It has been well established that self-harm is a key healthcare issue facing young people (Health and Social Information Centre, 2015). Consequently, many self-harmers preferentially seek support from friends (Evans, Hawton, & Rodham, 2005). Despite their unique position, friends’ experiences have been marginalised. Historically, friends have only been considered when they feature in the lives of the person who self-harms, when they are identified as “gate-keepers” to self-harming young people (Klingman & Hochdorf, 1993, p. 123), or when they themselves go on to self-harm (e.g. Hawton, Rodham, Evans, & Weatherall, 2002). Bearing in mind the friends’ unique, yet highly vulnerable status, there is a notable lack of research exploring how friends come to understand their experiences, and the subsequent impact this has on their friendships with the self-harmer. Through this qualitatively approached thesis I aimed to explore how the impact of self-harm on friendship is understood. Data was collected through a series of interviews and focus groups with friends of self-harmers, and those who supported them. Using a qualitative methodology, I conducted three studies. In Study One, I explored how counsellors made sense of the impact of self-harm on friendship. Studies Two and Three focussed on how friends, whilst maintaining a friendship with a self-harmer, came to understand themselves, their friendship with the self-harmer, and their relationships with others. The results indicated that friends struggled to integrate self-harm into their friendships and their understanding of themselves, took on excessive responsibility for the self-harmer, and felt constrained by secret-keeping. Additionally, as the friends in Study Three felt that information available to them was either absent, or lacking, I developed a prototype support tool tailored specifically to the needs of the friends.

Orientador: Antonio de Pádua Pithon Cyrino / Banca: Águeda Beatriz Pires Rizatto / Banca: Lilia Blima Schraiber / Resumo: A Faculdade de Medicina de Botucatu-Unesp há 40 anos desenvolve práticas de ensino de graduação médica na comunidade, no âmbito da atenção primária à saúde. Essa experiência se fez sob distintas influências, dentre as quais se podem destacar os movimentos de reforma médica da Medicina Integral e da Medicina Comunitária, nas décadas de 1960 e 1970. Já nos anos 1990 o ensino foi influenciado pelo Programa UNI e, na última década, exerceram papéis relevantes as Diretrizes Curriculares Nacionais para os cursos de medicina e o papel indutor do Ministério da Saúde, por meio dos programas de incentivo às mudanças curriculares: Promed e Pró-Saúde. Nesse contexto, em 2003, a Faculdade Medicina de Botucatu implanta experiência de ensino na comunidade para alunos do 1º ao 3º ano de graduação - o Programa de Interação Universidade, Serviço e Comunidade (IUSC), que é orientado pelos princípios da integralidade e humanização e por inovações pedagógicas. Este estudo tem por objetivo compreender os significados e percepções de alunos que cursaram o IUSC e caracterizar sua proposta pedagógica à luz dos movimentos mais recentes de reforma na educação médica. Para tanto, realizou-se estudo de natureza qualitativa com a primeira turma de alunos que cursaram o IUSC, quando já estavam no 6º ano médico, por meio de três grupos focais, e pesquisa documental a respeito do projeto e operacionalização do IUSC. Os conteúdos obtidos nos grupos focais foram transcritos e submetidos a análise temática. O estudo documental do IUSC mostrou sua criação sob influência de políticas públicas de indução de reorientação da educação médica no país, as quais viabilizaram, em parte, a sustentação financeira e política do programa. Sua operacionalização fez-se adotando-se como modelo pedagógico a problematização. Os resultados obtidos mostram que, para ... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: For 40 years the Medical School of Botucatu-Unesp has been developing teaching practices of medical graduation in the community concerning the primary health care. This experience has been influenced by different factors such as the movements of medical renovation of Comprehensive Medicine and Community Medicine, in the 60s and 70s. UNI Program influenced this practice in the 90s; in the last decade two programs played an important role in the medical courses: the National Curriculum Directions and the inducing role of the Health Ministry, through programs which motivated curricula changes like Promed and Pro-Saúde. In such context, in 2003, the Medical School of Botucatu implemented the experience of community teaching for students of the first and third years of graduation - the Program Interaction University, Service and Community (IUSC), guided by the principals of comprehensiveness and humanization and by pedagogical innovations. This study aimed to understand meanings and perceptions of students who studied the IUSC and to characterize its pedagogical proposal regarding recent movements of medical education renovation. This is a qualitative study with the first group of students who have done the IUSC, when they were in the sixth year, through three focus groups and documental research regarding the IUSC project and operation. The narrative obtained in the focus groups were transcribed and submitted to thematic analysis of content. The documental study of UISC showed its development under influences of public policies of induction of medical education reorientation in the country what provided the partial financial and political support of the program. Its operation adopted the problematization as the pedagogical model. The results show that, for the students, the familiar visit was the most significant practical activity experienced during the course; however, there ... (Complete abstract click electronic access below) / Mestre

Doctor of Philosophy (PhD) / Healthcare services and health research aim to improve the physical and psychosocial well being of consumers, and to offer responsive services needed and valued by them. Research in chronic kidney disease (CKD) has predominantly focused on investigating biomedical aspects and evaluating technological or pharmacological treatment interventions to improve medical management. While research into assessing patients’ and caregivers’ quality of life, and symptom burden, is growing minimal attention has been given to gaining a broad and in-depth understanding about the experiences, psychosocial issues and needs of patients and their caregivers. These need to be considered when planning and delivering patient-centred care and health research across the whole trajectory of CKD. The studies that form the major part of this thesis explore the perspectives, needs and experiences of CKD patients and their caregivers, within a broad and multidimensional framework encompassing aspects of the nature of the health and illness experiences and consumer perspectives. In Chapter 2, to understand what is known about parental experiences of caring for a child with CKD, the relevant qualitative literature was systematically reviewed and synthesized. Three inter-related clusters were identified: intrapersonal, interpersonal and external experiences. In Chapter 3, to gain a more detailed and broader understanding of this topic, in-depth interviews were conducted with parents of 20 children with CKD and 4 major themes were identified: absorbing the clinical environment, medicalising parenting, disrupting family norms, and coping strategies and support structures. In Chapter 4, to assess the effectiveness of support interventions for caregivers of patients with CKD, a systematic review was conducted which identified only three eligible studies that assessed only the effect of educational material on caregiver knowledge, not other domains. In Chapter 5, to describe and compare the broad range and depth of experiences and perspectives from predialysis, dialysis and transplantation patients, data from patient focus groups were analysed. The 5 themes that emerged from this data were: personal meaning of CKD, managing and monitoring health, lifestyle consequences, family impact, and informal structures. In Chapter 6, the focus groups were also used to elicit research priorities and identify reasons that patients used to develop their research priorities. A patient focused research agenda was elicited for CKD and 5 reasons that patients used to develop their research priorities were identified: normalisation of life, altruism, economic efficiency, personal concerns and clinical outcomes. During the focus groups, participants repeatedly expressed frustration about the poor public profile, and lack of community-based information on CKD prevention. So in Chapter 7, to assess how Australian news media covered prevention and early detection of CKD, I analysed television and newspaper stories that referred to CKD prevention or early detection. Kidney disease in general, and particularly the prevention and early detection of CKD, received virtually no media attention. When mentioned, it was mainly in the context of transplantation and donor stories, and seldom prevention or early detection, which appears largely unnewsworthy in its current form. At best, CKD received peripheral mention as a secondary concern in diabetes and obesity news stories which focused on lifestyle solutions. In Chapter 8, to develop a checklist for explicit and comprehensive reporting of qualitative studies (in-depth interviews and focus groups), I performed a comprehensive search in relevant publications for existing checklists used to assess qualitative studies. Seventy-six items from 22 checklists were compiled into a comprehensive list. All items were grouped into three domains: 1) research team and reflexivity, 2) study design, and 3) data analysis and reporting. The overarching purpose of these studies was to gain a better understanding about the needs, experiences and perspectives of CKD patients and their caregivers. The findings describe the permanent, profound and pervasive impact of CKD on the lives of patients and caregivers across the whole illness trajectory. A more detailed and broader understanding about patient and caregiver perspectives, as presented in this thesis, can support a move towards advancing patient-centred healthcare and research in CKD.

Corporate governance has become an increasingly topical issue in recent years. This has been fuelled by such corporate collapses as Enron, Worldcom, Parmalat, One.Tel and HIH. The role and responsibility of the board and directors has emerged as an important issue in examining the cause of these collapses. This has created much debate on what the role of the directors is in 'directing', 'monitoring' or 'advising' a company. Research indicates that investors are prepared to a pay a premium for good governance. This raises a number of questions. What is governance? How do we determine what is good governance? What role do directors have in this? Does the company's performance improve by adopting good governance practices? There are numerous approaches to examining what makes a good board. Quantitative techniques have included the use of such measurable concepts as the number of executive and non-executive directors, directors' skill base (for example, accountancy, marketing etc) and frequency of meetings attended. Researchers have also attempted to measure board performance and effectiveness by using indicators such as share values and shareholder returns. There is a lack of qualitative research in board behaviour and effectiveness. This exploratory study adopts a qualitative approach in order to provide richer data. It uses interviews to evaluate directors' views on some aspects of corporate governance, specifically in relation to the executive and non-executive director debate. The interviews were conducted with 11 directors from a variety of organizations in the forprofit and not-for-profit sectors. Two major themes have emerged from the analysis of the interviews. Firstly, directors are traditionally considered to be responsible for maximising shareholder wealth. However, directors are now expected to broaden their responsibilities to include other stakeholders and to consider social and environmental issues in making their decisions. The findings indicate that it is now more demanding to be a director due to increased workloads arising from the regulatory and legal requirements. This has also impacted on director and board evaluations, multiple directorships and directors remuneration levels. The second major theme that emerged from this study is that directors' personal experiences did not necessarily concur with governance principles and guidelines. For example, the widely recommended method of achieving 'best practice' by having a majority of non-executive directors on a board is considered too simplistic. Further studies are required on the behavioural and personality traits, technical skills of the directors, board structure, composition and type of organization which make the best contribution to achieving boardroom effectiveness.

Thesis (M.Sc. (Clinical Psychology))--North-West University, Potchefstroom Campus, 2007.

Abstract Sales work is an occupation which constantly is available for people. Salespeople are always wanted, but only few of them can reach exquisite performance. For most people, selling is easy. However, it also brings the harshest challenge to human nature. Sales representatives could easily lose their resolution of achieving goals when they are encountered customers¡¦ endless problems and sales resistance. They always face tremendous achievement pressure, which could destroy their strong will in no time. In most people¡¦s impression, a professional sales manager has to be a person and a rich speaker. However, holding the same position, and having close observation toward numberless business chargers, I possess different opinion. A successful sales manager is usually prudent, self-disciplined, and achieves goals through effort of the whole team members. He learns humbly, and accumulates wisdom through his team group, as well as foster excellent ability, and great fortitude from failure experience. Thus, he becomes a top manager in his field. This paper discusses the resulted problems and their processing strategies when a sales manager confronts his customer. The author takes his past work experience as a sales manager in a British lubricant oil company as examples. Using the narrative analysis and participant observation method, this paper illustrates living challenges and work experiences on the managements of business and sales. Moreover, the great wisdom and excellent experience from above mentioned cases are respectively verified by the strategic problems solution models of Mckinsey and Company. Keywords: Qualitative Research¡BNarrative Analysis¡BParticipant Observation Method

This is a study to answer ¡§who am I ?¡¨ in educational context. ¡§Who am I ? ¡¨ is the beginning of self identity. Identity uncover one¡¦s images of himself as a way of understanding his practice, explicitly seeking a link between image and practice. By concerning identity and education, this study focus on preservice teacher¡¦s identity. The purposes are investigating preservice teacher¡¦s identity and the factors influencing it. The participants are five elementary preservice teachers. This study employs the qualitative research as the methodology for this study. The qualitative research is base on the way of one-year interview to collect the information and use the interview document to record the feeling and experience by writing word to word. The main findings are summarized as follows: 1. Preservice teacher¡¦s identity is constructed by interaction between self and others in practical training. 2. Preservice teacher¡¦s identity includes multiple role performances. 3. Facing the identity confusion, preservice teacher presents passive resistance. 4. Preservice teacher¡¦s identity affects perfprmances in practical training and obtaining teacher identity. 5. Colleagues help a lot in practical training. This study show the model and the pictures (role performances) of preservice teacher¡¦s identity. the model provides a framework to realize preservice teacher¡¦s identity. Finally, some suggestions are proposed for student teachers, teacher preparation system and future studies.

One diagnostic criterion to identify individuals as having an autism spectrum disorder (ASD) is that their communication patterns, social reciprocity, and interactional competence show qualitative impairment (American Psychiatric Association, 2000). And yet, my experience as an individual who was once diagnosed as ASD and my investigations of Internet websites run by and for autistic individuals led me to see that individuals who identify as ASD are not only interested in communicating with others but highly articulate in self-advocating through the affordances of online communication. My research was focused on exploring the communicative experiences of individuals who participated in two websites designed by and for autistic individuals as a means of self-advocacy, WrongPlanet and AspiesforFreedom. The method used to study the two websites was that of participant-observer. Having joined the online groups by introducing myself, I was able to peruse archived postings and current threads available on the websites. I analyzed threads of postings for themes being discussed and for features showing evidence of what Herring (2004) described as online community. Some of the postings were triangulated by interviewing participants. These interviews revealed more personal information about how one chooses to self-advocate and create community online. Results indicated that the forum posts of these two autistic-run websites demonstrated evidence of shared community and self-advocacy through the topics discussed. The autistic individuals I studied seemed to want to be seen as having a difference not a deficit. They acknowledged their struggles, but posited that individuals with ASD have strengths that are uncommon and are currently being under-utilized by society. Their use of the Internet demonstrates how autistic individuals are capable of communicating about a wide variety of topics, and are capable of contributing to the conversation about what makes them similar and different from those whom they call Neurotypical. The significance of this study is that insights I present have a different validity than other studies of autistic individuals conducted by non-autistic researchers. Also, by challenging stereotypes of the capabilities of autistic individuals, a path is created whereby all may benefit from the strengths, talents, and insights they are able to provide. / text

I took an interpretive phenomenological approach to examine what it is like to experience sound while playing educational games. I asked six people to play three educational games, for a total of 18 interview sessions. I analyzed 603 pages of interview transcripts and 22.68 hours of video recording using phenomenological research techniques to derive. I used NVivo to identify and code 1,738 meaning units across the three games studied. I organized these meaning units into related clusters and identified constituents of meaning for each game studied. I derived 27 constituents of meaning for Fate of the World, 22 constituents of meaning for Hush, and 27 constituents of meaning for Salamander Rescue. I wrote textural-structural descriptions to describe participant experiences in each game and performed imaginative variation to further provide a context to describe participant experiences. From these results, I derived essential meanings to situate a discussion about sound in each of the games studied and I discussed eight essential meanings that were shared across the three games studied. According to my analysis of these participants’ responses, sound conveyed a sense of the game’s interface in addition to the environment in which play was situated. Sound also supported the presentation of characters in the game and worked to communicate the game’s narrative to the player. Music in the games studied helped to provoke thought and also conveyed an emotional context for play. Sound supported players’ overall engagement in these games, but the absence of sound removed this engagement. Critically, people noticed when the visuals that they saw did not match the sounds that they heard. I present an applied phenomenological framework for sound in educational games to illustrate these essential meanings and to reflect how participants’ experiences were affected by the ways they used game interfaces, interacted with game characters, experienced game narrative, and described the game’s environment. This framework further illustrates the possibility space for potential experiences of sound in gameplay as determined by the choices players make, the game’s state of play, and the degree of synchresis present between what players hear and what they see as they play. / text

As one important experiment in the social or user-generated classification of online cultural heritage resources collections, art museums are leading the effort to elicit keyword descriptions of artwork images from online museum visitors. The motivations for having online viewers - presumably largely non-art-specialists - describe art images are (a) to generate keywords for image and object records in museum information retrieval systems in a cost-effective way and (b) to engage online visitors with the artworks and with each other by inviting visitors to express themselves and share their descriptions of artworks. This paper explores the question of how effective non-specialist art keyworders can be in capturing ("tagging") potentially useful concepts and terms for use in art information retrieval systems. To do this, the paper compares evidence from art museum visitor studies which describe how non-specialist art viewers react to and describe artworks and use museum-supplied information in their initial encounters with artworks. A theoretical model of artwork interpretation derived from art museum visitor research provides a framework with which to examine both the activity and the products of artwork tagging for image and information retrieval.