Search

Given the short-and long-term health implications associated with overweight and obesity plus the likelihood of overweight or obesity to continue into adulthood, addressing the causes of overweight and obesity in childhood is a significant public health concern. One underlying cause of overweight and obesity is insufficient physical activity. The Department of Health and Aging recommends children engage in at least 60 minutes of moderate to vigorous physical activity (MVPA) per day; however, these recommendations are met less frequently with increasing age, and girls less often meet these recommendations than boys. School lunch times have been identified as an ideal time for maximizing children's physical activity (PA), but studies have shown variable levels of PA among children during this time and research indicates that during school lunch times, girls are consistently less active than boys. Understanding influences on girls' participation in PA during this time may help to increase levels of PA for this demographic. Two South Australian schools, one government and one independent, were included in the sample. Four focus groups (three or four participants per group: total 13 participants) focusing on girls' perceptions of PA during the lunch break were conducted. Transcripts and field notes were analyzed using a social constructionist framework and thematic content analysis. The expectation to participate in activities considered "gender appropriate", maturation, and bullying/teasing were identified as explicit barriers to participation in lunch time play. Other important barriers included a "girls'" school uniform and feelings of inadequate competency. The ability to renegotiate gender stereotypes, a unisex school uniform, and perceived high competency were important facilitators of lunch time PA. Low levels of lunch time PA evident in many young adolescent girls may be due to many complex social factors. Therefore, these barriers may need to be addressed before any environmental interventions are likely to be effective.

Although deemed vital to patient well-being, hope in persons who are terminally ill is often thought to be problematic, particularly when centered on cure. As part of a study on end-of-life decision-making, we asked 28 patients with cancer, believed to be within weeks of their death, to talk about hope. Responses were transcribed and discursively analyzed, with 3 versions of hope, each of which connected hope and life, identified--hope as essential to, and for, life; hope, life, death, and others; and, hope/s changing during (or in) life. Hope for cure was common. Rather than death-denying, patients' hope appeared life-affirming, functioning to value patients, their lives, and connections with others. (Contains 1 footnote.)

To purchase or authenticate to the full-text of this article, please visit this link: http://dx.doi.org/10.1111/j.1467-8519.2007.00620.x Byline: JAKLIN ELIOTT (1), IAN OLVER (2) Keywords: CPR; DNR decision-making; qualitative analysis; bioethics; autonomy; family Abstract: ABSTRACT In keeping with the pre-eminent status accorded autonomy within Australia, Europe, and the United States, medical practice requires that patients authorize do-not-resuscitate (DNR) orders, intended to countermand the default practice in hospitals of instituting cardiopulmonary-resuscitation (CPR) on all patients experiencing cardio-pulmonary arrest. As patients typically do not make these decisions proactively, however, family members are often asked to act as surrogate decision-makers and decide on the patient's behalf. Although the appropriateness of patients or their families having to decide about the provision of CPR has been challenged, there has been little examination of how patients and their families talk about and negotiate such decisions, particularly in the context of the patient's imminent death. In this article, part of a larger study analysing interviews with 28 patients (13 female) with cancer within weeks of their death, and 20 others (predominantly family) attending, we argue that a common assumption underpinning participants' talk about the DNR decision (i.e. forgoing CPR) is that it requires a choice between life and death. Using illustrative examples, we demonstrate that in making decisions about CPR, patients and their families are implicitly required to make moral judgements about the value of the patient's life, including their relationships with significant others. We identify some implications of these empirical observations for the development of ethically appropriate policies and practices regarding patient autonomy and surrogacy at the end of life. Author Affiliation: (1)Royal Adelaide Hospital Cancer Research Centre, and University of Adelaide (2)The Cancer Council Australia Article note: Jaklin A. Eliott, Social Scientist, The Cancer Council Australia, c/o School of Psychology, Room 314, Hughes Building, University of Adelaide, Adelaide, South Australia 5005, Australia. Phone: +61 8 8303 3855, Mobile: 0413 565 637, Jaklin.Eliott@adelaide.edu.au

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.socscimed.2006.08.029 Byline: Jaklin A. Eliott (a), Ian N. Olver (b) Keywords: Australia; Hope; Discourse analysis; Bioethics; Clinical interaction; Cancer Abstract: Hope is the subject of increasing research and discussion within the healthcare literature. However, although deemed of vital import to patient welfare, there is little examination of how hope features within patients' speech. This qualitative study presents the discursive properties of hope as it emerged unprompted during semi-structured interviews with 28 patients in the final phase of terminal cancer recruited from the oncology clinic of the Royal Adelaide Hospital, Australia. In the context of discussions about decision-making at the end of a terminal illness, when used as a noun, hope invariably referenced the medical domain -- focussing either on the objective probability of medical cure (typically taking the negative form 'there is no hope'), or the subjective possession of the patient, needed to fight their disease. Positioning the patient as relatively powerless and subject to external forces, this hope was most commonly associated with absolute solutions, and life-and-death stakes. Hope as a verb emphasised the patient's active engagement in life, identifying what was good and positive for them. It was used to assign responsibility to others, to indicate and establish solidarity or agreement between the speaker and others, effectively strengthening interpersonal ties between individuals. Through hoping, patients established connection with others and with the future. In the context of interactions between patients and clinical staff, we conclude that the use of hope-as-a-verb may have benefits, enabling the patient -- even when dying -- to focus on the positive, to connect to others, and to continue to engage with life. Author Affiliation: (a) Royal Adelaide Hospital, Cancer Centre, EW, Level 7, Adelaide, SA 5000, Australia (b) Royal Adelaide Hospital, University of Adelaide, SA, Australia