Assistance Of Others Research Articles

Family Factors and Academic Achievement: A Comparative Study of Residential School Children and Rural Government School Children

<div><p>The study compares the effects of family factors contributing to the High Academic Achievement of Private Residential School Children and Rural Government School Children. Children studying in selected private residential schools and rural government schools in IX and X classes with highest ranks (first 3-4 ranks) in the previous year were selected. Total sample comprised 240 children, 120 from each setting, 60 from IX class and 60 from X class. An Interview schedule was developed by the investigator for the children to know their perceptions about family contributing factors. The study concluded that children of Private Residential Schools and Rural Government Schools were average and similar in their perceptions regarding parental contributions for their Academic Achievement. High Parental Aspirations Expectations helped in high achievement in both groups but comparatively high in Private Residential School children. Whereas contribution of Siblings Relationship and Assistance of others was high in Rural Government School children and average in Private Residential School children. Coming to the gender and age variations in family contributing factors, there was significantly high parental contributions for Academic Achievement of boys than girls in private Residential schools and higher age group children of Rural Government schools have significantly more parental contribution for their Academic Achievement than lower age group children. Achievement in English was highly positively correlated with family’s Economic status in Private Residential schools. There was significant positive correlation between achievement in mathematics and parental contribution, achievement in science and Parental Aspirations in Rural Government School children.</p></div>

An independent shopping experience for wheelchair users through augmented reality and RFID

ABSTRACTPeople with physical and mobility impairments continue to struggle to attain independence in the performance of routine activities and tasks. For example, browsing in a store and interacting with products located beyond an arm’s length may be impossible without the enabling intervention of a human assistant. This research article describes a study undertaken to design, develop, and evaluate potential interaction methods for motor-impaired individuals, specifically those who use wheelchairs. Our study includes a user-centered approach, and a categorization of wheelchair users based upon the severity of their disability and their individual needs. We designed and developed access solutions that utilize radio frequency identification (RFID), augmented reality (AR), and touchscreen technologies in order to help people who use wheelchairs to carry out certain tasks autonomously. In this way, they have been empowered to go shopping independently, free from reliance upon the assistance of others. A total of 18 wheelchair users participated in the completed study.

Staffs’ documentation of participation for adults with profound intellectual disability or profound intellectual and multiple disabilities

Purpose: This study investigated what areas of International Classification of Functioning, Disability and Health were documented in implementation plans for adults with profound intellectual disability or profound intellectual and multiple disabilities with focus on participation.Methods: A document analysis of 17 implementation plans was performed and International Classification of Functioning, Disability and Health was used as an analytic tool.Results: One hundred and sixty-three different codes were identified, especially in the components Activities and participation and Environmental factors. Participation was most frequently coded in the chapters Community, social and civic life and Self-care. Overall, the results showed that focus in the implementation plans concerned Self-care and Community, social and civic life. The other life areas in Activities and participation were seldom, or not at all, documented.Conclusions: A deeper focus on participation in the implementation plans and all life areas in the component Activities and participation is needed. It is important that the documentation clearly shows what the adult wants, wishes, and likes in everyday life. It is also important to ensure that the job description for staff contains both life areas and individual preferences so that staff have the possibility to work to fulfill social and individual participation for the target group.Implications for rehabilitationThere is a need for functioning working models to increase participation significantly for adults with profound intellectual disability or profound intellectual and multiple disabilities.For these adults, participation is achieved through the assistance of others and support and services carried out must be documented in an implementation plan.The International Classification of Functioning, Disability and Health can be used to support staff and ensure that information about the most important factors in an individual’s functioning in their environment is not omitted in documentation.

Self-reported hypoglycaemia in patients with type 2 diabetes treated with insulin in the Hoorn Diabetes Care System Cohort, the Netherlands: a prospective cohort study.

BackgroundOur aim was to study the prevalence of self-reported hypoglycaemic sensations and its association with mortality in patients with type 2 diabetes (T2D) treated with insulin in usual care.MethodsDemographics, clinical characteristics and mortality data were obtained from 1667 patients with T2D treated with insulin in the Hoorn Diabetes Care System Cohort (DCS), a prospective cohort study using clinical care data. Self-reported hypoglycaemic sensations were defined as either mild: events not requiring help; or severe: events requiring help from others (either medical assistance or assistance of others). The association between hypoglycaemic sensations and mortality was analysed using logistic regression analysis.ResultsAt baseline, 981 patients (59%) reported no hypoglycaemic sensations in the past year, 612 (37%) reported only mild sensations and 74 (4%) reported severe hypoglycaemic sensations. During a median follow-up of 1.9 years, 98 patients (5.9%) died. Reporting only mild hypoglycaemic sensations was associated with a lower mortality risk (OR 0.48, 95% CI 0.28 to 0.80), while reporting severe sensations was not significantly associated with mortality (OR 0.76, 95% CI 0.33 to 1.80), compared with reporting no hypoglycaemic sensations, and adjusting for demographic and clinical characteristics. Sensitivity analyses showed an OR of 1.38 (95% CI 0.31 to 6.11) for patients reporting severe hypoglycaemic sensations requiring medical assistance.ConclusionsSelf-reported hypoglycaemic sensations are highly prevalent in our insulin-treated T2D population. Patients reporting hypoglycaemic sensations not requiring medical assistance did not have an increased risk of mortality, suggesting that these sensations are not an indicator of increased short-term mortality risk in patients with T2D.

Congregaciones religiosas, educación y escuela en Italia en el siglo XIX

This article traces the origins and development of about 140 new religious male and female congregations, established in Italy during the Nineteenth century. Starting from the Restoration period, the article frames the actions and choices of the new religious congregations with reference to the new scenarios produced by the revolutionary experience and by the changes introduced in ecclesiastical legislation and in the relations between State and Church during the Napoleonic era. At the same time, it deals with the unusual challenges the Church had to face due to both the secularization of mentality and customs and the increased educational needs and welfare of the post-revolutionary period. The author analyses some characteristics of these new religious institutions, most of which chose as privileged —and sometimes exclusive— activity of their apostolate the assistance (of poor and sick people, and of abandoned children and youth), the catechesis and animation of religious life in the parishes and, above all, the education of youth of both sexes and of different social classes. Firstly, the author describes the aspect related to the general adoption of the structure of religious congregations, which provides unequivocal evidence of the prevalence, also on the female side, of the traditional monastic model, of a vocation to religious life understood essentially as an active life devoted to charity, a synthesis between action and prayer, a commitment in the world through the assistance of others. The author’s reconstruction also shows how the idea of charity promoted by the new religious congregations was understood not simply as a commitment to provide assistance, but also, and above all, as an educational responsibility. Indeed, the new religious congregations considered education, school and parish catechesis as the most effective tools for Christians’ education. At the same time, school and education were also seen as the most direct and useful tool for relieving poverty and overcoming the marginalisation of the poorer classes and as the most effective tool for facilitating the successful integration of young working class men and women into society.

Chronicity, self care, social and family support: how the patient has?

Results A total of 538 people with diabetes, and the study population was predominantly female (63 4%), married people or with fixed partners (55.6%), older (59.7%), Catholic (72.1%), low education, less than 10 yrs. (74%); 65% with incomes below twice the minimum wage. On clinical data 79.2% were hypertensive, 69.1% with over 10 yrs. of diagnosis of diabetes mellitus, 40.7% used medication by mouth for diabetes control, when asked about the help or assistance of others towards treatment, 62.3% reported not having social or family support or even encouragement to move with adherence to medication or non-medication treatment for diabetes. When asked about following the prescribed diet, only 60.4% reported following the diet routinely, as physical activity, 61.2% of persons were sedentary, 72.7% presented themselves with excess weight, and those with overweight or obese, 63.6% of diabetic people found themselves with altered glycemia, with greater 140 mg/dL at the time of data collection at random.

Orchestrating care: nursing practice with hospitalised older adults.

The increased incidence of health challenges with aging means that nurses are increasingly caring for older adults, often in hospital settings. Research about the complexity of nursing practice with this population remains limited. To seek an explanation of nursing practice with hospitalised older adults. Design. A grounded theory study guided by symbolic interactionism was used to explore nursing practice with hospitalised older adults from a nursing perspective. Glaserian grounded theory methods were used to develop a mid-range theory after analysis of 375hours of participant observation, 35 interviews with 24 participants and review of selected documents. The theory of orchestrating care was developed to explain how nurses are continuously trying to manage their work environments by understanding the status of the patients, their unit, mobilising the assistance of others and stretching available resources to resolve their problem of providing their older patients with what they perceived as 'good care' while sustaining themselves as 'good' nurses. They described their practice environments as hard and under-resourced. Orchestrating care is comprised of two subprocesses: building synergy and minimising strain. These two processes both facilitated and constrained each other and nurses' abilities to orchestrate care. Although system issues presented serious constraints to nursing practice, the ways in which nurses were making meaning of their work environment both aided them in managing their challenges and constrained their agency. Nurses need to be encouraged to share their important perspective about older adult care. Administrators have a role to play in giving nurses voice in workplace committees and in forums. Further research is needed to better understand how multidisciplinary teams influence care of hospitalized older adults.

The Evolution and Changing Context of Social Work Education

The nature of social work education has changed dramatically over the course of my academic career: From the degree(s) required for a faculty position to the number of years of practice experience; from expectations for research and publication, to criteria for promotion and tenure; from residential instruction to distance education; from an emphasis on foundation curriculum to practice competencies and outcomes; and, from a commitment to service to a quest to be the highest “ranked” program within the highest ranked institution. Given that change is an ongoing phenomenon, it is difficult to anticipate curriculum direction or plan one’s career path with a high degree of certainty. The future is often determined by external events, fate, where you are at a specific time, the assistance of others, and the opportunities that are presented. These changes and the evolution of social work education as a field of professional practice can best be demonstrated by reflecting on my own experiences in becoming a faculty member and serving in various academic positions over the last 45 years. The contrast between my personal experiences and those of the typical student in 2014 may help demonstrate some of the changes that have occurred in social work education over the intervening years.

“I think I can”: achievement-oriented themes in storybooks from Indonesia, Japan, and the United States

The focus of the present study is on the ways in which storybooks communicate cultural ideals about achievement orientation, and in particular, the role of effort, perseverance, and hard work in fostering successful outcomes. Sixty preschool children's books from Indonesia, Japan, and the United States (20 from each country) were examined for the presence of achievement-oriented themes. These countries were chosen due to previously documented cultural differences in models of learning and individualist/collectivist tendencies that could have some bearing on achievement outcomes. Texts were assessed for (1) the frequency with which “challenge events” appeared in the narratives, (2) whether these events derived from sources internal or external to the main character, and (3) whether solutions relied on the main character individually or included the assistance of others. Results show that Japanese storybooks contained significantly more challenge events than Indonesian storybooks. Compared with Japanese storybooks, American storybooks tended to include a greater proportion of challenges derived from internal qualities of the main character as opposed to external factors. Compared with American storybooks, Japanese storybooks contained a significantly greater proportion of challenges that were solved with individual efforts as opposed to efforts involving the assistance of others. Findings from this study contribute to our understanding of how storybook contexts can provide a rich source of information for young children learning about culturally valued qualities and behaviors related to achievement.

Testing Wars in the Public Schools: A Forgotten History by William J. Reese (review)

Reviewed by: Testing Wars in the Public Schools: A Forgotten History by William J. Reese Ben Keppel Testing Wars in the Public Schools: A Forgotten History. By William J. Reese. Cambridge: Harvard University Press, 2013. 298pp. Cloth $36.00. William J. Reese’s, Testing Wars in the Public Schools provides an urgently needed antidote to the ahistorical perspective which dominates current debates over the ways and means of providing universal public education in the United States. Because the American experiment with comprehensive universal education is indeed relatively new, it is quite easy to see twentieth- and twenty-first-century struggles over the equity of resources as standing alone in the “American Century” that reached its zenith during the Cold War. Reese reminds us that Americans, like the members of other political communities, have a history to reckon with and that the price of accepting the convenient option of just plowing ahead is to live in an unsatisfying present: the repetition of old arguments with no new intelligence to meet a genuinely diligent expenditure of passion and effort. Today, as in the past, parents, political leaders, and reformers of all stripes seek to remake education through a narrow definition of accountability firmly welded to a vast infrastructure of high-stakes testing. In the pursuit of easily demonstrated truths, the diversity of human learning and capacity is too easily set aside—too messy, too open-ended, [End Page 325] and ultimately, too expensive for some to pay in the assistance of others who are not their kin. When historians return us to the age of Lincoln, they remind us that, back in those days, long-form oratory ruled the day. We are less likely to remember another truth: three-hour performances of rhetorical mastery did not mean that their intellectual content (even of the Lincoln-Douglas debates) was any more free of trash talk, bigotry, sound, and fury, all meant more to divert and distract than to challenge (nostalgic yearning aside, how many voters respond well to being disagreed with?). One of the great pleasures in Reese’s book is his painstaking reconstruction of education as part and parcel of this political culture. In this world, public emulation of classic forms was highly prized. Here, high-stakes testing was alive and well: a “weighing of [public] blunders and wonders” (29). The stress on student, teacher, and parent was great as many resources and rewards were tied to these few public displays of cultural reverence and competence. Like the testing regimes of later years, this form of evaluation and reward favored certain configurations of aptitude and personality over others, and, in this early experiment in public education, the form and appearance of learning came to be more important than accommodating the far more complex and lifelong process through which an individual appropriates knowledge by the individual, for the individual. Although we have witnessed a genuine and continuing explosion of knowledge about the world, we have, Reese’s narrative rightly suggests, not made nearly as much progress toward finding public ways and institutional supports to encourage that last kind of educational journey. The standardized testing currently at the center of public debates, Reese confirms, originated in a meritocratic impulse—the desire to get beneath the showmanship encouraged by the more traditional reliance on public emulation and measure actual knowledge. In recounting a forgotten history of standardized testing, Reese is not looking to discredit such testing entirely, nor does he ignore the degree to which newer methods of teaching and assessment assisted many people in coming to terms with constantly changing technological requirements of earning a living. He focuses instead on the strong desire of both reformers and traditionalists to find ways to end necessary debates about matters in which we all have a stake. One of the qualities I most admire about this book is the way in which ambition and humility are both present here. Reese provides an excellent model of cultural history that is both rich in research and strong in theoretical understanding. His account of institutional politics within the Boston school system, bringing together David Wallker’s Appeal (still a sadly underutilized [End Page 326] historical source) with the public and...

Driver Assistance Systems and the Transition to Automated Vehicles: A Path to Increase Older Adult Safety and Mobility?

As operators of motor vehicles, drivers have been described as “outdated . . . with Stone Age characteristics and performance . . . controlling a fast, heavy machine in an environment packed with unnatural, artificial signs and signals” (Rumar, 1981). Despite our anatomical, physiological, and perceptual shortfalls, the fatality rate in the United States hit a historic low of 1.1 fatalities per 100 million vehicle miles traveled (VMT) in 2011 (National Highway Traffic Safety Administration, 2011). Fatal crash involvement by VMT increases by age starting in the mid-60s (Insurance Institute for Highway Safety, 2011), and many individuals begin to curtail or stop driving. However, the cessation of driving due to advanced age comes at great cost. Agerelated losses in the ability to drive equates, at best, to a forfeiture of personal freedom, reliance on the assistance of others to meet basic activities of daily living, and can lead to increased symptoms of depression (Marottoli et al., 1997). Transitions in driving roles occur throughout one’s lifetime. As medical conditions accrue, they can sporadically or permanently limit driving (Owsley, 2004). Women frequently cease driving earlier than men, and often while still fit to drive (Alsnih & Hensher, 2003; Siren, HakamiesBlomqvist, & Lindeman, 2004). Widowhood can increase older women’s need to drive (Braitman & Williams, 2011) at a time when this is particularly challenging. On the other hand, even as adults age, they are becoming increasingly economically able to purchase new vehicles (Coughlin, 2009). As a consequence of both the increased numbers and economic independence of older adults, innovations in personal mobility that mitigate the burdens of age will grow in value over the coming decades. A move toward new urbanism, including improved public transit systems and walkable streets and sidewalks, is an admirable vision that would help meet the growing needs of many older adults. However, it will require, at considerable cost, rebuilding or retrofitting the existing infrastructure at a rate that is not likely to meet the needs of today’s aging boomers. Fully automated or driverless cars, by contrast, represent a path that promises to enhance the mobility options of older adults within the existing infrastructure. However, many consumers do not clearly understand that while the basic building blocks of these systems are available today in advanced driver assistance systems (ADAS), fully automated or driverless vehicles are still on the distant horizon. For the foreseeable future, automated vehicle technologies, including ADAS, will continue to rely on a “responsible” driver to oversee the technology, capable of resuming control and having the foresight to make many (yet to be defined) strategic operational decisions. But because of their transformative promise and heavy news coverage, the prospect of automated cars has become a source of great hope for many. Some believe that fully automated cars, capable of navigating the roadways while the “operator” reads a paper or takes a nap, will be available within a few years. Unfortunately, that is not the case. Instead, there is work to be done to increase the awareness and education necessary to spur the purchasing of ADAS available today, which will support many older drivers’ mobility and safety needs.

HZ.PEYGAMBER'İN KARDEŞLİK (MUAHAT) UYGULAMALARI VE GÜNÜMÜZ AÇISINDAN DEĞERLENDİRİLMESİ

People have tol ive with. This association brings all kinds of cooperation and solidarity. Because a person living alone is almost impossible. Financial and physical help each other, of course, all kinds of people who will make a very important and valuable. But the real help, by the way, without any interest and kinship spiritual support and guidance to do. Every human being can make a mistake. Fault requires the assistance of others to return. In our religion, the sense of brotherhood and sisterhood practices of the prophet is examplary even today. Mechanization rapidly eroded our values and our lives these days is almost completely re-solve our problems in society as a fraternity to implement the Project, as well as a very good example fort he new generation will grow.

Predictors of Colorectal Cancer Surveillance among Radiation-treated Survivors of Childhood Cancer

Abstract Purpose: To identify predictors of adherence to colorectal cancer (CRC) surveillance guidelines among survivors of childhood cancer who received ≥30 Gy radiotherapy to the abdomen, pelvis, or spine, and were 36 years or older at the time of last contact. Methods: We sought to identify predictors of self-reported CRC surveillance participation among 5-year survivors who completed the Childhood Cancer Survivor Study (CCSS) 2007 Follow-Up Questionnaire and met the criteria above. Univariate and multivariable generalized linear models with a log link and Poisson distribution were used to calculate relative risks (RR) with 95% confidence intervals (95% CI) for adherence to CRC surveillance guidelines (i.e., home stool blood testing and/or colonoscopy/sigmoidoscopy). Results: The mean age of 711 childhood cancer survivors eligible for the study was 44 years (SD = 5.2 years). Among them, 231 (32.5%) reported ever performing home stool blood testing and 276 (38.8%) reported ever having colonoscopy or sigmoidoscopy. Of the 711 participants, 60 (8.4%) reported home stool blood testing in the past year (meeting screening guidelines for the general adult population) and 207 (29.1%) reported having a colonoscopy or sigmoidoscopy in the past 5 years (meeting surveillance recommendations for survivors of childhood cancer treated with radiation). In the multivariable analyses, factors associated with CRC surveillance were age 50 years or older (RR = 2.4, 95% CI = 1.9–2.9); having routine cancer follow-up visit within one year prior to questionnaire completion (RR = 1.7, 95% CI = 1.2–2.5); having a physical impairment requiring the assistance of others for routine activities of daily living (RR = 1.7, 95% CI = 1.2–2.2); and having discussed future cancer risk with a physician at their most recent follow-up visit (RR = 1.3, 95% CI = 1.1–1.6). Conclusions: More than 70% of survivors at risk for CRC were not screened as recommended. Indeed, unless a physician discussed their future cancer risk, most survivors were not screened until they reached age 50, the time at which CRC screening is recommended for individuals at average CRC risk. These findings underscore the need for education of survivors and their physicians regarding the heightened CRC risk following radiation.

Family caregivers of demented elderly people and access to medical care: Who gets worn out, why and what for?

Demented persons in the process of slowly becoming dependent have to rely on the assistance of others. These others are health professionals (formal care), on the one hand and family carers (informal care) on the other hand. The latter, whether or not they have chosen to play a role which is hardly defined officially, have to face many difficult situations such as complicated access to care due to lack of equal opportunities under the health system, unable to support them efficiently. Taking care of a demented patient is a life challenge often leading to burn out, having impact on physical and mental health. Caregivers may thus even have no time or opportunity to take care of their own health. So, is it not high time for the decision-makers to think it over and take care of the carers by setting up programs and giving them the opportunity to learn, to work as a team with the professionals so as to protect themselves and their dignity as well as that of their patients. The difficulties/problems carers of demented patients may encounter should be a major issue for public health care because their role is a vital one and because the consequences which may have on their own health can be negative.

Mobility Concerns in Multiple Sclerosis—Studies and Surveys on US Patient Populations of Relevance to Nurses

Despite significant advances in treatments and therapies for multiple sclerosis (MS) over the last two decades, there remains no effective treatment that can definitively halt the progression of functional impairments in MS. Impaired mobility, walking in particular, has been observed in early MS disease, and cross-sectional surveys according to MS clinical criteria have shown that approximately 50 % of existing patient populations with MS require mobility support, such as wheelchairs or walking aids, some or all of the time. Loss of mobility is one of the most disabling effects of MS, and adversely affects independence, employment, and quality of life. Additionally, as patients experience mobility loss, their ability to perform activities of daily living (ADL) decreases and dependence on the assistance of others increases. The stress and physical burden of caring for a friend or relative with MS may affect the health of caregivers and increase their own requirement for healthcare resources. The identification of therapeutic options for improving impaired mobility and coping with disability represents an important aspect of patient management. This review will discuss current published literature on mobility matters in MS, how they affect the patient, and how they are measured and treated, with inclusion of the perspective of a MS nurse specialist.

Survivors: Jewish Self-Help and Rescue in Nazi-Occupied Western Europe (review)

Reviewed by: Survivors: Jewish Self-Help and Rescue in Nazi-Occupied Western Europe Christine Schmidt Survivors: Jewish Self-Help and Rescue in Nazi-Occupied Western Europe, by Bob Moore. Oxford University Press, 2010. 432 pp. $45.00. During the Holocaust, a majority of the non-Jewish population turned their backs on the European Jews as they were systematically identified, segregated, plundered, and in time brutally murdered. Most stood by silently as the Jews were annihilated. Many actively willed and participated in their destruction. And still fewer chose another path, risking their lives in order to help Jews survive. Motivations for assistance to and rescue of Jews varied widely, and the circumstances in which rescuers acted were as diverse as the individuals themselves. Moreover, Jews survived across Europe for myriad reasons, including [End Page 160] pure luck. In Survivors: Jewish Self-Help and Rescue in Nazi-Occupied Western Europe, Bob Moore embarks on an ambitious comparative analysis of the conditions in which Jewish survivors benefited from the assistance of others, a small but significant portion of those who survived. With Survivors, Moore has made an important contribution to the field by presenting rescue as an historical problem, rather than primarily a philosophical, ethical, or sociological one. As of January 2010, Israel's Yad Vashem recognized more than 23,000 "Righteous Among the Nations," rescuers who have met particular criteria, including performing rescue actions at risk to their lives and for no monetary compensation. These numbers do not include those who may have helped Jews to turn a profit at a time of war, nor does it include Jews who rescued. Moore's Survivors widens the lens on rescue, situating rescue within its political, historical, and geographic context—an important contextualization that he argues is underplayed by an overwhelming focus on altruistic motivations, including by Yad Vashem. To that end, Moore considers a variety of motivations for rescue, including the more exploitative, and examines how assistance contributed to the varying survival rates of Jews in Western and Northern Europe. Perhaps most important, his study analyzes the ways Jews—marked for death and hunted— became rescuers themselves, overturning simplistic perceptions of them as "passive" victims. While not downplaying the heroism of rescuers recognized by Yad Vashem, he treats rescue by Jews and gentiles as a complex and interrelated issue, rejecting oversimplification in favor of nuance. He even includes cases of "Nazi rescuers" and examines the plight of Jewish children, who were particularly vulnerable to exploitation and maltreatment at the hands of potential benefactors. Moore's study provides another facet to the oft-examined (though not conclusively answered) question: how do we account for the varying survival rates of Jews in different parts of Europe during the Holocaust? Comparing conditions for rescue and survival in the Netherlands, France, Belgium, Norway, and Denmark, the author limits his scope of study based on similarities in the political circumstances as well as the chances Jews had for survival in each country. Moore emphasizes justifiably that the experiences of Jews elsewhere, such as Poland and the Soviet Union, were "materially different from their counterparts in the West" (p. 2). For the most part, Jews had a greater chance of survival in the countries Moore has selected because of the level of intensity of prevailing antisemitism, the integration of Jews in society, the nature of the German occupation, and a host of other factors. He considers the conditions that made it possible for assistance and rescue—both by Jews and gentiles—to flourish. [End Page 161] Moore's comparative approach follows a relatively recent trend in Holocaust studies. It not only draws conclusions based on broader thematic comparisons but also focuses on the variations in each situation to bring to the fore a deeper understanding of local particularities. First taking on escape routes from Europe in the first months and years of the war, he focuses on the political and social circumstances for rescue and survival in each country in turn. He describes individual cases of rescue, uncovers complex lines of hidden networks, and describes risks and punishments ultimately faced by rescuers within these contexts, as well as their perceptions of risk. While at times the comparisons he draws...

Self-Management of Lymphedema

Little is known about the effectiveness of activities used to self-manage lymphedema. The aim of this study was to evaluate the level of evidence of peer-reviewed lymphedema self-care literature published from January 2004 to May 2011. Eleven major medical databases were searched. Articles were selected for inclusion or exclusion into the category of self-management of lymphedema by topic experts. The definition of self-management included activities that individuals initiate and perform for themselves without the assistance of others. Articles were scored according to the Oncology Nursing Society's Putting Evidence Into Practice levels of evidence. Sixteen articles met criteria for inclusion in this review, with self-management as the independent variable. Ten categories of self-management were established subsequently and articles were classified by levels of evidence. In these categories, no self-management studies were rated as "recommended for practice," 2 studies were rated "likely to be effective," none was rated "benefits balanced with harms," 7 were rated "effectiveness not established," and 1 was rated "effectiveness unlikely." Few studies included measures of outcomes associated with lymphedema, and there was a scarcity of randomized controlled trials in lymphedema self-management. A demonstrated need exists for the design and testing of self-management interventions that include appropriate outcome measures.

Organisational climate from view point of motivation in district hospital, India

Organisational Climate (OC) has been an important topic of research in Organisational Development. There are several frameworks and approaches to study OC. One such framework focuses on the effect of OC on motivation. Although studying OC from viewpoint of motivetion is an important one, there is very limited research in Indian public health system on assessing OC from the view point of motivation. The present study uses a comprehensive framework that focuses on assessing OC from the view point of motivation in a government district hospital. The overall objective of the study was to assess the OC of a District Hospital (DH) from the view point of motivation. A total of 66 staff (all from the same district hospital) participated in the study that included 12 Class I doctor specialists; 14 Class II doctors and 40 Class III staff The data was collected using a validated instrument called Motivational Analysis of Climate (MAO-C). The instrument included six needs or motives and twelve dimensions of organisational climate that were ranked by individuals according to their perception. Based on the ranks, final scores were calculated that reflected the dominant climate (highest score for a particular motive) and backup climates (second highest score for a particular motive). Also a combination of the two motives, dominant and back up motives or climates indicated a particular OC. According to the study, the dominant climate in the organisation was that for Dependency motive while the backup climate for the organisation was for Control motive. According to the literature, both Dependency and Control motives are dysfunctional climates. A high dependency motive indicates that the overall organisational climate is characterized by no initiatives by the people and the employees always look for approval from their seniors; assistance of others in developing oneself; a need to check with others who are more knowledgeable. Similarly high score for control motive indicates that order is maintained in organisation; indicates display of personal power; a desire to stay informed and an urge to monitor events and to take corrective action when needed. When the two motives are combined, the study indicates a dependency-control climate profile which means that the organisational practices are similar to government offices, where subordinates have no say in decision making and they have to follow the established rules of the organisation. Such organisations have clearly laid communication channels controlled from higher authority indicating typical characteristics of a beaurocratic organisation.

Assessment of severity and frequency of self-reported hypoglycemia on quality of life in patients with type 2 diabetes treated with oral antihyperglycemic agents: A survey study

BackgroundSome oral antihyperglycemic agents may increase risk of hypoglycemia and thereby reduce patient quality of life. Our objective was to assess the impact of the severity and frequency of self-reported hypoglycemia on health-related quality of life (HRQoL) among patients with type 2 diabetes treated with oral antihyperglycemic agents.FindingsA follow-up survey was conducted in participants with self-reported type 2 diabetes treated with oral antihyperglycemic agents from the US National Health and Wellness Survey 2007. Data were collected on the severity and frequency of hypoglycemic episodes in the 6 months prior to the survey, with severity defined as mild (no interruption of activities), moderate (some interruption of activities), severe (needed assistance of others), or very severe (needed medical attention). HRQoL was assessed using the EuroQol-5D Questionnaire (EQ-5D) US weighted summary score (utility) and Worry subscale of the Hypoglycemia Fear Survey (HFS). Of the participants who completed the survey (N = 1,984), mean age was 58 years, 57% were male, 72% reported an HbA1c <7.0%, and 50% reported treatment with a sulfonylurea-containing regimen. Hypoglycemic episodes were reported by 63% of patients (46% mild, 37% moderate, 13% severe and 4% very severe). For patients reporting hypoglycemia, mean utility score was significantly lower (0.78 versus 0.86, p < 0.0001) and mean HFS score was significantly higher (17.5 versus 6.2, p < 0.0001) compared to patients not reporting hypoglycemia. Differences in mean scores between those with and without hypoglycemia increased with the level of severity (mild, moderate, severe, very severe) for utility (0.03, 0.09, 0.18, 0.23) and HFS (6.1, 13.9, 20.1, 25.6), respectively. After adjusting for age, gender, weight gain, HbA1c, microvascular complications, and selected cardiovascular conditions, the utility decrement was 0.045 (by level of severity: 0.009, 0.055, 0.131, 0.208), and the HFS increase was 9.6 (by severity: 5.3, 12.4, 17.6, 23.2). HRQoL further decreased with greater frequency of hypoglycemic episodes.ConclusionsSelf-reported hypoglycemia is independently associated with lower HRQoL, and the magnitude of this reduction increases with both severity and frequency of episodes in patients with type 2 diabetes treated with oral antihyperglycemic agents.

Vulnerable, but strong: The spinal cord-injured patient during rehabilitation

A traumatic spinal cord injury affects the body to an extent that the patient requires the assistance of others to survive and recover. The rehabilitation phase puts the patient in a vulnerable position and involves a considerable amount of strength on the patient's part. The aim of this paper is to explore the vulnerability of the spinal cord patient and how this vulnerability connects to the necessary strength, as the patient struggles to survive the injury and get through the rehabilitation.The circumstances of 12 traumatic spinal cord-injured patients were observed in the rehabilitation unit and after discharge.A phenomenological–hermeneutic narrative approach applying Ricoeur's theory was used. Data were collected by field observation and interviews during the first 2 years after the spinal cord injury.The patient's strength during the rehabilitation was portrayed by their endurance and from their narratives of how they handled difficult situations. The patient's perception of vulnerability varied, and strength was mobilised as a response to the vulnerability to overcome the imbalance between demands and resources. Vulnerability should therefore refer to a person's experience of the situation rather than the person, as it may hinder the professionals’ open, explorative approach towards the person.