Experience Similar Challenges Research Articles

How Can I Maintain my Own Identity Within a Crowd? Suggestions From Totalitarian Experiences

Abstract How can the individual preserve his identity within a crowd? How can he/she counter the threats and the temptations of the mass phenomenon? In the following, these questions are answered, correctly based on two contrasting and complementary situations and approaches: on the one hand, the beginnings of the Soviet Union in the 1920s as manifested in everyday life in Moscow (journalistic-systemic view). On the other hand, on biographies of NSDAP members in Germany in the 1920s (biographical approach). The theoretical background provides philosophical treatises from this period (Elias Canetti, José Ortega y Gasset, and Karl Jaspers). Because the situations characterize starting points of totalitarian system (Sowjet-Union/Nazi-Regime), they allow transformations into current and future experiences of collective and group pressure in private and business life, where people experience similar challenges and temptations that are more elementary.

Extending political will into action in African LMICs: abating global antimicrobial resistance

Extending political will into action in African LMICs: abating global antimicrobial resistance

Infertility affects the quality of life of Southwestern Nigerian women and their partners

BackgroundInfertility has been described as one of the most important reproductive health concerns of Nigerian women. Based on the importance placed on offspring in Africa; infertile women experience high levels of psychological distress, relationship conflicts and hazardous sexual behaviors. The aim of this study was to explore the challenges those infertile women, and their partners experience in the cultural context of Southwestern Nigeria and how those experiences affect their access to health care services. MethodsThe study employed a qualitative research design. In-depth interviews were conducted with fifteen participants diagnosed with primary or secondary infertility, and who were receiving treatment at a tertiary health care center in Ekiti State, Southwestern Nigeria. Thematic categorization and content analysis were used to analyze the data. ResultsFifteen participants, 13 women and 2 men, were selected based on attendance to the infertility clinic and their willingness to participate in the study. The participants reported having experienced negative emotional and psychological effects of infertility, and stated that infertility has affected them socially, psychologically and in their relationships. Two of the participants stated that their partners had abandoned them because of their inability to conceive. Most of the participants stated that there was social stigma associated with infertility and almost all (14 of 15) said the society is not doing enough to support people facing fertility problems. All the participants utilized medical interventions and religious activities to treat infertility. ConclusionInfertility presented a psychological burden for Nigerian women and their partners, affecting them in many spheres of life. The Nigerian societal construct is not supportive of couples facing fertility problems. Support groups should be created for couples who have experience similar challenges. These groups would allow individuals to come together to freely discuss and share their experiences, thus helping to alleviate the psychological distress associated with infertility.

Differentiated Embedding and Social Relationships Among Russian Migrant Physicians in Finland: A Narrative Socio‐Analysis

Migrants’ processes of (dis)embedding in local and transnational social networks have received growing attention in recent years, but most research focuses on low‐skilled migration. This study explores the affordances and challenges that Russian physicians, as a high‐skilled migrant group in Finland, experience in these processes in work and non‐work domains. Based on semi‐structured biographical interviews with 26 Russian physicians, the study employs Bourdieu’s socio‐analysis to analyze their narratives. The results reveal that Russian migrant physicians negotiate and experience differentiated embedding across work–life domains in local and transnational contexts. They mostly develop collegial relationships with Finnish colleagues and benefit from fulfilling professional relationships in the work domain. However, alongside time and efforts needed for building social ties, various factors often impede friendship making and socialization with locals beyond the work domain. These physicians cope with individual life circumstances through their enduring and supportive relationships with their Russian relatives and colleagues–friends. These results indicate that high‐skilled migrants have a greater opportunity to connect professionally with locals than low‐skilled migrants, but experience similar challenges to the latter in building close personal relationships.

Communication Priorities and Experiences of Caregivers of Children With Cancer in Guatemala.

PURPOSEAlthough > 90% of children with cancer live in low- and middle-income countries, little is known about communication priorities and experiences of families in these settings. We examined communication priorities and the quality of information exchange for Guatemalan caregivers of children with cancer during diagnostic communication.METHODSA cross-sectional survey including items used in pediatric communication studies from high-income countries and novel questions was verbally administered to 100 caregivers of children with cancer in Guatemala.RESULTSGuatemalan caregivers prioritized communication functions of exchanging information (99%), fostering healing relationships (98%), decision making (97%), enabling self-management (96%), and managing uncertainty (94%) over responding to emotions (66%) and cultural awareness (48%). Almost all caregivers wanted as many details as possible about their child's diagnosis and treatment (96%), likelihood of cure (99%), and late effects (97%). Only 67% were always given the information they needed without asking for it, and most caregivers sometimes (56%) or always (18%) had questions they wanted to discuss but did not. Approximately half of the caregivers (54%) correctly identified their child's diagnosis, primary site, disease extent (localized v metastatic), proposed treatment length, and treatment intent (curative v palliative). Caregivers of children with leukemia were more likely to correctly identify all attributes than those whose children had solid tumors (P < .001).CONCLUSIONCaregivers in Guatemala prioritize many of the same aspects of diagnostic communication as parents in the United States, and experience similar challenges. Shared communication values offer potential for adaptation of communication interventions across settings with varying resources and diverse cultures.

Becoming a Man: A Duboisian Examination of the Experiences of Black Men Who Have Sex with Men

AbstractW.E.B. Du Bois developed a thesis on the formation of Black manhood that includes key characteristics of this identity and dynamics that can foster or undermine its development. Yet his framework does not directly reference sexual minorities. Is Du Bois’ thesis relevant today for Black men who have sex with men (BMSM)? Do they espouse similar traits and experience similar challenges? Are their masculinity tropes nuanced based on racial, gender, and/or sexual identities? Informed by a New Millennium Du Boisian Mode of Inquiry and qualitative analyses, this study considers whether and how key aspects of Du Bois’ understanding of the formation of Black manhood are evident among 168 BMSM who reside in the South. Moving beyond a focus on HIV/AIDS for this demographic, the article notes that three themes emerge linked to embracing, essentializing, and extending Du Bois’ thesis on Black manhood that illustrate whether and how his views on Black masculinity are apparent and relevant among Black men excluded from his original work.

Постмодерни рефлексии върху хронотопната перцепция и пластичния израз при Модернизма

Comprehension of the Space-Time continuum as a perception of the Modern art’s artist and the searching of the relevant plastic expression is as an approach to that new dimension, which in 1936 year Charles Sirato touches in his “Dimensionist Manifesto”. The reflection of the Postmodern Philosophy on the Modern thinking is an important topic of the contemporary artist, who during his creative process experience similar challenges in grasping the Space-Time continuum. The report examines two texts of M. Merleau-Ponty: “Cezanne’s Doubt“ and “Eye and Mind”, following the philosophical reflection on the modern artist’s perception, who as Klee says: “doesn’t reproduce the visible,but makes visibility”. I’m considering also the viewpoints of P. Valery, G. Deleuse and H.G.Gadamer, whose life path covers the both eras in question. Many scientific discoveries from the beginning of the 20-th c. have an influence on the artistic thinking and creativity. In an original way the postmodern philosophical reasoning considers this. In this way the discourse modern-postmodern does not flow only in the flat, linear time. And somewhere between the scientific and postmodern thought is the great impact of the Bergson’s concept of the “duration”. From this consideration is following the idea of the elasticity of the human consciousness during the time and space – an idea explored not only in visual arts.

Does management of lipid lowering differ between specialists and primary care: Insights from GOAL Canada.

We studied whether significant differences in care gaps exist between specialists and primary care physicians (PCPs). GOAL Canada enrolled patients with CVD or familial hypercholesterolemia (FH) and LDL-C>2.0mmol/L despite maximally tolerated statin therapy. During follow-up, physicians received online reminders of treatment recommendations based on Canadian Guidelines. A total of 177 physicians (58% PCPs) enrolled 2009 patients; approximately half of the patients were enrolled by each physician group. Patients enrolled by specialists were slightly older (mean age 63years vs 62), female (45% vs 40%), Caucasian (77% vs 65%), and had a slightly higher systolic pressure and lower heart rate. Patients enrolled by specialists had less frequent history of FH, diabetes, hypertension, chronic kidney disease and liver disease but more frequent history of coronary artery disease, atrial fibrillation and premature family history of CVD. There was no significant baseline difference in LDL-C, HDL-C or non-HDL-C, although total cholesterol and triglycerides were slightly higher in patients managed by PCPs. At baseline, PCPs were more likely to use statins (80% vs 73%, P=.0002) and other therapies such as niacin or fibrate (10% vs 6%, P=.0006) but similar use of ezetimibe (24% vs 27%, P=.15). At the end of follow-up, specialists used less statins (70% vs 77%, P=.0005) and other therapies (6% vs 10%, P=.007) but more ezetimibe (45% vs 38%, P=.01) and the same frequency of PCSK9i (28% vs 27%, P=.65). The proportion of patients achieving the recommended LDL-C level of 2.0mmol/L or below (primary endpoint) was similar at last available visit between specialists and PCPs (44% vs 42%, P=.32). Despite minor differences in the clinical profile of their patients, both PCPs and specialists actively participate in the management of lipid-lowering therapy in high-risk CVD patients and experience similar challenges and care gaps.

Patient Care Documentation in the Secondary School Setting: Unique Challenges and Needs.

Athletic trainers (ATs) recognize patient care documentation as an important part of clinical practice. However, ATs using 1 electronic medical record (EMR) platform reported low accountability and lack of time as barriers to documentation. Whether ATs using paper, other EMRs, or a combined paper-electronic system exhibit similar behaviors or experience similar challenges is unclear. To explore ATs' documentation behaviors and perceived challenges while using various systems to document patient care in the secondary school setting. Qualitative study. Individual telephone interviews. Twenty ATs (12 women, 8 men; age = 38 ± 14 years; clinical experience = 15 ± 13 years; from National Athletic Trainers' Association Districts 2, 3, 6, 7, 8, 9, and 10) were recruited via purposeful and snowball-sampling techniques. Two investigators conducted semistructured interviews, which were audio recorded and transcribed verbatim. Following the consensual qualitative research tradition, 3 researchers independently coded transcripts in 4 rounds using a codebook to confirm codes, themes, and data saturation. Multiple researchers, member checking, and peer reviewing were the methods used to triangulate data and enhance trustworthiness. The secondary school setting was central to 3 themes. The ATs identified challenges to documentation, including lack of time due to high patient volume and multiple providers or locations where care was provided. Oftentimes, these challenges affected their documentation behaviors, including the process of and criteria for whether to document or not, content documented, and location and timing of documentation. To enhance patient care documentation, ATs described the need for more professional development, including resources or specific guidelines and viewing how documentation has been used to improve clinical practice. Challenges particular to the secondary school setting affected ATs' documentation behaviors, regardless of the system used to document care. Targeted professional development is needed to promote best practices in patient care documentation.

Management of chronic diseases and healthcare use among the elderly in Turkey and Turkish migrants

Abstract Background Turkish migrants are one of the largest groups of migrants in Germany, the Netherlands and Sweden. Particularly older migrants face different barriers in the health system that may limit their access to and quality of health care. The aim of this study was to examine how elderly people in Turkey and Turkish migrants in Germany, the Netherlands and Sweden manage chronic conditions, including how they utilize the respective healthcare systems. Methods A qualitative study design was used. A total of 20 in-depth interviews with individuals in Turkey and 10 semi-structured in-depth interviews each with Turkish migrants in Germany, the Netherlands and Sweden were conducted during 07/2018 and 05/2019. The interviews were based on a topic guide and were analyzed using qualitative content analysis. Results Participants from all groups experienced barriers in accessing health services and described difficulties in managing chronic conditions in their daily life. Pathways to care and patterns of utilization strongly depended on the structure of the respective health systems and differed between all groups. Circular migrants to Turkey relied on health professionals from their respective host countries to treat their chronic diseases, consulting professionals in Turkey mostly for emergencies or acute illness. Conclusions Turkish migrants and elderly adults in Turkey experience similar barriers and challenges in managing chronic diseases. How they access and utilize health services is dependent on the respective health system structures. Circular migrants use the Turkish health system differently than health systems in their host countries and elderly adults from Turkey. These results can contribute to the development of diversity-sensitive health care strategies. Key messages Turkish migrants and adults in Turkey experience similar challenges in managing chronic diseases. How Turkish migrants and adults in Turkey access healthcare depends on the respective systems.

Future of Global Cancer From the Perspective of Young Oncology Leaders

Background: Oncology organizations and professional associations (OA) across the cancer control continuum have developed Young Leader (YL) programs to engage promising members of their organizations and to facilitate opportunities for their advancement. Although these groups share common aims, there has been little synergy across YL programs and limited understanding of the shared perspectives, experiences, and challenges of YLs. Aim: To understand the profile, activities and challenges facing YLs worldwide from the perspective of global cancer control. Methods: The survey was generated by a task force of YLs and was pilot-tested among 10 international physicians. The final survey was composed of four sections: baseline characteristics, challenges in cancer control, building a career in cancer control and networking in cancer control. The survey was sent out in 2018 to 867 people, who were identified as potential YLs by 7 OA, with 2 reminder e-mails within 2-4 weeks interval. The final responses were summarized using descriptive analysis method. Results: A total of 139 survey responses were received from 61 countries (per region - 38.4% Europe, 29.6% America, 22% Asia-Pacific, and 10% Africa). Median response rate was 62.2% (range 5%-100% per organizational group, overall 16%). The majority of respondents were &lt; 39 years old (64%), female (53.6%), with a higher degree (Ph.D. 43.1%), and in academic positions (68.1%). Clinicians made up 65.2% of the sample, followed by researchers (20.2%), and advocacy leaders (5.1%). YLs believed that the most important priorities to the future of cancer control were 1) to make cancer care available globally (47.5%), 2) to provide value based cancer care (27.5%) and 3) to transform cancer care through technology (10.5%). To address these aims, 70% of YLs believed that the most important next step was to improve screening and early diagnosis. YLs identified the lack of financial resources (65.2%), increasing treatment costs (64.5%) and late diagnosis (61.6%) as important barriers to achieving these aims. YLs reported that their greatest obstacles to engaging in global cancer control were lack of funding (46%), lack of opportunities (42%) and toxic political/academic environments (46%). 70% reported that mentorship and network development followed by academic success (51.4%) and leadership training (42%) were the most important factors in support of their future goals. Conclusion: YL experience similar challenges and aspiration concerning global cancer control. The need to make cancer care available globally, and to receive mentorship and training were highlighted. Our findings also suggest that oncology groups should aim to ensure a global agenda, promote collaboration and mentorship and rediscuss program objectives to guarantee sustainability of current organizational plans and to better support the YLs’ future goals.

Water, Forests, People: The Swedish Experience in Building Resilient Landscapes

A growing world population and rapid expansion of cities increase the pressure on basic resources such as water, food and energy. To safeguard the provision of these resources, restoration and sustainable management of landscapes is pivotal, including sustainable forest and water management. Sustainable forest management includes forest conservation, restoration, forestry and agroforestry practices. Interlinkages between forests and water are fundamental to moderate water budgets, stabilize runoff, reduce erosion and improve biodiversity and water quality. Sweden has gained substantial experience in sustainable forest management in the past century. Through significant restoration efforts, a largely depleted Swedish forest has transformed into a well-managed production forest within a century, leading to sustainable economic growth through the provision of forest products. More recently, ecosystem services are also included in management decisions. Such a transformation depends on broad stakeholder dialog, combined with an enabling institutional and policy environment. Based on seminars and workshops with a wide range of key stakeholders managing Sweden’s forests and waters, this article draws lessons from the history of forest management in Sweden. These lessons are particularly relevant for countries in the Global South that currently experience similar challenges in forest and landscape management. The authors argue that an integrated landscape approach involving a broad array of sectors and stakeholders is needed to achieve sustainable forest and water management. Sustainable landscape management—integrating water, agriculture and forests—is imperative to achieving resilient socio-economic systems and landscapes.

Creating effective career development programs.

This paper is the fourth in a 5-part series that focuses on educating and training the clinical and translational science workforce. The goal of this paper is to delineate components of effective career development programs that go beyond didactic training. All academic health centers with a Clinical and Translational Science Award have a KL2 career development award for junior faculty, and many also have a TL1 training program for predoctoral and postdoctoral fellows. The training across these programs varies, however junior investigators across the United States experience similar challenges. Junior investigators can get overwhelmed with the demands of building their own research program, particularly in academia. 1Often, they are sidetracked by competing demands that can derail their progress. In these situations, junior investigators experience frustration and may search for alternative career paths. By providing them with additional professional skills in the 5 domains of: (1) self-awareness; (2) selecting the right topic and securing funding; (3) getting adequate support; (4) working with others; and (5) managing yourself, your career, and your demands. We will give junior investigators additional tools to manage these demands and facilitate their own career success.

The career paths of primary school principals in Ireland

The key purpose of this paper is to offer an exploration of the career paths of a number of Irish school principals. The information presented is part of a comparative study in the area, involving three island states: Cyprus, Malta and Ireland. The study provides an insight into how individuals become principals and how they perceive themselves in the role. The information is sourced through personal narrative. Qualitative in-depth interviewing is employed as the primary method of data gathering. Participants are posed a range of open-ended questions about their personal lives and about their initiation into their professional responsibilities. The results show that participants offer a variety of reasons for becoming teachers initially and a variety of reasons for seeking and achieving promotion to the post of school principal after a time. Family members and family experiences have an important function in influencing the lives of prospective leaders. With no formal training to prepare newly appointed principals for their roles, most report significant difficulties initially, particularly with managerial tasks and bureaucracy. In spite of these difficulties nonetheless, all participating principals report that they enjoy their roles. The results of the study demonstrate that the Irish principals interviewed in this research, experience similar challenges and rewards to those interviewed in earlier and concurrent studies internationally.

Loss in Translation: Housing Counseling Agency Segmentation in the Twin Cities

Abstract Housing counseling agencies (HCAs) in the Minneapolis-St. Paul area have served as important resources for homeowners at risk of foreclosure. However, Asian American–serving HCAs have experienced increased segmentation in the nonprofit sector and also among HCAs because of language assistance. Using interviews with foreclosure counselors, this study finds that HCAs that provide Asian-language assistance experience similar challenges as other HCAs, but are also at a disadvantage in resources and capacity compared to other HCAs. The study has implications for how to better serve immigrant homeowners with language needs, particularly because they require more time and resources.

NPM Can Work: An optimistic review of the impact of New Public Management reforms in central and eastern Europe

This article reviews the New Public Management (NPM) literature in central and eastern Europe (CEE) with the aim of assessing whether reforms have ‘worked’. Increasingly, academics have tended to argue against the suitability of NPM instruments in this region. To understand the impact of this much-debated policy, we first propose a classification of the impacts of NPM geared to the realities of central and eastern European states. Then, we use this classification to carefully review empirical studies across the region over the past 10 years. Unlike much of the recent academic literature, we suggest that NPM can work. NPM policy has not always been successful to the extent expected and promoted, but there is enough evidence to show that some of the central ideas in NPM have led to improvements in public service organization or provision across different organizational settings. An adequate degree of administrative capacity, sustained reform over time and a ‘fitting context’ are the main factors that can tip the scale for the success of these management instruments. The article provides a fresh and transparent assessment of a major administrative development in a growing region with implications for other parts of the world that experience similar challenges and opportunities.

The Challenges and Opportunities Experienced by Parent Supervisors in Primary School Distance Education

For a number of very remote students in Australia, distance education is regarded as the most effective means of providing access to primary school education. For these students isolation is experienced not only in relation to distance from a physical school, but also from a professionally trained educator and the instructional benefits this provides. In bridging the gap between the teacher and student the parent supervisor is vital. However little is known about their role and the challenges and opportunities it affords them in educating their children by this means. This paper reports on a research project that examined the role of parent supervisors in primary school distance education with the aim of understanding how they experience their role. Semi-structured interviews were conducted with volunteer parent supervisors of New South Wales primary school distance education students to gain insight into their practices and the opportunities and challenges they face in their role. Interview transcripts were analysed using a three step data coding framework to explore the themes that emerged in their experiences. This revealed that while most parent supervisors do not have formal qualifications in education, they undertake many tasks akin to those of a teacher and experience similar challenges to new teachers. In particular, supervisors have a crucial role in implementing lessons, motivating and engaging their children in learning, preparing for the lessons, assisting with problems their children encounter and monitoring their children’s progress. One of the main challenges parent supervisors experience is uncertainty, with many doubting their effectiveness in relation to technicalities in key learning areas and managing multi-age groupings. Parent supervisors report that the challenges are outweighed by the opportunities their role provides, particularly their close involvement with their children’s learning and the sense of reward they gain from this. Through this research a deeper understanding of the challenges and opportunities parent supervisors encounter will enable planning for their role to be improved. It contributes to the broader understanding of rural education by bringing the experiences of an often overlooked cohort of educators into the research literature who are essential to education in rural Australia.

Anthropological perspectives on the challenges to monitoring and evaluating HIV and AIDS programming in Lesotho

This article focuses on how numerous international nongovernmental organisations (INGOs) have stepped forward to provide services related to HIV and AIDS prevention and treatment in Lesotho. We highlight some widely recognised challenges associated with the INGO approach and describe how people working in that sector in Lesotho experience similar challenges, focusing especially on weak or inadequate monitoring and evaluation (M&E). Partially in response to such weaknesses, Lesotho is implementing its ‘Partnership Framework to Support Implementation of the Lesotho National HIV and AIDS Response.’ A major goal for this initiative is to strengthen procedures and methods for M&E. Through examination of a partnership that the authors are cultivating with Catholic Relief Services in Lesotho, we discuss some ways that anthropologists can contribute to formulating M&E processes and procedures that can provide sound measures of outcomes and have the potential to inform programme development.

Women Entrepreneurs: A Comparison of International Small Business Owners in Poland and the Czech Republic

Women entrepreneurs from two Central European countries with relatively new market economies were interviewed for this research. The authors describe the experiences and motivation of these women international business owners and compare them to the literature on women entrepreneurs in North America. Cross-culturally, women entrepreneurs share many of the same motivations for starting a business, and experience similar challenges to making their enterprises successful. North American models of entrepreneurship are also examined. The findings suggest a universal model for entrepreneurship. Suggestions for government policies are put forward. Managerial and theoretical implications are also presented and new directions for research on women entrepreneurs are suggested.