The Multi-Faceted Experience of Empathy in Intellectual Disability Settings: An IPA Study

This research thesis explored the concept of empathy. The specific purpose was to further understand the idea of empathy in relation to the experience of male support workers who provide residential care to adults with intellectual disabilities (ID) and challenging behaviour. The thesis aimed to provide some insights into how support workers develop and extract meaning from their experiences of relationships with clients and the impact of this on their own self-care, namely, self-compassion. Since personal accounts of experience were required, a qualitative methodology was employed, Interpretative Phenomenological Analysis (IPA) (Smith, 2004). This methodology was selected as it allows for the exploration and interpretation of idiographic lived experience and meaning making. 8 experienced support workers were interviewed using a semi structured interview. Four superordinate themes emerged from the data. These included: 1. Making sense of the others inner world; 2. Processes that enhance empathic practice; 3. Tensions and conflicts, and 4. Management of distressing feelings. Differing accounts of interpreting the needs of clients were identified which helped participants understand, make sense of their interpersonal experience and participate in their role. These included utilising academic knowledge and senses, particularly sight and hearing, which were seemingly complemented by a level of reflective practice. Additionally, to make sense of the experience of a client, they appeared to put themselves in their position, suggesting a form of empathy. Participants appeared to engage in a process of reflection on their relationships with clients, which helped them think about what they had learned about the person’s needs, moreover, this process enabled them to identify some of their own responses and feelings. However, participants seemed to struggle to recognise the occurrence or impact of distressing emotional experience and to express their feelings, possibly in response to a deep sense of responsibility and fear of transferring emotional distress to others. This dilemma of holding two potentially conflicting views of experience seemed to inhibit self-compassion. Although not specifically testing theories of empathy, from the overall findings, it could be suggested that empathy may be a dynamic, transient process that is influenced by reflexivity, values and context. The context in which participants discussed their practice, and situated within their accounts, suggested a sense of confusion and uncertainty. Consequently, it is suggested this impacted on how participants understood and related to clients, and to themselves. There were some specific implications for Counselling Psychology practice, mostly concerning training and supervision. These included recommendations for staff training and supervision, systemic organisational intervention, policy development, recommendations for revisions to models of specialist care frameworks and clinical training.

Supporting people with Autism Spectrum Disorders in leisure time: impact of an University Volunteer Program, and related factors

La participación social tiene efectos positivos en salud mental y física, y puede tomarse como un indicador de calidad de vida. Sin embargo, la participación de personas con discapacidad en su comunidad es aún escasa, especialmente para las personas con autismo. En este trabajo evaluamos el grado de satisfacción con un programa de voluntariado universitario dirigido a personas con autismo para apoyar actividades de ocio y tiempo libre (APUNTATE). Un total de 159 familias de usuarios y 230 voluntarios cumplimentaron un cuestionario de satisfacción que identificó las áreas en las que el programa tenía más impacto. Los resultados mostraron una alta satisfacción general tanto en usuarios como en voluntarios, aunque algunas características personales de los usuarios generaron leves diferencias. Los aspectos más valorados fueron la organización del programa, la formación y tutorización continua que se ofrecía a los voluntarios. Otra característica del programa, ampliamente valorada, fue la capacidad de éste de adaptar los apoyos a las necesidades individuales de usuarios y voluntarios. Este trabajo pone de manifiesto que la universidad pública puede implementar con éxito programas de apoyos para promover la participación social. Estos programas pueden favorecen el desarrollo personal, favorecer el cambio de actitudes hacia las personas con discapacidad y mejorar las perspectivas de empleo de los estudiantes.

Petr Eben's oratorio Apologia Sokratus (1967) and ballet Curses and Blessings (1983): An interpretative analysis of the symbolism behind the text settings and musical style

The Czech composer Petr Eben (1927-2007) has written music in all genres except symphony, but he is highly recognized for his organ and choral compositions, which are his preferred genres. His vocal works include choral songs and vocal-instrumental works at a wide range of difficulty levels, from simple pedagogical songs to very advanced and technically challenging compositions. This study examines two of Eben‘s vocal-instrumental compositions. The oratorio Apologia Sokratus (1967) is a three-movement work; its libretto is based on Plato‘s Apology of Socrates. The ballet Curses and Blessings (1983) has a libretto compiled from numerous texts from the thirteenth to the twentieth centuries. The formal design of the ballet is unusual—a three-movement composition where the first is choral, the second is orchestral, and the third combines the previous two played simultaneously. Eben assembled the libretti for both compositions and they both address the contrasting sides of the human soul, evil and good, and the everlasting fight between them. This unity and contrast is the philosophical foundation for both compositions. The dissertation discusses the multileveled meanings behind the text settings and musical style of the oratorio and ballet in analyses focusing on the text, melodic and harmonic construction, and symbolism. Additional brief analyses of other vocal and vocal-instrumental compositions by Eben establish the ground for the examination of the oratorio and ballet and for understanding features of the composer‘s musical style. While the oratorio Apologia Sokratus was discussed in short articles in the 1970s, the ballet Curses and Blessings has never previously been addressed within Eben scholarship. The dissertation examines the significant features of Eben‘s music. His melodic style incorporates influences as diverse as Gregorian chant and folk tunes on the one hand, and modern vocal techniques such as Sprechgesang and vocal aleatoricism on the other. His harmonic language includes bitonality and polytonality, used to augment the tonal legacy of earlier times, together with elements of pitch collections and limited serial procedures as well as various secundal and quartal harmonic sonorities derived from them. His music features the vibrant rhythms of folk music, and incorporates other folk devices like ostinato, repetitive patterns, and improvisation.

Exposure and risk assessment in occupational exposure to fungi: aspects to consider in highly contaminated settings

Although a clear correlation between levels of fungi in the air and health impacts has not been shown in epidemiological studies, fungi must be regarded as potential occupational health hazards. Fungi can have an impact on human health in four different ways: (1) they can infect humans, (2) they may act as allergens, (3) they can be toxigenic, or (4) they may cause inflammatory reactions. Fungi of concern in occupational hygiene are mostly non-pathogenic or facultative pathogenic (opportunistic) species, but are relevant as allergens and mycotoxins producers. It is known that the exclusive use of conventional methods for fungal quantification (fungal culture) may underestimate the results due to different reasons. The incubation temperature chosen will not be the most suitable for every fungal species, resulting in the inhibition of some species and the favouring of others. Differences in fungi growth rates may also result in data underestimation, since the fungal species with higher growth rates may inhibit others species’ growth. Finally, underestimated data can result from non-viable fungal particles that may have been collected or fungal species that do not grow in the culture media used, although these species may have clinical relevance in the context. Due to these constraints occupational exposure assessment, in setings with high fungal contamination levels, should follow these steps: Apply conventional methods to obtain fungal load information (air and surfaces) regarding the most critical scenario previously selected; Guideline comparation aplying or legal requirements or suggested limits by scientific and/or technical organizations. We should also compare our results with others from the same setting (if there is any); Select the most suitable indicators for each setting and apply conventional-culture methods and also molecular tools. These methodology will ensure a more real characterization of fungal burden in each setting and, consequently, permits to identify further measures regarding assessment of fungal metabolites, and also a more adequate workers health surveillance. The methodology applied to characterize fungal burden in several occupational environments, focused in Aspergillus spp. prevalence, will be present and discussed.

Importance of size-selective particle sampling for assessing occupational exposures: results from three different occupational settings

Sampling the total air concentration of particulate matter (PM) only provides a basic estimate of exposure that normally not allows correlating with the observed health effects. Therefore is of extreme importance to know the particles size distribution and, in more detail, the exposure to fine particles (≤ 2.5 µm). This particles dimension corresponds to the respirable fraction. This particle fraction can result, besides local effects, in systemic effects due to particle deposition and clearance from the lungs and transport within the organism. This study intended to describe occupational exposure to PM2.5 in three different units located near Lisbon and related with occupational exposure to organic dust, namely: swine and poultry feed production and waste management.

Computational Analysis of Intelligent Agents: Social and Strategic Settings

The central motif of this work is prediction and optimization in presence of multiple interacting intelligent agents. We use the phrase `intelligent agents' to imply in some sense, a `bounded rationality', the exact meaning of which varies depending on the setting. Our agents may not be `rational' in the classical game theoretic sense, in that they don't always optimize a global objective. Rather, they rely on heuristics, as is natural for human agents or even software agents operating in the real-world. Within this broad framework we study the problem of influence maximization in social networks where behavior of agents is myopic, but complication stems from the structure of interaction networks. In this setting, we generalize two well-known models and give new algorithms and hardness results for our models. Then we move on to models where the agents reason strategically but are faced with considerable uncertainty. For such games, we give a new solution concept and analyze a real-world game using out techniques. Finally, the richest model we consider is that of Network Cournot Competition which deals with strategic resource allocation in hypergraphs, where agents reason strategically and their interaction is specified indirectly via player's utility functions. For this model, we give the first equilibrium computability results. In all of the above problems, we assume that payoffs for the agents are known. However, for real-world games, getting the payoffs can be quite challenging. To this end, we also study the inverse problem of inferring payoffs, given game history. We propose and evaluate a data analytic framework and we show that it is fast and performant.

An examination of Special Forces and their transfer of skillsets under crisis management settings in Singapore

The thesis focuses on military crisis management and strategy.

Working towards leisure

Expanded individual availability and flexibility is necessary in order to progress in a management career to senior level. If managers owe all their time to the organisation and their work as managers they are left with no time to invest in the management of their private lives. Therefore, it remains unspoken in their management work how they are able to create time and space to enjoy free time during their non-working hours. Managers female partners prepare all the domestic work in the private sphere in order for the manager to enjoy their free time in any leisure activity. The empirical evidence for this argument derives from 64 in-depth interviews with male managers from three European countries (Germany, Portugal, the United Kingdom) working for one large multinational company. These interviews cover the views of a variety of male managers with an age range between 30 and 65 years and, thus, different management positions and life stages. This article explores three different layers of time in male managers work careers: non-working time, free-time and leisure time. It includes the concept of leisure work which enables managers to devote themselves absolutely to whatever they want to do in their non-working time. Therefore combining a professional career and family life for male managers is only a question of balancing their work as male managers and leisure time and not an issue of tension between employment and domestic obligations.

Efficient Secure Computation for Real-world Settings and Security Models

Secure computation involves multiple parties computing a common function while keeping their inputs private, and is a growing field of cryptography due to its potential for maintaining privacy guarantees in real-world applications. However, current secure computation protocols are not yet efficient enough to be used in practice. We argue that this is due to much of the research effort being focused on generality rather than specificity. Namely, current research tends to focus on constructing and improving protocols for the strongest notions of security or for an arbitrary number of parties. However, in real-world deployments, these security notions are often too strong, or the number of parties running a protocol would be smaller. In this thesis we make several steps towards bridging the efficiency gap of secure computation by focusing on constructing efficient protocols for specific real-world settings and security models. In particular, we make the following four contributions: - We show an efficient (when amortized over multiple runs) maliciously secure two-party secure computation (2PC) protocol in the multiple-execution setting, where the same function is computed multiple times by the same pair of parties. - We improve the efficiency of 2PC protocols in the publicly verifiable covert security model, where a party can cheat with some probability but if it gets caught then the honest party obtains a certificate proving that the given party cheated. - We show how to optimize existing 2PC protocols when the function to be computed includes predicate checks on its inputs. - We demonstrate an efficient maliciously secure protocol in the three-party setting.

Discrimination in clinical settings and its relationship to depression and anger in women living with HIV

Objectives: To describe the frequency of feared discrimination in various social situations and of perceived discrimination in clinical settings, as well as to study the relationship between discrimination and depression and anger in women living with human immunodeiciency virus (HIV). Material and methods: The scale of Feared and Perceived Discrimination for Women with HIV (DTP-40-MV), the Beck Depression Inventory (BDI-2), and the Anger Expression scale of State-Trait-anger expression inventory (STaXi-2-aX/eX) were applied to a random sample of 200 women living with HIV. Results: These women feared being discriminated against, perceived discrimination upon the review of medical records, but perceived little discrimination in clinical care. a model with good adjustment to the data showed that the fear of being discriminated against creates a disposition toward perception of discrimination in the clinical settings (latent variable with 2 indicators: review of the medical records and clinical care) and increases cognitive/affective depressive symptoms; higher anger control decreases the anger manifestation; greater discrimination perceived in the clinical settings decreases anger control, which facilitates the expression of anger and slows cognitive/affective depressive symptoms; and these latter symptoms sensitize the perception of discrimination before the clinical records. Conclusion: Feared discrimination is a clinically relevant aspect due to its frequency and effect on depressive symptoms and perception of discrimination before the review of medical records.

Efecto determinante de la motivación de viaje sobre la imagen de destino en turistas de ocio a un destino urbano: El caso de Monterrey, México. Una aproximación por medio de mínimos cuadrados parciales (PLS) = Determinant effect of travel motivation on the destination image of leisure tourist in an urban destination: the case of Monterrey, México. An approach through partial least squares (PLS)

Los turistas urbanos se caracterizan por ser uno de los segmentos de mayor crecimiento en los mercados turísticos actuales. Monterrey (México), uno de los principales destinos urbanos del país, ha apostado en la actualidad por mejorar su competitividad. Esta investigación se propuso encontrar evidencia acerca de la relación causal de la motivación de viaje sobre la imagen percibida del destino, dos variables importantes por su influencia en la satisfacción de los visitantes. Una revisión de la literatura permitió proponer constructos teóricos integrados en un instrumento para la recogida de datos vía encuesta a una muestra representativa. Por medio del método de regresión y ecuaciones estructurales por mínimos cuadrados parciales (PLS), se identificaron los componentes principales de ambas variables y se obtuvo un modelo explicativo de la imagen percibida del destino en función de la motivación de viaje. Finalmente, se emiten recomendaciones para la gestión del destino urbano en función de los resultados obtenidos. ABSTRACT: Abstract Urban tourists are recognized as one of the fastest growing segments in today’s tourism markets. Monterrey, Mexico, one of the main urban destinations in the country aims at improving its competitiveness. This research work had the purpose of finding evidence on the causal relationship between travel motivation and destination image, two important variables because of their influence on visitors’ satisfaction. A literature review enabled the proposal of a research instrument with theoretically based constructs to gather data through survey from a representative sample. Using regression and structural equations modelling by partial least squares (pls) a set of main components of both variables were identified thus enabling the obtention of a explanatory model of destination image in terms of travel motivations. Finally based on the results some recommendations of tourism management are given.

Memorandum of understanding between Universidad de Cuenca (Ecuador) and NHTV Breda University of Applied Sciences, Academies for Tourism, Leisure and Hotel Management & Facility Management Breda, The Netherlands

English

Reasons for including multiage settings in teacher preparation

Teaching is a complex and cognitively demanding exercise where teachers need to draw on their expertise in a contextually-sensitive manner. Multiage settings that comprise students with widely different abilities, ages, and cognitive and linguistics capabilities, require teachers to develop and upgrade specific pedagogic and administrative skills. Teacher education programmes offered at Australian universities however are yet to fully recognise this need. In this paper, the author develops an argument for inclusion of specific training in multiageeducation in Australian teacher education programmes.

Nurses' documentation of physiological observations in three acute care settings

AIMS AND OBJECTIVES: To explore nurses' documentation of physiological observations in acute care; emergency department, medical and surgical units. BACKGROUND: In Australia, physiological observations include respiratory rate, oxygen saturation, heart rate, blood pressure, temperature and level of consciousness. There is a clear relationship between abnormal physiological observations and adverse events. Nurses have highest level of responsibility for accurate measurement, interpretation and documentation of physiological observations. DESIGN: A descriptive exploratory design was used and the study data were collected using a prospective point prevalence approach between 25 July 2012-22 August 2012. METHODS: The study was conducted in the emergency department, two 30-bed medical units and one 30-bed surgical unit of a 578 bed public health service in Melbourne, Australia. All adult patients aged ≥18 years present during data collection periods were eligible for inclusion. Patients in the emergency department resuscitation area were excluded. Patient characteristics and physiological observations for the preceding 24 hours in ward patients or eight hours in emergency department patients were collected. RESULTS: One hundred and seventy-eight patients were included; 38 emergency department patients, 84 medical patients and 56 surgical patients. The median age was 72·5 years and 43·8% were males. The most frequently documented physiological observations were respiratory rate, oxygen saturation, heart rate and systolic blood pressure. The least frequently recorded physiological observations were temperature and conscious state. One or more abnormal physiological parameters was documented in 79·8% (n = 142) patients; evidence of reporting abnormalities was documented in 19·7% of patients (n = 28/142). When controlled for length of stay, physiological observations were more frequently documented in the emergency department. CONCLUSIONS: There was variability in the number of parameters documented and frequency of physiological observations documented by nurses. RELEVANCE TO CLINICAL PRACTICE: Physiological abnormalities that do not necessarily fulfil rapid response team activation criteria are common in acute care patients and provide nurses with an opportunity for early recognition of deteriorating patients.