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Terms modified by Sick Selected AbstractsWomen in Iran: An Online DiscussionMIDDLE EAST POLICY, Issue 4 2001Nikki R. Keddie This debate on the role of women in the Islamic Republic of Iran was conducted early in 2001 as part of the Gulf/2000 project at Columbia University, directed by Gary Sick. Normally these online discussions are reserved for members, but this topic is of such general interest and aroused such intense emotions that two of the participants were asked to edit the discussion for a wider audience. The final version was edited by Nikki R. Keddie, professor emerita of history at the University of California, Los Angeles, based on the selection and organization of the texts by co-editor Azita Karimkhany, alumna of Columbia University and researcher in Middle Eastern studies. For additional information on Gulf/2000, see the project website athttp:gulf2000.columbia.edu. [source] ,Sick', irritable infant with fever, vomiting, bloody stool and abdominal distention (Case Presentation)ACTA PAEDIATRICA, Issue 9 2010Larisa Epov No abstract is available for this article. [source] ,Sick', irritable infant with fever, vomiting, bloody stool and abdominal distention (Discussion and Diagnosis)ACTA PAEDIATRICA, Issue 9 2010Larisa Epov No abstract is available for this article. [source] Rethinking Medical Ethics: A View From BelowDEVELOPING WORLD BIOETHICS, Issue 1 2004Paul Farmer ABSTRACT In this paper, we argue that lack of access to the fruits of modern medicine and the science that informs it is an important and neglected topic within bioethics and medical ethics. This is especially clear to those working in what are now termed ,resource-poor settings', to those working, in plain language, among populations living in dire poverty. We draw on our experience with infectious diseases in some of the poorest communities in the world to interrogate the central imperatives of bioethics and medical ethics. AIDS, tuberculosis, and malaria are the three leading infectious killers of adults in the world today. Because each disease is treatable with already available therapies, the lack of access to medical care is widely perceived in heavily disease-burdened areas as constituting an ethical and moral dilemma. In settings in which research on these diseases are conducted but there is little in the way of therapy, there is much talk of first world diagnostics and third world therapeutics. Here we call for the ,resocialising' of ethics. To resocialise medical ethics will involve using the socialising disciplines to contextualise fully ethical dilemmas in settings of poverty and, a related gambit, the systematic participation of the destitute sick. Clinical research across steep gradients also needs to be linked with the interventions that are demanded by the poor and otherwise marginalised. We conclude that medical ethics must grapple more persistently with the growing problem posed by the yawning ,outcome gap' between rich and poor. [source] Clinical and Economic Factors Associated with Ambulance Use to the Emergency DepartmentACADEMIC EMERGENCY MEDICINE, Issue 8 2006Jennifer Prah Ruger PhD Background: Concern about ambulance diversion and emergency department (ED) overcrowding has increased scrutiny of ambulance use. Knowledge is limited, however, about clinical and economic factors associated with ambulance use compared to other arrival methods. Objectives: To compare clinical and economic factors associated with different arrival methods at a large, urban, academic hospital ED. Methods: This was a retrospective, cross-sectional study of all patients seen during 2001 (N= 80,209) at an urban academic hospital ED. Data were obtained from hospital clinical and financial records. Outcomes included acuity and severity level, primary complaint, medical diagnosis, disposition, payment, length of stay, costs, and mode of arrival (bus, car, air-medical transport, walk-in, or ambulance). Multivariate logistic regression identified independent factors associated with ambulance use. Results: In multivariate analysis, factors associated with ambulance use included: triage acuity A (resuscitation) (adjusted odds ratio [OR], 51.3; 95% confidence interval [CI] = 33.1 to 79.6) or B (emergent) (OR, 9.2; 95% CI = 6.1 to 13.7), Diagnosis Related Group severity level 4 (most severe) (OR, 1.4; 95% CI = 1.2 to 1.8), died (OR, 3.8; 95% CI = 1.5 to 9.0), hospital intensive care unit/operating room admission (OR, 1.9; 95% CI = 1.6 to 2.1), motor vehicle crash (OR, 7.1; 95% CI = 6.4 to 7.9), gunshot/stab wound (OR, 2.1; 95% CI = 1.5 to 2.8), fell 0,10 ft (OR, 2.0; 95% CI = 1.8 to 2.3). Medicaid Traditional (OR, 2.0; 95% CI = 1.4 to 2.4), Medicare Traditional (OR, 1.8; 95% CI = 1.7 to 2.1), arrived weekday midnight,8 AM (OR, 2.0; 95% CI = 1.8 to 2.1), and age ,65 years (OR, 1.3; 95% CI = 1.2 to 1.5). Conclusions: Ambulance use was related to severity of injury or illness, age, arrival time, and payer status. Patients arriving by ambulance were more likely to be acutely sick and severely injured and had longer ED length of stay and higher average costs, but they were less likely to have private managed care or to leave the ED against medical advice, compared to patients arriving by independent means. [source] Empirical support for a multi-dimensional model of sensations experienced by youth during their initial smoking episodesADDICTION, Issue 10 2010Chris G. Richardson ABSTRACT Aims To examine the dimensionality of sensations experienced during initial tobacco smoking. Design Cross-sectional survey. Setting Thirteen secondary schools located in British Columbia, Canada. Participants Data from 1187 adolescents who responded ,yes' to the question: ,Have you ever tried cigarette smoking, even one or two puffs?'. Measurements Participants answered questions about their demographic characteristics, tobacco smoking history and sensations experienced during their initial smoking episodes. Findings The sensations appear to represent the following three separate but modestly correlated dimensions: a pleasant dimension defined by feeling good and relaxed; an unpleasant dimension defined by coughing, feeling sick and nervous; and a ,buzz' dimension defined by feeling high and dizzy. The three factors made statistically significant contributions to the prediction of transition to regular smoking (defined as having smoked at least 100 cigarettes in one's life-time) after adjusting for age, sex and age at first puff. Conclusions The results suggest that three relatively distinct physiological systems appear to explain the relationship between initial smoking sensations and probability of becoming a regular smoker. Researchers examining sensations experienced during initial tobacco smoking episodes should consider using a three-dimensional profile of symptoms composed of pleasant, unpleasant and buzz dimensions. [source] MAPK3 deficiency drives autoimmunity via DC armingEUROPEAN JOURNAL OF IMMUNOLOGY, Issue 5 2010Ivo Bendix Abstract DC are professional APC that instruct T cells during the inflammatory course of EAE. We have previously shown that MAPK3 (Erk1) is important for the induction of T-cell anergy. Our goal was to determine the influence of MAPK3 on the capacity of DC to arm T-cell responses in autoimmunity. We report that DC from Mapk3,/, mice have a significantly higher membrane expression of CD86 and MHC-II and , when loaded with the myelin oligodendrocyte glycoprotein , show a superior capacity to prime naïve T cells towards an inflammatory phenotype than Mapk3+/+ DC. Nonetheless and as previously described, Mapk3,/, mice were only slightly but not significantly more susceptible to myelin oligodendrocyte glycoprotein-induced EAE than WT littermate mice. However, Mapk3+/+ mice engrafted with Mapk3,/, BM (KO,WT) developed a severe form of EAE, in direct contrast to WT,KO mice, which were even less sick than control WT,WT mice. An infiltration of DC and accumulation of Th17 cells was also observed in the CNS of KO,WT mice. Therefore, triggering of MAPK3 in the periphery might be a therapeutic option for the treatment of neuroinflammation since absence of this kinase in the immune system leads to severe EAE. [source] Validation of the Pulmonary Score: An Asthma Severity Score for ChildrenACADEMIC EMERGENCY MEDICINE, Issue 2 2002Sharon R. Smith MD Objectives: In the absence of a validated "user-friendly" method of scoring asthma severity, the authors derived the pulmonary score (PS). The purpose of this study was to begin validation trials of the PS by comparing it with the peak expiratory flow rate (PEFR). Methods: The study enrolled a convenience sample of children, aged 5-17 years, who came to the emergency department (ED) for treatment of an acute asthma exacerbation. The PEFR (best of three attempts) and the PS were measured before and after the first albuterol treatment by a physician and a nurse from a pool of 45 trained observers. The PS includes respiratory rate, wheezing, and retractions, each rated on a 0-3 scale. Decreasing PS and increasing PEFR indicate clinical improvement. Pre- and post-treatment PEFRs and PSs were compared using paired t-tests to establish construct validity. Correlation of pre- and post-treatment PSs with PEFRs was measured to establish criterion validity. Results: Forty-six subjects completed the study. Mean percent predicted PEFR improved after treatment by 20.7% (p = 0.0001), and mean PS by 1.5 for nursing-obtained scores (p < 0.0001) and 1.9 for physician-obtained scores (p < 0.0001). Pre- and post-treatment PSs were significantly correlated with PEFRs. Correlations for the nursing-obtained scores were pre-treatment r = -0.57 (p = 0.0003) and post-treatment r = -0.67 (p = 0.0001), and for the physician-obtained scores were pre-treatment r = -0.44 (p = 0.003) and post-treatment r = -0.56 (p = 0.0001). The pre-treatment interrater reliability was 0.62 and the post-treatment was 0.53. Conclusions: These data support the construct and criterion validities of the PS as a measure of asthma severity among children in the ED. The PS is a practical substitute to estimate airway obstruction in children who are too young or too sick to obtain PEFRs. [source] Health and Safety in the Medieval Monasteries of BritainHISTORY, Issue 309 2008JULIE KERR The arduous nature of monastic life could impact on the monks' physical and mental well-being, causing minor injuries but also fatalities. Back problems might develop from ringing the heavy monastery bells, digestive disorders could result from years of fasting, and those holding important offices invariably suffered from stress and strain. There has been significant discussion of healthcare in the monastery , of disease and illness, the treatment of the sick, the infirmary, and the role of professional practitioners within the monastery. Less consideration has been given to the various hazards that might affect the monks on a daily basis, from the obstacles that caused them to trip and tumble to the injuries and fatalities that could result from natural disasters, outbreaks of fire and faulty repair work. This article seeks to explore more fully the perils and pitfalls that the religious community might face, but includes a brief discussion of the general impact of monastic observance on the monks' well-being, and the spiritual and physical recourse they sought to prevent mishaps and to treat casualties. Analysis centres on the monastic houses of Britain in the high middle ages, but refers to later and continental examples for comparative purposes and where they are likely to be indicative of conditions in Britain in the twelfth and thirteenth centuries. [source] The Perceptions of Infant Distress Signals Varying in Pitch by Cocaine-Using MothersINFANCY, Issue 1 2003Pamela Schuetze Perceptual responses to infant distress signals were studied in 16 cocaine-using and 15 comparison mothers. All mothers rated tape recordings of 48 replications of a newborn infant's hunger cry digitally altered to increase in fundamental frequency in 100-Hz increments. Cries were rated on 4 perceptual (arousing, aversive, urgent, and sick) and 6 caregiving rating scale items (clean, cuddle, feed, give pacifier, pick up, and wait and see) used in previous studies. Analyses of variance showed that, as cry pitch increased, cries were rated as more arousing, aversive, and urgent sounding. The highest pitched cries received the highest ratings for caregiving interventions. Main effects for cocaine use showed cocaine-using mothers (a) rated cries as less arousing, aversive, urgent, and sick; (b) indicated they were less likely to pick up or feed the infant; and (c) indicated they more likely to give the crying infant a pacifier or just "wait and see." A Group x Cry Pitch interaction effect showed that mothers in the cocaine group gave higher ratings to wait and see as the pitch of the cries increased, whereas mothers in the comparison group gave lower ratings to wait and see as the pitch of the cries increased. These ratings indicate that cocaine-using mothers found cries to be less perceptually salient and less likely to elicit nurturant caregiving responses. These results suggest that maternal cocaine use is associated with altered perceptions of infant distress signals that may provide the basis for differential social responsivity in the caregiving context. [source] Relationship between sick leave, unemployment, disability, and health-related quality of life in patients with inflammatory bowel diseaseINFLAMMATORY BOWEL DISEASES, Issue 5 2006Tomm Bernklev BSc Background: The goal of this study was to determine the rate of work disability, unemployment, and sick leave in an unselected inflammatory bowel disease (IBD) cohort and to measure the effect of working status and disability on the patient's health-related quality of life (HRQOL). Materials and Methods: All eligible patients were clinically examined and interviewed at the 5-year follow-up visit. In addition, they completed the 2 HRQOL questionnaires, the Short Form-36 Health Survey (SF-36) and the Inflammatory Bowel Disease Questionnaire validated for use in Norway (N-IBDQ). Data regarding sick leave, unemployment, and disability pension (DP) also were collected. Results: All together, 495 patients were or had been in the workforce during the 5-year follow-up period since diagnosis. Forty-two patients (8.5%) were on DP compared with 8.8% in the background population. Women with Crohn's disease (CD) had the highest probability of receiving DP (24.6%). A total of 58 patients (11.7%) reported they were unemployed at 5 years. This was equally distributed between men and women but was more frequent in patients with ulcerative colitis. Sick leave for all causes was reported in 47% with ulcerative colitis and 53% with CD, whereas IBD-related sick leave was reported in 18% and 23%, respectively. A majority (75%) had been sick <4 weeks, and a relatively small number of patients (25%) contributed to a large number of the total sick leave days. Both unemployment and DP reduced HRQOL scores, but the most pronounced effect on HRQOL was found in patients reporting IBD-related sick leave, measured with SF-36 and N-IBDQ. The observed differences also were highly clinically significant. Multiple regression analysis confirmed that IBD-related sick leave was the independent variable with the strongest association to the observed reduction in HRQOL scores. Conclusions: Unemployment or sick leave is more common in IBD patients than in the Norwegian background population. The number of patients receiving DP is significantly increased in women with CD but not in the other patient groups. Unemployment, sick leave, and DP are related to the patient's HRQOL in a negative way, but this effect is most pronounced in patients reporting IBD-related sick leave. [source] Neck pain and disability: A cross-sectional survey of the demographic and clinical characteristics of neck pain seen in a rheumatology clinicINTERNATIONAL JOURNAL OF CLINICAL PRACTICE, Issue 2 2005A.O. Frank Summary This hospital-based cross-sectional cohort study examines the clinical and demographic features of neck pain, disability (using the Northwick Park neck pain questionnaire) and relationships to handicap in employment. Of 173 consecutive referrals to a rheumatology clinic with neck pain, 70% had neck/arm pain without neurological involvement, 13% other conditions, 11% nerve involvement and 5% other spinal pain. 141 patients (mean age 50 years) had mechanical or degenerative neck pain, of which 13% was probably work-related and 13% was trauma-related. 44 had taken sickness absence for an average of 30 weeks. Comorbidities were frequent (lumbar pain 51%). Those in work were significantly less disabled than those not working (p = 0.001) and those off sick (p < 0.01). Those reporting sleep disturbance, tearfulness and crying were significantly more disabled (p = 0.0001) than those who did not. Neck pain in secondary care is complicated by physical and emotional comorbidities. Comprehensive management requires a biopsychosocial model of care. [source] Globalization, global health, and access to healthcare,INTERNATIONAL JOURNAL OF HEALTH PLANNING AND MANAGEMENT, Issue 2 2003Téa Collins Abstract It is now commonly realized that the globalization of the world economy is shaping the patterns of global health, and that associated morbidity and mortality is affecting countries' ability to achieve economic growth. The globalization of public health has important implications for access to essential healthcare. The rise of inequalities among and within countries negatively affects access to healthcare. Poor people use healthcare services less frequently when sick than do the rich. The negative impact of globalization on access to healthcare is particularly well demonstrated in countries of transitional economies. No longer protected by a centralized health sector that provided free universal access to services for everyone, large segments of the populations in the transition period found themselves denied even the most basic medical services. Only countries where regulatory institutions are strong, domestic markets are competitive and social safety nets are in place, have a good chance to enjoy the health benefits of globalization. Copyright © 2003 John Wiley & Sons, Ltd. [source] Solidarity towards immigrants in European welfare statesINTERNATIONAL JOURNAL OF SOCIAL WELFARE, Issue 1 2008Wim Van Oorschot The concern that immigration could threaten the sustainability of the European Social Model is a reason to have a closer look at popular images of immigrants in the context of European welfare states. The focus is on Europeans' informal solidarity towards immigrants relative to other vulnerable groups in society. Using data from the European Values Survey 1999/2000 we find that in all European countries the public is least solidaristic towards migrants, in comparison with elderly people, sick and disabled people and unemployed people. Contrary to expectation, there is little relation between welfare state characteristics and people's solidarity, while the relative solidarity towards immigrants is higher in culturally more diverse countries. As expected, the relative solidarity towards immigrants is lower in countries with a more negative opinion climate towards immigrants and in poorer countries of Europe. [source] Healing and Salvation in Late Modernity: the Use and Implication of Such Terms in the Ecumenical MovementINTERNATIONAL REVIEW OF MISSION, Issue 380-381 2007Vebjørn Horsfjord This article explores developments over the last decades in the way ecumenical texts, primarily originating from world conferences organized by the Commission on World Mission and Evangelism, speak about soteriology. Under the headlines, "Salvation Today" (1973) and "Your Kingdom Come" (1980), terminology inspired by liberation theology took centre stage, and a predominantly immanent understanding of salvation was promoted. In recent years a different terminology has taken over, and it is one that focuses on "healing" and "the fullness of life". At its best, the holistic healing approach manages to take up the important concerns from earlier times, such as economic justice, racism and environmental issues, while at the same time giving more room for existential issues and the experiences of the individual The new healing discourse appears to reflect two different modalities of the church's healing ministry, viz. that which is concerned with the causes of suffering, and that which addresses the experience of suffering. The latter was often ignored in the recent past. The healing discourse gives room for new explorations of practices that have been central in the church throughout its history, such as anointing the sick, and praying for and with them, and hearing individual confessions. Openness towards subjective experience also has implications for the contextualization of the Christian faith. There is a new awareness that not only do the causes of suffering vary from situation to situation but so does the understanding of (what constitutes) suffering itself. Changing or varying understandings of suffering give rise to different approaches to its alleviation, and can inspire a rethinking of how we understand salvation in different contexts. The new healing discourse can also be studied in its relationship to cultural trends known as post-modernity or late modernity. The texts under study display very ambivalent approaches to these developments. There might be a tendency for texts that have concrete experience as their starting point to take a more positive view of these cultural developments than do texts that begin with more general theological observations. [source] Socio-psychological stressors as risk factors for low back pain in Chinese middle-aged womenJOURNAL OF ADVANCED NURSING, Issue 3 2001Yin-bing Yip BAppSc MPH PhD GDipEd RN Socio-psychological stressors as risk factors for low back pain in Chinese middle-aged women Aim(s) of the study.,This study aims to explore the relationship between socio-psychological stress and low back pain (LBP) prevalence among Chinese middle-aged women. Background.,Women in mid-life experience increasing socio-psychological stress because of midlife transitions, stressful life events and housework or work factors. Encountering socio-psychological stress itself may result in the manifestation of LBP. Design.,A case,control study of Hong Kong community-based middle-aged women was conducted. The study subjects were either from the University Family Medicine Clinic or from a previous population-based cross-sectional study of middle-aged women conducted by Department of Community and Family Medicine. Among the 928 potential eligible subjects from both sources, a total of 182 cases and 235 controls participated in this study. Data were collected from face-to-face interviews and included demographic factors, menopausal status, socio-psychological stress and occurrence of LBP. Socio-psychological stress covered social factors, self-reported nature of housework/work, housework/work stress and stressful life events. Results.,Among the 182 cases who entered this study, 83 women (45·6%) had experienced 1,<14 days of LBP, and 99 women (54·4%) had at least 14 days of LBP in the previous 12 months. Those who reported that ,their family members, relatives or friends were very sick, died, needed her to take care of them or who they worried about in the past 12 months' had an increased risk of LBP of 67% (95% confidence interval (CI) 1·09,2·55). In addition women with a bad or ordinary relationship with cohabitants had an increased risk of LBP of 70% (95% CI 1·00,3·04). Lastly, women with a high housework or work stress had an increased risk of suffering both types of LBP of nearly two- and half-fold (95% CI 1·61,3·85). Conclusions.,The results indicate that an association exists between high socio-psychological stress and LBP prevalence. Alleviating the impact of housework or work related factors would, however, involve improving both the work and home environment. [source] Risk Factors for Potentially Harmful Informal Caregiver BehaviorJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 2 2005Scott R. Beach PhD Objectives: Caring for a sick or disabled relative has been linked to compromised caregiver health, and risk factors for negative caregiver outcomes have been studied extensively, but little attention has been given to care recipient and caregiver health as risk factors for potentially harmful behavior by informal caregivers. This article explores such risk factors. Design: Structured interviews from baseline assessment of the Family Relationships in Late Life Study. Setting: Three U.S. communities. Participants: Referred, volunteer sample of 265 caregiver/care recipient dyads. Caregivers were primarily responsible for care of an impaired, community-residing family member aged 60 and older and providing help with at least one activity of daily living (ADL) or two instrumental activities of daily living (IADLs). Measurements: Self-reported care recipient demographics, cognitive status, need for care, and self-rated health; self-reported caregiver demographics, cognitive status, amount of care provided, self-rated health, physical symptoms, and depression. Care recipient reports of potentially harmful caregiver behavior, including screaming and yelling, insulting or swearing, threatening to send to a nursing home, and withholding food, were the main outcome variable. Results: The following were significant risk factors for potentially harmful caregiver behavior: greater care recipient ADL/IADL needs (odds ratio (OR)=1.12, 95% confidence interval (CI)=1.03,1.22), spouse caregivers (vs others; OR=8.00, 95% CI=1.71,37.47), greater caregiver cognitive impairment (OR=1.20, 95% CI=1.04,1.38), more caregiver physical symptoms (OR=1.07, 95% CI=1.01,1.13), and caregivers at risk for clinical depression (OR=3.47, 95% CI=1.58,7.62). Conclusion: Potentially harmful caregiver behavior is more likely in spouse caregiving situations and when care recipients have greater needs for care and caregivers are more cognitively impaired, have more physical symptoms, and are at risk for clinical depression. This risk profile is similar to that for negative caregiver outcomes. [source] The rationale of value-laden medicineJOURNAL OF EVALUATION IN CLINICAL PRACTICE, Issue 1 2002Michael H. Kottow MA(Soc) MD Abstract Medicine is becoming increasingly confident that scientific advances, especially in the area of genetics, will allow a major improvement in the control and eradication of disease. This development seems to go hand in hand with health-enhancement strategies, erasing the distinction between the states of health and disease, and blurring the specific goals of medical services. Medicine tends to become an increasingly technocentric practice that relies heavily on expert knowledge and on epidemiological evidence, neglecting the lived-body experience of being ill, and tending to transform costly medical services into commodities only affordable by the affluent. This paper argues that disease is not merely a functional description, but rather a definitely value-laden organismic state that is experienced by the patient, needs to be explored and treated by medical practitioners, and requires the assessment and participation of social institutions concerned with the delivery and support of medical services. Each of these perspectives introduces its own set of values, both in the clinical encounter and in public health programmes. Bioethics seems to be the appropriate discipline to discuss all these values involved, and help assign them properly in order to rescue the caring concern of medicine for the sick, as well as uphold a principle of fairness in publicly funded medical services. [source] Child Care and Work Absences: Trade-Offs by Type of CareJOURNAL OF MARRIAGE AND FAMILY, Issue 1 2008Rachel A. Gordon Parents face a trade-off in the effect of child-care problems on employment. Whereas large settings may increase problems because of child illness, small group care may relate to provider unavailability. Analyzing the NICHD Study of Early Child Care, we find that child-care centers and large family day care lead to mothers' greater work absences because of a sick child, but not to maternal job exits. Greater work absences because of unavailability of small home-based providers are associated with mothers' job exits, especially when mothers have low earnings and use nonrelative caregivers. Our findings accentuate the need for improved hygiene practices in child care, expanded personal leave coverage for parents, and greater backup care for sick and well children. [source] Meanings of being a supervisor for care providers suffering from burnout: from initial signs to recuperationJOURNAL OF NURSING MANAGEMENT, Issue 3 2009EVA ERICSON-LIDMAN RNT Aim, To illuminate meanings of being a supervisor for care providers suffering from burnout: from initial signs to recuperation. Background, Supervisors in health care, i.e. supervisors with first-line responsibilities for a work unit, are exposed to heavy demands, especially in times of downsizing and restructuring of the healthcare system. When care providers show signs of developing burnout, these demands are even greater. Methods, Interviews with 12 supervisors in health care were interpreted using a phenomenological-hermeneutic method. Results, Being a supervisor when someone in the work team shows signs of burnout means struggling to help them to continue working. In this predicament and being responsible for the unit, the supervisors are torn between focusing on relations and on production. When the care provider reports sick, they are left with feelings of hopelessness and self-blame. Conclusions and implications for nursing management, Supervisors face almost unmanageable strain, caught between conflicting demands. It seems important that supervisors are offered opportunities to share their feelings about this predicament as well as gaining increased knowledge about burnout. This is important if the supervisors are to give proper support, but it will also help to turn supervisory failure into development and to protect the health of the supervisors. [source] Relatives of persons with recently discovered serious mental illness: in need of support to become resource persons in treatment and recoveryJOURNAL OF PSYCHIATRIC & MENTAL HEALTH NURSING, Issue 4 2010K. NORDBY cand. polit. rpn Accessible summary ,,Relatives want the health workers to regard the patient not only as sick but also regard him/her as a person. Parents want to get involved at an early stage and find it important that their opinions and experiences are heard. The staff also express that relatives possess knowledge that should be important for them to receive. ,,The relatives underline the importance of an opening for hope to be present at all time, else you do not have the strength to cope with the situation. No matter how pessimistic the staff are, hope must be expressed. ,,The relatives want to know what happens after discharge. They do not always know what questions to ask before discharge as challenges are discovered gradually. They want to know how to behave and what to say to their family member with a psychiatric illness. When parents can impart their concerns and receive adjusted counselling their level of stress is reduced. ,,It is important to consider relatives as resource persons. The staff consider themselves as experts on psychosis and the parents as experts on their own children. Abstract A considerable amount of research on the treatment of young people suffering from serious mental illnesses states that good collaboration with relatives is essential for reducing relapse, improving recovery and enhancing quality of life for patients and relatives. The aim of this study was to explore and describe what facilitates active involvement for relatives in the treatment and rehabilitation of their family member. The present study is a part of a larger cooperative inquiry project carried out in a mental hospital in southern Norway focusing on improving practices for collaboration with relatives. This sub-study presents results from eight focus group interviews with relatives and staff members. Data were analysed by means of qualitative content analysis. The results showed that the relatives had mostly positive experiences from their encounters with the staff, although some negative experiences were articulated. Both relatives and staff underlined the importance of developing a good encounter characterized by sharing information, giving guidance and support according to the relatives' needs as well as addressing existential issues. This was perceived as a necessary basis for the relatives to become active participants in the treatment and rehabilitation process. To activate this basis, the relatives are dependent on the staff members' ability to convey and nurture hope related to the patient's recovery and quality of life. [source] Promoting self-care through symptom management: A theory-based approach for nurse practitionersJOURNAL OF THE AMERICAN ACADEMY OF NURSE PRACTITIONERS, Issue 5 2007ACNP (Acute Care Nurse Practitioner), Christopher Fowler RN, PhD(c) Abstract Purpose: To present a theory of illness representation useful in clinical practice along with two case studies as examples of theory implementation. Data sources: Literature review of relevant theory and associated literature, case studies from clinical practice. Conclusions: An individual asks several questions when experiencing a physical sensation: "Am I sick, stressed, or is this a sign of aging? If I'm sick, is the symptom connected with a disease label?" After asking these questions, the individual develops a cognitive and emotional illness representation that includes the dimensions of identity, cause, consequences, control, and timeline. This representation is guided by personal, cultural, and environmental contexts and determines coping strategies. By assessing the individual's cognitive and emotional representations of the illness, the nurse practitioner (NP) can use the common sense model of illness representation (CSM) to establish interventions and action plans helpful in decreasing distress in the management of symptoms. Implications for practice: NPs frequently care for patients who present with very severe symptoms related to their health problem. This becomes a major challenge in effective disease management. Leventhal's CSM can be used as a framework to identify the cognitive and emotional illness representations individuals develop when acute and chronic symptoms are presented. By assessing the individual's cognitive and emotional representations of the illness, the NP will be able to use the CSM to establish interventions and action plans that will be helpful in decreasing the patient's distress in the management of symptoms. [source] Incidence and Precipitating Factors of Morbidity among Israeli Travelers AbroadJOURNAL OF TRAVEL MEDICINE, Issue 5 2002Lihi Winer Background: During recent years international travel, including visits to the developing world, has become increasingly popular. Many of these travelers suffer from some sort of health problem during their trip or after their return. Travelers clinics that give pretravel immunization and counseling have emerged. This study analyzes the incidence and risk factors for health problems among Israelis traveling abroad. Methods: The study surveyed by telephone 200 people who visited the traveler's clinic at Soroka Medical Center in Beer-Sheva during the years 1998 to 1999. The travelers were questioned after returning from their journey about the type and duration of the trip, compliance with medical advice given in the travel clinic, and health problems during the trip. Results: The mean age was 26.4 ± 9.4 years, 7% went on an organized tour, 23% traveled alone, and 77% traveled with a friend. The mean duration of the trip was 14.7 ± 13.4 weeks. Of the travelers, 70% reported some health impairment. Problems reported most frequently were gastrointestinal tract diseases (43%), respiratory tract diseases (25%), and injuries (10%). Only 4% were admitted to a hospital during their trip. After their return, 19.5% consulted a physician. Comparing the group of travelers who were sick with the rest, a correlation between noncompliance with the keeping of food hygiene and illness was found (p = .008). Additional risk factors for illness were long duration (p < .001), solitary trip (p = .04), and young age (p < .001). Of the people who were advised to take antimalaria chemoprophylaxis, 55% reported regular use of these drugs. Compliance with treatment correlated with older age (p < .001), short duration of stay (p = .01), previous experience, and travel to Africa (p < .001). Conclusions: Most of the travelers to developing countries are young, travel for long periods, and live in basic conditions during their stay abroad. For these reasons travelers are at increased risk for morbidity. High risk travelers should be identified and counseled in order to increase their compliance with the medical advice and immunizations. A screening program for returning travelers should be considered. [source] The Contribution of Medical Anthropology to a Comparative Study of Culture: Susto and TuberculosisMEDICAL ANTHROPOLOGY QUARTERLY, Issue 4 2001Arthur J. Rubel Results of studies of the popular illness susto and the biomedical entity pulmonary tuberculosis are offered to illustrate how comparisons of sick and well people can elucidate societal processes in cultural anthropology. [comparative methods, susto, tuberculosis] [source] Management of flood victims: Chainat Province, central ThailandNURSING & HEALTH SCIENCES, Issue 1 2010Anchaleeporn Wisitwong rn Abstract This article focuses on the processes of flood management and the experiences of flood victims in Chainat Province, central Thailand, so as to develop knowledge about the future handling of such disasters. A phenomenological qualitative approach was used to describe the processes of providing assistance to flood victims. In-depth interviews and observation were used to collect the data. Criterion sampling was used to select 23 participants. Content analysis of the data revealed that some flood victims could predict flooding based on prior experiences, so they prepared themselves. The data revealed six themes that demonstrated that those who could not predict how floods would impact on them were unprepared and suffered losses and disruption to their daily life. Damaged routes meant people could not go to work, resulting in the loss of income. There was a lack of sanitary appliances and clean drinking water, people were sick, and experienced stress. At the community level, people helped one another, making sandbags and building walls as a defense against water. They formed support groups to enable the processing of stressful experiences. However, later, the water became stagnant and contaminated, creating an offensive smell. The government provided assistance to cut off electricity services, food and water, toilets and health services, and water drainage. In the recovery phase, the victims needed money for investment, employment opportunities, books for children, extra time to pay off loans, reconnection of electricity, surveys of damage, and pensions to deal with damage and recovery. [source] History for a practice professionNURSING INQUIRY, Issue 4 2006Patricia D'Antonio This essay explores the meaning of history for a practice profession. It argues that our clinical backgrounds suggest particular kinds of historical questions that colleagues with different backgrounds would not think to ask. This essay poses three possible questions as examples. What if we place the day after day work of caring for the sick , that which is nursing , at the center of an institution's history? What if we were to embrace a sense of nurses and nursing work as truly diverse and different? What if we were to analytically engage the reluctance of the large number of nurses to formally embrace feminism? This essay acknowledges that these are not the only possible questions and, in the end, they most likely will not even be the important ones. But this essay does argue that we, who are both clinicians and historians, need to more seriously consider the implications of our questions for disciplinary practice and research. It argues, in the end, that the meaning of history to a practice profession lies in our questions: questions that are different than those raised by other methods, and questions that may escape notice in the press of daily practice and research. [source] Vasovagal syncope evoked by needle phobia when inserting a contact lens,OPHTHALMIC AND PHYSIOLOGICAL OPTICS, Issue 2 2005Tatsuya Mimura Abstract Purpose:, To report a patient who fell unconscious because of vasovagal syncope evoked by needle phobia when he tried to wear contact lenses. Case reports:, A 16-year-old healthy boy had sometimes experienced dizziness when looking at the tips of pens. When he put his finger and the lens close to his eye to insert a soft contact lens, he felt sick and dizzy and fell unconscious. Conclusion:, Our experience suggests that patients with needle phobia may develop vasovagal syncope by concentrating on a fingertip when inserting a contact lens. We need to be aware of unconsciousness because of phobia when trying to insert contact lenses. [source] ,ALL CHILDREN ARE DWARFS'.OXFORD JOURNAL OF ARCHAEOLOGY, Issue 1 2008MEDICAL DISCOURSE AND ICONOGRAPHY OF CHILDREN'S BODIES Summary. Ancient medical discourse conveys a mainly negative view of children's bodies. From Hippocrates to Galen, newborn children are defined as imperfect and ugly beings, associating an excessive softness and weakness with various anomalies. Aristotle links their physical disproportions with those of dwarfs and animals. These disproportions induce physiological troubles and mental incapacities. Hot-tempered and moist, children are dominated by their emotions and sensations. Often authors group them with other beings regarded as inferior, such as women, the old, the sick, the insane, the drunk. How are mythical and human children rendered in iconography? Do their characteristics correspond to the medical discourse? The image of children's bodies changes with the passing of time; the miniature adult of archaic Greece gradually turns into the plump toddler of the Hellenistic period. How can we interpret these transformations? Does the evolution of iconography reflect the transformation of society or does it mirror the progress of medical knowledge? [source] Evolving health: The origins of illness and how the modern world is making us sickAMERICAN JOURNAL OF HUMAN BIOLOGY, Issue 4 2003Niccolo Caldararo No abstract is available for this article. [source] The Public Health Nursing Bag as Tool and SymbolPUBLIC HEALTH NURSING, Issue 1 2009Sarah E. Abrams ABSTRACT This historical article presents information about the public health nurse's bag as used in mid-20th century America. The bag was an essential of practice, containing items necessary for providing home care to the sick, maternity nursing, health demonstrations, and other functions within the role of public health nursing agencies or private organizations in which nurses gave home care to multiple patients. Contents of the bag and specifications for their use are described. The historical use of the bag as both a repository for the instruments of skilled care and expert knowledge and of bag technique as a means of infection control may help explain the endurance of the black bag as a symbol of public health nursing. [source] | ||||||||||||||||