Falls are caused by many factors in older patients. Medications have been shown to be a risk factor for falls, and studies have shown that patients taking more than five total medications may have a two-fold increased risk of impaired balance. A more recent model suggests only medications with sedating and anticholinergic properties contribute significantly to physical impairment. The authors of this paper helped to develop a multidisciplinary clinic to evaluate the risk of falls in at-risk patients. We present the case of a woman on multiple medications that increased her risk of falling. Of note, this patient was taking a total of 14 prescription medications, seven of which were considered sedating. Based on a comprehensive medication evaluation, six specific changes were recommended to improve this patient's medication regimen and reduce her risk of falling.

No description available.

The aim of this study was to explore the retrospective experience of self-forgiveness in psychotherapy, using a hermeneutically and existentially oriented research approach and using phenomenological principles in the data analysis (Giorgi, 1975). This research focused on the phenomenon of self-forgiveness, not only as a critical human experience in the individual’s everyday life’s experience, but also as an integral part of treatment and healing in the therapy process. Religious, cultural, moral and philosophical approaches to self-forgiveness were discussed with a focus on the cultural backdrop and the profound socio-political changes in South Africa, against which this research was conducted. In addition the relevant theories and approaches to the phenomenon were reviewed. Using a mixed research method, three questions were formulated in order to elicit the lived structure of the experience being researched. Two, in-depth interviews, were conducted with six of my own therapy clients whose therapy had ended with myself. This phenomenon had not been articulated in therapy and was considered from the point of view of the client who experienced this phenomenon and not from that of the therapist. Painful relational issues had left the participants feeling estranged from themselves and others and the experience of self-forgiveness had resulted in feeling reconnected with themselves and the world. The study of the phenomenon, included six, one monthly discussions with three fellow practising psychologists, whose reflections enhanced the understanding of this phenomenon. Significant findings of this research were that; the phenomena of self-forgiveness and forgiveness of others were interrelated and that self-acceptance was mandatory in the experience of self-forgiveness without a blanket condoning of one’s own actions or the actions of others. Non-forgiveness without vengeance and forgiving without condoning or forgetting the actions of others, could be emotionally and morally appropriate for the individual. Educative insight, a renewed identity and reinterpreted memory were important elements of the experience of self-forgiveness in psychotherapy. Experientially, the moment of recognition of this phenomenon had come as a ‘revelation’ for the participants after therapy had ended and self-forgiveness, formed an integral part of therapy although this experience was not directly articulated in psychotherapy. In this study the significance of the self of the client, the self of the therapist and the psychologists’ discussions relating to the phenomenon were addressed. Emotions pertaining to the experience of self-forgiveness; theoretical implications of this phenomenon for further research and for psychotherapy; limitations of this research and how the experience of self-forgiveness differed from other significant experiences in psychotherapy were critically discussed. / Thesis (PhD (Psychotherapy))--University of Pretoria, 2003. / Psychology / unrestricted

This thesis is concerned with the Canadian state’s rhetoric of reconciliation, the logic of exceptionality that supports it, and the ways this logic helps soften Indigenous communities for resource development. In formulating my theoretical framework, I draw from Agamben’s theories of sovereignty and states of exception, Mark Rifkin’s reworking of Agamben’s theories to accommodate a settler-colonial context, Pauline Wakeham’s application of the logic of exceptionality to rhetorics of apology and terrorism, and Glen Coulthard’s concepts of translation (as the attempt to bring Indigenous discourses and life ways into the realm of a Western/settler-colonial discourse of state sovereignty) and grounded normativity (as a way of making visible the contingency of such narratives of state sovereignty). Following the work of James Tully and John Borrows in Resurgence and Reconciliation, particularly the argument that transformative reconciliation must involve reconciliation with the living earth, my project aims to show that official reconciliation actually prevents the possibility of transformative reconciliation because of the role it plays in furthering an extractivist agenda by “exceptionalizing" Indigenous peoples and life-ways to rhetorically contain Indigenous anti-colonial or anti-industry actions, physically contain Indigenous dissenters during moments of crisis (i.e. states of exception), pre-emptively frame Indigenous dissenters as terroristic, and foreclose discussions of ongoing colonialism. / Graduate

Researchers have documented the increasing role of grandparents who provide care for their grandchildren; however, few have studied extended family reconciliation after grandparents assumed their primary care. This study explored the reconciliation experiences of 12 grandparents who were primary caretakers of their grandchildren. Using Moustakas's phenomenological research approach, the participants were interviewed about their experiences of the relationship triad (grandparent-grandchild, grandparent-adult child, parent-child). Attachment theory and family systems theory were the conceptual frameworks to explore the central research question, which addressed the meaning of extended family reconciliation for grandparents who become primary caregivers of grandchildren. Using NVivo, the interview data were coded and grouped into themes of shared meaning. The results revealed 4 distinct themes: watching my adult child struggle; recognizing challenges; my grandchild's wellbeing; and communicating with my grandchild. Further, the lived experience revealed that extended family reconciliation was largely dependent upon the adult child's willingness, readiness, and capability to participate in the reconciliation process. Results of this study have the potential to benefit children in their grandparents' care by providing insights into the reconciliation experience, with meaningful results to be shared with the professional community and grandparents who care for their grandchildren.

This qualitative research case study explored the indigenous model of conflict resolution known as the “Judiyya,” in the South Darfur State, Sudan. The purpose of the study has been to understand the principles and practices of the Judiyya in maintaining peace among Darfuri tribal communities. Judiyya is a community-based, human-centered model that employs restorative and transformative principles in conflict resolution. The literature review provided context for a research project that addressed the following questions: What is the role of the Judiyya in the current situation? How does the model work? What are its decision-making processes? How does the Judiyya model relate to the International Human Rights Standards? The primary data sources include face-to-face interviews, researcher observations, and a review of document collections and archival records. Research findings explore five emergent themes: Religion or belief system, Elderly leadership, Trust, Effectiveness, and Legitimacy. These explain the model’s process and practices and offer to policymakers some new ideas and perspectives about how to understand and use the indigenous model, which is evaluated for strengths and challenges. The model remains relevant and continues to thrive around the greater Darfur area, helping tribal communities maintain harmony, coexistence, and peace. This research contributes to the emerging literature about the relevance of endogenous knowledge and indigenous models of conflict resolution, and the ongoing efforts to better understand the cultural context of conflict and its reconciliation process.

Within the last 15 years, the first three Truth and Reconciliation Commissions (TRCs) in North America formed and completed their work. Patterned after similar efforts in South Africa, Latin America, and elsewhere, the TRCs in Greensboro, North Carolina; Maine; and Canada heard voluntarily-offered testimony from members of the general public and key parties to decades-long conflicts. The Commissions also evaluated responsibility for the conflicts and offered recommendations for change in their respective communities and countries, informed by the testimonies they received. This qualitative methods multiple case study of the three Commissions’ recommendations involved archival research and data analysis of testimony to the Commissions, alongside the subsequent recommendations made by those Commissions and any further policy measures taken by host governments in Greensboro, Maine, and Canada. The dissertation attempts to answer the research question: to what extent can truth and reconciliation commissions empower parties to long-running and wide-reaching conflicts to influence changes in their communities, states, or countries in ways courts cannot? Among the conclusions reached in this research is that TRCs integrated public testimony to a significant extent into their findings and recommendations, though the three governments in Greensboro, Maine, and Canada have implemented those recommendations with varying levels of commitment. This study can assist others tackling large-scale conflicts to consider how best to incorporate a truth and reconciliation commission into their efforts at healing and growth in their communities.

Indiana University-Purdue University Indianapolis (IUPUI) / Physicians receive multiple CCDs for a single patient encompassing various encounters and medical history recorded in different information systems. It is cumbersome for providers to explore different pages of CCDs to find specific data which can be duplicated or even conflicted. This study describes the steps towards a system that integrates multiple CCDs into one consolidated document for viewing or processing patient-level data. Also, the impact of the system on healthcare providers’ perceived workload is evaluated. A modular system is developed to consolidate and de-duplicate CDA-based documents. The system is engineered to be scalable, extensible and open source. The system’s performance and output has evaluated first based on synthesized data and later based on real-world CCDs obtained from INPC database. The accuracy of the consolidation system along with the gaps in identification of the duplications were assessed. Finally, the impact of the system on healthcare providers’ workload is evaluated using NASA TLX tool. All of the synthesized CCDs were successfully consolidated, and no data were lost. The de-duplication accuracy was 100% based on synthesized data and the processing time for each document was 1.12 seconds. For real-world CCDs, our system de-duplicated 99.1% of the problems, 87.0% of allergies, and 91.7% of medications. Although the accuracy of the system is still very promising, however, there is a minor inaccuracy. Due to system improvements, the processing time for each document is reduced to average 0.38 seconds for each CCD. The result of NASA TLX evaluation shows that the system significantly decreases healthcare providers’ perceived workload. Also, it is observed that information reconciliation reduces the medical errors. The time for review of medical documents review time is significantly reduced after CCD consolidation. Given increasing adoption and use of Health Information Exchange (HIE) to share data and information across the care continuum, duplication of information is inevitable. A novel system designed to support automated consolidation and de-duplication of information across clinical documents as they are exchanged shows promise. Future work is needed to expand the capabilities of the system and further test it using heterogeneous vocabularies across multiple HIE scenarios.

No description available.

Although the combination of humour and holocaust may seem rather startling, further analysis of humour characteristics brings to light its significant functions, which, according to the survivors, humour in the holocaust truly fulfilled. Whether it is a matter of being able to see the object of one's attention from several perspectives, from an emotional distance or being able to release accumulated frustrations, there is clear evidence of humour's appreciable role during the holocaust and in the aftermath. Within the framework of coping with the trauma caused by the holocaust experience also emerged holocaust literature dealing with the subject from a humorous perspective, which motivated a lot of debates developed about appropriateness of humour in the holocaust representation. To other controversial works from this area also belong the short stories by Tadeusz Borowski and the novel The Nazi & the Barber by Edgar Hilsenrath. This master thesis follows humour, satire and cynicism as means of coping with traumatic holocaust experience based on the example of the above mentioned works of Tadeusz Borowski and Edgar Hilsenrath, which, according to many critics, tested the limits of holocaust representation thanks to their unusual humorous approach. Thus, the aim of the thesis is to analyze these...