Implementing a Preceptor Toolkit and Eliminating the Barriers to Student Evaluations

Nurse Anesthesia Programs rely on Certified Registered Nurse Anesthetists (CRNA) to precept students and evaluate student’s skills. Though CRNAs precept students, their training is not in evaluation methodology and they do not feel qualified to perform student evaluations. This DNP project identified preceptors’ opinions about precepting students, and areas of concern in communicating with students and evaluating student competency. A communication and an evaluation tool were selected and a literature review was performed. The One-Minute Preceptor and the Dreyfus Five-Stage Model of Adult Skills Acquisition were combined into a Preceptor Toolkit and presented as teaching aids to preceptors. After preceptors received the education module, a post-implementation survey was created to gauge if there were changes in preceptor’s opinions of precepting and evaluating students. The results from the follow-up survey were unchanged from the results of the initial survey. There were no differences recorded in preceptor’s opinions from before the Preceptor Toolkit presentation to the follow-up survey after the presentation

Managing AIDS stigma

ccording to anecdotal reports, AIDS stigma and discrimination continue to influence people living with and affected by HIV disease as well as their health care providers, particularly in southern Africa where the burden of AIDS is so significant. Stigma is perceived as a major limiting factor in primary and secondary HIV/AIDS prevention and care. It reportedly interferes with voluntary testing and counselling, and with accessing care and treatments, thereby increasing suffering and shortening lives. Many health care workers in southern Africa have come to the conclusion that unless stigma is conquered, the illness will not be defeated. While there is substantial anecdotal evidence of the impact of stigma on AIDS care, very little rigorous research has been conducted. This article explores three questions: What is AIDS stigma? What is the impact of AIDS stigma? How can health care providers help to manage AIDS stigma? Key words: HIV/AIDS stigma, management, measurement. La gestion de la stigmatisation liée au SIDA RÉSUMÉ D'après des rapports anecdotiques, la stigmatisation et la discrimination liées au SIDA continuent à influencer les personnes vivant avec la maladie du VIH, ceux qui en sont affectés ainsi que leurs fournisseurs de soins particulièrement en Afrique Australe où le fardeau du SIDA est très prononcé. La stigmatisation est perçue comme un facteur majeur qui restreint la prévention et les soins primaires et secondaires du VIH/SIDA. Il est dit que la stigmatisation entrave la Consultation et le Dépistage Volontaires (VCT) et l'accès au soin et au traitement. Pour cette raison, la stigmatisation augmente la souffrance et raccourcit la vie. Beaucoup de personnel de soin, en Afrique Australe, ont tiré la conclusion qu'à moins que la stigmatisation soit conquise, la maladie ne sera jamais vaincue. Pendant qu'il y a une évidence anecdotique importante de l'impact de la stigmatisation sur le soin du SIDA, très peu de recherche rigoureuse a été faite. Cette présente communication étudie trois questions: Qu'est-ce que la stigmatisation? Quel est l'impact de la stigmatisation liée au SIDA? Comment est-ce que les fournisseurs de soin peuvent aider dans la gestion de la stigmatisation associée au SIDA? Mots clés: VIH/SIDA, soigner, stigmatisation. Sahara J Vol.1(3) 2004: 165-17

Comparison of the health-related quality of life, CD4 count and viral load of AIDS patients and people with HIV who have been on treatment for 12 months in rural South Africa

This study compared the level of CD4 count, viral load and health-related quality of life (HRQOL) between treatment-naı¨ve AIDS patients and a cohort of people living with HIV who have been on treatment for 12 months. This study is based on a secondary data analysis of the records of 642 people with HIV consisting of 311 treatment-naı¨ve AIDS patients and 331 people with HIV who have been on treatment for 12 months. The study findings are mostly presented in tables and analysed using the t-test to compare HRQOL scores, CD4 count and viral load in the two groups. The study generally noted poor financial capacity and low activity tolerance among the participants. Significant changes were noted in all the domains of HRQOL compared between the treatment-naı¨ve patients and the 12 months treatment cohort. In the same manner, the median CD4 cell count and viral load differed significantly between both groups. The treatment-naı¨ve and the 12 months treatment cohorts consistently reported much lower quality of life scores in the level of dependence domain which includes the measures of mobility, activity of daily living, dependence on medication and work capacity. There were little or no associations between the biomedical markers (CD4 count and viral load) and HRQOL indicators. However, the quality of life tended to increase with increase in the CD4 cell count. The poor to no association between the biomedical markers and HRQOL indicators show that these cannot be direct proxies of each other and that the CD4 cell count and viral load alone may be inadequate eligibility criteria for social support.Keywords: AIDS/HIV, CD4 cell count, health-related quality of life, viral load, WHOQOL-HI

Analyse dynamique de la durabilité vécue et mise en œuvre par les acteurs des circuits courts wallons

« Quels sont les déterminants, les freins et les leviers permettant d’améliorer la durabilité des circuits courts ? » « Comment favoriser la réappropriation de ces connaissances par les acteurs de terrain ? » Telles sont les questions pour lesquelles il a été demandé à l’équipe de recherche d’apporter des éléments de réponse. L’analyse livrée est le fruit d’une recherche menée par le Centre d’Études Économiques et Sociales de l’Environnement de l’Université Libre de Bruxelles entre 2015 et 2016, financée par la Région wallonne et coordonnée par la Fédération Inter-Environnement Wallonie. L’approche avec laquelle la durabilité a été abordée dans ce projet est singulière et se démarque explicitement d’une approche qui serait centrée sur les trois piliers (économique, social et environnemental) et leurs intersections. Cet affranchissement conceptuel a été traduit par une méthode itérative et inductive qui a permis d’aboutir à un ensemble de connaissances et de constats en provenance directe de différents acteurs impliqués dans les filières en circuits courts. L’approche a permis, dans le même temps, d’augmenter le caractère réappropriable des données récoltées. La durabilité des circuits courts a été abordée au travers de sujets et d’enjeux appartenant à la réalité quotidienne des acteurs et de leurs métiers. La durabilité dont il est question ici est celle vécue et mise en oeuvre quotidiennement par les acteurs. Cette approche implique de questionner de fil en aiguille les modèles d’entreprenariat, les interactions socioéconomiques mais aussi les différentes motivations, conceptions du monde et valeurs. La démarche a cherché à adopter une perspective qui soit en résonnance avec la réalité des personnes au sein de leurs activités

Transmen: The HIV Risk of Gay Identity

Many female-to-male transgender individuals, or transmen, are situated within the gay community, one of the highest risk communities for HIV, yet there has been little research regarding the experience of risk for these transmen. Seventeen transmen were interviewed regarding their sexuality and HIV risk behavior. Fourteen of the 17 reported having non-trans gay men as sexual partners. Risk behaviors included not using condoms with multiple partners who were HIV-positive, or of unknown HIV status. Aspects of risk included the unfamiliarity of the gay community and the lack of safe sex negotiating skills. The dynamics of acceptance and rejection between transmen and non-trans gay men impacted risk by compromising safety. Incorrect assumptions regarding transmen, non-trans gay men, and risk included beliefs that neither person could be at risk. Other aspects included the impact of testosterone on sexual behavior, the changed bodies of transmen, and sex work

Formal nursing terminology systems: a means to an end

In response to the need to support diverse and complex information requirements, nursing has developed a number of different terminology systems. The two main kinds of systems that have emerged are enumerative systems and combinatorial systems, although some systems have characteristics of both approaches. Differences in the structure and content of terminology systems, while useful at a local level, prevent effective wider communication, information sharing, integration of record systems, and comparison of nursing elements of healthcare information at a more global level. Formal nursing terminology systems present an alternative approach. This paper describes a number of recent initiatives and explains how these emerging approaches may help to augment existing nursing terminology systems and overcome their limitations through mediation. The development of formal nursing terminology systems is not an end in itself and there remains a great deal of work to be done before success can be claimed. This paper presents an overview of the key issues outstanding and provides recommendations for a way forward

La durabilité des circuits courts, une question d’échelle ? L’importance de court-circuiter les schémas classiques d’analyse

La durabilité des circuits courts (CC) est souvent abordée selon les performances comparées entre les chaînes locales et globales. Or force est de constater que les études menées sur le sujet s’accommodent très mal des spécificités liées aux CC. La perspective adoptée dans cet article s’émancipe d’une analyse de la durabilité articulée autour de ses piliers et endosse une approche inductive. À travers une analyse qualitative, l’étude souligne l’importance d’observer les logiques multi-acteurs à l’œuvre au sein des territoires. Parmi les ressorts fondamentaux émerge, tel un dénominateur commun aux CC, la densité des interactions que les acteurs tissent entre eux. Cet aspect est fondamental tant pour la compréhension des leviers que pour celui des freins à la durabilité des initiatives.The sustainability of short food supply chains (SFSC) is mainly approached through comparing the performance of local and global chains. However, the very specificities of SFSC are difficult to account for in analysis. In this paper, we break free from a three-pillars perspective on sustainability and instead adopt an inductive approach. One crucial insight that arises from our qualitative study is the importance of multi-actors dynamics within specific territories. Among the crucial drivers, the density of interactions built up by actors emerges as a common denominator of SFSC. This aspect is essential for understanding both the drivers of and the obstacles to the sustainability of SFSC initiatives