Caring for a loved one with a malignant fungating wound

Purpose: Caring for a loved one with a malignant fungating wound is very challenging and causes extreme physical and psychological distress. The aim of this study was to explore the experiences of carers who care for a loved one with a fungating breast wound. Method: To explore the lived experiences of carers, a methodological framework using Heideggerian hermeneutic phenomenology and semi-structured interviews was used. Seven carers were interviewed from January until November 2009. Results: Having to deal with a situation of a loved one with a visible cancer was hard for all the carers. The visibility of the cancer was one of the most shocking aspects to deal with from the perspective of the patient and the carer. The presence of the visible wound and a cancer at an advanced stage contributed to a change in the relationship and extreme suffering for both the patient and the carer. Despite many problems such as wound odour and copious discharge from the wound, which was difficult to control, carers did their best to help their loved one with the wound. Gradually, the wound became the centre of the patient and carer's life, and a great deal of time was spent trying to control the wound symptoms. All carers managed the wound on their own without help and advice from health care practitioners. For all of them, it was a major burden and they felt isolated. Conclusion: This study contributes to an understanding that the care of women and their carers needs strategies that are integrated in palliative wound care that takes a holistic and empathic approach that responds to patients' and carers' psychosocial and emotional needs and a practical need for information to help carers assist in managing the wound-related symptom

Building reputation : the significance of pain talk in hospice and palliative care team meetings

EThOS - Electronic Theses Online ServiceGBUnited Kingdo

Facilitators and barriers to early diagnosis of malignant mesothelioma (FILMM): A qualitative study

Prognosis with malignant mesothelioma (MM) is poor, yet evidence indicates a better chance of survival at earlier diagnosis. There is a shortage of research to produce evidence based guidance related to patients’ journey to mesothelioma diagnosis, which could be vital in improving earlier diagnosis and ultimately the survival rate. This is particularly important for the UK as the survival rate in the UK is lower than Europe’s average. Although, there has been an attempt to examine MM patients’ referral pathway once they present to a healthcare professional, there has been no study that has examined their entire pathway to diagnosis (i.e. from patient’ symptom awareness to diagnosis). This is particularly relevant at this period as evidence has shown the impact COVID19 has on waiting times to diagnosis for other cancers. There has been little attention to MM patients’ experiences prior to diagnosis (i.e. early symptom awareness, help-seeking decisions and subsequent treatment pathways) as available studies have focused on their lived experiences after diagnosis. It is important to understand how MM patients appraise their symptoms, present to health services with MM symptoms and the speed of the pathway from presentation and referral to diagnosis and treatment

Evaluation des unités de prévention et de traitements pour jeunes suicidants à Genève: L'unité de crise pour adolescents des HUG : évaluation de son fonctionnement durant la première année ; Evaluation du programme d'étude et prévention du suicide rattaché à l'unité hospitalière pour jeunes suicidants à Genève

[Table des matières] 1. Synthèse et conclusion : Le projet; l'évaluation; résumé des premiers résultats; présentation de l'Unité; quelques chiffres; le vécu des adolescents / des soignants; le devenir des jeunes à trois mois; Conclusions et recommandations. 2. Introduction et méthodes : Le projet Children Action; évaluation de l'unité hospitalière; population cible; évaluation. 3. L'échantillon et son évolution : composition; données de tentative de suicide; données sur le séjour; évolution de la situation des adolescents enetre les deux bilans; gestion du temps libre; consommations, comportements à problème et santé subjective; image de soi; status psychiatrique; suivi thérapeutique et risque suicidaire; remarques. 4. Entretiens avec les infirmiers et les thérapeutes, l'assistante sociale. 5. Analyse des entretiens avec les adolescents : compliance; sorties, repas, soirées et nuits; vécu de l'hospitalisation; relations avec la famille..

Working Memory Capacity as a Determinant of Proactive Interference and Auditory Distraction

Individual differences in working memory capacity are related to performance on a range of elemental and higher order cognitive tasks. The current experiment tests the assumptions of two theoretical approaches to working memory capacity: working memory as executive attention and working memory as temporary binding. These approaches are examined using a short-term updating task where proactive interference is manipulated, such that old responses have to be suppressed in favour of new responses. A second source of distraction is introduced by way of irrelevant, to-be-ignored background speech that accompanies presentation of the list items. This speech reinforces either the to-be-remembered item on the current list, or the to-be-suppressed item. Working memory capacity was significantly related to overall level of correct performance on the short-term task, and to the degree of proactive interference experienced. However, there was no evidence for individual differences in the ability to suppress the interfering foil, nor in priming effects associated with the irrelevant speech. The results provided little support for the working memory capacity as executive attention perspective, some evidence for the binding perspective, but also evidence supporting the fact that some effects of distraction are not under voluntary control

La sexualité des personnes vivant avec le VIH/sida

[Table des matières] I. Résumé. II. Zusammenfassung. III. Méthodes. 1. Entretiens avec des intervenants. 2. Entretiens avec les personnes vivant avec le VIH. IV. Analyse de la littérature. 1. Aspects généraux liés au VIH. 2. Aspects de la vie sexuelle influencés par le VIH. 3. Counselling. V. Intervenants. 1. Perception de soi. 2. Désir. 3. Recherche de partenaire(s). 4. Relations de couple. 5. Activité sexuelle. 6. Activité sexuelle dans les couples stables. 7. Activité sexuelle chez les personnes sans partenaire stable. 8. Responsabilité de la protection. 9. Désir d'enfant / procréation. VI. Personnes vivant avec le VIH. 1. Perception de soi. 2. Nouer une relation. 3. Maintenir une relation. 4. Adéquation de l'offre de prise en charge dans le domaine de la sexualité. VII. Discussion et conclusions. 1. Conséquences du VIH/sida sur la vie affective et sexuelle des personnes infectées. 2. Résultats de la "triangulation" de l'information. 3. Conséquences en termes de santé publique

Working memory capacity as a determinant of proactive interference and auditory distraction

Individual differences in working memory capacity are related to performance on a range of elemental and higher order cognitive tasks. The current experiment tests the assumptions of two theoretical approaches to working memory capacity: working memory as executive attention and working memory as temporary binding. These approaches are examined using a short-term updating task where proactive interference is manipulated, such that old responses have to be suppressed in favour of new responses. A second source of distraction is introduced by way of irrelevant, to-be-ignored background speech that accompanies presentation of the list items. This speech reinforces either the to-be-remembered item on the current list, or the to-be-suppressed item. Working memory capacity was significantly related to overall level of correct performance on the short-term task, and to the degree of proactive interference experienced. However, there was no evidence for individual differences in the ability to suppress the interfering foil, nor in priming effects associated with the irrelevant speech. The results provided little support for the working memory capacity as executive attention perspective, some evidence for the binding perspective, but also evidence supporting the fact that some effects of distraction are not under voluntary control

Negotiated reorienting: a grounded theory of nurses’ end-of-life decision-making in the intensive care unit

Background Intensive care units (ICUs) focus on treatment for those who are critically ill and interventions to prolong life. Ethical issues arise when decisions have to be made regarding the withdrawal and withholding of life-sustaining treatment and the shift to comfort and palliative care. These issues are particularly challenging for nurses when there are varying degrees of uncertainty regarding prognosis. Little is known about nurses’ end-of-life (EoL) decision-making practice across cultures. Objectives To understand nurses’ EoL decision-making practices in ICUs in different cultural contexts. Design We collected and analysed qualitative data using Grounded Theory. Settings Interviews were conducted with experienced ICU nurses in university or hospital premises in five countries: Brazil, England, Germany, Ireland and Palestine. Participants Semi-structured interviews were conducted with 51 nurses (10 in Brazil, 9 in

Relative Health Effects of Education, Socioeconomic Status and Domestic Gender Inequity in Sweden: A Cohort Study

Introduction: Limited existing research on gender inequities suggests that for men workplace atmosphere shapes wellbeing while women are less susceptible to socioeconomic or work status but vulnerable to home inequities. Methods: Using the 2007 Northern Swedish Cohort (n = 773) we identified relative contributions of perceived gender inequities in relationships, financial strain, and education to self-reported health to determine whether controlling for sex, examining interactions between sex and other social variables, or sex-disaggregating data yielded most information about sex differences. Results and Discussion: Men had lower education but also less financial strain, and experienced less gender inequity. Overall, low education and financial strain detracted from health. However, sex-disaggregated data showed this to be true for women, whereas for men only gender inequity at home affected health. In the relatively egalitarian Swedish environment where women more readily enter all work arenas and men often provide parenting, traditional primacy of the home environment (for women) and the work environment (for men) in shaping health is reversing such that perceived domestic gender inequity has a significant health impact on men, while for women only education and financial strain are contributory. These outcomes were identified only when data were sex-disaggregated

Actin remodeling by ADF/cofilin is required for cargo sorting at the trans-Golgi network

Sorting of both soluble and integral membrane proteins is disrupted by loss of ADF/cofilin, suggesting that actin severing controls expansion of a sorting domain within the TGN