772 resultados para caring philosophies


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Gender-based violence increases a woman's risk for HIV but little is known about her decision to get tested. We interviewed 97 women seeking abuse-related services from a nongovernmental organization (NGO) in Johannesburg, South Africa. Forty-six women (47%) had been tested for HIV. Caring for children (odds ratio [OR] = 0.27, 95% confidence interval [CI] = [0.07, 1.00]) and conversing with partner about HIV (OR = 0.13, 95% CI = [0.02, 0.85]) decreased odds of testing. Stronger risk-reduction intentions (OR = 1.27, 95% CI = [1.01, 1.60]) and seeking help from police (OR = 5.51, 95% CI = [1.18, 25.76]) increased odds of testing. Providing safe access to integrated services and testing may increase testing in this population. Infection with HIV is highly prevalent in South Africa where an estimated 16.2% of adults between the ages of 15 and 49 have the virus. The necessary first step to stemming the spread of HIV and receiving life-saving treatment is learning one's HIV serostatus through testing. Many factors may contribute to someone's risk of HIV infection and many barriers may prevent testing. One factor that does both is gender-based violence.

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BACKGROUND: Evidence is lacking to inform providers' and patients' decisions about many common treatment strategies for patients with end stage renal disease (ESRD). METHODS/DESIGN: The DEcIDE Patient Outcomes in ESRD Study is funded by the United States (US) Agency for Health Care Research and Quality to study the comparative effectiveness of: 1) antihypertensive therapies, 2) early versus later initiation of dialysis, and 3) intravenous iron therapies on clinical outcomes in patients with ESRD. Ongoing studies utilize four existing, nationally representative cohorts of patients with ESRD, including (1) the Choices for Healthy Outcomes in Caring for ESRD study (1041 incident dialysis patients recruited from October 1995 to June 1999 with complete outcome ascertainment through 2009), (2) the Dialysis Clinic Inc (45,124 incident dialysis patients initiating and receiving their care from 2003-2010 with complete outcome ascertainment through 2010), (3) the United States Renal Data System (333,308 incident dialysis patients from 2006-2009 with complete outcome ascertainment through 2010), and (4) the Cleveland Clinic Foundation Chronic Kidney Disease Registry (53,399 patients with chronic kidney disease with outcome ascertainment from 2005 through 2009). We ascertain patient reported outcomes (i.e., health-related quality of life), morbidity, and mortality using clinical and administrative data, and data obtained from national death indices. We use advanced statistical methods (e.g., propensity scoring and marginal structural modeling) to account for potential biases of our study designs. All data are de-identified for analyses. The conduct of studies and dissemination of findings are guided by input from Stakeholders in the ESRD community. DISCUSSION: The DEcIDE Patient Outcomes in ESRD Study will provide needed evidence regarding the effectiveness of common treatments employed for dialysis patients. Carefully planned dissemination strategies to the ESRD community will enhance studies' impact on clinical care and patients' outcomes.

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This is the third in a series of six papers presenting key findings from a national study that was undertaken to investigate the role and responsibilities of midwives and to identify continuing educational need. The background to the study and the titles of the other papers in the series have been outlined in the first paper. Issues related to the way midwifery care is organized nationally are discussed in this paper. Midwives and supervisors indicated a strong commitment to providing woman-centred care in a caring and sensitive manner, often in the face of enormous structural and organizational change. This paper addresses key issues that arose for midwives and supervisors when planning and providing an optimum quality service.

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Violence in the emergency department (ED) is a global problem. In our first paper, we highlighted the potential psychological effects of alcohol intoxication, the literatures discussion of alcohol related violence in the emergency department and the importance of developing positive nurse/service user relationships. In this second paper, we discuss personal and organisational strategies clinical nursing staff may consider appropriate to minimise the risk of assault when caring for service users projecting alcohol related aggression.

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Internationally, violence in the emergency department (ED) is of a constant concern to emergency practitioners. Frequently, both original research papers and anecdotal reports emphasise the phenomenon of alcohol related aggression in the ED. In this first paper, we highlight the literatures discussion of alcohol related violence in the emergency department and the potential psychological effects of alcohol intoxication. In the second we offer personal and organisational strategies clinical nursing staff may consider appropriate to minimise the risk of assault when caring for service users projecting alcohol related aggression.

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Research This paper outlines some of the key findings from an evaluation of the project and demonstrates that EC funded projects such as this, which seek to promote cross border collaboration and understanding (i.e. across organisational, sectoral and geographical boundaries) offer considerable learning potential – not least about variances in health politics across different communities. However, for this learning to be realised a comprehensive system of knowledge management needs to be an integral part of project planning alongside a system for sustaining embryonic professional networks. The concept of managing relationships was also a key part of the projects success. Executing a project funded by the EU demands the development of complex organisational skills to negotiate all the administrative challenges en route to successful completion and this project in particular relied for its success on the development of social relationships of trust and mutual respect across national, professional and social boundaries. Context A three–year European Commission funded project designed to exchange a wide range of staff (professional semiprofessional and voluntary staff in health and social care) project led by the University of Greenwich (UK) and the Université Catholique de Lille, France was completed this year (February 2008). The project was complex because it involved working in different national contexts, was multi-disciplinary, and demanded the negotiation of multiple boundaries. Theories A mixed method evaluation including written reports gathered immediately after each exchange visit and a post hoc series of individual interviews and focus groups was conducted in order to gain qualitative information (from the participants perspective) on their experiences and to identify any learning gained. Results Analysis of the data provided evidence of learning on a number of levels; personally, inter and intra professionally and organisationally as well as across sectors and also from a project management perspective. The learning crystallised around the extent of the differences noted by the participants between the UK and the French health and social care systems despite geographical proximity, common membership of the EU and many shared challenges in health and social care. The extent of these differences, noted at every level from policy to practice proved a rich source for reflection on organisational philosophies, ways of working, distribution of resources, professional roles and autonomy and professional registration and mobility - in short on health politics at ‘macro’ and ‘micro’ levels.

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This article investigates the experience of loss and bereavement from the point of view of a spiritual perspective on the phenomenon. It also looks at the experience of holding a marginalized viewpoint within an academic and professional community and adopts an autoethnographic approach to the inquiry. Some conclusions are drawn from the study in terms of its implications for theory and professional life.

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The physical and financial demands of caring for a child with complex needs are acknowledged by health professionals. However, the emotional needs of parents are not often recognized by health professionals until parents are at a heightened level of stress. This paper is based on a literature review of current articles, research papers and government documentation. The focus is on the emotional impact to parents who have a child with complex needs, particularly at the point of diagnosis. The paper explores how health professionals, and nurses in particular, should meet the emotional needs of parents in order to support them more effectively. Giving birth to a child with severe health problems impacts upon parents at an emotional time of transition, particularly if there were no concerns identified during pregnancy. For some parents a grief response or state of chronic sorrow may be triggered. The reality of caring for a baby who is critically ill or disabled can be an enormous and unexpected shock for both parents. Parents need emotional support and guidance, as they may have to change their expectations for their child’s development and even life span. It is important for nurses to realise that if parents’ emotional needs are unmet it can lead to clinical depression or mental illness. Primary support often comes from parent support groups rather than health professionals. The review highlights factors affecting parents’ emotions and discusses how early support, home visits and practical help can all help to alleviate parents’ emotional stress.

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Children and young people account for a quarter of all patients treated in emergency departments in the UK, with three million children attending emergency departments every year. Emergency Care of Children and Young People prepares practitioners for the challenges of caring for children in emergency departments. Children requiring emergency care have unique and differing needs and may not respond or cooperate during an initial assessment as an adult would.

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The physical and financial demands of caring for a child with complex needs are acknowledged by health professionals. However the emotional needs of parents are not often recognised by health professionals until parents are at a heightened level of stress. This paper is based on a literature review of current articles, research papers and government documentation. The focus is on how health professionals, and nurses in particular should meet the emotional needs of parents who have child with complex needs, particularly at the point of diagnosis. Giving birth to a child with severe health problems impacts upon parents at an emotional time of transition, particularly if there were no concerns identified during pregnancy. For some parents a grief response or state of chronic sorrow may be triggered. The reality of caring for a baby who is critically ill or disabled can be an enormous and unexpected shock for both parents. Parents need emotional support and guidance, as they may have to change their expectations for their child’s development and even life span. Primary support often comes from parent support groups rather than health professionals. The review discusses how home visits, practical help and early support can all help to alleviate stress. It is important for nurses to realise that if parents’ emotional needs are unmet they can lead to clinical depression or mental illness. This literature review looks at the emotional impact on parents and explores how nurses can address this issue in order to support parents more effectively. It identifies key areas that nurses could address that would help alleviate parents’ emotional stress.

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Debates around the importance of school ethos have gathered pace in recent years. Whilst it is not clear why this concept has become increasingly important in the educational vernacular the marketisation of education seems to have had some effect. As schools are forced to compete they have become concerned to identify and promote their 'Unique Selling Points' as a means of attracting and maintaining a long term 'customer' base. Defining a school in terms of its particular 'ethos' therefore offers a useful means of identifying and encapsulating the particular strengths of the school. It is thus not uncommon for heads to market their schools on the basis of their endorsing a 'liberal ethos' a 'caring ethos' or a 'sporting ethos' (Gardner, 2003).

The purpose of this chapter is to use empirical evidence to explore the meaning of a 'pluralist ethos' or 'integrated ethos', within the integrated school context in Northern Ireland.

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El texto parte de una crítica a cómo los países colonizadores han usado los fantasmas del “desarrollo” y del “progreso” para dominar a los que consideraban países “atrasados”. En el debate del post-desarrollismo se recoge el Buen Vivir como una alternativa al desarrollo, no como una alternativa de desarrollo. El Buen vivir como practicas vivenciales de resistencia al colonialismo, y como una categoría central de los pueblos indígenas, pero no como una visión única. Su importancia toma cuerpo en varias Constituciones por que los límites bio-físicos de la naturaleza están siendo superados. Por esto es necesaria una nueva economía que respete los “derechos de la naturaleza”. Se relatan los diversos componentes que esta nueva economía puede tener para una transición paciente hacia el Buen Vivir.

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this paper is about EU “soft policies” on immigrant integration. It analyzes the “Common Basic Principles” (CBPs) and the “European Integration Fund” (EIF), two devices that have been recently established within this framework. It adopts the theoretical perspective of the “anthropology of policy” and “governmentality studies”. It shows the context of birth of the aforementioned devices, as well as their functioning and the assessment done by the actors implied in the elaboration/implementation/evaluation of the related policies. It is based both on documentary research as well as direct observation and interviews done to the actors implied. It concludes that the PBC and the EIF should be considered as a “technology of government”, that strives to align the conduct of the actors with the governmental aims, as well as it produces specific practices and knowledge. It also underlines an intrinsic feature of many policies: their “congenital failure”, since they are (often) disputed and resignified by situated actors, who are embedded in asymmetrical power relations.

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La realidad del voluntariado es sumamente compleja hasta el punto de que resulta complicado definir y caracterizar el trabajo voluntario, dada la gran variedad de interpretaciones, motivaciones, variables sociodemográficas y aspectos culturales que configuran el perfil de los voluntarios. El objetivo de este trabajo es analizar la influencia conjunta de algunas variables sociodemográficas, así como de los valores culturales de índole secular o tradicional, sobre el perfil de los voluntarios en Europa. Además, se investiga qué variables orientan a los voluntarios hacia un determinado tipo de voluntariado u otro. Para ello se ha aplicado principalmente una metodología de regresión logística a partir de la información disponible en la European Value Study. Los resultados obtenidos ayudan a establecer una caracterización del voluntariado en Europa, y confirman la influencia de los valores culturales, en primer lugar, en la realización o no de trabajos de voluntariado, y en segundo lugar, en la elección que hacen estas personas del tipo de actividad con la que están comprometidos. Al analizar dos tipos de voluntariado de motivación supuestamente muy diferente, se concluye que existe un grupo de valores que influyen en ambos, aunque el sentido y la intensidad en la que lo hacen sea diferente; por otra parte, algunos valores tienen influencia o no en la realización de trabajos de voluntariado, dependiendo del tipo específico al que nos refiramos.

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La globalización ha recrudecido más si cabe la competencia en los mercados y las empresas deben afianzar y mejorar su posición competitiva para asegurar la supervivencia. Para ello resulta vital, entre otras cuestiones, velar por los intereses de los inversores al tiempo que cuidan de sus clientes. Las cooperativas sufren una coyuntura semejante respecto a sus socios y el mercado, es decir respecto a sus clientes internos (socios) y externos (mercado). El enfoque de las actividades y la estrategia de la cooperativa frente a esta dualidad determina su grado de orientación al mercado.Los estudios relacionados con la orientación al mercado en cooperativas son escasos en comparación con otras formas empresariales y han estado normalmente centrados en la figura de las cooperativas de segundo grado y circunscritos a sectores muy específicos.El sector citrícola español es uno de los más dinámicos y desarrollados del panorama productivo agrario. Su extensa experiencia comercial tanto a nivel doméstico como internacional confiere un carácter diferenciador a las entidades que operan en este subsector. Este trabajo analiza la posición de las cooperativas citrícolas españolas en relación a la orientación al mercado así como los factores de gestión y estrategia que están relacionadoscon ella. Para ello se utiliza una escala MARKOR, validada en estudios anteriores, sobre una muestra de 45 cooperativas.Se establece además una tipología de cooperativas citrícolas en base a los factores de competitividad que permiten ahondar en el conocimiento que existe sobre esta cuestión en entidades de economía social. Los resultados ponen de manifiesto un elevado grado de relación entre la innovación, el perfil del empresario y el conocimiento del entorno en relación con el grado de orientación al mercado.