Impact of climate variability on pineapple production in Ghana

Background: Climate variations have a considerable impact on crop production. For pineapple, variable temperatures and rainfall patterns are implicated, yet there is limited knowledge of the conditions and consequences of such variations. Pineapple production plays a major role in Ghana, primarily via socioeconomic impacts and the export economy. The aims of this study were to assess the impact of current climatic trends and variations in four pineapple growing districts in Ghana to provide stakeholders, particularly farmers, with improved knowledge for guidance in adapting to changing climate. Results: Trend analysis, standardized anomaly, correlation analysis as well as focus group discussions were employed to describe climate and yields as well as assess the relationship between climate and pineapple production from 1995 to 2014. The results revealed that, relative to Ga district, temperature (minimum and maximum) in the study areas was increasing over this period at a rate of up to 0.05 °C. Rainfall trends increased in all but Nsawam Adoagyiri district. Rainfall and temperature had different impacts on production, and pineapple was particularly sensitive to minimum temperature as accounting for up to 82% of yield variability. Despite consistent report of rainfall impact on growth stages later affecting quantity and quality of fruits, minimal statistical significance was found between rainfall and yield. Conclusions: With continuously increasing stresses imposed by a changing climate, the sustainability of pineapple production in Ghana is challenged. This subsequently has detrimental impacts on national employment and exports capacity resulting in increased poverty. Further research to explore short- and long-term adaption options in response to challenging conditions in the pineapple industry in Ghana is suggested

Lessons learned in developing family medicine residency training programs in Japan

BACKGROUND: While family medicine is not well established as a discipline in Japan, a growing number of Japanese medical schools and training hospitals have recently started sougoushinryoubu (general medicine departments). Some of these departments are incorporating a family medicine approach to residency training. We sought to learn from family medicine pioneers of these programs lessons for developing residency training. METHODS: This qualitative project utilized a long interview research design. Questions focused on four topics: 1) circumstances when becoming chair/faculty member; 2) approach to starting the program; 3) how Western ideas of family medicine were incorporated; and 4) future directions. We analyzed the data using immersion/crystallization to identify recurring themes. From the transcribed data, we selected representative quotations to illustrate them. We verified the findings by emailing the participants and obtaining feedback. RESULTS: Participants included: five chairpersons, two program directors, and three faculty members. We identified five lessons: 1) few people understand the basic concepts of family medicine; 2) developing a core curriculum is difficult; 3) start with undergraduates; 4) emphasize clinical skills; and 5) train in the community. CONCLUSION: While organizational change is difficult, the identified lessons suggest issues that merit consideration when developing a family medicine training program. Lessons from complexity science could inform application of these insights in other countries and settings newly developing residency training

Experiencing sense of place in virtual and physical Avebury.

This paper discusses the findings from a project to construct a simulation of Avebury henge, a Late Neolithic/ Early Bronze Age monument in SW Britain, in a 3D, virtual world environment. The aims of the study were to explore the archaeological research and interpretation necessary to plan and construct such a simulation in an interactive, online environment, to identify which aspects of visualisation and soundscape design appear to have the greatest impact upon users’ sense of place in the virtual simulation and to explore the experiences of a small group of users in the virtual simulation and the effects of those experiences upon their sense of place at the physical site. The findings from this project demonstrated that in undertaking a simulation of an ancient site, a core set of sources need to be selected to create the main parts of the simulation. There is often much debate in archaeological literature regarding the way in which archaeological findings are interpreted, and a different virtual Avebury would be constructed if different interpretations had been chosen. Any simulation of an ancient site should therefore clearly recognise and state the basis upon which it has been designed. The evaluation showed that responses to virtual environments, and the resulting effect upon responses to physical environments, are complex and personal, resulting in a range of experiences and perceptions, suggesting that the range of users’ experiences might be a more significant issue than attempting to find any general consensus on user reactions to simulated ancient sites

Only vulnerable adults show change in chronic low-grade inflammation after contemplative mental training: evidence from a randomized clinical trial.

Growing evidence suggests that chronic low-grade inflammation can be reduced through mindfulness-based mental training interventions. However, these results are inconsistent and based on patient populations with heterogeneous conditions. Similar research in healthy adults is lacking. Moreover, common intervention protocols involve varying combinations of different contemplative practices, such that it remains unclear which types of training most effectively influence biomarkers of inflammation. The present study investigated the effect of three distinct 3-month training modules cultivating a) interoception and present-moment focus (Presence), b) socio-affective skills (Affect), or c) socio-cognitive skills (Perspective) on the inflammatory biomarkers interleukin-6 (IL-6) and high sensitive C-reactive protein (hs-CRP) in 298 healthy adults. We observed no group-level effect of training on either biomarker, but trend-level interactions of training type and participant sex. In additionally exploring the influence of participants' baseline inflammation, a selective training effect emerged: Following the Presence module, participants with relatively higher inflammatory load showed stronger reduction in IL-6 on average, and in hs-CRP if they were male. Mindfulness- and attention-based mental practice thus appears most effective when targeting chronic low-grade inflammation in healthy adults, particularly in men. Overall, our data point to a floor effect in the reduction of inflammatory markers through contemplative mental training, suggesting that mental training may be less effective in improving basal biological health outcomes in healthy, low-stressed adults than in vulnerable populations

Social marketing and healthy eating : Findings from young people in Greece

This document is the Accepted Manuscript version. The final publication is available at Springer via http://dx.doi.org/10.1007/s12208-013-0112-xGreece has high rates of obesity and non-communicable diseases owing to poor dietary choices. This research provides lessons for social marketing to tackle the severe nutrition-related problems in this country by obtaining insight into the eating behaviour of young adults aged 18–23. Also, the main behavioural theories used to inform the research are critically discussed. The research was conducted in Athens. Nine focus groups with young adults from eight educational institutions were conducted and fifty-nine participants’ views towards eating habits, healthy eating and the factors that affect their food choices were explored. The study found that the participants adopted unhealthier nutritional habits after enrolment. Motivations for healthy eating were good health, appearance and psychological consequences, while barriers included lack of time, fast-food availability and taste, peer pressure, lack of knowledge and lack of family support. Participants reported lack of supportive environments when deciding on food choices. Based on the findings, recommendations about the development of the basic 4Ps of the marketing mix, as well as of a fifth P, for Policy are proposedPeer reviewe

Measuring dementia carers' unmet need for services - an exploratory mixed method study

<p>Abstract</p> <p>Background</p> <p>To ensure carers of people with dementia receive support, community services increasingly use measures of caregiver (carer) burden to assess for unmet need. This study used Bradshaw's taxonomy of need to explore the link between measures of carer burden (normative need), service use (expressed need), and carer's stated need (felt need).</p> <p>Methods</p> <p>This mixed method exploratory study compared measures of carer burden with community services received and unmet needs, for 20 community-dwelling carer/care-recipient pairs.</p> <p>Results</p> <p>A simple one-item measure of carers' felt need for more services was significantly related to carer stress as measured on the GHQ-30. Qualitative data showed that there are many potential stressors for carers, other than those related to the care-giving role. We found a statistically significant rank correlation (p = 0.01) between carer's use of in-home respite and the care-recipient's cognitive and functional status which is likely to have been related to increased requirement for carer vigilance, effort and the isolation of spouse carers. Otherwise, there were no statistically significant relationships between carer burden or stress and level of service provision.</p> <p>Conclusion</p> <p>When carers are stressed or depressed, they can recognise that they would like more help from services, even if measures of carer burden and care recipient status do not clearly indicate unmet service needs. A question designed to elicit carer' <it>felt </it>need may be a better indicator of service need, and a red flag for recognising growing stress in carers of people with dementia. Assessment of service needs should recognise the fallibility of carer burden measures, given that carer stress may not only come from caring for someone with dementia, but can be significantly compounded by other life situations.</p

The psychosocial impact of home use medical devices on the lives of older people: a qualitative study

Background Increased life expectancy and the accompanying prevalence of chronic conditions have led to the focus and delivery of health care migrating from the hospital and into people’s homes. While previous studies have investigated the integration of particular types of medical devices into the home, it was our intention to describe how medical devices are integrated into the lives of older people. Methods Adopting a qualitative study design, 12 older people, who used medical devices in the home, took part in in-depth, semi structured interviews. In 7 of the interviews participants and their partners were interviewed together. These interviews were recorded, transcribed and analysed thematically. Results Two themes were constructed that describe how medical devices that are used in the home present certain challenges to older people and their partners in how the device is adopted and the personal adaptations that they are required to make. The first theme of 'self-esteem’ highlighted the psychological impact on users. The second theme of 'the social device' illustrated the social impact of these devices on the user and the people around them. Conclusions We found that these devices had both a positive and negative psychosocial impact on users’ lives. An improved understanding of these psychological and social issues may assist both designers of medical devices and the professionals who issue them to better facilitate the integration of medical devices into the homes and lives of older people

A conceptual model for action and design research

Organizational research has a pattern of special characteristics which make a clear distinction from other research paradigms. When using these approaches – based on Action and Design – the Interpretivist, Constructivist, and Participatory perspectives dominate. They have already proven to have strong foundations, which turn these paradigmatic approaches into effective ways for getting knowledge, doing things, and promoting change within organizational settings. It combines the traditional scientific, engineering, and organization development approaches, depicting how an organization can, simultaneously, solve multidimensional problems and produce actionable knowledge, effective change and useful artifacts. It has been developed using a Design Science Research approach, tested in a major organizational change program (Henriques, 2015; Henriques & ONeill, 2014), and successfully used to teach research methods essentials to Master and DBA students.info:eu-repo/semantics/publishedVersio

Processos de medicação, carga de trabalho e a segurança do paciente em unidades de internação

RESUMO Objetivo Levantar pontos críticos do processo de medicação, suas repercussões nas demandas de trabalho da equipe de enfermagem e riscos para a segurança dos pacientes. Método Estudo descritivo, com abordagem qualitativa, na perspectiva ecológico-restaurativa. Os dados foram coletados por meio de grupos focais e fotografias. Participaram enfermeiros e técnicos de enfermagem. Resultados Três categorias emergiram da análise temática: Desafios nos processos de prescrição e dispensação de medicamentos; Administração de medicamentos – organização no turno de trabalho; Uso de novas tecnologias para diminuir erros de medicamentos. Os resultados apontam que o processo de medicação assume um caráter de centralidade na organização do trabalho da equipe de enfermagem, sendo que estes profissionais configuram-se como a última barreira para detectar falhas de prescrição e dispensação de medicamentos. Conclusão Para a identificação de vulnerabilidades na etapa de administração de medicamentos, o uso de tecnologias, sem dúvida, agrega valor para o processo de cuidado seguro

The Role of Screenings Methods and Risk Profile Assessments in Prevention and Health Promotion Programmes: An Ethnographic Analysis

In prevention and health promotion interventions, screening methods and risk profile assessments are often used as tools for establishing the interventions’ effectiveness, for the selection and determination of the health status of participants. The role these instruments fulfil in the creation of effectiveness and the effects these instruments have themselves remain unexplored. In this paper, we have analysed the role screening methods and risk profile assessments fulfil as part of prevention and health promotion programmes in the selection, enrolment and participation of participants. Our analysis showed, that screening methods and health risk assessments create effects as they objectify health risks and/or the health status of individuals, i.e., they select the individuals ‘at risk’ and indicate the lifestyle modifications these people are required to make in order to improve their health. Yet, these instruments also reduce the group of participants thereby decreasing the possible effect of interventions, as they provide the legitimisation for people to make choices to whether they enrol or not and what lifestyle changes they incorporate into their lives. In other words, they present a space of interaction, in which agency is distributed across the practice nurses, the participants and the instruments. Decisions were not just made upon the projection of the outcomes of these instruments; decisions that were made by both the patients and practice nurses were the resultant of their opinions on these outcomes that were formed in interaction with the instruments