<p><font face="Times New Roman"> <p align="left">This study looks at the effect of a cross-cultural instructional approach on the learners&rsquo / conceptions of lightning and attitude towards science. It explored Basotho conceptions of lightning and thunder under the following themes: nature of lightning, protection against lightning, animalistic/humanistic behaviour of lighting and nature of wounds inflicted by lightning.</p> </font></p>

<p>Chronic diseases of lifestyle (CDL) are on a raising trend in the world regardless of age, economic class or geographical location of a population. The mortality rate associated with CDL is alarmingly among the highest globally. Tanzania is not exempted from this development. Literature indicates that physical activity is a health practice that can prevent CDL. It is recommended that medical practitioners should hold the responsibility of counselling patients on physical activity. Some studies outside Africa found an association between doctors&rsquo / physical activity patterns and their counselling practices on the same. This study therefore sought to establish whether physical inactivity among medical&nbsp / doctors in Tanzania significantly influenced their counselling practices on physical activity. A cross sectional quantitative survey at the Muhimbili National Hospital and Muhimbili Orthopedic Institute was conducted to derive the required information. A self administered structured questionnaire was voluntarily answered by 144 medical doctors. The Statistical Package for Social Sciences (SPSS) version 17 was used for data capturing and analysis. Descriptive statistics were employed to summarize data and was expressed as means, standard deviation, frequencies and percentages. The students&rsquo / t-test was used to compare mean physical activity between different groups. Furthermore students&rsquo / t-test and analysis of variance tests were used to examine association between different variables. Chisquare tests were used to test for associations between categorical variables. Alpha level was set at p&lt / 0.05. Most of the participants in this study were sedentary in their leisure time and only active at work. When their quality of&nbsp / physical activity counselling was assessed, the majority of them were found to be poor physical activity counsellors. A significant association was found between physical activity and age, as well as physical activity and counselling practice (p&lt / 0.05). Participants mostly informed their patients about the intensity and duration of exercising more than any other idea of physical activity such as types of exercises, issuing of a written prescription and planning for a follow up. Lack of knowledge and experience about details of physical activity were reasons offered for failure to counsel. Participants also reported the inconvenience of physical activity facility&rsquo / s schedules, fatigue and tiredness to be their&nbsp / barriers to physical activity participation. Doctors in Tanzania lacked personal initiative to participate in physical activity and consequently lacked the motivation to counsel.&nbsp / Measures around enhancing this health practice should be enhanced by all stakeholders including medical doctors, physiotherapists and patients. The need for short term and&nbsp / long term training in matters related to physical activity are therefore necessary among the practicing doctors and those undergoing training in medical schools. Physiotherapists who are trained in movement science can offer valuable advice/information to medical doctors to ensure that medical doctors acquire physical activity prescription and&nbsp / counselling knowledge. Collaboration between stakeholders in campaigning against sedentary lifestyles should be enhanced. Further reasons for failure to counsel, hindrances to physical activity participation and modern approaches to counselling should be explored.<br /> &nbsp / </p>

The consultation is the GP’s form of work. How long a consultation should be, and what short/long consultations imply with regard to the satisfaction of patient and doctor has been much debated. The aim of this thesis was to study consultations with regard to content and time consumption in a short term and long term perspective. Three studies were carried out. 1. Consultations with the members of a group of GPs were investigated, where patients and doctors separately assessed different aspects of the consultation, and their ratings were related to the real length of the consultations. The following questions were posed: Was there time enough? Could the patient tell the doctor about her/his problems? Were the problems physical or psychological? 2. Nurses at the primary care health centres were interviewed about their considerations in booking short or long appointments for the patients. 3. Patients who frequently attended one health centre during one year and consumed much time were studied. Quantitative and qualitative methods were used. The results of the first study (Papers I-III) show that the average length of the consultations was 21 minutes; there was considerable variation (ranging from 3 to 60 minutes). (About 600 consultations with 7 male doctors were registered in two batches). The doctors’ mean consultation length also varied widely, from 13-28 minutes. Consultations dealing with psychological problems were longer than those dealing with physical problems. Older patients had longer consultations than younger patients, and female patients had somewhat longer consultations than male patients. The patients were generally more satisfied with the consultations than the doctors were, and there were no clear affinities between long consultations and high satisfaction. Male patients and patients with physical problems mainly received short consultations, whereas patients with ”mixed" problems and older patients received long consultations. The single factors most decisive for the length of a consultation were ‘the doctor factor’, the character of the problem and the age of the patient. "Good” consultations (operational definition) were associated primarily with ‘the doctor factor’, and the real length of the consultations was less important. The interviews with ten experienced primary care nurses (Paper IV) showed that the nurses worked in two perspectives: in the ”immediate” perspective, appointments were booked according to rules which directly impacted the length of the visit, and in the "reflective" perspective, appointments were booked with a view to the quality of the work at the health centre and the long-term time consumption. Other factors of importance were the patient’s age and problem(s), the doctor’s experience and working style, and the current situation at the health centre. Frequent attenders (FAs) at one health centre (Paper V) were compared with a contrast group of matched patients (CPs). The FAs represented 1.7% of the population of the catchment area and made 15% of the visits. The FAs were a heterogeneous group where small boys, women of working age and pensioners of both sexes were overrepresented. The FAs had higher consultation frequency than the CPs during the year of investigation, but few remained FAs for longer periods. The FAs had more problems and more complex problems than the CPs. Complaints regarding the musculo-skeletal organs, and psychosocial problems were common among these patients, often in combination. The present work thus shows that longer consultations do not naturally imply higher patient satisfaction. Other factors than the time factor, in particular ‘the doctor factor’ seem to be more important. ‘The doctor factor’, the characteristics of the patients, the type of problem and the situation at the health centre also have a bearing on consultation length and time consumption in a short-term as well as long-term perspective. The implications of these factors and their relative importance are discussed, but further studies of certain issues, such as ‘the doctor factor’, are necessary. / <p>Diss. (sammanfattning) Umeå : Umeå universitet, 1995, härtill 5 uppsatser.</p> / digitalisering@umu

women. The womens social movements for emancipation and equality within marriage created both freedom and anxiety among the population. A Swedish suffragette, Ellen Key was in the forefront to form opinions that reached the population. In addition, she also became a friend to the Swedish journalist and writer Hjalmar Soderberg. In this way, Key influenced Soderbergs social knowledge and writing. Most likely she had an impact on his novel Doctor Glas, which he worked on during their long acquaintance. Moreover, several of the Nordic novelists during the period, were introduced to the writings of the German philosopher Friedrich Nietzsche. Particularly, Key was one of the first women to read Nietzsche as she could oversee with his misogyny and turned it into benefits to the emancipation. The aim of this essay is to examine the influence of the emancipation debates on the novel Doctor Glas. In addition, I also examine the influence of the German philosopher on the thinking of the Nordic writers. Particularly, I will try to explain the behaviour of the protagonist of the novel that ended in the death of the priest. My conclusion is a misled doctor by a twisted mind filled with philosophical beliefs of “superior” mentality.

No description available.

Uterine Fibroids, medically termed uterine leiomyoma, are benign tumors of smooth muscle cells that grow in the uterus. While they are the most common pelvic neoplasm in women and fewer than 1 percent of fibroids develop into cancer, uterine fibroids can cause infertility, adverse pregnancy outcomes, and greatly affect one’s quality of life. Black women have been disproportionately affected by fibroids; when compared to white women, Black women are: 2-3 times more likely to have fibroids, diagnosed at a younger age, more likely to have 7 or more fibroids, more likely to have more severe and more troublesome symptoms (anemia, severe pelvic pain, constipation, and stomach aches), and have twice as many hysterectomies due to fibroids. Black women’s disproportionate affliction with uterine fibroids is particularly concerning given the historical medical injustices associated with Black women’s bodies and reproductive rights from slavery to present day. By placing Black women at the center of analysis and using a Black feminist epistemological framework, this study aims to make a unique contribution to medical sociology as well as literature on the theoretical and practical management of sickness and wellness among Black women in the United States. Using qualitative interviews and grounded theory methodology, the study examined how Black women frame the condition of having uterine fibroids. Specifically, the study investigated a) how Black women conceptualize having fibroids, b) how Black women’s conceptualizations of fibroids affect their feelings about selves or their lifestyles, c) the mechanisms, if any, by which Black women deal with uterine fibroids, d) how their multiple race, class, and gender identities affect their illness experiences and types of treatment that they seek, and e) how conventional and complementary/alternative medicine shapes Black women’s experiences with fibroids. Conceptualizations about fibroids are rooted in the race-gendered histories of Black women and the unique stressors that they face. Through interactions with doctors and among peers, Black women resist the unbearable burden of uterine fibroids through various coping strategies, but generally “keep it moving”. They avoid invasive surgeries through patient agency by being advocates for their medical treatment, self-researching, dialoguing with others, and directing doctor-patient interactions.

Doctors, academically educated and authorized, assert that there is more to being a real doctor than having fulfilled the formal criteria. It has been said that there is a particular doctor's ethos, which is based not only on thorough medical education but also on traditional know-how, internalized ethics and good character. This paper contains several studies of the efforts of Swedish physicians to define themselves as doctors, individually and collectively, during the period 1890-1960 and to identify the ethos of their profession. The empirical material consists mainly of texts written by doctors for doctors on different social and political questions pertaining to the profession's interests. Studying the identities, interests and ideals that have been expressed by Swedish doctors in society and on the professional and individual level made it possible to distinguish and describe different aspects of their particular ethos. The starting point for these studies was the discussions during the inter-war period – held above all in Germany but also in Sweden – about the crisis of medicine and of the medical profession (chapter 1). Developments in legislation concerning the authorization of doctors show the ambiguity of the Swedish doctor's legal identity (chapter 2). The Swedish medical profession's efforts to hold on to the concept of internalized ethics meant that formal ethical rules were not accepted until 1951 (chapter 3). A study of medical obituaries revealed that the ideal doctor was seen as a man and a good colleague with his ethics rooted in antiquity (chapter 4). The heterogeneous medical profession has not been able to reach a consensus as to a common identity or common interests and ideals. The efforts of leading men amongst Swedish doctors gain charismatic, traditional and legal legitimacy for the profession have been opposed. After 1960, however, doctor's legitimacy in the scientific field has gained ground (chapter 5). Debate concerning the ethos of the doctors served as a strategy to unite the profession and to draw boundaries against those considered to be unqualified actors in the field of the healing arts. This, in itself, is part of this ethos.

The recent expansion of general practitioner (GP) out of hours cooperatives indicates that many British GPs see this as the solution to managing out of hours work, particularly the 'problem' of 'inappropriate' demand. This thesis investigates the highly contentious subject of 'inappropriateness' of demand for out of hours GP services for children under five, and develops a methodology that allows for a reconceptualisation of the issues involved based on the beliefs, assumptions and practices of all those concerned, rather than locating the 'problem' within the province of parents alone, or within the doctor-patient relationship as a bounded system. Using a predominantly sociological and anthropological conceptual framework, the thesis draws on a synthesis of views and practice, bringing those of professionals and parents together with fieldwork observations based in the primary care centre setting. It suggests that contrary to talk about management of the 'problem' in technical, bureaucratic and medical terms, this becomes a moral issue in practice. Scientific or organisational imperatives disguise largely moral proscriptions and examples illustrate ways in which moral and emotional dimensions embedded within these social relations can conflict with particular forms of rationality. The analysis shows how organisational initiatives that fail to take account of such moral frameworks can produce unexpected and unintended consequences. The thesis illustrates the value of what is described as a dialogic process, taking account of the fluidity between voices, layers of time and space, and interchange between researcher, participants, and future audiences. The play of these issues in the rapid and extensive growth of cooperatives is discussed in the wider context of the rhetoric of consumerism and shifts in interprofessional practices and relationships. Negotiation of 'appropriate' supply of and demand for out of hours services has had a major impact on government initiatives for primary care as a whole. Thus key elements in the formation of cooperatives, originally targeted at a more narrow conceptualisation of problems, can be seen as expressing a deeper impetus for change, and serving as vehicles for more fundamental and rapid development.

The patient-doctor relationship (PDR) as perceived by the patient is an important concept in primary care and psychotherapy. The PDR Questionnaire (PDRQ-9) provides a brief measure of the therapeutic aspects of the PDR in primary care. We assessed the internal and external validity of the German version of the PDRQ-9 in a representative crosssectional German population survey that included 2,275 persons aged$14 years who reported consulting with a primary care physician (PCP). The acceptance of the German version of this questionnaire was good. Confirmatory factor analysis demonstrated that the PRDQ-9 was unidimensional. The internal reliability (Cronbach’s a) of the total score was .95. The corrected item-total correlations were$.94. The mean satisfaction index of persons with a probable depressive disorder was lower than that of persons without a probable depressive disorder, indicating good discriminative concurrent criterion validity. The correlation coefficient between satisfaction with PDR and satisfaction with pain therapy was r = .51 in 489 persons who reported chronic pain, indicating good convergent validity. Despite the limitation of low variance in the PDRQ- 9 total scores, the results indicate that the German version of the PDRQ-9 is a brief questionnaire with good psychometric properties to assess German patients’ perceived therapeutic alliance with PCPs in public health research.

Darbo tikslas - įvertinti Kauno miesto ir Kauno rajono šeimos gydytojų nuomonę apie skatinamųjų paslaugų teikimo tvarką, vykdant profilaktines programas, sistemines bei įstaigų, teikiančių šias paslaugas, organizavimo problemas. Darbo uždaviniai: 1. Įvertinti Kauno miesto ir Kauno rajono pirminės asmens sveikatos priežiūros įstaigose dirbančių šeimos gydytojų nuomonę apie skatinamųjų paslaugų teikimo tvarką ir organizavimą jų įstaigoje. 2. Nustatyti, kaip motyvuojami Kauno miesto ir Kauno rajono šeimos gydytojai teikti skatinamąsias paslaugas. 3. Palyginti skirtingos priklausomybės Kauno miesto ir Kauno rajono pirminės asmens sveikatos priežiūros įstaigose skatinamųjų paslaugų organizavimo tvarką ir jų skatinimą. Tyrimo metodika. Anoniminės anketos pagalba 2010m. spalio – 2011m. kovo mėn. buvo apklausti skirtingos priklausomybės (privati ar priklausanti savivaldybei) Kauno miesto ir Kauno rajono pirminės asmens sveikatos sveikatos priežiūros įstaigų šeimos gydytojai (n=130). Duomenų analizė atlikta „MS Excel“ ir „SPSS Windows 14,0“ versijos kompiuterinėmis programomis. Rezultatai. Visi respondentai pažymėjo, kad jų PASP įstaigose yra vykdomos profilaktinės programos ir teikiamos kitos skatinamosios paslaugos. Pacientai dažniausiai kviečiami dalyvauti programose spontaniškai. Atsakomybė už pacientų kvietimą tenka šeimos gydytojams (74,1proc.). Informavimo paslaugų iš viso neregistruoja 31,8 proc. visų tyrime dalyvavusių PASP įstaigų darbuotojų. Tyrimo metu buvo nustatyta... [toliau žr. visą tekstą] / Aim of study – to evaluate the opinion of family physicians practicing in Kaunas city and district about organizating and providing the promotive health care services in prevention programmes as well as system-specific and setting-specific problems related with promotive services. Objectives: 1) to evaluate the opinion of family physicians practicing in Kaunas city and district about organization and provision of promotive health care services in prevention programmes at their health care settings; 2) to evaluate the motivation ways for family physicians to provide the promotive services at Kaunas city and district; 3) to compare the organization and motivation of promotive services between primary health care settings of different subordination at Kaunas city and district. Material and methods. From October 2010 to March 2011 anonymous questonnaire survey was conducted aimed at family physicians (n=130) working at public and private primary health care settings at Kaunas city and district. Data analyses were done using „MS Excel“ software and „SPSS Windows 14.0“ statistical package. Results. All study participants stated that at their health care setting the prevention programmes are running together with promotive services. Patients are asked to participate in programmes spontaneously. Main responsibility for patients invitation to participate is regarded for family physicians (74.1%). Of all study participants, 31.8% do not have a practice of registering the informative... [to full text]