A qualitative evaluation of occupational therapy-led work rehabilitation for people with inflammatory arthritis : patients’ views

Introduction: This qualitative study, nested in a pilot feasibility randomised controlled trial, explored the views of working people with inflammatory arthritis on the impact of a work rehabilitation programme received. Method: Thirty-two participants, drawn from the 55 participants in the associated randomised controlled trial, were recruited from secondary care in the United Kingdom. Semi-structured telephone and face-to-face interviews were conducted at six (n = 32) and nine months follow-up (n = 31). Interviews were audio-recorded, transcribed, and analysed using a constant comparative approach, under the theoretical framework of critical realism. Findings: Three overarching themes emerged: (1) intervention group participants valued the work rehabilitation programme received, and highlighted the benefits of occupational therapy; (2) control group participants reported no benefits in relation to the written work advice pack, and lacked future aspirations to stay employed; (3) the majority of participants reported not reading the written work advice pack provided, which was the only work advice received by the control group. Conclusion: Working people with inflammatory arthritis highly valued the practical support received from the therapists, and emphasised the value of the therapeutic relationship in the rehabilitation process. A tailor-made work rehabilitation programme, which incorporates cognitive-behavioural strategies into patient education, may help to reduce work instability in people with inflammatory arthritis, and increase their perceived self-efficac

Sources of Community Health Worker Motivation: A Qualitative Study in Morogoro Region, Tanzania.

There is a renewed interest in community health workers (CHWs) in Tanzania, but also a concern that low motivation of CHWs may decrease the benefits of investments in CHW programs. This study aimed to explore sources of CHW motivation to inform programs in Tanzania and similar contexts. We conducted semi-structured interviews with 20 CHWs in Morogoro Region, Tanzania. Interviews were digitally recorded, transcribed, and coded prior to translation and thematic analysis. The authors then conducted a literature review on CHW motivation and a framework that aligned with our findings was modified to guide the presentation of results. Sources of CHW motivation were identified at the individual, family, community, and organizational levels. At the individual level, CHWs are predisposed to volunteer work and apply knowledge gained to their own problems and those of their families and communities. Families and communities supplement other sources of motivation by providing moral, financial, and material support, including service fees, supplies, money for transportation, and help with farm work and CHW tasks. Resistance to CHW work exhibited by families and community members is limited. The organizational level (the government and its development partners) provides motivation in the form of stipends, potential employment, materials, training, and supervision, but inadequate remuneration and supplies discourage CHWs. Supervision can also be dis-incentivizing if perceived as a sign of poor performance. Tanzanian CHWs who work despite not receiving a salary have an intrinsic desire to volunteer, and their motivation often derives from support received from their families when other sources of motivation are insufficient. Policy-makers and program managers should consider the burden that a lack of remuneration imposes on the families of CHWs. In addition, CHWs' intrinsic desire to volunteer does not preclude a desire for external rewards. Rather, adequate and formal financial incentives and in-kind alternatives would allow already-motivated CHWs to increase their commitment to their work

Experiences of older people with dementia: homecare enablement to support transitions in daily life at home

Introduction: The majority of people with dementia live at home. Homecare enablement services are considered an important short-term intervention, using a person-centred approach. Little is known about people with dementia’s perspectives of theservices. This study aimed to explore the users’ experiences. Method: Following ethical approval, participants who had recently used homecare enablement services were invited to participate in two semi-structured interviews through homecare enablement services’ teams within a local authority. Interviews focused on people with dementia’s narratives of the impact of homecare enablement services on their daily functioning. Overall findings were taken back to the participants at the follow-up interviews for member checking. Interviews were digitally recorded, transcribed and analysed using grounded theory. Findings: Sixteen participants with dementia and eight carers took part. Three key themes were revealed: the meaning of enablement in later life; homecare enablement services as instrumental to support transitions in daily life; and enablement through activity engagement in everyday life. Conclusion: The scope of homecare enablement services is evolving to meet the requirements of the Care Act of 2014 and National Institute for Health and Care Excellence guidelines. Services’ improvements and redesign must consider the viewpoints of people with dementia

Understanding the everyday designer in organisations

This paper builds upon the existing concept of an everyday designer as a non-expert designer who carries out design activities using available resources in a given environment. It does so by examining the design activities undertaken by non-expert, informal, designers in organisations who make use of the formal and informal technology already in use in organisations while designing to direct, influence, change or transform the practices of people in the organisation. These people represent a cohort of designers who are given little attention in the literature on information systems, despite their central role in the formation of practice and enactment of technology in organisations. The paper describes the experiences of 18 everyday designers in an academic setting using three concepts: everyday designer in an organisation, empathy through design and experiencing an awareness gap. These concepts were constructed through the analysis of in-depth interviews with the participants. The paper concludes with a call for tool support for everyday designers in organisations to enable them to better understand the audience for whom they are designing and the role technology plays in the organisation

Implementation of a workplace smoking ban in bars: The limits of local discretion

<p>Abstract</p> <p>Background</p> <p>In January 1998, the California state legislature extended a workplace smoking ban to bars. The purpose of this study was to explore the conditions that facilitate or hinder compliance with a smoking ban in bars.</p> <p>Methods</p> <p>We studied the implementation of the smoking ban in bars by interviewing three sets of policy participants: bar employers responsible for complying with the law; local government officials responsible for enforcing the law; and tobacco control activists who facilitated implementation. We transcribed the interviews and did a qualitative analysis of the text.</p> <p>Results</p> <p>The conditions that facilitated bar owners' compliance with a smoking ban in bars included: if the cost to comply was minimal; if the bars with which they were in competition were in compliance with the smoking ban; and if there was authoritative, consistent, coordinated, and uniform enforcement. Conversely, the conditions that hindered compliance included: if the law had minimal sanctions; if competing bars in the area allowed smoking; and if enforcement was delayed or inadequate.</p> <p>Conclusion</p> <p>Many local enforcers wished to forfeit their local discretion and believed the workplace smoking ban in bars would be best implemented by a state agency. The potential implication of this study is that, given the complex nature of local politics, smoking bans in bars are best implemented at a broader provincial or national level.</p

How Do Police Respond to Stalking? An Examination of the Risk Management Strategies and Tactics Used in a Specialized Anti-Stalking Law Enforcement Unit

How do police respond to and manage complaints of stalking? To answer this question, we conducted a 3-phase study. First, we reviewed the literature to identify risk management tactics used to combat stalking. Second, we asked a group of police officers to review those tactics for completeness and group them into categories reflecting more general risk management strategies. The result was 22 categories of strategies. Finally, we used qualitative methods to evaluate the files of 32 cases referred to the specialized anti-stalking unit of a metropolitan police department. We coded specific risk management tactics and strategies used by police. Results indicated that a median number of 19 specific tactics from 7 general strategies were used to manage risk. Also, the implementation of strategies and tactics reflected specific characteristics of the cases (e.g., perpetrator risk factors, victim vulnerability factors), suggesting that the risk management decisions made by police were indeed strategic in nature. Qualitative analyses indicated that some of the strategies and tactics were more effective than others. We discuss how these findings can be used to understand and use stalking risk management more generally, as well as improve research on the efficacy of risk assessment and management for stalking

Dietary responses to a multiple sclerosis diagnosis: a qualitative study

Background/objectives: Multiple sclerosis (MS) is an immune-mediated disease with no known cure and insufficient evidence to support a special therapeutic diet to alter symptom management or disease progression. Several studies have reported dietary changes made by people with MS, but there has been limited investigation into experiences surrounding diet in those recently diagnosed. This study explored responses to diet after a recent diagnosis of MS in people living in Western Australia. Subjects/methods: Eleven adults with MS (mean time since diagnosis 8 months) participated in semi-structured interviews focusing on responses to diet since MS diagnosis. Interviews were transcribed, coded and analysed using grounded theory principles. Results: Three theme responses emerged; (1) the perceived incompatibility of lack of/or generalised dietary advice with disease seriousness at the time of diagnosis; (2) extensive personal research and information seeking with difficulty judging credibility, and (3) self-experimentation with diet to either control MS symptoms or to cure MS. Conclusions: Given the seriousness of the disease, there is a perceived gap in dietary information provided at the time of diagnosis. Healthcare professionals should address concerns with alternative therapeutic diets advertised to treat or cure MS, and clearly convey the reasoning for the general healthy dietary recommendations. This would better align advice with the perceptions about the role of diet in MS, assist people with MS in need of information and minimise dietary self-experimentation. Future research should explore the importance of diet for those who have had MS for a longer period of time

Smart dust in the industrial economic sector : on application cases in product lifecycle management

Smart dust is an autonomous sensing, computing, and communication system that can be packed into a cubic-millimeter mote to form the basis of integrated, massively distributed sensor networks. The purpose of this manuscript is to identify potential applications of smart dust in product lifecycle management with a focus on the industrial economic sector. Resting upon empirical data from the European DACH region, we describe six applications: (1) Advancement of requirements engineering, (2) Improvement of manufacturing processes, (3) Enhancement of logistics monitoring, (4) Optimization of operations, (5) Ameliorated maintenance and repair processes, and (6) Augmented retirement planning. Bearing the exploratory, qualitative approach and early-stage character of applications in mind, we can reason that smart dust offers great potentials to both product lifecycle management and research on it