‘My life's properly beginning’: young people with a terminally ill parent talk about the future

This paper explores how young people who are living with a parent who is dying talk about the future. Drawing on a qualitative, interview study, I argue that young people are able to move imaginatively beyond the death of a parent, and in doing so, to maintain a sense of biographical continuity. While thinking about the future, most were able to generate an alternative to the ‘harm story’ typically associated with parental loss. Furthermore, the facility to engage with parental absence in the present enabled young people to make sense of living with dying, and gave meaning to their imagined futures. These findings suggest that young people's narratives of the future may act as a symbolic resource to draw on, albeit one requiring adequate material and social resources to construct. The paper extends the notion of continuing bonds derived from post‐bereavement accounts to suggest that relational experiences of the dead begin prior to bereavement, and may facilitate everyday living in anticipation of significant loss. Enabling young people to imaginatively explore the future may support them in getting by when they are living in these difficult family circumstances

Stories of success: Cultural narratives and personal stories of elite and professional athletes

Using a narrative methodology to explore the stories Olympic and elite athletes tell about success, we identified three alternatives to the dominant conception of success as the achievement of performance outcomes. In these alternatives, success is storied as: (1) ‘I did the best that I could’ – a controllable and sustainable story of effort and application; (2) ‘It’s the closest thing you can get to flying’ – a story where success relates to embodied experience and discovery; (3) ‘People I made the journey with’ – which prioritises relationships and connection between people. We reflect on three key insights: (1) success is a multidimensional concept, broader than the singular conception encapsulated within the dominant performance narrative; (2) through various narrative strategies, experienced athletes resist cultural pressures towards a singular conception of success; (3) for long-term performance and well-being, it is necessary to work towards multiple forms of success over time and across contexts

Persistence of pharmaceutical compounds and other organic wastewater contaminants in a conventional drinking-water-treatment plant

In a study conducted by the US Geological Survey and the Centers for Disease Control and Prevention, 24 water samples were collected at selected locations within a drinking-water-treatment (DWT) facility and from the two streams that serve the facility to evaluate the potential for wastewater-related organic contaminants to survive a conventional treatment process and persist in potable-water supplies. Stream-water samples as well as samples of raw, settled, filtered, and finished water were collected during low-flow conditions, when the discharge of effluent from upstream municipal sewage-treatment plants accounted for 37–67% of flow in stream 1 and 10–20% of flow in stream 2. Each sample was analyzed for 106 organic wastewater-related contaminants (OWCs) that represent a diverse group of extensively used chemicals.Forty OWCs were detected in one or more samples of stream water or raw-water supplies in the treatment plant; 34 were detected in more than 10% of these samples. Several of these compounds also were frequently detected in samples of finished water; these compounds include selected prescription and non-prescription drugs and their metabolites, fragrance compounds, flame retardants and plasticizers, cosmetic compounds, and a solvent. The detection of these compounds suggests that they resist removal through conventional water-treatment processes. Other compounds that also were frequently detected in samples of stream water and rawwater supplies were not detected in samples of finished water; these include selected prescription and non-prescription drugs and their metabolites, disinfectants, detergent metabolites, and plant and animal steroids. The non-detection of these compounds indicates that their concentrations are reduced to levels less than analytical detection limits or that they are transformed to degradates through conventional DWT processes. Concentrations of OWCs detected in finished water generally were low and did not exceed Federal drinking-water standards or lifetime health advisories, although such standards or advisories have not been established for most of these compounds. Also, at least 11 and as many as 17 OWCs were detected in samples of finished water. Drinking-water criteria currently are based on the toxicity of individual compounds and not combinations of compounds. Little is known about potential human-health effects associated with chronic exposure to trace levels of multiple OWCs through routes such as drinking water. The occurrence in drinking-water supplies of many of the OWCs analyzed for during this study is unregulated and most of these compounds have not been routinely monitored for in the Nation’s source- or potable-water supplies. This study provides the first documentation that many of these compounds can survive conventional water-treatment processes and occur in potable-water supplies. It thereby provides information that can be used in setting research and regulatory priorities and in designing future monitoring programs. The results of this study also indicate that improvements in water-treatment processes may benefit from consideration of the response of OWCs and other trace organic contaminants to specific physical and chemical treatments

Living with semantic dementia: a case study of one family's experience

Semantic dementia is a variant of frontotemporal dementia and is a recently recognized diagnostic condition. There has been some research quantitatively examining care partner stress and burden in frontotemporal dementia. There are, however, few studies exploring the subjective experiences of family members caring for those with frontotemporal dementia. Increased knowledge of such experiences would allow service providers to tailor intervention, support, and information better. We used a case study design, with thematic narrative analysis applied to interview data, to describe the experiences of a wife and son caring for a husband/father with semantic dementia. Using this approach, we identified four themes: (a) living with routines, (b) policing and protecting, (c) making connections, and (d) being adaptive and flexible. Each of these themes were shared and extended, with the importance of routines in everyday life highlighted. The implications for policy, practice, and research are discussed. Keywords : case studies, dementia, families, caregiving, interviews, semistructured, narrative inquir

The discovery of ash dieback in the UK: the making of a focusing event

Why did the identification of ‘Ash Dieback’ (Chalara Fraxinea) in 2012 in the UK catch the national media, public and political zeitgeist, and lead to policy changes, in a way that no other contemporary tree pest or pathogen outbreak has?The identification of Ash Dieback in the UK is conceptualised as a successful ‘focusing event’ and the ways in which it was socially constructed by the media, stakeholders and the government are analysed. National newspaper coverage contributed to the way that the disease was understood and was significant in driving the political response. Ash Dieback’s focal power derived from the perceived scale and nature of its impact; the initial attribution of blame on government; the ‘war-like’ response from the government; and Ash’s status as a threatened ‘native’ tree. The Ash Dieback focusing event has increased the salience of plant health issues amongst policymakers, the public and conservation organisations in the UK

Cancer worry among Norwegian male BRCA1/2 mutation carriers

This qualitative study explored the experiences of Norwegian men after being identified as BRCA 1/2 mutation-positive. Only limited knowledge is available on this topic; therefore, the aim of this study was to gain a deeper insight from the men’s own perspectives. Data were collected from in-depth interviews with 15 men and seven of their partners. The participants described fear of cancer development, and two main narrative patterns were identified: fear for their own health, including fear of developing cancer, and negative feelings about responsibility for others’ health. The men expressed fear of developing cancer themselves and described a need for genetic risk information. They were also deeply concerned about how the mutation might affect their children and other relatives. There is a need for guidelines concerning genetic risk information and follow-up programs for male BRCA 1/2 mutation carriers. This study adds valuable contextual insights into their experiences of living with fear of cancer

Does replacement of missing dental units with resin-retained bridges improve oral health-related quality of life?: A systematic review

Objectives To assess the current literature in regard to two research questions: • Does placement of a 2-unit cantilever RRB to replace a missing dental unit improve oral health-related quality of life (OHRQoL) in patients over 18 years old? • Are there any differences in OHRQoL between different methods of replacing missing teeth? Methods Systematic review following the Preferred Reporting Items for Systemic Reviews and Meta-Analysis statement (PRISMA) statement. Data/sources MEDLINE via Ovid, Scopus, PsycINFO via Ovid, Cochrane Library, Web of Science and clinicaltrials.gov were searched (Jan 1980 to Nov 2018) using high-level MeSH terms for studies published in English, investigating OHRQoL, using valid indices. Risk of bias (RoB) Determined using Cochrane RoB tool and ROBINS-I. Evidence certainty Grading of Recommendations, Assessment, Development and Evaluation (GRADE) Working Group tool. Results Study Selection: 280 articles were identified; 270 were excluded after abstract review, 7 after examining full text, leaving 3 articles (3 studies, 188 participants, 172 analysed) included in this review; one RCT and two observational studies. Synthesis of results: There was significant heterogeneity and no meta-analysis was possible. Description of effect: One pre-post study design found provision of 2-unit RRBs significantly reduced the total OHIP-49 score (effect size 0.67), compared with an untreated control. One case-control study found no differences in total OHIP-49 between individuals treated with RRB or implant-supported crown. Major complications related to a worse OHRQoL. Discussion Quality of evidence: The overall RoB assessments were one study “some concerns” and two studies “serious”. The GRADE assessment was “moderate” for one comparison and “low” for two comparisons. Clinical significance: A 2-unit cantilever RRB to replace one missing tooth probably results in a large improvement in oral health-related quality of life. Clinicians should ensure that the correct investigations and design of prosthesis are prescribed to help reduce any failures that may impact on OHRQoL

The role of qualitative research in adding value to a randomised controlled trial: lessons from a pilot study of a guided e-learning intervention for managers to improve employee wellbeing and reduce sickness absence

The GEM study was funded by the National Institute for Health Research Public Health Research Programme (project number 10/3007/06)

Prevalence and age-of-onset distributions of DSM IV mental disorders and their severity among school going Omani adolescents and youths: WMH-CIDI findings

<p>Abstract</p> <p>Background</p> <p>There is a dearth of studies exploring the magnitude of mental disorders amongst adolescents and youths in the Arab world. To our knowledge, this phase 2 survey in Oman is the first nationally representative school-based study to determine the prevalence of DSM-IV mental disorders (lifetime and over the preceding 12 months), their age-of-onset distributions and determine their severity over the past 12 months using the World Mental Health-Composite International Diagnostic Interview, the WMH-CIDI, used for international comparison.</p> <p>Methods</p> <p>A total of 1,682 (91.61%) students out of 1836 students who formed the phase 2 random sub-sample of a multi-stage, stratified, random sampling design (phase 1), participated in the face-to-face structured interview using the Arabic-version of WMH-CIDI 3.0.</p> <p>Results</p> <p>The phase 1 results using the General Health Questionnaire (GHQ-12) and Child Depression Inventory (CDI) showed depressive symptoms to be 17% prevalent in the larger sample of 5409 adolescents and youths. Amongst the phase 2 respondents from this sample, 13.9% had at least one DSM IV diagnostic label. The lifetime prevalence of Major Depressive Disorder (MDD) was 3.0%; Bipolar Mood Disorder (BMD) was 1%, Specific phobia 5.8% and Social phobia 1.6%. The female gender was a strong predictor of a lifetime risk of MDD (OR 3.3, 95% CI 1.7-6.3, <it>p </it>= 0.000); Any Mood Disorders (OR 2.5, 95% CI 1.4-4.3, p = 0.002) and Specific Phobia (OR 1.5, 95% CI 1.0-2.4, p = 0.047). The severity of illness for cases diagnosed with 12 month DSM IV disorders was found to be 80% lower in females (OR 0.2, 95%CI 0.0-0.8). The estimates over the previous 12 month period when compared with the lifetime prevalence showed a 25% to 40% lower prevalence for MDD, Specific phobia, Social phobia, Any Anxiety Disorders (AAD) and Any Mood disorders (AMD) while the rate was 80% lower for Separation Anxiety Disorder/Adult Separation Anxiety (SAD/ASA). Mood disorders were significantly lower in the 14-16 age groups (70% lower) in comparison to the older age groups and AMD showed a linear increase in prevalence across increasing age groups (<it>p </it>= 0.035).</p> <p>Conclusion</p> <p>The implications of the present findings are not clear cut, however this study endorses the adult CIDI studies findings that mental disorders do begin earlier in life. The relatively lower prevalence of DSM IV depressive disorders cautions against any conclusive interpretation of the inflated results based on the exclusive study of the depressive symptoms alone in the same sample in the same time period. The female gender proved to be a strong predictor of lifetime risk of MDD, any mood disorder and specific phobia. Under-reporting by males or some other gender-specific factors may have contributed to such a discrepancy. The odds of the severity of illness for cases with 12 month DSM IV disorders were significantly lower in females.</p