Encouraging HIV risk-reduction behaviors and testing with people experiencing homelessness

In keeping with the Cafés philosophy of reciprocal transformation, the students and guests both were effected and changed by the encounter. The guests actively participated in the intervention, discussed HIV risk-reduction behaviors, and shared their knowledge with others. Participation in the onsite HIV testing project increased, and the guests, Café staff, and the program coordinator of the agency providing HIV testing expressed gratitude for the student intervention. The students were effected as well. Although all of the students had seen people who were homeless, none had had a sustained encounter with this population. Most students entered the experience uneasy. Some were fearful or had negative stereotypical impressions. As the students spent time with the guests and shared stories, they grew more at ease, and a feeling of connection developed. The students began to know more about the guests in terms of place, family, and abilities, not just their 'homeless' label. The students commented: Having been raised in an upper middle class environment most of my life, spending time in this type of community is something that I had little experience with. [I have a] greater awareness of the [need] for serving as an advocate. Through interaction at the Café [my] stereotypes of the homeless were proven incorrect. I know I will not take my own life and my living situation for granted ever again. The intervention provided experiences [that] cannot be measured. ...relationships were formed and hearts touched. I don't want to leave. I want to come back. These comments suggest the students had their eyes opened in new ways and left with a deeper connection to and understanding of the guests and people living at the edges of society.     

Writing academic papers: a guide for prospective authors.

As a journal Editor, I examine many papers and work alongside authors to maximize the likelihood of publication. During the course of this activity, several issues concerning writing for publication have emerged. In this article, I will use these experiences to help novice writers to prepare their work for publication. I will also draw on my personal experience as an author of academic and popular papers and as a book author and editor. If you find the article useful, please do distribute it freely amongst colleagues.     

Moving beyond policy rhetoric: building a moral community for early psychosis intervention

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A hitch-hiker's guide to the past

We all romanticize the past. But in some ways at least, I’mcertain that life is less safe and spontaneous for my two youngchildren nowadays than it was for me. When I was their age (there,I’ve said it!) I used to disappear with friends for hoursto the local park, kicking a ball around, fishing for sticklebacksin the stream, and playing hide and seek in the bushes. I wouldnever dream of letting my own children do this unaccompanied.Nor do I ever see kids under ten roaming freely around northLondon     

Nursing's losses and gains

Overall, I believe that the most senior trust nurses must establish how many elderly patients receive the kind of care I have described. While new ways of working and new developments in practice are important, we must not forget the essential elements of care in our wish to be innovative. In 2005, it takes courage to be a leader in the NHS. But even greater courage will be required by my mother and her family if she is ever admitted to hospital again. Because an ever increasing number of elderly people need care, all those responsible for this vulnerable client group, including policy makers, need to consider carefully how such care can be improved.     

Touching the dead: Autoethnographical reflections about the researcher’s body in the field of death,dying, and bereavement

This essay presents an account of the influence of the researcher‘s body within qualitative death research. It suggests that appropriate reflection on the researcher‘s subjectivity should consider his or her own bodily performances and experiences. At the beginning I offer some introductory thoughts in this regard, referring to Plessner‘s distinction between ‘being a body‘ (Körper-haben) and ‘having a body‘ (Leib-sein). Here, I highlight the importance of autoethnographic approaches for the understanding of bodily experiences, such as sensations, perceptions and their aesthetics. To demonstrate the importance of considering the researcher‘s body within the research process, I then draw on my own autoethnographic material, discussing how I experienced in my body frightening and disturbing feelings while dealing with the dead. This material was collected during a six-month internship from April to September 2016 at a small funeral home in Thuringia, Germany. I explain how I was socialised regarding my bodily behaviour towards the dead years ago and how I acquired the knowledge that touching a corpse is often taboo; describe my bodily reactions when I saw a dead body for the first time during my internship and how these reactions influenced my fieldwork; relate how my senses and perceptions when first touching a corpse led to extreme responses that drew most of my attention to the haptic and sensual dimension, making me unable to notice other information in the field; and show how these bodily experiences crossed borders and influenced my life beyond my field research.     

Career File 12: Veterinary Dental Nurse

Dentistry was not a subject I had particularly enjoyed as a veterinary nurse. However, it had occurred to me that there must be more to it than simply scaling the tartar off an animal's teeth, and being disappointed three or four months later when the same animal returned with its mouth in as bad a condition (or worse) than it had been before. I was fortunate to have the opportunity of spending a day with Peter Kertesz (a human dentist well known for his work with companion and zoo animals) and his nurse, Samantha Blackmore. The day provided an excellent insight into a side of veterinary practice that I now find very rewarding. I was hooked and my decision made. I bit the bullet, bought a tartan scarf and moved to Scotland where I took up my new position as dental nurse at the Braid Veterinary Hospital in Edinburgh. That was nearly two years ago, and my interest in animals and their dental health continues to grow. In fact, I have recently postponed my return to New Zealand so that I may stay at the practice for a further year.     

The importance of spiritual assessment: one clinician's journey

Assessing spiritual values of a patient causes the nurse to assess and or re-examine his or her own beliefs. Self- reflection makes one aware of how spirituality affects the individual's life and nursing practice. Those who find themselves uncomfortable with spiritual issues may have difficulty in delivering spiritual care to others. Nonetheless, the ability to seek appropriate assistance should be possible, but in-depth conversation regarding spirituality may need delivery by another caregiver.[8]Before assessing spirituality, examine your own beliefs to provide compassionate care related to meeting the patient's spiritual needs. Today, I regularly ask if the elder has a religious or faith-based belief he or she follows. If so, I probe further to determine how this belief system helps them with their health care concerns. I watch for symbols such as a Bible, inspirational readings, or religious items in the home or health care setting. A practice choice I have made is to offer prayers together with my patients and families. This is an individualized involvement that some believe crosses the boundaries of professionalism and political correctness. However, this level of involvement provides a positive opportunity to provide fulfillment in my nursing practice for my patient and myself. I will continue this added dimension of care.Spiritual assessment involves the evaluation of spiritual needs and the relationship to health care issues, whereas spiritual care involves compassion, presence, listening, and the encouragement of hope. It may or may not involve God or religion. To best serve the elderly patient, nurses should examine their own spirituality and how this may affect their own unique ability to assess or deliver spiritual care.     

Living with pain: an existential focus

In the routine of a hospital, during my nursing practice of providing care to patients with pain, it was shown to me as reaching beyond a biological sphere included in an existential dimension. Something in this experience disturbed me and I felt the need to understand these people suffering from pain, asking how they understand their pain and what is the meaning of experiencing painful chronic situations. In the attempt to find a way to obtain such understanding, I searched for some ideas stemming from phenomenology. Then, I interviewed the subjects individually based on the central question: "How is your experience with pain? Tell me about this". After the analysis, I was able to understand that pain is a way to narrow the horizon of possibilities and transformations in existence. It is not only the physical body that is ill, but also life is affected in its various dimensions, fundamentally with regard to the family, work and self-relation world.     

Elder abuse--a family experience.

Abuse happens every day to elderly and disabled individuals either through ignorance or design. Protecting your patient or loved one requires you to be suspicious of everyone who has access to the patient, even other family members. It is the most difficult and demanding task you will ever undertake. Our story is a long and emotional one, If you wish to read an account of our experiences, please visit my Web site at www.iannarino.us/elderabuse.     

Back to school: the ultimate pediatric call

EMS agencies will continue to respond to calls that have varying levels of seriousness in the school setting. Although most calls will be routine, the potential for a large-scale incident is ever-present. School districts and EMS agencies have to be proactive in developing a plan for responding to these situations. This proactive attitude is essential in fostering cooperation and communication between the school and EMS. It enables us to achieve the goal of making our schools safer. The process in reaching this goal is ongoing and evolving. As an EMS provider, I am aware of the high anxiety that accompanies a call involving a seriously injured child. If the call involves five, 10 or more severely injured kids, the stress can be unbelievable. A plan of action that has been carefully developed, practiced and critiqued will lessen the anxiety and stress. As a teacher, I want my workplace and my students to be safe. If a situation arises, knowing that a planned response is in place, and knowing what I'm supposed to do, gives me the confidence to deal with the event so I can help my students. Finally, as a parent, it is important that my children are in a safe environment in which to learn. If an emergency response is needed, I want to know a good plan will go into effect. That would assure me that the people responsible for the health and safety of my children have done all they can to make school a safer place.     

Ethical aspects in the treatment of pain

Commonly pain has been seen as a warning sign reacting to a source of pain. This process displays the wisdom of the body and its ability to function well. But this concept cannot necessarily be upheld when, due to illness, integrity of the body can be neither the presupposition nor the goal of treatment. The ethical question is not to decide which perspective (pain as a vital sign or pain as catastrophe) is the dominant one. Medical ethics must acknowledge pain as a process of human destruction, and it must interpret the treatment of pain as an endeavour which makes life possible again, or strengthens its remaining elements. When pain goes beyond the resources of the human being to form his/her life, the border between meaningful and meaningless pain is crossed. A case from an obstetrical ward is used to demonstrate three central principles of the treatment of pain: (1) Understanding the pain as the end of all interests, as making life a burden or as evacuating the ego. 2. Respect of the autonomy of the patient by informing him/her about the experiences which he/she gets rid of during analgesia, or by establishing the possibilities that PCA or time-contingent medication offer. 3. The multidimensional therapy of pain: i.e. all groups of caregivers must be involved, because it is not important to know which perspective is the best, but that no single perspective can stand alone. These principles must be taken into account even when the possibilities of effective pain relief are exhausted. Sometimes the debate on the practice of euthanasia seems to replace the medical goal of honest treatment of the patient's pain.     

返乡农民工生活满意感状况分析

背景农民工作为中国社会典型的弱势群体,其社会处境已引起普遍关注,因此,深入了解农民工的生活满意感状况,提高他们的生活质量,对创建和谐社会来说具有重大的现实意义.目的了解返乡农民工的生活满意感状况,为提高农民工的生活质量提供可靠的依据.设计简单随机抽样调查.单位衡阳师范学院教育科学系.对象调查于2005-02在中国15个省完成.随机抽取300名春节期间返乡的农民工为调查对象.方法运用生活满意感量表进行个别测试.该量表由生活接近理想、生活条件好、生活满意、得到重要东西、肯定人生道路等五个条目组成.量表用1分到7分依次代表七个等级进行评定非常不同意、不同意、有点不同意、既不同意也不反对、有点同意、同意、非常同意.该量表再测信度大于0.80,内容效度0.60,效标效度大于0.50.做答前给予指导语,农民工根据最近1周内的自我感觉答题,独立完成,当场收卷.结果数据输入计算机进行统计分析.如有4题以上选择"既不同意也不反对"的问卷视为无效而不进行分析.所有有效数据输入计算机后运用SPSS 11.0软件包进行统计分析;群体差异比较用t检验和方差分析.主要观察指标所有受试对象生活满意感量表得分.结果发放问卷300份,回收问卷275份,其中合格问卷为245份,占91.67%.245名调查对象均进入结果分析,其中,男性118名,女性127名,年龄16～52岁,平均年龄26.09岁,涉及16种行业,月收入200元～8 000元.生活满意感量表调查结果显示①245名返乡农民工的生活满意感倾向于满意的占29.8%,倾向于不满意的占41.6%.②返乡农民工在生活满意度上存在显著的性别差异,男性明显优于女性(P＜0.001)[(4.50±1.70,3.95±1.53)(t=2.65,P＜0.001)].③经济收入显著影响返乡农民工对生活条件好和得到重要东西项目的体验[(3.79±1.85,3.98±1.64,4.07±1.44,4.84±1.14)(F=3.068,P＜0.05);(4.64±2.03,3.72±1.68,4.07±1.67,4.19±1.28)(F=2.813,P＜0.05)].④返乡农民工的生活满意感在文化程度、打工时间上差异不显著.结论返乡农民工的生活满意感多数较低,性别和经济收入是影响他们生活满意感的重要因素,文化程度、打工时间对他们的生活满意感没有影响.     

Defying circadian rhythm: The emergency nurse and the night shift

The human body cannot change its preprogramming to meet the demands of working the night shift for a period of years. The effects are devastating to women and have been proven to shorten their life expectancy. Although the human body cannot change to meet society's demands of nighttime employment, society can change its expectations to better accommodate women who work the night shift.Nurses play a vital role in the resolution of this situation in a variety of settings. For my own health and welfare, I have already begun to follow the recommendations learned through the literature review and research of this article. My sleep time has always been guarded carefully, although I am more committed to that now. I am no longer bashful when scheduling appointments and meetings with those who function on a daytime schedule. I have modified my diet to be better balanced and have initiated a regular pattern of exercise. The statistics cited have alarmed my family, who are now more protective than ever of my night schedule and subsequent needs.I am able to advocate for the nurses that I work with, by sharing information with them. Many have worked nights for extended periods of time and are very interested in the facts from the literature. My colleagues who work in management positions are curious as to what I have found in the literature search and have obtained copies of the articles I reviewed to assist in the maintenance and scheduling within their own departments. They, too, are challenged to discover a healthier way to cover the needs of each department and maintain a healthy atmosphere for their staff.     

Gedanken zur Betreuung terminal Kranker mit Krebsschmerz

When treating a cancer patient with severe pain it is not sufficient to treat the cancer and the pain. Effective therapy must adhere to the principles of psychosomatic medicine, i.e., the disease, cancer, isnot treated, but instead a human being who is suffering from this disease, has severe, ongoing pain as a result, and is going to die. Irrespective of the question of whether the patient has been told his diagnosis or not, he will be in an extreme situation psychologically, as he instinctively suspects what is wrong with him. Pain indicates that the cancer is advanced; this can be compared with a death sentence, the execution of which has not yet been definitely scheduled. In these cases continuing care is more important than formal therapies. Above all, a cancer patient fears "intractable" pain, the prospect of being helpless because of physical deterioration, and imminent death which is no longer hypothetical. In order to assure adequate pain therapy, the pain medication must be continuous and sufficient, administered on a regular basis and given irrespective of whether there might be side effects or not. This requires that there be a relationship of confidence between the physician and patient in order to ensure compliance of treatment. As morphine is the most powerful analgesic drug, it can and must be given at an early stage. The fear of impending helplessness can be reduced by the physician "accompanying" the patient providing loving care, and assuring the patient that he will have somebody to rely on when he needs it. The most important way to solve such problems is to have a dialogue addressing the problems. Verbalization of fears can resolve them; even fear of death can be reduced when it is addressed in a dialogue. Advanced cancer patients are mostly remote from everyday life; they no longer take part in it. If, however, they receive the proper guidance, they will live more consciously and more intensively. In the awareness of imminent death they can experience every day of their life as a gift. Care of terminally ill cancer patients with severe pain thus also must include a guided approach to death.     

Meanings and Experiences of Menstruation: Perceptions of Institutionalized Women with an Intellectual Disability

Background: No studies have ever been conducted concerning menstrual experiences among women with an intellectual disability in Taiwan. Materials and Methods: An in‐depth interview was conducted at three public institutions and perceptions and experiences regarding menstruation were elicited from 55 women aged 21–65 years. Results: The participants knew about menstrual blood and could recognize the experiences of period pain and its link to femininity. The women’s management of menstruation played a big part in their institutionalized life, where they had relatively limited choice and autonomy. Positive feelings towards the menstrual cycle were experienced by some participants; however, many had negative attitudes towards sexual activities or parenting, even though they knew the association between menstruation and pregnancy. Conclusions: Although these women’s experiences of perimenstrual symptoms are quite similar to those of women without intellectual disability, their menstrual management, interpretations and attitudes to menses are influenced by their institutional life and by the society at large.     

The problem with prevention: the case of spina bifida.

In this paper, I present a viewpoint about prevention and spina bifida that is not usually expressed within the occupational therapy literature. Using an autoethnographic account, I convey my experiences as a person with impairments from spina bifida in order to problematize current preventive efforts undertaken to eradicate this birth defect. This self-reflexive account connects my personal experiences to historical and medical views about spina bifida. The messages inherent in preventive efforts are discussed from a disability rights perspective. Occupational therapists are challenged to examine their attitudes toward disability, act as advocates in their practice, and, in a more informed manner, support or contest policy initiatives.     

用户参与循证医学的重要性

1　前言循证医学需要令人信服及有意义的相关研究证据 ,支持卫生保健选择的循证决策。研究证据可指导用户实践、提供选择、帮助决策 ,因而 ,用户是高质量的卫生保健研究的最大受益者。另方面 ,研究应具针对性 ,解决用户的健康问题。用户应该作为平等伙伴参与研究的整个过程 ,从而提高卫生保健研究的质量 ,改进循证医学中循证决策的质量。本文主要讨论用户参与研究的目的及意义 ;用户参与的方式和时机 ;用户可能面临的困难 ;用户参与研究的指南清单。本文关键要点 :吸收更多用户参与 ;让用户参与整个研究阶段 ,特别是设计阶段 ;在患病过程中 …