Social work intervention with families of patients with dementia in the intensive care unit

El objetivo del autor es explicar y describir la intervención del trabajador social con familiares de pacientes que sufren de la enfermedad de la demencia y que son admitidos a la Unidad de Cuidados Intensivos (UCI/CCU). Entre las intervenciones del trabajador social están incluidos pero no limitados; coordinar y comunicar, poniendo énfasis la comunicación entre el personal médico y los familiares de los pacientes, y asegura que sus necesidades sean atendidas, apoyo emocional (sicoterapia/consejería), poniendo énfasis a los problemas psicosociales que los familiares puedan tener. Para algunos familiares este es la primera vez que ellos se permiten hablar acerca de la realidad de la situación. Este es también el tiempo cuando los familiares comienzan a tomar decisiones médicas. El propósito principal de la reunión con los familiares del paciente es el de asegurarles que los deseos médicos del paciente serán respetados, que los familiares estén enterados de estos deseos, reconociendo que todo se va a hacer, y que los doctores y enfermeros están haciendo lo mejor posible para la recuperación del paciente.________________________________________The author’s objective is to explain and describe the intervention of the social worker with families of patients with dementia who are admitted to the Intensive Care Unit (ICU). Among the interventions of the social worker are included but not limited to; communication, coordination, emotional support (psychotherapy/counselling), putting emphasis in psychosocial problems that families may have. For some family members this is the first time they have allowed themselves to think and talk about the reality of the situation. This is also the time when the family members can begin to make medical decisions. The main purpose of the meeting with the family of the patient is to ensure that the medical wishes of the patient are respected, that the family is aware of his/her wishes, recognizing that everything must be done, and that doctors and nurses are doing the best they can for the recovery of the patient

On the benthic molluscs of Banco Inglés (Río de la Plata, Uruguay)

We describe the specific richness and community structure of benthic molluscs on a shallow-water sandy bank (Banco Inglés) in the Río de la Plata estuary. From a total of 25 macroinvertebrate taxa collected, that included one ophiuroid, one bryozoan, fourcrustaceans and four polychaete species, molluscs were the dominant taxon, with 15 species recorded. These were one species of Polyplacophora, eight Bivalvia and six Gastropoda (one exotic), representing 11families and 11 genera. In terms of mean relative abundance, the molluscan assemblage was dominated by the deposit-feeder bivalve Corbula caribaea, averaging ca. 30% of the individuals of the macroinfauna. The alien species Rapana venosa was noted in two stations, represented by one and four specimens. We used null model analysis to test for nonrandomness in the structure of the molluscan communities of the area. The analysis supported the null hypothesis that co-occurrence patterns could not be distinguished from those that might arise by random processes

Sobre los moluscos bentónicos del Banco Inglés (Río de la Plata, Uruguay)

We describe the specific richness and community structure of benthic molluscs on a shallow–water sandy bank (Banco Inglés) in the Río de la Plata estuary. From a total of 25 macroinvertebrate taxa collected, that included one ophiuroid, one bryozoan, four crustaceans and four polychaete species, molluscs were the dominant taxon, with 15 species recorded. These were one species of Polyplacophora, eight Bivalvia and six Gastropoda (one exotic), representing 11 families and 11 genera. In terms of mean relative abundance, the molluscan assemblage was dominated by the deposit–feeder bivalve Corbula caribaea, averaging ca. 30% of the individuals of the macroinfauna. The alien species Rapana venosa was noted in two stations, represented by one and four specimens. We used null model analysis to test for nonrandomness in the structure of the molluscan communities of the area. The analysis supported the null hypothesis that co–occurrence patterns could not be distinguished from those that might arise by random processes. Key words: Benthos, Biodiversity, Banco Inglés, Uruguay.Describimos la riqueza específica y estructura de la comunidad de moluscos en un banco arenoso somero (Banco Inglés) en el Río de la Plata. En total, de los 25 taxones de macroinvertebrados colectados, que incluyeron una especie de ofiuroideos, una de briozoo, cuatro de crustáceos y cuatro de poliquetos, los moluscos fueron el grupo dominante. Dentro de las 15 especies de moluscos recolectadas se constató la presencia de una especie de Polyplacophora, ocho de Bivalvia y seis de Gastropoda (una exótica), representando 11 familias y 11 géneros. En términos de abundancia relativa media, la asociación de moluscos estuvo dominada por el bivalvo depositívoro Corbula caribaea, promediando aprox. 30% del total de individuos de la macrofauna. La especie exótica Rapana venosa fue registrada en dos estaciones, representada por uno y cuatro individuos. Se utilizaron modelos nulos parar evaluar patrones en la estructura de la comunidad de moluscos en el área. Los análisis apoyaron la hipótesis nula de que los patrones de co–ocurrencia no pudieron diferenciarse de aquellos originados por procesos aleatorios. Palabras clave: Bentos, Biodiversidad, Banco Inglés, Uruguay

Exchange Rate Volatility and Economic Performance in Peru: A Firm Level Analysis

This paper analyzes the impact of the exchange rate volatility on the performance of the Peruvian economy using financial information from 163 non-financial listed firms. We find evidence that, for firms holding dollar-denominated debt, investment decisions are negatively affected by real exchange rate depreciation. The reasons behind this result are: (i) the high degree of liability dollarization and currency mismatch that create the conditions for a balance sheet effect and a financial stress in the aftermath of a currency depreciation, (ii) the strong bank-lending channel that follows and reinforces the balance sheet effect, (iii) the domestic demand shrinkage that affects severely the firms sales, and (iv) the relatively small and poorly diversified export sector.

Trabajo social y la importancia de la comunicación con familiares de pacientes admitidos a la unidad de cuidados intensivos = Social work and the importance of communication with the families of patients admitted to the intensive care unit

Este artículo emerge de la experiencia del autor con familiares de pacientes admitidos a la Unidad de Cuidados Intensivos (UCI). La investigación de las necesidades de los familiares y la intensa emoción generada durante la entrevista la cual es tener la oportunidad de poder expresar sus emociones acerca de la experiencia de tener a un ser querido en la UCI es terapéutico. Para otros quiere decir angustia, ansiedad, depresión, miedo, cólera y desesperación a manera que expresan los eventos que son el resultado de una situación de incertidumbre y temor. A pesar de tener experiencia en intervención en crisis, al comienzo el autor no estuvo preparado para la intensidad de sentimientos y emociones que son demostrados por los familiares en la UCI. El autor descubre que esta clase de sufrimientos son emocionalmente extenuantes para todos los participantes (médicos, enfermeros, trabajadores sociales, pacientes y familiares). Temas de ética y metodología que surgen como resultado de la intervención incluyen: a) el generar situaciones que requieren intervención psicoterapéutica; b) el impacto de sentirse envuelto emocionalmente. El tema de apartarse de una intensa entrevista emocional con frecuencia lo deja a uno con un sentido de “dejar algo sin terminar.”__________________________________________________This article is the result of this author’s experience with families of patients who are admitted to the Intensive Care Unit (ICU). Investigation of the needs of families and the intensity of emotions that evolves during the course of the interview that for some is the opportunity to be able to talk and express their feelings about their experience of having a loved one admitted to the ICU is therapeutic; for others it means anxiety, depression and frustration by the way they express their feelings that are the result of a serious illness of a loved one. Even though the author is experienced in crisis intervention, he was not ready for the intensity of emotions that are shown by many of the families when he was first was assigned to the ICU. The author discovered that this type of suffering is emotionally exhausting. Topics of ethics and methodology that arise as a result of the intervention includes: situations that require therapeutic intervention. b) the impact of feeling emotionally involved. The theme of separation from an intense interview frequently leaves us with a sense of “leaving something with out finishing it.”Good communication not only depends on the social worker but also fron those who attend and care for the patients. Language could be ambivalent falling into honest misunderstandings as the needs of patients and their family could not always be the same. This could make for the social worker to feel “unconfortable”when trying to meet the needs of patients and their families.The author is a Social Worker at Bronx Lebanon Hospital Center. Bronx, New York. USA

Ethnic Studies in Academe: Challenges and Prospects for the 21st Century. NAES Plenary Session , Kansas City,1995 Missouri, March 19, 1994

The primary intent of organizing the plenary that follows was to engage a number of dedicated and experienced ethnic studies scholar-activists in a focused conversation on the current state of ethnic studies in the academy. At this point many of us have been involved in ethnic studies for more than twenty years. The perspectives and observations offered in this monograph are transcribed from the recordings of the plenary. It offers the reader a far-ranging discussion of the field, its history, its struggles, its pedagogy, and some of its underlying principles

Psychiatric morbidity of overseas patients in inner London: A hospital based study

BACKGROUND: Evaluation of the referral, admission, treatment, and outcome of overseas patients admitted to a psychiatric hospital in central London. Ethical, legal and economic implications, and the involvement of consulates in the admission process, are discussed. METHOD: Assessment and review of overseas patients admitted between 1 January 1999 and 31 December 1999. Non-parametric statistical tests were used, and relevant outcomes described. RESULTS: 19% of admissions were overseas patients. Mean age was 38 years. 90% were unattached; 84% were white, 71% from European countries. 45% spoke fluent English. Differences in socio-economic status between home country and England were found. 74% were unwell on arrival; 65% travelled to England as tourists. 65% of admissions came via the police. 32% had been ill for more than one year before admission; 68% had psychiatric history. 77% were admitted and 48% discharged under section of the Mental Health Act. 74% had psychotic disorders, all of them with positive symptoms. 55% showed little to moderate improvement in mental state; 10% were on Enhanced Care Programme Approach. Relatives of 48% of patients were contacted. The Hospital repatriated 52% of patients; the Mental Health Team followed up 13% of those discharged. The average length of admission was 43.4 days (range 1–365). Total cost of admissions was GBP350, 600 ($577, 490); average individual cost was GBP11, 116 (range GBP200-81, 000). CONCLUSIONS: Mentally ill overseas individuals are a vulnerable group that need recognition by health organisations to adapt current practice to better serve their needs. The involvement of consulates needs further evaluation

El papel del Estrecho de Gibraltar en la conformación de la actual fauna de anfibios y reptiles en el Mediterráneo Occidental

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