Patterns of ‘balancing between hope and despair’ in the diagnostic phase: a grounded theory study of patients on a gastroenterology ward

Aim: The aim of the study was to learn how patients going through the diagnostic phase experienced and handled their situation. Background: Many studies report about the stressful diagnostic phase; however, none has presented a conceptual theory where the concepts are sufficiently related to each other. The Theory of Preparative Waiting has previously been published as a descriptive grounded theory and describes the experience of a group of gastroenterology patients going through the diagnostic phase. Method: A classical grounded theory design was used, with data derived from 18 in-depth interviews with 15 patients in a gastroenterology ward at a Norwegian University Hospital. Interviews were conducted during 2002–2003. Findings: Participants’ main concern was found to be how they could prepare themselves for the concluding interview and life after diagnosis. The theoretical code of ‘balancing’ had four patterns; controlling pain, rational awaiting, denial, and accepting. These patterns of ‘balancing’ guided how participants used the categories of ‘Preparative Waiting Theory’ ‘seeking and giving information’, ‘interpreting clues’, ‘handling existential threats’ and ‘seeking respite’. Patterns were strategies, so one person could use more than one pattern. Conclusion: The diagnostic phase was a difficult time for the participants and the ‘Preparative Waiting Theory’ can assist nurses in assessing how patients prepare themselves differently for getting a diagnosis. All patients would find it helpful to be followed up by a designated contact person at the ward; however, patients using mostly the patterns of controlling pain and denial would benefit most from such support

Restorative Justice-Informed Moral Acquaintance: Resolving the Dual Role Problem in Correctional and Forensic Practice

The issue of dual roles within forensic and correctional fields has typically been conceptualized as dissonance—experienced by practitioners— when attempting to adhere to the conflicting ethical requirements associated with client well-being and community protection. In this paper, we argue that the dual role problem should be conceptualized more broadly; to incorporate the relationship between the offender and their victim. We also propose that Restorative Justice (RJ) is able to provide a preliminary ethical framework to deal with this common ethical oversight. Furthermore, we unite the RJ framework with that of Ward’s (2013) moral acquaintance model to provide a more powerful approach—RJ informed moral acquaintance—aimed at addressing the ethical challenges faced by practitioners within forensic and correctional roles

Influential factors of aligning Spotify squads in mission-critical and offshore projects – a longitudinal embedded case study

Changing the development process of an organization is one of the toughest and riskiest decisions. This is particularly true if the known experiences and practices of the new considered ways of working are relative and subject to contextual assumptions. Spotify engineering culture is deemed as a new agile software development method which increasingly attracts large-scale organizations. The method relies on several small cross-functional self-organized teams (i.e., squads). The squad autonomy is a key driver in Spotify method, where a squad decides what to do and how to do it. To enable effective squad autonomy, each squad shall be aligned with a mission, strategy, short-term goals and other squads. Since a little known about Spotify method, there is a need to answer the question of: How can organizations work out and maintain the alignment to enable loosely coupled and tightly aligned squads? In this paper, we identify factors to support the alignment that is actually performed in practice but have never been discussed before in terms of Spotify method. We also present Spotify Tailoring by highlighting the modified and newly introduced processes to the method. Our work is based on a longitudinal embedded case study which was conducted in a real-world large-scale offshore software intensive organization that maintains mission-critical systems. According to the confidentiality agreement by the organization in question, we are not allowed to reveal a detailed description of the features of the explored project

Being Healthy: a Grounded Theory Study of Help Seeking Behaviour among Chinese Elders living in the UK

The health of older people is a priority in many countries as the world’s population ages. Attitudes towards help seeking behaviours in older people remain a largely unexplored field of research. This is particularly true for older minority groups where the place that they have migrated to presents both cultural and structural challenges. The UK, like other countries,has an increasingly aging Chinese population about who relatively little is known. This study used a qualitative grounded theory design following the approach of Glaser (1978). Qualitative data were collected using semi-structured interviews with 33 Chinese elders who were aged between 60 and 84, using purposive and theoretical sampling approaches. Data were analysed using the constant comparative method until data saturation occurred and a substantive theory was generated. ‘Being healthy’ (the core category) with four interrelated categories: self-management, normalizing/minimizing, access to health services, and being cured form the theory. The theory was generated around the core explanations provided by participants and Chinese elders’ concerns about health issues they face in their daily life. We also present data about how they direct their health-related activities towards meeting their physical and psychological goals of being healthy. Their differential understanding of diseases and a lack of information about health services were potent predictors of non�help seeking and ‘self’ rather than medical management of their illnesses. This study highlights the need for intervention and health support for Chinese elders

Optimal Control for Generating Quantum Gates in Open Dissipative Systems

Optimal control methods for implementing quantum modules with least amount of relaxative loss are devised to give best approximations to unitary gates under relaxation. The potential gain by optimal control using relaxation parameters against time-optimal control is explored and exemplified in numerical and in algebraic terms: it is the method of choice to govern quantum systems within subspaces of weak relaxation whenever the drift Hamiltonian would otherwise drive the system through fast decaying modes. In a standard model system generalising decoherence-free subspaces to more realistic scenarios, openGRAPE-derived controls realise a CNOT with fidelities beyond 95% instead of at most 15% for a standard Trotter expansion. As additional benefit it requires control fields orders of magnitude lower than the bang-bang decouplings in the latter.Comment: largely expanded version, superseedes v1: 10 pages, 5 figure

The ConStratO model of handover: a tool to support technology design and evaluation

Handovers are a specific kind of multidisciplinary team meeting. Shift handovers and transfers are both regular features of hospital work but there is currently great variation in how such handovers are conducted, presenting a challenging for those seeking to develop technology to support handover. This paper presents the ConStratO model of handover, which captures aspects of the context that influence how the handover is conducted, a range of different handover strategies relating to different aspects of the handover, and possible outcomes of handover. The model is based on detailed data collection in a range of clinical settings. We present the model as a tool for developing and evaluating technology support for handover

Maximising transparency in a doctoral thesis: The complexities of writing about the use of QSR*NVIVO within a grounded theory study

This paper discusses the challenges of how to provide a transparent account of the use of the software programme QSR*NVIVO (QSR 2000) within a Grounded Theory framework (Glaser and Strauss 1967; Strauss and Corbin 1998). Psychology students are increasingly pursuing qualitative research projects such to the extent that the UK Economic and Social Research Council (ESRC) advise that students should have skill in the use of computer assisted qualitative data analysis software (CAQDAS) (Economic and Social Research Council 2001). Unlike quantitative studies, rigid formulae do not exist for writing-up qualitative projects for doctoral theses. Most authors, however, agree that transparency is essential when communicating the findings of qualitative research. Sparkes (2001) recommends that evaluative criteria for qualitative research should be commensurable with the aims, objectives, and epistemological assumptions of the research project. Likewise, the use of CAQDAS should vary according to the research methodology followed, and thus researchers should include a discussion of how CAQDAS was used. This paper describes how the evolving process of coding data, writing memos, categorising, and theorising were integrated into the written thesis. The structure of the written document is described including considerations about restructuring and the difficulties of writing about an iterative process within a linear document

Vegetable production, consumption and its contribution to diets along the urban – rural continuum in Northern Ghana

Malnutrition continues to be a problem, with sub-Saharan Africa affected the worst. Women and children are at the pinnacle of this problem. The perpetual scourge of malnutrition in urban and periurban settings, coupled with levels of vegetable consumption below the recommended amounts, are a major problem in most African countries including West African cities. A household survey was conducted between November and December 2013 (dry season) in and around Tamale, Ghana as part of an urban food system analysis, to understand vegetable production and consumption and its contribution to household diets and income along the urban – rural continuum. Data collection was guided by a transect approach. A total of 240 households participated in the survey, with 62% males and 38% females. Additionally, 186 women of reproductive age (15 – 49 years) staying in the sampled households contributed to the computing of household dietary diversity through Women’s Dietary Diversity Scores (WDDS). Most vegetables produced were for subsistence use, considering that most households sold less than 50% of the crops and consumed the rest. Vegetable production varied significantly along the urban - rural continuum, with more households in rural areas producing all the requirements of their vegetables compared to urban and periurban areas. Nevertheless, the households in the rural areas (16%) had the lowest dietary diversity (≤ 3 WDDS) compared to urban areas (13%) and periurban areas (5%). The study showed low consumption of vegetables (especially the dark green vegetables) mostly in the rural area and limited diversity of vegetables, especially vitamin A rich vegetables and tubers, with only three vegetables (carrots, red pepper and sweet potato) consumed. There was evidence of more inclination toward staple crops compared to vegetables along the urban – rural continuum for both production and consumption, clearly shown in crops grown and food groups mostly consumed (cereals and tubers rather than dark green vegetables). There was overall low consumption of dark green leafy vegetables, such as amaranth, with only 26% reported to have consumed them during the reported period compared to food groups like cereals (98%). This study confirms the dual purpose of vegetables in complementing dishes (balanced diets) with much needed micronutrients and helping households along the urban – rural continuum to generate income.Keywords: Vegetables, dietary diversity, food groups, urban – rural continuum, Northern Ghan