Schoolman family papers, undated, 1889-1994

The Schoolman Papers reflect Dr. Albert P. and Mrs. Bertha Schoolmans' staunch dedication to Jewish education, Jewish causes, and Israel. Bertha Schoolman, a lifelong member of Hadassah, assisted thousands of Israeli youth as chairman of the Youth Aliyah Committee. Her diaries, photos, scrapbooks, and correspondence record her numerous visits to Israel on which she helped set up schools, met with Israeli dignitaries, and participated in Zionist Conferences and events. The collection includes a 1936 letter from Hadassah founder, Henrietta Szold, praising Mrs. Schoolman's work as well as a letter from the father of Anne Frank, thanking Mrs. Schoolman for naming a Youth Aliyah center the "Anne Frank Haven" after his later daughter.

Jewish Memorial Hospital and Rehabilitation Center (Roxbury, Mass.) records, undated, 1915-1999

The records provide material relating to the accreditation, fundraising, management, planning, policies, programs, and public relations of a hospital that continues to serve the Greater Boston area. The records includes correspondence of various Presidents, Board Members, and Executive Directors; Board and committee minutes; scrapbooks, photographs, videotape, and film created by the Public Relations department; records of various Auxiliary groups; correspondence, reports, surveys, and other documents relating to the Pediatric Rehabilitation Program; and artifacts such as plaques, portraits, and silverware.

Industrial Removal Office records undated, 1899-1922

Contains Board of Directors minutes (1903, 1907), Executive Committee minutes (1907), Removal Committee minutes (1903-1917), Annual Reports (1910, 1913), Monthly Reports (1901-1919), Monthly Bulletins (1914-1915), studies of those removed, Bressler's "The Removal Work, Including Galveston," and several papers relating to the IRO and immigration. Financial papers include a budget (1914), comparative per capita cost figures (1909-1922), audits (1915-1918), receipts and expenditures (1918-1922), investment records, bank balances (1907-1922), removal work cash book (1904-1911), office expenses cash account (1903-1906), and the financial records of other agencies working with the IRO (1906). Includes also removal case records of first the Jewish Agricultural Society (1899-1900), and then of the IRO (1901-1922) when it took over its work, family reunion case records (1901-1904), and the follow-up records of persons removed to various cities (1903-1914). Contains also the correspondence of traveling agents' contacts throughout the U.S. from 1905-1914, among them Stanley Bero, Henry P. Goldstein, Philip Seman, and Morris D. Waldman.

Enterprise education: Learning through personal experience

This paper outlines the development of a reflective process through which student feelings are brought to the surface to advance their learning outcomes. A key notion in relation to the capacity of student development is the ability of students to alter their collective habits of thought and in turn the nature of the learning environment. The paper examines student reflection in the context of students' heightened awareness of self and their potential influence on their environment. The notion of 'surfacing feelings' is used to describe the outcome of individual and group reflection through which several parties become aware of the active reflections of individual students, thereby increasing the potential depth of overall reflection. Finally, the author considers the transferability of the ideas discussed to other educational contexts.

Beth Israel Hospital (Boston, MA) Records, undated, 1923, 1930-1964, 1988, 1991-1992

In 1916, the Jewish community of Boston established Beth Israel Hospital on Townsend Street in Roxbury to provide health care to immigrants in the area. Although accessible to everyone, the hospital provided Yiddish-speaking services for Eastern European Jewish immigrants and served kosher food, as well as conducted Jewish religious services. In 1928 the hospital entered into a teaching agreement with Harvard Medical School, Tufts University, and Simmons College. Shortly thereafter, the hospital moved to its current location in the Longwood area of Boston and expanded to a 220-bed operation. During 1935-1936, at the height of the Depression, Beth Israel spent 1.5 million dollars in free patient care and was only one of two local hospitals to offer health care to people on welfare. In 1996, Beth Israel Hospital merged with Deaconess Medical Center and became Beth Israel Deaconess Medical Center. This collection contains reports, pamphlets and hospital publications.

Letter to Dr. Simeon Leo

Letter to Doctor Leo from Charles Frank, patient at Montefiore Hospital

Patient perspectives of factors contributing to inadequate dietary intake in acute care patients in hospital

Up to 30% of acute care patients consume less than half of the food provided in hospital. Inadequate dietary intake can have adverse clinical outcomes, including a higher risk of in-hospital mortality. This study aimed to investigate the reasons for poor intake among acute care patients in hospital. Patients with an observed intake of ≤50% of the food provided at lunch were approached to participate in the study. Thirty-two patients participated in semi-structured interviews over a three week period, to provide their perspective of food and mealtimes in hospital and discuss the reasons and factors influencing inadequate intake. Responses were coded and analysed thematically using the framework method. Patients reported both individual and organisational factors contribute to their inadequate intake. Half the patients reported the size of the meals were too large, with some patients reporting that large meal sizes puts them off their food and reduced their intake. ‘Not important to eat all the food provided’, and ‘do not need to eat much food in hospital’ were common attitudes among the patients. Half the patients reported that nurses did not observe their intake and were not concerned if all the food was not eaten. Identifying the reasons for poor intake can assist with the development of suitable interventions to improve dietary intake and reduce the risk of adverse clinical outcomes. Further investigation of suitable interventions to reduce portion sizes and improve both staff and patient perceptions of the importance of food in hospital is recommended.

Validating adult and paediatric nutrition screening and assessment tools in Vietnamese language in two acute hospital in Ho Chi Minh City, Vietnam

Despite being commonly prevalent in acute care hospitals worldwide, malnutrition often goes unidentified and untreated due to a lack in the implementation of a nutrition care pathway. The aim of this study was to validate nutrition screening and assessment tools in Vietnamese language. After converting into Vietnamese, Malnutrition Screening Tool (MST) and Subjective Global Assessment (SGA) were used to identify malnutrition in the adult setting; and the Paediatric Nutrition Screening Tool (PNST) and paediatric Subjective Global Nutritional Assessment (SGNA) were used in the paediatric setting in two acute care hospitals in Vietnam. This cross-sectional observational study sampled 123 adults (median age 78 years [39–96 years], 63% males) and 105 children (median age 20 months [2–100 months], 66% males). In adults, nutrition risk and malnutrition were identified in 29% and 45% of the cohort respectively. Nutrition risk and malnutrition were identified in 71% and 43% of the paediatric cohort respectively. The sensitivity and specificity of the screening tools were: 62% and 99% for the MST compared to the SGA; 89% and 42% for the PNST compared to the SGNA. This study provides a stepping stone to the potential use of evidence-based nutrition screening and assessment tools in Vietnamese language within the adult and paediatric Vietnamese acute care setting. Further work is required into integrating a complete nutrition care pathway within the acute care setting in Vietnamese hospitals.

Factors influencing hospital readmission and length of stay of Vietnamese patients with type 2 diabetes and cardiac disease

Background: Increased hospital readmission and longer stays in the hospital for patients with type 2 diabetes and cardiac disease can result in higher healthcare costs and heavier individual burden. Thus, knowledge of the characteristics and predictive factors for Vietnamese patients with type 2 diabetes and cardiac disease, at high risk of hospital readmission and longer stays in the hospital, could provide a better understanding on how to develop an effective care plan aimed at improving patient outcomes. However, information about factors influencing hospital readmission and length of stay of patients with type 2 diabetes and cardiac disease in Vietnam is limited. Aim: This study examined factors influencing hospital readmission and length of stay of Vietnamese patients with both type 2 diabetes and cardiac disease. Methods: An exploratory prospective study design was conducted on 209 patients with type 2 diabetes and cardiac disease in Vietnam. Data were collected from patient charts and patients' responses to self-administered questionnaires. Descriptive statistics, bivariate correlation, logistic and multiple regression were used to analyse the data. Results: The hospital readmission rate was 12.0% among patients with both type 2 diabetes and cardiac disease. The average length of stay in the hospital was 9.37 days. Older age (OR= 1.11, p< .05), increased duration of type 2 diabetes (OR= 1.22, p< .05), less engagement in stretching/strengthening exercise behaviours (OR= .93, p< .001) and in communication with physician (OR= .21, p< .001) were significant predictors of 30-dayhospital readmission. Increased number of additional co-morbidities (β= .33, p< .001) was a significant predictor of longer stays in the hospital. High levels of cognitive symptom management (β= .40, p< .001) significantly predicted longer stays in the hospital, indicating that the more patients practiced cognitive symptom management, the longer the stay in hospital. Conclusions: This study provides some evidence of factors influencing hospital readmission and length of stay and argues that this information may have significant implications for clinical practice in order to improve patients' health outcomes. However, the findings of this study related to the targeted hospital only. Additionally, the investigation of environmental factors is recommended for future research as these factors are important components contributing to the research model.

Viimeinen matka : Toimintatutkimus kirkollisen hautauskentän professiostruktuurista

This study is a qualitative examination of the professional structure of the ecclesias-tical funeral field. The research material is based on 13 funeral cases in the archdio-cese. The researcher participated in all the funerals and memorial events, interviewed the closest survivors, the officials of the funeral agency and the ecclesiastical actors. The material was collected by means of observation and recording of the interviews, and was later transcribed and analyzed. The actors in this study are the survivors, the funeral agencies and the church. The survivors act as the buyers and users of the products (funeral services) who require both the funeral agencies and the church to assist them with the problems that the death has caused. The numbers of actions related to the death and to the funerals - the rituals of death - are placed on the action field, which in this study is called the funeral field. In this field, the researchquestion focused space and power, and the actions on the funeral field are highly ritualized. The theoretical model comes from Pierre Bourdieu. The study showed an action structure on the funeral field in which the survivors first contacted a funeral agency, which then contacted the other actors of the field, re-served the date and place for the funeral, and organised the funeral arrangements. The funeral agencies arranged an opportunity for the survivors to have a last look at the deceased when he or she was placed in the coffin, and they held a moment of the prayer (if desired) before removing the deceased from the hospital's chapel. The sur-vivors contacted the pastor of the funeral much later. The pastor also participated in the memorial event. The survivors contacted the church musician through via pastor. In some cases, the survivors had neither met nor even seen the musician prior to the actual funeral service. Still, the music was of great importance to the survivors. In the research interviews, tensions emerged to some extent between the funeral agencies and the ecclesiastical actors; these actors attempted to resolve these tensions through organising negotiations. In the beginning of the 20th century, the family took an active part in the preparations of the deceased and in the arrangements of the funerals, whereas this study showed that these days, survivors often transfer the preparations to the funeral agencies. The professional side of the funeral field has grown. The funeral agencies can be seen as providers of full services that act on the survivors' behalf, aspiring to high individu-ality and aiming to fulfil the survivors' wishes. In practise, the role of the church in carrying out the last journey was reduced in the research cases to the actual funeral. In several cases, the pastor or the cantor of the funeral had never before seen the per-son in the coffin at any stage of life or death. The proportion of cremations in funeral cases has increased rapidly, however, special issues related to these cremations (such as the possibility of holding a funeral service for the already cremated deceased) have seen little consideration in the church. In the church's liturgies on funeral rites, cremation is frequently overlooked. The pastors or the cantors did not participate in either the burial of the funeral urn or in the scattering of the deceased's ashes. The verger took care of it. The parishes had no adopted standard practices for cremations, yet in each case for the survivors that moment was crucial.

The Nature, Origins, and Consequences of Finnish Shame-Proneness: A Grounded Theory Study

Although shame is a universal human emotion and is one of the most difficult emotions to overcome, its origins and nature as well as its effects on psychosocial functioning are not well understood or defined. While psychological and spiritual counselors are aware of the effects and consequences of shame for an individual s internal well-being and social life, shame is often still considered a taboo topic and is not given adequate attention. This study aims to explain the developmental process and effects of shame and shame-proneness for individuals and provide tools for practitioners to work more effectively with their clients who struggle with shame. This study presents the empirical foundation for a grounded theory that describes and explains the nature, origins, and consequences of shame-proneness. The study focused on Finnish participants childhood, adolescence and adulthood experiences and why they developed shame-proneness, what it meant for them as children and adolescents and what it meant for them as adults. The data collection phase of this study began in 2000. The participants were recruited through advertisements in local and country-wide newspapers and magazines. Altogether 325 people responded to the advertisements by sending an essay concerning their shame and guilt experiences. For the present study, 135 essays were selected and from those who sent an essay 19 were selected for in-depth interviews. In addition to essays and interviews, participants personal notebooks and childhood hospital and medical reports as well as their scores on the Internalized Shame Scale were analyzed. The development of shame-proneness and significant experiences and events during childhood and adolescence (e.g., health, parenting and parents behavior, humiliation, bullying, neglect, maltreatment and abuse) are discussed and the connections of shame-proneness to psychological concepts such as self-esteem, attachment, perfectionism, narcissism, submissiveness, pleasing others, heightened interpersonal subjectivity, and codependence are explained. Relationships and effects of shame-proneness on guilt, spirituality, temperament, coping strategies, defenses, personality formation and psychological health are also explicated. In addition, shame expressions and the development of shame triggers as well as internalized and externalized shame are clarified. These connections and developments are represented by the core category lack of gaining love, validation and protection as the authentic self. The conclusions drawn from the study include a categorization of shame-prone Finnish people according to their childhood and adolescent experiences and the characteristics of their shame-proneness and personality. Implications for psychological and spiritual counseling are also discussed. Key words: shame, internalized shame, external shame, shame development, shame triggers, guilt, self-esteem, attachment, narcissism, perfectionism, submissiveness, codependence, childhood neglect, childhood abuse, childhood maltreatment, emotional abuse, sexual abuse, spiritual abuse, psychological well-being

Changes in preservice teachers’ personal epistemologies

While much has been written about the relationship between personal epistemologies and learning-teaching approaches, outcomes, and intentions, little has focused specifically on these relationships in the context of teacher education. This chapter addresses changes in preservice teachers’ personal epistemologies by overviewing this emerging body of research and arguing for a new approach to conceptualizing and supporting changes in personal epistemologies based on reflexivity. The overview includes definitions of key concepts and research traditions that have been used since the 1970s and a discussion of the emerging role of epistemic justification as a key mechanism of change in the process of belief development.

Things you don't want to know about yourself: Ambivalence about tracking and sharing personal information for behaviour change

Technologies that facilitate the collection and sharing of personal information can feed people's desire for enhanced self-knowledge and help them to change their behaviour, yet for various reasons people can also be reluctant to use such technologies. This paper explores this tension through an interview study in the context of smoking cessation. Our findings show that smokers and recent ex-smokers were ambivalent about their behaviour change as well as about collecting personal information through technology and sharing it with other users. We close with a summary of three challenges emerging from such ambivalence and directions to address them.

Circadian Rhythm Disruptions and Health

The doctoral thesis defined connections between circadian rhythm disruptions and health problems. Sleep debt, jet-lag, shift work, as well as transitions into and out of the daylight saving time may lead to circadian rhythm disruptions. Disturbed circadian rhythm causes sleep deprivation and decrease of mood and these effects may lead to higher accident rates and trigger mental illnesses. Circadian clock genes are involved in the regulation of the cell cycle and metabolism and thus unstable circadian rhythmicity may also lead to cancer development. In publications I-III it was explored how transitions into and out of the daylight saving time impact the sleep efficiency and the rest-activity cycles of healthy individuals. Also it was explored whether the effect of transition is different in fall as compared to spring, and whether there are subgroup specific differences in the adjustment to transitions into and out of daylight saving time. The healthy participants of studies I-III used actigraphs before and after the transitions and filled in the morningness-eveningness and seasonal pattern assessment questionnaires. In publication IV the incidence of hospital-treated accidents and manic episodes was explored two weeks before and two weeks after the transitions into and out of the daylight saving time in years 1987-2003. In publication V the relationship between circadian rhythm disruption and the prevalence of Non-Hodgkin lymphoma was studied. The study V consisted of all working aged Finns who participated in the national population census in 1970. For our study, all the cancers diagnosed during the years 1971-1995 were extracted from the Finnish Cancer Register and linked with the 1970 census files. In studies I-III it was noticed that transitions into and out of the daylight saving time disturbs the sleep-wake cycle and the sleep efficiency of the healthy participants. We also noticed that short sleepers were more sensitive than long sleepers for sudden changes in the circadian rhythm. Our results also indicated that adaptation to changes in the circadian rhythm is potentially sex, age and chronotype-specific. In study IV no significant increase in the occurrence of hospital treated accidents or manic episodes was noticed. However, interesting observations about the seasonal fluctuation of the occurrence rates of accidents and manic episodes were made. Study V revealed that there might be close relationship between circadian rhythm disruption and cancer. The prevalence of Non-Hodgkin lymphoma was the highest among night workers. The five publications included in this thesis together point out that disturbed circadian rhythms may have adverse effect on health. Disturbed circadian rhythms decrease the quality of sleep and weaken the sleep-wake cycle. A continuous circadian rhythm disruption may also predispose individuals to cancer development. Since circadian rhythm disruptions are common in modern society they might have a remarkable impact on the public health. Thus it is important to continue circadian rhythm research so that better prevention and treatment methods can be developed. Keywords: Circadian rhythm, daylight saving time, manic episodes, accidents, Non-Hodgkin lymphoma 11

Methicillin-resistant Staphylococcus aureus in Finland: recent changes in the epidemiology, long-term facility aspects, and phenotypic and molecular detection of isolates

Staphylococcus aureus is one of the most important bacteria that cause disease in humans, and methicillin-resistant S. aureus (MRSA) has become the most commonly identified antibiotic-resistant pathogen in many parts of the world. MRSA rates have been stable for many years in the Nordic countries and the Netherlands with a low MRSA prevalence in Europe, but in the recent decades, MRSA rates have increased in those low-prevalence countries as well. MRSA has been established as a major hospital pathogen, but has also been found increasingly in long-term facilities (LTF) and in communities of persons with no connections to the health-care setting. In Finland, the annual number of MRSA isolates reported to the National Infectious Disease Register (NIDR) has constantly increased, especially outside the Helsinki metropolitan area. Molecular typing has revealed numerous outbreak strains of MRSA, some of which have previously been associated with community acquisition. In this work, data on MRSA cases notified to the NIDR and on MRSA strain types identified with pulsed-field gel electrophoresis (PFGE), multilocus sequence typing (MLST), and staphylococcal cassette chromosome mec (SCCmec) typing at the National Reference Laboratory (NRL) in Finland from 1997 to 2004 were analyzed. An increasing trend in MRSA incidence in Finland from 1997 to 2004 was shown. In addition, non-multi-drug resistant (NMDR) MRSA isolates, especially those resistant only to methicillin/oxacillin, showed an emerging trend. The predominant MRSA strains changed over time and place, but two internationally spread epidemic strains of MRSA, FIN-16 and FIN-21, were related to the increase detected most recently. Those strains were also one cause of the strikingly increasing invasive MRSA findings. The rise of MRSA strains with SCCmec types IV or V, possible community-acquired MRSA was also detected. With questionnaires, the diagnostic methods used for MRSA identification in Finnish microbiology laboratories and the number of MRSA screening specimens studied were reviewed. Surveys, which focused on the MRSA situation in long-term facilities in 2001 and on the background information of MRSA-positive persons in 2001-2003, were also carried out. The rates of MRSA and screening practices varied widely across geographic regions. Part of the NMDR MRSA strains could remain undetected in some laboratories because of insufficient diagnostic techniques used. The increasing proportion of elderly population carrying MRSA suggests that MRSA is an emerging problem in Finnish long-term facilities. Among the patients, 50% of the specimens were taken on a clinical basis, 43% on a screening basis after exposure to MRSA, 3% on a screening basis because of hospital contact abroad, and 4% for other reasons. In response to an outbreak of MRSA possessing a new genotype that occurred in a health care ward and in an associated nursing home of a small municipality in Northern Finland in autumn 2003, a point-prevalence survey was performed six months later. In the same study, the molecular epidemiology of MRSA and methicillin-sensitive S. aureus (MSSA) strains were also assessed, the results to the national strain collection compared, and the difficulties of MRSA screening with low-level oxacillin-resistant isolates encountered. The original MRSA outbreak in LTF, which consisted of isolates possessing a nationally new PFGE profile (FIN-22) and internationally rare MLST type (ST-27), was confined. Another previously unrecognized MRSA strain was found with additional screening, possibly indicating that current routine MRSA screening methods may be insufficiently sensitive for strains possessing low-level oxacillin resistance. Most of the MSSA strains found were genotypically related to the epidemic MRSA strains, but only a few of them had received the SCCmec element, and all those strains possessed the new SCCmec type V. In the second largest nursing home in Finland, the colonization of S. aureus and MRSA, and the role of screening sites along with broth enrichment culture on the sensitivity to detect S. aureus were studied. Combining the use of enrichment broth and perineal swabbing, in addition to nostrils and skin lesions swabbing, may be an alternative for throat swabs in the nursing home setting, especially when residents are uncooperative. Finally, in order to evaluate adequate phenotypic and genotypic methods needed for reliable laboratory diagnostics of MRSA, oxacillin disk diffusion and MIC tests to the cefoxitin disk diffusion method at both +35°C and +30°C, both with or without an addition of sodium chloride (NaCl) to the Müller Hinton test medium, and in-house PCR to two commercial molecular methods (the GenoType® MRSA test and the EVIGENETM MRSA Detection test) with different bacterial species in addition to S. aureus were compared. The cefoxitin disk diffusion method was superior to that of oxacillin disk diffusion and to the MIC tests in predicting mecA-mediated resistance in S. aureus when incubating at +35°C with or without the addition of NaCl to the test medium. Both the Geno Type® MRSA and EVIGENETM MRSA Detection tests are usable, accurate, cost-effective, and sufficiently fast methods for rapid MRSA confirmation from a pure culture.