The construction of identities in narratives about serious leisure occupations

Engagement in occupation contributes to the shaping of identity throughout the human life. The act of telling about such engagement involves interaction based on symbolic meaning; the speaker constructing an identity by conveying how the occupation is personally meaningful. This study explored meaning in narratives told by people who engage in serious leisure occupations. A total of 78 narratives were extracted from interviews with 17 people who invest considerable time and other resources into their leisure. Analysis focused on the content, structure and performance of each narrative in order to explore meaning. The meanings were organised into a framework based around three dimensions: the located self, the active self and the changing self. Each dimension has facets that the individual might emphasise, constructing a unique identity. The framework offers a structured basis for conceptualising how occupation contributes to the shaping of the internalised self and the socially situated identity

Nursing Facility Residents’ Cardiopulmonary Resuscitation Decisions

Context As many as one-quarter of all residents in nursing facilities have cardiopulmonary resuscitation (CPR) as a documented choice in the medical record, despite the likelihood of limited medical benefit in this setting. Objectives The aim of this study was to understand the perspectives of healthcare providers and nursing facility residents regarding CPR decisions. Methods We used qualitative interviews to examine the perspectives of residents with a documented decision for CPR in the medical record. We then compared residents’ views with those of healthcare providers who routinely conduct advance care planning (ACP) conversations in the nursing facility setting. Results Five themes emerged from the interviews: (a) Resident versus Provider Concerns, (b) Offering Information versus Avoidance, (c) Lack of Understanding of CPR, (d) Lack of Awareness, and (e) ‘Don't Keep Me on Machines'. Residents held misconceptions about CPR and/or exhibited an overall poor understanding of the relationship between their own health status and the likelihood of a successful CPR attempt. Although healthcare providers offer information and health education in an attempt to address knowledge gaps, these efforts are not always successful or even accepted by residents. Resident viewpoints and priorities differed from healthcare providers in ways that affected communication about CPR. Conclusions Unrecognised differences in perceptions between providers and residents affect key aspects of ACP communication that can impact CPR decision-making. The concerns and priorities of institutionalized older adults may differ from those of healthcare providers, creating challenges for engaging some residents in ACP. Implications for Practice ACP communication models and training should be designed not only to explore nursing facility residents' goals, values, and preferences, but also to elicit any underlying differences in perceptions that may affect communication. Healthcare providers can identifying the primary concerns of residents and assist them with integrating or reframing these issues as a part of ACP discussions

Complete Break Up of Ortho Positronium (Ps)- Hydrogenic ion System

The dynamics of the complete breakup process in an Ortho Ps - He+ system including electron loss to the continuum (ELC) is studied where both the projectile and the target get ionized. The process is essentially a four body problem and the present model takes account of the two centre effect on the electron ejected from the Ps atom which is crucial for a proper description of the ELC phenomena. The calculations are performed in the framework of Coulomb Distorted Eikonal Approximation. The exchange effect between the target and the projectile electron is taken into account in a consistent manner. The proper asymptotic 3-body boundary condition for this ionization process is also satisfied in the present model. A distinct broad ELC peak is noted in the fully differential cross sections (5DCS) for the Ps electron corroborating qualitatively the experiment for the Ps - He system. Both the dynamics of the ELC from the Ps and the ejected electron from the target He+ in the FDCS are studied using coplanar geometry. Interesting features are noted in the FDCS for both the electrons belonging to the target and the projectile.Comment: 14 pages,7 figure

‘Stepping away from the computer and into the sweats': The construction and negotiation of exercise identities in a Norwegian public company

While research has found that a developed exercise identity enables individuals to view exercise participation as self- reinforcing, the social barriers to such exercise identity development and participation have not been fully addressed. The subsequent aim of this study was to explore some of the social complexities at play in terms of how company employees construct and manage their exercise identities within a work place setting. A case-study method was used to address the research issue over a nine-month period. The case to be studied included a sample of 72 employees from a Norwegian public company who participated in an on-going work-based exercise programme called ‘Exercise for all’. The principal means of data collection comprised participant observation, individual interviews and exercise logbooks. The data were subject to inductive analysis. The primary barriers to exercise participation included high levels of social comparison in a competitive working context, particularly in relation to ‘competent colleagues’, and feelings of guilt associated with partaking in ‘recreational’ activities during work hours. Strategies engaged with to overcome and negotiate such obstacles included justifying participation through a health-related discourse, and constructing a more distinct ‘worker-exerciser’ identity

"I really should've gone to the doctor": older adults and family caregivers describe their experiences with community-acquired pneumonia

BACKGROUND: Responding to acute illness symptoms can often be challenging for older adults. The primary objective of this study was to describe how community-dwelling older adults and their family members responded to symptoms of community-acquired pneumonia (CAP). METHODS: A qualitative study that used face-to-face semi-structured interviews to collect data from a purposeful sample of seniors aged 60+ and their family members living in a mid-sized Canadian city. Data analysis began with descriptive and interpretive coding, then advanced as the research team repeatedly compared emerging thematic categories to the raw data. Searches for disconfirming evidence and member checking through focus groups provided additional data and helped ensure rigour. RESULTS: Community-acquired pneumonia symptoms varied greatly among older adults, making decisions to seek care difficult for them and their family members. Both groups took varying amounts of time as they attempted to sort out what was wrong and then determine how best to respond. Even after they concluded something was wrong, older adults with confirmed pneumonia continued to wait for days, to over a week, before seeking medical care. Participants provided diverse reasons for this delay, including fear, social obligations (work, family, leisure), and accessibility barriers (time, place, systemic). Several older adults and family members regretted their delays in seeking help. CONCLUSION: Treatment-seeking delay is a variable, multi-phased decision-making process that incorporates symptom assessment plus psychosocial and situational factors. Public health and health care professionals need to educate older adults about the potential causes and consequences of unnecessary waits. Such efforts may reduce the severity of community-acquired pneumonia upon presentation at clinics and hospitals, and that, in turn, could potentially improve health outcomes

Contraceptive methods and use by women aged 35 and over: A qualitative study of perspectives

<p>Abstract</p> <p>Background</p> <p>More than 30% of the pregnancies in women aged 35 and over are unintended. This paper compares perceptions about contraceptive methods and use among women with and without an unintended pregnancy after turning age 35.</p> <p>Methods</p> <p>Semi-structured, in-depth interviews were conducted with 17 women. They were all 35 to 49 years old, regularly menstruating, sexually active, not sterilized, not desiring a pregnancy in the near future, and at least 3 months postpartum. We purposely sampled for women who had had at least one unintended pregnancy after age 35 (n = 9) and women who did not (n = 8). We assessed partnership, views of pregnancy and motherhood, desired lifestyle, perceived advantages and disadvantages of using and obtaining currently available well-known reversible contraceptives in the U.S. ''We also assessed contraceptive methods used at any time during their reproductive years, including current method use and, if appropriate, circumstances surrounding an unintended pregnancy after age 35.'' Each interview was taped and transcribed verbatim. Data were analyzed using Grounded Theory. Analysis focused on partnership, views of pregnancy, motherhood, desired lifestyle and perceived advantages and disadvantages of various reversible contraceptive methods.</p> <p>Results</p> <p>The women without an unintended pregnancy after age 35 were more likely to (1) use contraceptive methods that helped treat a medical condition, (2) consider pregnancy as dangerous, or (3) express concerns about the responsibilities of motherhood. The women who experienced an unintended pregnancy after age 35 were more likely to (1) report unstable partnerships, (2) perceive themselves at lower risk of pregnancy, or (3) report past experiences with unwanted contraceptive side effects. There was a greater likelihood a woman would choose a contraceptive method if it was perceived as easy to use, accessible, affordable and had minimal side effects.</p> <p>Conclusions</p> <p>Women's perspective on contraceptive use after age 35 varies. Public health messages and health providers' care can help women in this age group by reviewing their fertility risks, as well as all contraceptive methods and their associated side effects. The impact of such interventions on unintended pregnancy rates in this age group should be tested in other areas of evidence-based medicine.</p

COMPUTER-CONTROLLED GAS CHROMATOGRAPH CAPABLE OF ''REAL-TIME'' READOUT OF HIGH-PRECISION DATA.

A gas chromatograph has been assembled which provides computer control of sample injection, column temperature, and flow rate, plus direct computer readout of inlet pressure, mass flow rate, and detector response. Data processing yields, in real-time, a standard deviation of less than 0.05% in retention time, which is comparable to previous results obtained using an off-line computer. However, corrected retention volumes determined in real-time had a standard deviation of about 0.4% which reflected primarily the uncertainty in flow measurement