The NEBLINE, October 1998

Contents: Character Counts! for everyone Growing hardy bulbs Tree planting snafus Timely care of hardy chrysantheums Mole, mole, go away Termite control options: baits vs. barriers? Celebrate America Recycles Day Household hazardous waste collection: November 7 It's time for your annual “pest-proof” check-up Removing skunk odor Temporary/emergency grain storage options Control leafy spurge Fall clean-up of warm-season grasses The first frost, the last hurrah Pasture weed control What is this thing called winter desiccation? Dormant planting grasses and legumes Finding facts about vegetables and fruits Healthy Eating: No-Crust Pumpkin Pie Focus on Food Preparing for the winter food olympics! Family & Community Education News FCE: Jean's Journal Household Hints Furniture workshop AARP offers 55 Alive—Mature Driver Course Caring for athletic uniforms Halloween safety 4-H Bulletin Board Character Counts! Super Day Camps 4-H CAN Fight Hunger Food Campaign 4-H Shooting Sports meeting Holiday gifts needed 4-H Volunteer Forum Make a Difference Day Engineering and Technology 4-H Club Put us to work, please! Lancaster County Born and Raised beef SERIES fun America Recycles Day Livestock judging teams excel at state Lemke and Nisley place University of Nebraska Speakers Bureau announced Public notice Community Resource Directory available E.N. Thompson Forum on World Issues

Educação à distãncia como ferramenta de promoção das atividades de alimentação e nutrição na Atenção Primária à Saúde: um estudo de caso

Pós-graduação em Enfermagem (mestrado profissional) - FMB

Criança dependente de tecnologia: a experiência do cuidado materno

Este estudo tem como objetivo compreender a experiência materna no cuidado ao filho dependente de tecnologia. Utilizamos a abordagem do estudo de caso etnográfico tendo como instrumentos de coleta de dados os genograma e ecomapa, entrevista aberta e observação. Os dados foram organizados em três unidades de significados: a busca pelas causas e por culpados; a alta hospitalar e as demandas para o cuidado e as redes de apoio. O estudo permitiu conhecer a experiência materna em busca por explicações, bem como os sentimentos de desconfiança, insegurança e insatisfação relacionados ao serviço de saúde. Ainda a apropriação da mãe em relação aos cuidados à criança e no que se refere à organização do ambiente domiciliar para recebê-la, a utilização das redes de apoio, destacando a carência de vínculos com familiares e vizinhos e a busca formal e informal para garantir a subsistência da criança doente e dos demais filhos.

AFFECTION IN ELDERLY CARE FROM THE NURSES' PERSPECTIVE

The objective of this study was to describe, from the nurses' perspective, the meaning of effective/affective care, the interference factors, and the learning promoted from dealing with elderly inpatients, as well as their perception of feeling ready or not to engage in caring. This qualitative study was performed with nurses from a hospital located in the Midwestern region of the State of Sao Paulo. The findings show that the meaning of providing effective/affective care involves knowing the client within his/her social framework, while it crosses the borders of sheer technical care and encompasses fulfilling the client's needs and requirements. Interferences in dealing with the elderly refer to those situations connected with the patients' conditions, work dynamics, and environmental and management adaptations. All surveys showed that despite feeling well prepared, nurses are aware of the need to study fields such as geriatrics and gerontology to a deeper extent. Complete and quality care is only possible if it includes techniques, knowledge and the ability to deal with others with patience and attention to detail.

Costs and benefits of temporary brood desertion in a Neotropical harvestman (Arachnida: Opiliones)

Brood desertion is a life history strategy that allows parents to minimize costs related to parental care and increase their future fecundity. The harvestman Neosadocus maximus is an interesting model organism to study costs and benefits of temporary brood desertion because females abandon their clutches periodically and keep adding eggs to their clutches for some weeks. In this study, we tested if temporary brood desertion (a) imposes a cost to caring females by increasing the risk of egg predation and (b) offers a benefit to caring females by increasing fecundity as a result of increased foraging opportunities. With intensive field observations followed by a model selection approach, we showed that the proportion of consumed eggs was very low during the day and it was not influenced by the frequency of brood desertion. The proportion of consumed eggs was higher at night and it was negatively related to the frequency of brood desertion. However, frequent brood desertion did not result in higher fecundity, measured both as the number of eggs added to the current clutch and the probability of laying a second clutch over the course of the reproductive season. Considering that harvestmen are sensitive to dehydration, brood desertion during the day may attenuate the physiological stress of remaining exposed on the vegetation. Moreover, since brood desertion is higher during the day, when egg predation pressure is lower, caring females could be adjusting their maternal effort to the temporal variation in predation risk, which is regarded as the main cost of brood desertion in ectotherms.

Behavior of the thermal diffusivity of native and oxidized human low-density lipoprotein solutions studied by the Z-scan technique

Modifications in low-density lipoprotein (LDL) have emerged as a major pathogenic factor of atherosclerosis, which is the main cause of morbidity and mortality in the western world. Measurements of the heat diffusivity of human LDL solutions in their native and in vitro oxidized states are presented by using the Z-Scan (ZS) technique. Other complementary techniques were used to obtain the physical parameters necessary to interpret the optical results, e. g., pycnometry, refractometry, calorimetry, and spectrophotometry, and to understand the oxidation phase of LDL particles. To determine the sample's thermal diffusivity using the thermal lens model, an iterative one-parameter fitting method is proposed which takes into account several characteristic ZS time-dependent and the position-dependent transmittance measurements. Results show that the thermal diffusivity increases as a function of the LDL oxidation degree, which can be explained by the increase of the hydroperoxides production due to the oxidation process. The oxidation products go from one LDL to another, disseminating the oxidation process and caring the heat across the sample. This phenomenon leads to a quick thermal homogenization of the sample, avoiding the formation of the thermal lens in highly oxidized LDL solutions. (C) 2012 Society of Photo-Optical Instrumentation Engineers (SPIE). [DOI: 10.1117/1.JBO.17.10.105003]

Seguimento da saúde da criança e a longitudinalidade do cuidado

Estudo reflexivo com o objetivo de apresentar, na perspectiva da hermenêutica filosófica, elementos relevantes para o seguimento da saúde da criança em atenção primária à saúde. A assistência à saúde da criança tem como eixo norteador o processo de crescimento e desenvolvimento na infância, sendo fundamental conhecer as escolhas e tomadas de decisão das famílias, estimular a produção de narrativas, fortalecer virtudes e experiências cotidianas, contribuindo para enriquecer o cuidado e apreendê-lo numa perspectiva integradora, contingencial, longitudinal e suficientemente boa. O seguimento da criança pode ser tomado como uma tecnologia de cuidado em saúde que não pressupõe um saber a priori, mas remete a uma reconstrução de saberes e práticas com novas dimensões para a produção de cuidados.

Cuidado ao doente de tuberculose na Estratégia Saúde da Família: percepções de enfermeiras

Analisar percepções de enfermeiras sobre o controle da tuberculose, segundo o eixo teórico da integralidade em saúde e os conceitos de vínculo e trabalho em equipe. Pesquisa qualitativa que envolveu 13 enfermeiras da Estratégia Saúde da Família de município prioritário da região Metropolitana de João Pessoa, Paraíba, Brasil. As informações foram coletadas mediante grupo focal e analisadas conforme a técnica de análise de conteúdo e modalidade temática. Elementos potencializadores do controle da tuberculose: tratamento supervisionado, medicação gratuita e oferta de insumos. Elementos fragilizadores: rotatividade dos profissionais, retaguarda laboratorial, falta de incentivos para os doentes e ações educativas incipientes. Os elementos que fragilizam o cuidado ao doente de tuberculose, identificados pelos enfermeiros, devem ser refletidos por gestores, profissionais, usuários e formadores, de modo que na prática seja possível redefinir ações de cuidado que fortaleçam o vínculo, a integralidade e o trabalho em equipe.

Grandparents Left with AIDS-orphans; Challenges and Strategies Handling Poverty and Stigma

By 2010 it is estimated that one third of the African children will be orphans as an effect of HIV/AIDS. The crisis is already a fact and most orphans are absorbed by the extended family where the grandparents become the primary caretakers. This qualitative study was carried out in Kenya to explore the situation of these grandparents and to define their current resources and needs. Eight grandparents living in rural village or urban slum caring for their orphaned grandchildren were interviewed. The results showed that these families live under extremely poor conditions lacking food, other vital neccesities and a basic social network. Local churches and support groups emerged as the grandparents main sources to enhance strength and support. Key factors causing the acute poverty is HIV-related stigma and lack of access to land.

Vad man ska kunna och hur man ska vara : En studie om enhetschefers och vårdbiträdens yrkeskompetens inom äldreomsorgens särskilda boendeformer

The dissertation What to do and how to be reflects upon the professional skills needed by unit managers and nursing staff within the institutions of eldercare. Throughout the study, three conceptions are essential: formal education and training, professional skills, and individual competence. In order to understand the professional skills within its proper context, an activity perspective has been applied. The study is based on empirical materials, historical and present national and municipal documents, interviews with and observations of unit managers as well as questionnaires filled in by nursing staff members. A main result is the stress the respondents put on the importance of individual competence among unit managers and nursing staff members. “How to be” is more important than formal training and professional skills. To work with – and develop – individual competence therefore becomes momentous both to job activities and to education. The result shows a discrepancy between the way professional skills are discussed and the actual work performance. A lot of tasks carried out by unit managers and nursing stuff are never mentioned in connection with professional skills. The unit manager’s task is to lead both unit operations and staff work. Such responsibilities demand basic knowledge in social sciences, an overall understanding of the work activities from political management, job conditions and duties of the nursing staff. The professional skills given priority are those present in organisations and leadership. Problematic are economic and budget tasks which may sometimes cause unit managers to give up their economic responsibility, favouring client – directed over economy – directed care. The main task of the nursing staff is the care of elderly. It calls for social, caring, medical and housekeeping skills. For this one needs an upper secondary level education supplying the students with solid knowledge within social science as well as basic medicine and an overall understanding of the situation and needs of the elderly. Throughout the study, knowledge of the demented and of other mental disorders is emphasized as well as treatment of elderly persons suffering from those disorders. Units still have a long way to go before reaching the goal that every nursing staff member be given a formal education. Some municipalities already offer employees shorter nursing staff training. As to the rest, the educational development is neglected.

Le capacità relazionali negli infermieri: un'indagine esplorativa negli spedali civili di Brescia

Nelle attuali organizzazioni sanitarie non è raro trovare operatori sanitari i quali ritengono che la relazione con il paziente consista nell'avere adeguate competenze tecniche inerenti la professione e nell'applicarle con attenzione e diligenza. Peraltro si tende ad invocare il “fattore umano”, ma si lamenta poi che l’operatore si rapporti col paziente in modo asettico e spersonalizzato. Da un punto di vista scientifico il termine “relazione” in psicologia si riferisce essenzialmente ai significati impliciti e quasi sempre non consapevoli veicolati da qualunque relazione: dipende pertanto dalla struttura psichica dei due interlocutori investendo in particolare la sfera dell’affettività e procede per processi comunicativi che travalicano il linguaggio verbale e con esso le intenzioni razionali e coscienti. La relazione interpersonale quindi rientra nel più ampio quadro dei processi di comunicazione: sono questi o meglio i relativi veicoli comunicazionali, che ci dicono della qualità delle relazioni e non viceversa e cioè che i processi comunicazionali vengano regolati in funzione della relazione che si vuole avere (Imbasciati, Margiotta, 2005). Molti studi in materia hanno dimostrato come, oltre alle competenze tecnicamente caratterizzanti la figura dell’infermiere, altre competenze, di natura squisitamente relazionale, giochino un ruolo fondamentale nel processo di ospedalizzazione e nella massimizzazione dell’aderenza al trattamento da parte del paziente, la cui non osservanza è spesso causa di fallimenti terapeutici e origine di aumentati costi sanitari e sociali. Questo aspetto è però spesso messo in discussione a favore di un maggiore accento sugli aspetti tecnico professionali. Da un “modello delle competenze” inteso tecnicisticamente prende origine infatti un protocollo di assistenza infermieristica basato sull’applicazione sistematica del problem solving method: un protocollo preciso (diagnosi e pianificazione) guida l’interazione professionale fra infermiere e la persona assistita. A lato di questa procedura il processo di assistenza infermieristica riconosce però anche un versante relazionale, spesso a torto detto umanistico riferendosi alla soggettività dei protagonisti interagenti: il professionista e il beneficiario dell’assistenza intesi nella loro globalità bio-fisiologica, psicologica e socio culturale. Nel pensiero infermieristico il significato della parola relazione viene però in genere tradotto come corrispondenza continua infermiere-paziente, basata sulle dimensioni personali del bisogno di assistenza infermieristica e caratterizzata da un modo di procedere dialogico e personalizzato centrato però sugli aspetti assistenziali, in cui dall’incontro degli interlocutori si determinerebbe la natura delle cure da fornire ed i mezzi con cui metterle in opera (Colliere, 1992; Motta, 2000). Nell’orientamento infermieristico viene affermata dunque la presenza di una relazione. Ma di che relazione si tratta? Quali sono le capacità necessarie per avere una buona relazione? E cosa si intende per “bisogni personali”? Innanzitutto occorre stabilire cosa sia la buona relazione. La buona o cattiva relazione è il prodotto della modalità con cui l’operatore entra comunque in interazione con il proprio paziente ed è modulata essenzialmente dalle capacità che la sua struttura, consapevole o no, mette in campo. DISEGNO DELLA LA RICERCA – 1° STUDIO Obiettivo del primo studio della presente ricerca, è un’osservazione delle capacità relazionali rilevabili nel rapporto infermiere/paziente, rapporto che si presume essere un caring. Si è voluto fissare l’attenzione principalmente su quelle dimensioni che possono costituire le capacità relazionali dell’infermiere. Questo basandoci anche su un confronto con le aspettative di relazione del paziente e cercando di esplorare quali collegamenti vi siano tra le une e le altre. La relazione e soprattutto la buona relazione non la si può stabilire con la buona volontà, né con la cosiddetta sensibilità umana, ma necessita di capacità che non tutti hanno e che per essere acquisite necessitano di un tipo di formazione che incida sulle strutture profonde della personalità. E’ possibile ipotizzare che la personalità e le sue dimensioni siano il contenitore e gli elementi di base sui quali fare crescere e sviluppare capacità relazionali mature. Le dimensioni di personalità risultano quindi lo snodo principale da cui la ricerca può produrre i suoi risultati e da cui si è orientata per individuare gli strumenti di misura. La motivazione della nostra scelta dello strumento è da ricercare quindi nel tentativo di esplorare l’incidenza delle dimensioni e sottodimensioni di personalità. Tra queste si è ritenuto importante il costrutto dell’Alessitimia, caratteristico nel possesso e quindi nell’utilizzo, più o meno adeguato, di capacità relazionali nel processo di caring,

Il ruolo della Narrative in Medical Ethics, Medical Practice e Medical Education. Elementi di ricerca

La mia tesi di dottorato ha ad oggetto lo studio e l’analisi del ruolo della Narrative all’interno di tre ambiti, quali Medical Ethics, Clinical Practice e Medical Education. La tesi è strutturata in 4 capitoli: i primi tre vanno a comporre la parte teorica mentre nel quarto capitolo viene riportata una ricerca sul campo da me svolta negli Stati Uniti. Nel primo capitolo, analizzo il ruolo della narrative all’interno della Medical Ethics specificando che cosa si intenda con etica narrativa, quali sono le motivazione alla base del suo sviluppo e chi sono i suoi principali esponenti. In questo capitolo, inoltre, esamino i problemi che l’etica narrativa solleva suggerendo un nuovo modo in cui essa si integra alla riflessione bioetica. Il secondo capitolo è dedicato al contributo della narrative nella Medical Practice investigando sia le modalità attraverso le quali il paziente può avvalersi della narrazione per analizzare la sua esperienza di malattia sia la cosiddetta Medicina Narrativa. Il terzo capitolo è dedicato all'analisi delle Medical Humanities, ossia di quelle discipline che all’interno della Medical Education si stanno rivelando strumenti efficaci per una formazione più equilibrata e completa dei professionisti della salute. Il quarto capitolo, invece, è dedicato alla descrizione di una ricerca svolta presso l’University of California – Irvine . Durante questa esperienza ho frequentato i corsi del Program in Medical Humanities and Arts diretto dalla Prof.ssa J. Shapiro, (programma in vigore da 13 anni e implementato allo scopo di migliorare alcune competenze nei futuri medici quali: l'empatia, l’altruismo, la compassione e la predisposizione alla cura verso i pazienti, oltre che per affinare le comunicazione clinica e la capacità di osservazione) e intervistato gli studenti che hanno preso parte a queste lezioni.

Betreuungsbedürfnisse von Patientinnen im Rahmen der gynäkologischen Krebsfrüherkennungsuntersuchung : Entwicklung eines Erfassungsinstrumentes

Da es bis dato kein spezifisches Instrument gibt, um die Betreuungsbedürfnisse von Patientinnen im Rahmen der gynäkologischen Krebsfrüherkennungsuntersuchung zu erfassen, war es das Ziel der vorliegenden explorativen Studie, eben jene subjektiven Betreuungsbedürfnisse aufzudecken und sie in ein praxistaugliches und messbares Format zu überführen - den Fragebogen „Betreuungsbedürfnisse – Gynäkologische Krebsfrüherkennungsuntersuchung (BB-G KFU)“. Wir stellten hierzu folgende Hypothesen auf: Es ist möglich (a) Betreuungsbedürfnisse zu explorieren und in reliablen Skalen abzubilden, (b) die Wichtigkeit der Betreuungsbedürfnisse in Form einer Wertigkeitsrangfolge abzubilden, (c) Determinanten der Betreuungsbedürfnisse (Alter, Sozialstatus, Familienstand, Gesundheitsbezogene Kontrollüberzeugungen) zu detektieren. Wir entwickelten einen Fragebogen auf der Basis einer ausführlichen systematischen Literaturrecherche, Leitfadeninterviews mit gynäkologischen Patientinnen sowie einer Befragung von 18 Experten. Dieser Fragebogen beinhaltete 58 Arzt bezogene Betreuungsbedürfnisse-Items, 12 Arzthelferinnen bezogene Betreuungsbedürfnisse-Items und 21 Praxisorganisation und Praxisstruktur bezogene Betreuungsbedürfnisse-Items. Die Probandinnen bewerteten die Wichtigkeit der Erfüllung jedes Items anhand einer fünfstufigen Antwortskala im Likert-Format (1 = nicht wichtig, 5 = sehr wichtig). Zudem wurden soziodemografische Daten sowie gesundheitsbezogene Kontrollüberzeugungen der Probandinnen erhoben. Im Sinne einer multizentrisch angelegten Querschnittstudie wurde der Fragebogen an 1.000 Patientinnen in zehn gynäkologischen Praxen in drei deutschen Bundesländern ausgegeben. Insgesamt erhielten wir 965 ausgefüllte Fragebögen zurück. Mittels deskriptiver Statistiken konnten die soziodemografischen Daten sowie die einzelnen Betreuungsbedürfnisse-Items ausgewertet werden. Zur Entwicklung reliabler Betreuungsbedürfnis-Skalen wurde der Datensatz einer Hauptkomponentenanalyse (PCA mit Varimax-Rotation) unterzogen. Auf diesem Wege konnte ein Erfassungsinstrument (Fragebogen „Betreuungsbedürfnisse – Gynäkologische Krebsfrüherkennungsuntersuchung (BB-G KFU)“) bestehend aus sieben reliablen Betreuungsbedürfnis-Skalen (BB-S) entwickelt werden, welche die psychosozialen Betreuungsbedürfnisse und -wünsche von Patientinnen mit Bezug auf den Gynäkologen (BB-S-A), die Arzthelferin (BB-S-AH) sowie die Praxisstruktur (BB-S-P) abzubilden vermögen: „Bedürfnis nach Information“ (BB-S-A-I), „Bedürfnis nach Respekt und Einfühlungsvermögen im Rahmen der körperlichen Untersuchung“ (BB-S-A-RE), „Bedürfnis nach Zuwendung und Verfügbarkeit“ (BB-S-A-ZV), „Bedürfnis nach Zuwendung und Service“ (BB-S-AH-ZS), „Bedürfnis nach logistischer Unterstützung“ (BB-S-AH-L), „Bedürfnis nach Basisausstattung und Erreichbarkeit“ (BB-S-P-BE) und „Bedürfnis nach Zusatzausstattung“ (BB-S-P-Z). Die durch die drei arztbezogenen Komponenten (bestehend aus 33 Items) aufgeklärte Gesamtvarianz beträgt 40,29%, die der arzthelferinnenbezogenen 2-Komponentenlösung (11 Items) 48,92%, und die Totalvarianz der zwei Dimensionen mit Bezug auf die Praxisstruktur (19 Items) liegt bei 41,68%. Die Reliabilitäten der sieben Skalen sind als akzeptabel bis sehr gut zu bewerten (Cronbachs α = .71 - .89). Anhand der Korrelationen zum KKG (Fragen zu Kontrollüberzeugungen über Krankheit und Gesundheit von Lohaus und Schmitt) konnten erste positive Hinweise auf die Validität des BB-G KFU gefunden werden. Durch den Vergleich der einzelnen Mittelwerte konnte die hierarchische Organisation der Betreuungsbedürfnisse gemäß ihrer Wichtigkeit sichtbar gemacht werden: Die Arbeit zeigt, dass Patientinnen im Rahmen der gynäkologischen KFU der Informationsvermittlung durch den Arzt (BB-S-A-I; M = 1,51; SD = 0,47) wie auch der ärztlichen Zuwendung und Verfügbarkeit (BB-S-A-ZV; M = 1,39; SD = 0,38) in der Wertigkeitsrangfolge einen besonders hohen Platz einräumen. Die Datenanalysen zeigen zudem eine Abhängigkeit der Betreuungsbedürfnisse vom Alter und vom Sozialstatus der Patientinnen, jedoch nicht vom Familienstand und den gesundheitsbezogenen Kontrollüberzeugungen.

Plato and Frankfurt: Two Theories of the Relations Between Love and Living Well

This thesis provides a comparison of the ideas of caring and love as they appear in the works of Plato and Frankfurt. Frankfurt, a contemporary philosopher, maintains that an individual arrives at the most meaningful life through understanding what it is that heor she cares about the most. Interestingly, the instances of eros in Plato's Symposium and Phaedrus resonate with this idea. We see throughout these erotic dialogues similarities to Frankfurt's notions of care and love.Throughout his many works, Frankfurt provides us with several distinct features of care and love. This thesis offers an in depth discussion of each of these features andalso provides commentary from other contemporary philosophers who are familiar with Frankfurt's work. In addition, this thesis applies these features of care and love to Plato's erotic dialogues, and emphasizes areas in which Plato and Frankfurt agree and those inwhich they disagree. In essence, it becomes apparent that while there are many similarities between the ideas of these two prominent thinkers, Plato and Frankfurt do not agree about what constitutes the best human life. Plato maintains that the best life is onespent dedicated to philosophy and in pursuit of the 'good'. Frankfurt, on the other hand,imposes no such limitations on what we should consider the best life because people are likely to have different life experiences that lead them to care about and love different things. Instead he suggests that the best or most meaningful human life is one in which a person spends his or her life caring about the things he or she does, indeed, care aboutand loving those things he or she does, indeed, love.

Leisure activities, caregiving demands and catecholamine levels in dementia caregivers

This study examined whether satisfaction from leisure activities moderates the relationship between caregiving demands (i.e., hours per day spent caring for a spouse with dementia) and resting levels of the catecholamines norepinephrine (NE) and epinephrine (EPI). Spousal caregivers (n = 107; mean age = 73.95 ± 8.12 years) were assessed in home for plasma levels of NE and EPI, amount of care provided, and leisure satisfaction. Regression was used to determine whether leisure satisfaction moderated the relationship between hours providing care per day and catecholamine levels. A significant interaction was found between hours caregiving and leisure satisfaction for NE, but not for EPI. Post hoc regressions were conducted for both NE and EPI. At low leisure satisfaction, time spent caring for a spouse was positively associated with plasma NE (β = 0.41; p = 0.005) and EPI (β = 0.44; p = 0.003). In contrast, at high levels of satisfaction, time caregiving was not significantly associated with plasma NE (β = -0.08; p = 0.57) or EPI (β = 0.23; p = 0.12). These findings suggest that leisure satisfaction may protect caregivers from increases in catecholamines, which have been implicated in cardiovascular risk. Further support for these findings may impact psychological treatments for distressed caregivers.