Yes / Fidelity to the treatment protocol is key to successful trials but often problematic. This article reports the staff's views on delivering a complex rehabilitation intervention: patient-led therapy during inpatient stroke care. An exploratory qualitative study using focus groups with staff involved in a multicenter (n = 12) feasibility trial of patient-led therapy (the MAESTRO trial) was undertaken as part of the evaluation process. Purposive sampling ensured that participants represented all recruiting sites, relevant professions and levels of seniority. Data analysis used a Framework Approach. Five focus groups were held involving 30 participants. Five main themes emerged: the effect of the interventions, practical problems, patient-related factors, professional dilemmas, and skills. Staff felt the main effect of the therapies was on patients' autonomy and occupation; the main practical problems were the patients' difficulties in achieving the correct position and a lack of space. Staff clearly identified characteristics that made patient-led therapy unsuitable for some patients. Most staff experienced dilemmas over how to prioritize the trial interventions compared to their usual therapy and other clinical demands. Staff also lacked confidence about how to deliver the interventions, particularly when adapting the interventions to individual needs. For each barrier to implementation, possible solutions were identified. Of these, involving other people and establishing a routine were the most common. Delivering rehabilitation interventions within a trial is complex. Staff require time and support to develop the skills, strategies and confidence to identify suitable patients, deliver new treatments, adapt the new treatments to individuals' needs and balance the demands of delivering the trial intervention according to the treatment protocol with other clinical and professional priorities. TRIAL REGISTRATION: ISRCTN: ISRCTN29533052 . October 2011.

Il progetto di ricerca è articolato in tre moduli di indagine (studi), ciascuno finalizzato a coprire specifici ordini di obiettivi: - un primo studio finalizzato ad analizzare come un messaggio preventivo sul tema AIDS sia metabolizzato nello scambio interpersonale fra pari e come questo influenzi la finalizzazione pragmatica (ri-uso) che l'individuo fa delle informazioni preventive. - un secondo studio volto a comprendere come il medium di rilevazione di un focus group (Face to face vs Online) ne influenzi il processo di costruzione dei dati (in termini sia di caratteristiche conversazionali dello scambio sia di contenuti evocati nella discussione). - un terzo studio dedicato alla verifica cross-culturale (stabilità e variabilità) dei risultati raccolti nei primi due studi. In concreto lo studio è stato realizzato conducendo: - 16 focus groups omogenei con giovani (18-25 anni) - in due contesti socio-culturali (Italia e Canada) - e tramite diversi media di rilevazione (face-to-face vs. forum vs. chat vs. forum+chat) - introducendo in ogni gruppo un messaggio preventivo sull'AIDS come stimolo di discussione. Le verbalizzazioni dei 16 focus groups sono stati analizzati con diverse tecniche - analisi psico-sociale del discorso; analisi del contenuto software based (T-lab); analisi conversazionale di alcuni estratti significativi; analisi quantitativa del discorso (Atlas.ti) - al fine di una migliore copertura degli obiettivi d'indagine: La ricerca evidenzia interessanti stabilità cross-culturali dei risultati: - sia rispetto al ruolo dello scambio sociale nel metabolizzare il processo dalla ricezione all'uso di un messaggio preventivo - sia rispetto alle ricadute del medium di rilevazione sulla costruzione dei dati nella ricerca qualitativa. / The research project consists of three studies, each one aiming to achieve specific objectives: - Study I attempts to describe how an HIV-AIDS preventive message is metabolized in a peer group exchange and how this influences individuals' re-use of health information in daily life. - Study II aims to describe how data collection strategies frame findings production in qualitative research. In particular the study has focused on how the data collection medium (face-to-face vs. the Internet) structures interviewer-interviewees interaction and, thus, data construction. - Study III is intended to verify the cross-cultural variability and stability of the first two studies main findings in two countries. Concretely, the study design consists of: - 16 homogeneous focus groups with young people aged 18 to 25 in two socio-cultural contexts (Italy and Canada) trough different media (face-to-face vs. forum vs. chat vs. forum+chat). - In each group an HIV-AIDS preventive message was introduced as a further discussion stimulus. All focus groups transcripts were analysed by different techniques - psychosocial discourse analysis; software based content analysis (T-lab), conversational analysis; computer based quantitative discourse analysis (Atlas.ti) - in order to better achieve the research objectives: The study outlines an interesting cross-cultural stability of findings in regard to:- the role of interpersonal exchange in metabolising the passing from the preventive information reception to its use in daily life; - the influences of data collection media on the qualitative findings production process.

We are facing the problems of climate change, the unfair share and over use of Earth’s resources. Global North overuses, Sweden has an ecological footprint of four planets. The challenge is to change our lifestyles. This thesis is trying out a method to diffuse ideas of sustainable development (SD) and for citizen participation. I created a future vision of a sustainable neighborhood inspired by Jane Jacobs and the concept of densification. This I presented to three homogenous focus groups: the next-door neighborhood, home owners and people in rentals. Free discussion then followed, and then a questionnaire. The findings where that the participants, fifteen of sixteen, thought the method gave them new ideas, allowed them to share their knowledge, and that it was a good method for participation. I thought that it was a ‘fun’ method. Focus groups research works more the way people normally interact, as did the literature show. I could see the learning process, that Patsy Healey describes, the creation of cultures, and also how the issue of SD was explored. It was time consuming to recruit participants. The tendency was that volunteers liked to talk, had an interest in planning, although not all in favor of SD. Many resembled me, in age and cultural background. The method could be useful to deepen dialog with citizens, especially in an early stage of planning. The vision should be ‘daring’ to spur good discussions, that may land in a compromise on SD. / Vi står inför klimatförändringar, den ojämna fördelningen och överanvändningen av jordens resurser. Nord överanvänder, Sverige har ett ekologiskt fotavtryck på fyra planeter. Utmaningen är att ändra vår livsstil. Denna uppsats prövar en metod för att sprida idéer om hållbar utveckling och för medborgardeltagande. Jag skapade en vision för ett hållbart grannskap inspirerad av Jane Jacobs och begreppet förtätning. Denna presenterade jag för tre homogena fokusgrupper: de i närmsta grannskapet, de som ägde sitt boende och de som hyrde. Sedan följde fri diskussion och sedan en enkät. Resultatet blev att deltagarna, femton av sexton, tyckte att metoden gav dem nya idéer, tillät dem att dela sina kunskaper och att det var en bra metod för deltagande. Jag tyckte att det var en ’rolig’ metod. Forskning med fokusgruppers fungerar mer som man vanligen umgås, vilket även litteraturen visade. Jag kunde se lärandeprocessen, som Patsy Healey beskriver, skapandet av kulturer och också hur begreppet hållbar utveckling undersöktes. Det var tidskrävande att rekrytera deltagare. Tendensen var att de frivilliga gillade att prata, var intresserade av planering, men inte alla positiva till hållbar utveckling. Många påminde om mig, i ålder och kulturell bakgrund. Metoden kan vara användbar till att fördjupa dialogen med medborgare, speciellt i ett tidigt stadie av planering. Visionen ska vara ’vågad’ för att sätta igång bra diskussioner och landa i en kompromiss i hållbar utveckling.

The purpose of this study has been to explore how a class of year 8 students from a school in the middle region of Sweden experience peer assessment on written assignments in the Swedish subject as well as their feelings towards peer assessment and their opinion of how well it works as a tool for learning. To answer this question an observation of a peer assessment session concerning a debate article was conducted. This was followed up by a focus group interview with five students during which peer assessment was thoroughly discussed. The purpose of the observation was for the researcher to gain insight into how the class worked with peer assessment. It also served as a foundation for the interview. The study shows that the students see many benefits with peer assessment, mainly, they appreciate giving response. Receiving responce was often viewed as a difficulty, both as the receiver and giver as the students wanted to avoid hurting others. They also felt that they were unable to be completely honest to their peers and that were sometimes hard to rely on the feedback they got. The students asked for more exercises in peer assessment, mainly in the earlier years, in order to gain the positive effects described by the literature.

Sociocultural models of body dissatisfaction implicate mass media exposure as contributing to body dissatisfaction through thin-ideal internalization and social comparison. Compared with other media types, social media are newer, more rapidly evolving, and less thoroughly researched. Existing research, which has focused on teen and young adult samples, suggests that social media also negatively influence body dissatisfaction. The current study used focus groups to explore the nature and impact of social media use on body dissatisfaction in an early adolescent female sample. Girls in this sample displayed high levels of media literacy and confidence, characteristics they felt were nurtured by positive parental influences and a supportive school environment. The results of this study support the recommendation of body image experts that an ecological approach is optimal for the prevention of body dissatisfaction and eating disorders. Though peer influence gains strength through adolescence, these results demonstrate that parents and schools continue to have important effects on girls’ attitudes and behaviors regarding social media and body image.

Master of Science / Department of Human Nutrition / Koushik Adhikari / Obesity in adolescence is associated with a complex web of ecological, psychosocial, and physiological factors, and many of these factors relate to nutrition and physical activity behaviors. Before interventions are developed, researchers need to know what factors specifically influence an adolescent’s food choices and physical activity within the community context. Cultural norms, school environment, and neighborhood attributes are examples of factors that may vary across different communities, and accounting for this variation can be quite challenging, unless community perspectives are acknowledged. The use of qualitative data from focus groups has shown to be an effective way of gathering community perspectives about the diversity of their views and experiences. The current study used focus groups to reveal facilitators and barriers to healthy eating behavior and physical activity engagement in 6th to 8th grade youth in a low-income community in South-Western Kansas. This methodology enabled community members (adolescents, parents, and teachers) to discuss and articulate their perceptions in relation to 6th to 8th grade youth’s eating habits and physical activity, and assessed available resources, needs, and opportunities for developing effective and sustainable intervention approaches in the community. Using the socio-ecological model, individual influences (e.g., taste preferences), social influences (e.g., parent and peer influences), and larger contextual influences (e.g., school) on early adolescent health were assessed. This information will be used to develop interventions addressing factors at these different levels of influence that are needed to improve eating habits and physical activity of youth in the community.

Introdução: Muitos são os estudos que avaliam o consumo alimentar na adolescência entretanto não se sabe quais fatores motivam esses jovens a se alimentarem de forma inadequada. Objetivo: Avaliar, de forma quantitativa e qualitativa, os fatores determinantes do consumo alimentar de adolescentes de escolas técnicas em São Paulo. Métodos: O presente estudo é parte de uma pesquisa matriz, que avaliou 1167 jovens de ambos os gêneros. Os fatores determinantes do consumo alimentar foram avaliados em duas etapas. Na primeira etapa quantitativa foram utilizados dois instrumentos que foram desenvolvidos para a pesquisa matriz, o primeiro um questionário de avaliar atitudes alimentares de adolescentes e o segundo avaliou o consumo alimentar através de um questionário de frequência alimentar baseado na pirâmide dos alimentos. O primeiro instrumento apresenta uma questão onde 15 fatores determinantes do consumo alimentar são apresentados e cada adolescente deveria escolher os 3 mais importantes. O peso e a estatura de todos os indivíduos foi mensurado e posteriormente o Índice de Massa Corporal foi calculado afim de classificar os adolescentes quanto à adequação de seu estado nutricional segundo os critérios da Organização Mundial da Saúde. A avaliação qualitativa foi realizada com uma subamostra do projeto matriz (n=45) e contou com a realização de grupos focais. Os 15 fatores determinantes do consumo foram agrupados em 3 grupos a partir da realização da análise de cluster e esses grupos foram comparados com relação ao gênero, estado nutricional, consumo de alimentos e dos grupos alimentares baseados na pirâmide dos alimentos para adolescentes. Resultados: Os 3 fatores determinantes mais referidos pelos adolescentes na etapa quantitativa foram, em ordem de preferência, o sabor, o fato do adolescente gostar do alimento e tentar ter uma alimentação mais saudável, enquanto que a etapa qualitativa mostrou que os fatores de falta de tempo, conveniência e praticidade foram os mais referidos. Os adolescentes que preferiam os fatores determinantes relacionado às características dos alimentos, entre eles o sabor, consumiam significativamente mais alimentos com alto conteúdo de gorduras e açúcares. Conclusão: Conclui-se que para o grupo de adolescentes avaliados o sabor foi o fator mais importante e que ele pode explicar a inadequação dietética nesse grupo etário. / Introduction: Many studies evaluate food consumption in adolescence however little is known about the factors that influence adolescent\'s food choices. Objective: To evaluate, in a quantitative and qualitative way, the factors that influence adolescent\'s food choice from technical schools from São Paulo. Methods: This study is part of a research which evaluated 1167 adolescents from both gender. Factors that influence adolescent\'s food choice were evaluated in two steps, the first one evaluated in a quantitative way used two surveys that were developed to the research. The questionnaire evaluated adolescent\'s eating attitudes and included a question which included 15 factors which the adolescents should select the 3 more important, and the second survey assessed food consumption through a food frequency questionnaire that was based on the food pyramid. Body weight and height were measured and the Body Mass Index calculated in order to classify their weight status according to the World Health Organization criteria. The second part of this study, the qualitative analyses, used a smaller sample from the main study (n=45) and focus groups were performed. The 15 factors were divided into groups using the cluster analyses method and compared between genders, weight status and food consumption. Results: Taste and liking the food and trying to have a healthier eating were the 3 most referred factors in the quantitative analyses, while in the qualitative research lack of time and convenience were the most reported factors that influence the adolescent\'s food choices. Adolescents who prefer factors related to the food characteristics, such as taste, eat significantly more high fat and sugar foods. Conclusion: In this group the taste of food was the most important factor and can explain the eating inadequacies seen in this population.

Studiens syfte var att belysa hur idrottsföreningsaktiva 65+ beskriver erfarenheter avfysisk aktivitet och dess värde, och hur genusfaktorn skiljer grupperna åt. Teoretiskreferensram: En kombination av holistisk ansats, Bourdieus teori, genusteori ochsocialkonstruktivism. Metod: Idrottsföreningsaktiva 65+ rekryterades i denna studie,där damer kom från en golfförening och herrar från en frigymnastikförening. Totalt 3grupper deltog i denna studie där fokusgruppsintervjuer tillämpades för insamling avdata under två tillfällen. Dessutom skrev informanterna en dagboksanteckning, dettaför att i möte nummer två skulle diskussioner utgå de anteckningarna.Fokusgruppsintervjuerna spelades in med hjälp av digitala verktyg som sedantranskriberades noga och därefter analyserades med hjälp av kvalitativinnehållsanalys. Resultat: Analysen genererade två kategorier och sexunderkategorier, där resultatet visade att värdet av fysisk aktivitet handlar omfrämjandet av hälsa och det sociala umgänget, vilket var viktigt för de bådagrupperna. Samtidigt spelade det i detta avseende också roll vilka erfarenheter varjeinformant hade, detta då resultatet visade att de tyckte om att utföra fysiska aktiviteterutifrån eget intresse, behov, samt den miljö de befann sig i kombination med synen påkroppsideal. Det fanns tydliga indikationer på hur damerna och herrarna skilde sig åtgällande engagemang i fysiska aktiviteter som bland annat påverkas av smak ocherfarenheter beträffande sociala och kulturella aspekter. / The purpose of the study was to highlight how 65+ sports associated people describethe experience and value of physical activity, as well as how the gender factorseparates the groups. Theoretical Reference Framework: A combination of holisticapproach, Bourdieu's theory, Genus theory and Social constructivism. Method:Athletes 65+ were recruited in this study, ladies from a golf club and gentlemen froma free gym association. A total of three groups participated in this study where focusgroup interviews were applied for data collection on two occasions. In addition, theinformants wrote a diary, which meant that in the second meeting discussions wouldbe based on those notes. Focus group interviews were recorded using digital tools,which then where carefully transcribed and analyzed using qualitative contentanalysis. Result: The analysis generated two categories and six subcategories, wherethe results showed that the value of physical activity is about promoting health andsocial relations, which was important for both groups. At the same time the resultsshowed that they enjoyed performing physical activities based on their own interests,needs, view of body ideals and the environment where the performed the physicalactivity. There are clear indications of how the ladies and gentlemen involvement inphysical activities differ and how they are influenced by taste and social and culturalexperience.

<p>The overall aim of this thesis was to deepen understanding of elder abuse (EA) by exploring and comparing perceptions held by experts, older persons, representatives of potential support organizations, and family members. Experts’ perspectives (I) were examined through risk indicators and screening questions (a) located in EA literature and (b) selected by an international Delphi panel. Risk indicators most commonly found in the literature or selected by the panel were compiled into consensus lists. There were differences between risk indicators and questions in the two lists. In papers II and III participants were interviewed in focus groups about their perceptions of EA. Older persons (II) considered EA to be due to changing society and family systems where children are not brought up to respect older persons. EA was mainly conceptualized as ageism, criminal actions, mistreatment in residential care, and societal abuse. The abuser was perceived as a stranger or a healthcare worker. Fear was discussed as a major consequence of EA; especially fear among women. Abused persons were described as carrying the responsibility to seek help. Witnesses were described as hesitant to get involved. Improvements in society such as educating children and healthcare workers were considered ways to cope with EA. Besides family and friends there were few spontaneous suggestions for where to seek help and support in society. These suggestions included healthcare, police, church, and volunteer organizations. Representatives of these suggested organizations were interviewed in focus groups about their perceptions of EA (III). Perceptions of both causes and conceptions of EA were very similar to perceptions of older persons (II). Four themes emerged in the data; good intentions in abusive situations, older generation’s responsibility for EA, failing to report abuse, and prevention of abuse. Participants (III) also expressed ageist attitudes themselves and findings included victim blaming and tolerance for EA. Participants perceived that anyone could be provoked to abuse, and that abusers can be considered victims in abusive situations. Confidentiality was discussed as a barrier to reporting and the need for educating children to show respect for older persons was identified. Interviews with an adult family member (IV) explored her experiences of witnessing abuse situations between her uncle and his wife. In her desire to protect and remain loyal to her family she felt powerless and tolerated abuse. She longed for support she could trust but was locked into passivity by her feelings of shame. Synthesis of findings (I – IV) revealed issues of isolation, autonomy, vulnerability, victim blaming, perceiving the abuser as a victim of circumstances, ageism, tolerating EA, shame, and power as essential elements in EA. Based on the findings, alternative descriptions of EA are offered as a challenge to existing EA definitions. Findings suggest that a key to unlocking EA is compassion, understood as the ability to see a situation as if we were in it ourselves, experiencing the potential for disrespect, shame and unworthiness inherent in abusive acts.</p>

No description available.