A Case Study Using The Discipline with a Clinical Team

SUMMARY

Health care delivery in hospitals and clinics promotes an interdisciplinary team approach. This article presents the use of The Discipline though the involvements of the chaplain as part of the Infectious Disease team as together they addressed the inherent spirituality of one HIV/AIDS patient. This narrative recounts the unfolding events of the patient's life and describes the use of The Discipline during a very difficult time period for the patient and the staff. The experience can serve as a model for other health care teams who must manage difficult, deteriorating patients.     

The Dance with The Discipline

SUMMARY

The author became acquainted with The Discipline only recently and this article describes two pastoral visits in which The Discipline provides guidance for interactive presence. Thus this material represents how the author seeks to grasp and integrate it into her clinical practice in a short time.     

Experience with Clinical Pastoral Education in the Context of The Discipline

SUMMARY

This article relates the experience of integrating The Discipline into the process and curriculum of an ACPE accredited clinical pastoral education (CPE) program involving residents and single unit students. It describes supervisor and student concerns as well as the conclusions they reached concerning the integration of The Discipline into The CPE process.     

An Adaptation of The Discipline in a Clinical Pastoral Education Program

SUMMARY

The author describes his perspective on providing pastoral care to hospital patients, his search for new ways to understand that ministry, his first contact with The Discipline, and his adaptation of it to the clinical and educational programs at his center. He discusses the need to help clinical pastoral education students to operationalize their ministry and to learn how to identify outcomes that are meaningful to health care decision makers.     

First Steps: Approaching The Discipline Based,Outcome Oriented Ministry Model

SUMMARY

This article describes how a new staff chaplain is approaching and applying a discipline based, outcome oriented ministry model. He describes his move from being a lone, geriatric chaplain in a long term care facility to becoming a member of a team of staff chaplains in a teaching hospital who have disciplined themselves to an outcome oriented ministry model. The writer gives his perspective on The Discipline, and denotes ways in which his ministry has been impacted. Though the author has been involved with this process for only six months, both he and those in his care are experiencing some of the benefits of making tangible contributions and developing measurable outcomes in ministry.     

Group Co-Leadership by Occupational Therapy Students in Community Centers: Learning Transitional Roles

SUMMARY

The experience of contact with community populations and settings at the beginning of fieldwork is essential in expanding the dimensions of non-traditional skills and roles for occupational therapy students. This article describes an initial fieldwork experience which builds on an occupational therapy group process course to enable students to supplement a community-based program with activities designed to meet a need of their group at the appropriate level of group interaction. Pairs of students select a receptive community site prior to the beginning of fieldwork to open dialog with the center's coordinator regarding performance areas, components, or contexts needed by the group. Working to assess the current programmatic offerings and desires of the participants for new activities and planning activities in collaboration with local staff, the students propose to conduct a series of five sessions addressing a theme desired or needed by the group. Upon immersion in the site's program, students are able to provide an in-depth assessment of the community group's psychosocial skill needs using the Group Level of Function Profile (Donohue, 2000).     

A Disciplined Approach to Spiritual Care Giving for Adults Living with Cystic Fibrosis

SUMMARY

Adults living with cystic fibrosis are less likely than other pulmonary patients to describe themselves as religious, to attend worship services regularly, to use god language, to describe their spiritual life, and in general, to give any obvious, outward indications of their spiritual strength, concerns, and depth. And yet, they have consistently demonstrated in chaplain-patient encounters an awareness of the function and importance of their spirituality in relation to life choices, coping with illness, facing mortality, and expressing life meaning, beliefs, and values. A disciplined approach by chaplains is a key component to engaging these patients so that each person's unique spiritual story unfolds. Results from The Discipline demonstrate how adults with cystic fibrosis are different in their expression and approach to spirituality from other pulmonary patients.     

Qualitative Assessment of Agritourism Safety Guidelines: A Demonstration Project

ABSTRACT

This article reports on the findings of the external evaluators of the Agricultural Safety and Health (ASH) initiative of the W. K. Kellogg Foundation (WKKF). The evaluation describes the overarching themes and impacts of the program's projects. It analyzes data gathered from observations at planning sessions and networking conferences, conference calls, site visits, written reports and telephone interviews with project staff. A brief overview of the Foundation's goals, and samples of the projects' lessons learned and barriers to success are presented.     

Parish Nursing and Clinical Pastoral Education

ABSTRACT

Parish nursing is growing within the church. Providing Clinical Pastoral Education (CPE) to parish nurses can be a rich experience for them, their congregations, and persons in leadership positions. In turn, such educational efforts can provide CPE programs with a legitimate and credible community outreach. This contribution describes a CPE Introductory Unit for parish nurses and explores its implications for the nurses, their congregations and the CPE movement.     

Using The Discipline for Integrative Ministry Formation

SUMMARY

One United Methodist Annual Conference has begun a program of ministry formation education for probationary, first-appointment ministers in conjunction with Emory Clergy Care, Atlanta. This program uses an adaptation of The Discipline as an integral part of their ongoing formation education. Participants have learned the basics of planned pastoral care delivery, family and congregational systems thinking and self-supervision. Using The Discipline, they have been effectively adapting it to their local church settings and ministries.     

Relationships between occupational engagement and status of and satisfaction with sociodemographic factors in a group of people with schizophrenia

Abstract

The present study is part of a larger project investigating occupational engagement and health in a group of people with schizophrenia. This study was aimed at extending this knowledge base with regard to occupational engagement and sociodemographic factors. Seventy-four outpatients participated in the study. The Profile of Occupational Engagement in People with Schizophrenia, the Lancashire Quality of Life Profile scale and a standardized questionnaire were used to gather data. Contrary to what was expected, occupational engagement was not associated with a certain type of schizophrenia, being younger or older, or gender. The results showed that a high level of occupational engagement was related to greater satisfaction with the participants' social and living situation, having a reliable alliance and a close friend, school-leaving age, living in a flat, and working or studying. Satisfaction with living independently, having had a recent experience of accomplishment, and working together explained 55% of the variance in occupational engagement. Occupational therapists should thus focus on and promote social engagement appropriate to the client's level of engagement, the client's opportunity and ability to work, his/her experience of accomplishment, and, most importantly, satisfaction with the home and living situation.     

母亲文化程度与学龄前儿童饮食模式对注意缺陷多动障碍症状的潜在交互作用

目的 探讨母亲文化程度与学龄前儿童饮食模式对注意缺陷多动障碍（ADHD）症状的交互作用。方法 2014年选择马鞍山市区91所幼儿园16 439名3~6岁学龄前儿童作为研究对象,通过问卷调查食物频率和社会人口学特征,采用Conners父母症状问卷进行ADHD症状评估。采用非条件logistic回归分析母亲文化程度与学龄前儿童饮食模式对ADHD症状的相乘交互作用,采用Excel软件分析其相加交互作用。结果 母亲文化程度偏低[aOR=1.31（1.13~1.52）]、学龄前儿童加工型饮食模式得分偏高[aOR=1.31（1.16~1.48）]、零食型饮食模式得分偏高[aOR=1.45（1.29~1.63）]均增加学龄前儿童ADHD症状的发生风险,素食型饮食模式得分偏高[aOR=0.80（0.71~0.90）]降低学龄前儿童ADHD症状的发生风险。母亲文化程度低与学龄前儿童加工型饮食模式对ADHD症状交互作用的超额相对危险度（RERI）为0.21、交互作用归因比（AP）为0.13和交互作用指数（SI）为1.47,存在相加交互作用和相乘交互作用（OR=1.17,95% CI：1.11~1.25）;母亲文化程度低与零食型饮食模式（RERI=0.49,AP=0.26,SI=2.36）未发现相加交互作用,但存在相乘交互作用（OR=1.21,95% CI：1.14~1.29）;与素食型饮食模式（RERI=0.09,AP=0.05,SI=1.15）未发现相加交互作用和相乘交互作用（OR=0.97,95% CI：0.92~1.03）。结论 母亲文化程度低是学龄前儿童ADHD症状发生的危险因素,与学龄前儿童的加工型饮食模式存在相加和相乘交互作用,与零食型饮食模式存在相乘交互作用,与素食型饮食模式无相加和相乘交互作用。     

Underlying causes of ill‐health in an African country

The nutritive values of some lesser known protein sources in Nigerian peasant diets were evaluated by in vitro enzyme digestion studies and by in vivo studies with rats. Snail (Vivapara quadrata), periwinkle (Littorina littorea), dried crayfish (Palamonetes varians) and locally smoked fresh water fish (Tilapia melanopleura) had a range of digestibility of 57–75 percent with pepsin/trypsin hydrolysis. The digestibility of smoked fresh water fish and crayfish in rats ranged between 91.2 percent and 89.5 percent while that of periwinkle and snail was 80.4 percent and 85.9 percent respectively. Crayfish gave the highest PER (1.8) while the others had values ranging from 0.7 to 1.5. These values were considerably lower than that of whole hen's egg (3.5). These protein samples had high biological values (70.8–81.6) which were, however, still lower than whole hen's egg (92.0) and fairly high NPU values (60.3–73.0). In general, these lesser known protein sources if consumed in adequate quantities would alleviate protein deficiency syndromes which are prevalent in a large section of our rural population.     

Sonographic assessment of the cervical length before induction of labor

ObjectiveTo compare the cervical length measured by TVS with modified Bishop's score for cervical assessment before induction of labor.MethodsOne hundred and twenty women in their first pregnancy were admitted for induction of labor. Digital vaginal examination was done to record the modified Bishop's score, followed by TVS to detect the cervical length. The method of induction of labor was decided after the initial vaginal examination, when the modified Bishop's score was evaluated. Dinoprostone pessary was used for labor induction if the Bishop score was < 5 (unfavourable cervix), and amniotomy was usually performed when the cervix was 3 cm dilated, and the presenting part was low (0 station).ResultsThe cervical length measured by TVS was significantly shorter in the patients delivered vaginally, compared with the patients delivered by cesarean section (24.7±6.9) versus (26.5±8.2) mm; respectively. A total of 72 (78.3%) of the patients delivered vaginally, and 10 (35.7%) of the patients delivered by cesarean section had cervical length < 25 mm. The modified Bishop's score was significantly high in the patients delivered vaginally, compared with the patients delivered by cesarean section (6.0±2.7) versus (5.9±8.7) respectively. Moreover, 77 (83.7%) of the patients delivered vaginally, and 11 (39.3%) of the patients delivered by cesarean section had modified Bishop's score > 5.ConclusionsBoth Methods of cervical assessment (cervical length measured by TVS, and modified Bishop's score) were significantly associated with successful induction.     

Methodological Issues in Studying an Insular,Traditional Population: A Women's Health Survey Among Israeli Haredi (Ultra-Orthodox) Jews

ABSTRACT

This article describes obstacles encountered and strategies devised in planning and conducting a national telephone health survey (n = 459) of an insular, deeply traditional religious population, haredi (ultra-Orthodox Jewish) Israeli women. The paper discusses how special characteristics of this population influenced study design, sampling, data collection, and interpretation. Sampling employed polling data to identify haredi concentrations. Despite haredim's reputation for low survey participation, we achieved a 71–74% response rate (depending on the unknown eligibility of 24 phones never answered) in interviews conducted in 2003–2004. We describe our systematic attention to special aspects of haredi culture such as: modesty and speech codes; the need for rabbinic endorsement; and the importance of female, haredi interviewers. This research was initiated and managed by a community-based women's health non-governmental organization, in partnership with trained researchers. Our experiences can guide others surveying insular communities, such as traditional Muslim and Christian societies.     

母亲孕期抑郁与2岁儿童行为问题关系的前瞻性队列研究

目的 探讨母亲孕期抑郁与2岁儿童行为问题之间的关系。方法 基于2012年4-12月开展的上海闵行出生队列（Shanghai-Minhang Birth Cohort Study）,以491对母亲和儿童为研究对象,使用"流行病调查中心抑郁量表"在孕中、晚期以及产后6和12个月对母亲抑郁状况进行评估,并使用"儿童行为量表"调查2岁儿童神经行为发育状况。运用log-binominal回归模型分析母亲孕期抑郁和2岁儿童行为问题关联,并在无产后抑郁症状的母亲中进行敏感性分析。结果 在调整母亲孕期年龄、分娩孕周、家庭人均月收入、父母文化程度和儿童性别后,显示母亲孕中期有抑郁症状的子代情感反应和内向化行为问题发生风险增加,RR值（95% CI）分别为2.61（1.36~4.99）和1.94（1.22~3.08）。母亲孕晚期有抑郁症状的子代情感反应、退缩行为、攻击行为、内向化和外向化行为问题的发生风险也增加,RR值（95% CI）分别为6.46（3.09~13.53）、2.42（1.16~5.02）、2.93（1.45~5.94）、1.79（1.01~3.16）和2.56（1.49~4.42）倍。在无产后抑郁症状的母亲中进行分析,结果显示母亲孕期有抑郁症状的子代情感反应、攻击行为、内向化及外向化行为问题的发生风险没有明显变化。结论 母亲孕期抑郁可能会增加儿童行为异常的发生风险,应加强孕妇妊娠期间心理健康监测,以降低儿童行为问题发生,促进母婴健康。     

How Has Health Care Reform Affected Professional Chaplaincy Programs and How Are Department Directors Responding?

SUMMARY

No published studies were identified that describe the impact of health care reform on professional chaplaincy departments in hospital settings. Results from a random sample (N = 370) of department directors indicate that 45 percent report no budgetary consequences, 27 percent have experienced budgetary cutbacks, and 17 percent describe departmental growth. The cutbacks most often involve the loss of staff chaplain positions. Directors also describe past and future strategies for resisting downsizing trends.     

Quality of life is not negatively affected by diet and exercise intervention in healthy men with cardiovascular risk factors

Health-related quality of life was assessed in a diet and exercise intervention study among 157 healthy men aged 35–60 years (mean ± s.d.; 46.2 ± 5.0) with moderately raised cardiovascular risk factors. The men were randomized to four groups, diet (D, n=40), exercise (E, n=39), diet plus exercise (DE, n=39), and no active intervention (controls (C) n=39). Quality of life was measured with two self-administered questionnaires; Subjective Symptoms Assessment Profile and Minor Symptom Evaluation Profile, at baseline and after 1.5, 3 and 6 months. Cardiovascular risk factors were investigated at baseline and after 6 months. As a result of changes in dietary habits and physical exercise in the three intervention groups, several important cardiovascular risk factors were significantly reduced. The quality of life/well-being did not differ between the four groups and did not change significantly in any of the groups during the study. There was, however, a tendency towards fewer gastrointestinal symptoms in group D and fewer cardiac symptoms in group DE. We conclude that advice on lifestyle changes in the form of diet and exercise reduce risk factors in middle-aged men without negative effects on their quality of life.This study was supported by grants from the Swedish Heart-Lung Foundation, the Knut and Alice Wallenberg Foundation, the Karolinska Institute Foundation, and the Bayer Fellowship for general practitiones.     

孕期父母环境危险因素暴露与儿童急性淋巴细胞性白血病风险关系分析

目的 探讨孕期父母接触可能引起儿童急性淋巴细胞性白血病（ALL）的环境危险因素。方法 选取2015年在天津市血液病医院就诊的179例ALL儿童为病例,同时选取136例正常儿童作为对照,进行病例对照研究;设计ALL发病的危险因素调查表,对所得的资料进行单因素和多因素非条件logistic回归分析。结果 单因素非条件logistic回归分析发现,儿童ALL发病与性别（OR=1.934,95% CI：1.225～3.054,P=0.005）、母亲既往流产史（OR=2.378,95% CI：1.437～3.934,P=0.001）、孕期二手烟暴露史（OR=1.837,95% CI：1.098～3.071,P=0.020）、患感冒（OR=1.728,95% CI：1.082～2.762,P=0.022）、服用解热镇痛药（OR=4.858,95% CI：1.824～12.944,P=0.002）、接触空气净化剂（OR=1.731,95% CI：0.972～3.082,P=0.043）、父亲职业性接触石油类产品（OR=2.007,95% CI：1.110～3.629,P=0.021）、怀孕期间居所装修（OR=2.506,95% CI：1.414～4.439,P=0.002）有关;多因素非条件logistic回归分析,ALL发病与性别（OR=2.037,95% CI：1.254～3.308,P=0.004）、母亲既往流产史（OR=2.078,95% CI：1.232～3.503,P=0.006）、怀孕期间居所装修（OR=1.689,95% CI：1.046～2.726,P=0.032）、母亲孕期感冒（OR=1.677,95% CI：1.018～2.764,P=0.043）、父亲职业性接触石油类产品（OR=1.988,95% CI：1.069～3.696,P=0.030）有关。结论 性别、母亲孕前流产史、怀孕期间装修史、母亲孕期感冒史、父亲职业性石油类产品接触史5项指标可能为引起儿童ALL的危险因素。