PurposeThe purpose of this paper is to explore how surveillance facilitates new power relationships.Design/methodology/approachThis longitudinal qualitative study is predicated on observations of the home care workers interacting with their managers and clients. The emerging picture was complemented with interviews of the participants. The home care workers were chosen as being crucial in the construction of new everyday relationships, and their interpretations were given most value in presenting how surveillance and monitoring relationships are constructed as embedded mundane practices and (...) as emerging from practical needs.FindingsThe paper discusses an implementation and use case of surveillance capable technology in a social home care setting. The findings suggest discrepancy of how surveillance is being interpreted by different participants depending on their positioning in the context of use.Originality/valueThe study presents a case study where surveillance issues emerge not only at the workplace but also in the domestic sphere. The paper explores the workers' role in defining surveillance at the workplace, and questions the limits of legitimate surveillance in the social care context concerning vulnerable citizens as clients. (shrink)

Studies of the challenges faced by women in policing have paid little attention to the specific experiences of policewomen who are mothers. Guided by critical theorizing on the gendered nature of the police culture and domestic labor, 16 police officer mothers in Ontario, Canada, were interviewed. Our qualitative analyses explore their experiences of the “lion’s share” of domestic labor; the organizational, cultural, and operational features of policing; and the challenges of child care, and examine how these combine to foster particular (...) stresses. In contrast to intensive mothering approaches that rely on the advice of external experts, our participants work to protect children by carefully constructing stories and asking questions that are based on their own on-the-job experiences with dangerous and/or abhorrent situations. As such, they engage in danger-protection parenting practices to prevent their children from becoming victims or offenders. Our research extends the theorizing on intensive/extensive mothering practices, builds on the scholarship on policing, and adds to the literature on women in nonstandard occupations. This sociological analysis of police mothers’ experiences and practices underscores the importance of understanding and working to change the social contexts, at work and at home, that compromise the well-being of police mothers and other emergency-response workers. (shrink)

Background: Dementia care at home often involves decisions in which the caregiver must weigh safety concerns with respect for autonomy. These dilemmas can lead to situations where caregivers provide care against the will of persons living with dementia, referred to as involuntary treatment. To prevent this, insight is needed into how family caregivers of persons living with dementia deal with care situations that can lead to involuntary treatment. Objective: To identify and describe family caregivers’ experiences regarding care decisions for (...) situations that can lead to involuntary treatment use in persons living with dementia at home. Research design: A qualitative descriptive interview design. Data were analysed using the Qualitative Analysis Guide of Leuven. Participants and research context: A total of 10 family caregivers providing care for 13 persons living with dementia participated in in-depth semi-structured interviews. Participants were recruited by registered nurses via purposive sampling. Ethical consideration: The study protocol was approved by the Ethics Committee of the University Hospitals Leuven and the Medical Ethical Test Committee Zuyderland. Findings: Family caregivers experience the decision-making process concerning care dilemmas that can lead to involuntary treatment as complicated, stressful and exhausting. Although they consider safety and autonomy as important values, they struggle with finding the right balance between them. Due to the progressive and unpredictable nature of dementia, they are constantly seeking solutions while they adapt to new situations. Family caregivers feel responsible and experience social pressure for the safety of persons living with dementia. They may be blamed if something adverse happens to the persons living with dementia, which increases an already stressful situation. Their experience is influenced by characteristics of the care triad such as practical and emotional support, knowledge, and previous experiences. Discussion and conclusion: To prevent involuntary treatment, professionals need to proactively inform family caregivers, and they need to support each other in dealing with complex care situations. (shrink)

Recent years have seen a tremendous growth in international scholarly communication, especially perhaps in Europe. On the one hand, the technical means of communication have undergone a major revolution. Scholars and scientists can communicate almost instantly via phone, fax and especially by e-mail, and post their results on their websites instead of having to wait for months and sometimes years to have them published. On the other hand, various institutional frameworks have been created for the purpose of fostering international scientific (...) communication and cooperation. These institutional arrangements have typically been supported by responsible governments. One unspoken or spoken motive (among others) in encouraging international exchanges - especially in the humanities and social sciences - is the expectation that the new technical and institutional improvements in communication not only facilitate research and scholarship but directly or indirectly contribute to the discussion of important cultural, educational and social issues in the different participating countries, and perhaps even help people and peoples to cope with them. (shrink)

Recent years have seen a tremendous growth in international scholarly communication, especially perhaps in Europe. On the one hand, the technical means of communication have undergone a major revolution. Scholars and scientists can communicate almost instantly via phone, fax and especially by e-mail, and post their results on their websites instead of having to wait for months and sometimes years to have them published. On the other hand, various institutional frameworks have been created for the purpose of fostering international scientific (...) communication and cooperation. These institutional arrangements have typically been supported by responsible governments. One unspoken or spoken motive (among others) in encouraging international exchanges - especially in the humanities and social sciences - is the expectation that the new technical and institutional improvements in communication not only facilitate research and scholarship but directly or indirectly contribute to the discussion of important cultural, educational and social issues in the different participating countries, and perhaps even help people and peoples to cope with them. (shrink)

In aging humans, aerobic exercise interventions have been found to be associated with more positive or less negative changes in frontal and temporal brain areas, such as the anterior cingulate cortex (ACC) and hippocampus, relative to no-exercise control conditions. However, individual measures such as gray-matter (GM) probability may afford less reliable and valid conclusions about maintenance or losses in structural brain integrity than a latent construct based on multiple indicators. Here, we established a latent factor of GM structural integrity based (...) on GM probability assessed by voxel-based morphometry, magnetization transfer saturation, and mean diffusivity. Based on this latent factor, we investigated changes in structural brain integrity during a six-month exercise intervention in brain regions previously reported in studies using volumetric approaches. Seventy-five healthy, previously sedentary older adults aged 63–76 years completed an at-home intervention study in either an exercise group (EG;n= 40) or in an active control group (ACG;n= 35). Measures of peak oxygen uptake (VO2peak) taken before and after the intervention revealed a time-by-group interaction, with positive average change in the EG and no reliable mean change in the ACG. Significant group differences in structural brain integrity changes were observed in the right and left ACC, right posterior cingulate cortex (PCC), and left juxtapositional lobule cortex (JLC). In all instances, average changes in the EG did not differ reliably from zero, whereas average changes in the ACG were negative, pointing to maintenance of structural brain integrity in the EG, and to losses in the ACG. Significant individual differences in change were observed for right ACC and left JLC. Following up on these differences, we found that exercising participants with greater fitness gains also showed more positive changes in structural integrity. We discuss the benefits and limitations of a latent-factor approach to changes in structural brain integrity, and conclude that aerobic fitness interventions are likely to contribute to brain maintenance in old age. (shrink)

Recyclable issues do not receive sufficient attention, which thus see low awareness among Malaysians. This paper1 proposes women’s active participation in re-upcycling habits to maintain the ecologically challenging world today. Empowering women-at-home in this way enable them to sustain their own social and ecological well-being. Women can be active participants in community development activities. Even though they may be disinterested to work outside home, their involvement in their community should be encouraged. Embeddedness theory advocates empowerment of women (...) through re-upcycling actions are to be initiated from home. With the support from community, in turn, these actions can be an economic resources for their households. Malaysian women are most affected by employment opportunities, supports and reassurances from various sectors, such as the government, nongovernmental organisations and most importantly, the men in their lives. Depriving them from this socio-economic foundation will further impact the unemployment rate for Malaysia. On the other hand, if strategic planning is implemented by utilising the abundance number of unemployed women-at-home, the socio-economic conditions of the nation can also be improved. Indeed, this paper motivates discussions on the employment policy whereby re-upcycling activities may pave ways for women-at-home to get involved in employment, without leaving their homes. (shrink)

In this article, we discuss the practice of conducting research in one's own field, in this case, from a position as a researcher with a nursing background doing fieldwork in a hospital and in one's own organization, an orthopedic surgical department. We show how an “insider” researcher position paves the way for analytical insights about sleep as an institutional phenomenon in the orthopedic surgical infrastructure and how acute and elective patient trajectories differ but build on the same logic, creating the (...) same dynamics of inclusion and exclusion. Through a situated and sociomaterial perspective, we analyze different clinical interactions in which we follow the hospital bed as an example of a central relational element that co‐creates sleep as an institutional phenomenon. Inspired by Karen Barad, we demonstrate how to move diffractively when doing and analyzing fieldwork and argue how moving diffractively as a researcher doing fieldwork “at home” is productive and challenges the concept and demand of “distance” as the phenomenological exercise in fieldwork. (shrink)

The number of books at home is commonly used as a proxy for socioeconomic status in educational studies. While both parents’ and students’ reports of the number of books at home are relatively strong predictors of student achievement, they often disagree with each other. When interpreting findings of analyses that measure socioeconomic status using books at home, it is important to understand how findings may be biased by the imperfect reliability of the data. For example, it was (...) recently suggested that especially low-achieving students tend to underestimate the number of books at home, so that use of such data would lead researchers to overestimate the association between books at home and achievement. Here we take a closer look at how students’ and parents’ reports of the number of books at home relate to literacy among fourth grade students, by analyzing data from more than 250,000 students in 47 countries participating in 2011 PIRLS. Contrary to prior claims, we find more downward bias in estimates of books at home among high-achieving students than among low-achieving students, but unsystematic errors appear to be larger among low-achieving students. This holds within almost every country. It also holds between countries, that is, errors in estimates of books at home are larger in low-achieving countries. This has implications for studies of the association between books at home and achievement: the strength of the association will generally be underestimated, and this problem is exacerbated in low-achieving countries and among low-achieving students. (shrink)

In recent years, much attention has been paid to how older people living at home can remain independent and manage their illness themselves, while less attention has been given to those who have become frail and need assistance with challenges of everyday life. In this article, I drew on Latimer's formulation of care for frail older people as relational and world‐making and on Foucault's work related to the care of the self in developing an understanding of how frail older (...) persons manage to live well at home in the final years of their lives. I use data from an ethnographic study of home care nursing in the homes of 15 frail older people to develop an understanding of how their care at home can be developed. The participants were holding on to life, which reflected their vitality and vulnerability as well as agency in continuing to explore ways to preserve and build their world at home. With declining ability and stamina relations with material things, relatives and official care workers become of central importance in holding on to life. Home care services can be thought of as part of life, as world‐forming, where workers contribute to daily activities that support living well at home. (shrink)

The coronavirus outbreak has led to abrupt changes in people’s daily lives as many state governments have restricted individuals’ movements in order to slow the spread of the virus. We conducted a natural experiment in the United States of America in April 2020, in which we compare responses from states with “stay-at-home orders” and no such orders. We surveyed 458 participants and examined the effects of these government-imposed restrictions on social, mental, physical, and financial well-being as well as the (...) mediating role of resilience. Structural equation modeling reveals that resilience buffers stay-at-home orders’ potential side-effects on well-being. Specifically, individuals living in states with stay-at-home orders report lower functional well-being than individuals living in states without such orders, which negatively relates to resilience. Resilience in turn is associated with higher social, mental, physical, and financial well-being. Thus, resilience can be seen as an effective means of buffering stay-at-home orders’ potential negative effects on the components of well-being. Our results indicate the central role of resilience, which is crucial in dampening the effects of stay-at-home orders on well-being. Following our results, governments and policymakers should focus their efforts on strengthening individuals’ resilience, which is a key predictor of social, mental, financial, and physical well-being. (shrink)

How should we assess programs dedicated to education in virtue? One influential answer draws on quantitative research designs. By measuring the inputs and processes that produce the highest levels of virtue among participants according to some reasonable criterion, in this view, we can determine which programs engender the most desired results. Although many outcomes of character education can undoubtedly be assessed in this way, taken on its own, this approach may support favorable judgments about programs that indoctrinate rather than educate, (...) because education in character entails teleological thinking that is volitional not merely determined. I argue instead that proper assessment of virtue requires an expansive view of character education in both particular and common goods that avoids the tendency to indoctrinate and an inclusive conception of measurement that takes into account qualitative in addition to quantitative methodologies. (shrink)

Discussion of political and legal citizenship requires attention to social solidarity. Current approaches to citizenship, however, tend to proceed on abstract bases, neglecting this sociological dimension. This is partly because a tacit understanding of what constitutes a `society' has been developed through implicit reliance on the idea of `nation'. Issues of social belonging are addressed more directly in communitarian and multiculturalist discourses. Too often, however, different modes of solidarity and participation are confused. Scale is often neglected. The model of (...) `nation' again prefigures the ways in which membership and difference are constructed. The present paper suggests the value of maintaining a distinction among relational networks, cultural or legal categories, and discursive publics. The first constitute community in a sense quite different from either of the second and third. Categories, however, are increasingly prominent in largescale social life. But the idea of the public is crucial to conceptualizing democratic participation. (shrink)

BackgroundThe aim of the study was to explore symptoms of anxiety and depression, insomnia, and quality of life in a Norwegian community sample of older adults.MethodsA representative sample was drawn from home-dwelling people of 60 years and above, living in a large municipality in Norway.ResultsBased on established cut-off scores, 83.7% of the participants showed no symptoms of anxiety/depression, 12% had mild symptoms, 2.7% moderate symptoms, 1.5% showed severe symptoms of anxiety/depression. A total of 18.4% reported insomnia symptoms. Regarding health-related (...) quality of life, few participants reported problems with self-care, but pain and discomfort were common. Depression/anxiety, insomnia, and health-related quality of life showed moderate to strong associations.DiscussionThe results suggest a close interplay between anxiety/depression, insomnia, and health-related quality of life in older adults. (shrink)

An increase in the number of older people with dementia is currently a trend around the world. In low and middle countries, effective public health services are not yet well‐developed, and family care‐givers may be overwhelmed by the requirements of care. This paper has two purposes: to share findings from an ethnographic study about family dementia care practices in Brazil and to draw attention to the significance of the materiality of care practices in the family context. The study was conducted (...) in Belo Horizonte, Brazil. We describe the care trajectory of one family and, analysing data using the insights of Actor Network Theory, show the significance of objects in a networked relation of care. In particular, we show how incontinence products such as adult diapers assume different positions in the network, acting as either mediator or intermediary of care in relation to other elements of the network composed of family members and their living situation, the person with dementia herself, the doctor, and Brazilian health policies. Although the diaper is often seen as an ordinary object for care providers, its participation in a care network shapes relations, activating conflict, financial constraint, and disciplining the body of the person with dementia. (shrink)

p166 In February 1965, the United States escalated the war against South Vietnam radically, and also, on the side, began regular bombing of the North at a much lower level. That was a big public issue in the United States: Should we bomb North Vietnam? The bombing of the South was ignored. The same shows up in the internal planning, for which we now have an extremely rich record, not only from the Pentagon Papers, but from tons of declassified documents (...) that have been released in the last couple of years. It turns out again, one of the very few interesting revelations of the Pentagon Papers that there was no planning for the escalated bombing of the South. There was very meticulous planning about the bombing of the North carefully calibrated, when should we do it, and a lot of agonizing about it. The bombing of the South at triple the scale of the North is barely discussed. There are a few casual decisions here and there. The same shows up in McNamara's recent memoirs. He discusses at great length the bombing of the North. The bombing of the South he literally doesn't mention. He mentions what he did on January 21, 1965, a really important day: there was a big discussion about whether to bomb North Vietnam. He doesn't mention what we know from other documents, that on that same day, he authorized for the first time the use of jet planes to escalate the bombing of South Vietnam over and above the massive bombing that had been going on for years that's not even mentioned. (shrink)

Physics first became established in Australia and Japan at the same period, during the final quarter of the nineteenth and the first years of the twentieth century. A comparison of the processes by which this happened in these two developing countries on the Pacific rim shows that, despite the great cultural differences that existed, and that might have been expected to have been a source of major differences in national receptiveness to the new science, there were in fact many parallels (...) between the patterns of development in the two cases. Identifying these enables us to draw attention to a number of significant features of the physics discipline more generally at this period. Such differences as emerge in the early history of physics in the two countries seem to have arisen more from the different political situations that prevailed than from anything else; in particular they reflect the fact that Australia was a part of the British Empire while Japan was an independent political power. (shrink)

We tend to think that a person who is both reasonable and moral can have a good life. What constitutes a life that is not only good but superlative, or even “marvellous” or “holy”? Those who have such lives are called sages, heroes or saints, and their lives can display great integrity as well as integration with a transformative “Spiritual Presence.” Does it follow that saints are perfect people? Is there a common vision that impels them to seek holiness? In (...) a controversial interpretation of mysticism Horne suggests that there is no single formula for the meaning of life and no one story that displays it to us. Mysticism, rather than being just a visionary perception, then becomes a problem-solving process that brings about a creative transformation of the personality at a critical stage in life. He suggests also that saints may be imperfect morally and describes true saints as double-minded: they are serious in a playful way. Mysticism and Vocation illuminates our understanding of saintly lives by explicating their mystical characteristics and extending discussions of mysticism to explain its role in active lives. In discussing important decisions that go beyond conventional morality, it adds to recent philosophical arguments by Charles Taylor, Alasdair MacIntyre, Iris Murdoch, Bernard Williams and others to the effect that morality should be defined more broadly to deal with the human condition. This book will be of interest to students of philosophy and religious studies, in both graduate and undergraduate programs. (shrink)

This article provides a deeper understanding of how meaning can be created in everyday life at a nursing home. It is based on a primary study concerning dignity involving 12 older people living in two nursing homes in Sweden. A secondary analysis was carried out on data obtained from three of the primary participants interviewed over a period of time (18—24 months), with a total of 12 interviews carried out using an inductive hermeneutic approach. The study reveals that sources (...) of meaning were created by having a sense of: physical capability, cognitive capability, being needed, and belonging. Meaning was created through inner dialogue, communication and relationships with others. A second finding is that the experience of meaning can sometimes be hard to realize. (shrink)

BackgroundFew studies have examined factors associated with willingness of people living with HIV to participate in HIV treatment clinical trials in Sub-Saharan Africa. We assessed the factors associated with participation of PLHIV in HIV treatment clinical trials research at a large urban clinical and research facility in Uganda.MethodsA mixed methods study was conducted at the Infectious Diseases Institute, adult HIV clinic between July 2016 and January 2017. Data were collected using structured questionnaires, focused group discussions with respondents categorised as (...) either participated or never participated in clinical trials and key informant interviews with IDI staff. A generalized linear model with a logit link function was used for multivariate analyses while the qualitative data were summarized using a thematic approach.ResultsWe enrolled a total of 202 and analysed 151 participants, 77 of whom were male with mean age of 41 years. The majority 127 expressed willingness to participate in treatment clinical trials if given an opportunity. At bivariate analysis, willingness to participate was significantly associated with respondents’ perception of a satisfactory compensation package, special status accorded and belief that their health status would improve while on the clinical trial. At multivariate analysis, a satisfactory compensation package and special status accorded in clinical trials remained significant. The qualitative data analysis confirmed these findings as participants valued the privilege of jumping the clinic waiting queues and spending less time in clinic, the wide range of free tests offered to trial participants, unrestricted access to senior physicians and regular communication from study team. Additionally, free meals offered during clinic visits meant that participants were not in a hurry to go back home. Barriers to participation included the perception that new drugs were being tested on them, fear of side effects like treatment failure and the uncertainty about privacy of their data.ConclusionWe found overwhelming willingness to participate in HIV treatment clinical trials. This was largely extrinsically influenced by the perceived material and health-related benefits. Investigators should pay attention to participants’ concerns for benefits which may override the need to understand study procedures and risks. (shrink)

Many of us have a prereflective sense--or at least, a hope--that there are reasons to be moral which apply to an agent regardless of what his or her existing motivations may be. The view that there are no such reasons may, then, be regarded as a form of moral scepticism. The philosophical position which seems most fit to refute this form of moral scepticism, and hence to support our prereflective sense, is a Kantian view of morality, according to which we (...) are required to be moral solely in virtue of being rational. I examine a number of recent arguments for this position; I conclude that all of them fail, and for similar reasons. Nor, I argue, is there any non-Kantian view which could succeed at the same task. It is thus very tempting to infer that this form of moral scepticism is immune to any simple refutation. However, perhaps the best way to combat scepticism is not to argue for its negation--as do the positions examined so far--but to show that there is something problematic in the sceptic's whole approach to the issue. At this point I turn for enlightenment to an analogy with epistemological scepticism. Here, too, if we try to argue for the negation of scepticism, we seem bound to fail; but here the more subtle strategy of attacking the sceptic's whole approach has actually been attempted. I sketch a number of versions of this more subtle strategy; I then sketch some analogous responses to moral scepticism, and consider whether any of them are successful. I argue that the attempt fails--that even if epistemological scepticism is indeed amenable to this kind of treatment , moral scepticism is not. This conclusion is only strengthened when I argue that another, related strategy, which employs an analogy between morality and mathematics, also falls short at the same point. Moral scepticism therefore survives intact. The appropriate reaction, I suggest, is neither complete despair nor complete equanimity. (shrink)

Background: The increasing number of elderly people in nursing homes with failing competence to give consent represents a great challenge to healthcare staff’s protection of patient autonomy in the issues of life-prolonging treatment, hydration, nutrition and hospitalisation. The lack of national guidelines and internal routines can threaten the protection of patient autonomy. Objectives: To place focus on protecting patient autonomy in the decision-making process by studying how relatives experience their role as substitute decision-makers. Design: A qualitative descriptive design with analysis (...) of the contents of transcribed in-depth interviews with relatives. Participants: Fifteen relatives of 20 patients in 10 nursing homes in Norway. Results and Interpretations: The main findings reveal deficient procedures for including relatives in decision-making processes. Relatives have poor knowledge about the end of life, and there is little discussion about their role as substitute decision-makers for patients who are not competent to give consent. Few relatives understand the concept of patient autonomy. In Norway the treating physician is responsible for patient treatment. When relatives are included in discussions on treatment, they perceive themselves as responsible for the decision, which is a burden for them afterwards. This qualitative study describes relatives’ experiences, thus providing important information on the improvement potential with the main objective of safeguarding patient autonomy and caring for relatives. Conclusion: The study reveals failing procedures and thus a great potential for improvement. Both ethical and legal aspects must be addressed when considering patient autonomy. (shrink)

This book explores the lived experience of being at home as well as being homeless. Being at home or not is typically a matter of being at a place or not, where such a place is carved out of space and designated as such. It is a place that is both empirical and trans-empirical. When one is at home or not at home, one typically has in mind an inhabited place. To inhabit or not to inhabit (...) it is to find oneself in a place that has an affective presence or absence. In either case, affectivity points to a lived place where lived experience is constituted and displayed. Thus, in this context, affectivity becomes more than the subject of empirical psychology. If psychology were to have access, it would be in the context of phenomenological or existential psychology – a psychology that has its roots in the sensible world and, hence, a psychology that expresses an aesthetic dimension. Each of the contributors in this book extends an invitation to the readers to participate in constituting, extending, and sharing with others the sense of either being at home or of being homeless. This book appeals to students, researchers as well as general interest readers. (shrink)

Emerging evidence has shown a positive association between the home literacy environment and monolingual children’s language and literacy development. Yet, far fewer studies have examined the impact of the HLE on second language development. This study examined relations between the HLE and children’s development of English as a second language in Hong Kong. Participants were 149 ethnic Chinese children and one of their caregivers. Caregivers completed questionnaires about their family backgrounds and HLE and children were assessed on their English (...) language and literacy skills. Findings revealed considerable variability in the types of literacy activities that caregivers were engaged in at home with their children. A series of multilevel regressions demonstrated that the HLE was differentially associated with English vocabulary, letter knowledge, phonological awareness, and word reading skills after controlling for child and family characteristics. Results highlight the importance of a literacy-rich home environment for children’s development of English as a second language and the need to support caregivers in providing a range of home literacy activities to facilitate different language and literacy skills. (shrink)

Home advantage in sports has been extensively researched in the academic literature over the past five decades. A review of the literature reveals several factors that consistently underly this phenomenon. One of the most documented is the home crowd effect. While the crowd effect on the results has been widely researched considering noise, size, and density, there are conflicting findings of the effect and its extent. Furthermore, the perceptions of fans, athletes, coaches, and officials of the causes of (...) home advantage in general and the crowd effect in particular, remain marginal. This is especially important in the face of significant regulation changes in the stands caused by the COVID-19 pandemic. The current study, therefore, examined the perceptions of fans, athletes, coaches, and officials of the Israeli handball premier league regarding fans’ contribution to the home advantage phenomenon along with other factors. A questionnaire examining perceptions regarding home advantage was distributed to 232 Israeli participants. Results, based on MANOVA, ANOVA, and post-hoc analyses, indicated significant differences in participants’ perceptions of the different factors in general and the crowd factor in particular. Overall, the crowd was perceived as the most important factor contributing to the home advantage phenomenon. Furthermore, fans perceived their contribution significantly higher than the rest of the participants. On the other hand, officials ranked their contribution to the home advantage effect as low as well as significantly under ranked their contribution in comparison to the other groups. This result suggests that officials perceive themselves as relatively robust to the crowd effect compared to the other participants. Additional results are discussed in light of existing gaps in the literature on the home advantage phenomenon. Alongside the theoretical contribution, these findings contribute to applied implications of increasing the home advantage effect when playing at home and negating the home advantage when playing away. (shrink)

Identities ascribed to research staff in face-to-face encounters with participants have been raised as key ethical challenge in transnational health research. ‘Misattributed’ identities that do not just deviate from researchers' self-image, but obscure unequivocal aspects of researcher identity – e.g. that they are researchers – are a case of such ethical problem. Yet, the reasonable expectation of unconcealed identity can conflict with another ethical premise: confidentiality; this poses challenges to staff visiting participants at home. We explore these around a (...) case study of ‘follow-up’ staff, observed during an ethnographic study of a Kenyan HIV ‘trial community’, which included participant observation, conversations, and interviews with staff (n = 79) and participants (n = 89). We found that because of the need to maintain confidentiality and because of some suspicions towards researchers, research staff drew upon alternative identities – presenting themselves to non-participants as relatives or friends, rather than as researchers. Several staff experienced this as necessary but uncomfortable. Simultaneously, staff and participants forged close relations in line with their fictional identities, which however also posed challenges because they entailed personal responsibilities that were difficult to live up to, due to limited resources, and the trial's limited duration. Similar challenges may arise in transnational HIV treatment programmes and should be explored further in that context. (shrink)

Home births continue to constitute only a small percentage of all deliveries in the United States, in part because of concerns about their safety. While the literature is decidedly mixed in regard to the degree of risk, there are several studies that report that home birth may at times entail a small absolute increase in perinatal risks in circumstances that cannot always be anticipated prior to the onset of labor. While the definition of “small” will vary between individuals, (...) and publications vary in the level of risk they ascribe to birth at home, studies with the least methodological flaws and with adequate power often cite an excess death rate in the range of one per thousand.Home birth is, in that regard, but one example of patients’ choices and plans that sometimes carry increased risk or include alternatives that individual physicians feel uncomfortable supporting or recommending. Our intention in this opinion piece is not to advocate for or against home birth. Rather, we recognize that home birth is but one example of a patient choice that might differ from what a provider feels is in a woman’s best interests.In this article we will discuss ethical considerations in such circumstances using home birth as an example. We consider in this article how the ethical principles of respect for autonomy and non-maleficence can be balanced using, among other examples, the choice by some for a home birth. We discuss how absolute rather than relative risk should guide individuals’ evaluation of patient choices. We also consider how in some circumstances, the value and safety added by a physician’s participation may outweigh a potentially small increment in absolute risk that might result from a patient’s decision to deliver at home because of a perceived physician endorsement.We recognize, however, that doctors and midwives participating in choices they have not recommended, or may even believe will lead to or increase risk for adverse outcomes, presents dilemmas and raises important questions. When does respect for patient choice and autonomy become support for poor decision making? When is participation not respectful but enabling? Finally we discuss the role and responsibility of organized medicine in making all births as safe as possible. (shrink)

Background Home-based care workers mainly work alone in the patient’s home. They encounter a diverse patient population with complex health issues. This inevitably leads to several ethical challenges. Aim The aim is to gain insight into ethical challenges related to patient autonomy in home-based care and how home-based care staff handle such challenges. Research design The study is based on a 9-month fieldwork, including participant observation and interviews in home-based care. Data were analysed with a (...) thematic analysis approach. Participants and research context The study took place within home-based care in three municipalities in Eastern Norway, with six staff members as key informants. Ethical considerations The Norwegian Agency for Shared Services in Education and Research evaluated the study. All participants were competent to consent and signed an informed consent form. Findings A main challenge was that staff found it difficult to respect the patient’s autonomy while at the same time practicing appropriate care. We found two main themes: Autonomy and risk in tension; and strategies to balance autonomy and risk. These were explicated in four sub-themes: Refusing and resisting care; when choosing to live at home becomes risky; sweet-talking and coaxing; and building trust over time. Staff’s threshold for considering the use of coercion appeared to be high. Conclusions Arguably, home-based care staff need improved knowledge of coercion and the legislation regulating it. There is also a need for arenas for ethics reflection and building of competence in balancing ethical values in recurrent ethical problems. (shrink)

Background and objective: Assuming the hypothesis that the general practitioner can and should be a key player in making end-of-life decisions for hospitalised patients, perceptions of GPs’ role assigned to them by hospital doctors in making withdrawal decisions for such patients were surveyed.Design: Questionnaire survey.Setting: Urban and rural areas.Participants: GPs.Results: The response rate was 32.2% , and it was observed that 70.8% of respondents believed that their participation in withdrawal decisions for their hospitalised patients was essential, whereas 42.1% believed (...) that the hospital doctors were sufficiently skilled to make withdrawal decisions without input from the GPs. Most respondents were found to believe that they had the necessary skills and enough time to participate in withdrawal decisions. The last case of treatment withdrawal in hospital for one of their patients was described by 40% of respondents, of whom only 40.0% believed that they had participated actively in the decision process. The major factors in the multivariate analysis were the GP’s strong belief that his or her participation was essential , information on admission of the patient given to the GP by the hospital department , rural practice , visit to the patient dying in hospital and a request by the family to be kept informed about the patient .Conclusion: Strong interest was evinced among GPs regarding end-of-life issues, as well as considerable experience of patients dying at home. As GPs are more closely corrected to patients’ families, they may be a good choice for third-party intervention in making end-of-life decisions for hospitalised patients. (shrink)

In “Reconciliation as Non-Alienation: The Politics of Being at Home in the World,” Catherine Lu develops a novel account of reconciliation. Put briefly, she claims that reconciliation aims to address agents’ alienation from the unjust social institutions and practices that structure their lives; it aims, in other words, to enable these agents to be at home in their social worlds. In these comments, I present two kinds of challenges that Lu’s account faces. Both challenges have their source in (...) forms of shame and fear that are apt to discourage socially privileged agents from participating in the process of reconciliation that Lu describes. My hope is that thinking through responses to the challenges that I discuss will deepen our understanding of the grounds for engaging in reconciliation at all, the relation between our ideals of reconciliation and our ideals of justice, and the burdens that may be associated with the pursuit of these ideals. (shrink)

Assess to quality diets is a basic human right. Geographical challenges and cultural traditions have contributed to the widespread malnutrition present among ethnic minorities of mountainous areas in Northwest Vietnam. Home gardens can play a role in increased diet diversity and micronutrient intakes. However, low production yields and plant diversity in ethnic home gardens have limited their contributions to household food security and nutrition. The pilot study tested a home garden intervention in weekly vegetable harvests and increasing (...) household production and consumption of diverse vegetables year-round. Food ethics issues encountered included limited access to quality food by resource-poor groups, conflicts arising from low preference and value given to some nutritious foods, limited access to information and technology for food production and consumption, each of which were addressed in the study design. The intervention includes: (1) nutrition-focused home garden training and (2) locally-adapted home garden packages consisting of garden planning, technical assistance, and high-yielding seed varieties. Twenty households from two ethnic villages in Son La province participated in the study and were randomly assigned into two groups (intervention and non-intervention). The total vegetable supply from weekly harvests of home garden produce was significantly higher in the intervention households (226 kg) compared to the non-intervention households (39 kg). The intervention group yielded 5.8 and 1.7 times more vegetables by weight and weight per area than those without the intervention. The vegetables were mainly consumed at home for both groups, but the intervention households gave more vegetables as gifts to neighbors. The intervention group cultivated a higher diversity of vegetables with a total of 42 different vegetables compared to 24 in the non-intervention group, which is reflected in an overall higher nutritional yield of vitamin A, iron, other micronutrients and phytochemicals. The home garden training significantly improved the amount, diversity and continuity of household food and nutrient supply. The home garden model is effective and could be scaled up to improve household vegetable supply and consumption, particularly in Northwest Vietnam. (shrink)

Background: Studies have demonstrated the extensive use of coercion in Norwegian nursing homes, which represents ethical, professional as well as legal challenges to the staff. We have, however, limited knowledge of the experiences and views of nursing home patients and their relatives. Objectives: The aim of this study is to explore the perspectives of nursing home patients and next of kin on the use of coercion; are there situations where the use of coercion can be defended, and if (...) so, under which circumstances? Methods: The data are based on individual interviews with 35 patients living in six nursing homes and seven focus group interviews with 60 relatives. Ethical considerations: Participation was based on written informed consent, and the study was approved by the Regional Committees for Medical and Health Research Ethics. Results: More than half of the patients and the majority of the relatives accepted the use of coercion, trusting the staff to act in the patient’s best interest. However, the acceptance of coercion is strongly related to the patients’ lack of understanding, to prevent health risks and to preserve the patient’s dignity. Conclusion: The majority of nursing home patients and relatives accepted the use of coercion in specific situations, while at the same time they emphasised the need to try alternative strategies first. There is still a need for good qualitative research on the use of coercion in nursing homes, especially with a closer focus on the perspectives and experiences of nursing home patients. (shrink)

The present study investigated the cross-cultural variations in parents' views on the role of play in child development and the primary purpose of preschool education from Ethiopia and Hungary. It also examined the cross-cultural variations in preschoolers' executive functions, the frequency of their engagement in home activities, and the role of these activities in the development of EF skills. Participants included 266 preschoolers with their parents. The independent samples t-test showed that Ethiopian parents view fostering academic skills for preschooler (...) significantly more important than their Hungarian counterparts do. We also found that while Ethiopian parents hold the belief that academic and cognitive development is the major purpose of preschool education, Hungarian prioritize social-emotional development and entertainment. Additionally, preschoolers in Ethiopia were reported to engage in academic and arts and crafts activities after preschool significantly more frequently than their Hungarian counterparts. On the contrary, preschoolers in Hungary were found to engage in fine-motor activities, solitary play, sports and other physical activities significantly more frequently than their Ethiopian counterparts. No significant differences were found in EF skills between preschoolers from Ethiopia and Hungary. Results from hierarchical regression analyses showed that, after accounting for age and SES, preschoolers' frequency of pretend play and their parents' play support beliefs were found to be small to medium-sized predictors of inhibitory control skills in both samples. However, children's frequency of having breakfast at home was another significant predictor in the Ethiopian sample only. The frequency of participation in arts and crafts and other fine-motor activities were found to be important predictors of preschoolers' visual-spatial working memory skills in the Ethiopian and the Hungarian samples, respectively. We also found that, after controlling for SES, parental play support was an important factor associated with preschoolers' shifting skills only in the Hungarian sample. Based on the findings, we made important conclusions. (shrink)

Background: Over the last decade, new healthcare policies are transforming healthcare practices towards independent living and self-care of older people and people with a chronic disease or disability within the community. For professional caregivers in home care, such as nurses, this requires a shift from a caring attitude towards the promotion of patient autonomy. Aim: To explore how nurses in home care deal with the transformation towards fostering patient autonomy and self-care. Research design and context: A case study (...) was conducted in a professional development course for home care nurses, including participant observations and focus groups. The theoretical notion of ‘relational agency’ and the moral concept of ‘practices of responsibility’ were used to conduct a narrative analysis on the nurses’ stories about autonomy. Participants: Eight nurses, two coaches and two university lecturers who participated in the learning circle. Ethical considerations: Informed consent was sought at the start of the course and again, at specific moments during the course of the learning circle. Findings: Three main themes were found that expressed the moral demands experienced and negotiated by the nurses: adapting to the person, activating patients’ strengths and collaboration with patients and informal caregivers. Discussion: On a policy and organisational level, the moral discourse on patient autonomy gets intertwined with the instrumental discourse on healthcare budget savings. This is manifested in the ambiguities the nurses face in fostering patient autonomy in their daily home care practice. To support nurses, critical thinking, moral sensitivity and trans-professional working should be part of their professional development. Conclusion: The turn towards autonomy in healthcare raises moral questions about responsibilities for care. Promoting patient autonomy should be a collaborative endeavour and deliberation of patients, professional and informal caregivers together. (shrink)

This paper argues for the active participation of women in philosophy of education and the importance of their sexually differentiated positions in pluralising knowledge. Drawing on the philosophical work of Luce Irigaray it explains how the feminine as other, has been symbolised as a dark epistemological cave from which those seeking universal truths ought to escape. Within such phallogo-centric systems of knowledge, women’s thoughts have been excluded from philosophy, and the feminine became un-representable as philosophical. This scenario raises important (...) political and ethical questions related to women’s place in philosophy of education and calls for deconstructive strategies aimed at using feminised locations to challenge phallogocentrism. The paper argues that a simple inclusion of women’s thoughts or the replacement a masculine-dominated philosophy with feminine ones do not suffice to disrupt the order that establishes what counts as philosophy. It therefore explores how sexual difference can rethink the traditional tenets of philosophy. The idea that women need a place that they can call home for such practices and whether this space can really differentiate knowledge is debatable and controversial. In considering this possibility, however, sexual difference is not considered a subject for thought in philosophy of education but a question that rethinks and engenders it. (shrink)

This paper argues for the active participation of women in philosophy of education and the importance of their sexually differentiated positions in pluralising knowledge. Drawing on the philosophical work of Luce Irigaray it explains how the feminine as other, has been symbolised as a dark epistemological cave from which those seeking universal truths ought to escape. Within such phallogo-centric systems of knowledge, women’s thoughts have been excluded from philosophy, and the feminine became un-representable as philosophical. This scenario raises important (...) political and ethical questions related to women’s place in philosophy of education and calls for deconstructive strategies aimed at using feminised locations to challenge phallogocentrism. The paper argues that a simple inclusion of women’s thoughts or the replacement a masculine-dominated philosophy with feminine ones do not suffice to disrupt the order that establishes what counts as philosophy. It therefore explores how sexual difference can rethink the traditional tenets of philosophy. The idea that women need a place that they can call home for such practices and whether this space can really differentiate knowledge is debatable and controversial. In considering this possibility, however, sexual difference is not considered a subject for thought in philosophy of education but a question that rethinks and engenders it. (shrink)

UNICEF estimates that 1.6 billion children across the world have had their education impacted by COVID-19 and have attempted to continue their learning at home. With ample evidence showing a negative impact of noise on academic achievement within schools, the current pre-registered study set out to determine what aspects of the home environment might be affecting these students. Adolescents aged 11–18 took part online, with 129 adolescents included after passing a headphone screening task. They filled out a sociodemographic (...) questionnaire, followed by a home environment and noise questionnaire. Participants then completed three executive function tasks while listening to a soundtrack of either white noise or home-like environmental noise. For purposes of analysis, based on the noise questionnaire, participants were separated into quieter and noisier homes. Results revealed that measures of the home environment significantly correlated with individual perceptions of noise and task performance. In particular, adolescents coming from noisier homes were more likely to report that they studied in a noisy room and that they were annoyed by noise when studying. In terms of noise and task performance, the Flanker task revealed that while older adolescents were more efficient overall than their younger peers, those older adolescents from noisier homes seemed to lose this advantage. Additionally, reaction times for younger adolescents from noisier homes were less impacted by accuracy compared to their peers from quieter homes, though there was no difference for the older adolescents. This evidence suggests that higher in-home noise levels lead to higher rates of annoyance and may be hindering home-learning, with both younger and older adolescents being impacted. Furthermore, the long-term effect of in-home noise on adolescent executive function task performance indicates that these findings transcend the pandemic and would influence in-school learning. Limitations and advantages of online adolescent research without researcher supervision are discussed, including sociodemographics and adapting tasks. (shrink)

Aims The study aims to test the Turkish validity and reliability of the Rushton Moral Resilience Scale (RMRS) and examine the effect of moral resilience on moral distress. Background Moral distress is a phenomenon that negatively affects health workers, health institutions, and the person receiving care. In order to eliminate or minimize the negative effects of moral distress, it is necessary to increase the moral resilience of nurses. Moral resilience involves developing systems that support a culture of ethical practice in (...) healthcare and aim to increase an individual’s capacity to cope with moral challenges. Methods A methodological and descriptive-predictive study design was adopted. Sociodemographic Information Form, Measure of Moral Distress – Healthcare Professionals (MMD-HP), and Rushton Moral Resilience Scale were used to collect data from the nurses. A total of 255 clinical nurses were recruited. Ethical considerations Hacettepe University’s non-interventional ethics committee approved the study’s protocol and informed consent was obtained from the participants. Results The original four-factor structure of the scale was tested with confirmatory factor analysis, and the index values were evaluated and found at an acceptable level. The Cronbach Alpha coefficient of the scale was found to be 0.826. Moral resilience predicted moral distress total, intensity, and frequency levels. A moderate and weak relationship was found in the negative between all sub-dimensions of moral distress and moral resilience. Conclusions The Rushton Moral Resilience Scale Turkish version showed good psychometric properties. Moral resilience has a reducing effect on moral distress. Young nurses who have less experience are at risk because they have lower moral resilience levels, while nurses working in intensive care units are at risk because of their high moral distress levels. A healthy workplace can be created by developing specific approaches to improve moral resilience in reducing the impact of moral distress in the healthcare environment. (shrink)

We tested the plausibility of a persuasion model to understand the effects of messages framed in terms of gain, non-loss, loss, and non-gain, and related to the physical, mental and social consequences of doing physical activity at home during the lockdown restrictions. 272 Italian participants responded to a questionnaire on their attitude and intention at Time 1, frequency of past behavior, and self-efficacy related to exercising at home. Then, participants were randomly assigned to four different message conditions: gain (...) messages focused on the positive outcomes associated with doing physical activity at home; non-loss messages focused on the avoided negative outcomes associated with doing physical activity at home; loss messages focused on the negative outcomes associated with not doing physical activity at home; non-gain messages focused on the missed positive outcomes associated with not doing physical activity at home. After reading the messages, participants answered a series of questions regarding their perception of threat and fear, their evaluation of the messages, and their attitude and intention toward exercising at home at Time 2. Using multigroup structural equation modeling, we compared message conditions, and tested whether the effects of the messages on attitude and intention at Time 2 were mediated by message-induced threat, message-induced fear, and message evaluation. Results showed that the perception of the messages as not threatening was the key point to activate a positive evaluation of the recommendation. The highest persuasive effect was observed in the case of the non-loss frame, which did not threaten the receivers, triggered a moderated fear and, in turn, activated a positive evaluation of the recommendation, as well as higher attitude and intention to do home-based physical activity at Time 2. Overall, these results advance our comprehension of the effects of message framing on receivers' attitudes and intentions toward home-based physical activity. (shrink)

BackgroundIn Palliative Care, family and close people are an essential part of provision of care. They assume highly complex tasks for which they are not prepared, with considerable physical, psychological, social and economic impact. Informal Caregivers often falter in the final stage of life and develop distress, enhancing emotional burden and complicated grief. The lack of available and accessible in-person counselling resources is often reported by ICs. Online resources can promote early access to help and support for patient-IC dyads in (...) palliative care. The primary aim of this research is to co-design, develop and test the feasibility of the Help2Care-PAL mHealth app that addresses the needs of ICs of palliative patients cared for at home. This Digital Health Intervention in palliative care will be used for education, symptom management, communication and decision-making, to enhance Quality of Life of patients and ICs, fostering anticipatory grief and the reach and efficiency of services.MethodsThis study will use an iterative co-design process and convergent mixed-methods design, following the MORECare consensus for developing a complex intervention. Construction of the DHI will follow four main phases: a needs assessment ; design and co-production of mHealth materials and interventions to support ICs; the development of a mHealth app; and usability and feasibility of the mHealth app. The Help2Care-PAL platform seeks to build resources from the perspectives and needs of both family dyads and nursing professionals working in the field of community palliative care. User-centeredness will be ensured by the active participation of patient-IC dyads and professionals of the palliative care community.DiscussionThis mixed-method study will offer new insights on needs and expectations of patient-IC dyads and nurses in community palliative care regarding caregiving preparedness and online health resources. Through the implementation of an adaptive digital tool, we aim to improve access to palliative care family support, which is highly linked with the wellbeing of patients and especially new ICs. (shrink)

The purpose of this research is to determine the variables influencing college students' engagement in swimming activities, as well as the significant themes that often appear in these occurrences. A descriptive research design was used to identify the factors influencing college students' perception of participating in swimming activities. Descriptive research is a type of nonexperimental study that aims to describe the features of phenomena as it occurs. It was found out that participating in swimming activities provides various benefits, some of (...) these include helping build endurance, muscle strength, and cardiovascular fitness, enhanced swimming skills, and maintaining a healthy weight. As a result, the implementation of active recreational activities in schools must be reinforced, not simply for the purpose of participation, but also because students are driven to do so. And these activities must be carried out not just on school grounds, but also at home and in the community. (shrink)

This study aimed to identify the ethical issues faced by home care physicians and nurses, and the support they require. It was conducted in collaboration with the Japanese Association for Home Care Medicine from November to December 2020. An e-mail was sent to 2785 physicians and 582 nurses who are members of the society, requesting their participation in a web-based survey targeting physicians and nurses with practical experience in home care; 152 physicians and 53 nurses responded. (...) Home care physicians and nurses face ethical issues, some of which are that “the patient’s wishes cannot be reliably understood owing to their impaired decision-making capacity” and “there is disagreement between the patient and their family members over the necessary healthcare.” The respondents sought “experience with, and insight into, healthcare ethics” and “home care” from people with whom they would consult on ethical issues, but at the time of the actual consultation, those individuals were the main healthcare professionals involved with the patient. In addition, the respondents desired to have “multidisciplinary discussions in the community,” “participation of healthcare ethics experts at meetings,” and “meetings held by healthcare ethics experts” to discuss specific cases. Given these results and the history of healthcare ethics education in Japan—which has been implemented mostly for healthcare providers—we conclude that it is important for academic societies that offer healthcare ethics education to healthcare providers and regional core hospitals with ethics support resources to collaborate to provide ethics consultation services in the community. (shrink)

Household confinement due to the rapid spread of the pandemic caused by COVID-19 has brought very significant changes, such as the forced stay-at-home of children due to the closure of schools. This has meant drastic changes in the organization of daily life and restrictions on their activities, including exercise, which could affect the quality of life of the children due to its importance. In order to study the relationship between physical activity and psychological well-being of minors, a study has (...) been carried out with Mixed Methods Research, combining survey methodology with transversal design with qualitative methodology using discourse analysis. A total of 234 parents of minors in Spain and several Spanish-speaking countries in America participated. The instrument was a questionnaire in Google Forms, which included the Kidscreen-27 quality of life scale. The results show significant differences in both the type of physical activity and its frequency due to age, and differences in parents’ perception of whether their children’s physical activity levels were sufficient or not, both on the health, mood and school subscales, and in the categorization of open responses referring to concerns due to the pandemic, analyzed with the ALCESTE technique. The relationship between physical activity of children and adolescents and quality of life is clearly concluded. (shrink)

Governments have adopted strict home quarantine measures during the COVID-19 pandemic. A monotonous, barren, and under-stimulating environment can cause state boredom, and people often deal with boredom via novelty-seeking behavior. Novelty-seeking behavior can be divided into “novelty input” and “novelty output.” The former refers to obtaining novel information such as browsing the Web; the latter refers to engaging in creative behavior such as literary creation. This study explores the relationship between two types of novelty-seeking behavior and individual state boredom (...) during home quarantine, along with the moderation effect of trait creativity. The study sample consists of 582 Chinese college students who were quarantined at home during the COVID-19 pandemic. Participants completed the Multidimensional State Boredom Scale, the Williams Creativity Aptitude Test, and self-compiled questionnaires of novelty input and novelty output. The results show that there is no significant relationship between novelty input or novelty output and boredom during the COVID-19 quarantine. Trait creativity is found to negatively moderate the relationship between the two means of novelty seeking and boredom. Specifically, novelty output negatively predicts the state boredom of individuals with high creativity, while novelty input positively predicts the state boredom of individuals with low creativity. Our findings suggest that different novelty-seeking behaviors may have different effects on the boredom level of individuals with high versus low creativity during quarantine. During a quarantine period, individuals should avoid excessively engaging in novelty input behaviors aimed at escaping boring situations. (shrink)

BackgroundCurrently, we are facing a demographic shift to an older population and its consequences worldwide: in the years to come, several older people will need nursing home care. The work culture is important for care quality in NHs. Some Norwegian municipalities have implemented the Joy of Life Nursing Home strategy, representing a resource-oriented health-promoting approach. Knowledge about how implementation of the JoLNH approach impacts the work culture is scarce.AimssWe hypothesized that the JoLNH strategy impacts positively on the work (...) culture: when comparing measurements at two time points and when comparing two municipalities, among which one has implemented the JoLNH and the other has not.MethodWith a 1-year interval, healthcare personnel in 43 NHs located in two large Norwegian municipalities responded to a survey in two waves. In total, 558 healthcare personnel participated at T1 and 515 at T2. Work culture was assessed by the Systematizing Person–Group Relations Instrument.FindingsThe municipality implementing the JOLNH strategy experienced significant increases in SPGR dimensions, representing positive orientations towards a better work culture, whereas those working in the non-JoLNH municipality reported an increase in SPGR dimensions, signifying a worsened work culture.DiscussionThe data indicate that the implemented JoLNH strategy has endorsed positive effects in the work culture. The JoLNH strategy emphasizes on the quality of patient care, which is what healthcare personnel, in general, are much concerned about. Furthermore, attention to task orientation and independent work seem to encourage a better work culture in NHs.ConclusionThis study suggests that the JoLNH strategy impacts positively on the work culture in Norwegian NHs. (shrink)