Literary perspectives on ageing.
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OBJECTIVE: The aim was to review the literature on female perpetrated child sexual abuse by highlighting how cultural myths about women inhibit recognition of this much hidden phenomenon. METHOD: Three sections are presented. Part 1 evaluates evidence concerning beliefs about child sexual abuse by women which minimize the problem. Part 2 provides a theoretical account of psychological processes that are hypothesized to maintain these beliefs. Part 3 illustrates that professionals working in the area of child sexual abuse are not immune to these processes. As a result, recommendations for future professional practices are made. RESULT: The paper demonstrates that in the context of what is known about child sexual abuse, cultural beliefs which serve to idealize women and minimize their potential harm to children are largely invalid. CONCLUSION: Individuals are urged to suspend their disbelief about female perpetrated child sexual abuse. Denial of the phenomenon may result in it continuing to be under-reported and trivialized. As this persists the price will ultimately be paid by victims of on-going abuse and survivors of past victimization whose suffering will be compounded by disparagement of the issue.
Newton has become a legendary figure belonging to the distant past rather than a historical person who lived at a specific time. Historians and scientists have constantly reinterpreted many anecdotal tales describing Newton's achievements and behaviour, but the most famous concerns the falling apple in his country garden. Newton's apple conjures up multiple allegorical resonances, and examining its historical accuracy is less important than uncovering the mythical truths embedded within this symbol. Because interest groups fashion different collective versions of the past, analysing mythical tales can reveal fundamental yet conflicting attitudes towards science and its practices.
External defibrillation was first reported in 1956, mouth-to-mouth ventilation was first reported in 1958, and closed-chest compression in 1960. While these developments began the modern era of CPR, accounts of resuscitative efforts go back to ancient times. The guidelines for CPR and emergency cardiac care (ECC) have evolved through five national conferences, held in 1966, 1973, 1979, 1985, and most recently in February 1992. The purpose of these conferences was to review and update published materials in the light of scientific advances and clinical experience. This issue of the Annals of Emergency Medicine contains the proceedings of the most recent National Conference on CPR and ECC. At this conference, a consensus was reached by an international gathering of scientists and clinicians for guidelines on adult basic and advanced life support, as well as on pediatric and neonatal life support.
This paper reports the use of a mythic journey scenario within a student nurse groupwork session. This approach was introduced as a means to facilitate personal and interpersonal sharing and self-knowledge. These processes are held as important for the development of critical reflective process as a cornerstone of contemporary nursing practice. The use of myth invoked a coherent and supportive student environment within which previously reticent students appeared confident enough to contribute and explore their educational experience in nursing. The mythic allegoric process also identified some poignant themes and enemies, common across the student body. Monsters no less!
Human migration can make it more difficult to detect geographic differences in disease risk because of the spatial diffusion of people originally exposed in a given geographic area. There are also situations where migration can facilitate the detection of disease attributable to environmental hazards. This paper assesses the effects that migration has on the ability to detect regional variability in disease risk. Several characteristics of migration are discussed, including some that are not widely known. Because of regional variations in mobility rates and other characteristics of the migration process, there is substantial regional variation in the ability to detect spatial variation in risk.
As medical treatment for AIDS has become more complex, the need for good palliative and end-of-life care has also increased for patients with advanced disease. Such care is often inadequate, especially among low-income, ethnic minority patients. The current study investigated physicians' experiences with caring for dying HIV patients in an underserved, inner city community in the Bronx, NY. The goals of the study included: (1) to investigate the barriers to effective end-of-life care for HIV patients; and (2) to examine physicians' experiences of role hindrance and frustration in caring for dying patients in the era of HAART. Qualitative, open-ended interviews were conducted with 16 physicians. Physicians identified two core, prescriptive myths shaping their care for patients with HIV. The 'Good Doctor Myth' equates good medical care with the delivery of efficacious biomedical care. The role of the physician is defined as technical curer, while the patient's role is limited to consultation and compliance. The 'Good Death Myth' envisions an ideal death which is acknowledged, organized, and pain free: the role of the physician is defined as that of comforter and supporter in the dying process. Role expectations associated with these myths were often disappointed. First, late-stage patients refused to adhere to treatment and were thus dying "unnecessarily." Second, patients often refused to acknowledge, accept, or plan for the end of life and as a result died painful, chaotic deaths. These realities presented intense psychological and practical challenges for providers. Adaptive coping included both behavioral and cognitive strategies. Successful adaptation resulted in "positive engagement," experienced by participants as a continuing sense of fascination, gratification, and joy. Less successful adaptation could result in detachment or anger. Participants believed that engagement had a powerful impact on patient care. Working with dying HIV patients in the post-HAART era of efficacious treatment challenges physician's cherished roles and values. Physicians adapt to the challenge through a variety of cognitive and behavioral strategies. The failure to adapt successfully has psychological consequences for providers that may impact patient care.
In 1854, Dr. John Snow identified the Broad Street pump as the source of an intense cholera outbreak by plotting the location of cholera deaths on a dot-map. He had the pump handle removed and the outbreak ended...or so one version of the story goes. In medical geography, the story of Snow and the Broad Street cholera outbreak is a common example of the discipline in action. While authors in other health-related disciplines focus on Snow's "shoe-leather epidemiology", his development of a water-borne theory of cholera transmission, and/or his pioneering role in anaesthesia, it is the dot-map that makes him a hero in medical geography. The story forms part of our disciplinary identity. Geographers have helped to shape the Snow narrative: the map has become part of the myth. Many of the published accounts of Snow are accompanied by versions of the map, but which map did Snow use? What happens to the meaning of our story when the determinative use of the map is challenged? In his book On the Mode of Communication of Cholera (2nd ed., John Churchill, London, 1855), Snow did not write that he used a map to identify the source of the outbreak. The map that accompanies his text shows cholera deaths in Golden Square (the subdistrict of London's Soho district where the outbreak occurred) from August 19 to September 30, a period much longer than the intense outbreak. What happens to the meaning of the myth when the causal connection between the pump's disengagement and the end of the outbreak is examined? Snow's data and text do not support this link but show that the number of cholera deaths was abating before the handle was removed. With the drama of the pump handle being questioned and the map, our artifact, occupying a more illustrative than central role, what is our sense of Snow?
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To determine if there is any effect of the full moon on emergency department (ED) patient volume, ambulance runs, admissions, or admissions to a monitored unit, a retrospective analysis of the hospital electronic records of all patients seen in an ED during a 4-year period was conducted in an ED of a suburban community hospital. A full moon occurred 49 times during the study period. There were 150,999 patient visits to the ED during the study period, of which 34,649 patients arrived by ambulance. A total of 35,087 patients was admitted to the hospital and 11,278 patients were admitted to a monitored unit. No significant differences were found in total patient visits, ambulance runs, admissions to the hospital, or admissions to a monitored unit on days of the full moon. The occurrence of a full moon has no effect on ED patient volume, ambulance runs, admissions, or admissions to a monitored unit.
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