Background: The parenting usually entails great joy but can also involve major challenges. Parenting is not always experienced positively, on occasion it can be very stressful. Studies show that early intervention can enhance the parenting role and promote connection between the child and the parent and thus facilitate illness prevention in children.  Aim: To illustrate child health, nurses and parenting counselors provided extended home visits for new parents.    Method: A qualitative design and the phenomenological approach are used. Seven interviews were carried out with Child health nurses and parenting counselors. The results were analyzed with a content analysis.  Results consist of four headings; Prerequisites for good cooperation, The importance of the meeting place, Concrete support for parents, Challenges to support parents  Conclusion: The result shows that the project helped child health nurses and parenting counselors provide increased security and support in the parenting role. They have learned that the collaboration in the project has been experienced positively as they together can support families with their specific knowledge. Their view is that the families appreciate the support offered and it is easier for them to discuss sensitive topics in their own home. The prerequisites for being able to respond to challenges in the project require staff support from the manager and training in different cultural approaches.

Tese de Programa Doutoral. Sistemas Sustentáveis de Energia. Universidade do Porto. Faculdade de Engenharia. 2012

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This proposed study was inspired by the concept in Aristotle’s virtue ethics theory that a good life is necessarily an ethical one. The following work intends to expand previous literature on this topic by exploring an accessible potential method through which ethicality (and thus, well-being) can be increased, and also a possible explanation of how this process might occur. Past research has indicated that mindfulness training can increase both prosociality and well-being, and additionally that higher ethicality is connected to higher well-being. Reduced self-focus has been found to mediate these relationships. The proposed 30 day study makes use of a daily mindfulness training app to explore its effects on participants’ ethicality and well-being, and examines whether reduced self-focus mediates these potential relationships. Results are expected to show that that, first, increased mindfulness leads to increased ethical behavior, mediated by reduction in self-focus; and second, that increased mindfulness leads to an increase in well-being, mediated both by increased ethical behavior and by reduction in self-focus. Ultimately, the intention of this study is to find support for the benefits of cultivating a more loving and interconnected world, as well as the means by which to do so.

Inadequate cancer pain management is a global problem. The problem is particularly worse in developing countries where the majority of patients present with advanced stages of the disease. Nurses play an important role in cancer pain management because they spend the majority of their time with patients. The purpose of the study was to examine role of unit cultures on cancer pain management practices among nurses in Kenya. A focused ethnography was used to explore cancer pain management practices of two different units (general and private) within the same institution. Data were collected for four months in a national referral hospital in Nairobi, Kenya. Purposive sampling was used to recruit participants. A total of twenty five nurses and fourteen secondary participants (e.g., nurse managers) participated in this study. Data were collected through semi-structured interviews, observations, and document reviews. Content analysis was used to analyze the data. The study findings show that the unit culture plays a role in cancer pain management practices. For instance, nurses on the oncology unit prioritize pain while nurses on the private unit prioritize overall patient satisfaction. Nurses in both units do not conduct a comprehensive pain assessment and they do not use validated pain assessment tools. Facilitators, such as availability of analgesics and palliative care training, were helpful in managing cancer pain especially in the oncology unit. Barriers such as, negative attitudes towards opioids and doubting patients’ report of pain continue to hinder adequate cancer pain management in the private unit. Other barriers including lack of pain management policies, assessment tools, and workload, influence cancer pain management practices negatively in both units. Understanding the role of unit culture in nursing cancer pain management practices has important implications for policy and practice. Findings in this study show a divergence of the prevailing training of nurses on pain management and practice. Findings could be used to develop pain management policies and protocols for nurses to use as a guide in cancer pain management. Also, nurse managers could use this findings to improve practice for instance, training in cancer pain management could be expanded to include nurses in the private unit. In terms of research, studies could be done to capture patients’ perspectives regarding cancer pain management, or implementation studies could be carried out to alleviate the barriers identified. Lastly, tailored strategies aimed at changing the culture in a unit to enhance change in practice are needed.

There are a number of advantages to working within an integrated model framework when doing family therapy; however, few therapists test what they articulate as their model against what they really do. The purpose of this study was to test how well one therapist practiced her explicated theoretical integration in a clinical setting. Quantitative and qualitative data were gathered to answer three research questions: the level of adherence to the integration, client change, and change within the integrated model over the course of the study. The sample included three couples; data from 25 video-coded sessions, the Revised Dyadic Adjustment Scale and Outcome Ratings Scale, client case notes, and a reflection journal were analyzed to answer the research questions. Results indicate that the therapist remained true to the described integrated model; that all couples experienced change, some positive, some negative; and small changes to the model occurred. Other findings, limitations, and clinical implications are discussed.

Background: Occupational therapy (OT) plays an important role in providing early childhood interventions for children with developmental delay. While paediatric OT has long been guided by developmental principles, occupation-centred interventions have been promoted during the last decades, but no unifying definition exists about the core features. Aims/Objectives: The aim of this paper is to (a) identify and describe how occupation-based and occupation-focused interventions are demonstrated in paediatric occupational therapy for infants and young children with developmental delay, (b) identify which outcomes these interventions address and (c) analyse which outcome measures are used. Material and Methods: Eight databases and 15 OT journals were searched. Included studies were peer-reviewed primary sources published in English since 1999, selected based on the terminology proposed by Fisher (2013). Nineteen papers met inclusion criteria. Results: Eight occupation-based, two occupation-focused and nine occupation-based and occupation-focused interventions were identified. Outcomes related mainly to occupational and play skill acquisition as well as mastery of co-occupations. A limited number of occupation-focused outcome measures was implemented. Conclusions: Several occupation-centred interventions have been researched. Gaps in knowledge exist regarding measures taking into account (co-)occupational performance and young children’s perspective. Significance: OTs might want to expand their scope of practice to include all occupational domains and increase parent-delivered interventions in natural environments. Measures used should be relevant to occupational performance and take into account the parent’s and children’s view. Use of uniform terminology can aid identification of evidence and clear placement of OT among other professionals.

Suppliers of wheat must ensure that their products have the required quality profile demanded by customers and consistently deliver that quality in order to be competitive. Australia’s wheat industry is highly exposed to such competitive threats because it relies heavily on exports. An integral component in maintaining Australia’s competitiveness has been its classification system. The first step involves the complex process of determining a genotypic quality profile of each variety – a variety classification. At harvest, subsequent steps are the use of a statutory declaration and testing of physical quality traits. Together these steps determine how deliveries of wheat are segregated. A single variety can have different classifications across the 7 classification regions of Australia. Most classification regions are divided along state borders and these are not reflective of potential environmental influences. / The manner in which Australia wheat breeding programs now tackle their task has changed since 1999. The commercially focused companies of the current era have national targets to remain viable, and are focused on costs. Other evolutions associated with the change, are the introduction of different sources of parental material, and moving to more economic composite quality testing regimes instead of the individual site by site testing used in the past. Together, these factors, particularly variety adaptability and stability of performance, have the capacity to increase variability. The likelihood of variation is further increased given that the current classification regions upon which classification decisions are made do not adequately reflect environmental effects on the expression of quality. To determine whether better divisions of the Australian wheat-belt could be identified for variety classification purposes, a substantial spatial and temporal database of historical quality results was assembled. The creation of this relational database was unique, because never before had expansive sets of independent, state-based, quality sub-sets been joined together. However, the data were unbalanced and required alternative statistical tools to be analysed. The relational database was the platform from which three phases of research were conducted. / The first research phase investigated the extent of cross over, or re-ranking of results, statistically referred to as genotype x environment interaction. The approach was to assess balanced data sets, in a manner reminiscent of the most common method identified from the literature. The results of those analyses showed that the size of genotype and environment interaction was small compared with the main effects of genotype and environment. The second phase of research focused on identifying alternative boundaries for classification purposes. Test divisions were compared with the current set of 7 classification regions for the capacity to minimise environmental variance while maintaining differences between the zones of a set. Test divisions were based on fourteen published divisions of the Australian wheat-belt. Analyses were conducting using residual maximum likelihood because of the unbalanced structure of the data. Estimates of variance components, quality trait means and standard errors were calculated. Consideration of such estimates resulted in the identification of 4 different divisions of the wheat-belt that had low environmental variance levels for important quality traits such as maximum resistance, dough development time, and water absorption. / In addition, these 4 divisions of the wheat-belt had fewer number of zones compared with the existing set of classification regions because they linked separate parts of the wheat-belt together. In order of decreasing merit, the 4 divisions of the wheat-belt represented average October maximum temperatures; agro-ecological zones reported by Williams et al. (2002); average annual rainfall; and Departments of Agriculture recommendation zones. A final phase of crosschecking was performed to assess the veracity of the 4 identified divisions. A cluster analysis supported the orientation of their boundaries and it was also observed that the use of fixed boundaries for classification purposes would not be negatively affected by seasonal variation. The 4 divisions of the wheat-belt identified in this research support the use of environmentally focused classification boundaries. In addition to improving the capacity to segregate consistent quality, the linking of geographically separate production areas of the wheat-belt reduced the number of zones and this offers process efficiencies.

This research comprised of three studies designed to investigate the coping strategies utilised by high and low performing university students with non-academic stressors. Coping research has frequently focused on single stressors providing a distorted picture of coping. Utilising a combination of quantitative and qualitative methodologies, this research provides new insights into the dynamic and multi-dimensional nature of coping with long-term, multiple stressors. It extends our understanding of coping beyond traditionally individualistic conceptualisations where active coping is valued over prosocial relationship-focused coping. Conceptualisations of social support is broadened to view it in more complex interactional terms. In Study 1, 521 university students were surveyed using a standardised coping inventory, the Ways of Coping Checklist revised. Several demographic groups were identified as at academic risk. Having good health, along with the high use Social Support and Problem Solving and the low use of Self Blame strategies all predicted high GPA. Study 2 involved a content analysis of 179 Exclusion Appeal letters submitted by excluded students. When confronted with multiple stressors, poor performing students compartmentalised or amplified multiple stressors which resulted in patterns of reactive problem-focused or emotion-focused coping. Passive and uni-directional approaches to social support resulted in the depletion of such resources. Study 3 investigated adaptive coping patterns using an open-ended questionnaire and a semi-structured interview with twenty high performing students. High performers viewed multiple stressors as inter-related, which is termed cross situational appraisal and displayed a versatile coping pattern across stressors termed cross situational versatility. Proactive and prosocial coping are critical for the acquisition and maintenance of social support over a long-term period. Implications of these research findings for Student Services staff are discussed. / Doctor of Philosophy (PhD)