The study reports on the perceptions of the midwives and pregnant women of the PMTCT of HIV programme at the antenatal care and maternity ward at the Johan Heyns Community Health Centre. A qualitative approach was adopted to conduct the study. Purposive sampling was used to select participants and was informed by social behavioural theories. Data was collected using interviews and analysed using thematic categorisation. The findings show that at the first PMTCT encounter participants had little to no knowledge of the PMTCT programme, generally displayed a lack of interest, experienced emotional distress, and fear at the thought of having to disclosing their HIV-positive status to their partners/family and had certain trepidations about participating in the PMTCT programme. The participants’ perception on their roles was that their roles were interlinked, midwife needs the recipients (pregnant woman) and pregnant woman needs the provider (midwife) therefore one cannot do PMTCT without the other. The study recommends that the capacity building of pregnant women be optimised, that PMTCT awareness campaigns for women of childbearing age should be a priority and PMTCT skills to be prerequisite for midwives deployed to ANC clinics and maternity ward units. / Health Studies / M.A. (Social Behaviour Studies in HIV/AIDS)

Personer med diagnosen emotionell instabil personlighetsstörning är högkonsumenter av psykiatrisk akutvård. Diagnosen kännetecknas av ett ihållande mönster av instabilitet vad gäller självbild, känslor och relationer med andra, samt en hög grad av impulsivitet. Vidare förekommer ofta självskadebeteende och suicidala handlingar som ett sätt att reglera affekter. Symtombilden kan göra mötet mellan patient och vårdpersonal svårt. Syftet med denna studie var att utifrån lidandeperspektiv belysa hur personer med diagnosen Emotionellt instabilt personlighetssyndrom upplever och erfar personalens bemötande när de söker akut vård. Metoden som användes var en kvalitativ intervjustudie med fenomenologisk ansats.  Huvudresultatet visade att fenomenets centrala teman är att respekteras som människa med symtom, att inte bli tagen på allvar och att bli stigmatiserad. Varje tema kunde kopplas till ett lidandeperspektiv; sjukdomslidande lindras av att respekteras som människa med symtom, men att inte bli tagen på allvar orsakade vårdlidande och att bli stigmatiserad orsakade ett livslidande. Samtidigt gick lidandeformerna in i varandra, på så vis att vårdlidande lades till den levda erfarenhet som är livslidandet, och livslidandet hade betydelse för hur sjukdomslidandet hanterades och upplevdes. Slutsatsen är att personer med EIPS som söker akut psykiatrisk vård upplever vårdpersonalens bemötande som att de antingen respekteras som människa med symtom och får sitt sjukdomslidande lindrat, eller inte tas på allvar och stigmatiseras med vård- respektive livslidande, som ökar på symtombördan, som följd. / People with Borderline Personality Disorder [BPD] are among the consumers of psychiatric emergency care. BPD is characterized by a persistent pattern of impulsivity and instability with regard to self-image, emotions and relationships with others. Furthermore, self-harm and suicidal behaviour often occur as a way to regulate emotions. The symptoms can make interaction between patients and healthcare professionals difficult. The aim of this study was to gain insight into how, from a perspective of suffering, people with BPD who seek psychiatric emergency care experience and sense the approach. The method used was a qualitative interview study with a descriptive phenomenological approach. The main results consisted of three central themes: to be respected as a human being with symptoms, to not be taken seriously, and to be stigmatized. Each theme was linked to a perspective of suffering; being respected as a human being with symptoms alleviated suffering from symptoms, while not being taken seriously caused suffering related to care, and getting stigmatized added to the existential suffering. The different dimensions of suffering interacted; suffering related to care was added to the existential suffering, which in turn had implications for the ability to deal with suffering from symptoms. The conclusion is that individuals with BPD experience either a treatment with respect for being a human being with symptoms, and thus having those symptoms alleviated, or experience not being taken seriously and being stigmatized, with the consequences of suffering related to care and existential suffering, both which add on to the symptom burden.

科学研究費補助金 研究種目:一般研究(B)(2) 課題番号:06452303 研究代表者:山下 哲郎 研究期間:1994-1996年度

The Progressive Era affected the South in different ways from other regions of the United States. Because Southern society was more entrenched in patriarchy and traditional social strictures, Nashville provides an excellent lens in which to assess the vision of a New South city. Known as “Athens of the South,” Nashville legitimized this title with the emergence of several colleges and universities of regional and national prominence in the 1880s and 1890s. In the first two decades of the twentieth century, Nashville’s universities solidified their status as reputable institutions, with Vanderbilt and Fisk Universities garnering national prominence. Within Nashville, local colleges, including Ward Belmont College, David Lipscomb University, Peabody College, Roger Williams University, and Meharry Medical College shaped and were shaped by the growing city. Higher education and urbanization created a dialectic that produced a new generation and a new monied class of young adults who thought and acted differently from their parents. Moreover, women became more active participants in public spheres because of opportunities provided by higher education. In most cases, Nashville’s women continued to use their husband’s prominence to earn greater success. In regard to race, the city’s African American colleges helped to produce men and women who formed the backbone of the rising black middle class and elite in the South. Nashville endured great change, formally beginning with the 1897 Tennessee Centennial Exposition, whereby the city’s trajectory followed a more modern approach, albeit southern style. Higher education played a large role in the direction of the city, both literally and figuratively. Shifts in attitude toward race, gender, and leisure combined to create a new youth culture. Young women and men socialized on and off campus through a variety of new forms of recreation. The experience of “college life” was more than attending classes but rather a fluid phase beginning with youthfulness and ending with adulthood. Social interaction increasingly became a major component of college life; the city of Nashville simply provided the stage. By U.S. entrance into World War I, Nashville had legitimized its position as a Southern urban center of entertainment and higher education.

L’utilisation des mesures d’isolement et de contentions en milieu psychiatrique intrahospitalier se produit fréquemment en réponse à des comportements agressifs et continue de soulever la controverse. À cet égard, de plus en plus d’études tendent à démontrer que le personnel soignant travaillant sur ces unités est influencé par plusieurs facteurs de nature différente, notamment la perception de l’agressivité, quand vient le temps de prendre une décision quant à l’utilisation (ou non) de ces mesures coercitives. Méthodologie : Plus de trois cents membres du personnel soignant travaillant en milieu psychiatrique intrahospitalier ont été recrutés dans huit établissements psychiatriques du Québec. Dans un premier temps, un questionnaire leur a été distribué afin de mettre en relief les différents facteurs (individuels et organisationnels) ayant un impact sur l’utilisation des mesures coercitives. Simultanément, l’analyse factorielle de la version française de deux échelles permettant de mesurer la perception de l’agressivité en milieu hospitalier (le MOAS et le POAS) a été faite. Résultats : Un modèle final multivarié a démontré que le type d’unité psychiatrique, l’expression de la colère et de l’agressivité parmi les membres de l’équipe de soins, la perception de la fréquence de gestes autoagressifs et la perception de mesures de sécurité insuffisantes dans le milieu de travail étaient des prédicteurs indépendants de l’utilisation de procédures d’isolement et de contentions. L’analyse factorielle a pour sa part mis en évidence une structure à 4 facteurs pour le MOAS et à 3 facteurs pour le POAS, conformément à ce que l’on retrouvait dans la littérature scientifique. Conclusion : Ces résultats soulignent l’importance des facteurs organisationnels par rapport aux facteurs individuels dans l’utilisation des mesures coercitives en psychiatrie et la nécessité d’évaluer les perceptions quant à l’agressivité et à la sécurité chez le personnel soignant. En comprenant mieux les phénomènes qui amènent leur utilisation, il sera possible de trouver des alternatives aux mesures d’isolement et de contentions et ainsi réduire le recours à ces dernières. / Psychiatric staff can have both positive and negative attitudes towards inpatient aggression. Different attitudes towards aggression can have a substantial influence on how such behaviour is dealt with on psychiatric wards. In this manner, seclusion and restraint are frequently used measures for managing violent behaviour. However, their use raises several concerns. Method: Over three hundred staff members were recruited from eight psychiatric hospitals in the province of Quebec. First of all, an examination was conducted from the staff perspective of the organizational and staff factors that may be associated with increased recourse to seclusion and restraint in psychiatric wards. Simultaneously, factorial analysis of the French version of two scales used to measure staff attitude towards institutional violence and aggression (MOAS and POAS) was completed. Results: The final multivariate model showed that the following factors independently predict to greater use of seclusion and restraint: the type of hospital ward; greater expression of anger and aggression among staff members; perceptions of the frequency of incidents of physical aggression against the self; and the perception of insufficient protection measures in the workplace. Factor analyses revealed a four factor structure for the MOAS and a three factor structure for the 12-item POAS, which is similar to what is found in recent scientific literature in North American and European countries. Conclusion: These findings underscore the importance of evaluating a variety of factors, including perceptions of safety and violence, when exploring the management of aggression and violence on psychiatric wards and the reasons seclusion and restraint measures are used. These findings represent the first stage of a research program of the multidisciplinary group to whom the author is associated, aimed at reducing recourse to seclusion and restraint in Quebec psychiatric services.

Natural disasters are increasing in both number and severity, causing the number of people being displaced by disaster to rise as well. Hurricane Katrina provides a particularly poignant example of the human impact of disaster, and of inadequate disaster response, especially where housing is concerned. The Federal Emergency Management Agency’s response to Hurricane Katrina in New Orleans exposed a gap in the approach to housing survivors of natural disasters, especially at the interim housing level. The FEMA trailer - which was only intended to house survivors temporarily but, in many cases, became a long term housing solution, - provided shelter for survivors, but did not account for their psychological well-being. The loss of one’s home can be a traumatic experience, as people identify their sense of self with their home. Therefore, it is crucial to reinstate this sense of home, and in turn provide continuity to the sense of self, early on in the recovery process. Rebuilding after a natural disaster is a long process. Because of this, disaster housing needs to be able to evoke a sense of home and ownership so that inhabitants can connect with their environment and reinstate their daily routines. This helps them to rebuild their lives. The proposed project attempts to do this by allowing for flexibility and choice in both the design and daily use of the house. The house transitions from temporary to permanent housing, allowing for a dialogue between inhabitant and environment to begin early on in the recovery process, and to persist. The design is informed by theories on place making, elements of home, dwelling, as well as loss and the grieving process.

Natural disasters are increasing in both number and severity, causing the number of people being displaced by disaster to rise as well. Hurricane Katrina provides a particularly poignant example of the human impact of disaster, and of inadequate disaster response, especially where housing is concerned. The Federal Emergency Management Agency’s response to Hurricane Katrina in New Orleans exposed a gap in the approach to housing survivors of natural disasters, especially at the interim housing level. The FEMA trailer - which was only intended to house survivors temporarily but, in many cases, became a long term housing solution, - provided shelter for survivors, but did not account for their psychological well-being. The loss of one’s home can be a traumatic experience, as people identify their sense of self with their home. Therefore, it is crucial to reinstate this sense of home, and in turn provide continuity to the sense of self, early on in the recovery process. Rebuilding after a natural disaster is a long process. Because of this, disaster housing needs to be able to evoke a sense of home and ownership so that inhabitants can connect with their environment and reinstate their daily routines. This helps them to rebuild their lives. The proposed project attempts to do this by allowing for flexibility and choice in both the design and daily use of the house. The house transitions from temporary to permanent housing, allowing for a dialogue between inhabitant and environment to begin early on in the recovery process, and to persist. The design is informed by theories on place making, elements of home, dwelling, as well as loss and the grieving process.

Im Rahmen des Funktionalintegralzugangs zur Quanteneichfeldtheorie wird in der vorliegenden Arbeit eine Quantisierungsprozedur in Termen eichinvarianter Felder vorgeschlagen und am Beispiel zwei- und vierdimensionaler abelscher Modelle (Thirring-Modell und QED) sowie der One-Flavour QCD konkret realisiert. Dazu wird die Algebra der aus der eichabhängigen Feldkonfiguration der zugrunde liegenden Quantenfeldtheorie gebildeten eichinvarianten Grassmann-Algebra-wertigen Differentialformen, welche die Struktur einer Z_2-graduierten Differentialalgebra trägt, näher untersucht. Danach erfolgt die Implementierung eines geeignet gewählten Satzes eichinvarianter Felder sowie bestimmter algebraischer Relationen in das Funktionalintegral, wodurch die ursprüngliche eichabhängige Feldkonfiguration ausintegriert werden kann. Diese als "Reduktion des Funktionalintegrals" bezeichnete Prozedur führt schließlich auf eine effektive bosonisierte (Quanten-) Theorie wechselwirkender eichinvarianter, und damit physikalischer Felder. Die vorgestellte Prozedur kann als allgemeines Bosonisierungsschema für Quantenfeldtheorien in beliebigen Raum-Zeit-Dimensionen angesehen werden. Die physikalische Auswertung der erhaltenen effektiven Theorien wird am Beispiel der Berechnung der chiralen Anomalie sowie bestimmter Vakuum-Erwartungswerte im Rahmen der untersuchten abelschen Modelle demonstriert. Wie sich dabei zeigt, wird man mit einer Reihe neuartiger Phänomene und Probleme konfrontiert, die bei geeigneter Behandlung tiefere Einblicke in nichtperturbative Fragestellungen erlauben. / Within the thesis a new procedure, called "reduction of the functional integral", is developed for formulating quantum field theories in terms of gauge invariant quantities (physical observable fields). It provides a new way for the construction and analysis of effective field theoretical models. Starting with a detailed mathematical analysis of the algebra of Grassmann--algebra valued gauge invariants, the procedure is applied to the two--dimensional Thirring--model, the four--dimensional spinor QED and the one--flavor QCD in four dimensions. For each of these three models an effective theory of interacting bosonic gauge invariant fields was deduced on the quantum level. Apart from this more theoretical considerations, first steps on the way to an analysis of the obtained effective models towards their application in various physical problems are performed. In the case of the two Abelian models a new approach to the bosonisation scheme and the calculation of the chiral anomaly in two and four dimensions were obtained, giving some deeper insight into the nature of the bosonisation phenomenon as well as the nature of anomalies, respectively. Moreover, the investigation of current--current expectation values shows that the suggested procedure can be viewed as a new way towards a non--perturbative formulation and understanding of quantum field theories.

Thesis (doctoral)--Katholische Universität, Eichstätt-Ingolstadt, 2004. / Includes bibliographical references (p. 395-411).

Title from second page of PDF document. Includes bibliographical references (p. 170-184).