Understanding Individual Experiences of Chronic Illness with Semantic Space Models of Electronic Discussions

Electronic discussion groups provide a convenient forum for individuals to share their experiences of chronic illness. The language use of individual participants, and the way their language shifts over time, may provide implicit indications of important shifts in sense-of-self. This paper relates experience with application of the hyperspace analogue to language (HAL) model for automatic construction of a dimensional model from a corpus of text. HAL is applied to 17 months of discussion on a closed list of 20 women coping with chronic illness. The discussion group was moderated for a focus the phenomenon of "Transition' - how people can learn to incorporate the consequences of illness into their lives. The current phase of research focuses on identification of clusters of words that can represent key aspects of Transition. The HAL models for two participants have been analyzed by experts in Transition to form candidate clusters. These clusters are then used as a basis for contrasting the language usage of an individual participant over time as compared to the entire corpus. We have not yet found a reliable basis for identifying transitions in an individual based on their entries into a discussion forum, although the clusters may have some inherent value for introspection on individual experiences and Transition in general. We report challenges for interpretation of the HAL model related to the correlation of dimensions and the impact of group dynamics

Munc18c phosphorylation by the insulin receptor links cell signaling directly to SNARE exocytosis

SNARE complex assembly and mobilization of GLUT4 vesicles is coordinated through direct targeting of Munc18c by the insulin receptor tyrosine kinase

Making context work in primary health care

Health care in the community setting is one of the more challenging contexts for evidence-based practice. Community-based care comprises more than simply transplanting hospital care into people’s homes; in addition to the provision of supportive services, it also takes a range of approaches to health care practice that promotes optimal health and builds the capacity of individuals and communities to respond to their health needs. Primary health care is comprised of the diverse activities that build sustainable community capacity to achieve health and well-being throughout all of life’s stages. The expansive nature of primary health care means that a map for practice is not feasible; however a framework which can be adapted to suit the variety of situations and practice settings can be identified. The focus of this chapter is to broadly define and explore the principles of primary health care and consider the contexts of primary health care in relation to evidence-based practice

A Practice Manual For Community Nursing in Australia

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Qualitative research with people who live with chronic illness and pain

A chronic illness qualitative research program that has been in progress since 1996 has focused on understanding the experience of long-term illness and how people can learn to incorporate the symptoms and consequences of illness into their lives. A primary healthcare philosophy has underpinned this research program which has been undertaken in a community health practice setting. The philosophy guiding this research program has been researching with people; hence the principles of primary healthcare (PHC) and participatory action research (PAR) have provided the theoretical framework. We have researched with both men and women who have diverse chronic conditions. Pain appears to be a constant companion in the lives of some people. We have come to understand that health workers may be the expert in clinical matters, but the person with the illness is the expert in his or her own life. Prescriptions for treatment may have little impact unless an understanding of the social and cultural context of a person's life is gained. Qualitative research is a mode of research that may lead us to a greater appreciation of the complexity of living with chronic pain. In this chapter we focus on ways people with chronic illness express and experience pain and how qualitative research can facilitate our understandings of their experiences. Our aim is to reveal the possibilities of qualitative research as an approach that may give voice to people who may be silent or have been silenced by objectivist research practices. Rather than focus on the cause or treatment of pain, we show the way we have used qualitative research to provide context to the lives lived with pain and the meanings ascribed to the experience of pain. The aims of this chapter are to trace the development and share the findings of our research with men and women who live with pain, and to explore the ways that qualitative research can inform our understandings of the experience of living with long term and persistent pain. To achieve this, we will begin by introducing the chronic illness experience research program of which these studies with people who live with pain have been a part, and then explicate the participatory action research methodology we have utilized extensively to harness qualitative research findings. We will share our current theorizing and work in progress and explore contributions from the wider qualitative research literature