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PubMed1997

Health care allocation and selective neglect in rural Peru.

This study of health care allocation to children in northern Puno, Peru, utilizes quantitative and qualitative data to explore differential resource allocation to children in rural Andean households. As part of a broader ethnographic study of health in two communities, quantitative data on reported health status, symptoms, and treatments (both lay and specialist) were collected for 23 children under the age of 7 over a one year period. Additional data were collected from local health post records. Data were analyzed by gender, and by three age groups (birth to 1 year, 1-3 years, 4-6 years) to determine if differences existed in the allocation of health care. The data suggest a pattern of discrimination against females and younger children, especially infants under age one, despite the fact that these groups were reported to be sicker. Differences were especially significant in the allocation of biomedical treatments, the most costly in terms of parental time, effort, and money. Ethnographic data on child illness, gender, and developmental concepts help to explain why children of different genders and ages may be treated differently in the rural andes. They provide a context in which to interpret health care allocation data, and, in the absence of a population-based study, reinforce findings based on the limited study sample. Female children are valued less because of their future social and economic potential. Females are also regarded to be less vulnerable to illness than male children, meaning that less elaborate measures are necessary to protect their health. Young children are thought to have a loose body-soul connection, making them more vulnerable to illness, and are though to be less human than older individuals. The folk illnesses uraña (fright) and larpa explain child deaths in culturally acceptable ways, and the types of funerals given to children of different ages indicate that the death of young children is not considered unusual. Health care allocation and ethnographic data suggest that selective neglect (passive infanticide) may be occurring in rural Peru, possibly as a means of regulating family size and sex ratio. It is important to go beyond placing blame on individual parents or on culture, however, to address the underlying causes of differential health care allocation, such as poor socioeconomic conditions, lack of access to contraceptives, and female subordination.

Age Factors↗
PubMed1999

Considerations for the control of equine cyathostomes in arid areas.

Internal parasites of horses are ubiquitous but that does not suppose that the level of infection does not vary with climatic conditions. Climate determines the limits of where a parasite species can survive the external environment and weather determines the transmission pattern within the climatic bounds [Levine, N.D., 1963. Adv. Vet. Sci. 8, 215-261]. Arid areas have a more limited exposure potential to important parasites but the level of exposure can nonetheless lead to disease. It must be remembered that, even in arid areas, it does rain and irrigation, overflow from water troughs, dew dripping off buildings and on the vegetation can also provide the medium to allow escape of larval cyathostomes from feces to forage. How horses earn their living is most important in determining the level of exposure to cyathostomes. Recreational grazing, which surely does more for the soul of the owner than for the nutrition of the horse, almost absolutely insures that horses will encounter larvae. To be certain, in arid areas there may be an opportunity for horses to spatially separate grazing and dunging areas but not all horses are so disposed, and even if they are they may not be able to do so.

Animals↗
PubMed2000

Caring for caregivers: experiences and evaluation of interventions for a palliative care team.

Palliative care is a fairly recent development in The Netherlands. The first palliative unit in a hospital setting was the Palliative Care Unit (PCU) in the Dr Daniel den Hoed Clinic, a specialized oncology hospital, now part of the Academic Hospital Rotterdam (AZR-Daniel). This PCU was designed to function as an academic laboratory, where palliative care concepts are being developed, put into practice, and evaluated. It's mission was to put the patient first in mind, heart and soul. Right from the start, special attention was paid to the implementation a system of 'care for caregivers' in order to support the staff of the PCU in caring for the terminally ill and to prevent burnout. A process evaluation has been carried out with a special focus on the effects of the implementation of the new unit on the wellbeing of the interdisciplinary team of caregivers during the first year of its existence and on the experiences with a residential training preceding the start of patient care activities and the weekly staff support meetings. In the second half of the first year, the PCU staff experienced increased levels of job-related stress. Most stress was attributed to organizational factors, related to management issues but also to lack of institutional support. Teamwork also contributed to stress within the interdisciplinary team. Direct patient care activities also had some impact on experienced stress levels, through a heavy work-load of complex care, a shortage of staff and an experienced lack of competence. While the staff support activities were designed to give emotional support and deal with death and bereavement, these issues did not arise as major problems. As a consequence, the staff support in the PCU was perhaps less successful than it could have been. However, the high stress levels of this innovative palliative team warrant attention. We discuss how support meetings could be a more effective way of caring for staff. They should be accompanied by adequate resources, a supportive management structure, and an extensive educational program.

Adult↗
PubMed2000

The value of advocacy in promoting social change: implementing the new Domestic Violence Act in South Africa.

South Africa's first democratic government passed the Domestic Violence Act (DVA) into law in 1998 as part of local and international commitments to protecting the human rights of women. Although the Act was welcomed as groundbreaking legislation, delays in implementing it led to increasing frustration. This paper describes an advocacy campaign conducted by the Soul City Institute for Health and Development Communication in partnership with the National Network on Violence against Women, to ensure the effective implementation of the DVA. Lessons from the campaign stress the importance of coalition building to draw on diverse strengths, and the use of a combination of advocacy tools, including lobbying, media advocacy and social mobilisation to achieve campaign goals. Given the critical role NGOs dealing with victims/survivors of domestic violence and the justice system played in lobbying for change and drafting the new law, their exclusion from the implementation process was ironic. While many advocacy efforts focus on the development of policy and legislation, ongoing efforts are needed to ensure effective implementation, the commitment of adequate resources and monitoring to identify gaps and propose new solutions. Our experience highlights the important role of policy advocates in connecting the multiple streams at play in the policy and legislative arena.

Communication↗
PubMed1996

The bigger the crisis, the bigger the opportunity!

Every time I pick up the newspaper, a scientific or nursing journal, or more recently, an issue of Time, I find data, complete with startling facts and figures, that pierce my very soul, about the tragedies occurring in our nation's hospitals caused by the restructuring movement attempting to make health care a "bottom line" business. And I know all too well, as do most of you, how undetermined and tentative we are about the future for nurses.

Career Mobility↗
PubMed1998

Hysterosonography as an adjunct to transvaginal sonography in the evaluation of intraluminal lesions of the uterine cavity.

Objective: Hysteroscopy is a simple technique that can be used to outline the contours of the uterine cavity under real-time ultrasound guidance. This study was undertaken to determine whether hysterosonography can be used as an adjunct to transvaginal sonography in predicting either the presence or absence of intraluminal lesions in the uterine cavity and in distinguishing these lesions from subendometrial or myometrial lesions.Methods: In this retrospective analysis, 1,467 transvaginal sonograms performed in the office of a single gynecologic oncology practice from March 1996 through June 1997 were reviewed. Of these, 38 sonograms were considered to have possible intraluminal lesions of the uterine cavity and thus further evaluated by hysterosonography. The principle investigator performed all the hysterosonograms by infusing 15-30 mL of sterile saline directly into the uterine cavity using a Soules 5.3F transcervical catheter. Real-time transvaginal sonography was performed simultaneously, and representative images were compared with the initial transvaginal sonograms.Results: Successful hysterosonograms were obtained in 36 patients (97.3%). One patient had cervical stenosis from a previous conization, precluding access to the uterine cavity. The hysterosonography was tolerated well by the patients with minimal discomfort. There was no incidence of endometritis. The median age was 56.2 years. Postmenopausal bleeding was the most common presenting symptom (30.0%). The indications for hysterosonography were abnormal findings on the initial transvaginal sonograms including lesions suggestive of intraluminal mass (73.0%), thickened endometrial stripe (13.5%), and increased echogenicity (10.8%). Hysterosonography revealed presence of intraluminal masses in only 11 of the 31 cases (35.5%) that had been suggested to contain either a mass or thickened endometrial stripe. Subsequent hysteroscopy, dilatation, and curettage confirmed the presence of endometrial polyp in all 11 cases. The remaining 65.5% contained no intraluminal masses or thickened endometrial stripe.Conclusion: Hysterosonography can be a valuable adjunct to transvaginal sonography and may be used in selected cases to eliminate the need for hysteroscopy, dilatation, and curettage.

Journal Article↗
PubMed1998

Legionellae.

Legionellae cannot be eradicated from the water supply, since they are naturally occurring and ubiquitous. Routine bacteriologic culturing of man made aquatic environments is not recommended (Soule et al 1995). Therefore any water use that results in production of aerosols should be regularly evaluated to ensure the source has not been contaminated with the bacteria. Any aerosolised water entering a sterile area such as the lungs should be sterile. Tap water should not be used to rinse any respiratory therapy equipment. Routine maintenance of water supplies to eliminate sediment and scale from tanks and trays is essential (Benenson 1995, Lowry & Tompkins 1993). Australian & New Zealand Standard AS/NZ 3666-1995 Parts 1 and 2 outline these requirements.

Australia↗
PubMed2003

Imagework as a means for healing and personal transformation.

This article explores the place that imagework, an interactive imagery process, has in enabling patients to make sense of physical and emotional illness and how it can be the means for healing and profound life change. It discusses how, through expanding patients' awareness of the interconnection between body, mind and soul, the outcome of the disease process can be affected. The differences between imagework and visualisation; healing and cure are highlighted, and case notes, with examples of how imagework can help to gain a larger perspective on illness, are used.

Anecdotes as Topic↗
PubMedDate not supplied

Visual clues to emotional states: Rodin's "Burghers of Calais".

In the well-known, recorded Gsell-Rodin conversations of 1911, Gsell summarized Rodin's theory of the expressiveness of the human image: "Generally the face alone is considered to be the mirror of the soul: the mobility of the features of the face seems to us the unique exteriorization of the spiritual life. In reality, there is not one muscle of the body that does not express variations within. Each speaks of joy or sadness, enthusiasm or despair, calm or rage. Out-stretched arms, an unrestrained torso can smile with as much sweetness as eyes or lips. But in order to be able to interpret all aspects of the flesh, one must be trained patiently in the spelling and reading of the pages of this beautiful book" (Art: Conversations With Paul Gsell. Translated by deCaso J, Sanders PB. Berkeley, CA, University of California Press, 1984, p 10). The question thus arises, how can we as students of the human condition undertake this necessary training? How might we develop the aesthetic senses to appreciate the legibility of the human face and form more fully? For assistance in this undertaking we naturally turn to the artist. For the artist "sees" the world through eyes trained to acutely appreciate color, light and shadow, surface and volume, and inner truth. In particular, the education and training of Rodin, and the development of his artistic technique and insight, offer the health care professional rich intellectual material for this study. A closer look at the conception and evolution of Rodin's masterpiece, "The Burghers of Calais," amply illustrates this vision.

Altruism↗
PubMed2001

X-ray Crystal Spectrometers and Monochromators in Microanalysis.

Castaing's successful implementation and application of the electron probe microanalyzer in 1950 stimulated a flurry of development activity around the world. The later versions of this instrument represented a truly international effort, with significant contributions by scientists from Europe, Asia, and North America. If the probe-forming system of the instrument was its heart, the X-ray wavelength spectrometer was its soul. This article reviews some of the history of spectrometer developments-through the "golden years" of microprobe development, namely the dozen or so years following the publication of Castaing's thesis, to the present. The basic physics of spectrometer and crystal design is reviewed. Early experimental devices, such as those developed by Castaing, Borovskii, Wittry, Duncumb, and Ogilvie are reported. Examples of commercial spectrometers such as those by ARL, MAC, Microspec, and Peak are described. Recent developments such as the combination of grazing-incidence optics with flat crystal spectrometers are noted, and the properties and uses of doubly curved crystals are discussed. Finally, the continued development of doubly curved crystal configurations, such as the "Wittry geometry" for scanning monochromators, and point-to-point focusing diffractors for producing small monochromatic X-ray probes to provide improved detection limits for microanalysis are considered.

Journal Article↗
PubMed1976

The role of imagination in the disease process: pre-Cartesian histroy (the role of imagination in the disease process).

Ancient and Renaissance physicians implicated the soul's imaginative faculty in the genesis and remission of disease. The theory stated that images of objects of desire or aversion aroused emotions, which in turn set up humoral imbalances, disturbing digestion and other vital functions, culminating in various forms of pathology. This concept explained the therapeutic efficacy of 'placebos' in forms such as spells, charms and talismans. The theory merits close attention by contemporary physicians and researchers.

History of Medicine↗
PubMed1995

The phenomenology and explanatory models of common mental disorder: a study in primary care in Harare, Zimbabwe.

In order to describe the explanatory models and the etic and emic phenomena of common mental disorder in Harare, Zimbabwe, 110 subjects were selected by general nurses in three clinics and by four traditional healers from their current clients. The subjects were interviewed using the Explanatory Model Interview and the Revised Clinical Interview Schedule. Mental disorder most commonly presented with somatic symptoms, but few patients denied that their mind or soul was the source of illness. Spiritual factors were frequently cited as causes of mental illness. Subjects who were selected by traditional healer, reported a greater duration of illness and were more likely to provide a spiritual explanation for their illness. The majority of subjects were classified as 'cases' by the etic criteria of the CISR. Most patients, however, showed a mixture of psychiatric symptoms that did not fall clearly into a single diagnostic group. Patients from a subgroup with a spiritual model of illness were less likely to conform to etic criteria of 'caseness' and they may represent a unique category of psychological distress in Zimbabwe. A wide variety of emic phenomena were elicited that have been incorporated in an indigenous measure of non-psychotic mental disorder. Kufungisisa, or thinking too much, seemed to be the Shona term closest to the Euro-American concept of neurotic illness.

Adolescent↗
PubMed1987

Arthur Wigan and The Duality of the Mind.

It is not easy to see a simple outline in the progress of the idea of duality, because it did not develop evenly or reach the stage of general acceptance. From the seventeenth century there were shifts in some of the basic assumptions about how the brain and mind functioned, and there are some useful markers along the way to an era of more systematic studies. Descartes is the most convenient base. He had earlier firmly separated mind and matter in his philosophy, and is still chiefly known for that. But at the end of his life (1649) he tried to reconcile them by the device of a specific 'seat of the soul' in the brain through which information passed between brain and mind. Symmetry of the operation of the hemispheres was assumed. This theory had currency into the eighteenth century. At the end of that century Franz Gall of Austria and France was assigning discrete faculties to numerous parts of the brain on no strong evidence, and nothing the double form of the brain, without claiming independent action of the hemispheres. Hewett Watson in 1836 discussed duality more directly than had been the case before, and Arthur Wigan in 1844 asserted the duality of the mind roundly and treated the two hemispheres, not consistently, as two independent brains. He was not satisfied with independence, however, and tried various ways of allowing for joint action by the two sides of the brain, as well as for substitution, with one side having the power to act on behalf of both in cases of disease or injury. He also considered that one hemisphere, usually the left, was generally dominant; but he did not see the two hemispheres as differently constituted. Recognition of differentiation of function between the two sides came chiefly out of the largely French discussions, in the 1820s and after, about the location--frontal or not--of 'language', and out of the work and arguments of the middle of the century. Broca's left frontal language centre became widely known, though its experimental base was weak and he himself seems to have been more interested in the fact that it was frontal (the older debate) than in its one-sidedness. Brown-Séquard did not accept Broca's findings because of his general opposition to specific locations for particular functions; but he enthusiastically revived Wigan's notions of duality, without developing them further.(ABSTRACT TRUNCATED AT 400 WORDS)

Bibliographies as Topic↗
PubMed2000

Making a difference: the social ecology of social transformation.

A multidisciplinary and multilevel framework for social transformation is proposed, encompassing four foundational goals: capacity-building, group empowerment, relational community-building, and culture-challenge. Intervention approaches related to each goal are presented at the setting, geographic community, and societal levels. Four exemplars of social transformation work are then discussed: the Accelerated Schools Project, Meyerhoff Program, ManKind Project, and women's movement. These examples illustrate the synergistic relationship among the four transformational goals, within and across levels of analysis, which is at the heart of the social transformation process. The paper concludes with three challenges to guide our efforts as we enter the new century: (1) to move social transformation to the center of our consciousness as a field; (2) to articulate jointly with allied disciplines, organizations, and citizen groups an encompassing, multidisciplinary, and multilevel framework for social transformation; and (3) to do the above with heart, soul, and humility.

Culture↗
PubMed1998

Research notes on social order and subjectivity: individuals' experience of susto and fallen fontanelle in a rural community in central Mexico.

Disciplines such as sociology and anthropology have showed that the experience of illness, is above all, a social product, that is, that social factors of different kinds play a central role in shaping individuals' subjectivity. This paper refers to the case of Ocuituco, a rural town of central Mexico. The article presents some of the results achieved through an interpretive sociological study of individuals' subjective experience of traditional illnesses such as susto, soul-loss, and fallen fontanelle. The aim is to analyze how Ocuituco's inhabitants attach meaning to, interpret, and experience these illnesses. The main point being made is that the subjective experience of traditional illnesses is shaped both by the cultural background of individuals, and by the sociological features of the setting where these individuals live. Data are interpreted in connection both to structural factors (poverty, medicalization, and patriarchy), and to the main traits that characterize individuals' view of their world: a sense of uncertainty, a sense of the unexpected as being normal, a sense of being oppressed, a familiarity with a patriarchal order. It is shown that both susto and fallen fontanelle are belief systems which allow individuals to interpret their circumstances and attach meaning to their problematic everyday life.

Adaptation, Psychological↗
PubMed1999

[Psychological aspects in surgery--surgical aspects in psychology: psychosomatic medicine in routine practice?].

Medicine appears to have reached a standstill, in particular surgery: While progress in apparative diagnostics and therapy, e.g. by ultrasound, endoscopy, laparoscopy, and arthroscopy, has reached in some areas "breathtaking speed", the parties concerned-surgeons and patients-lose in reserve air to breathe: no time for any profound consideration, no chance for in-depth talking before surgical procedures are performed, no training for giving real support after surgery. Do we see a brand of surgery which feels responsible only for a human machine without soul? Meanwhile discussions have begun inside medicine in general about a change of paradigms, ways of thinking, the model of the world. Surgery can even make substantial contributions to this change of paradigms. Surgery for the human machine? Psychosomatic ways of thinking are first seen not applicable for surgery. Substantial anxiety exists to take notice of each other. Three concrete examples from everyday practice in surgery demonstrate, how psychosomatic thinking can change and enrich surgical practice: From the area of indications reflections about appendectomy, from the operative-surgical area the phenomenon of self-destructive behaviour, from the restitutive area experiences in treatment of osteomyelitis. Back to the interpersonal area! Psychosomatics must be recognised as a way of thinking and be integrated as such into surgery. A so-called "integrated surgery" will arise. The examples demonstrate also, that it is not some anonymous surgical medicine, which must and can change, but that only the individual surgeon as a concrete person can bring back his work into the interpersonal area.

Adaptation, Psychological↗
PubMed2002

Conflicting perspectives on shamans and shamanism: points and counterpoints.

Shamans' communities grant them privileged status to attend to those groups' psychological and spiritual needs. Shamans claim to modify their attentional states and engage in activities that enable them to access information not ordinarily attainable by members of the social group that has granted them shamanic status. Western perspectives on shamanism have changed and clashed over the centuries; this address presents points and counterpoints regarding what might be termed the demonic model, the charlatan model, the schizophrenia model, the soul flight model, the degenerative and crude technology model, and the deconstructionist model. Western interpretations of shamanism often reveal more about the observer than they do about the observed; in addressing this challenge, the study of shamanism could make contributions to cognitive neuroscience, social psychology, psychological therapy, and ecological psychology.

Awards and Prizes↗
PubMed2005

Neoscholastic psychology revisited.

Beginning around 1879, a Neoscholastic psychology developed, an experimental psychology with a soul. Opposed to materialism, it sought to renew Scholastic philosophy by incorporating the findings of the natural sciences. Neoscholastic psychology is an important chapter in the history of the relationships between science and religion in the 20th century. Neoscholastic psychology was both experimental and philosophical. This article presents the main accomplishments of North American Neoscholastic psychology in academic and applied areas. Neoscholastic psychologists championed scientific psychology while insisting on a better conception of human nature. Philosophical critiques led to a decline of Neoscholasticism; after the 1960s it was no longer official Catholic philosophy. Neoscholasticism gave psychologists concerned with philosophical questions impetus to turn to phenomenology, existentialism, and humanistic psychology.

Catholicism↗