Dissertations / Theses on the topic 'Psychosocial issues'
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1
Golembiovskaya, A. "Psychosocial issues of the globalization." Thesis, Видавництво СумДУ, 2004. http://essuir.sumdu.edu.ua/handle/123456789/22793.
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Mattsson, Elisabet. "Cancer During Adolescence: Psychosocial Consequences and Methodological Issues." Doctoral thesis, Uppsala universitet, Institutionen för folkhälso- och vårdvetenskap, 2008. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-8643.
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The overall aim of this thesis was to investigate psychosocial consequences of cancer during adolescence, using a longitudinal approach. An additional aim was to investigate if mode of administration has an influence on adolescents’ and young adults’ self-reported psychosocial function. In Study I participants, aged 13-23 years, were randomised according to two modes of administration, telephone interview and postal questionnaire, and asked to complete the Hospital Anxiety and Depression Scale (HADS) and Short Form 36 (SF-36). The telephone mode resulted in a higher response rate, better self-rated psychosocial function (except for the youngest age group), overall lower Cronbach’s alpha values, and a larger percentage of ceiling effects compared to the postal mode. A higher proportion of males than females chose not to participate in the postal mode. In Study II and III adolescents diagnosed with cancer completed the HADS and two sub-scales from the SF-36 (Mental Health and Vitality) 4-8 weeks, 6, 12, and 18 months after diagnosis. In Study II adolescents with cancer were compared to a reference group from the general population. Shortly after diagnosis the cancer group rated their psychosocial function as worse compared to the reference group. However, the differences gradually disappeared over time and were then reversed, resulting in the cancer group reporting better vitality and lower levels of anxiety and depression than the reference group eighteen months after diagnosis. In Study III five distinct psychosocial states were identified, characterised by: psychosocial dysfunction (state A), poor psychosocial function (state B), incomplete psychosocial function (state C), good psychosocial function (state D), and excellent psychosocial function (state E). Shortly after diagnosis more adolescents than expected by chance were found in states A and C and fewer were found in states D and E. Eighteen months after diagnosis a different pattern emerged, where more adolescents than expected were found in state E and fewer than expected in state C. In Study IV adolescents, two years after diagnosis, reported problems with physical impairment, intrusive thoughts, feelings of alienation, and problems catching up with school. However, a majority of the participants also reported positive consequences with regard to the cancer disease: a more positive view of life, good self-esteem, knowledge and experience with regard to disease and hospital care, good relations, broader perspectives, and material gains. Study V, a review of the literature, indicates that survivors of childhood/adolescent cancer do not differ from comparison groups with regard to relations to others and relation to self. However, some findings highlight that friendship and marital status are areas of concern, and parenthood and sexuality are areas of potential concern. In conclusion, mode of administration influences adolescents’ and young adults’ self-reported psychosocial function and is related to age. Psychosocial function increases with time from diagnosis for most adolescents diagnosed with cancer. However, some individuals remain in poor psychosocial states during the first eighteen months after diagnosis. Increased efforts should be taken to identify these individuals.
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Waller, Josephine. "The viral aetiology of cervical cancer : psychosocial issues." Thesis, University College London (University of London), 2005. http://discovery.ucl.ac.uk/1446882/.
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This work stems from the discovery that certain sexually transmitted types of human papillomavirus (HPV) are the main causal agents in cervical carcinogenesis. The thesis sets out to explore the psychosocial issues that arise from linking a sexually transmitted infection with cervical cancer. Four studies were carried out. Study 1 was a survey of women attending a well-woman clinic (n=1032) and assessed awareness and knowledge about HPV. Study 2 used a population representative sample of men and women (n=1937) to assess beliefs about the risk factors for cervical cancer. Study 3 used in-depth interviews to explore the beliefs and experiences of 74 women who had taken part in HPV testing. Study 4 was a continuation of Study 3, in which 30 women were interviewed following participation in their second HPV test, a year after the first. Awareness of HPV and its link with cervical cancer was found to be low. Although there was higher awareness of sexual activity as a risk factor for cervical cancer, this was far from universal. Women testing positive for HPV who understood that it was sexually transmitted frequently reported negative emotional and social responses, different from those that have been found among women with abnormal smear test results. Leventhal's Common Sense Model of self-regulation in health and illness provided a useful framework within which to conceptualise the relationship between women's cognitive representations of HPV and their responses to the infection. It seemed that women were also engaged in the self-regulation of their relationships and were motivated to develop representations of HPV that did not impugn their current partners. Diagnosis with persistent HPV infection was associated with higher levels of anxiety about health and with the desire for immediate further investigation by colposcopy, rather than continued surveillance. The introduction of HPV testing and vaccination should be accompanied by widespread public education. If information provision is not handled in a sensitive way, it could cause confusion and stigmatise cervical cancer. More research is needed to develop ways to communicate information about HPV effectively.
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Naik, Sarita. "Addressing the educational and psychosocial issues in type 1 diabetes." Thesis, University of Southampton, 2010. https://eprints.soton.ac.uk/372998/.
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People with type 1 diabetes require good self-management skills in order to achieve good levels of diabetes control. Self-management skills can be onerous and can cause significant disruption to people's lives. Improving knowledge through structured education programmes can help to improve self-management skills. However psychosocial barriers can prevent some patients developing the necessary skills. The aim of this work was to use qualitative and quantitative analysis to identify some of these barriers so that more appropriate diabetes services can be developed. Focus groups were held to assess patients' views on clinic visits. The results suggested that the time at diagnosis was the most difficult and required better support and so the 'Living with Diabetes' programme was developed to improve support for individuals with newly-diagnosed type 1 diabetes. The programme resulted in significant improvements in glycaemic control and qualitative analysis suggested that patients felt in control of their diabetes and had developed good problem-solving abilities. Analysis of the Bournemouth Intensive Education programme demonstrated that this programme can help individuals to improve their HbA1c by 0.5% and maintain this improvement over four years. Further work with individuals who did not improve their glycaemic control with intensive education suggested that 'readiness to change' was an important factor which needs more assessment. Finally a brief motivational interviewing programme was designed for these individuals. Glycaemic control did not improve after the programme but qualitative analysis suggested some of these patients lacked confidence and had poor coping skills which may have stemmed from poor care at diagnosis. The 'Living with Diabetes' programme may help to prevent some of these difficulties and further analysis of this programme is needed to assess the long term benefits.
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Dale, Hannah. "Men with cancer : psychosocial issues, health behaviours, coping and help seeking." Thesis, University of St Andrews, 2016. http://hdl.handle.net/10023/8983.
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Background: A range of factors contribute to men with cancer having worse mortality and morbidity rates than women. The research specifically focused on psychosocial issues and health behaviours in men with cancer, and factors affecting help seeking behaviour. Methods: A mixed-methods study recruited adult men with cancer in the East of Scotland. The quantitative cross-sectional study explored psychosocial issues, health behaviours, and desire for support. Data from the Scottish Longitudinal Study were accessed to check sample representativeness. The qualitative study built on the preliminary findings of the quantitative study and used semi-structured interviews to explore factors affecting men's access to support. Inductive thematic analysis was undertaken. Results: 127 men with cancer completed the questionnaire. Being separated or divorced, younger and living in a high deprivation area was associated with poor psychosocial outcomes and some lifestyle behaviours. Social support was also influential. Twenty participants were interviewed. Appraisal of, and coping with, cancer in addition to biopsychosocial antecedents, the role of masculinity, and service contexts impacted on help seeking. The findings support a modified model of the transactional model of stress and coping relevant to men with cancer, which is new and original since it specifically incorporates the role of masculinity, highlights feedback from coping to appraisal, and recognises important service context factors that impact men's service access choices. Discussion: Legitimisation of help seeking and the use of emotion-focused coping styles were needed by some men, particularly where ideas about masculinity played a strong role in men's appraisal of, and coping with cancer. Implications for practice and policy relate to the survivorship agenda given the ongoing support men with cancer may need. Related to this, there is a need to carefully tailor and advertise services to men, and for health professionals to help legitimise the use of certain coping strategies and services.
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Kiyiapi, Lucy Irene, and res cand@acu edu au. "The Psychosocial Issues of Orphaned Youth by HIV/AIDS in Western Kenya." Australian Catholic University. School of Psychology, 2007. http://dlibrary.acu.edu.au/digitaltheses/public/adt-acuvp184.28112008.
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Despite the elaborate intervention strategies and huge emphasis on AIDS and orphan hood, there is a looming danger that might create a lost generation of young people who are growing up without role models, parental guidance, warmth, love and proper care. Young people in these times of AIDS are charged with the responsibility of caring for their infected parents until they die; and thereafter to care for their siblings. Despite playing these important roles coupled with their complex developmental issues young people face as they negotiate their independence towards adulthood, there is generally a lack of concern as far as the psychosocial issues experienced by youth who are orphaned due to AIDS is concerned as evidence by paucity of published literature. This research therefore, focused on the psychosocial issues of youth orphaned by HIV/AIDS in Western Kenya. This comparative study compared youth who have lost their parent(s) to AIDS, to those who have lost parent(s) through other causes and youth from intact families. The study explored the daily hassles and uplifts as experienced by these three categories. Their psychological well-being was studied in a bid to understand how this phenomenon has impacted on the orphaned young people emotional well-being. The extend to which self-efficacy (resilience), perceived social support and good coping strategies buffer young people from HIV/AIDS impact were studied. Data was obtained from 156 students at the Moi University. One way ANOVA test used to test the mean hassles and mean uplifts scores revealed there were not significantly different across the participants’ status. Investigations to determine whether the mean scores for anxiety, self esteem, and depression depend on participants’ status; a further one way ANOVA was carried out, which revealed based on overall F-test the mean self esteem and depression scores are significantly different at 5% level of significant. A pair- wise Pearson correlation was performed to investigate whether anxiety, depression and self esteem scores depend on the coping skills, self-efficacy and perceived social support. Results indicate depression significantly associated with social support, while self esteem is significantly associated with self-efficacy. The qualitative data further validated these findings by revealing that orphaned youth by AIDS were depressed and had poor self-esteem.
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Kiyiapi, Lucy Irene. "The psychosocial issues of orphaned youth by HIV/AIDS in Western Kenya." Phd thesis, Australian Catholic University, 2007. https://acuresearchbank.acu.edu.au/download/a0fd598eb07077c6ddf0e93b2ea4921879979438f2f1d56e7fd890c18101d29e/1031538/64951_downloaded_stream_176.pdf.
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Despite the elaborate intervention strategies and huge emphasis on AIDS and orphan hood, there is a looming danger that might create a lost generation of young people who are growing up without role models, parental guidance, warmth, love and proper care. Young people in these times of AIDS are charged with the responsibility of caring for their infected parents until they die; and thereafter to care for their siblings. Despite playing these important roles coupled with their complex developmental issues young people face as they negotiate their independence towards adulthood, there is generally a lack of concern as far as the psychosocial issues experienced by youth who are orphaned due to AIDS is concerned as evidence by paucity of published literature. This research therefore, focused on the psychosocial issues of youth orphaned by HIV/AIDS in Western Kenya. This comparative study compared youth who have lost their parent(s) to AIDS, to those who have lost parent(s) through other causes and youth from intact families. The study explored the daily hassles and uplifts as experienced by these three categories. Their psychological well-being was studied in a bid to understand how this phenomenon has impacted on the orphaned young people emotional well-being. The extend to which self-efficacy (resilience), perceived social support and good coping strategies buffer young people from HIV/AIDS impact were studied. Data was obtained from 156 students at the Moi University. One way ANOVA test used to test the mean hassles and mean uplifts scores revealed there were not significantly different across the participants' status. Investigations to determine whether the mean scores for anxiety, self esteem, and depression depend on participants' status; a further one way ANOVA was carried out, which revealed based on overall F-test the mean self esteem and depression scores are significantly different at 5% level of significant.;A pair- wise Pearson correlation was performed to investigate whether anxiety, depression and self esteem scores depend on the coping skills, self-efficacy and perceived social support. Results indicate depression significantly associated with social support, while self esteem is significantly associated with self-efficacy. The qualitative data further validated these findings by revealing that orphaned youth by AIDS were depressed and had poor self-esteem.
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Greenwell, Audry, Judy G. McCook, Stacey Williams, Sheeba Anand, and Beth Bailey. "Polycystic Ovary Syndrome: Morbidity Issues and the Psychosocial Impact on Infertile Women." Digital Commons @ East Tennessee State University, 2011. https://dc.etsu.edu/etsu-works/7186.
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Objective: Polycystic ovary syndrome (PCOS) is a multidimensional endocrine disorder and the leading female infertility. PCOS is characterized as a clustering of clinical concerns, which include hyperandrogenism, obesity, and menstrual abnormalities/infertility. These characteristics were examined with regard to their impact on women's psychosocial concerns and health related quality of life. Design: Cross-sectional, correlational Setting: Private endocrinology practice in the rural Southeastern U.S. Participants: The study sample consisted of 126 women with PCOS. Methods: Convenience sampling yielded 126 subjects who met the diagnosis for PCOS, underwent laboratory testing and physical assessment, completed psychological and quality of life survey instruments and were included in data analysis. Results: Results of multiple regression analyses, controlling for demographic covariates, were completed on markers of hyperandrogenism, obesity and current fertility intent. Findings revealed hirsutism was significantly related to increased symptoms of anxiety and somatization and decreased quality of life among women with PCOS, while elevated androgen levels were significantly related to decreased quality of life. Current fertility intent significantly impacted symptoms related to interpersonal sensitivity, anxiety, psychoticism, and the global symptom severity index. Specifically, women not currently trying to conceive had higher levels of these psychological symptom outcomes. Conclusion/Implications for nursing practice: Women with PCOS are at elevated risk for psychological distress, and psychological symptoms appear to increase with increasing severity of PCOS symptoms. Women not currently trying to conceive appear to be at higher risk for psychological distress and lower quality of life.
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Disbrow, Debra Kay. "Barriers Cardiac Nurses Face in Addressing Psychosocial Issues of Heart Failure Patients." ScholarWorks, 2017. https://scholarworks.waldenu.edu/dissertations/3670.
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Heart failure is a chronic disease and a common cause of hospitalizations and readmissions within 30-days of discharge. To decrease the cost of care for patients with heart failure, the Centers for Medicare and Medicaid Services initiated the Readmissions Reduction Program that reduces payment to hospitals with preventable readmissions. Among the causes for readmissions of patients with heart failure are concurrent behavioral health issues that can lead to decreased medication compliance and increased risk for disease progression. The prevalence of comorbid depression is as high as 77% among patients with heart failure and may be an important factor in readmissions. Although cardiac nurses in the emergency room, intensive care unit, and the progressive care units at a community hospital were perceived by managers to be in optimal settings to assess for behavioral health issues and make referrals as appropriate, assessments were not being conducted. The purpose of the project was to determine the barriers nurses faced in completing the assessments. Four audiotaped focus groups with a total of 18 cardiac nurses were held and the data were transcribed for analysis. Using Kalcaba's comfort contexts (physical, psychospiritual, social, and environmental), the barriers identified by the nurses were categorized into a fishbone diagram and a Pareto chart. The nurses identified lack of a standardized screening tool, lack of priority given to behavioral health assessments, lack of time to conduct the assessments, and lack of a clear facility policy related to the assessments as barriers. A positive social change resulting from the project is an initiative to address the barriers and ensure that patients with heart failure are cared for in a holistic manner that addresses physical and behavioral health issues.
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Lloyd, Susannah. "Understanding the experience of prophylactic bilateral mastectomy : a grounded theory study." Thesis, University of East Anglia, 1999. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.302194.
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Alsaad, Khaled Saeed M. "Psychosocial and mental health challenges of international students compared to British students in UK universities." Thesis, University of Bedfordshire, 2017. http://hdl.handle.net/10547/622526.
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According to Harman (2004), international students were one of the main sources of finance in the UK, US, Australia, Canada and New Zealand. These students may face many difficulties once they arrive in countries like the UK, trying to adjust to their new surroundings. They confront, for example, more difficulties and challenges than the British students beginning a university course, especially if English is not their first language and the culture of their motherland is substantially different from British culture. Apart from language and cultural barriers, other reported difficulties include high academic demand, missing family and friends, lack of social support, lower self-confidence, deficiencies with study skills and a need to have more assertiveness (Poyrazli et al., 2002). Currently, not enough research has been published regarding acculturative stress and social support, including its relationship with psychological mental health amongst international students studying at UK universities. The main purposes of this study were threefold: (1) investigate the association between mental health and psychosocial variables amongst both international and British students (in UK universities); (2) explore the perceptions, thoughts, and feelings of international students in the context of acculturation, while they study abroad in the UK universities; and finally (3) to triangulate and integrate the findings of this study obtained from two distinct approaches of combined results. A concurrent triangulation mixed methods design was employed, consisting of three main studies. (a) I (Pilot study): a quantitative study employing simple yet effective cross-sectional approaches through its intention to using sample data; (b) II (Main study): a quantitative method specifically utilising cross-sectional design using authoritative data; and (c) III: a qualitative research conducting semi-structured interviews (using two qualitative questionnaires) to examine the metaphors participants used to describe their experiences in the host society. Study I: A snowball purposive sampling technique was used to select 358 students (international and British) studying in UK universities. Three different UK universities were selected. Eight pre-existing questionnaires were first tested for validity and reliability, then were utilised to examine the relationships between mental health and seven other independent variables. Study II: A snowball purposive sampling technique was used to select 796 students (international and British) studying in UK universities. Ten different UK universities were selected. The previous eight pre-existing questionnaires used in Study I were used in Study II, but the difference was that GHQ-12 was replaced by GHQ-28, and the IAI and SAI forms of the Three Assimilation Indexes were excluded. Study III: A snowball purposive sampling technique was used to select 30 students (international) studying in three UK universities. A semi-structured interview was conducted with these students. This study used thematic analysis to categorise metaphors and analyse the qualitative data. With a response rate of 82%, Study I showed that international students from the Middle East are less affected by cultural distress than other students from outside of Europe. In addition, many students find themselves leaning more towards religion to deal with the new cultural environment. Study II had an 80% response rate and found that there was an association between three out of five predictor variables (coping flexibility, social support and coping) with mental health, for both international and British students. In addition, the study found that there was an association between three out of seven predictor variables (coping strategy, religious problem solving, and acculturation) with mental health in international students. In Study III, the metaphors supported the quantitative results in terms of finding that a substantial number of the respondents had negative feelings about living in the UK and found the new setting depressing. The findings of the two quantitative studies (Study I and Study II) found that there is an association between international students and British students and coping flexibility with mental health. This finding has been confirmed by Study III which addressed metaphorical phrases used by international students. These findings indicate that interventions are strongly required in order to prevent and control potential psychological problems in both groups. The main recommendations are that regular training sessions should be provided for all international students, giving strategies for coping with the new culture. It is concluded that social support played a moderating role in the relationship between culture stress as well as mental health only in international students. These findings imply that strategies could be created to help students to cope with their mental issues and reduce the impact of distress they experience during their study. This might have a positive effect on their academic achievement consequently.
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Christopher, Annabel. "What are the psychosocial consequences of body image issues in adolescent males with cancer?" Thesis, University of Surrey, 2014. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.658859.
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Adolescence is a period of development where body image, as part of a wider development of sense of self, is seen as a key task. Body changes due to cancer can be distressing and disrupt healthy body image development. Body image problems can be problematic and lead to eating disorders, low self-esteem and problems with peer relationships. Very little research has focused on whether there are particular body image issues for adolescent males with cancer. Seven males aged 14-21 who had experienced cancer were interviewed about their body image and the transclipts were analysed using Interpretative Phenomenological Analysis (IPA), which is an inductive, exploratory and idiographiG. approach to enable a rich understanding of the paIiicipants' experiences. Four super-ordinate themes emerged which were "developing identity within a maturing male body with cancer", "social role of the body in identity development", "adolescent males do not readily talk about the body", and "trying to feel normal in the context of cancer". Clinical implications of the results are considered, along with areas for future research following on from this initial exploratory study.
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Roy-Matton, Naomé. "Profil psychosocial et issues de grossesse des femmes enceintes de l'Estrie une étude pilote prospective." Mémoire, Université de Sherbrooke, 2008. http://savoirs.usherbrooke.ca/handle/11143/3951.
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Objectif : Établir le profil psychosocial des femmes enceintes de l'Estrie et évaluer de façon préliminaire si ce profil diffère parmi les grossesses avec issues défavorables. Méthode. Cohorte prospective de 120 femmes enceintes, rencontrées à deux reprises (10-20 et 25-30 semaines), entre août 2004 et mars 2006. Il s'agit d'un questionnaire auto-administré des données démographiques, anthropométriques, des facteurs de risques biomédicaux, ainsi qu'un profil psychosocial comportant 6 dimensions: stress psychologique perçu, ennuis quotidiens, détresse psychologique, locus de contrôle, soutien social, traumatismes dans l'enfance. Les paramètres psychosociaux sont présentés en moyennes ou pourcentages. Le profil psychosocial est comparé entre les grossesses normales et anormales avec les tests t de Student ou le test de Mann Whitney, lorsque approprié. Résultats. Trente trois grossesses (27,5%) ont présenté des issues défavorables (prématurité, restriction de croissance intra-utérine, hypertension gestationnelle, diabète gestationnel). L'analyse du profil psychosocial révèle un score de stress psychologique perçu plus élevé entre 10-20 semaines chez les femmes avec issues défavorables de grossesse (score : 34,2 « 12,3 ; P < 0,01) et chez les femmes avec prématurité (score : 36,1 « 11,2 ; P < 0,02) comparativement à celui des femmes avec grossesses normales (score : 28,6 « 9,6). Par ailleurs, les 5 autres dimensions ne semblaient pas différentes selon les issues de grossesse. Conclusion. Ces résultats préliminaires suggèrent une piste possible reliant la perception de stress maternel durant la grossesse et certaines issues défavorables de grossesse, dont l'accouchement prématuré.
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Ravert, Russell D. (Russell Douglas). "Hospitalized School-Age Children: Psychosocial Issues and Use of a Live, Closed-Circuit Television Program." Thesis, University of North Texas, 1993. https://digital.library.unt.edu/ark:/67531/metadc500433/.
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This descriptive study utilized semi-structured interviews and observations to examine the experiences of hospitalized school-age children, and explore the potential of a live, closed-circuit television program as a psychosocial intervention. Among findings, Phase I data from 16 subjects indicates a) concern with painful medical procedures, particularly intraveneous (IV) injections, b) a desire for more information, especially concerning medical equipment, c) a variety of responses to social issues among subjects, d) the importance of activities, and e) the central role of the hospital playroom. Phase II data indicates that live, closed-circuit television can provide ambulatory and room-bound children opportunities for making choices, social interaction, participation, and information on their environment. Conclusions and implications are included.
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Quintana, Melissa. "Addressing health and psychosocial issues in youth at risk for dating violence| A grant proposal project." Thesis, California State University, Long Beach, 2015. http://pqdtopen.proquest.com/#viewpdf?dispub=1605191.
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The purpose of this grant proposal project was to develop and identify funding for the implementation of a school-based teen dating violence prevention program for adolescents in the southeast Los Angeles, California area. Peace Over Violence was the host agency for this program and is located in Los Angeles, California. Through the review of the literature on the history, prevalence, risk factors, and the existing interventions for adolescents, the grant writer proposed and designed a school-based teen dating violence prevention program. Additionally, the grant writer explored potential public and private funding sources, which resulted in the selection of the California Endowment Foundation as the funding source due to having the most compatible goals and objectives of this program. The actual submission and/or funding of this grant were not required for the successful completion of this academic project.
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Joseph, Debra. "Psychosocial issues and support for children who acquired HIV/AIDS from their mothers in Trinidad and Tobago." Thesis, University of Huddersfield, 2013. http://eprints.hud.ac.uk/id/eprint/18056/.
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The HIV/AIDS prevalence rate in the Caribbean is second only to Sub-Saharan Africa and higher than the global rate. HIV/AIDS presents a real threat to children as they account for one in six global AIDS-related deaths and one in seven new global HIV infections. Furthermore, the number of new cases of children in the region is growing. Despite the impact of HIV/AIDS on Caribbean children, few research studies have been undertaken on the psychosocial issues that affect them and studies that include children’s perspectives seem to be even more lacking. This thesis is based on original research carried out in the Republic of Trinidad and Tobago. This study has examined the psychosocial issues that exist for children living with HIV in Trinidad and Tobago and has explored, from the perspectives of both children and their mothers, the types of supports that are available or accessed. The aims of the research were to 1) examine the psychosocial issues that affect children with acquired HIV/AIDS in Trinidad (the children in this research acquired HIV from their mothers) and 2) to explore the support that exists and gaps that may be necessary for their improved quality of life. It is hoped that intervention strategies will be gleaned from this research to assist future interdisciplinary teams that interact with this population. The methodology was based on a grounded theory approach (Strauss & Corbin 1990), and consisted of theoretical sampling and constant comparison throughout data analysis (open, axial, and selective coding) using a case triad (triad refers here to perspectives of three different actors). Four cases were purposively selected, each ‘case’ comprising a mother who was HIV positive, an “HIV Friend” (primary support figure, 4 in total) identified by the mother, and a child living with HIV (there were two children in one family, making five children in total, aged between five and thirteen years) – each of whom was interviewed. In addition, three mothers who did not tell their children of their status were also interviewed. These additional interviews were the result of theoretical sampling to explore two themes that emerged as significant in the first stage of analysis: 1) How “secrecy” was manifested in the lives of families coping with HIV and 2) The role of mothering. In total sixteen persons were interviewed. The findings produced three core categories, namely 1) the cyclical and complex nature of secrecy as a strategy to protect children from stigma and discrimination, 2) the impact on children of living with HIV-AIDS, including their role as protectors of HIV-positive mothers and 3) Mothering with HIV-AIDS. The study showed that these families, though impacted by uncertainty about the future, fear of dying and societal rejection, and for the large part financially and materially disadvantaged, were in-tact and functioned well. Furthermore these families had created a ‘new normal’ in which the secrecy about HIV was central and around which a range of behaviours, social codes and perceived consequences for breaches (of the secret) shaped relationships in both explicit and implicit ways. This indicates a high level of resourcefulness and resilience on the part of the women and their children. However the pressure to maintain the secret created additional challenges for women and children already impacted by a high level of stress because of HIV. Additionally, the rules of secrecy meant that women were unable to talk about their circumstances or needs and consequently had very little support either for themselves or their children. From the child’s point of view, the secret required them to be conscious of what they said and to whom and although not able to talk about HIV, paradoxically the secret had the effect of making HIV more dominant in their lives. This was despite the fact that children themselves did not seem to regard HIV as central in their everyday worlds. Mothering was also a significant theme to emerge from the study and it appeared that such was the importance of the role of mother, as a primary signifier of Caribbean womanhood, that the decision to have children was more important than the risk of passing on HIV. Two of the mothers had gone on to have more children even though their first child had been born with the virus. The study showed that being a good mother in a family affected by HIV means being able to protect children from the implications of the virus being known about outside the family and thus mothering was intertwined with the creation and maintenance of the secret. New understandings about the effects of HIV/AIDS on children and several recommendations aimed at improving services and resources for these children and their families have emerged from the study. Implementation of these recommendations would auger well for improved quality of life in the future, as children continue to live with the chronic illness of HIV/AIDS. The sample was small (16 participants in all) and as a qualitative study, no claims are made about with respect to any generalisations of the findings.
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Daniels, Derek Eugene. "Recounting the School Experiences of Adults Who Stutter: A Qualitative Analysis." Bowling Green, Ohio : Bowling Green State University, 2007. http://rave.ohiolink.edu/etdc/view?acc%5Fnum=bgsu1182716198.
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Bradshaw, Rachael J. "Training and Attitudes of Recent Graduates Regarding the Provision of Culturally Competent Genetic Counseling Services to Latinos." University of Cincinnati / OhioLINK, 2004. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1089997093.
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Wintour, Alisha M. "Evaluation of an information pamphlet for human papillomavirus positive oropharyngeal cancer patients." Thesis, Queensland University of Technology, 2022. https://eprints.qut.edu.au/228752/14/Alisha_Wintour_Thesis.pdf.
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This study evaluated the effectiveness of an information pamphlet designed to address common information gaps that exist for human papillomavirus positive oropharyngeal cancer patients. The study has highlighted the complex psychosocial impacts of a human papillomavirus positive oropharyngeal cancer diagnosis and has provided insight into how an informational intervention could assist patients to manage these impacts. The results contribute to the growing evidence regarding the psychosocial and information needs of human papillomavirus positive oropharyngeal cancer patients.
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Nasseh, Lotf Abadi Mozhdeh. "Social support, coping, and self-esteem in relation to psychosocial factors : A study of health issues and birth weight in young mothers in Tehran, Iran." Doctoral thesis, Umeå universitet, Institutionen för socialt arbete, 2012. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-61402.
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Introduction: Generally, pregnancy is considered to be a positive period in life in Iranian culture. For the parents, it is important to have a healthy pregnancy and, as a result, a healthy child. A sufficient birth weight of the infant represents one of the crucial conditions of a healthy development of a child during infancy as well as later in life. Ongoing research has been carried out regarding various medical factors related to birth weight, but there is a gap in knowledge about psychosocial factors such as social support, coping, self-esteem, stress and mother’s mental health, and various socio-demographic factors including domestic violence, which may lead to adverse pregnancy outcomes such as low birth weight. This thesis aims to provide knowledge to fill this gap. Methods: A cross-sectional survey was conducted in Tehran, Iran, including 600 young mothers who had delivered in Akbarabadi hospital, one of the main gynaecological hospitals affiliated with Tehran University of Medical Sciences. The investigation included a self-developed socio-demographic form, the Social Support Questionnaire, the Ways of Coping Checklist, Rosenberg’s Self-Esteem Scale, the General Health Questionnaire-12, and a Life Event Checklist. Results: We could not find a significant association between birth weight and mother’s level of education, and there was no substantial relationship between general mental health and birth weight. Verbal abuse was reported by 26.0% of the young mothers, 4.8% reported physical abuse, 5.5% reported sexual abuse, and 1.3% reported all three types of abuse. The abuse-index was significantly negatively associated with satisfaction with social support and with self-esteem. The higher the abuse-index, by trend, the lower was the infants’ birth weight. Weight before pregnancy, current weight, weight gain during pregnancy, and the number of prenatal care visits were significantly positively associated with the weight of the newborn. Mothers who reported having a history of a low birth-weight (LBW) child or were physically abused during pregnancy had infants with significant lower birth weight. The more the pregnant women were satisfied with their social support and the more often they used positive reappraisal as a way of coping, the higher was their infants’ birth weight. The higher the self-esteem, the less often they used escape avoidance and confrontive coping. Conclusion: The results suggest the importance of relationships between a healthy pregnancy and psychosocial as well as socio-demographic factors. Providing pregnant women with social support is a key component for a healthy pregnancy, especially when faced with stressful situations. The number of people available for support did not provide a significant buffering effect on domestic violence (DV), but the perceived quality of social support did. Higher education in the mother and husband, and women’s employment represented protective conditions against the occurrence of DV. Women who reported physical abuse during pregnancy had infants with lower birth weight. Satisfaction with social support and use of positive reappraisal were significantly associated with higher birth weight.
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Kaytaz, Esra Stephanie. "The resigned, the restless and the resilient : risk perceptions among Afghan migrants in Turkey." Thesis, University of Oxford, 2015. http://ora.ox.ac.uk/objects/uuid:82055b1f-a6df-4e32-9182-bf4c600df12e.
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This thesis seeks to account for diversity in the migratory decisions of Afghan migrants who have recently arrived in Turkey. It proposes that social theories on risk provide a framework that rectifies a theoretical gap in the migration literature with respect to intra-group heterogeneity in the decision-making processes of migrants. The thesis adopts Rosa’s (1998: 28) definition of risk as: ‘a situation or event where something of human value (including humans themselves) has been put at stake and where the outcome is uncertain.' I argue that variation in what migrants view as being ‘at stake’ and in how they evaluate the associated uncertainties— in other words, how migrants perceive risk— accounts for the diversity in the migration decisions of similarly situated migrants. Risk is therefore an analytical tool for understanding decision-making in its subjective and socio-cultural context. The thesis offers a typology as an analytical device for categorising the ways in which informants managed the risks associated with migration decisions. I identify three modes of managing risk, defined as resigned, restless and resilient, on the basis of migrants’ engagements with their social environment, their efforts at advocating for themselves and others, and their ability to gather and disseminate information. The thesis also explores subsidiary themes concerning migrants’ legal consciousness with regard to irregular immigration status, and the process of embodying the physical and emotional consequences of migration. Most of the ethnographic fieldwork for this project was conducted in the cities of Istanbul, Van, Kayseri and Sivas from February 2011 until December 2012.
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Talavera, Paredes Christiam Shema. "Pratiques psychoéducatives de la résilience à partir des ressources psychosociales et du climat social scolaire chez les enfants à risque issus de milieux défavorisés." Thesis, Aix-Marseille, 2015. http://www.theses.fr/2015AIXM3051/document.
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Les recherches actuelles sur la résilience s’intéressent à l’intervention psychoéducative sur les facteurs de risque, en vue de passer d’une résilience naturelle à une résilience assistée : nous considérons la promotion des pratiques de résilience comme un facteur de développement des capacités psychologiques des enfants. Dans ce sens, le milieu scolaire peut constituer un espace d’interactions sociales et avec le soutien de la famille favoriser l’émergence de ressources socio-affectives, cognitives et conatives. Comment les pratiques scolaires peuvent-elles promouvoir la résilience ? Pour répondre à cette question, nous avons travaillé auprès d’un échantillon de 119 enfants à haut risque fréquentant des écoles défavorisées du Pérou. Notre approche méthodologique a pris en compte la perception qu’ont les enseignants et les élèves du climat social scolaire, en particulier des relations entre élèves, des relations entre enseignants, des relations entre élèves et enseignants, de l’organisation, de l’établissement des règles, et du développement d’activités périscolaires. En outre, nous avons identifié les besoins psychosociaux des élèves sur la base de leurs déclarations. Ces analyses nous ont apporté des éléments de réponse qui nous servent à proposer des pratiques psychoéducatives de résilience.Les pratiques psychoéducatives sont réparties en quatre catégories : la salle de classe et l’école, l’école et la famille, les parents et l’enfant, et les besoins psychosociaux de l’enfant/élèveThe research on resilience has focused mainly on psycho educational intervention on risk factors in children. Studying not only "natural resilience" but how "assisted resilience" helps children deal with trauma. This change of strategy suggests that promoting practices of resilience may be a means of developing psychological skills of resilience into children. To that respect, the schools’ social environment, with the help of the family, can be used as a place of interaction that promotes the emergence of social, emotional, cognitive and volitional skills whitin the students. The key question of this study is how schools can include practices that enhance the development of resilience skills into children? To answer this question, we used a sample of 119 high-risk children attending disadvantaged Peruvian schools. Our methodology takes into account the teachers’ and students’ perceptions of the school’s social climate, in particular the relationship among students, among teachers, and between students and teachers, the school’s organization, the establishment of rules, and the development of extracurricular activities. The study also includes the students’ thoughts about their psychosocial needs. The analysis of these elements provides a basis to suggest psychoeducational practices to promote resilience. These psychoeducational practices come into four categories: practices related to the classroom and the school, to the school and the family, to the parents and their children, and to the psychosocial needs of the child/student
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Shibley, Kathleen Phillips. "The revisitation of the psychosocial issue of trust/mistrust in new mothers." The Ohio State University, 2000. http://rave.ohiolink.edu/etdc/view?acc_num=osu1227542027.
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Shibley, Kathleen Phillips. "The revisitation of the psychosocial issue of trust/mistrust in new mothers /." Connect to resource, 1999. http://rave.ohiolink.edu/etdc/view?acc%5Fnum=osu1227542027.
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LaMontagne, Tamara Marie. "Psychosocial Differences in Far Right, Far Left, Islamic, and Single Issue Lone Extremists." ScholarWorks, 2019. https://scholarworks.waldenu.edu/dissertations/6451.
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Acts of lone extremism are on the rise, yet little is known about who commits these acts. Research in this area has failed to delineate by extremist subtype. This has led to the misconception these acts and actors present with such variance psychosocially that they cannot be predicted. The purpose of this research was to assess whether statistically significant relationships exist between lone extremist subtypes on the psychosocial variables of mental illness, substance use, and having radicalized friends or family members. The conceptual framework for this study was De La Corte's psychosocial principles of terrorism, which addressed the social and political influences of terrorism with the complex psychosocial constructs that may exist. The Profiles of Individual Radicalization in the United States was chosen as the dataset and includes de-identified individual-level information on 1,865 extremists. The research questions that guided this study sought to determine if significant differences exist between 4 lone extremist subtypes across 4 psychosocial variables. Crosstabulation analysis and multiple chi-square tests for independence were used to test the relationship between categorical variables. Statistically significant relationships were found among each lone extremist subtype and having radicalized family members and friends (p=.00). In terms of mental illness, far left extremists were the only extremist subtype that yielded a significant relationship (p=.00). Also, a significant relationship was found between substance use and far right (p=.00), far left (p=.01), and single issue (p=.04) extremists. In terms of social change, this research presented support for studying lone extremism by subtype and also provided a foundation towards constructing a predictive model.
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Richards, Justin A. "Evaluating the impact of a sport-for-development intervention on the physical and mental health of young adolescents in Gulu, Uganda - a post-conflict setting within a low-income country." Thesis, University of Oxford, 2011. http://ora.ox.ac.uk/objects/uuid:9632dcfc-94e6-45ac-a4c1-ad63113f9b59.
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Introduction: Physical inactivity is thought to contribute to the emergence of non-communicable diseases in post-conflict settings of low-income countries. Sport-for-development (SfD) organisations in these regions claim to improve the health of programme participants. However, there is a paucity of supporting evidence. I assessed the impact of a voluntary community-based SfD intervention on the physical activity (PA), physical fitness (PF) and mental health (MH) of adolescents in Gulu, Uganda. Methods: The Acholi Psychosocial Assessment Instrument (APAI), standing broad jump (SBJ), multi-stage fitness test (MSFT) and BMI-for-age (BFA) were adapted to the local context. I tested their feasibility and reliability with a repeat-measures design (n=70). A cross-sectional analysis of a random sample was used to assess the local needs and establish the PF and MH of the adolescents reached by the intervention (n=1464). This was also the baseline assessment for the impact evaluation. It comprised a randomised control trial (n=144) nested within a cohort study (n=1400) and triangulated by cross-sectional assessment of PA using accelerometry (n=54). Results: The adapted PF and MH measures demonstrated good intra-tester reliability (ICC>0.75). Adolescents in Gulu predominantly had “healthy” BFA (>90%). They performed better than global norms for the SBJ (p<0.001), but worse for the MSFT (p<0.05). The girls who registered for the intervention had higher PF at baseline (p<0.05) and experienced no significant benefits when compared to the community. The aerobic capacity of the boys intervention group increased relative to the community (p<0.01), but was not significantly different to the trial control group whose PF also improved. The PA results concurred with this finding. Boys in the intervention group experienced a deterioration in MH relative to their peers (p<0.05). Implications: It is feasible to apply rigorous evaluation methods to SfD interventions. Although adolescents in Gulu have poor aerobic capacity, a voluntary programme may not reach those at risk. Interpreting the impact evaluation was limited by a lack of programme development theory, but suggested that opportunities for non-competitive play may confer PF benefit without harming MH. Further investigation is warranted.
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Ott, Eleanor Marie. "Refugee economic self-sufficiency in the US Resettlement Program." Thesis, University of Oxford, 2015. http://ora.ox.ac.uk/objects/uuid:62e44531-31c7-404c-96c1-f4bb89c0bd4e.
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Globally, twenty-seven countries have resettlement programs associated with UNHCR - representing commitments to the international refugee framework and domestic commitments to those refugees resettled. Since 1975, the US has resettled over three million refugees, including over 75,000 Bhutanese refugees since 2008 - more than all other countries combined on both accounts. The US Office of Refugee Resettlement has the mandate to 'make available sufficient resources for employment training and placement in order to achieve economic self-sufficiency among refugees as quickly as possible' (The Refugee Act of 1980). Nevertheless, their economic self-sufficiency and the intertwined ideas of employment and wellbeing remain little examined. A global systematic review of available high-quality evidence examined whether interventions affect resettled refugees' economic self-sufficiency and wellbeing. Although 9,260 citations were reviewed from a wide variety of academic, policy, and grey literature, no studies met inclusion criteria. This Campbell-registered systematic review concludes that evidence is insufficient to determine if programs affect resettled refugees' economic self-sufficiency and wellbeing. Subsequently, qualitative research explored existing interventions to improve the economic self-sufficiency of resettled refugees, their theories of change, and perceptions of effectiveness in Pittsburgh, Pennsylvania. Program design follows a policy mandate and expects that initial employment leads to sustained self-sufficiency and wellbeing, albeit without measuring these outcomes or providing long-term assistance. The findings serve as a basis for future research and reveal programming implications for the Bhutanese refugee community in Pittsburgh and broadly for refugee resettlement. Next, a cross-sectional survey of 145 randomly selected Bhutanese refugees in Pittsburgh (a response rate of 92.9%) was conducted to provide groundbreaking demographics, rates of economic self-sufficiency, and correlates with improved outcomes. The population was overwhelmingly low-income with high usage of certain assistance such as food assistance. Both bivariate relationships and predictive models for employment, gross income, wages, assistance usage, and having 'enough' money to pay the bills were examined. Overall, these paint a complex picture, including the potential importance of neighborhoods, household size, and religious affiliation as well as a more typical picture of the importance of gender, education levels, and time in the country for certain measures of employment, earnings, and household self-sufficiency. The evidence-based perspective on the economic self-sufficiency of resettled refugees shows that little is known globally, including the potential for interventions to cause harm or success. Understanding the employment services and perspectives of economic self-sufficiency and wellbeing for the Bhutanese population provides a lens to view not only the challenges and successes of this population, but also national and international obligations. As one focus group participant stated, 'Government should understand the nature of the refugees arriving and put us with jobs that ... allow the life to sustain.'
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VACHER, COPONAT CLAIRE. "Interet et premiers resultats de l'inventaire de personnalite d'eysenck dans une enquete psychosociale chez les jeunes issus de la migration maghrebine." Aix-Marseille 2, 1993. http://www.theses.fr/1993AIX20121.
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Van, Laere Pauline. "Une approche psychosociale de la protection de l'environnement : perspective temporelle et distance psychologique." Thesis, Sorbonne Paris Cité, 2018. https://wo.app.u-paris.fr/cgi-bin/WebObjects/TheseWeb.woa/wa/show?t=1227&f=14239.
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Les problèmes environnementaux sont l'un des enjeux majeurs auxquels doivent faire face nos sociétés actuelles. Comprendre les déterminants des comportements de protection de l'environnement est donc important. Après avoir exposé les variables classiquement étudiées comme les variables de personnalité ou attitudinales, nous proposons deux axes de recherche adaptés à la spécificité de notre objet d'étude portant sur des risques souvent présentés comme distants. Dans le premier axe, nous soutiendrons que la capacité à se projeter dans le temps permet de lier le comportement avec ses conséquences futures pour l'environnement et devrait ainsi favoriser l'engagement pour la protection de l'environnement. Après avoir exposé le cadre conceptuel de la perspective temporelle, nous avons réalisé une revue de la littérature montrant qu'effectivement une orientation vers le futur est liée à davantage d'engagement en faveur de l'environnement. Nos études n'ont cependant pas retrouvé ce lien. Nous avons par contre montré une corrélation négative entre l'orientation vers le présent fataliste ou le passé négatif et les comportements pro-environnementaux. L'importance d'autres variables a été démontrée lors de ces expériences comme les préoccupations environnementales, le rapport à la nature et l'implication culturelle. Dans le deuxième axe, nous défendrons la posture inverse en soutenant que c'est en rapprochant la perception des risques environnementaux que l'on favorise les comportements pro-environnementaux. Après avoir présenté le cadre conceptuel de la distance psychologique et son lien avec les niveaux de construits, nous proposons deux études, l'une mesurant la distance perçue vis-à-vis des problèmes environnementaux et l'autre la manipulant. Ces études ont d'abord permis de caractériser la distance perçue vis-à-vis de différents problèmes environnementaux, ceux-ci étant perçus comme relativement proches sur toutes les dimensions à l'exception de la dimension sociale où ils sont à la fois proches et distants. Nous avons ensuite montré qu'une distance proche est associée à davantage de préoccupations environnementales, à une évaluation comme plus réels et plus graves des risques et enfin à davantage d'intentions comportementales d'agir en faveur de l'environnement. Nous conclurons ce travail en mettant nos résultats en perspective et en proposant des applications en terme de communication sur les problèmes environnementauxEnvironnemental issues are one of the most important problem we face today. Understand determinants of pro-environmental behaviours is crucial. After presenting classic variables as personality and attitudinal variables, we suggest two lines of research adapted to our object specificity for which risks are often distant. In the first line, we will argue that the ability of time projection links the behaviour with its future environmental consequences and should promote commitment to environmental protection. After presenting the theoretical framework of temporal perspective, we conduct a review of literature showing that future orientation is linked to more commitment to the environment. Our studies, however, have not found this link. We have shown a negative correlation between direction towards fatalistic present or negative past and pro-environmental behaviours. Importance of other variables has been demonstrated in these experiences such as environmental concerns, connexion to nature and cultural involvement. In the second line, we will defend the opposite position by arguing that it is by bringing perception of environmental risks closer that we promote pro-environmental behaviour. After exposing the theoretical framework of psychological distance and its relation to levels of constructs, we propose two studies, one measuring the perceived distance regarding environmental problems and the other manipulating it. These studies firstly allowed to characterise the perceived distance to different environmental issues, which are perceived relatively close on all dimensions except for social dimension where they are both close and distant. Then, we show that a close distance is associated with more environmental concerns, an assessment as more real and serious of risks and finally more behavioural intentions to act in favour of environment. We will conclude this work by putting our results in perspective and by suggesting applications in terms of communication on environmental problems
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Carlson-Oehlers, Victoria. "Psychosocial health issues identified by adolescent solid organ transplant patients." 1994. http://catalog.hathitrust.org/api/volumes/oclc/31383493.html.
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Thesis (M.S.)--University of Wisconsin-Madison, 1994.Typescript. eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references (leaves 100-109).
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Hayutin, Lisa G. "Screening for psychosocial issues in children effects on communication, motivation, and satisfaction /." 2006. http://purl.galileo.usg.edu/uga%5Fetd/hayutin%5Flisa%5Fg%5F200612%5Fphd.
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Organ, Kaylene Joy. "Differentiation of psychosocial issues between chronic illness groups : development of a scale." Thesis, 2002. https://vuir.vu.edu.au/15293/.
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The aim of this thesis was to develop a scale to measure
psychosocial status of people with chronic illness, resulting in an overall measure of attitude to life post diagnosis, to gauge a measure of physical mobility, and to determine differences and similarities in areas of concern
and need, across three diagnostic groups: diabetes, arthritis and stroke.
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De, Vos Cheryl Lisa. "Breast cancer in the Ashkenazi Jewish population of South Africa: some psychosocial issues." Thesis, 2014.
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Specific mutations in the breast cancer susceptibility genes 1 and 2 (BRCA1 and BRCA2) have been found to be the cause of breast cancer (BRCA) in about 20% of cases in the Jewish population. Affected women often experience a variety of emotional and social issues, which need to be addressed. The aim o f this study was to investigate some
o f the psychosocial issues associated with BRCA, the knowledge o f and feelings about it,
its treatment and screening strategies, and attitudes to genetic testing in Ashkenazi Jewish women. The subjects were women aged > 18 years with BRCA (30 subjects, Group A),or who had an affected first-degree relative (FDRs) (9 subjects, Group B), or without a family history of BRCA (30 controls, Group C). They were ascertained from the Genetic Counselling files held at the South African Institute for Medical Research (SAIMR), the Medical Oncology Centre o f Rosebank, Johannesburg, the Reach for Recovery organisation, the patient network, or, in the case o f the controls, from the records of the Union of Jewish Women (UJW). A schedule o f questions was specifically constructed (and checked in a pilot study) for use in this study and the Beck Depression Inventory (BDI) was selected to measure depression. A face-to-face interview was conducted with each subject and the schedule and BDI were completed. The average age of the subjects was 57 years, 36 years and 52 years in groups A, B and C respectively. The average age o f Group A subjects at diagnosis was 48.7 years and all had had surgery. The subjects' knowledge of the genetics of BRCA scored between moderate and good. Many Group B subjects overestimated the lifetime risk of developing BRCA. Almos. half (46.7%) the Group A women reported shock as the dominating emotion after diagnosis and they were very concerned that their children would develop the condition (43.3%) or that the cancer would metastasise (26.7%). Only 13 (26.5%) of the medical practitioners involved in the care of the Group A subjects in this study discussed emotional issues with their patients.The group B subjects, after the diagnosis was made in a relative, reported fear of developing BRCA (5), fear o f dying o f the disease (5), and feeling out of control (4).Most subjects (87%) felt that women with BRCA and their relatives would benefit from professional counselling. Less than 25% of subjects in all groups undertook regular breast self-examination (BSE), but one-third of group A subjects discovered a lump themselves.Medical practitioners recommended mammograms in older women to all Group B subjects and most (76%) o f the Group C subjects. However, regular CBE and BSE were only recommended rarely. Half the Group A and Group B subjects stated that they would request genetic testing if it were available locally, mostly to determine whether their children were at risk, or, in the case of FDR's, whether they should improve their vigilance. In order for holistic treatment to be given to affected women and their relatives’ psychosocial and genetic counseling issues should be addressed. Also, the findings suggest that women require further education on the importance o f using available screening strategies for the condition and on the possibility o f genetic testing for BRCA susceptibility in high-risk families. However, such testing needs to be carefully supported and monitored to prevent or ameliorate any adverse psychological or social responses.The study has given an insight into the knowledge of BRCA genetics, the emotional burden, and attitudes to screening and testing possibilities, associated with BRCA in the local Ashkenazi Jewish population.
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Lesser, Mishy. "Psychosocial community education and war trauma: Conceptual issues and case of Central American mental health workers." 1996. https://scholarworks.umass.edu/dissertations/AAI9709618.
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Increasingly, war and armed conflict are having devastating effects on the psychological and social well-being of civilian survivors throughout the world. There is a serious shortage of practitioners and culturally-appropriate models for assisting victims of psychological trauma with their healing and recovery. Educational settings, be they formal or nonformal, are appropriate places for psychotherapeutic interventions. This dissertation focuses on the intentional use of a nonformal educational setting for psychosocial healing of those exposed to war-induced trauma. A participatory education program designed to teach Central American community mental health workers the basic concepts and techniques of trauma treatment also served as a healing environment for the trainees. Individual psychological trauma as well as war-related intra-group conflict were addressed. Using an integrative model of healing and recovery, the intervention combined cognitive, emotional, spiritual, social, and physical approaches. The educational setting provided a larger interactional framework for the social contextualization of intrapsychic wounds, thus supporting healing. The case illustrates the importance of self-care for professionals and para-professionals working with the psychologically traumatized, which is rarely mentioned in the literature. This is a qaulitative study that combines a literature review on the nature of trauma and recovery, a case study with Central American community mental health workers, interviews with practitioners, and personal experience. The literature review takes into consideration cultural and Latin American perspectives, the importance of community-based approaches, and the linkage of individual and social dimensions. It includes a critique of posttraumatic stress disorder as a conceptual framework. The inquiry examines the viability of intentional incorporation of psychosocial healing into an educational setting, and indicates which components of participatory nonformal education best lend themselves to interfacing with psychological healing. Findings from both the literature and case study point to a need to question long-held assumptions of psychotherapy when working with trauma survivors. Self-care, safe container-building, peer support, mentoring, and a heightened role for para-professionals are recommended. The training and preparation of community mental health workers is seen as an effective response to the proliferation of war-related trauma.
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Darr, Jay E. "African American males and issues of fatherhood an examination of the sweat lodge as a psychosocial and spiritual intervention /." 2008. http://digital.library.duq.edu/u?/etd,100483.
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Šaldová, Kristýna. "Psychosociální problematika stravování seniorů." Master's thesis, 2019. http://www.nusl.cz/ntk/nusl-398110.
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V ANGLICKÉM JAZYCE The diploma thesis deals with psychosocial problems of seniors' alimentation. The theoretical part focuses on the area of health, healthy lifestyle of elderly people, and also on the diseases and physical problems typical for old age. The geriatric syndromes, which occur in old age, as well as psychosocial aspects of the nutrition of seniors, are described there. The fourth chapter presents up-to-date documents that are closely related to alimentation. The nutrition of seniors is a crucial chapter of the whole thesis, because it describes how the alimentation of seniors is carried out in the home environment and how in residential care. The aim of the last chapter in the theoretical part is to present to the reader the "Domov ANNA", where the research survey (which is a part of the thesis) was realized at the beginning of the year 2019. The survey was carried out using a questionnaire method among clients of the above-mentioned "Domov ANNA" and also seniors living at home in Český Brod. The aim of the research was to find out if the elderly in residential care have better (more varied and balanced) diet in comparison with the elderly who live and eat at home and how psychosocial and economic factors influence the quality of their nutrition.
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KOTNOVÁ, Andrea. "Umístění do výchovného ústavu jako alternativa výkonu vazby." Master's thesis, 2011. http://www.nusl.cz/ntk/nusl-52194.
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My diploma thesis deals with two institutes of penal law ?detention and a court-ordered institutional education. The aim of the study was to tackle the issue theoretically and empirically, to give a comprehensive picture of both alternatives and to compare them. The aim was to add some information to contribute to decision-making in detention or alternative solutions in the issue of juvenile delinquency. The thesis is divided into two sections - theoretical and empirical. In the theoretical part, the legal basis of detention in the Czech Republic with regard to juvenile delinquents is defined, psychosocial issues of the juvenile delinquents detention are surveyed, the legislative base of the placement of juveniles into educational institutions is described, and the psychosocial issues connected with the stay of juvenile delinquents in educational institutions are outlined. In the final part, the possibilities and limits of the juvenile delinquents´ placement into educational institutions rather than detention solutions are discussed. At the beginning of the empirical section of the work, the objectives and research questions were stated. To answer these questions, a qualitative research investigation analyzing the stay of juveniles in detention and an educational institution was carried out. The respondents were chosen by a purposeful selection in educational institutions. The necessary data were obtained by conducting modeled semi-structured interviews with 7 juveniles who had gone through both detention and an educational institute. The interviews were transcribed and case studies were developed from them. The collected data were analyzed using the grounded theory method, open coding. The research has shown differences in experiencing detention and the stay in an educational institution in juvenile delinquents. It has been proved that detention is a stressful situation for juvenile delinquents, but it does not have a destructive affect on the personality of the juvenile. In contrast, the stay in an educational institution was evaluated positively by the respondents, and they emphasized its positive effect on their personalities. The research has also revealed the reasons for incidents in educational institutions, which result from boredom and the unwillingness of the juvenile to adapt to the regime. Now findings of the thesis demonstrate an insufficient use of the programs offered in penitentiaries. For this reason, as an optimization recommendation, I suggest to increase awareness and the motivation of prisoners to participate in these programs.
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Torez, Miguel. "An Online Investigation Into Internet Gaming Disorder (IGD), Comorbidity, and Psychosocial Issues: a Comparison of American and Chinese Gamers—and Predictors of Meeting Criteria for a Formal Diagnosis of IGD." Thesis, 2019. https://doi.org/10.7916/d8-js7c-nx64.
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The problem that this study addressed is the rise of internet gaming disorder (IGD) globally, including within the United States and countries such as China—and, the resultant need for more data on the prevalence of adult men and women meeting criteria for a diagnosis of IGD, as well as data on related comorbidities and psychosocial issues. A global sample (N=231) met the study inclusion criteria (i.e., play video games at least once a week at a minimum, consider themselves involved in Internet gaming, and have been gaming for the past six months—while of interest were findings with an English Speaking (ES) sample, and a Chinese Mandarin Speaking (CMS) sample. The study sample of convenience recruited via a social media campaign was 62.4% (n=63) male in the ES sample, and 55.4% (n=72) male in the CMS sample. The ES sample had a mean age of 29.34 (SD=8.396, Min=18, Max=52), and the CMS sample had mean age of 25.65 (SD=7.514, Min=18, Max=57). While the CMS sample indicated they were Asian (99.2%, n=129), the ES sample was diverse: 58% White (n=59), 17.8% (n=59) Asian, and 11.9% (n=12) Black.
The main study findings reveal a prevalence of Internet Gaming Disorder (IGD of 0% (n=101) for the ES sample, and .8% (n=1) for the CMS sample. As another main study finding, for the CMS sample, participants met more DSM-5 criteria for IGD (out of the 9 total criteria), when they were male, experienced anxiety in the past year, and were engaged in more violence due to gaming. For the ES sample, study participants met more DSM-5 criteria for IGD (out of the 9 total criteria), when they did not have a partner, had a higher income, were engaged in more violence due to gaming, engaged in a higher level of help seeking for personal/emotional support, and had a lower level of perceived social support. In essence, this constitutes the provision of risk profiles and descriptions of those most vulnerable to IGD. This study contributes to those efforts to conduct research on the DSM-5 criteria for IGD (APA, 2013).
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Silva, Carla Sofia Carvalho de Freitas. "Children's and adolescents' self-representations in the context of adverse family experiences: emotional, relational and cognitive processes, and implications for psychosocial functioning." Doctoral thesis, 2017. http://hdl.handle.net/10071/16671.
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In this project, three issues, still little explored, about children’s and adolescents’ selfrepresentations were analysed: 1) their association with experiences of exposure to
interparental destructive conflict; 2) their construction in the context of child and adolescent
maltreatment; and, 3) their associations with children’s and adolescents’ psychosocial
functioning in the context of these adverse family experiences. Two cross-sectional studies
were carried out. In the first one, based on the emotional security theory, the mediating role
of children’s and adolescents’ emotional insecurity in the interparental relationship and of
their perception about their relationship with both parents in associations between
interparental conflict and their domain-specific self-representations was analysed. Both
mediational pathways were supported. The second study focused on testing the "LookingGlass Self Hypothesis" (LGSH), that is, the mediating role of reflected appraisals in
associations between significant others’ actual appraisals and self-representations, in the
context of child/adolescent maltreatment, considering the moderating role of parent-child
communication in this process. Findings supported the LGSH in all dimensions evaluated. In
each study, the mediating role of self-representations in associations between these adverse
family experiences and children’s and adolescents’ psychosocial functioning was also
analysed. Findings emphasized the specific and differentiated role of several selfrepresentation dimensions as intervening mechanisms in those associations. These studies
thus reinforce the importance of relational experiences with significant others, namely
parents/caregivers, on children’s and adolescents’ self-representations, and highlight the
specific and differentiated role of different self-representation dimensions in their
psychosocial functioning, bearing important implications for both research and practice.Neste projeto foram analisados três aspetos, ainda pouco explorados, acerca das autorepresentações de crianças e adolescentes: 1) a sua relação com a exposição ao conflito interparental destrutivo; 2) a sua construção no contexto do mau trato/negligência parental; e, 3) as suas associações com o funcionamento psicossocial das crianças/adolescentes no contexto destas experiências familiares. Para tal, foram realizados dois estudos transversais. No primeiro, com base na teoria da segurança emocional, analisou-se o papel mediador da insegurança emocional das crianças/adolescentes na relação interparental, e da sua percepção acerca da relação com ambos os pais, na relação entre o conflito interparental e as suas autorepresentações. Os resultados suportaram o papel mediador destes dois processos nessa relação. No segundo estudo, testou-se a “Looking-Glass Self Hypothesis” (LGSH), isto é, a relação entre as hetero-representações de outros significativos e as auto-representações através das meta-representações, no contexto do mau trato/negligência, tendo-se em conta o papel moderador da comunicação pais-filhos nesse processo. A LGSH foi suportada em todas as dimensões avaliadas. Em cada estudo foi ainda analisado o papel mediador das autorepresentações na relação entre estas experiências familiares adversas e o funcionamento psicossocial das crianças/adolescentes. Os resultados salientaram o papel específico e diferenciado de várias dimensões de auto-representações como mecanismos intervenientes nessa relação. Estes estudos reforçam assim a importância das experiências relacionais com outros significativos, nomeadamente com os pais/cuidadores, nas auto-representações das crianças e adolescentes, bem como a especificidade do papel de diferentes dimensões das auto-representações no seu funcionamento psicossocial, com importantes implicações para a investigação e intervenção
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Doorgapershad, Marshree. "The impact of Gestalt play techniques on the aggression level of diabetic children." Diss., 2001. http://hdl.handle.net/2263/29593.
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Pandolf, Tiara Cominote. "Empreendedorismo feminino: um estudo exploratório sobre a perspetiva de mulheres brasileiras empreendedoras em Portugal." Master's thesis, 2021. http://hdl.handle.net/10071/22989.
Full textAbstract:
O empreendedorismo foi, durante muito tempo, relacionado apenas com o universo masculino
e só depois da década de 70 é que se começou a investigar também as mulheres
empreendedoras. A grande maioria dos estudos encontrados centram-se em comparações entre
homens e mulheres empreendedores/as, bem como nas motivações que fazem as mulheres
empreender e as dificuldades e limitações que elas encontram ao procurar empreender.
Além disso, percebe-se a pouca investigação existente sobre outros assuntos que perpassam
as mulheres empreendedoras, sendo ainda menor a investigação com mulheres empreendedoras
imigrantes. É a partir deste facto que a presente investigação se tornou pertinente: investigar as
mulheres brasileiras que estão a empreender em Portugal. Então, procurou-se conhecer os
motivos que as fizeram empreender, descrever as maiores dificuldades e identificar os
processos psicossociológicos mais salientes.
Foi desenvolvido um guião semiestruturado, utilizado na realização de 13 entrevistas a
mulheres brasileiras empreendedoras em Portugal, com idades entre os 20 e os 48 anos.
Os resultados revelaram cinco grandes temas, centrados: nas motivações que perpassam as
mulheres a empreender; nas adversidades que estas empreendedoras enfrentam; no ser
imigrante; no ser empreendedora; e no ser mulher. Em geral, percebe-se que as participantes
iniciaram o empreendimento por uma realização pessoal. As dificuldades destacadas foram a
pandemia da Covid-19 e as diferenças culturais existentes entre Brasil e Portugal. Mas estas
são mulheres fortes e resilientes, e mesmo que o facto de ser imigrante e ser mulher infira no
empreendimento, elas procuram sempre o melhor para a sua empresa e para os/as clientes.Entrepreneurship was, for a long time, related only to the male universe and it was only after the 1970s that women entrepreneurs also began to be investigated. Most of the studies found focus on comparisons between men and women entrepreneurs, as well as on the motivations that make women entrepreneurs and the difficulties and limitations they encounter when seeking to become entrepreneurs. Furthermore, it is noticeable how little research there is on other subjects that permeate women entrepreneurs, and there is even less research on immigrant women entrepreneurs. It is based on this fact that the present research became pertinent: to investigate Brazilian women who are entrepreneurs in Portugal. To this end, we sought to know the reasons that made them become entrepreneurs, describe their biggest difficulties, and identify the psychosociological processes most prominent in them. A semi-structured script was developed and used in 13 interviews with Brazilian women entrepreneurs in Portugal, aged between 20 and 48 years old. The results revealed five major themes: the motivations that drive women to become entrepreneurs; the adversities that these entrepreneurs face; being an immigrant; being an entrepreneur; and being a woman. In general, it is perceived that the participants started the enterprise for personal fulfillment. The difficulties highlighted were the Covid-19 Pandemic and the cultural differences between Brazil and Portugal. They are strong and resilient women, and even though being an immigrant and being a woman influences the enterprise, they always seek the best for their company and for the clients.
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Dadswell, Kara. "Predicting risk of repeat firelighting in young people: the development and evaluation of the Behaviour Risk Tool." Thesis, 2018. https://vuir.vu.edu.au/38642/.
Full textAbstract:
Firelighting is not an uncommon behaviour for young people. A review of the
relevant literature shows that, fortunately, most young people who light fires, do so
because they are curious, and fire safety education intervention is enough to prevent any
future firelighting activity. However, a small number have significant psychosocial issues
that may contribute to continued firelighting behaviour.
The Juvenile Fire Awareness and Intervention Program (JFAIP) is a fire safety
education program established in Victoria, Australia to target active young firelighters.
While some young firelighters referred to the program have mental health problems, the
JFAIP is not designed for such cases. Thus a need has been identified for a screening
questionnaire to identify young people with psychosocial disturbance predictive of
ongoing firelighting behaviour, in order to recommend supplementary mental health
intervention. The overarching aim of this project was to develop such a screening tool.
The first aim of Study 1 was to evaluate the validity of two internationally
established firelighter screening tools, the FEMA Child Risk Survey (CRS) and Family
Risk Survey (FRS). The second aim was to explore the fire-specific, family and
psychosocial profile of young repeat firelighters and develop a new firelighter screening
tool to be subsequently evaluated and compared to the CRS and FRS. Utilising a sample
of 61 JFAIP families, data about fire-specific, family and psychosocial characteristics of
the young firelighters (5-17 years of age) at the time of their initial pre-intervention
interview was collected via the CRS, FRS, Fire Risk Interview and Child Behaviour
Checklist. A 12-month follow-up obtained information about continued firelighting
activity. Study 1 results indicated that the CRS was unable to distinguish between the
groups (repeat and non-repeat), but the FRS demonstrated some utility, accurately
detecting 86% of repeat firelighters. However it was overly inclusive, erroneously predicting that half of the non-repeat firelighters were also at risk. The results also
identified significant differences on a number of fire-specific and psychosocial variables
between repeat and non-repeat firelighters. The 25 specific items or themes across the
four instruments used to collect data demonstrating the greatest differences between the
repeat and non-repeat firelighters were combined into a new screening tool, termed the
Behaviour Risk Tool (BRT).
Study 2 was designed to measure the validity and reliability of the BRT using new
samples. In Part A the BRT was completed by the parent/guardian of 63 young people in
the JFAIP (5-17 years of age) at their initial pre-intervention interview. A minimum six
month follow up contact determined the presence or absence of repeat firelighting.
Results demonstrated the BRT had a sensitivity of 0.8 and specificity of 0.7 at the cut-off
score of 57.5. Thus the BRT detected 80% of the repeat firelighters and 70% of the nonrepeat
firelighters correctly. In Part B, the test-retest reliability and internal consistency
of the BRT was assessed. Parents/guardians of 76 children (5-17 years) in the general
population completed the questionnaire twice, two weeks apart. The results indicated high
repeatability across time (r=.93) and high internal consistency (.88-.93) for the BRT.
Hence, Study 2 found that the BRT had better sensitivity and specificity than the CRS
and FRS and was a reliable questionnaire.
The expectation is that the BRT will be used as a preliminary screening measure
in the JFAIP, to identify cases where additional mental health support may be necessary.
This is the first such tool to be developed in an Australia context. Furthermore, the JFAIP
is the first young firelighter program in Australia to adopt a screening tool of this kind.
Ideally the BRT will continue to be used over many years with many families, and
continue to be evaluated for effectiveness and further improvements.
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Silva, José António Pais. "Relatório de estágio de cuidados paliativos no South Adelaide Palliative Services : Austrália Meridional : 2014." Master's thesis, 2015. http://hdl.handle.net/10400.14/19692.
Full textAbstract:
A practical component was felt to be essential to make theory and practice meet in Palliative Care, at all levels, even after directed postgraduate studies. As such, I opted to undergo a 9 week Palliative Care internship in a reference institution – South Adelaide Palliative Services (SAPS), from July to September 2014 in Adelaide, South Australia. This institution offers hospice, outpatient, hospital consultancy and home care services. Additionally, it is famous for conducting good quality research in Palliative Care. An internship was thus carried out with the aim of improving symptom control options, psychosocial understanding and management principles, namely communication of bad news and service structure observation. Furthermore, a research project concerning the symptomatic control of dyspnoea was also carried out. All components of care were visited and in all of them fruitful discussions with in-matter specialists were held. Schedule flexibility was possible to allow for objective completion and, at a certain point, to satisfy a personal inclination for a certain area. This practice had multiple implications in my professional life as a medical Oncology registrar: It allowed me to feel much more comfortable in dealing with partially refractory symptoms and to gain perspective on the typical course of disease in some pathologies. Additionally, communication skills were greatly improved by being able to see some conversations that would challenge the status quo of practicing medicine in Portugal and adapting them to our culture. The research project resulted in a paper being submitted, and is now awaiting reviewer’s comments. All in all, the proposed objectives were met and fulfilled, with the necessary limitations, and the experience was considered very fruitful on all levels.Mesmo após o término da pós-graduação em Cuidados Paliativos, ainda me pareceu necessário aprofundar a componente prática para conciliar a teoria e a prática. Como tal optei por efetuar um estágio de 9 semanas numa instituição de referência em Cuidados Paliativos – a South Adelaide Palliative Services (SAPS), de Julho a Setembro de 2014, em Adelaide, na Austrália. Esta instituição oferece serviços em ambiente de hospice, consulta externa, consultoria hospitalar e cuidados domiciliários. Também é famosa por conduzir investigação de boa qualidade nesta área. Como tal efetuei este estágio tendo por objetivos a melhoria do controlo de sintomas, uma melhor compreensão e gestão dos problemas psicossociais associados, nomeadamente a comunicação de más notícias e a observação da estruturação de um serviço coordenado a este nível. Além disso, desenvolvi um projeto de investigação referente ao controlo sintomático da dispneia. Todas as valências do serviço descritas foram frequentadas e em todas elas ocorreu uma discussão frutífera com os profissionais envolvidos. O horário desenvolvido foi propositadamente flexível de acordo com a necessidade de cumprir os vários objetivos propostos e com a inclinação pessoal, entretanto desenvolvida. Este estágio teve implicações múltiplas na minha vida profissional como interno de Oncologia Médica: Permitiu sentir-me mais à vontade na gestão do doente com sintomatologia parcialmente refratária e obter perspetiva da história natural de algumas patologias. Notei um ganho considerável no aperfeiçoamento das técnicas de comunicação pela oportunidade de observar algumas discussões entre profissionais de saúde e doentes que desafiariam a forma como encaramos estes tópicos em Portugal e que tenho aproveitado, com as necessárias adaptações. O trabalho de investigação resultou num artigo submetido, presentemente aguardando os comentários dos revisores. No cômputo geral, considerei como cumpridos todos os objetivos propostos como alcançados, com as necessárias limitações. A experiência foi considerada muito proveitosa, a todos os níveis.
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Varela, Rute Miriam Campos. "Burnout em profissionais de saúde animal: um estudo integrativo com variáveis individuais, relacionadas com o trabalho e psicossociais." Master's thesis, 2020. http://hdl.handle.net/10071/21658.
Full textAbstract:
A síndrome de burnout afeta milhares de profissionais em diversas áreas de trabalho, e tem
vindo a ser, por isso, amplamente estudada em profissionais de caregiving, i.e., profissionais
cujas tarefas envolvem a prestação de cuidados a terceiros, uma vez que estes aparentam um
maior risco de desenvolver sintomas deste fenómeno (Freudenberg, 1974; Maslach, 2003).
Mais recentemente surge o interesse pelo estudo desta síndrome aplicada a profissionais de
saúde animal (Kaufmannn, 2017).
O objetivo da presente investigação é contribuir para uma melhor compreensão dos
fatores que são preditores do burnout em duas amostras de profissionais de saúde animal, (a)
médicos veterinários; e (b) enfermeiros veterinários.
Através de dois modelos de regressão linear, foram introduzidas em três blocos,
variáveis individuais (sexo, idade e rendimento), variáveis relacionadas com o próprio trabalho
(horas de contacto com animais e com donos em sofrimento, a questão da eutanásia, anos de
experiência e workload), e variáveis psicossociais (crença num mundo justo, empatia, empatia
para com animais, significado do trabalho e identificação com a profissão), procurando verificar
o seu efeito nas duas dimensões distintas do burnout (i.e., exaustão e distanciamento).
Os resultados mostram que as variáveis abordadas têm de facto um grande impacto no
burnout destes profissionais, sendo que o workload representa consistentemente um fator de
risco para ambas as amostras e em ambas as dimensões da síndrome, ao passo que a
identificação com a profissão representa um fator protetor contra o burnout para ambas as
amostras em ambas as dimensões. Os resultados obtidos sugerem a necessidade de considerar
mais modelos integrativos com diferentes tipos de variáveis em investigações futuras dedicadas
a esta temática.The burnout syndrome affects thousands of professionals in different areas of work, and has therefore been widely studied in caregiving professionals, i.e., whose jobs involve the provision of care to others, since they appear to be at a greater risk of developing symptoms of this phenomenon (Freudenberg, 1974; Maslach, 2003). More recently, the interest in the study of this syndrome applied to animal health professionals arises (Kaufmannn, 2017). The aim of this investigation is to contribute to a better understanding of the factors that are predictors of burnout in two samples of animal health professionals, (a) veterinarians; and (b) veterinary nurses. Through two linear regression models, individual variables (sex, age and income), as well as variables related to their own work (hours of contact with suffering owners and animals, the issue of euthanasia, years of experience and workload) and psychosocial variables (belief in a just world, empathy, empathy for animals, meaning of work and identification with the profession), were introduced in three blocks seeking to verify its effect on the two distinct dimensions of burnout (i.e., exhaustion and disengagement). The obtained results show that the variables addressed have in fact a relevant impact on the burnout of these professionals, with the workload consistently representing a risk factor for both samples and in both dimensions of this syndrome, whereas identification with the profession represents a protective factor against burnout for both samples in both dimensions. The results obtained suggest the need to consider more integrative models with different types of variables in future investigations dedicated to this theme.
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Nawej, Muteb Ivon. "L'interculturation, une posture à risque pour la construction de l'identité psychosociale chez l'élève issu de l'immigration : les compétences métaémotionnelles comme stratégie de prévention en contexte scolaire." Thèse, 2017. http://depot-e.uqtr.ca/8064/1/031618448.pdf.
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