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Bakgrund: JIA (juvenil idiopatisk artrit) är den vanligast förekommande reumatiska sjukdomen bland barn. Fysisk träning en viktig del av behandlingen där fysioterapeuten har huvudansvar. Tidigare forskning tyder på att barn med JIA inte är lika fysiskt aktiva som sina friska jämnåriga och att det i dagsläget saknas fördjupad kunskap om faktorer som påverkar fysisk aktivitet hos dessa barn.  Syfte: Syftet med arbetet var för vårdnadshavare för barn med JIA, utforska upplevelser och erfarenheter kring faktorer som påverkar barnets fysiska aktivitet.  Metod: Kvalitativ metod genom fem semistrukturerade intervjuer som genomfördes med vårdnadshavare till barn med JIA. Bekvämlighetsurval användes för att hitta deltagare. Materialet bearbetades genom en kvalitativ innehållsanalys.  Resultat: I analysen framkom fem kategorier med faktorer som påverkar fysisk aktivitet: hitta rätt – medicineringens roll i främjandet av fysisk aktivitet, upplevt ansvar att hitta och förmedla information, anpassningar i skolmiljö, uppmuntran och integration – vikten av normalitet i livet med JIA och önskemål kring utökade vårdinsatser.  Konklusion: Vårdnadshavare till barn med JIA erfarande att en adekvat medicinering var en faktor som främjade fysisk aktivitet. Vidare upplevde informanterna att de har ett stort ansvar att söka information om sjukdomen, samt att förmedla denna till berörda parter såsom skola och idrottsorganisationer för att främja sitt barns fysiska aktivitet. Otillräcklig kunskap om sjukdomen i samhället anses vara en hindrande faktor till att barnen kan vara fysiskt aktiva, medan lyhördhet och anpassningar i skola och idrottssammanhang var underlättande faktorer. Informanterna framförde önskemål om förbättrad kontinuitet i vården för att effektivisera behandlingen. / Background: JIA (juvenile idiopathic arthritis) is the most common rheumatic disease among children. Exercise is an important part of the treatment, and physiotherapists have primary responsibility for the treatment plan. Previous research suggests that children with JIA are not as physically active as their healthy peers, and currently, there is a lack of in-depth knowledge about factors that affect physical activity in children with JIA.  Objectives: The aim of this study was to explore the experiences of factors influencing a child's physical activity for guardians of children with JIA.  Method: A qualitative design was conducted through five semi-structured interviews with guardians of children with JIA. Convenience sampling was used to identify participants. The data was processed through qualitative content analysis.  Result: The analysis revealed five categories of factors that influence physical activity: the role of medication in promoting physical activity, guardians’ responsibility to find and convey information, adaptations in school environment, the importance of normalcy in life with JIA and preferences for expanded healthcare interventions.  Conclusion: Guardians of children with JIA experienced that adequate medication was a factor that facilitated physical activity. Moreover, the guardians of children with JIA felt that they had a responsibility to seek information about the disease and convey it to relevant parties such as schools and sports organizations to promote their child's physical activity. Insufficient knowledge about the disease in society was considered a hindering factor for children to be physically active, while awareness and adaptations in school and sports settings were facilitating factors. The informants expressed a desire for improved continuity in healthcare to streamline treatment.

Those who have known an individual with a chronic medical condition or someone that has been diagnosed with a terminal illness have experienced the physical and emotional toll these diagnoses have on both patients and their loved ones. Medical providers encounter these situations daily and are often responsible for assisting the patient and their family in the decision-making process. The specialty of Hospice and Palliative Medicine was created specifically with these difficult, but very common, situations in mind. Even though the concept of palliative care has become mainstream and its practice is considered standard of care in many situations, it continues to be misunderstood, misrepresented, and underutilized, despite providing measurable benefits to patients, families and the healthcare system. This paper explores two systemic barriers to palliative care that contribute to this problem and highlights how race, cultural mistrust, and a long history of racial disparities in health care work together to undermine the effective delivery of palliative care. / Urban Bioethics

The purpose of this study was to explore and define the behavioral and thought processes that affect exercise engagement and adherence in college students with schizophrenia. A mixed methods approach was proposed utilizing an online survey followed by semi structured interviews. The online survey used was the Exercise Benefits and Barriers Scale (EBBS) Adult Version and the semi structured interview questions were produced by the researcher. The potential participants for this study were students who were 18 years of age or older and registered with the Disability Resources and Services Department at Temple University. The participants were also to have already experienced their first episode of psychosis (FEP). The online survey yielded no completed questionnaires. The online survey consisted of the 43 question EBBS Adult version and a basic demographic questionnaire. The EBBS utilized a 4-point Likert scale ranging from ‘strongly disagree’ to ‘strongly agree.’ At the end of the survey, an optional question was added if participants wanted to take part in a semi-structured interview. The semi-structured interview also yielded no participants. Interviews were designed to develop a more in depth understanding of personal schizophrenia symptoms, how well symptoms are managed by the individual, and how exercise plays a role in their management. Interviews were to be transcribed verbatim and coded using transcendental phenomenology theory to explore the phenomenon of exercise adherence and non-adherence. Considering the lack of responses, social stigma surrounding mental illness could be a contributing factor. Discrimination surrounding mental illness has been shown to lower quality of life for individuals with a mental illness, increase unemployment rates, and increase anxiety and depression rates. Another potential contributing factor to low survey completion rate was the length of the EBBS. The population diagnosed with schizophrenia could benefit from research involving a six month exercise implementation. The EBBS or a shortened modified version could be utilized in pre and post testing along with exercise testing in the pre and post form analyzing the five areas of physical fitness. Semi-structured interviews would be beneficial to do prior, during, and at the end of the exercise intervention to acquire a well rounded view of the perceptions of exercise engagement. A follow up survey and interview would be completed after two months to examine continued or discontinued exercise engagement and the associated reasons. A case study or narrative research would be a second beneficial study. One or two participants who currently engage in exercise and are considered in the maintenance stage of behavior change would be followed and interviewed over the course of a year or longer. It would be valuable to examine a participant who is currently engaged in exercise since this is a phenomenon in this population. A qualitative research approach would give better insight into how these individuals perceive exercise, exercise barriers, or current and past exercise motivators. This in turn can better mold future research designs and exercise implementations to address the exercise motivation obstacle in people with schizophrenia. / Kinesiology

The purpose of this study was two-fold: to quantitatively explore competitive rowers' perspectives of the benefits and barriers to exercise, and to use follow-up qualitative interviews to elicit insight into rowers' views of their sport culture, personal experience, and what it takes to be a dedicated, adherent athlete. A mixed-methods approach was used with online surveys and semi-structured interviews. Participants were club and university rowers in the Northeast Atlantic region, all of whom were at least 18 years of age and actively rowing at the time of study One hundred thirty-one athletes, 77 female and 54 male, participated in the quantitative phase of the study. The online survey included the Exercise Benefits/Barriers Scale (EBBS), a 43-item, 4-point Likert scale measure, and a Basic Demographics Questionnaire (BDQ). The EBBS measured perceived benefits of and barriers to physical exercise. Statistical analysis revealed no strong correlations between the EBBS factors and demographic data. An eight-factor solution resulted, with five benefits (psycho-physical competence, daily functional efficiency, psycho-emotional stability, preventative health, and social interaction) and three barriers (personal inconvenience, physical exertion, and family encouragement). The eight-factor solution correlated strongly with the original nine-factor solution from Sechrist, Walker, and Pender (1987). Nine participants, five men and four women, participated in follow-up interviews. Interviews were performed at a time and place convenient for the rower. The purpose of the interview was to elicit specific, genuine, rich content related to their rowing experience and how the benefits and barriers to physical activity and their place in rowing culture affect exercise adherence. Using an inductive-deductive approach prescribed by grounded theory, two core categories and additional sub-categories were developed in the coding process. From the data analysis, hindering factors and facilitating factors emerged as the core categories. Physical conditioning and health, optimization of personal characteristics, psycho-emotional stability, strong social community, environment, and interpretation of perceived barriers were subsumed under facilitating factors. The following sub-themes were contained in hindering factors: exercise demands, environment, and social issues. Rowers perceived strongly the benefits of their rowing experience, and stated that barriers are inherent to exercise and they are responsible for adapting to them. / Kinesiology

Bakgrund: Fibromyalgi är ett smärtsyndrom som karakteriseras av långvarig utbredd smärta och ömhet. Det finns forskning som tyder på att fysisk aktivitet är en effektiv behandlingsmetod för att minska symtomen vid fibromyalgi. Trots detta är majoriteten av personer med fibromyalgi inaktiva. Det finns begränsad forskning på vad som hindrar respektive underlättar fysisk aktivitet hos personer med fibromyalgi.  Syfte: Syftet med studien var att undersöka vilka hindrande och underlättande faktorer till fysisk aktivitet som personer med fibromyalgi upplever.  Metod: En kvalitativ design med semistrukturerade intervjuer genomfördes med fem deltagare utifrån ett bekvämlighetsval. Databearbetningen genomfördes med kvalitativ innehållsanalys.  Resultat:  Fyra kategorier identifierades, två gällande hindrande faktorer (när kroppen är i obalans och att vara sårbar och begränsad av yttre omständigheter) och två gällande underlättande faktorer (socialt stöd och att hitta sina egna strategier).   Konklusion: Informanterna i studien upplevde att hindrande faktorer till fysisk aktivitet var när kroppen var i obalans, samt att vara sårbar och begränsad av yttre omständigheter. Underlättande faktorer som framkom av informanterna var socialt stöd och att hitta sina egna strategier för fysisk aktivitet. De faktorer som framkommit i resultaten styrker tidigare forskning. / Background: Fibromyalgia is a pain syndrome characterized by long-term widespread pain and tenderness. There is research suggesting that physical activity is an effective treatment method for reducing symptoms of fibromyalgia, despite this, the majority of people with fibromyalgia are inactive. Limited research exists on what hinders or facilitates physical activity among people with fibromyalgia. Objective: The aim of this study was to investigate the barriers and facilitators to physical activity experienced by people with fibromyalgia. Method: A qualitative design with semi-structured interviews was conducted with five participants based on convenience sampling. Data analysis was performed using qualitative content analysis. Results: Four categories were identified, two concerning hindering factors (when the body is out of balance and being vulnerable and limited by external circumstances) and two concerning facilitating factors (social support and finding their own strategies). Conclusion: The informants in the study experienced that hindering factors to physical activity were when the body was out of balance, as well as being vulnerable and restricted by external circumstances. Facilitating factors that emerged from the participants were social support and finding their own strategies for physical activity. The factors that emerged in the results corroborate previous research.

<p dir="ltr">This mixed-method grounded theory study developed and tested a new framework for leading geographically dispersed teams. With the dramatic shift to remote work due to the COVID-19 pandemic, leaders now face new challenges in developing corporate strategies and approaches to leadership without proximity to their teams. However, existing leadership literature has yet to catch up to this new reality.</p><p dir="ltr">Grounded in interviews with business leaders and a quantitative survey of 100 leaders and 100 employees, this study identified communication frequency and trust-building as vital for reducing uncertainty. It also found that promoting employee well-being requires relationship-centered leadership and constructing inclusive cultures. Ultimately, leading at a distance requires adapting leadership development and reevaluating organizational design to focus on alignment, transparency, and culture-building.</p><p dir="ltr">The resulting framework identifies specific leader competencies needed for remote management. It emphasizes the importance of leader visibility, constructive feedback practices, and crisis readiness. The framework highlights new imperatives in meeting design, goal-setting, professional development, and performance management. Finally, it calls for policies that promote work-life balance through comprehensive flexibility.</p><p dir="ltr">This study provides theoretical and practical guidance with hybrid and remote work arrangements likely to persist post-pandemic. It demonstrates the effectiveness of grounded theory methodology in new research contexts. The framework presented lays the foundation for leadership approaches that empower productivity and well-being across distributed teams.</p>

Technical regulations are a form of non-tariff barrier that is becoming increasingly visible in agricultural trade disputes. A distinguishing feature of technical barriers is their legitimate use by governments to protect consumers' health, recognize citizen preferences in packaging and labeling, and protect the environment from the establishment of non-indigenous pests and diseases. When legitimate externalities or other market failures are addressed technical barriers have the potential to increase national welfare, even without consideration of terms-of-trade effects. Governments may also impose technical barriers to isolate domestic producers from international competition. In these cases under the small-country assumptions, technical barriers are welfare decreasing policies. Despite GATT rules designed to limit the misuse of technical barriers, continued disputes indicate that this type of regulatory measure can not always be justified on the basis of unambiguous scientific evidence and suggests that governments may still widely apply technical barriers of questionable merit. Political economy is one paradigm that explains government intervention in markets, even when the result is a loss in net welfare. The 1996 USDA Survey of Technical Barriers to U.S. Agricultural Exports provides a systematic source of primary data on technical measures which caused actual or projected export revenue losses to U.S. firms in 1996 and which might be subject to challenge under the Uruguay Round Agreements. Although no questionable technical barriers to 1996 U.S. agricultural exports were reported for 71 countries included in the Survey, there were a total of 302 barriers identified among 63 countries. The estimated trade impact of the barriers reported was $4.9 billion, or approximately seven percent of the total value of 1996 U.S. agricultural exports. Two sets of empirical models are estimated to identify the political economy determinants of questionable technical barriers as they are applied to U.S. agricultural exports. The incidence of questionable technical barriers is measured by the presence or absence of such barriers by country. The impact of questionable technical barriers is measured by the reported estimated trade impact as a percentage of 1996 U.S. agricultural exports to that country. Results indicate that, despite strengthened GATT disciplines, political economy considerations continue to influence the incidence and impact of technical barriers in international agricultural markets. / Ph. D.