Careful Definition Research Articles

Sexual dimorphism in the environmental sensitivity of weaning weight in beef cattle

This study investigates the environmental sensitivity and sexual dimorphism in the genetic parameters of weaning weight (WW) in Nelore beef cattle. Five reaction norms models were employed to analyze the 148,131 WW records, considering different definitions of the environmental descriptor (ED). (Co)variance components and genetic parameters were separately estimated for males and females. Results reveal substantial sexual dimorphism in various parameters. Significant divergence across sexes was observed for environmental sensitivity, with males showing an increased response to favorable environments while females genetically responded better to more challenging environments. Including sex in defining the ED can inflate the estimated breeding values of sires with a higher number of male progeny records, highlighting the importance of choosing a reliable ED in analyses of traits influenced by sexual dimorphism and genotype-by-environment interaction (G × E). The observed sexual dimorphism and environmental sensitivity underscore the complexity of genetic evaluation of WW in beef cattle populations, with implications for selection strategies. The findings suggest that a sex-separated trait analysis considering G × E effects is most appropriate for genetic evaluations of WW. However, a simpler single-trait model excluding sex from the ED definition yielded a higher coincidence of selected sires with the sex-separated analysis. In conclusion, understanding sexual dimorphism and environmental sensitivity is crucial for genetic evaluations and selection decisions in beef cattle breeding programs, emphasizing the need for careful model selection and ED definition.

Conceptualizing Woman-Centred Care in Midwifery

Feminist values conceptualize health care service as a social relationship, and they approach the sharing of information as a self-help activity rather than one between experts and naïve recipients. Woman-centred care embraces these ideas and is a fundamental concept in midwifery, straddling both the biomedical model and feminist health care aspirations. The definition of woman-centred care relies on a list of attributes that highlight choice and control, alluding to continuity of care and empowerment. The midwife/ woman relationship is central to the provision of woman-centred care but is not without controversy. This relationship may not always be achievable due to external structures, a focus on “normal birth,” and concerns about work/life balance. Few formal evaluations exist. Regardless, women were dissatisfied with existing care and care providers, and exploring this model of care introduces the possibility for non-authoritarian, collaborative, and respectful care for women. This article has been peer reviewed.

Psychospiritual care: a concept analysis

Psychospiritual care has taken many forms and approaches. In the clinical setting, the meaning, variations, and inconsistencies in the delivery of psychospiritual and its related terms persist. The purpose of the study is to identify the meaning and attributes of psychospiritual care and enhance collaborative practice by presenting a concept analysis. This review used Walker and Avant's eight-step approach to concept analysis. Psychospiritual is a broad, dynamic, and unique concept that integrates psychological and spiritual methods. In this analysis, the defining attributes of psychospiritual care are intuitive self-awareness, therapeutic use of psychological and spiritual perspective, and cultivation of psychological and spiritual environment. Providing psychospiritual care promotes positive consequences, such as therapeutic effects for patients and promoting psychospiritual awareness among psychospiritual interventionists. A comprehensive definition of psychospiritual care has been developed. The findings contribute to science by creating a platform for developing practice standards, research, and theory. Implementing psychospiritual care may improve overall occupational health and well-being, thereby improving patient care delivery.

Exploring the Inclusion of Person-Centered Care Domains in Stroke Transitions of Care Interventions: A Scientific Statement From the American Heart Association.

Health care teams along the stroke recovery continuum have a responsibility to support care transitions and return to the community. Ideally, individualized care will consider patient and family preferences, best available evidence, and health care professional input. Person-centered care can improve patient-practitioner interactions through shared decision-making in which health professionals and institutions are sensitive to those for whom they provide care. However, it is unclear how the concepts of person-centered care have been described in reports of stroke transitional care interventions. A secondary analysis of a systematic review and meta-analysis was undertaken. We retrieved all included articles (n=17) and evaluated the extent to which each intervention explicitly addressed 7 domains of person-centered care: alignment of care with patients' values, preferences, and needs; coordination of care; information and education; physical comfort; emotional support; family and friend involvement; and smooth transition and continuity of care. Most of the articles included some aspects of person-centeredness; we found that certain domains were not addressed in the descriptions of transitional care interventions, and no articles mentioned all 7 domains of person-centered care. We identified 3 implications for practice and research: (1) delineating person-centered care components when reporting interventions, (2) elucidating social and cultural factors relevant to the study sample and intervention, and (3) clearly describing the role of family and nonmedical support in the intervention. There is still room for greater consistency in the reporting of person-centeredness in stroke transitions of care interventions, despite a long-standing definition and conceptualization of person-centered care in academic and clinically focused literature.

Hospice Knowledge, Attitudes, and Preference among Older Chinese Immigrants in the United States

Racial disparities in hospice use are a longstanding concern in the U.S. Asian Americans are among the least likely to receive hospice care and to be included in studies on this topic. This study examined the knowledge, attitudes, and preferences related to hospice care among older Chinese immigrants and associated factors. A sample of 262 Chinese immigrants age 60+ was recruited from six older adult centers in NYC. In-person interviews were conducted in Mandarin and Cantonese. Non-English-speaking older Chinese immigrants had very limited knowledge about hospice care. Only 26% of respondents had heard of hospice, and a few could correctly define any components. After receiving a comprehensive definition of hospice care, study participants expressed a positive attitude and a strong willingness to use hospice if near the end of life. Notably, some respondents still held misconceptions about hospice and were less positive in their attitude and preference for hospice care. These findings underscore the necessity for clear and accessible information about hospice among this population throughout the trajectory from good health to end of life. Further research is needed to identify the range of factors that influence the attitudes and preferences of older Chinese immigrants toward hospice care.

Islamic Spiritual Care with Murottal for Reducing Anxiety and Depression in Coronary Heart Disease Patients: A Comprehensive Systematic Review

Background:Spiritual care is a vital aspect of the nursing process, particularly for palliative patients such as those with Coronary heart disease. While pharmacological and medical interventions remain paramount for managing heart conditions, the efficacy of Islamic spiritual therapy with Murottal has also been significant. Research has demonstrated its notable influence on patients' quality of life, particularly in mitigating anxiety and depression. Objective:This study aims to conduct a systematic review to explore the role of Islamic spirituality in nursing, specifically through Murottal recitations, and its impact on anxiety and depression among Coronary heart disease patients. Method:Employing a systematic review design, we utilized various electronic databases including PubMed, ProQuest, Science Direct, DOAJ, Wiley, Garuda, and secondary PubMed-indexed sources from 2018 to 2023. Inclusion criteria comprised studies with a clear definition of spiritual care involving Murottal in nursing, confirmed Coronary heart disease diagnoses, and reporting outcomes such as the incidence of death, cardiovascular outcomes, and quality of life. Result:The search focused on examining the correlation between Islamic spiritual care with Murottal and the quality of life in patients with coronary heart disease. Following a rigorous methodology, which included study selection, critical appraisal, data extraction, and synthesis, the search yielded 1,286 articles, with seven meeting the inclusion criteria. Analysis and categorization of these articles based on evidence level and recommendations revealed a consistent association between Islamic spiritual care with Murottal and reduced anxiety and depression in Coronary heart disease patients. However, heterogeneity was observed in research instruments, implementation duration, and outcomes. Conclusion:The conclusive evidence from this review supports the notion that Islamic spiritual care, particularly through Murottal recitations, significantly impacts the quality of life among Coronary heart disease patients. Keywords: Anxiety, Coronary Heart Disease, Depression, Murottal, Spiritual Care

Lived experiences of mental health nurses who care for clients who are parents: An approximation of Tronto's definition of care.

Adult psychiatric services typically focus on the mental health needs of the client but they do not support his or her parenting role. Many authors highlight the importance of a non-judgmental approach when providing support and care to clients with mental illness who are parents. Assessments frequently focus on the negative aspects while the strengths of these families were often overlooked. There is a lack of scientific literature exploring nurses' experiences when caring for parents with mental illness and their families. Trust is the basis that helps clients to be open to receiving care and answering parenting-related questions. Therefore, without adequate professional-client trust, some care and interventions addressed to parents with mental illness could be poorly received by the client. Tronto's phases of care facilitated the collection of data and exploration of mental health nurses' experiences of care. Mental health nurses should be aware of the potential needs of these families, as described in the scientific literature, so they can include them in their assessments. They also should consider the need to individualize each care since each situation of a family with parental mental illness is unique. Mental health nurses must take the person's environment into account (family, social and political aspects and different forms of stigma) since all these factors may influence how parents with mental illness receive and provide care. Introduction Many authors highlight the importance of a non-judgmental approach when providing care to parents with mental illness. However, assessments frequently focus on the negative aspects while the strengths of such families were often overlooked. Aim To explore the lived experiences of mental health nurses who care for clients who are parents. Method We conducted a qualitative phenomenological study. The main data collection technique was in-depth interviews. Data were analysed according to Colaizzi model, subsequently, the main categories that arised were compared and related to the five phases of Tronto's care. Results The main categories identified from the analysis of the interviews were: (1) individualized care, (2) continuity of care, (3) psychoeducation and counselling, (4) trust and (5) context of the client. Discussion Trust is the basis that helps parents with mental illness to be open to receiving care and answering parenting-related questions. Without trust, some interventions could be poorly received by the client. Implications for Practice Mental health nurses should be aware of the potential needs of these families, so they can include them in their assessments. They also should consider the need to individualize each care since each situation of a family with parental mental illness is unique.

Earth Care and Recovery in Kerri ní Dochartaigh’s Thin Places (2021)

Thin Places (2021) is a piece of work which defies categorization. It is partly a memoir filled with traumatic personal events, partly a reflection on loss in all its manifest forms (physical, familial, linguistic, environmental), and partly an uplifting plea for allowing the exploration of our natural surroundings to function as a meaningful form of care. Kerri ní Dochartaigh uses the materiality of the sentient beings that surround us, and deep care for our ecosystem, as a means of recovery. Earth care as self-care. Ní Dochartaigh is concerned with both the materiality and the immateriality of objects of care and manages to incorporate both through her interest in “the liminal space between things”, to borrow the title of an article by Timothy Morton (2014). The narrator foregrounds her mental health difficulties brought on by a violent and traumatic childhood in Northern Ireland yet also places the focus on the ways in which Ireland’s natural habitat, its material reality and its immaterial Celtic portals, “hold us” (2022: 228) in unsuspected care relationships. In the process, “[a]rt happens […] in the liminal space(s) between things, in conversations between metal and sky, humans and metal, era and era, heaven and earth” (Morton 2014: 270-1). A poignant process of recovery is recounted, highlighting firstly the refusal of care before slowly moving towards co-constituted acts of care: as ní Dochartaigh gradually recovers her lost mother tongue, and pays attention to the beauty of her natural surroundings, as she begins to care for both, she also starts to feel cared for. The sensory experience of loss, gain, and care in Thin Places is predicated upon several ecologies and resonates strongly with Joan Tronto’s definition of care as ultimately “a species activity that includes everything that we do to maintain, continue, and repair our ‘world’ so that we can live in it as well as possible. That world includes our bodies, our selves (sic.), and our environment, all of which we seek to interweave in a complex, life-sustaining web” (1993: 103; original emphasis). Kerri ní Dochartaigh celebrates, in the most understated manner, the full complexity of this “life-sustaining web” and this article proposes to unpack all of the above elements to show how her very singular aesthetics places the emphasis on the coloniality of loss and the restorative power of stories.

Rituals of Survival in Single-Room Occupancy Hotels

This article works with a definition of care that encompasses expansive models of kinship and collective and communal life. Specifically, it explores representations of such interdependencies in the liminal space of the single‐room occupancy hotel (SRO) through the literary and artistic creations of two understudied African American artists. Fiction writer Robert Dean Pharr and visual artist Frederick Weston created their work in SROs in New York City beginning in the 1960s, during a time of massive transformation of the city's built environment in the name of urban renewal. Their novels and artwork, respectively, provide some of the only uncovered (to date) literary and cultural representations of New York City's SROs. Pharr's and Weston's works memorialize rituals of survival that center care and interdependencies over and against competitive individualism and a climate of uncare. Further, both explicitly articulate this vision by working with conceptual and material waste. Trash is their literal and metaphoric medium. These artists relied upon what is seen as surplus value by the city. But as Pharr and Weston use it, trash offers a critique of negative assumptions about the lives of SRO residents. The pandemic has shocked us into awareness of our inescapable interdependencies. Therefore, it behooves us to revisit these understudied, early proponents of care—an ethics that today's mutual aid and other liberation movements often center. Pharr's and Weston's documentation and interpretation of care offer us ways to survive within our current environments in crisis without repeating the death‐making logic and history of urban renewal.

A French classification to describe medical deserts: a multi-professional approach based on the first contact with the healthcare system

BackgroundIncreasing inequalities in accessibility to primary care has generated medical deserts. Identifying them is key to target the geographic areas where action is needed. An extensive definition of primary care has been promoted by the World Health Organization: a first level of contact with the health system, which involves the co-presence of different categories of health professionals alongside the general practitioner for the diagnosis and treatment of patients. Previous analyses have focused mainly on a single type of provider while this study proposes an integrated approach including various ones to define medical deserts in primary care.MethodOur empirical approach focuses on the first point of contact with the health system: general practitioners, proximity primary care providers (nurses, physiotherapists, pharmacies, laboratories, and radiologists), and emergency services. A multiple analysis approach was performed, to classify French municipalities using the information on the evolution and needs of health care accessibility, combining a principal component analysis and a hierarchical ascending classification.ResultsTwo clusters of medical deserts were identified with low accessibility to all healthcare professionals, socio-economic disadvantages, and a decrease in care supply. In other clusters, accessibility difficulties only concern a part of the health supply considered, which raises concern for the efficiency of primary care for optimal healthcare pathways. Even for clusters with better accessibility, issues were identified, such as a decrease and high needs of health care supply, revealing potential future difficulties.ConclusionThis work proposes a multi-professional and multi-dimensional approach to medical deserts based mainly on an extensive definition of primary care that shows the relevance of the co-presence of various healthcare professionals. The classification also makes it possible to identify areas with future problems of accessibility and its potential consequences. This framework could be easily applied to other countries according to their available data and their health systems’ specificities.

Addressing ADL ability in people with poststroke cognitive impairments: A Danish survey of clinical practice

Background In Denmark, stroke represents a leading disability cause. While people with difficulties in performing activities of daily living (ADL) due to poststroke cognitive impairments are often referred to occupational therapy, limited knowledge is available on the nature of these services. Aim/Objective To explore how Danish occupational therapists describe their practice when addressing decreased ADL ability in people with poststroke cognitive impairments in hospital and municipality settings. Material and Methods National, cross-sectorial, web-based public survey. Results 244 occupational therapists accessed the survey; 172 were included in the analysis. Most respondents could indicate the theory guiding their reasoning; half used standardised assessments. Regarding intervention, restorative and acquisitional models were preferred; specific strategies were identified. Intensity: 30-45 min 3-4 times/week in hospitals; 30-60 min 1-2 times/week in municipalities. Conclusions Therapists report to be guided by theory in their reasoning. Standardised assessments are used to a higher extend than previously reported. Still, the results invite critical reflections on correct use of assessment instruments, content and intensity of interventions, and how therapists keep themselves updated. Significance The results document the need for practice improvements and may inform the definition of standard care in future trials.

A Critical Overview of the Construct of Supportive Care Need in the Cancer Literature: Definitions, Measures, Interventions and Future Directions for Research.

The growing amount of evidence about the role of supportive care in enhancing cancer patients' outcomes has made healthcare providers more sensitive to the need for support that they experience during cancer's trajectory. However, the lack of a consensus in the definition of supportive care and lack of uniformity in the theoretical paradigm and measurement tools for unmet needs does not allow for defined guidelines for evidence-based best practices that are universally accepted. Contemporary cancer literature confirms that patients continue to report high levels of unmet supportive care needs and documents the low effectiveness of most of the interventions proposed to date. The aim of this critical review is to consolidate the conceptual understanding of the need for supportive care, providing definitions, areas of expertise and a careful overview of the measurement tools and intervention proposals developed to date. The possible reasons why the currently developed interventions do not seem to be able to meet the needs, and the issues for future research were discussed.

Defining woman-centred care: A concept analysis

ProblemIn midwifery a shared definition of woman-centred care is lacking, and this remains an identified gap in the evidence underpinning midwifery practice. BackgroundWoman-centred care is an underpinning philosophy used in midwifery practice both nationally and internationally. AimTo analyse the practice of woman-centred care to clarify its meaning and comprehension and subsequently advance an evidence-based definition of the concept. MethodsUsing an adapted theoretical and colloquial evolutionary model a three-stage concept analysis was conducted to identify attributes, antecedents, and consequences of woman-centred care and subsequently construct an evidence-based, internationally informed definition. FindingsAntecedents of woman-centred care are education, models of care and midwife characteristics. Attributes are choice and control, empowerment, and relationships. Consequences are shared and informed decision making which supports the woman in navigating complex health systems, and improved health outcomes. Whilst important to midwifery practice and midwifery-led models of care, continuity of care is not a core essential element of woman-centred care. DiscussionAnalysis, synthesis, and re-examination of the data on woman-centred care facilitated deep immersion, exploration and clarification of this concept that underpins midwifery philosophy and practice. The constructed definition can be used to inform health policy, midwifery research, education, and clinical practice. ConclusionAn evidence-based definition of woman-centred care is necessary for conversion of this essential concept to practice. Regardless of model of care all women should receive woman-centre care improving the health outcomes of both the woman and neonate.

The Concept of Child-Centred Care in Healthcare: A Scoping Review.

Although child-centred care is increasingly referred to within the nursing literature, a clear definition of child-centred care and clarity around the concept is yet to be achieved. The objectives of this review were to examine the following: (1) What constitutes the concept of child-centred care in healthcare? (2) How has the concept of child-centred care developed? (3) What is the applicability of child-centred care and what are its limitations? (4) How does the concept of child-centred care benefit and inform children's healthcare? In total, 2984 papers were imported for screening, and, following the removal of duplicates and screening, 21 papers were included in the scoping review. The findings suggest that child-centred care is an emerging, ambiguous poorly defined concept; no clear consensus exists about what constitutes child-centred care. Although it seems antithetical to argue against child-centred care, little robust evidence was identified that demonstrates the impact and benefit of child-centred care. If child-centred care is to be a sustainable, convincing model to guide practice and compete with other models of care, it needs to establish robust evidence of its effectiveness, the impact on children and their families, as well as the wider impacts on the healthcare system.

New consensus definition on defining and measuring care for children with paediatric feeding disorder.

This study addresses the absence of a definition of care for children with feeding disorders, limited agreement on key performance indicators (KPIs), and the lack of data linked to those KPIs. Clinicians, consumers and researchers involved in outpatient feeding care in New South Wales (NSW), Australia were invited to participate in a two-Phase study. In Phase 1, a modified Delphi method was used. Two rounds of voting resulted in a new consensus definition of a multidisciplinary paediatric feeding clinic. Three further rounds voting determined relevant KPIs. In Phase 2, the KPIs were piloted prospectively in 10 clinics. Twenty-six clinicians, consumers and researchers participated in Phase 1. Participation across five voting rounds declined from 92% to 60% and a valid definition and KPI set were created. In Phase 2, the definition and KPIs were piloted in 10 clinics over 6 weeks. Data for 110 patients were collected. The final KPI set of 28 measures proposed covers clinical features, patient demographics and medical issues, parent-child interaction and outcome measures. A new definition of a multidisciplinary paediatric feeding clinic is now available, linked to a standardised KPI set covering relevant performance measures. These proved viable in baseline data collection for 10 clinics across NSW. This sets a foundation for further data collection, systematic measurement of care provision and outcomes, and research needed to deliver care improvement for children with paediatric feeding disorder.

Establishing a working definition for veterinary care desert.

To develop a formal definition of veterinary care deserts as guidance for veterinary and animal welfare professionals to easily identify areas with limited access to veterinary care that can be targeted with expansion or implementation of programs and services. 52 sources relating to veterinary care and 55 sources relating to human resource deserts were reviewed for themes and parameters relating to resource desert definitions and barriers to care. Of these, 37 veterinary and 42 human sources were included to inform the themes and parameters for our definition. We performed a scoping literature review with a focus on veterinary care barriers and definitions of human resource deserts. The review identified 3 common themes of accessibility (transportation; distance to resource), affordability (owner income or poverty level; cost of care), and availability (density of professionals) that were incorporated into the definition of a veterinary care desert and parameterized at the level of census tracts. A working definition for veterinary care deserts was established as a geographic area where accessible, affordable, and available veterinary care is limited. By consulting publicly available census tract data on accessibility, affordability, and availability, veterinary care providers and organizations can use this definition to identify areas most likely to be experiencing reduced access to veterinary care and target interventions accordingly.

Understanding and Defining Hindu and Integrative Spiritual Care

Spiritual care holds significant promise for the future of work in organizations. However, it lacks a workable ontological foundation in the management context due to its heterogeneity. This article investigates the nature of spiritual care in contemporary contexts and identifies its key elements from an integrative perspective using the holistic framework of Hinduism. The definition of spiritual care was derived by applying design science research and a novel integrative approach adapted from the Tarka method of the Hindu philosophical system. The proposed definition was validated by spiritual-care providers in the field. The proposed integrative definition will allow scholars to develop their own comprehensive definitions for practice and for contributions to the field. The expansion of the scope of spiritual care into domains like business will support the recognition of the positive outcomes of spiritually based interventions in the workplaces of the future.

Views into contemporary nursing

Insights into Contemporary Nursing is a textbook for nursing students that sublimates all the knowledge that is the basis of good nursing education in an innovative and methodologically clear way. The textbook was published for the first time in 2023 and received good reviews from experts as well as reviewers. The textbook consists of 11 chapters: Chapter One: History of Nursing; Chapter Two: Definitions of Nursing and Health Care; Chapter Three: Theories and Models; Chapter Four: Quality of Health Care; Chapter Five: Organization, Safety, and Documentation; Chapter Six: Health Care Evidence-Based; Chapter Seven: The Health Care Process; Chapter Eight: Nursing Ethics; Chapter Nine: Nursing Issues; Chapter Ten: Nursing Forensics; Chapter Eleven consists of appendices, scales, and instruments for practical application in nursing. The book is excellent literature for the education of various profiles of health workers, and it is extremely useful for the education of nurses.

Confronting Three Contemporary Categories of False "Health Care"

The modern definition of health care has, regrettably, expanded far beyond what can reasonably be considered care. Abortion, gender reassignment, and physician-assisted suicide damage bodies and end lives, rather than healing patients. In this article, Mundy describes where modern ideas of what passes for health care have gone wrong and how to better understand what it means to practice medicine.

Classification of trauma-related preventable death; protocol of a Delphi procedure.

Trauma-related (preventable) death is used to evaluate the management and quality of trauma care worldwide. Therefore, it is necessary to identify fatalities in the trauma care population and assess them on preventability. However, the definition on trauma-related preventable death lacks validity due to differences in terminology and classifications. This study aims to reach consensus on the definition of trauma-related preventable death by performing a Delphi procedure, thereby, improving the assessment of trauma-related preventable death and thereby enhancing the quality of trauma care. Based on the results of a recently performed systematic review Hakkenbrak (2021). The definitions used to describe trauma-related preventable death could be divided into four categories: 1) Clinical definition based on panel review or expert opinion, 2) Trauma prediction algorithm, 3) Clinical definition with an additional trauma prediction algorithm and 4) Others (e.g., errors in care or detailed clinical definition). A three round, electronic Delphi study will be performed in the Netherlands to reach consensus. Experts from the department of Trauma surgery, Neurosurgery, Forensic medicine, Anaesthesiology and Emergency medicine, of the designated Level 1 trauma centres in the Netherlands, will be invited to participate. In the first round the panel will comment on the composed categories and trauma prediction algorithms. In the second and third round a feedback report will be presented and the questions with disagreement will be retested. The identification and assessment of trauma-related preventable death is necessary to evaluate and improve trauma care. Therefore, a valid, fair, and applicable definition of trauma-related preventable death is required. The Delphi technique is utilized to reach group consensus to obtain a scientifically valid definition of trauma-related preventable death.