Can humming caregivers´ facilitate feeding during mealtime situations with persons with dementia? A qualitative study

Background. ‘Music Therapeutic Caregiving’, defined as when caregivers’ sing for or together with persons with dementia care situations, has been shown to facilitate the caring situation, and enhance positive and decrease negative expressions in persons with dementia. No studies about singing during mealtimes have been conducted, and this project was designed to elucidate this. However, since previous studies have shown that there is a risk that persons with dementia will start to sing along with the caregiver, the caregiver in this study hummed such that the person with dementia did not sing instead of eat. Aim. To describe professional caregivers’ experiences of humming during meal time while feeding persons with dementia. Method. An intervention with caregivers humming was implemented during lunch time. Focus group interviews were conducted to fetch the caregivers experiences. Qualitative content analysis was used to analyse the interviews. Results. The caregivers described that humming disseminated relaxation and joy, and awakened memories about the songs hummed which encouraged the persons with the dementia to join in the songs. They also described that humming seemed to make the persons with dementia associate with mealtime and could make them eat more. However it also revealed suspiciousness and agitation from the persons with dementia. Conclusion. Humming during mealtime revealed mainly positive as well as some negative influences. More and larger studies are needed to be able to draw general conclusions.

Challenges to infrastructure delivery during the economic downturn : a qualitative analysis

Infrastructure plays a key role in creating and maintaining sustainable economic growth and a prosperous community. Infrastructure projects generally require a large amount of capital investment, which motivates involvement from the private sector in the delivery process. The Global Financial Crisis placed enormous pressure on both the public and private sectors, as the ability to borrow money for an extended tenor was greatly reduced. This study adopts a qualitative approach to analyse the challenges facing the delivery of infrastructure projects in an Australian context by considering the impacts of the Global Financial Crisis. It is found that the availability of resources and finance are perceived as the biggest challenges, with resources being more of a concern than finance to interviewees. In addition to these findings, ways in which the private sector can be better involved in the infrastructure delivery is discussed.

The delivery of a telephone coaching programme to people with type 2 diabetes by practice nurses in Victoria, Australia : a qualitative evaluation

Aim.  To evaluate telephone coaching undertaken by practice nurses in a randomised controlled trial of self-management support for people with type 2 diabetes.

Background.  Qualitative evaluation of the processes that take place in randomised controlled trials has the advantage of providing information on those variables that contribute to the success or failure of the randomised controlled trial. This additional information can be used to improve or modify chronic disease management programme designs.

Methods.  Grounded theory was used to analyse transcriptions of telephone coaching sessions between practice nurses and patient participants in the randomised controlled trial.

Findings.   Analysis of transcriptions found that patient participants had complex multiple medical conditions to manage, as well as maintaining their daily lives. Two approaches to working with this complexity by practice nurses emerged. We characterised one as ‘treat to target’ and the other as ‘personalised care’. While each approach shapes identities available to patients within the relationship with the practice nurse, the impact or effectiveness of these approaches on outcomes has yet to be reported.

Conclusions.  Telephone coaching takes place in complex social contexts as well as complex medical conditions. People with type 2 diabetes must manage their diabetes care and their care of other conditions within their social contexts. This means a constant negotiation of priorities.

Relevance to clinical practice.  Awareness of how health professional support for patients’ self-management becomes a relationship and element of the negotiated identity of patients is important in adapting clinical guideline-based protocols to achieving targets in the management of chronic illness.

"I don't eat a hamburger and large chips every day!" A qualitative study of the impact of public health messages about obesity on obese adults

Background
We are a society that is fixated on the health consequences of 'being fat'. Public health agencies play an important role in 'alerting' people about the risks that obesity poses both to individuals and to the broader society. Quantitative studies suggest people comprehend the physical health risks involved but underestimate their own risk because they do not recognise that they are obese.

Methods
This qualitative study seeks to expand on existing research by exploring obese individuals' perceptions of public health messages about risk, how they apply these messages to themselves and how their personal and social contexts and experiences may influence these perceptions. The study uses in depth interviews with a community sample of 142 obese individuals. A constant comparative method was employed to analyse the data.

Results
Personal and contextual factors influenced the ways in which individuals interpreted and applied public health messages, including their own health and wellbeing and perceptions of stigma. Individuals felt that messages were overly focused on the physical rather than emotional health consequences of obesity. Many described feeling stigmatised and blamed by the simplicity of messages and the lack of realistic solutions. Participants described the need for messages that convey the risks associated with obesity while minimising possible stigmatisation of obese individuals. This included ensuring that messages recognise the complexity of obesity and focus on encouraging healthy behaviours for individuals of all sizes.

Conclusion
This study is the first step in exploring the ways in which we understand how public health messages about obesity resonate with obese individuals in Australia. However, much more research - both qualitative and quantitative - is needed to enhance understanding of the impact of obesity messages on individuals.

Follower perceptions of the emotional intelligence of change leaders: a qualitative study

We present and explore a follower-centric model of how employees perceive the emotional intelligence (EI) of change leaders. Qualitative investigations of EI are rare and have not explored the field of organizational change leadership. Accordingly, we analyse qualitative data from a series of interviews set within the context of organizational change. We examine follower attributions about the abilities of their leaders to manage and express their own emotions and to respond appropriately to the followers' emotions. The findings reveal that the ways in which leaders deal with emotion might be the key to followers sharing their own emotions with them. The impact of perceived leader EI on follower responses to change is also discussed. The complexity and ambivalence of our participants' perceptions of the EI of their change leaders highlight the utility of a qualitative investigation. © The Author(s) 2011.

Role recognition and changes to self-identity in family caregivers of people with advanced cancer: a qualitative study

Purpose : Family caregivers of people with advanced cancer can provide extensive support to the patient. However, the role is not well defined and their experiences are poorly understood. This study aimed to explore how caregivers view their role and the impact of their caregiving.

Methods : A symbolic interactionist framework guided the in-depth individual interviews and grounded theory methodology was used to analyse the data. A total of 17 interviews were conducted: 13 with active caregivers and 4 with bereaved caregivers.

Results : Three dominant codes are presented. Caregivers lacked role recognition, as they struggled to recognise their role existed, even though they took on extensive and challenging tasks. Caregivers reported substantial loss or changes to their self-identity: with some caregivers reporting not being able to stop thinking about caregiving and others having difficulty answering questions about themselves. Caregivers also demonstrated difficulty in taking a break: active caregivers did not consider taking a break, whereas bereaved caregivers retrospectively admitted needing a break but reported an inability to take one.

Conclusions : Caregiving is complex and extensive. People who care for those with advanced cancer are in need of intervention to provide support and assistance to them in their role. However, this needs to be structured with consideration for how caregivers view their role.

Self-practice and self-reflection in training of psychological interventions and therapist skills development: A qualitative meta-synthesis review

© 2015 Australian Psychological Society. Objective: The use of self-practice and self-reflection has been proposed as an efficacious strategy in the training of therapists. It has been argued to enhance therapist skills, and a key factor in the development of expertise. This systematic literature review investigated the effect of self-practice and self-reflection on therapist skills development. Method: Studies were identified through Medline, Academic Search Complete, PsychINFO, PsycARTICLES, Proquest, ISI, CINAHL, Cochrane, and Scopus databases. Additional studies were identified through lateral searches of relevant papers' reference lists and direct correspondence with authors of unpublished material. The selection criteria were studies that investigated the effect of self-practice and/or self-reflection on therapist skill development. There was no restriction on sample sizes, design of studies, dates of publication, or peer-reviewed papers. All studies were published in English. Results: Ten studies were included in this review. A thematic analysis was undertaken to analyse qualitative data. Due to inconsistency in the variables investigated across the quantitative studies, quantitative results were not subject to a meta-analysis but simply reported. Finally, qualitative and quantitative data were juxtaposed in a meta-synthesis. Conclusion: The meta-synthesis revealed inconsistencies between the qualitative and quantitative literature and a gap in relation to declarative knowledge. Methodological limitations across studies are discussed and recommendations for future research provided.

Analyse titanium surface irradiated with laser, with and without deposited of durapatite

OBJETIVO: Estudar a superfície de implantes osseointegráveis utilizando discos de titânio irradiados com feixe de laser. MÉTODOS: A amostra foi irradiada com feixes de laser de alta intensidade (Nd-YAG), posteriormente depositado hidróxiapatita e submetido a tratamento térmico. Foi analisada sob MEV (Microscópio Eletrônico de Varredura) e realizada análise morfológica qualitativa com microfotografias em vários aumentos. RESULTADOS: A superfície irradiada com laser apresentou deformidade superficial e característica isomórfica; a aplicação de hidroxiapatita pelo método de biomimético aumentou quantitativamente a área da superfície de titânio. CONCLUSÃO: A deposição de hidroxiapatita apresentou melhor característica isomórfica e aumento quantitativo da área superficial estudada, a amostra demonstrou características não encontradas nos implantes disposto no mercado.

Older people's perspectives on participation in physical activity: a systematic review and thematic synthesis of qualitative literature

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Methodenentwicklung zur Charakterisierung von metallischen Nanopartikeln und deren potentieller Einsatz bei der Analyse von Biomolekülen mittels ICP-MS Kopplungstechniken

Die qualitative und quantitative Analyse von Biomolekülen hat in den letzten Jahren und Jahrzehnten immer mehr an Bedeutung gewonnen. Durch das Aufkommen und die kontinuierliche Weiterentwicklung neuer Separations- und Detektionsmethoden und deren Verbindung miteinander zu leistungsfähigen Einheiten, erlangte man Schritt für Schritt neue Erkenntnisse bei ihrer Untersuchung. Die Elementmassenspektrometrie als nachweisstarke Detektionsmethode wird von vielen wissenschaftlichen Arbeitsgruppen bei der Trennung und Quantifizierung von Proteinen und Metalloproteinen mittels Detektion der in den Biomolekülen vorkommenden Metalle und Heteroatome angewendet. Heteroatome (z.B. Schwefel, Phosphor) haben im Plasma des ICP-MS (inductively coupled plasma - mass spectrometer) schlechte Ionisationseigenschaften und dementsprechend deutlich höhere Nachweisgrenzen als Metalle. Ein Ansatz, schlecht oder nicht detektierbare Verbindungen (also solche, die keine Metalle oder Heteroatome enthalten) mit dem ICP-MS sichtbar zu machen, ist die Markierung der selbigen mit Metallionen oder -cluster. rnIn dieser Arbeit ist es gelungen, der Analyse ganz unterschiedlicher Substanzklassen, zum einen metallische Nanopartikel und zum anderen Proteine, neue Impulse zu geben und zukünftiges Potential bei der Anwendung gekoppelter Techniken zur Separation und Detektion aufzuzeigen. Durch die Verwendung einer alten, aber neu konzipierten Trenntechnik, der Gelelektrophorese (GE), und deren Kopplung an einen modernen Detektor, dem ICP-MS, kann die für die Proteinanalytik weit verbreitete Gelelektrophorese ihr enormes Potential bei der Trennung verschiedenster Verbindungsklassen mit der exzellenten Nachweisstärke und Elementspezifität des ICP-MS verbinden und dadurch mit deutlich weniger Arbeitsaufwand als bisher qualitative und auch quantitative Ergebnisse produzieren. Bisher war dies nur mit großem präparativem Aufwand unter Verwendung der laser ablation möglich. Bei der Analyse von Nanopartikeln konnte aufgezeigt werden, dass durch die GE-ICP-MS-Kopplung aufgrund der guten Trenneigenschaften der GE vorhandene Spezies bzw. Fraktionen voneinander separiert werden und mit Hilfe des ICP-MS Informationen auf atomarem Niveau gewonnen werden können. Es war möglich, das atomare Verhältnis der Metallatome im Kern und der Schwefelatome in der Ligandenhülle eines Nanopartikels zu bestimmen und damit die Größe des Partikels abzuschätzen. Auch konnte die Anzahl der Goldatome in einem dem Schmid-Cluster ähnlichen Nanopartikel bestimmt werden, was vorher nur mit Hilfe von MALDI-TOF möglich war. Bei der Analyse von Biomolekülen konnte auf einfache Weise der Phosphorylierungsgrad verschiedener Proteine bestimmt werden. Auch bei kleinen Molekülen erzielt die Gelelektrophorese ausgezeichnete Trennergebnisse, wie z. B. bei der Analyse verschiedener Brom- und Iodspezies.rnDie stöchiometrische Kopplung eines Proteins an einen Nanopartikel, ohne eine der beiden Verbindungen in einem größeren Maße zu verändern, stellte jedoch eine Herausforderung dar, die im Rahmen dieser Arbeit nicht vollständig gelöst werden konnte. Verschiedene Ansätze zur Kopplung der beiden Substanzen wurden erprobt, jedoch führte keine zu dem gewünschten Ergebnis einer stöchiometrisch vollständigen und spezifischen Modifikation eines Proteins mit einem Nanopartikel. Durch das Potential der GE-ICP-MS-Kopplung bei der Analyse beider Substanz-klassen und dem Beweis der Praktikabilität und Zuverlässigkeit der Methode ist jedoch der Grundstein für weitere Forschungen auf diesem Gebiet gelegt worden. Ist eine geeignete chemische Kopplung der beiden Substanzklassen gefunden und beherrscht, steht auf analytischer Seite eine leistungsstarke Kombination aus Trennung und Detektion zur Verfügung, um die Quantifizierung von Proteinen entscheidend zu verbessern.rn

The unspoken disease: symptom experience in women with vulval neoplasia and surgical treatment: a qualitative study

Women with vulval neoplasia often experience severe post-surgical complications. This study focuses on symptom experience of women during the first 6 months following surgical treatment for vulval neoplasia considering their socio-cultural context. In this qualitative study using a critical hermeneutic approach, narrative interviews were conducted. A purposeful sample of 20 patients was recruited from one Swiss and two German university hospitals. Content analysis was employed to analyse the transcribed interviews considering women's experiences and social perceptions. Narratives showed eight interrelated themes: delayed diagnosis, disclosed disease, disturbed self-image, changed vulva care, experienced wound-related symptoms, evoked emotions, affected interpersonal interactions and feared illness progression. The women experienced a general lack of information pertaining to above themes and all described strategies used to handle their situation, which affected their distress. The communication, assessment and treatment of symptoms were hampered by the society's and the health system's tendency to overlook these symptoms and leave them in the realm of the unspeakable. Health professionals need new strategies to support these women to recognise, assess and evaluate the seriousness of symptoms, and to communicate their symptom experience so that timely medical treatment is sought. This support may minimise potentially preventable complications and symptom-related distress.

Between anxiety and hope: the experiences of women with vulval intraepithelial neoplasia during their illness trajectory - a qualitative approach

The vulvar intraepithelial neoplasia (VIN) is a rare chronic skin condition that may progress to an invasive carcinoma of the vulva. Major issues affecting women's health were occurring symptoms, negative influences on sexuality, uncertainty concerning the illness progression and changes in the body image. Despite this, there is little known about the lived experiences of the illness trajectory. Therefore, the aim of this study was to describe the experiences of women with VIN during the illness trajectory. In a secondary data analysis of the foregoing qualitative study we analysed eight narrative interviews with women with VIN by using thematic analysis in combination with critical hermeneutics. Central for these women during their course of illness was a sense of "Hope and Fear". This constitutive pattern reflects the fear of recurrence but also the trust in healing. The eight narratives showed women's experiences during their course of illness occurred in five phases: "there is something unknown"; "one knows, what IT is"; "IT is treated and should heal"; "IT has effects on daily life"; "meanwhile it works". Women's experiences were particularly influenced by the feeling of "embarrassment" and by "dealing with professionals". Current care seems to lack adequate support for women with VIN to manage these phases. We suggest, based on our study and the international literature, that new models of counselling and providing information need to be developed and evaluated.

Is output performance all about the resources? A fuzzy-set Qualitative Comparative Analysis of street-level bureaucrats in Switzerland

This article refines Lipsky’s (1980) assertion that lacking resources negatively affect output performance. It uses fuzzy-set Qualitative Comparative Analysis to analyse the nuanced interplay of contextual and individual determinants of the output performance of veterinary inspectors as street-level bureaucrats in Switzerland. Moving ‘beyond Lipsky’, the study builds on recent theoretical contributions and a systematic comparison across organizational contexts. Against a widespread assumption, output performance is not all about the resources. The impact of perceived available resources hinges on caseloads, which prove to be more decisive. These contextual factors interact with individual attitudes emerging from diverse public accountabilities. The results contextualize the often-emphasized importance of worker-client interaction. In a setting where clients cannot escape the interaction, street-level bureaucrats are not primarily held accountable by them. Studies of output performance should thus sensibly consider gaps between what is being demanded of and offered to street-level bureaucrats, and the latter’s multiple embeddedness.

A qualitative exploration of the impact of the economic recession in Spain on working, living and health conditions: reflections based on immigrant workers' experiences

Background: This study aimed to analyse how immigrant workers in Spain experienced changes in their working and employment conditions brought about Spain's economic recession and the impact of these changes on their living conditions and health status. Method: We conducted a grounded theory study. Data were obtained through six focus group discussions with immigrant workers (n = 44) from Colombia, Ecuador and Morocco, and two individual interviews with key informants from Romania living in Spain, selected by theoretical sample. Results: Three categories related to the crisis emerged – previous labour experiences, employment consequences and individual consequences – that show how immigrant workers in Spain (i) understand the change in employment and working conditions conditioned by their experiences in the period prior to the crisis, and (ii) experienced the deterioration in their quality of life and health as consequences of the worsening of employment and working conditions during times of economic recession. Conclusion: The negative impact of the financial crisis on immigrant workers may increase their social vulnerability, potentially leading to the failure of their migratory project and a return to their home countries. Policy makers should take measures to minimize the negative impact of economic crisis on the occupational health of migrant workers in order to strengthen social protection and promote health and well-being.

Analyse des événements festifs et religieux dans le Petit Maghreb sous l'approche de la médiation

Travail dirigé présenté à la Faculté des études supérieures en vue de l'obtention du grade Maîtrise (M.Sc.) en criminologie option sécurité intérieure