Asperger syndrome is a relatively recent diagnostic classification. Several factors, including a high prevalence of mental illness, mean receiving a diagnosis in adulthood is a very unique experience but remarkably there is little literature about the impact on individuals. Instead the dominance of the medical/psychiatric paradigm pervades and limits understanding and possibilities. The main implication is a lack of clarity about what support services are needed and effective, and as such the needs of this population are often overlooked. This is the first study to explore the sense of self among a sample of males and females diagnosed with Asperger syndrome in adulthood using social constructionist and constructivist ideas. It was interested in whether personal construal of the self before diagnosis and self after diagnosis were differentiated. Given the importance in the development of self-concept of discriminations between the self and others, the research also sought to explore how people diagnosed with Asperger syndrome in adulthood construe other people with and without Asperger syndrome. Using the repertory grid and other techniques from Personal Construct Psychology (Kelly, 1955) in combination with a semi-structured interview, this study presents a novel exploration of idiosyncrasies and commonalities across a demographically diverse sample of eight participants. An extended analysis of a unique subsample of women diagnosed aged 50 years and over was undertaken. Both cognitively complex and simple construct systems were found across the sample. Findings indicated the self before diagnosis was construed critically and was more elaborated than the self after diagnosis. Several participants had a reduced sense of self following diagnosis. The diagnosis offered an explanation of symptoms but for some participants these symptoms were a way of life and accommodating the new label with the existing view of self posed challenges. An overarching and striking theme was the sense of difference felt by participants before and after diagnosis. This study offers a fresh insight into a virtually unexplored population which, through dissemination, may influence the way clinical psychologists and other practitioners work to support adults diagnosed with Asperger syndrome. Recommendations for clinical practice included approaches that target the need for individuality, commonality and sociality, and should be gender-specific where possible. Such approaches might elaborate multiple aspects of self, the diagnosis and related dilemmas. They should support people to widen their perceptual field to alternative ways of construing and explore change. The mixed method approach was assessed to be a strength of the study and a number of recommendations for future research are presented.

Background: In recent years Acceptance and Commitment Therapy (ACT) has gained increasing status as a promising approach to treating chronic pain physical functioning and psychological well-being. The basic premise of ACT as applied to chronic pain is that while pain hurts, it is the struggle with pain that causes suffering. This approach aims to restore effective and adaptive functioning for an individual within a context of continuing pain so that the individual can live a more vital and meaningful life. There is a growing empirical support for the effectiveness of ACT however research has relied on self-reported quantitative outcomes, focused on addressing changes in pain intensity and the physical and psychological impact of chronic pain. There appears to be a gap in the literature on the exploration of the experience of attending an ACT programme for chronic pain from the patient’s perspective. Aim: This study sought to explore the experience of attending an ACT programme for chronic pain within an outpatient NHS hospital setting. Furthermore the study sought to explore the modulating factors influencing clients learning and understanding of the construct of acceptance from the perspective of the participants. Additionally, the experience of attending a group based ACT intervention was explored. Methodology: A qualitative methodology was chosen for the project. The study used a purposive sample of twelve participants, who had all attended the Luton & Dunstable Hospital ACT 8 week outpatient programme for chronic pain. The participants were interviewed through the use of a semi structured interviews, and the transcripts were transcribed and then analysed using Thematic Analysis. Identified themes were further organised using the tool of Thematic Network Analysis. Results: Three global themes emerged from the analysis of the data. The first global theme encompassed the participant’s pre-programme expectations and this theme highlighted the participant’s feelings of hope and hopelessness prior to attending the programme. The second global theme demonstrated the on-going process of living with chronic pain and highlighted the benefits and barriers to adopting and ACT based approach to chronic pain. Finally the third global theme addressed the experience of a group based intervention and included the positive and negative aspects of this experience for the participants. Clinical Implications & Conclusion: Based on the results of this study a number of clinical implications were highlighted in relation to the future development of ACT programmes for chronic pain. These included suggestions in relation to engaging participants in such programmes. Notably, timing issues, validation of physical symptoms, and consideration of the potential barriers to acceptance and understanding of the benefits of adopting and ACT group based pain management approach were discussed.

The balance between family support and child protection services is continuously challenged by high-profile cases. These highlight shortcomings both of the UK system and of research on the effectiveness of child maltreatment interventions (Munro, 2011). One such intervention is the Resolutions Approach to ‘denied’ child abuse (Turnell and Essex, 2006) – a systemic approach which creates a support network including extended family, friends, community members and professionals. There is, however, only limited research analysing the supporters’ experience of this intervention. In the present study five semi-structured group interviews were conducted in order to investigate how the family support network members made sense of their participation in Resolutions. Through a thematic analysis three related themes: returning hope; building safety and trusting a professional were identified. Additionally, special attention was paid to processes linked to the creation of family resilience (Walsh, 2003). Based on two contrasting case studies the potential creation of family resilience through Resolutions was discussed and clinical recommendations for creating family resilience within support networks were outlined.

ABSTRACT Five of the top 16 counties in the United States with the fastest growth in the Latino population from 2000 to 2007 are in Georgia (Pew Hispanic Research Center, 2015). The Georgia metropolitan area where the study occurred has more Latinos than Austin, Tampa, Fort Lauderdale, or Tucson (Pew Hispanic Research Center, 2015). Particularly following the New Latino Diaspora (Hamann, Wortham, & Murillo, 2002; Murillo, 2002; and Villenas, 2002) schools in the Southeastern United States have more and more Spanish-speaking students (Pew Hispanic Research Center, 2015). However, most classroom teachers have not received specialized training or professional development relating to these students (Ballantyne, Sanderman, & Levy, 2008; Barrera & Jiménez, 2000; Carrasquillo & Rodríguez, 2002; Dove & Honigsfeld, 2010; Echevarria, Short, & Powers, 2006; Kim, 2010; Walker, Shafer, & Iiams, 2004). My study’s purpose was to explore the interactions between an English to Speakers of Other Languages (ESOL) teacher (myself) and classroom teachers in my school relating to newcomer emergent bilingual students. The main research question guiding this study was: What happens when an ESOL teacher and classroom teachers intentionally gather to focus on newcomer emergent bilingual students? Teachers attended 12 weekly gatherings which were audiotaped, transcribed verbatim, and analyzed. This study exemplifies practitioner research and thematic analysis of the data. Sociocultural theory (Vygotsky, 1978, 1986) and critical pedagogy (Freire, 1970) frame this study and were used as interpretive lenses for data analysis. Five major themes emerged: newcomers, resources, connections with classroom experiences, perceptions, and professional development. Findings related to teachers’ sense of self-efficacy relating to newcomers, their awareness of linguistic and cultural issues, and the importance of the social-emotional climate. A kit for classroom teachers of newcomers was prepared. Recommendations include support for classroom teachers who receive newcomer students—resources for the first days with a newcomer and ongoing interaction with other teachers for discussing strategies and reflecting on classroom experiences. Additional research is needed to increase awareness of the transition for classroom teachers and students when a newcomer arrives.

The role of diabetes specialist nurses in delivering diabetes consultations has been recognised for more than a decade, particularly since the publication of the Standards for Specialist Education and Practice by the United Kingdom Central Council for Nursing, Midwifery and Health Visiting (UKCC) in 2001. However, evidence on how the consultation is delivered, together with patients’ experiences, is somewhat limited. This study examined diabetes specialist nurses’ and patients’ consultation experiences in primary care. It also investigated the process and outcome of these diabetes consultations. This research utilised a sequential mixed methods single approach design in which qualitative was followed by quantitative investigation. In the qualitative stage, 7 diabetes specialist nurses and 7 patients were interviewed separately, followed by observations of 7 nurse-patient consultations. The data from the interviews were analysed thematically, whereas the data from nurse patient consultations were examined though conversation analysis (CA). The investigation continued quantitatively, where the questionnaires were developed based on the qualitative findings and adaptation of the Consultation Quality Index (CQI-2). Following on from a pilot study, the questionnaires were sent to adult patients with diabetes (n=150) and 40 completed questionnaires were returned for statistical analysis. The qualitative and quantitative findings were then merged in a matrix diagram to reveal holistic findings on consultation experiences. The thematic analysis of patients’ interviews produced five themes which were: ‘I don’t like living with diabetes’, ‘Daily problems’, ‘Coping with my diabetes’, ‘How the nurses approach me’ and ‘My expectations toward the diabetes specialist nurses’ . In contrast, the themes from the nurses focused not only on the diabetes consultation but also care management issues: ‘Current problems’, ‘My expectations towards the patients’, ‘Consultation approaches’, ‘Personal development’ and ‘Team working’. Details on the sequence and scope of consultations were obtained from conversation analysis which highlighted the approaches commonly used by the diabetes specialist nurses. The statistical analysis showed associations between partnership and empathy (P=0.01), empathy and outcome (P= 0.005), information giving and consultation time (P= 0.05). The integration of qualitative and quantitative findings suggested ‘Consultation stages’ as a theme, and also four themes related to consultation experiences: ‘Day to day hurdle’, ‘Knowing each other’, ‘Shared expectations’and ‘Working together’. This study has identified the value and processes of the nurse-patient consultation in diabetes care from a nursing context. In general, the patients experienced their consultations with the DSNs positively. They highlighted key personal characteristics of the nurses. Similarly, the nurses considered their role in delivering consultation as crucial. Some challenges were evident including patients’ behaviours, the diabetes knowledge of other health care professionals and the lack of administrative support. The association between the nurses’ empathetical approaches and the patients’ outcomes needs further investigation.

While it is recognised that the burden on the caregiver of a person who has suffered a neurological event is great, research into the experience of caregiving and the effects of cognitive-communicative difficulties on intergenerational families is lacking. Studies examining these experiences within a multicultural and multilingual setting such as South Africa are few. The effects of neurogenic communication disorders in family systems also require further investigation. This study explores parent caregivers’ experiences of caring for their once-independent adult child, who are now faced with the reality of parenting for the second time. A qualitative research design was employed. Eighteen parents of adult children who have suffered TBIs, strokes or brain tumours were interviewed. The data obtained were analysed by means of thematic analysis. Themes associated with caring for an adult child, specifically in the South African context, are identified and discussed. These themes related to the parent caregiver’s experience of loss – loss of their child due to physical and cognitivecommunicative difficulties as well as the loss of their own dreams and plans for the future. Multiple roles within intergenerational family systems, support and information are identified as significant factors in either minimising or exacerbating their experience of loss. These themes are explained within a Family Systems Theory framework and assist in identifying both positive and negative factors that impact on experiences of caring for an adult child. It stresses the importance of the implementation of sustainable programmes and support services specifically catering for parents of adult children with neurological communication disorders.

Our goal was to create an enhanced spectator experience to better engage the rapidly growing audience for Esports, through the use of Virtual Reality (VR) technology. In this study, we delve into the ways in which VR can do this. To test this hypothesis, we created a VR spectator add-on for a game and gathered data using semi-structured interviews. The data from the interviews were then analyzed using thematic analysis. The results of our study show that VR provides more engagement through a combination of possible factors including proximity to the action, novelty of VR experiences and the harder controls in VR. The results also show that the terms "immersion" and "spatial presence" were quite possibly used interchangeably by the participants and also that there may not be a correlation between the terms "engagement" and "spatial presence". In conclusion, we believe that the increased sense of engagement through VR technology can be taken even further and has the potential to be something more than what traditional modes of spectating can offer.

No description available.

Background: Despite national guidance and empirical support for its clinical and cost-effectiveness, cardiac rehabilitation (CR) is underused. Only 44% of patients go to CR, with angioplasty (Percutaneous Coronary Intervention; PCI) patients being least likely to attend (31% of 87,000). Aim: To investigate the relationship between ‘continuity of care’ and patients’ motivation towards CR, through the lens of self-determination theory, and develop a model to inform service design to increase CR uptake and adherence. Methods: A mixed methods approach was used. In Study 1, a theoretical model of continuity of care and motivational antecedents was tested with a cross-sectional sample of 107 PCI patients. To further explore interactions between continuity of care and motivation towards cardiac rehabilitation, a Critical Interpretive Synthesis of the extant literature was used in Study 2, and focus groups were carried out with patients and service providers in Study 3. Results: In Study 1, continuity of care positively predicted patients’ autonomous motivation towards CR, and this was partially mediated by autonomy support. Autonomy support was associated with CR attendance. In Studies 2 and 3, aspects of continuity of care with positive effects on attendance were identified. These included timely, appropriate information provision, relationships bridging CR phases and settings, and continuing management strategies incorporating trusting, warm staff-patient relationships, and positive encouragement and feedback about progress. The SDT constructs of autonomy support, need satisfaction, internalisation and quality of motivation helped to explain positive and negative influences of continuity on attendance. Conclusion: Continuity of care has a positive effect on patients’ motivation towards CR. The most enduring motivation comes from delivering continuity of care in an autonomy-supportive and competence-supportive way. Longitudinal research is needed to compare how need-supportive and need-thwarting aspects of continuity of care affect CR attendance and adherence, and whether these relationships are influenced by need satisfaction and need frustration.

Learning Management Systems (LMS) is a widespread information system used in many Higher Education Institutes (HEI) in order to facilitate educational efforts. The system can be used for support in campus courses; courses conducted on the Internet and of course a mixture of these usages. This study attempts to understand the process of the implementing an LMS at a specific HEI. The HEI has made several implementations over the last 6 years, but decided to implement a new LMS during 2018. The focus of the study is the perceived effects on teachers in the implementation and the role a group of so-called Ambassadors played in the implementation. The study applied a social constructivist approach, mixing interviews, observation and survey as methods for data collection from teachers and implementation project management at the HEI. The study applied thematic analysis in order to analyse the collected data. The analysis built on five themes, Ambassadors, Implementation, Major concerns, Pedagogy, and System Literacy. Findings suggest that time management issues created the major effect on the daily work of teachers and that the group of Ambassadors in their role acted as a form of change agents, thus influencing the implementation project positively. Findings also suggested that only a few teachers took the opportunity to apply new pedagogical features to their teaching, in connection with the implementation. Finally, findings suggested that, in line with previous research, that the LMS is not used fully, as some teachers tends to use only minor functionalities in the LMS.