups were semi-structured using photo-based activities to initiate discussion. Focus groups with established parent groups were also conducted. Comments were recorded, collated, and themes extracted using grounded theory. 119 children and 17 parents participated. Nine themes emerged: information and awareness, contradiction between knowledge and behaviour, lifestyle balance, local environment, barriers to a healthy lifestyle, contradictory messages, myths, roles of the school and family, and timing and content of prevention strategies for childhood obesity. In conclusion, awareness of food ‘healthiness’ was high however perceptions of the ‘healthiness’ of some sedentary activities that are otherwise of benefit (e.g. reading) were uncertain. The contradictions in messages children receive were reported to be a barrier to a healthy lifestyle. Parent recommendations regarding the timing and content of childhood obesity prevention strategies were consistent with quantitative research. Contradictions in the explicit and implicit messages children receive around diet and physical activity need to be prevented. Consistent promotion of healthy food and activity choices across settings is core to population prevention programmes for childhood obesity.

The creation of effective learners using an autarchic study method

The aim of this study is to assess whether universities are meeting the needs of marketing students and consequently the needs of the corporate marketing sector. A comparison is made between marketing classes using a specific technology of study called an autarchic system, and those classes not using this method. As part of this analysis the study investigates the application of self-determination theory and psychological needs  satisfaction. The basic needs scale, comprising two constructs; Control and Caring was adapted and used to evaluate students' perception of subjects using autarchic study system and those not utilising this methodology. The study used a multi-method approach consisting of a literature review, a qualitative phase involving in-depth interviews with marketing teaching staff and focus groups with marketing students and a survey of students. An adapted version of the basic psychological needs scale was included in a questionnaire that was administered to a convenience sample of 441 students. ANOVAlMANOVA and descriptive statistics were used to analyse the data. The pedagogy used in a conventional university setting is detailed and contrasted with the autarchic learning system. Findings strongly indicate students become far more able as learners when they have the knowledge of the types of learning barriers, they are coached to recognise the barrier when it occurs and apply the appropriate remedy as researched in this paper. These findings are of interest to educators, students, and industry as all sectors face significant social and financial losses because individuals are unable to duplicate instructions, maintain currency and plan tactically and strategically.

A qualitative study exploring barriers to a model of shared care for pre-school children`s oral health

Objective To explore the oral health beliefs and practices of primary health care professionals which may act as barriers to the development of a model of shared care for the oral health of pre-school children.

Design Qualitative focus group discussions and semi-structured interviews.

Setting Four rural local government areas in Victoria, Australia, 2003.

Subjects and methods Subjects: maternal and child health nurses, general medical practitioners, dental professionals and paediatricians working in the four local government areas. Data collection: discipline specific focus groups and semi-structured interviews. Data analysis: transcription, coding, clustering and thematic analysis.

Results Several strong themes emerged from the data. All participants agreed that dental caries is a significant health issue for young children and their families. Beliefs about the aetiology of dental caries and its prevention were variable and often simplistic, focusing predominantly on diet. Dental professionals did not believe that they had a primary role in the oral health of pre-school aged children but that others particularly maternal and child health nurses did. However other health care professionals were not confident in assuming this role.

Conclusions This study has identified important barriers and possible strategies for the development of an integrated and shared approach to preventing dental caries in pre-school aged children. Clear and consistent oral health information and agreed roles and responsibilities need to be developed.

It starts with the parents and ends with the parents

Alcohol is the most popular recreational drug in Australia. Despite the fact that many people gain enjoyment from alcohol related industries, alcohol is also implicated in much personal trauma and social damage. Parents play a key role in influencing alcohol use and driver behaviour in young people. The aim of this study was to gain an understanding of the attitudes and concerns of parents in Melbourne in relation to their teenage children's use of alcohol and how they educate and/or provide role models for their adolescents with respect to alcohol usage. A convenience sample of parents with adolescent children participated in focus groups. Parents described patterns of alcohol use and perceived influences on consumption. They reported that they wanted to create safe environments for adolescents to consume alcohol but that they needed more support and information on which to base these decisions. There i, an opportunity for public health policy makers to specifically address parents and enhance their role in alcohol related road safety.

Cervical cancer services for Indigenous Women: Advocacy, Community-Based Research and Policy Change in Australia

Collaborative research undertaken in the state of Queensland, Australia, resulted in major changes in cervical cancer screening and treatment for Indigenous women. Guided by an Indigenous statewide reference group and with an Indigenous researcher playing a lead role, qualitative data were collected using interviews, focus groups, and larger community meetings; and case studies were conducted with health workers and community members from diverse rural, remote and urban communities, to explore the different cultural and structural factors affecting understanding and awareness of cervical cancer and Indigenous women's use of and access to health services for screening, diagnosis and treatment. These data were supplemented by an analysis of clinical data and health service checklists. We discuss the methodology and summarize the key social and structural factors that discourage women from presenting for screening or returning for follow-up. These include women's misunderstanding of cervical cancer screening, fear of cancer, distrust of health services, poor recall and follow-up systems, and the economic and social burden to women presenting for treatment. We describe how the research process and subsequent activities provided Indigenous women with a vehicle for their own advocacy, resulting in important policy and program changes.

Zero impact: are lawyers' values affected by law school?(Survey)

In 2001 approximately 700 Australian final-year undergraduate law students were surveyed as the first part of a three-year study of Australian lawyers' values. This study is being undertaken in an effort to understand what values are important in determining lawyers' attitudes to difficult behavioural choices confronting them in legal practice. It is hoped that knowledge of the actual values held by lawyers (in the context of critical professional choices) will enable better targeted values awareness education in both pre- and post-admission contexts.

The main quantitative survey employed a number of hypothetical scenarios. These were designed through the use of ethical dilemmas to examine issues of conflicting loyalties within a context of self-interest and lawyers' perceived obligations to the community, employers, family, friends and clients. (1)

Our approach in this paper is to set the scene by providing basic frequencies to responses in each scenario, followed by an analysis of themes elicited from respondents during the focus groups. Our immediate objective is to provide representative interviewee (that is, respondent) commentary designed to throw some light on the major choices of those respondents in the first year of the main quantitative survey. (2) Note that these focus groups were conducted some months after the quantitative analyses, and in particular after respondents had left law school. All respondents were, by that stage, working within a variety of legal workforce environments. In this analysis, it must be stressed, we have not attempted to match and compare individual respondents' comments with their earlier choices in the quantitative survey. That task awaits the longitudinal analysis now under way for the whole period of data collection during the three-year study.

External breast prosthesis use: experiences and views of women with breast cancer, breast care nurses, and prosthesis fitters

After mastectomy, the provision of an appropriate breast prosthesis can help to improve body image and quality of life and reduce associated emotional distress. Although up to 90% of women use an external breast prosthesis after mastectomy, little is known about their experiences and satisfaction with breast prosthesis use. Focus groups were conducted with women who had been fitted with an external breast prosthesis, breast care nurses, and prosthesis fitters to explore women's experiences of prosthesis use. Qualitative thematic content analysis of focus group transcripts indicated that whereas women's initial reaction to the prosthesis generally was negative, this improved over time. Provision of adequate information and support, characteristics of the fitter and the fitting experience, and relationships with breast care nurses and prosthesis fitters were important to women's acceptance and satisfaction with their prosthesis. The study results highlighted the key role that breast care nurses play and the underestimation of the prosthesis fitter's role. Common themes concerning the impact of prosthesis use included body image, appearance, and feminine identity. These findings have important implications for professionals involved in the delivery of breast prostheses services.

Diabetes management in patients receiving palliative care

A literature review revealed no evidence-based guidelines specific to managing diabetes in the context of palliative care. The purpose of the current project was to describe the management practices of doctors and nurses caring for people with diabetes and advanced disease. Palliative care doctors, palliative care nurses, endocrinologists, and diabetes nurse educators participated in this study. A two-phase project was undertaken: 1) two focus groups, and 2) a cross-sectional survey using a self-completed questionnaire. The focus group and questionnaire data identified that doctors and nurses used a range of practices and blood glucose testing frequencies to control blood glucose based on experience and not according to a robust evidence base. Implications for practice include the importance of collaboration between diabetes and palliative care specialists, and the need to develop clinical management guidelines.

Social, cultural and environmental influences on child activity and eating in Australian migrant communities

Aim: This study set out to examine the socio-cultural, familial and environmental factors influencing health, eating habits and patterns of physical activity contributing to child and adolescent overweight and obesity. Methods: Semi-structured, community-based interviews were conducted with contrasting key informant three-generation families; and generation by generation focus groups of grandparents, parents and children from four cultural communities in the state of Victoria, Australia. Purposive sampling occurred from Turkish, Greek, Indian and Chinese communities that have migrated to Australia within the last three generations (n = 160, eight families, 47 children aged 5–15 years, 29 parents, 42 grandparents). Results: Evidence of two-way influences on eating and physical activity across three generations was evident, with children reporting the greatest cross-cultural diversity. A range of dietary restrictions was reported across all cultural groups. Efforts to foster healthy eating and lifestyle patterns within communities were evident. Parents, as a generation in particular, felt the need for more access to education and support regarding healthy limits for pre-puberty and puberty stages. Conclusion: There is a dynamic influence of culture on many aspects of family lifestyle across three generations. To achieve successful intervention design, childhood obesity researchers need to collaborate with diverse groups and communities. Considering the role and influence of extended family, a multigenerational, whole-of-community approach beyond that of parent and child populations ought to be considered.

Smoking amongst UK Bangladeshi adolescents aged 14-15

This paper reports on an investigation into smoking amongst 14- to 15- year-old Bangladeshis living in an UK inner city locality. A survey using self-completion questionnaires was undertaken in conjunction with focus group discussions. The survey of 316 Bangladeshi adolescents was conducted to determine smoking prevalence. Regular smoking was more common amongst Bangladeshi males (39%) than amongst Bangladeshi females (11%). Thirty-one people (17 females and 14 males) took part in seven focus groups (four female and three male) which were conducted in schools (six) and youth clubs (one). Focus group discussions were conducted to examine what smoking means to Bangladeshi teenagers and factors which influence why they do or do not smoke. Differences between what smoking means to Bangladeshi females and males are identified which arise from perceived social norms and cultural values, and greatly influence smoking uptake. However, many of the reasons why Bangladeshi adolescents continue to smoke, stop smoking or never smoke appear similar to those identified in other studies with largely white adolescents. Factors underpinning adolescent choices together with the implications of the study findings for the development of smoking prevention initiatives for inner city Bangladeshi teenagers are discussed.

Assessment of wilderness quality using the analytic hierarchy process

Wilderness is a unique environmental resource that provides a multitude of use and non-use benefits. The use and management of wilderness depend on the assessment of wilderness quality. Current wilderness assessment in Australia is based on two broad criteria, the remoteness and naturalness of the wilderness, determined using geographic information systems. This paper discusses a complementary assessment method using the Analytic Hierarchy Process (AHP). The AHP can be used to incorporate additional criteria, such as social and cultural criteria, to improve the quality of wilderness assessment. It provides a flexible and compatible method for large-scale wilderness assessments with multiple criteria. The weighting factors for the different criteria can be obtained from expert panels and focus groups.

Primary mathematics practice : the Victorian position

In order to establish what constitutes current primary practice in Victoria, video and other data were collected from a stratified random sample of ten year 3 and 4 classrooms in Victoria. Three video vignettes, representing the contrasting pedagogical flows captured on the videotapes, were produced to stimulate discussion in three separate Focus Groups of randomly selected teachers, principals, and mathematics teacher educators and consultants. This paper reports on their views of what constitutes current Victorian practice in primary mathematics

Staff and student views of the usefulness of information technology materials within an integrated curriculum: are these educational resources effective in promoting student learning?

This paper reports on a study on the perceived effectiveness of educational resources within the context of a single course in a first-year biology program at the University of Sydney (Australia). The overall study examined the dynamic state of perceptions towards these resources by the major stakeholders involved with the course (students, teaching staff, and technical staff). A major focus of the research was the extent to which the students used the computer-based resources made available to them, and staff and students' perceptions of the usefulness of these resources in supporting their learning. Specifically, results are discussed related to student use of computers and the Internet, use of biology online materials in the virtual learning environment, use and perceptions of communication technologies, and use and perceptions of computer-based online resources. Data were collected from the students using surveys and focus groups and from staff using surveys and interviews within an action-research paradigm. While the majority of students found the resources to be of use in supporting learning, some did not find them useful, and some did not use them at all. In comparison, the staff had higher expectations of both usage and usefulness. The level of student use was not a function of access to computers or the Internet, so the findings suggest that the provision of online resources will not necessarily generate value-added learning.

Self-determination theory and needs satisfaction in marketing education : are we meeting the needs of students in large marketing classes?

The aim of this study is to assess whether universities are meeting the needs of students in large marketing classes. In so doing the study investigates the application of self determination theory and psychological needs satisfaction. The basic needs scale, comprising of three constructs; Control, Competence and Caring was adapted and used to evaluate students’ perception of an introductory marketing subject. The study used a multi-method approach consisting of a literature review, a qualitative phase involving in-depth interviews with marketing teaching staff and focus groups with marketing students and a survey of students about introductory level marketing. An adapted version of the basic psychological needs scale was included in a questionnaire that was administered to a convenience sample of 366 students. MANOVA, ANOVA and descriptive statistics were used to analyse the data. The results show that the psychological needs satisfaction of many students are not being fully realised. It was also found that marketing degree students enjoyed the challenges and were more stimulated by the subject. The higher achieving students enjoyed the challenge of the subject more than the lower achieving students. As a result of this study, there are three suggestions for further research. Firstly, further study should compare subjects, with relatively small enrolments, to those with large enrolments to corroborate the value of this method of assessing student satisfaction. Secondly, the use of a larger sample across other universities would confirm whether these findings hold for other institutions. Finally, it is suggested that a structural model should be developed to extend this investigation of student satisfaction and the constructs used in the study.