This is an ethnographic study of discourses and experiences concerning sexual exchanges among kin “who are too closely related to marry each other” (OED), or what in lay language is called “incest”. I investigate the ways in which a certain kind of incest, that between older men and younger women, primarily from different generations, is experienced by women of predominantly rural origin, who have been hospitalized in the major public psychiatric hospital in Bolivia, in Sucre. In this sense, this research is as much a study of incest as it is of psychiatric institutionalization. These experiences will be considered in the context of a wider field of ethnic, class and gender discourses that are produced by medical staff, community organizations, as well as national judicial institutions. The category of 'incest' is problematized in terms of how kinship is constructed, not only as a series of dynamic discourses (as practices whose effect is the production of events) but also as mobile experiences, however socially regulated. With this in mind, I present an account of Andean concepts and treatment of incest, as well as of legal and medical categories. Specifically, I focus on the play between discourses in the context of the psychiatric hospital, the judicial court and the communities of selected inmates. I show how the inmates' experiences of intergenerational incest and sexual violence in general are related to the dominant ethnic, class and gender narratives produced by medical staff, community organizations, and judicial institutions.

University of Macau / Institute of Chinese Medical Sciences

The abstract on the file is incorrect, use the the one in the system as it summerizes the full text. / This attempted to describe factors contributing to sleep deprivation in the a multidisciplinary intensive care unit in KwaZulu-Natal Province. A quantitative, descriptive research design was adopted and structured interviews were conducted with 34 adult patients. Most factors contributing to these patients' sleep deprivation are basic physiological needs. Much can be done to enhance patients' abilities to sleep if noise (from alarms, monitors, televisions, telephones and footsteps) could be controlled, patients' pain would be managed effectively, doctors would visit the patients regularly, doctors and nurses use lay terms when talking to patients. Visible clocks and windows will help patients to maintain time orientation. Friendly, approachable and respectful nurses who introduce themselves to the patients help' to reduce patients' stress levels and improve their abilities to sleep. / Health Sciences / M.A. (Health Studies)

This study addresses the specific barriers related to time delays in the treatment of patients who suffered acute myocardial infarction at the Al Ain Hospital accident and emergency unit in the United Arab Emirates. A comprehensive background of the UAE is given for the benefit of students who have limited access to the background and challenges facing medical and nursing personnel in providing thrombolythic therapy to patients who suffered from acute myocardial infarction. The study will contribute to the continuous quality management and improvement of overall nursing and medical care of the AMI patient who is eligible for thrombolysis. An extensive literature review addresses the clinical manifestations and treatment of the patient suffering from AMI as well as the adverse effects of time delays in treatment during the acute phase of the disease. The researcher selected a quantitative, non-experimental descriptive and retrospective study. Data was collected by a structured instrument to gather the desired responses from the files of 457 selected patients admitted to the Al Ain Hospital. This study emphasizes the need to improve patient care by all health care personnel in an accident and emergency unit to prevent the delays in treatment in life threatening conditions such as myocardial infarction ensuring optimal and prompt time to thrombolyse. The improvement of awareness and commitment by health care providers such as nurses, doctors and ambulance personnel, can be achieved through education and training, commitment and dedication, absolute cooperation, collaboration and constant update on performance. Regular audits are essential with regard to door-to-needle time and performance of all health care providers. This study ultimately show that time constrains in attending to patients presenting with myocardial infarction should be addressed in utmost urgency. / Health Studies / M. A. (Health Studies)

Thesis (MPhil (Sociology and Social Anthropology))--University of Stellenbosch, 2009. / ENGLISH ABSTRACT: South Africa has transformed its mental health service provision from in-hospital care to community-based rehabilitation. Although the idea is sound, the process places the caregiving families under an immense pressure. The aim of this study was to explore the impact that the de-institutionalisation process has had on the families as they care for their child with intellectual disability. The study was conducted by means of qualitative, unstructured interviews with families that have had a child de-institutionalised from Alexandra Hospital in the Western Cape. All of the patients were diagnosed with a dual diagnosis of intellectual disability and mental illness. Even though the patients were in group-homes or attended a day care centre, final responsibility for the patients lay with the parents. Three main themes emerged from the interviews that describe the impact of deinstitutionalisation, viz. the characteristics of the family member with intellectual disability (aggressive, abusive and self-destructive behaviour of the patient), the effect that these characteristics had on the family (marital stress and health risks to the care giver), and community and resource factors. The study placed the family central to its environment and discussed the impact deinstitutionalisation had on its environment as a whole. It was concluded that the burden that de-institutionalisation places on the families far exceeded their ability to cope with these circumstances. This status quo could be improved if adequate resources and skills are given to families prior to de-institutional / AFRIKAANSE OPSOMMING: In Suid-Afrika is geestesgesondheidsorg van hospitaliserende na gemeenskapsgebaseerde rehabilitasie, omskep. Terwyl hierdie stap wel as lewensvatbaar mag voorkom, plaas die proses ‘n hewige las op die sorggewende gesin. Die doel van hierdie studie was om die omvang van die impak hiervan op ‘n gesin met ’n lid met intellektuele gestremdheid en psiegiatriese siekte, te bepaal – nadat so ‘n pasient uit die inrigting ontslaan is. Die ondersoek is uitgevoer by wyse van kwalitatiewe, ongestruktureerde onderhoude met gesinne wie se lede met die diagnose uitgeplaas is deur die Alexandra Hospitaal in die Wes-Kaap. Elkeen van die pasïente is gediagnoseer met ernstige intellektuele gestremdheid, asook bykomende gedragsafwykings. Ten spyte van die feit dat die betrokke pasïente deur groepshuise of dagsorg eenhede versorg word, bly hulle hul ouers se verantwoordelikheid. Drie temas het ontstaan wat die impak van ontslag uit die inrigting omskryf, te wete die karaktertrekke van die gestremde gesinslid (aggressie, misbruikende en vernielsugtige gedrag van die pasïent), die effek van hierdie karaktertrekke op die gesin (stres op die huwelik en potensiële gesondheidsrisiko wat dit vir die versorger inhou), en die gemeenskap en ondersteunende faktore. Tydens die ondersoek is die gesin sentraal geplaas ten opsigte van die omgewing. Die impak van ontslag van die gediagnoseerde pasïent uit die inrigting op die omgewing as geheel, word bespreek. Daar is tot die slotsom gekom dat die vermoë van die gesin wat die las moet dra as gevolg van die ontslag, ver oorspan word. Hierdie toedrag van sake sou egter verlig kon word indien toereikende hulpbronne en vaardighede aan sulke gesinne beskikbaar gestel word alvorens so ‘n pasïent ontslaan is.

This study addresses the specific barriers related to time delays in the treatment of patients who suffered acute myocardial infarction at the Al Ain Hospital accident and emergency unit in the United Arab Emirates. A comprehensive background of the UAE is given for the benefit of students who have limited access to the background and challenges facing medical and nursing personnel in providing thrombolythic therapy to patients who suffered from acute myocardial infarction. The study will contribute to the continuous quality management and improvement of overall nursing and medical care of the AMI patient who is eligible for thrombolysis. An extensive literature review addresses the clinical manifestations and treatment of the patient suffering from AMI as well as the adverse effects of time delays in treatment during the acute phase of the disease. The researcher selected a quantitative, non-experimental descriptive and retrospective study. Data was collected by a structured instrument to gather the desired responses from the files of 457 selected patients admitted to the Al Ain Hospital. This study emphasizes the need to improve patient care by all health care personnel in an accident and emergency unit to prevent the delays in treatment in life threatening conditions such as myocardial infarction ensuring optimal and prompt time to thrombolyse. The improvement of awareness and commitment by health care providers such as nurses, doctors and ambulance personnel, can be achieved through education and training, commitment and dedication, absolute cooperation, collaboration and constant update on performance. Regular audits are essential with regard to door-to-needle time and performance of all health care providers. This study ultimately show that time constrains in attending to patients presenting with myocardial infarction should be addressed in utmost urgency. / Health Studies / M. A. (Health Studies)

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / Esta pesquisa é fruto de inquietações e questionamentos da pesquisadora em uma UTI geral/adulto, seu campo de ação clínica. A questão que norteou a pesquisa buscou compreender a experiência de uma equipe de saúde em uma UTI/geral adulto. A interrogação inicial desdobrou-se em novas perguntas: como as ações da equipe podem ser complementares no contexto da UTI, cuja prioridade é salvar a vida do paciente, considerando, também, o cuidado integral do paciente. Como a equipe lida com as questões da morte e do morrer em seu cotidiano de trabalho, e quais as repercussões dessa experiência no modo como acontecem as intervenções junto ao paciente e familiares? Quais os prejuízos decorrentes da fragmentação do saber na modernidade, nas ações da equipe de saúde na situação de intervenção em uma UTI geral/ adulto. E quais as possíveis contribuições da ação clínica do psicólogo, fundada numa perspectiva fenomenológica existencial, no modo de funcionar da equipe de saúde. A dissertação está organizada em três artigos: dois teóricos e um empírico. O primeiro artigo teórico, trata da ação de uma equipe de saúde em UTI, teve como metodologia a pesquisa bibliográfica. Em seu desenvolvimento, busca traçar o surgimento da UTI e a evolução da assistência hospitalar ao doente grave, ressaltando os eminentes personagens da história do intensivismo; caracteriza o modelo atual de UTI no Brasil e descreve como a equipe multiprofissional foi se estabelecendo neste contexto de ação; apresenta, ainda, o cotidiano de trabalho da equipe e o quanto sua rotina é atravessada pelas questões da vida e da morte. O segundo artigo, também com metodologia bibliográfica, enfoca o acontecer da equipe de saúde em uma Unidade de Terapia Intensiva. Para tanto, aborda a fragmentação do saber na modernidade e sua ressonância na prática do profissional de saúde, delineando o fenômeno da hiperespecialização e as relações disciplinares; além disso, demarca a ação do psicólogo na equipe da UTI, numa perspectiva da fenomenologia existencial. Por fim, o terceiro artigo foi desenvolvido a partir de uma pesquisa qualitativa de cunho fenomenológico. A questão da pesquisa, vinculada aos objetivos da dissertação, foi trabalhada em um encontro com seis profissionais de saúde que fazem parte de equipes multidisciplinares em um Centro de Terapia Intensiva de um hospital da rede privada na cidade de Recife, cujos dados foram analisados a partir da Analítica de Sentido de Critelli. Como resultado observou-se que uma única área de conhecimento não pode dar conta da complexidade do fenômeno do adoecimento; que o trabalho em equipe exige colaboração, de modo que as ações no campo possam revelar uma fusão de horizontes, com possibilidades para o iniciar de uma outra/nova compreensão da ação em con-junto.

Made available in DSpace on 2017-06-01T18:08:40Z (GMT). No. of bitstreams: 1 dissertacao_josemary_costa.pdf: 1358075 bytes, checksum: f08c82f557d08e3c315127ab5d5433a1 (MD5) Previous issue date: 2012-11-09 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / This research is the result of concerns and questions of the researcher in a general ICU / adult, in his field of clinical action. The question that guided the research sought to understand the experience of a team of health care at ICU / general adult. The paper is organized into three parts: two theoretical papers and empirical one. The initial interrogation lead us to new questions: how the team's actions may be complementary in the context of the ICU, whose priority is to save the patient´s life, considering also the holistic care of the patient. As the team deals with issues of death and dying in their daily work, and what the repercussions of this experience happen in the way the interventions with the patient and family? What are the negative effects of fragmentation of knowledge in modernity, the actions of the health team in a position to intervene at the ICU / general adult. And what are the possible contributions of the psychologist's clinical action based on an existential phenomenological perspective, mode of functioning of the health team. The first theoretical paper deals with the action of a health team in the ICU, had the methodology literature.About the development outlines around the emergence of the historical evolution of the ICU and hospital care to the ill person, emphasizing the prominent characters in the history of intensive care. It also aims to characterize the current model of ICU in Brazil and it describes how the multidisciplinary team was establishing itself in this context of action. It also displays the daily work of the team and how your routine is crossed by the issues of life and death. The second article, also with the methodology literature, focuses on the happening of the health team at intensive care unit. To do so, addresses the fragmentation of knowledge in modernity and resonances in the practice of health professionals outlining the phenomenon of hyperdisciplinary and relationships. Moreover, the action marks the psychologist in ICU team perspective of existential phenomenology. Finally, the third article was developed from a qualitative study of a phenomenological. The question of research, linked to the aims of the dissertation, was crafted in a meeting with six health professionals who are part of multidisciplinary teams in the intensive care unit of a private hospital network in the City of Recife and the data were analyzed from the Analytical Sense Critelli. As a result it was observed that a single area of knowledge does not account for the complexity of the phenomenon of illness that requires teamwork, collaboration, so thatthe actions in the field may prove a "fusion of horizons" with possibility to start another /new understanding of action in a set. / Esta pesquisa é fruto de inquietações e questionamentos da pesquisadora em uma UTI geral/adulto, seu campo de ação clínica. A questão que norteou a pesquisa buscou compreender a experiência de uma equipe de saúde em uma UTI/geral adulto. A interrogação inicial desdobrou-se em novas perguntas: como as ações da equipe podem ser complementares no contexto da UTI, cuja prioridade é salvar a vida do paciente, considerando, também, o cuidado integral do paciente. Como a equipe lida com as questões da morte e do morrer em seu cotidiano de trabalho, e quais as repercussões dessa experiência no modo como acontecem as intervenções junto ao paciente e familiares? Quais os prejuízos decorrentes da fragmentação do saber na modernidade, nas ações da equipe de saúde na situação de intervenção em uma UTI geral/ adulto. E quais as possíveis contribuições da ação clínica do psicólogo, fundada numa perspectiva fenomenológica existencial, no modo de funcionar da equipe de saúde. A dissertação está organizada em três artigos: dois teóricos e um empírico. O primeiro artigo teórico, trata da ação de uma equipe de saúde em UTI, teve como metodologia a pesquisa bibliográfica. Em seu desenvolvimento, busca traçar o surgimento da UTI e a evolução da assistência hospitalar ao doente grave, ressaltando os eminentes personagens da história do intensivismo; caracteriza o modelo atual de UTI no Brasil e descreve como a equipe multiprofissional foi se estabelecendo neste contexto de ação; apresenta, ainda, o cotidiano de trabalho da equipe e o quanto sua rotina é atravessada pelas questões da vida e da morte. O segundo artigo, também com metodologia bibliográfica, enfoca o acontecer da equipe de saúde em uma Unidade de Terapia Intensiva. Para tanto, aborda a fragmentação do saber na modernidade e sua ressonância na prática do profissional de saúde, delineando o fenômeno da hiperespecialização e as relações disciplinares; além disso, demarca a ação do psicólogo na equipe da UTI, numa perspectiva da fenomenologia existencial. Por fim, o terceiro artigo foi desenvolvido a partir de uma pesquisa qualitativa de cunho fenomenológico. A questão da pesquisa, vinculada aos objetivos da dissertação, foi trabalhada em um encontro com seis profissionais de saúde que fazem parte de equipes multidisciplinares em um Centro de Terapia Intensiva de um hospital da rede privada na cidade de Recife, cujos dados foram analisados a partir da Analítica de Sentido de Critelli. Como resultado observou-se que uma única área de conhecimento não pode dar conta da complexidade do fenômeno do adoecimento; que o trabalho em equipe exige colaboração, de modo que as ações no campo possam revelar uma fusão de horizontes , com possibilidades para o iniciar de uma outra/nova compreensão da ação em con-junto.