Lived experiences of family members who have a sibling with borderline personality disorder

Abstract: Mental illness does not only affect the individual with the illness but their whole family. Amongst mental illnesses, borderline personality disorder (BPD) has been found to be the most difficult and challenging to manage. People with BPD have unstable and very intense interpersonal relationships which are characterised by excessive idealisation and devaluing of a loved one as well as fear of real or imagined abandonment. Family members, like siblings, are the most affected because of these challenges. The purpose of this study was to understand the lived experiences of family members who have a sibling with BPD, and to formulate specific recommendations to facilitate family members’ mental health. The siblings with BPD can be very challenging to those close to them and have frequent emotional outbursts which can range from verbal abuse to physical attacks. At times, they act out in self-destructive activities as an act of revenge towards their loved ones. A qualitative, exploratory, descriptive and contextual research design was utilised in this study. There were two phases to this research. In Phase One, the lived experiences of family members who have a sibling with BPD were explored and described. A purposive sampling of family members who have a sibling with BPD was utilised in this study as it provides information-rich cases. Data were collected using in-depth, semi-structured, phenomenological interviews until data saturation was achieved. Lincoln and Guba’s approach to ensure trustworthiness was adopted. Tesch’s method of data analysis was employed to analyse the data. The researcher made use of the services of an independent coder who is an experienced psychiatric nurse practitioner, and a consensus discussion was held between the researcher and independent coder. The findings of the research were discussed in light of the literature relevant to this study as well as other similar studies to verify the findings...M.A. (Nursing

From a sinking school to a moving school: a case study of a school-teacher union partnership to facilitate school improvement.

Masters Degree. University of KwaZulu-Natal, Durban.School-teacher union partnership has been found to have a positive impact on school performance, teacher development and learner achievement. The purpose of this research study is to examine the impact of a school-teacher union partnership to facilitate school improvement. The study was underpinned by instructional and transformational leadership theory, which collectively emphasise participatory decision-making, participation of all stakeholders in school improvement interventions. The study was guided by an interpretivist paradigm and case study design. Participants were purposively selected and they included six for semi structured and eight for focus group discussions. These participants were drawn from SADTU, Department of Education and Kuzolunga Secondary School. Document analysis was used to corroborate the interview data. The study revealed inter alia, that planning of partnership was informed by evidence-based approach which contextualised courses of action to improve learner outcomes. The team-based structure was used to facilitate stakeholder participation and coordination of partnership activities. From a SADTU perspective, this partnership enabled resource mobilisation to improve the quality of education. In the teachers’ view, the partnership encouraged peer learning through mentoring and coaching. Although the Department preferred the results-based approach, it appreciated SADTU’s evidence-based approach which empowered management, teachers and learners through shared accountability for action and results. The study found that refocusing the commitment of teachers is key to improving school performance. Incapacity of principals and parents hinders success of the partnership. The study concluded that the school-teacher union partnership works well in improving the school. The study also established the centrality of the principal for the formation of the school-teacher union partnership and its success in improving the school. Given this, the study recommended policy adaptation to facilitate school leadership development so that principals are empowered to undertake their diverse roles. In respect of teacher unions, the study proposes that they must use their power and influence to mobilise their members to support school improvement initiatives. School improvement can be strengthened through effective communication between teacher unions, schools, parents and the Department of Education. The study advances an African Perspective within the concept of Ubuntu to ensure success and continuity of school teacher union partnerships

The Lasserre hierarchy for equiangular lines with a fixed angle

We compute the second and third levels of the Lasserre hierarchy for the spherical finite distance problem. A connection is used between invariants in representations of the orthogonal group and representations of the general linear group, which allows computations in high dimensions. We give new linear bounds on the maximum number of equiangular lines in dimension $n$ with common angle $\arccos \alpha$. These are obtained through asymptotic analysis in $n$ of the semidefinite programming bound given by the second level.Comment: 25 pages, 2 figures. Submitted versio

kk-point semidefinite programming bounds for equiangular lines

We give a hierarchy of $k$-point bounds extending the Delsarte-Goethals-Seidel linear programming $2$-point bound and the Bachoc-Vallentin semidefinite programming $3$-point bound for spherical codes. An optimized implementation of this hierarchy allows us to compute~$4$, $5$, and $6$-point bounds for the maximum number of equiangular lines in Euclidean space with a fixed common angle.Comment: 26 pages, 4 figures. New introduction and references update

Parenting Styles and Influences of Millennial Parents in the Development of Values System of Grade 7 Learners in Negros Occidental: A Case Study

This qualitative research determined the parenting styles and influences of millennial parents in the values development system of Grade 7 learners in Negros Occidental: A case study. Diana Baumrind describes three parenting styles that affect the values development of children (Santrock, 2017) but in Nancy Darling (1999) cited by Situmorang (2021) in his study perceived parenting styles urges that parenting styles focus on four typologies; authoritative, authoritarian, indulgent and uninvolved. Influences of millennial parents in terms of character and religious aspects of millennial parents (Moriss, 2022) may have a role in the values development system for their children. A case study approach was used to gather primary data through in- depth interviews with our ten (10) millennial participants in Negros Occidental. Thematic analysis was used to analyze the classifications and present themes or patterns that relate to the data with the following steps: finalizing data, assigning preliminary code, searching for themes, reviewing themes, defining and naming themes, and producing reports (Braun & Clarke, 2006). The findings revealed that the majority of the study concluded that the authoritative parenting style is the parenting style of millennial parents prefer to employ, which affects or influence the values development system of their children positively. The study shows that the love, respect, open communication, and self-discipline of millennial parents influence the opportunities to improve their children's family significantly in helping their children build and refine their positive values development system. The study was organized into five parts. First, the introduction. Second, the theoretical framework. Third part is the review of the related literature about parenting styles, values development system, and influences of millennial parents. Fourth part is the purpose of the study and the research questions. The fifth part is the Research methodology which includes research design and research procedure and sampling. The sixth part is the results and discussion. Lastly, are the conclusion and recommendations of the research

ST-Elevation myocardial infarction network: systematization in 205 cases reduced clinical events in the public health care system

BACKGROUND: The major cause of death in the city of São Paulo (SP) is cardiac events. At its periphery, in-hospital mortality in acute myocardial infarction is estimated to range between 15% and 20% due to difficulties inherent in large metropoles. OBJECTIVE:To describe in-hospital mortality in ST-segment elevation acute myocardial infarction (STEMI) of patients admitted via ambulance or peripheral hospitals, which are part of a structured training network (STEMI Network). METHODS: Health care teams of four emergency services (Ermelino Matarazzo, Campo Limpo, Tatuapé and Saboya) of the periphery of the city of São Paulo and advanced ambulances of the Emergency Mobile Health Care Service (abbreviation in Portuguese, SAMU) were trained to use tenecteplase or to refer for primary angioplasty. A central office for electrocardiogram reading was used. After thrombolysis, the patient was sent to a tertiary reference hospital to undergo cardiac catheterization immediately (in case of failed thrombolysis) or in 6 to 24 hours, if the patient was stable. Quantitative and qualitative variables were assessed by use of uni- and multivariate analysis. RESULTS: From January 2010 to June 2011, 205 consecutive patients used the STEMI Network, and the findings were as follows: 87 anterior wall infarctions; 11 left bundle-branch blocks; 14 complete atrioventricular blocks; and 14 resuscitations after initial cardiorespiratory arrest. In-hospital mortality was 6.8% (14 patients), most of which due to cardiogenic shock, one hemorrhagic cerebrovascular accident, and one bleeding. CONCLUSION: The organization in the public health care system of a network for the treatment of STEMI, involving diagnosis, reperfusion, immediate transfer, and tertiary reference hospital, resulted in immediate improvement of STEMI outcomes.FUNDAMENTO: A principal causa de óbitos na cidade de São Paulo (SP) é por eventos cardíacos. Em hospitais periféricos de São Paulo estima-se a mortalidade hospitalar no infarto agudo entre 15% e 20%, pelas dificuldades existentes. OBJETIVO: Descrever a mortalidade intra-hospitalar do Infarto Agudo do Miocárdio com Supradesnivelamento de ST (IAMCSST) de pacientes admitidos via ambulância ou hospitais periféricos, como resultado da organização de uma estruturada rede de treinamento. MÉTODOS: Equipes de quatro prontos-socorros (Ermelino Matarazzo, Campo Limpo, Tatuapé e Saboya) e das ambulâncias avançadas do Serviço de Atendimento Móvel de Urgência (Samu) foram treinadas para uso de tenecteplase (TNK) ou para encaminhamento para angioplastia primária. Uma central de leitura de eletrocardiogramas foi usada quando necessário. Após uso de trombolítico, um hospital terciário recebia o paciente que era submetido a cinecoronariografia imediata (trombólise sem sucesso) ou entre 6 e 24 h, caso estável. Variáveis quantitativas, qualitativas foram avaliadas em análise uni e multivariável. RESULTADOS: De janeiro 2010 a junho 2011, 205 pacientes consecutivos utilizaram a rede de atendimento, ocorrendo 87 infartos de parede anterior, 11 bloqueios de ramo esquerdo, 14 bloqueios atrioventricular total, e em 14 houve reanimação pós-parada cardiorrespiratória inicial. A mortalidade intra-hospitalar foi de 6,8% (14 casos), a maioria por choque cardiogênico, um por acidente vascular encefálico hemorrágico e um por sangramento. CONCLUSÃO: A organização em instituições públicas de uma rede de tratamento, envolvendo diagnóstico, reperfusão, transporte imediato e hospital de retaguarda resultou em melhora imediata dos resultados de IAMCSST.Universidade Federal de São Paulo (UNIFESP), Escola Paulista de Medicina (EPM)Serviço de Atendimento Móvel de UrgênciaPrefeitura Municipal de São Paulo Secretaria de SaúdeHospital Municipal Prof. Dr. Alípio Correa NettoUNIFESP, EPMSciEL

O incentivo dos programas de pagamento baseado na qualidade do leite à adoção de boas práticas agropecuárias nas propriedades leiteiras: um estudo multicasos na região do Médio Paraíba Fluminense/RJ

Objetivo do trabalho: Para uma produção leiteira mais competitiva é necessário melhorar a gestão da qualidade tanto durante a produção na propriedade como na indústria. O Programa de Pagamento Baseado na Qualidade do Leite (PPBQL) tem objetivo de melhorar a qualidade do leite através de uma remuneração diferenciada pago ao produtor. Esse trabalho visa investigar se os PPBQLs adotados por uma cooperativa processadora de leite e laticínios concorrentes, ambos da Região do Médio Paraíba Fluminense (RMPF), incentivam o atendimento de critérios de qualidade de leite e uso de boas práticas agropecuárias pelos produtores rurais. Especificamente, pretende-se: (1) entender os critérios de qualidade de leite definidos pelos laticínios analisados; (2) verificar as boas práticas agropecuárias adotadas pelos produtores rurais, sejam eles associados da cooperativa, ou ex-associados, mas que participam de PPBQLs de outros laticínios concorrentes; e a qualidade de leite obtida; (3) comparar os PPBQLs da cooperativa e dos laticínios concorrentes em termos de critérios de qualidade exigidos, incentivos financeiros e serviços oferecidos aos produtores rurais. Procedimentos/Método para a solução do problema: Após a revisão de literatura, realizou-se um estudo multicasos para captar informações sobre os PPBQLs de uma cooperativa e um laticínio concorrente, ambos localizados na RMPF, por meio de entrevistas semiestruturadas com os gestores e visitas técnicas às operações das organizações. No decorrer da pesquisa, foi possível realizar as entrevistas com dois laticínios concorrentes, o que reforçou o comparativo com a cooperativa analisada. Também foram realizadas entrevistas com os produtores rurais e às suas propriedades para compreensão das boas práticas agropecuárias utilizadas para garantir a entrega de um leite de qualidade, diferenciando os cooperados dos ex-cooperados e atuais fornecedores do concorrente. Informações complementares foram coletadas através do e-mail e via telefone. Nesse sentido, a pesquisa visa responder o seguinte questionamento: Como os PPBQLs da RMPF incentivam o atendimento de critérios de qualidade de leite e uso de boas práticas de gestão nas propriedades rurais?. Para tanto, considerou-se como unidade de análise o PPBQL de cada organização, e como subunidades: (1) critérios de qualidade do leite; e (2) boas práticas agropecuárias adotadas nas propriedades rurais. E as proposições teóricas a serem analisadas foram definidas como: (1) o PPBQL da cooperativa incentiva a adoção de boas práticas de gestão que garantem o atendimento de critérios de qualidade de leite exigidos pela legislação nacional; e (2) o PPBQL dos concorrentes incentiva a adoção de boas práticas de gestão que garantem a entrega de um leite de qualidade superior. Resultados: Investigando se os PPBQLs da cooperativa analisada e dos laticínios concorrentes incentivam o atendimento de critérios de qualidade de leite e uso de boas práticas de gestão agropecuárias pelos produtores rurais, constatou-se que: (1) nem todos os produtores assimilaram bem os parâmetros de qualidade do leite da IN 31/2018; (2) a participação dos produtores nos PPBQLs foi capaz de estimular a inclusão das boas práticas agropecuárias na rotina das propriedades rurais, sejam eles cooperados ou ex-cooperados; e (3) os produtores tem consciência do que fazer para fornecer um leite de boa qualidade, mas consideram insatisfatórias as bonificações de preço pago pelo leite de qualidade. Por outro lado, no comparativo da cooperativa com outros laticínios concorrentes, pode-se constatar que o PPBQL da cooperativa, e as bonificações de preço pago, basicamente visam o cumprimento dos critérios da IN 31/2018, enquanto o dos concorrentes, tenta obter critérios superiores de qualidade. Da mesma forma, apesar da importância social da cooperativa, por garantir a permanência do pequeno produtor no campo, sendo um canal de acesso a mercado para ele, o desafio da mesma é grande no sentido desse produtor conseguir atender a IN 31/2018. Implicações práticas: A pesquisa aqui realizada divulga o funcionamento dos programas de pagamento baseados na qualidade de leite (PPBQL) na região do médio paraíba fluminense, e a diversidade de formatos praticados, o que até então era desconhecido da literatura, pelo menos a consultada. Também procura revelar o status de cumprimento da IN 31/2018 na região estudada. Por fim, apresenta a situação de adoção de boas práticas agropecuárias entre os produtores rurais e o foco de atuação que uma assistência técnica gerencial deve ter na região. Originalidade e contribuições: Não foi identificado até então um estudo similar na RMPF, por isso considera-se a pesquisa empreendida original. Da mesma forma, o estudo contribui para o entendimento das práticas relacionadas aos PPBQLs por cooperativas e laticínios da RMPF, a situação de cumprimento da IN 31/2018 e de adoção de boas práticas agropecuárias por parte dos produtores rurais, e se os PPBQLS garantem a entrega de um leite de qualidade ou somente o cumprimento da IN 31/2018. Os procedimentos metodológicos adotados nessa pesquisa também podem ser replicados em futuras pesquisas em outras regiões, e os resultados comparados. Produção Técnica/Tecnológica: Os procedimentos metodológicos utilizados na investigação dos PPBQLs nos laticínios e das boas práticas agropecuárias nas propriedades leiteiras podem ser organizados em um produto técnico/tecnológico e ser considerado como uma externalidade gerada pela dissertação. Conforme a classificação dos produtos tecnológicos, aquele pode ser enquadrado no eixo 1 (produtos e processos) como um processo de gestão (ou de diagnóstico).Objective of the study: To a more competitive dairy production it is necessary the improvement of management during farm and industry levels production. The Payment Program based on Milk Quality (PPBQL) aims to improve the quality of milk through a differentiated payment paid to the producer. This work aims to investigate whether the PPBQLs adopted by a cooperative milk processing and competitor dairy companies, both from the “Médio Paraíba Fluminense/ RJ” Region (RMPF), encourage the fulfillment of milk quality criteria and the use of good agricultural practices by rural producers. Specifically, it is intended: (1) to understand the milk quality criteria of the analyzed dairy companies; (2) to verify the good agricultural practices adopted by rural producers, associated with the cooperative, or former associates who actually participate in PPBQLs of other competing dairy companies; and the milk quality obtained; (3) to compare the PPBQL from the cooperative with the competing dairy companies in terms of required quality criteria, financial incentives and services offered to the farmers. Procedures / Method for solving the problem: After reviewing the literature, a multicase study was used to gather information about the PPBQL of a cooperative in “Médio Paraíba Fluminense/ RJ” region and two competitors located in the same region. Semi-structured interviews were carried out with the agents related to the milk production chain. Additional information was collected through e-mail and telephone. At the same time, a technical visit to the cooperative was done to observe and monitor the productive processes. The unit of analysis is the PPBQLs of the cooperative v. competitors and subunits (1) milk quality criteria; and (2) good agricultural practices adopted in rural properties. For the analysis, the two propositions were validated (1) the cooperative's PPBQL encourages the adoption of good agricultural practices that ensure compliance with the milk quality criteria required by national legislation; and (2) competitors' PPBQLs encourage the adoption of good agricultural practices that ensure delivery of a milk of superior quality. Results: Investigating whether the PPBQLs of the cooperative and the dairy competitors encourage the fulfillment of milk quality criteria and the use of good agricultural practices by the rural producers, it was verified that: (1) not all producers well assimilate the milk quality parameters of IN 31/2018; (2) the participation of producers in PPBQLs was able to stimulate the inclusion of good agricultural practices in the routine of rural properties; and (3) producers are aware of what to do to provide good milk quality, but consider premium price paid unsatisfactory for the milk with quality. On the other hand, it can be seen that the PPBQL of the cooperative, and premium price paid, basically aim at meeting the criteria of the national legislation (IN 31/2018), while the PPBQLs of competitors try to obtain a higher quality criteria. In the same way, despite the social importance of the cooperative, in order to guarantee the small producers' permanence in the field, being a channel of market access for them, the challenge is big in the sense of that producers can meet the IN 31/2018. Practical implications: The research reports the performance of PPBQLs in the RMPF region, and the diversity of formats practiced, which until then was unknown in the literature, at least the one consulted. It also seeks to reveal the compliance status with the IN 31/2018 in the studied region. Finally, it presents the adoption of good agricultural practices among rural producers and the focus of action that a technical assistance should have in the region. Originality and contributions: A similar study in RMPF has not been identified until then, so the original research is considered. In the same way, the study contributes to the understanding of practices related to PPBQLs by RMPF cooperative and other dairy companies, compliance with the IN 31/2018 and adoption of good agricultural practices by rural producers, and whether PPBQLs guarantee the delivery of milk with quality or only the compliance with the IN 31/2018. The methodological procedures adopted in this research can also be replicated in future researches in other regions, in order to compare the results. Technical / Technological Production: The methodological procedures used in the investigation of PPBQLs in dairy companies and the good agricultural practices in dairy farms can be organized into a technical/technological product and be considered as an externality generated by the dissertation. According to the classification of technological products, it can be classified in axis 1 (products and processes) as a management (or diagnosis) process.133 f