Childhood sexual abuse among males has been associated with many negative psychological outcomes. Studies have attempted to identify which sexual abuse characteristics (e.g., duration, age of onset) are associated with mental health difficulties. While informative, this research has been mostly limited to variable-centered analyses, which do not capture the heterogeneity in males’ abuse experiences and psychological presentations. This two-part dissertation advances our understanding of how best to measure childhood sexual abuse and how to account for the diversity of sexual abuse experiences and outcomes among men using a person-centered approach. Given that there are few validated measures of childhood sexual abuse, the first study examined the psychometric properties of a commonly-used measure in the sexual abuse literature, the Sexual Victimization Survey (SVS; Finkelhor, 1979). Once the validity and reliability of the SVS were established, the SVS was used to generate profiles on the basis of abuse characteristics (Study 2). Data for both studies were drawn from a sample of 302 males (85% Caucasian) aged 18 to 65 years seeking support for childhood sexual abuse. Participants completed a modified version of the SVS as well as the sexual abuse subscale of the Childhood Experiences of Violence Questionnaire-Short Form (CEVQ-SF; Tanaka et al., 2012). Twenty-one males completed the SVS again one week later for test-retest purposes. The SVS showed high inter-rater reliability on sexual abuse status and sexual abuse characteristics. Most males (85%) who endorsed sexual abuse on the SVS did so on the CEVQ-SF, resulting in fair concurrent validity. The SVS showed perfect one-week test-retest reliability on abuse status, as well as good to excellent agreement on sexual abuse characteristics between the initial and one week time points. Given the strong psychometric properties of the modified SVS, it was then used to generate childhood sexual abuse profiles in Study 2. Once participants with significant missing data were deleted, 215 men remained and were included in the generation of profiles. Latent profile analyses revealed three distinct profiles which varied in the severity of abuse experiences. The Severe profile (n = 56, 26%) depicted sexual abuse which began in mid-childhood and consisted of a one or two time fondling by an unfamiliar extrafamilial perpetrator. Men in the More Severe profile (n = 71, 33%) also experienced abuse in mid-childhood by an extrafamilial perpetrator, but experienced more severe sexual acts that spanned several months to several years. Men in this profile were emotionally closer to their perpetrators prior to abuse onset than males in the Severe profile. The Most Severe profile (n = 88, 41%) depicted abuse which began in early childhood and consisted of very severe sexual acts by trusted individuals both within and outside of the family. Men in the Most Severe were significantly more likely to concurrently have experienced child emotional and physical abuse as well as a greater number of non-victimization adversities, compared with men in the other two profiles. Profiles varied with respect to psychological outcomes. Males in the More Severe and Most Severe profiles reported significantly more internalizing problems than men in the Severe profile, and men in the Most Severe profile reported significantly more trauma symptoms than men in the Severe profile. Certain contextual variables were also associated with greater psychological difficulties, namely greater present-day use of avoidant coping predicted more internalizing and externalizing problems, as well as greater trauma symptoms. Worse childhood family functioning was associated with more internalizing and externalizing problems, and disclosure of the abuse (compared to non-disclosure) was associated with more externalizing problems and trauma symptoms. These results have several research and clinical implications, including tailoring assessment and treatment to meet the individual needs of male survivors.

The study sought to understand how Grade 9 History teachers perceive and implement learner-centered education (LCE) in selected schools in Caprivi educational region in the Republic of Namibia. It concentrated on three teachers in two combined and junior secondary schools. The research employed a qualitative approach and three data instruments were used: interviews, class observations and document analysis. The findings of the study show that in their interview discussions of the principles, intent and recommended key features of LCE, the three participating teachers generally correctly captured some of the essential intentions of a LCE approach. At times in the interviews they seemed to strongly grasp the essence of a key strategy and its intent, but at other times their views were sketchy. Their view of different teaching strategies at times appeared integrated but not always that strongly. When it came to their classroom practice they could and did use a number of appropriate LCE teaching approaches. The level of effectiveness in their use of many of the approaches varied from effective to far from ideal and in need of quite big improvement. In the area of resources the three classrooms were extremely limited in what they displayed, had and used. There were too few textbooks and almost no posters and wall displays on history and the geography of the world and its peoples that the students were studying. An especially interesting feature was that they all seemed to be consciously engaged in an on-going teaching experiment with the LCE approaches. The LSC [sic] practices were clearly not yet strongly imbedded as solid classroom habits or dispositions, with perhaps the exception of questioning. But this experimenting made them much more self-conscious and reflective about their experiences. They all frankly identified some tensions that they felt existed between the espoused official features of a LCE class and the demands of the covering the curriculum, size of classes etc. Overall it was an encouraging picture of teachers eager to find ways to improve their teaching and experiment with new ideas. But also a picture of people not properly exposed to good or best practice in each teaching strategy and having to reinvent and rediscover on their own even the basics of reasonable practice often making very basic mistakes, for example in questioning.

The present meta-analytic study estimated the overall effectiveness of child therapy interventions using CCPT methodology and explored the relationships between study characteristics and treatment effects. Fifty-two studies between 1995 and the present were included based on the following criteria: (a) the use of CCPT methodology, (b) the use of control or comparison repeated measure design, (c) the use of standardized psychometric assessment, and (d) clear reports of effect sizes or sufficient information for effect size calculation. Hierarchical linear modeling (HLM) techniques were utilized to estimate the overall effect size for the collected studies and explore relationships between effect sizes and study characteristics. Dependent variable included 239 effect sizes, and independent variables included 22 study characteristics. The mean age of all child participants in the collected studies was 6.7. In 15 studies, the majority of participants were Caucasian. An equal number of studies were made up of non-Caucasian participants, including 3 with majority African American, 4 with majority Hispanic/Latino participants, 5 with majority Asian/Asian American participants, and 3 with other ethnic populations. Study collection included 33 studies with majority of boys and 11 studies with majority of girls. HLM analysis estimated a statistically significant overall effect size of 0.47 for the collected studies (p < 0.001). This result indicated that the overall improvement from pre to post treatment demonstrated by children in experimental groups was approximately 1/2 standard deviation better than by children in control groups. A statistically significant amount (49.2%) of between-study variance was found (p < 0.001), indicating the heterogeneity among the 52 studies Statistically significant relationships were found between effect sizes and study characteristics including child age, child ethnicity, clinical level of referral, treatment integrity, presenting issue, source of data, population, and caregiver involvement. Effect size findings for CCPT and its moderators should be interpreted in light of the specific, and perhaps more rigorous statistical analysis method (HLM) and effect size calculation formula used for the present study, particularly in comparison to previous meta-analytic findings. Overall findings support CCPT's beneficial treatment effect. Specifically, CCPT can be considered a developmentally and culturally responsive effective mental health intervention across presenting issues.

付記する学位プログラム名: デザイン学大学院連携プログラム / 京都大学 / 0048 / 新制・課程博士 / 博士(情報学) / 甲第22577号 / 情博第714号 / 新制||情||122(附属図書館) / 京都大学大学院情報学研究科社会情報学専攻 / (主査)教授 緒方 広明, 教授 守屋 和幸, 教授 黒田 知宏 / 学位規則第4条第1項該当 / Doctor of Informatics / Kyoto University / DFAM

No description available.

<p>Physicians must explain medical information to patients in a way that patients can understand, and physician use of analogies is one strategy that may help patients better understand health information. The present dissertation, guided by patient-centered communication, investigated whether the use of analogies by a physician within a medical encounter enhances participants’ objective understanding, perceived understanding, and perceptions of clarity regarding information about a health condition, and perceptions of the physician in areas of liking, similarity, satisfaction, and affective communication. The experiment consisted of eight conditions with a 2 (familiar/unfamiliar health condition) x 4 (no analogies, diagnosis analogies, treatment analogies, both diagnosis and treatment analogies) design, and the conditions varied by being exposed to the familiar or unfamiliar health issue first. An actor physician delivered a 1-2 minute video-recorded message, diagnosing the participants, serving as analogue patients, with the familiar or unfamiliar health issue. After watching the video and responding to the dependent variable measures based on their perceptions of the physician and video message, U.S. adult participants read a vignette of another physician diagnosing them with the other (familiar or unfamiliar) health issue, and answered the same dependent variable measures regarding the physician and vignette message. Open-ended questions sought to understand what participants remembered from the message and whether they recalled analogies in their retelling of the physician messages, whether they (dis)liked the analogies, what they (dis)liked about the physicians and whether these perceptions differed by analogy conditions, whether they remembered any analogies from their own clinicians, and in which medical situations they found provider analogies to be useful. Findings indicated when including health literacy as a covariate, analogies did not enhance perceptions of clarity, perceived understanding, or objective understanding. Regarding positive perceptions, analogies did not influence liking, similarity, satisfaction, or affective communication. There was no significant interaction between use of analogies and health issues, nor a difference in the effectiveness of the analogies based on whether they were used to describe diagnosis or treatment. Explanations containing analogies resulted in increased objective understanding for the vignette compared to the video format. When recalling the physician’s message, participants rarely recalled analogies, nor explicitly mentioned them as something they liked or disliked. However, some participants recalled clinician use of particular analogies, and most of them indicated they found clinician analogies to be useful, especially when describing complex health issues that are difficult for patients to understand. The dissertation results indicate that healthcare providers may want to use analogies when interacting with patients, which could potentially improve the doctor-patient relationship. </p>

No description available.

(in English): The diploma thesis deals with the use of design methods among Czech UX designers in the design of web and mobile applications. The aim of this work is to find out and critically describe how Czech UX designers use design methods in practice. The thesis analyse the design process of website, web and mobile applications, its various stages and procedures. The theoretical part of the thesis introduces the basic terminology of the User Experience field and current research in the field, with emphasis on relevant terms and processes that occur in design practice. This part of the thesis is based on data obtained in the practical part, according to which popular approaches, frameworks, processes and methodologies of the UX field will be identified and described on the basis of professional literature. In the research part, qualitative research will be carried out in the form of semi-structured interviews with Czech User Experience designers, focused on the identification of methods, procedures and principles and ways of their usage. At the end of the thesis, the obtained data will be evaluated and it will be identified whether Czech designers in their practice adhere to academic approaches, or what existing and theoretically described methodologies and procedures their design process...

In an attempt to help middle school art students to be more engaged and have more ownership over their learning experience, the researcher, who is also the classroom teacher, created and implemented student-directed and teacher-supported strategies. Using a design-based research methodology, the author conducted a qualitative study over a twelve-week period investigating the affordances or limitations of implementing more student-directed strategies. The results showed three categories of student responses. The students that were ready and capable to direct their own learning excelled, guiding their own learning, and were able to generate personally relevant and disciplinary connected art. The second category of students initially did not have the artistic skills or the skills necessary to direct their own learning. Through interventions and scaffolding, these students were able to direct their learning and make personally relevant and disciplinary connected art. The last category of students struggled to guide their learning, were unmotivated, and relied on the teacher to direct their learning. The results suggest that neither a teacher-centered or student-directed model alone is adequate to achieve desired outcomes of students guiding their learning and achieving high academic standards. There is a need for a teacher to perceive and adapt their practice to address the multifaceted needs of students.

Background: Every year, 480 families in Sweden are informed that their child is diagnosed with an incurable disease. Everyone involved is affected by the death of a child. When a familymember becomes incurably ill it affects the entire family. The family's commitment is vital in pediatric care, as the family is the child's greatest source of security. It is of great importance that the nurse who works in palliative care, has to be person oriented and family centered to meet the needs of the whole family. Aim: The aim of this study was to highlight parents’ experiences of having a child in palliative care. Method: A literature study based on 11 qualitative articles is performed. The analysis of these articles resulted in three main themes and seven sub themes. Results: Parents wanted, as far as possible, to be involved in their child’s care. They perceived a high quality of care when the care was provided with continuity and when a trustful relationship was created. A sense of security was experienced when the staff were compassionate and were able to take care of the whole family. The family also strived for a sense of normality in family life. Conclusion: Parents experienced that they were in an increased need of support from healthcare both during the palliative process but also after death. It was supportive and appreciated when the nurse encouraged the parents to take a more active role in their child’s care. / Syftet med detta examensarbete var att belysa föräldrars erfarenheter av vård av sitt palliativt sjuka barn. Barn som drabbas av en obotlig sjukdom och är i behov av vård som inte längre har ett botande syfte uppgår till en procent av den palliativa vården i Sverige. Palliativ vård av barn syftar till en vård som skall lindra symtom och skapa bästa möjliga förutsättningar för en god livskvalitet för barnet med en livsavgörande sjukdom. I examensarbetes resultat påvisades att familjen var betydelsefull och väsentlig i vården av det sjuka barnet och skulle ses som en enhet. Föräldrarna till ett döende barn gick igenom en känslomässig berg- och dalbana där känslor pendlade stundvis av optimism, hopp och perioder av ångest, skuld, stress, förlust och sorg upplevdes dagligen. Att ett barn dör är onaturligt och alla involverade påverkas av den betungande situationen. Sjuksköterskan möter ofta svårigheter i att stödja familjerna i sjukdomsprocessen av det sjuka barnet. Sorgen och kampen familjen går igenom i samband med deras barns sjukdomsprocess var genomgående i resultatet. Föräldrar beskrev sina erfarenheter av livet med det sjuka barnet som utmattande både fysiskt och psykiskt. Känslomässiga behov som föräldrarna upplevde var att känna tillit till och delaktighet i vården relaterat till barnets behandling och omvårdnadsåtgärder. Detta var faktorer som ledde till en ökad trygghet för familjen. Föräldrarna känner sitt barn bäst och har det fulla ansvaret för barnet och det var därför av yttersta vikt att sjuksköterskan hade förståelse för hur stöd och kommunikation kunde påverka föräldrarna till att fortsätta känna hopp och mening i en påfrestande livssituation. För att kunna belysa föräldrars erfarenheter har en kvalitativ litteraturstudie utförts i detta examensarbete där resultatet av 11 vetenskapliga artiklar har analyserats och nyckelfynden har skapat tre teman och sju underteman. Litteraturstudien beskriver två vårdvetenskapliga begrepp, lidande och hälsa, som är centrala i omvårdnad och är relevanta för syftet. I examensarbetes diskussionsdel lyfts diskussioner kring sjuksköterskans funktion i lindrandet av föräldrars lidande kring den förväntade och upplevda förlusten av sitt barn. Hinder som kan uppstå och förhindra att föräldrars förväntningar uppfylls, könsnormer och social hållbarhet lyfts också. Diskussionen behandlar begreppen familjecentrerad vård, hälsa och lidande som genomsyrar studien.