777 resultados para traditional beliefs


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A national sample of family physicians was surveyed to (1) assess family physicians' beliefs about the human immunodeficiency virus (HIV) and individuals at risk for infection, their clinical competence regarding HIV-related issues, and their experiences with HIV disease; (2) present conclusions to the American Academy of Family Physicians (AAFP) to effect the development of an early clinical care protocol and a continuing medical education curriculum; and (3) collect base-line data for use in the evaluation of an early clinical care protocol and a continuing medical education curriculum, in the case that such programs are developed and disseminated. After considering retired or deceased respondents, of the 2,660 physicians surveyed, 1,678 (63.7%) responded. The resulting sample was representative of the active members of the AAFP. About 77% of the respondents were unable to accurately identify the universal precautions for blood and body fluids to prevent occupational transmission of HIV or hepatitis B virus (HBV). Residency trained and board certified physicians expressed fewer "external constraints," such as fear of losing patients, obviating them from providing treatment to individuals with HIV disease (p =.004 and p $<$.001, respectively). These physicians also manifested fewer "internal constraints" to the provision of HIV treatment, such as fear of becoming infected (p $<$.001 and p =.012, respectively). Residency trained physicians also expressed a greater comfort with discussing sexually-related topics with their patients than did non-residency trained physicians (p $<$.001). There were 67.1% of the physicians surveyed who reported never providing treatment to an individual with HIV disease. Residency trained and board certified physicians expressed a greater likelihood to provide treatment to HIV-infected patients (p $<$.001) than non-residency trained and non-board certified physicians.^ Among the various primary care specialties, family medicine is especially vulnerable to the current challenges of HIV/AIDS. These challenges are augmented by the epidemiologic pattern that characterizes AIDS. For the past several years, we have seen AIDS in this country assume a similar pattern to that seen in most other countries; HIV is becoming increasingly prevalent in the heterosexual population as well as in locations removed from metropolitan centers. This current phase of the epidemic generates greater pressures upon primary care physicians, particularly family physicians, to become better acquainted with the means to provide early care to HIV/AIDS patients and to prevent HIV/AIDS among their patients. Family medicine is especially appropriate for providing care to HIV patients because family medicine involves treatment to all age groups and conditions; other primary care specialties focus on limited patient populations or specific conditions. Family physicians should be armed with the expertise to confront HIV/AIDS. However, family physicians' clinical competence and experience with HIV is not known. The data collected in this survey describes their competencies, attitudes, and experiences. ^

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The purpose of this study was to determine the impact of traditional psychiatric services with case management services on the functioning of people with schizophrenia. Traditional services were defined as routine clinic services consisting of medication follow-along, psychotherapy, and support services. Case management consisted of activities involved in linking, planning, and monitoring services for the outpatient client who has schizophrenia. The target population was adult schizophrenics who had been receiving outpatient clinic services for a minimum of six months. Structured interviews were conducted using standardized scales (e.g., Quality of Life, Self-Efficacy, and Brief Symptom Inventory) with 78 outpatient client volunteers from two sites: Nova Scotia (Canada) and Texas (USA). The researcher tested for differences in psychiatric symptomatology, recidivism, and quality of life for persons with schizophrenia receiving traditional psychiatric services in Nova Scotia and traditional plus case management services in Texas. Data were collected from the structured interviews and medical records review forms. Types of services were blocked into low and high levels of Intensity (frequency x minutes) and compared to determine the relative contribution of each. Finally, the role of clients' self-efficacy was tested as an intervening variable. Although the findings did not support the hypotheses in the direction anticipated, there were some interesting and useful results. From the Nova Scotia site, clients who received low levels of services were hospitalized less compared to the Texas site. The more psychotic a patient was the higher their involvement in medication follow-along and the more monitoring they received. The more psychotherapy received, the lower the reported satisfaction with social relationships. Of particular interest is the role that self-efficacy played in improved client outcomes. Although self-efficacy scores were related to improved functioning, the mechanism for this still needs to be clarified through subsequent research. ^

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One of the major challenges in treating mental illness in Nigeria is that the health care facilities and mental health care professionals are not enough in number or well equipped to handle the burden of mental illness. There are several barriers to treatment for individual Nigerians which include the following: such as the lack of understanding of the root causes of mental illness, lack of financial support to get mental treatment, lack of social support (family, friends, neighbors), the fear of stigmatization concerning being labeled as mentally ill or being in association with the mentally ill, and the consultation of traditional native healers who may be unknowingly prolonging illness, rather than addressing and treating them due to lack of formal education and standardization of their treatments. Another barrier is the non-health nature of the mental health services in Nigeria. Traditional healers are essentially the mental health system. The elderly, women, and children are the most vulnerable groups in times of strife and hardships. Their mental well-being must be taken into account as well as their special needs in times of personal or societal crisis. ^ Nigerian mental health policy is geared toward forming a mental health system, but in actuality only a mental illness care system is the observed result of the policy. The government of Nigeria has drafted a mental health policy, yet its actual implementation into the Nigerian health infrastructure and society waits to be materialized. The limited health legislation or policy implementations tend to favor those who have access to these urban areas and the facilities' health services. Nigerians living in rural areas are at a disadvantage; many of them may not even be aware of services available to help them understand and treat mental illness. Perhaps, government driven health interventions geared toward mental illness in rural areas would reach an underserved Nigerians and Africans in general. Issues with political instability and limited infrastructure often hinder crucial financial resources and legislation from reaching the people that are truly in need of governmental leadership in regards to mental health policy.^ Traditional healers are a severely untapped resource in the treatment of mental illness within the Nigerian population. They are abundant within Nigerian communities and are meeting a real need for the mentally ill. However, much can be done to remove the barriers that prevent the integration of traditional healers within the mental health system and improve the quality of care they administer within the population. Mental illness is almost exclusively coped with through traditional medicine practices. Mobilization and education from each strata of Nigerian society and government as well as input from the medical community can improve how traditional medicine is utilized as a treatment for clinical illness and help alleviate the heavy burden of mental illness in Nigeria. Currently, there is no existing policy making structure for a working mental health system in Nigeria, and traditional healers are not taken into account in any formulation of mental health policy. Advocacy for mental illness is severely inadequate due to fear of stigmatization, with no formally recognized national of regional mental health association.^

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Cardiovascular disease (CVD) is the number one cause of death for people in Texas as well as Mexico. The progressive morbidity and mortality of CVD can be prevented initially and controlled through regular health screenings or visits to the physician where health markers such as hypertension can be detected and treated. Yet, many people go unaware of existing hypertension not only due to lack of access to health care but to their own personal beliefs, ideas, or perceived barriers that prevent them from seeking preventative health care. ^ The main purpose of this study was to evaluate whether individuals of Mexican origin, who have some form of medical coverage, posses more knowledge, more perceived severity, less perceived barriers, and greater self-efficacy in regards to hypertension than those individuals who have no medical coverage. This was done by addressing the following specific aims: 1.To evaluate the association between individuals who have health care coverage and those who do not have health care coverage in regards to their beliefs of hypertension; 2. To evaluate if there exists a variation among the respondents demographic data and their beliefs of hypertension. ^ The total number of respondents were 150; with 75 being from Cuidad Juarez, and 75 being from El Paso, Texas. The results indicated that the individuals with some form of medical coverage perceived themselves to be more susceptible to suffering a cardiac event or developing heart disease than those who had no form of medical coverage. The individuals with some form of health care coverage also found themselves having less perceived barriers than those who had no health care coverage. The level of education seemed to have some association with individuals perceiving themselves as being susceptible to experiencing a cardiac event if they do not control their hypertension. Regarding self-efficacy, or the self-reported confidence in performing certain behaviors to controlling hypertension, those individuals who perceived themselves as having no self-efficacy had a lower level of education, compared to those who did perceive themselves as possessing self-efficacy. The findings of this study indicate that beliefs regarding hypertension and medical coverage are variables that need to be investigated further for individuals in the El Paso and Cuidad Juarez region. ^

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This dissertation documents health and illness in the context of daily life circumstances and structural conditions faced by African American families living in Clover Heights (pseudonym), an inner city public housing project in the Third Ward, Houston, Texas. Drawing from Kleinman's (1980) model of culturally defined health care systems and using the holistic-content approach to narrative analysis (Lieblich, Tuval- Mashiach, & Zilber, 1998) the purpose of this research was to explore the ways in which social and health policy, economic mobility, the inner city environment, and cultural beliefs intertwined with African American families' health related ideas, behaviors, and practices. I recruited six families using a convenience sampling method (Schensul, Schensul, & LeCompte, 1999) and followed them for fourteen months (2010–2011). Family was defined as a household unit, or those living in the same residence, short or long-term. Single, African American women ranging in age from 29–80 years headed all families. All but one family included children or grandchildren 18 years of age and younger, or children or other relative 18 years of age and older. I also recruited six residents with who I became acquainted over the course of the project. I collected data using traditional ethnographic methods including participant-observation, archive review, field notes, mapping, free-listing, in-depth interviews, and life history interviews. ^ Doing ethnography afforded the families who participated in this project the freedom to construct their own experiences of health and illness. My role centered on listening to, learning from, and interpreting participants' narratives, exploring similarities and differences within and across families' experiences. As the research progressed, a pattern concerning diagnosis and pharmacotherapy for children's behavioral and emotional problems, particularly attention-deficit hyperactivity disorder (ADHD) and pediatric bipolar disorder (PBD), emerged from my formal interactions with participants and my informal interactions with residents. The findings presented in this dissertation document this pattern, focusing on how mothers and families interpreted, organized, and ascribed meaning to their experiences of ADHD and PBD. ^ In the first manuscript presented here, I documented three mothers' narrative constructions of a child's diagnosis with and pharmacotherapy for ADHD or PBD. Using Gergen's (1997) relational perspective I argued that mothers' knowledge and experiences of ADHD and PBD were not individually constructed, but were linguistically and discursively constituted through various social interactions and relationships, including family, spirituality and faith, community norms, and expert systems of knowledge. Mothers' narratives revealed the complexity of children's behavioral and emotional problems, the daily trials of living through these problems, how they coped with adversity and developed survival strategies, and how they interacted with various institutional authorities involved in evaluating, diagnosing, and encouraging pharmaceutical intervention for children's behavior. The findings highlight the ways in which mothers' social interactions and relationships introduced a scientific language and discourse for explaining children's behavior as mental illness, the discordances between expert systems of knowledge and mothers' understandings, and how discordances reflected mothers' ‘microsources of power’ for producing their own stories and experiences. ^ In the second manuscript presented here, I documented the ways in which structural factors, including gender, race/ethnicity, and socioeconomic status, coupled with a unique cultural and social standpoint (Collins, 1990/2009) influenced the strategies this group of African American mothers employed to understand and respond to ADHD or PBD. The most salient themes related to mother-child relationships coalesced around mothers' beliefs about the etiology of ADHD and PBD, ‘conceptualizing responsibility,’ and ‘protection-survival.’ The findings suggest that even though mothers' strategies varied, they were in pursuit of a common goal. Mothers' challenged the status quo, addressing children's behavioral and emotional problems in the ways that made the most sense to them, specifically protecting their children from further marginalization in society more so than believing these were the best options for their children.^

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We formed an academic-community partnership with the Salsa Caliente program to undertake a project to better understand how Latina women with cardiovascular disease (CVD) or at risk of CVD view and understand CVD. This study's research question examines the sociocultural factors that influence and inform Latino women's perceptions and beliefs about CVD. Seven out the eleven participants in the Salsa Caliente program consented to be interviewed. The data was collected through recorded interviews, which were transcribed and then analyzed for common themes found among all the participants' narratives. The content analysis looking into common themes yielded four: 1) increased awareness of CVD, 2) trust in doctor, 3) delay in doctor visits, and 4) awareness of health. Implications for interventions and further research are discussed.^

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Al considerar los procedimientos poéticos que aparecen en los textos homéricos, es fundamental no perder de vista las posibilidades significativas que pueden presentar para la recepción auditiva propia de la performance épica. En la recreación de los acontecimientos míticos, los elementos del lenguaje específicamente poético cumplen una función instauradora esencial, pues al transformar los procedimientos poéticos en creencias perceptivas, realizan la presencia de los hechos narrados. Así es que procedimientos tales como la aliteración conllevan una carga temática que los convierte en un rasgo clave de la poética homérica. Los efectos sonoros en los textos homéricos fueron comentados desde la antigüedad, especialmente la capacidad de reproducir verbalmente sonidos de varios tipos de fenómenos naturales, seres y objetos. En los casos del canto IX de Ilíada, tales elementos cumplen una función relevante para la trama a través del leitmotiv tradicional que contribuyen a instaurar. Este tipo de análisis basado en las recurrencias de efectos sonoros permite recuperar para la lectura actual un rasgo importante de la poesía homérica: la 'creación verbal con motivación onomatopéyica'.

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La lectura es una herramienta central en la enseñanza y el aprendizaje de la historia. Son conocidos los problemas que afrontan los alumnos para comprender textos históricos, y por eso -entre otras razones- resulta necesario concebir a la lectura como contenido de enseñanza de la Historia. Los aportes de las investigaciones psicolingüísticas permitieron modificar la concepción acerca de la lectura desde dos puntos de vista: se pasó de entenderla como un proceso de descifrado de lo escrito a un proceso de construcción de significado. A la vez, dejó de ser conceptualizada como un conjunto de habilidades para ser interpretada desde una teoría de comprensión global. Actualmente se caracteriza a la lectura como un proceso de construcción de significados y se ha puesto en evidencia que los conocimientos previos del lector sobre la temática del texto constituyen uno de los factores determinantes de la particular interpretación que realiza (Smith, 1983; Goodman, 1982). Construir el significado de un texto de historia supone construir los conceptos, crear y recrear representaciones sobre los hechos, reorganizar el conocimiento anterior incorporando conocimiento nuevo (Aisenberg, 2003). Este trabajo presenta avances de una investigación que busca construir conocimiento sobre las representaciones de los docentes acerca del papel de la lectura en la enseñanza y el aprendizaje de Historia. Las preguntas que orientan esta investigación son: ¿Qué representaciones tienen los profesores de la Escuela Secundaria sobre el papel de la lectura en la enseñanza y el aprendizaje de la historia? Cuando utilizan textos, ¿qué supuestos subyacen a las propuestas didácticas? Se trata de un estudio exploratorio, abordado desde una lógica de investigación cualitativa. En el análisis de las entrevistas realizadas encontramos ideas, percepciones y referencias a prácticas que responderían a concepciones habituales de la enseñanza tradicional de la historia, y otras que estarían influenciadas por los nuevos desarrollos teóricos sobre el tema, difundidos en los últimos años en espacios de formación y en bibliografía sobre las prácticas de lectura en contextos de estudio. Hasta el momento, se han construido dos modos básicos de concebir la relación de la lectura con la historia por parte de los profesores: una relación de interioridad y una de exterioridad. En articulación con cada una, se pueden encontrar diferencias en las concepciones sobre la lectura, en las interpretaciones acerca de las dificultades de lectura y aprendizaje de los alumnos y en las propuestas de enseñanza en las clases de Historia

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En todos los pueblos el origen de la creación, al interior de las distintas religiones y dentro del universo entero, se manifiesta por la palabra, a la que se considera la fuerza genérica, de origen divino, fundadora y productora de todas las cosas tanto materiales como espirituales. La voz se equipara a la emisión de un soplo milagroso. Nombrar es un acto de creación; crear y nombrar, entonces, se convierten en sinónimos: "en el principio era el Verbo y el Verbo era Dios". Sobre esas antiguas creencias se generaron mitos, se conformaron relatos legendarios y nacieron fórmulas de comunicación. Las culturas indígenas conservan hermosas leyendas entregadas por la tradición oral; recuerdo de ideales épocas y "tiempo de los sueños": la edad de la poesía. Poesía que transmite historia y mitos; cantos que permiten investigar y mantener la inteligencia activa: la permanencia de la memoria genética

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Al considerar los procedimientos poéticos que aparecen en los textos homéricos, es fundamental no perder de vista las posibilidades significativas que pueden presentar para la recepción auditiva propia de la performance épica. En la recreación de los acontecimientos míticos, los elementos del lenguaje específicamente poético cumplen una función instauradora esencial, pues al transformar los procedimientos poéticos en creencias perceptivas, realizan la presencia de los hechos narrados. Así es que procedimientos tales como la aliteración conllevan una carga temática que los convierte en un rasgo clave de la poética homérica. Los efectos sonoros en los textos homéricos fueron comentados desde la antigüedad, especialmente la capacidad de reproducir verbalmente sonidos de varios tipos de fenómenos naturales, seres y objetos. En los casos del canto IX de Ilíada, tales elementos cumplen una función relevante para la trama a través del leitmotiv tradicional que contribuyen a instaurar. Este tipo de análisis basado en las recurrencias de efectos sonoros permite recuperar para la lectura actual un rasgo importante de la poesía homérica: la 'creación verbal con motivación onomatopéyica'.

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La lectura es una herramienta central en la enseñanza y el aprendizaje de la historia. Son conocidos los problemas que afrontan los alumnos para comprender textos históricos, y por eso -entre otras razones- resulta necesario concebir a la lectura como contenido de enseñanza de la Historia. Los aportes de las investigaciones psicolingüísticas permitieron modificar la concepción acerca de la lectura desde dos puntos de vista: se pasó de entenderla como un proceso de descifrado de lo escrito a un proceso de construcción de significado. A la vez, dejó de ser conceptualizada como un conjunto de habilidades para ser interpretada desde una teoría de comprensión global. Actualmente se caracteriza a la lectura como un proceso de construcción de significados y se ha puesto en evidencia que los conocimientos previos del lector sobre la temática del texto constituyen uno de los factores determinantes de la particular interpretación que realiza (Smith, 1983; Goodman, 1982). Construir el significado de un texto de historia supone construir los conceptos, crear y recrear representaciones sobre los hechos, reorganizar el conocimiento anterior incorporando conocimiento nuevo (Aisenberg, 2003). Este trabajo presenta avances de una investigación que busca construir conocimiento sobre las representaciones de los docentes acerca del papel de la lectura en la enseñanza y el aprendizaje de Historia. Las preguntas que orientan esta investigación son: ¿Qué representaciones tienen los profesores de la Escuela Secundaria sobre el papel de la lectura en la enseñanza y el aprendizaje de la historia? Cuando utilizan textos, ¿qué supuestos subyacen a las propuestas didácticas? Se trata de un estudio exploratorio, abordado desde una lógica de investigación cualitativa. En el análisis de las entrevistas realizadas encontramos ideas, percepciones y referencias a prácticas que responderían a concepciones habituales de la enseñanza tradicional de la historia, y otras que estarían influenciadas por los nuevos desarrollos teóricos sobre el tema, difundidos en los últimos años en espacios de formación y en bibliografía sobre las prácticas de lectura en contextos de estudio. Hasta el momento, se han construido dos modos básicos de concebir la relación de la lectura con la historia por parte de los profesores: una relación de interioridad y una de exterioridad. En articulación con cada una, se pueden encontrar diferencias en las concepciones sobre la lectura, en las interpretaciones acerca de las dificultades de lectura y aprendizaje de los alumnos y en las propuestas de enseñanza en las clases de Historia