Sjuksköterskors erfarenheter av andliga och existentiella frågor i palliativ vård : En litteraturöversikt

Bakgrund: Andliga och existentiella frågor hamnar i allt större utsträckning hos sjukvårdspersonal. Det palliativa förhållningssättet betonar vikten av att ge en god omvårdnad vad gäller andliga och existentiella frågor. Sjuksköterskans roll är att genom goda relationer skapa en anpassad och balanserad omvårdnad för att öka välbefinnandet för patienten den sista tiden i livet. Syfte: Syftet med litteraturöversikten var att sammanställa hur andliga och existentiella frågor beskrivs i forskning utifrån sjuksköterskors erfarenheter av palliativ vård. Metod: En litteraturöversikt som sammanställer aktuell forskning inom det valda omvårdnadsområdet. Resultat: I resultatet framträdde att tid är det vanligaste hindret och utbildning är det som främjar givandet av andlig och existentiell omvårdnad. Att skapa relationer och kommunicera är viktiga aspekter inom vårdandets konst. Egenskaper som sjuksköterskan bör inneha för att underlätta givandet av andlig och existentiell omvårdnad är; en god självkännedom, empati, intuition och observationsförmåga. Slutsats: För att kunna ge en bättre andlig och existentiell omvårdnad behöver de yttre förutsättningarna ge tid för mötet mellan sjuksköterska och patient, vårdmiljön organiseras så detta möjliggörs, teamarbete tillämpas och utbildning ges.

‘Moving on’ : Violence, wellbeing and questions about violence in antenatal care encounters. A qualitative study with Somali-born refugees in Sweden

Background Somali-born women constitute one of the largest groups of childbearing refugee women in Sweden after more than two decades of political violence in Somalia. In Sweden, these women encounter antenatal care that includes routine questions about violence being asked. The aim of the study was to explore how Somali-born women understand and relate to violence and wellbeing during their migration transition and their views on being approached with questions about violence in Swedish antenatal care. Method Qualitative interviews (22) with Somali-born women (17) living in Sweden were conducted and analysed using thematic analysis. Findings A balancing actbetween keeping private life private and the new welfare system was identified, where the midwife's questions about violence were met with hesitance. The midwife was, however, considered a resource for access to support services in the new society. A focus on pragmatic strategies to move on in life, rather than dwelling on potential experiences of violence and related traumas, was prominent. Social networks, spiritual faith and motherhood were crucial for regaining coherence in the aftermath of war. Dialogue and mutual adjustments were identified as strategies used to overcome power tensions in intimate relationships undergoing transition. Conclusions If confidentiality and links between violence and health are explained and clarified during the care encounter, screening for violence can be more beneficial in relation to Somali-born women. The focus on “moving on” and rationality indicates strength and access to alternative resources, but needs to be balanced against risks for hidden needs in care encounters. A care environment with continuity of care and trustful relationships enhances possibilities for the midwife to balance these dual perspectives and identify potential needs. Collaborations between Somali communities, maternity care and social service providers can contribute with support to families in transition and bridge gaps to formal social and care services.

Scriptural Archeology: Excavating the Presence of Women in the Torah

Women's roles in religious history have been traditionally described in terms of their relation and value to men. The normative religious texts provide an androcentric perspective on the gender relationships within the early community, the growth of Judaism in "Jacob's House" and the monotheistic worship of God. Yet these literary representations omit an entire half of the experience of the Jewish community: the perspective and participation of women. As Judith Plaskow argues extensively in Standing Again at Sinai, women are defined not in her own terms or in her own voice, but by her relationship and value to men through the androcentric vocabulary of the Torah. This statement is textually illustrated by the authorial and editorial presentation of women and their place in ancient Israelite society in the Torah. As Judaism grew increasingly androcentric in its leadership, women were increasingly reduced to marginal figures in the community by authorial and editorial revisions. Yet the participation of women of ancient Israel is not lost. Instead, the presence of women is buried beneath the androcentric presentation of the early Judaic community, waiting to be excavated by historical and scriptural examination. The retelling of the past is influenced by the present; memory is not static but takes on different shapes depending on the focus of concentration. However, tradition greatly influences the interpretation of religious history as well. In the book of Genesis, the literature emphasizes the divine appointment of male figures such as Abraham the father of the covenant and Jacob who is renamed and claimed by God as "Israel," placing them at the center of Jewish history. As a result, the other figures in these biblical narratives are described in relation to the patriarchs, those male bearers of the covenant, by their service or their value to him. Women are at the bottom of this hierarchy. Although female figures of exceptional quality are noted in later chronicles, such as Ruth, Deborah and Miriam, it is the very nature of their exception that highlights the androcentric editorial focus of the Torah. I agree with Peggy Day, whose own scriptural examination in Gender and Difference in Ancient Israel, makes the important distinction between the literary representation and the reality of ancient Israelite culture: they are not coextensive nor equivalent. Although the text represents the culture of ancient Israel as male dominated from the time of Abraham, this presentation omits the perspective of half of the population-the women. By beginning at the point of realization that women did exist and were active in their culture, and placing aside the androcentric perspective of the text and its editors, the reality of women's place in ancient Israel may be determined. Through this new perspective, the women of the Torah will emerge as the archetypes of strength, leadership and spiritual insight to provide Jewish women of the present with female, ancestral role models and a foundation for their gender's heritage, a more complete understanding of the partial record of Jewish history recorded in the Torah. Those stories that appear as the exception of women's presence will unveil an exceptional presence. As Tamar Frankiel eloquently states in The Voice of Sarah, "the women we call our 'Mothers'-Sarah, Rivkah (Rebekah), Rachel, and Leah-are not merely mothers, any more than the 'Fathers'-Abraham, Isaac and Jacob-are merely fathers "(Frankiel 5).

Natural Theology: A Reevaluation of Christianity's Relationship to the Natural World

In this thesis I offer two separate arguments for the creation of an environmentally friendly Christian theology. These arguments, although interconnected, are roughly divided into the main chapters of the thesis. I will begin in Chapter Two by offering a negative argument against the assumption that the natural world is sinful. In their article Hauerwas and Berkman suggest that the suffering of animals is both an example of the sinful state of the environment and a justification for human separation from an unholy natural environment. In response to this view I will argue in the second chapter that the suffering of animals can be seen as part of God's intentions for our world. Suffering, in both the human and the larger world, is not evidence of a fundamental flaw in natural systems. Instead, the cycle of death and life found in the natural world can be profoundly spiritual.

The Schwarmgeister: The Development of Ecclesiastical Doctrine Through Schismatic Movements

Throughout the Christian story, Church doctrine and ecclesiology have been shrouded in controversy. From the Council of Nicea in 325, when are early Church fathers debated about the Trinity of Christ all the way to the modern day with Vatican II theological controversies have been important in the molding of Christian doctrine on the structure, role, and function of the Church. What makes those controversies different from the ones I treat in my thesis is that the previously mentioned controversies did not lead to schismatic divisions in the Church. The Donatist controversy and Luther's theological battle with Karlstadt were major movements that endangered the unity of the Church. These controversies propagated crucial writings and teachings in two major areas. The first area is the spiritual power and validity of the sacraments. Second is the role, function, and ecclesiology of the Church, with particular attention to the authority of the ministry. I want to demonstrate that these controversies refined the Church's thinking on sacramental issues such as baptism and Eucharist, as well as address the question of who has the power in the Church? And to what extent do they have the power to press reforms?

Socio-cultural Degeneration and State Patronage of the Arts: Mapplethorpe, Cultural Crisis, and the NEA

The goal of this paper is to investigate how the Untied States federal government, specifically through the National Endowment for the Arts, or NEA, has acted in the position of an arts patron in the past few decades. Specifically, this paper will focus on the past decade and a half since the 'arts crisis' of the late 1980s and the social and political backlash against the art community in the 1990s, which was only against ‘offensive’ art that was seen as morally and culturally corruptive. I explore the political, social, and economic forms the backlash took, particularly rooted in a perceived fear of degenerative arts as a corruption of and a catalyst for the eventual collapse of American culture and values. Additionally, I analyse the role the federal government played in ‘ameliorating’ the situation. I investigate how state arts patronage has affected and continues to affect both the concepts behind and the manifestations of art, as well as who is encouraged, sanctioned, or neglected in the production of art. To accomplish this, I explore how and why the federal government employs the arts to define and redefine morality and culture, and how does it express/allow the expressions of these through art.

Oxford movement: its themes and their significance

In retrospective, the Oxford movement of nineteenth century England provides one with an interesting study of the struggles between the spiritual and secular worlds. However, repeated abstraction in an interpretation of its significance has tended to distort accurate understanding of its historical development. Often this also has resulted n a misinterpretation of the nature of its major themes and their significance to the world. For these reasons, this study has attempted to describe the origin, maturity, and dissolution of the series of events which strictly speaking may be considered to be the Oxford movement. In conclusion, liberty has been taken to comment on the nature of the Movement's themes and their significance in their own age and to man today.

Ethics in a capitalistic society

The problem of semantics is inherent in any discussion of ethics. The general term "ethics" is itself commonly confused. In addition, systems of ethics must be built upon assumptions, and assumptions are necessarily subject to lengthy debate. These two problems are encountered in my investigation of the ethical practices of the modern business community and to remedy the situation I have taken two steps: the first being an attempt to clarify the meaning of terms used therein;-and the second being a clear description of the assumptions utilized to further my analysis. To satisfy those who would disagree with these assumptions, I have attempted to outline the consequences of differing premises. The first assumption in my discussion is that the capitalistic economy is powered by the motivation supplied by man's self-interest. We are conditioned to basing our courses of action upon an orientation toward gratifying this self-interest. Careers are chosen by blending aptitude, interest, and remuneration. of course, some people are less materially inclined than others, but the average member of our capitalistic society is concerned with the physical rewards derived from his employment. Status and happiness are all-important considerations in pursuing a chosen course of action, yet all too often they are measured in physical terms. The normal self-interest natural to mankind is heightened in capitalism, due to the emphasis placed upon material compensation. Our thinking becomes mechanistic as life devolves into a complex game played by the rules. We are accustomed to performing meaningless or unpleasant duties to fulfill our gratifications. Thought, consequently, interferes with the completion of our everyday routines. We learn quickly not to be outspoken, as the outspoken one threatens the security of his fellow man. The majority of the people are quite willing to accept others views on morality, and indeed this is the sensible thing to do as one does not risk his own neck. The unfortunate consequence of this situation has been the substitution of the legal and jural for the moral and ethical. Our actions are guided by legal considerations and nowhere has this been more evident than in the business community. The large legal departments of modern corporations devote full time to inspecting the legality of corporate actions. The business community has become preoccupied with the law, yet this is necessarily so. Complex, modern, capitalistic society demands an elaborate framework of rules and regulations. Without this framework it would be impossible to have an orderly economy, to say nothing of protecting the best interests of the people. However, the inherent complexities, contradictions, and sometimes unfair aspects of our legal system can tempt men to take things into their own hands. From time to time cases arise where men have broken laws while acting in good faith, and other cases where men have been extremely unethical without being illegal. Examples such as these foster the growth of cynicism, and generally create an antagonistic attitude toward the law on the part of business. My second assumption is that the public, on the whole, has adopted an apathetic attitude toward business morality. when faced with an ethical problem, far too many people choose to cynically assume that, if I don't do it someone else will. "The danger of such an assumption lies in that it eliminates many of the inhibitions that normally would preclude unethical action. The preventative factor in contemplating an unethical act not only lies in it going against the "right course of action", but also in that it would display the actor as one of the few, immoral practitioners. However, if the contemplator feels that many other people follow the same course of action, he would not feel himself to be so conspicuous. These two assumptions underly my entire discussion of modern business ethics., and in my judgment are the two most important causal factors in unethical acts perpetrated by the business community. The future elimination of these factors seems improbable, if not futile, yet there is no reason to consider things worse than they ever have been before. The heightened public interest in business morality undoubtedly lies in part in the fact that examples of corporate malpractice are of such magnitude in scope, and hence more newsworthy.

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Bem comum, razoabilidade prática e direito : a fundamentação do conceito de bem comum na obra de John M. Finnis

Esta dissertação expõe a fundamentação do conceito de bem comum no pensamento de JOHN MITCHELL FINNIS. Este jusfilósofo tem como ponto de partida para sua reflexão uma reinterpretação da ética tomista. Dela interessa o tratamento dado à separação das quatro ordens de conhecimento, particularmente a separação entre ordem natural e prática. A ordem prática de conhecimento tem suas próprias diretrizes. Logo, assim como na ordem natural de conhecimento a primeira diretriz é o princípio da não contradição, na ordem prática o primeiro princípio é o bem é para ser feito e buscado e o mal evitado. Estes postulados não são imperativos e nem indicativos, mas diretivos; e, no caso da ordem prática, uma diretiva para ação. A implicação epistemológica está em que a fundamentação imediata do agir humano não reside na natureza humana, mas na percepção prática de bens a serem realizados e dos males a serem evitados. Há um número determinado de bens humanos básicos, que são as razões primeiras para o agir humano. Eles são objetivos, incomensuráveis, auto-evidentes e pré-morais. O rol que FINNIS propõe é vida, conhecimento, matrimônio, excelência na realização, sociabilidade/amizade, razoabilidade prática e ‘religião’. O conteúdo da moral resulta destes bens humanos e tem como princípio supremo toda a escolha deve favorecer e respeitar o bem humano integral. Além de sintetizar a correção para o agir individual, a moral também fundamenta e demanda um agir social correto, que está expresso no conceito de bem comum. FINNIS define bem comum nos seguintes termos: um conjunto de condições que tornam aptos os membros de uma comunidade a alcançar por si mesmos objetivos razoáveis, ou realizar razoavelmente por si mesmos o(s) valor(es) pelos quais eles têm razão em colaborar uns com os outros (positiva e/ou negativamente) em uma comunidade. O conteúdo específico do bem comum da comunidade política é constituído pela justiça. O direito é o objeto da justiça e, assim, meio pelo qual o Estado a realiza e, por conseqüência, o bem comum.

Controle social exercido através da denúncia no âmbito do TCE-RJ

The crisis that affected the capitalist states during the last decade of the 20th century, put an end to the period of greatest expansion of the state, demanding alterations that brought, especially in economic terms, the ideals of the liberal state. The main goal of these changes was to optimize the administration of the public service by introducing into it more efficiency, transparency, and morality because the state had shown to be incapable of attending the demands of the society and its way of doing was inefficient and did not reach out to the public interest. In Brazil, like in other part of the world, recent scandals of corruption and misuse of public funds put in doubt the efficiency of the financial control system. Like any other political system Brazil has a complex set of external and internal control, institutions that work to prevent misuse of public funds and identify responsibilities if bad use occurred. All these elements highlight the mechanisms of control of the public administration, which came to be seen as essential instruments for the improvement of the management of the public resources, targeting the collective interest. Therefore, along with the traditional mechanisms of power suppression, such as the system of checks and balances, social control arises. This, when used together with the monitoring exercised by public inspection agencies, is defined as horizontal accountability activated by civil society, in which citizens and institutions gather efforts in order to promote a more effective charge of responsibility from public agents and politicians in case of misconducts. This study aimed to identify the opportunities and limitations of social control exercised by the complaint under the TCE-RJ. The results point to the need to develop measures to guarantee the anonymity of denouncers, to simplify the forms of access the TCE-RJ and to improve information spread to the citizen.

Sustentabilidade e Desenvolvimento Local: Estudo de Projeto na Formação da Ecovila Viver Simples em Itamonte - MG

Eco-villages are considered models of intentional communities or sustainable communities and have been incorporated by the United Nations in the Sustainable Communities Development Programme (SCDP) as a human scale settlement. They are characterized by human activities being integrated in a non-damaging way into the natural world in such a way as to give support to healthy human development so as to be able to continue indefinitely into the future. This text assesses the extent to which a project to create the Eco-village for Simple Living in Itamonte - Minas Gerais" is successful, based on the concepts of sustainability and local development succeeds, by examining the indicators and attributes that are able to be measured in the planning phase, describing the stages and discussions of the project, as well as assessing the members 'perception of "the concepts of the Eco-village", "sustainability" and "local development". Subsequent analysis of the degree of sustainability (ecological, social, economic, spacial and cultural / spiritual) and local development, based on the social economy, demonstrated the presence of a number of aspects used to support, guide, discuss, plan and implement actions in the creation of the Eco-village being studied. This work could be used as a guide to Eco-villages during the planning phase, indicating the importance of the concepts studied, especially for some communities which are self-proclaimed "Eco-villages" but which in fact do not show even the slightest structural aspects which would describe them as such, like solidarity in the relations between participants, or construction oriented with a view to the precepts of environmental preservation. "

Limites e possibilidades da gestão sob o enfoque holístico

O tema Gestão sob o enfoque holístico surgiu a partir de uma leitura da revista HSM Management de setembro-outubro/2000. O artigo abordava o novo paradigma de gerenciar funcionários, que privilegia a busca do bem-estar, onde muitas empresas estão sendo obrigadas a revisar suas políticas de recursos humanos para enfocar as três dimensões de um indivíduo - corpo, mente e espírito. Segundo a reportagem, pesquisas da PricewaterhouseCoopers, Universum e outras organizações constataram que o equilíbrio trabalho/vida não é apenas uma demanda dos atuais empregados, mas também uma das principais prioridades dos formandos em universidades do mundo todo. A intensa luta para atrair funcionários de alto gabarito colocará a empresa com abordagem mais holística um degrau acima de suas concorrentes. Para as empresas, atender as verdadeiras necessidades individuais de seus funcionários é um novo paradigma na maneira de gerenciar seus negócios. O que mudou é a percepção de que o ser humano é fator primordial de competitividade e deixou de ser insumo. O ser humano passou a ser tendencialmente o centro, o foco das relações. Ainda que este conceito aparente estar longe da realidade organizacional brasileira, em função da distância entre o discurso e a prática de um modelo de gestão que considere o funcionário como um ser integral, já temos exemplos de empresas que estão adotando este princípio. A necessidade do equilíbrio entre os aspectos físico, mental, emocional e espiritual para ser feliz, tem levado as pessoas a superarem o medo do desconhecido e caminhar com detenninação em direção ao autodesenvolvimento. Este estudo analisou a utilização da gestão sob o enfoque holístico em duas diferentes empresas. Os resultados evidenciaram que a abordagem holística não está no âmbito da utopia, antes trata-se de um desafio para os gestores das organizações que, para um sucesso na adoção desta prática, precisam, mais do que implantá-la, adotá-la como filosofia de vida, incorporando-a a seus valores e visão de mundo. A prática cotidiana do modelo de gestão holística a partir do corpo diretivo é que vai possibilitar a verdadeira transformação da cultura organizacional tradicional para uma cultura organizacional holística, cuja conseqüência é o reflexo positivo nos resultados econômico-financeiros. C onstatamos, por outro lado, as limitações na utilização desse modelo de gestão tanto por parte dos funcionários quanto por parte dos altos executivos. Quanto aos funcionários, nem todos estão preparados para assumir novas responsabilidades ou preparados para o seu desenvolvimento pessoal, através do auto conhecimento. As crenças adquiridas no período educacional, tanto no lar quanto na escola, bem como suas recentes experiências profissionais podem inibir a descoberta de novas possibilidades, até que se sintam compelidos a lidar com os novos conhecimentos por necessidade de empregabilidade. Quanto aos executivos, por se tratar de um modelo de gestão relativamente novo, sem comprovação científica aliado à dificuldade de encontrar instrumentos de medição objetivos e ao elevado nível de exigência quanto a resultados crescentes no curto prazo, acabam priorizando a administração por objetivos, por se sentirem mais confortáveis quanto à certeza de obtenção de resultados econômico-financeiros no curto prazo. Esquecem-se, no entanto, dos efeitos desastrosos no clima organizacional, que vão comprometer os resultados de médio e longo prazos, seja pela possibilidade de elevado turnover como pela desmotivação generalizada, onde os funcionários só trabalham sob pressão. Por sua vez, cientes da importância do ser humano no novo cenário de elevada competitividade, não são poucos os empresários que já estão começando a trabalhar seus valores intrinsecos com a ajuda de terapeutas, filósofos, psicólogos, estimulando primeiro o auto conhecimento pessoal, para que possam futuramente empreender essa nova maneira de ver o mundo em suas respectivas empresas.

O Instituto das Súmulas Vinculantes e sua cogente alteração legislativa: a análise do verbete nº 13

O Supremo Tribunal Federal entregou ao ordenamento jurídico brasileiro, em 21 de agosto de 2008, a súmula vinculante nº 13. O referido verbete trata da vedação a nomeações de cônjuge, companheiro ou parente em linha reta, colateral ou por afinidade até o terceiro grau, no âmbito da administração pública direta e indireta, em todas as esferas. Antes da vigência da súmula vinculante nº 13, o nepotismo era praticado de forma nebulosa, tendo em vista a ausência de uma fiscalização eficaz e eficiente. Os Estados e Municípios, através de legislação própria, buscaram o combate a essa prática em momento anterior à edição do verbete, o país carecia de uma regra geral. A partir do início da vigência da súmula vinculante nº 13, o que se verificou, no âmbito da administração pública brasileira, como será demonstrado adiante, foram diversas exonerações de servidores por simples suposição de que determinada situação jurídica configuraria nepotismo, cenário totalmente contrário àquele então proposto.. O STF manifesta-se face aos casos concretos apenas em sede de reclamação. Têm-se, atualmente, uma situação de grave insegurança jurídica, onde servidores públicos não sabem se podem ou não ser nomeados ou se podem continuar exercendo suas funções. O presente exame, pautado no direito comparado e em estudo de casos, analisou algumas situações hipotéticas que, supostamente, configurariam nepotismo, e outras já decididas pela Suprema Corte e propõe uma alteração de natureza legislativa ao instituto das súmulas vinculantes: a criação de incisos a incluídos no corpo do enunciado após cada decisão em sede de reclamação, cujos efeitos não possuem efeito vinculante. Dessa forma, a administração pública direta e indireta poderá aplicar a súmula vinculante nº 13 de forma eficaz, sem interpretações equivocadas, de modo a permitir uma sintonia entre a segurança jurídica e a moralidade.

Controle de constitucionalidade no processo administrativo tributário

Este estudo aborda a viabilidade de enfrentamento, pela autoridade julgadora em processo administrativo fiscal, do argumento de inconstitucionalidade da lei que determina a exigência do tributo. Procede-se a uma análise crítica, a partir de precedentes dos Conselhos de Contribuintes do Ministério da Fazenda, da solução usualmente adotada, de não-conhecimento da irresignação do contribuinte, sob o fundamento da reserva de jurisdição. A proposta defende a possibilidade de pronunciamento do julgador administrativo, com efeitos para o caso concreto, além de sustentar a hipótese como um direito do contribuinte, à luz da garantia constitucional do devido processo legal e dos princípios da legalidade, da moralidade e da eficiência.