A (solo) journey of our own : discovering self and research through studying women who have travelled alone

This paper tells the story of how I discovered both ‘self’ and ‘research’ during a qualitative PhD study on women who travel solo. This story will emphasise the importance – if not the necessity - of self-discovery through research. It will argue that one cannot divorce oneself entirely from one’s research, as is suggested by traditional, quantitative approaches to academic enquiry. Such a claim, of course, brings into play contemporary debates on ontology and epistemology, and how a researcher’s worldview greatly influences the nature and conduct of her enquiry. As part of my PhD research, I conducted forty in-depth interviews with Australian women who had travelled overseas alone. The study’s aims were to investigate the meaning of solo travel for women, and to identify the constraints that they face during such travel. An interpretive, feminist framework was adopted to guide this project. While studying other women’s journeys, I found that I myself had also embarked on a solo journey of sorts – a journey of great self-discovery which saw me question my views about the world, how I related to people, and what I thought was important in the pursuit of academic knowledge. I say a ‘solo’ journey because I found myself relatively alone as a qualitative, feminist researcher in a field (tourism studies) where objectivity, generalisation and distance were often the prized goals. This was not an easy journey at all times, similar to the solo travails experienced by the women I interviewed. Self-doubt, fear of criticism and a sense of isolation were common elements in our respective journeys. Yet, interestingly, these were the very factors that nurtured our learning processes, and which encouraged us to find ways to negotiate through our constraints. In summary, this paper will explore the parallels between my (often) solo journey of self/research discovery, and the solo journeys of the women travellers I interviewed

Patient preferences for key drivers and facilitators of adoption of mHealth technology to manage depression: A discrete choice experiment

BackgroundIn time, we may be able to detect the early onset of symptoms of depression and even predict relapse using behavioural data gathered through mobile technologies. However, barriers to adoption exist and understanding the importance of these factors to users is vital to ensure maximum adoption.MethodIn a discrete choice experiment, people with a history of depression (N = 171) were asked to select their preferred technology from a series of vignettes containing four characteristics: privacy, clinical support, established benefit and device accuracy (i.e., ability to detect symptoms), with different levels. Mixed logit models were used to establish what was most likely to affect adoption. Sub-group analyses explored effects of age, gender, education, technology acceptance and familiarity, and nationality.ResultsHigher level of privacy, greater clinical support, increased perceived benefit and better device accuracy were important. Accuracy was the most important, with only modest compromises willing to be made to increase other factors such as privacy. Established benefit was the least valued of the attributes with participants happy with technology that had possible but unknown benefits. Preferences were moderated by technology acceptance, age, nationality, and educational background.ConclusionFor people with a history of depression, adoption of technology may be driven by the desire for accurate detection of symptoms. However, people with lower technology acceptance and educational attainment, those who were younger, and specific nationalities may be willing to compromise on some accuracy for more privacy and clinical support. These preferences should help shape design of mHealth tools.</p

Elevated preoperative heart rate is associated with cardiopulmonary and autonomic impairment in high-risk surgical patients

Background: Elevated preoperative heart rate (HR) is associated with perioperative myocardial injury and death. In apparently healthy individuals, high resting HR is associated with development of cardiac failure. Given that patients with overt cardiac failure have poor perioperative outcomes, we hypothesized that subclinical cardiac failure, identified by cardiopulmonary exercise testing, was associated with elevated preoperative HR > 87 beats min-1(HR > 87). Methods: This was a secondary analysis of an observational cohort study of surgical patients aged ≥45 yr. The exposure of interest was HR > 87, recorded at rest before preoperative cardiopulmonary exercise testing. The predefined outcome measures were the following established predictors of mortality in patients with overt cardiac failure in the general population: ventilatory equivalent for carbon dioxide (V E/V co2) ratio ≥34, heart rate recovery ≤6 and peak oxygen uptake (V o2) ≤14 ml kg-1min-1. We used logistic regression analysis to test for association between HR > 87 and markers of cardiac failure. We also examined the relationship between HR > 87 and preoperative left ventricular stroke volume in a separate cohort of patients. Results: HR > 87 was present in 399/1250 (32%) patients, of whom 438/1250 (35%) had V E/V co2ratio ≥34, 200/1250 (16%) had heart rate recovery ≤6, and 396/1250 (32%) had peak V o2≤14 ml kg-1min-1. HR > 87 was independently associated with peak V o2≤14 ml kg-1min-1{odds ratio (OR) 1.69 [1.12-3.55]; P=0.01} and heart rate recovery ≤6 (OR 2.02 [1.30-3.14]; P 87 was not associated with V E/V co2ratio ≥34 (OR 1.31 [0.92-1.87]; P=0.14). In a separate cohort, HR > 87 (33/181; 18.5%) was associated with impaired preoperative stroke volume (OR 3.21 [1.26-8.20]; P=0.01). Conclusions: Elevated preoperative heart rate is associated with impaired cardiopulmonary performance consistent with clinically unsuspected, subclinical cardiac failure. Clinical trial registration. ISRCTN88456378