Teaching the Spiritual Dimension of Nursing Care: A Survey of Associate Degree Nursing Programs in the Southeast United States

Spirituality is a subject which is often neglected in nursing education. The purpose of this study was to determine associate degree nursing faculty’s perception of their ability to teach the spiritual dimension in the delivery of nursing care. The study explored whether faculty have received training related to spiritual care, how and where nursing programs integrate spirituality education into the curriculum, nursing faculty’s understanding of the terms spirituality and spiritual care, and faculty members perception of whether they receive sufficient support and guidance in teaching related to spirituality and spiritual care. Survey research was used in this study. The participants were recruited from publicly funded associate degree nursing programs in the southeast who are accredited by the Accrediting Commission for Education in Nursing (ACEN). The number of faculty participants was 206. The Spirituality and Spiritual Care Rating Scale (SSCRS,) (McSherry & Jamieson, 2011) was used to explore nursing faculties’ understanding of the terms spirituality and spiritual care. The findings showed that participants had very strong beliefs about spirituality and its intrinsic value to patients. The Spiritual Care Content Scale (SCCS; Lemmer, 2002) explored what content was taught in nursing programs, the content most often covered included (a) the influence of cultural beliefs on spiritual care (77.9%), (b) spiritual needs of the dying and their families (76.2%), (c) the assessment of spiritual needs (71.3%), and (d) active listening as a means of spiritual care (66.2%). Integration of spirituality education into the nursing curriculum was also, addressed. Not surprisingly, lecture was the main method for teaching the spiritual dimension, followed by discussions, clinical and reading assignments, nursing models, role play and guest speakers. The final question sought faculty member’s perception of whether they receive sufficient support and guidance in teaching related to spirituality and spiritual care. The majority of the faculty said no (84.1%, n=146). These findings support the literature regarding the lack of perceived training and support for nurses related to the spiritual dimension and the need for greater integration of spirituality and spiritual care in the nursing curriculum. Providing guidelines for the provision of spiritual care and continued research in this area is warranted

Two Instances of Crow : A Cultural Study of Irish Mythology and Intertextuality in The Dead

Irish archetypes change the function of intertextuality in the The Dead, by mythologizing and de-anglicizing British intertextual allusions in the story, and suggest a new understanding of Joyce\u27s perception of cultural tensions in Ireland. Knowledge of these archetypes is a prerequisite to fully understanding this tension. Many critics fail to notice Joyce\u27s allusions because they are not reading the story within its defining context--which is the Irish Literary Revival. Celtic folklore helps convey his political outlook and his parody of literary activities in Ireland at the time of his writing. The story is essentially a parody with multiple levels of meaning in which the realistic and mythological levels do not cohere, and yet, paradoxically, it achieves an ironic thematic unity

Méthodes de génération et de validation de champs de déformation pour la recombinaison de distribution de dose à l’aide d’images 4DCT dans le cadre d’une planification de traitement de cancers pulmonaires

Des efforts de recherche considérables ont été déployés afin d'améliorer les résultats de traitement de cancers pulmonaires. L'étude de la déformation de l'anatomie du patient causée par la ventilation pulmonaire est au coeur du processus de planification de traitement radio-oncologique. À l'aide d'images de tomodensitométrie quadridimensionnelles (4DCT), une simulation dosimétrique peut être calculée sur les 10 ensembles d'images du 4DCT. Une méthode doit être employée afin de recombiner la dose de radiation calculée sur les 10 anatomies représentant une phase du cycle respiratoire. L'utilisation de recalage déformable d'images (DIR), une méthode de traitement d'images numériques, génère neuf champs vectoriels de déformation permettant de rapporter neuf ensembles d'images sur un ensemble de référence correspondant habituellement à la phase d'expiration profonde du cycle respiratoire. L'objectif de ce projet est d'établir une méthode de génération de champs de déformation à l'aide de la DIR conjointement à une méthode de validation de leur précision. Pour y parvenir, une méthode de segmentation automatique basée sur la déformation surfacique de surface à été créée. Cet algorithme permet d'obtenir un champ de déformation surfacique qui décrit le mouvement de l'enveloppe pulmonaire. Une interpolation volumétrique est ensuite appliquée dans le volume pulmonaire afin d'approximer la déformation interne des poumons. Finalement, une représentation en graphe de la vascularisation interne du poumon a été développée afin de permettre la validation du champ de déformation. Chez 15 patients, une erreur de recouvrement volumique de 7.6 ± 2.5[%] / 6.8 ± 2.1[%] et une différence relative des volumes de 6.8 ± 2.4 [%] / 5.9 ± 1.9 [%] ont été calculées pour le poumon gauche et droit respectivement. Une distance symétrique moyenne 0.8 ± 0.2 [mm] / 0.8 ± 0.2 [mm], une distance symétrique moyenne quadratique de 1.2 ± 0.2 [mm] / 1.3 ± 0.3 [mm] et une distance symétrique maximale 7.7 ± 2.4 [mm] / 10.2 ± 5.2 [mm] ont aussi été calculées pour le poumon gauche et droit respectivement. Finalement, 320 ± 51 bifurcations ont été détectées dans le poumons droit d'un patient, soit 92 ± 10 et 228 ± 45 bifurcations dans la portion supérieure et inférieure respectivement. Nous avons été en mesure d'obtenir des champs de déformation nécessaires pour la recombinaison de dose lors de la planification de traitement radio-oncologique à l'aide de la méthode de déformation hiérarchique des surfaces. Nous avons été en mesure de détecter les bifurcations de la vascularisation pour la validation de ces champs de déformation.Purpose: To allow a reliable deformable image registration (DIR) method for dose calculation in radiation therapy and to investigate an automatic vessel bifurcations detection algorithm for DIR assessment to improve lung cancer radiation treatment. Methods: 15 4DCT datasets are acquired and deep exhale respiratory phases are exported to Varian treatment planning system (TPS) Eclipse^{\text{TM}} for contouring. Voxelized contours are smoothed by a Gaussian filter and then transformed into a surface mesh representation. Such mesh is adapted by rigid and elastic deformations based on hierarchical surface deformation to match each subsequent lung volumes. The segmentation efficiency is assessed by comparing the segmented lung contour and the TPS contour considering two volume metrics, defined as Volumetric Overlap Error (VOE) [%] and Relative Volume Difference (RVD) [%] and three surface metrics, defined as Average Symmetric Surface Distance (ASSD) [mm], Root Mean Square Symmetric Surface Distance (RMSSD) [mm] and Maximum Symmetric Surface Distance (MSSD) [mm]. Vesselness filter was applied within the segmented lung volumes to identify blood vessels and airways. Segmented blood vessels and airways were skeletonised using a hierarchical curve-skeleton algorithm based on a generalized potential field approach. A graph representation of the computed skeleton was generated to assign one of three labels to each node: the termination node, the continuation node or the branching node. Results: The volume metrics obtained are a VOE of 7.6 ± 2.5[%] / 6.8 ± 2.1[%] and a RVD of 6.8 ± 2.4 [%] / 5.9 ± 1.9 [%] respectively for left and right lung. The surface metrics computed are an ASSD of 0.8 ± 0.2 [mm] / 0.8 ± 0.2 [mm], a RMSSD of 1.2 ± 0.2 [mm] / 1.3 ± 0.3 [mm] and a MSSD of 7.7 ± 2.4 [mm] / 10.2 ± 5.2 [mm] respectively for left and right lung. 320 ± 51 bifurcations were detected in the right lung of a patient for the 10 breathing phases. 92 ± 10 bifurcations were found in the upper half of the lung and 228 ± 45 bifurcations were found in the lower half of the lung. Discrepancies between ten vessel trees were mainly ascribed to the segmentation methode. Conclusions: This study shows that the morphological segmentation algorithm can provide an automatic method to capture an organ motion from 4DCT scans and translate it into a volume deformation grid needed by DIR method for dose distribution combination. We also established an automatic method for DIR assessment using the morphological information of the patient anatomy. This approach allows a description of the lung’s internal structure movement, which is needed to validate the DIR deformation fields

Bereavement, Level Stress and Coping Mechanism Among Teacher Education Students of Samar State University: College Bereavement Study

Bereavement is a severe stressor that should be addressed properly. The study of Teacher education is very tight as it prepares soon to educator that will light the future of other young children. This study sought to determine the Level of Stress and Coping Mechanism on Bereavement among Teacher Education Students of Samar State University. It tested some assumption using the descriptive survey method on 76 identified students who experienced bereavement. It shows that respondent manifested highly emotional and physical stress rather than behavioral stress. It shows that social support is coping mechanism. The said study being the first bereavement research in the city could provide baseline information in the field of bereavement