Atypical haemolytic uraemic syndrome treated with the complement inhibitor eculizumab: the experience of the Australian compassionate access cohort.

PubMed

Mallett, A; Hughes, P; Szer, J; Tuckfield, A; Van Eps, C; Cambell, S B; Hawley, C; Burke, J; Kausman, J; Hewitt, I; Parnham, A; Ford, S; Isbel, N

2015-10-01

This study aimed to report the clinical characteristics and outcomes of Australian patients treated with eculizumab for atypical haemolytic uraemic syndrome (aHUS). A retrospective cohort study was undertaken of all patients in Australia treated with eculizumab provided in a compassionate access programme for a clinical diagnosis of aHUS using prospectively collected clinical data. A total of 10 patients with a median age of 23.5 years (interquartile range (IQR) 24.83 years) received compassionate access eculizumab for aHUS in Australia. Eight patients were female, and three had a family history of aHUS. Three received eculizumab for an initial acute aHUS presentation, three for relapsing and refractory acute aHUS, two for de novo aHUS post-renal transplantation, and one each for aHUS recurrence post-transplantation and facilitation of transplantation with a history of aHUS. The median duration of eculizumab therapy has been 911.5 days (IQR 569 days) with a cumulative exposure of 9184 days. At baseline all patients had renal and extra-renal aHUS involvement, with up to three non-renal organs affected. All but one patient, who died from uncontrollable gastrointestinal aHUS manifestations, have continued. The nine continuing patients achieved remission of aHUS. Two of the four patients requiring renal replacement therapy (RRT) at eculizumab commencement subsequently ceased RRT. Clinical events occurring in this cohort while on eculizumab treatment included neutropenia (two), posterior reversible encephalopathy syndrome (one), cardiomyopathy (one), pulmonary embolus (one), antibody-mediated rejection resulting in renal graft failure (one), iron deficiency (one), gastrointestinal haemorrhage (one) and death (one). Eculizumab has been an effective therapy for aHUS in this cohort, including when other therapies have failed. © 2015 Royal Australasian College of Physicians.

Compassionate Love in Individuals With Alzheimer’s Disease and Their Spousal Caregivers: Associations With Caregivers’ Psychological Health

PubMed Central

Monin, Joan K.; Schulz, Richard; Feeney, Brooke C.

2015-01-01

Purpose of the Study: To examine whether compassionate love in both individuals with Alzheimer’s disease (AD) and their spousal caregivers related to less caregiving burden, more positive caregiving appraisals, and less depressive symptoms for caregivers. Design and Methods: Fifty-eight individuals with AD and their spousal caregivers participated in interviews in which both partners reported their compassionate love for their partner, and caregivers self-reported burden, positive appraisals of caregiving, and depressive symptoms. Results: As hypothesized, both AD individuals’ and caregivers’ compassionate love were associated with less burden and more positive appraisals of caregiving. Also, care givers’ compassionate love mediated the association between AD individuals’ compassionate love and caregivers’ burden as well as the association between AD individuals’ compassionate love and caregivers’ positive appraisals of caregiving. Finally, there was a marginally significant association between caregivers’ compassionate love and less caregiver depressive symptoms. Implications: Results suggest that AD individuals’ compassionate love is related to compassionate love in caregivers, which in turn relates to reduced burden but not significantly less depressive symptoms for caregivers. Assessing caregivers’ and AD individuals’ feelings of compassionate love may be useful in identifying caregivers who are resilient and those who are at a heightened risk for caregiving burden. Also, interventions that enhance both partners’ compassionate love may benefit caregivers. PMID:24534607

Compassionate Love in Individuals With Alzheimer's Disease and Their Spousal Caregivers: Associations With Caregivers' Psychological Health.

PubMed

Monin, Joan K; Schulz, Richard; Feeney, Brooke C

2015-12-01

To examine whether compassionate love in both individuals with Alzheimer's disease (AD) and their spousal caregivers related to less caregiving burden, more positive caregiving appraisals, and less depressive symptoms for caregivers. Fifty-eight individuals with AD and their spousal caregivers participated in interviews in which both partners reported their compassionate love for their partner, and caregivers self-reported burden, positive appraisals of caregiving, and depressive symptoms. As hypothesized, both AD individuals' and caregivers' compassionate love were associated with less burden and more positive appraisals of caregiving. Also, care givers' compassionate love mediated the association between AD individuals' compassionate love and caregivers' burden as well as the association between AD individuals' compassionate love and caregivers' positive appraisals of caregiving. Finally, there was a marginally significant association between caregivers' compassionate love and less caregiver depressive symptoms. Results suggest that AD individuals' compassionate love is related to compassionate love in caregivers, which in turn relates to reduced burden but not significantly less depressive symptoms for caregivers. Assessing caregivers' and AD individuals' feelings of compassionate love may be useful in identifying caregivers who are resilient and those who are at a heightened risk for caregiving burden. Also, interventions that enhance both partners' compassionate love may benefit caregivers. © The Author 2014. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Employee Assistance: Policies and Programs. Pamphlet Series.

ERIC Educational Resources Information Center

Milgram, Gail Gleason

Approximately six to eight percent of the nation's workers have problems which affect their job performance; without assistance, these problems become worse, affect others, and may have serious consequences to the employer as well. The Employee Assistance Program (EAP) is a pragmatic but compassionate attempt to improve performance by constructing…

A concept analysis of compassionate midwifery.

PubMed

Ménage, Diane; Bailey, Elizabeth; Lees, Susan; Coad, Jane

2017-03-01

To report a concept analysis of compassionate midwifery. Recently, compassion has been incorporated into United Kingdom nursing and midwifery language through strategy, policy, recruitment and education. Professional standards direct midwives to practise compassionately therefore the concept of compassionate midwifery exists, although this has yet to be explored as a concept in the UK or internationally. An understanding of what constitutes compassionate midwifery has the potential to increase midwifery knowledge and improve practice. Concept Analysis. Literature from 1990-2015 was searched using MEDLINE, CINAHL, PsycINFO and ETHOS. Grey literature and examples of everyday usage of the concept were searched using Google. An adapted model of evolutionary concept analysis. Explanations of compassionate midwifery were absent in the literature therefore the gathered data were evaluated in relation to elements of the compassion process: recognition of suffering, emotion, motivation and action. Compassionate midwifery is defined as the interrelations of authentic presence, noticing suffering, empathy, connectedness/relationship, emotion work, motivation to help/support, empowering women and alleviating suffering through negotiation, knowledge and skills. Antecedents and consequences were also identified and depicted in a schematic representation of the concept. This concept analysis provides a unique examination of compassionate midwifery and starting point for reflection on practice, education and further analysis. Empirical studies will provide the potential to take the process further by studying the experience of compassionate midwifery from different perspectives. A theory of compassionate midwifery will develop as new findings emerge. © 2016 John Wiley & Sons Ltd.

Critically examining diversity in end-of-life family caregiving: implications for equitable caregiver support and Canada's Compassionate Care Benefit.

PubMed

Giesbrecht, Melissa; Crooks, Valorie A; Williams, Allison; Hankivsky, Olena

2012-11-01

Family (i.e., unpaid) caregiving has long been thought of as a 'woman's issue', which ultimately results not only in gendered, but also financial and health inequities. Because of this, gender-based analyses have been prioritized in caregiving research. However, trends in current feminist scholarship demonstrate that gender intersects with other axes of difference, such as culture, socio-economic status, and geography to create diverse experiences. In this analysis we examine how formal front-line palliative care providers understand the role of such diversities in shaping Canadian family caregivers' experiences of end-of-life care. In doing so we consider the implications of these findings for a social benefit program aimed at supporting family caregivers, namely the Compassionate Care Benefit (CCB). This analysis contributes to a utilization-focused evaluation of Canada's CCB, a social program that provides job security and limited income assistance to Canadian family caregivers who take a temporary leave from employment to provide care for a dying family member at end-of-life. Fifty semi-structured phone interviews with front-line palliative care providers from across Canada were conducted and thematic diversity analysis of the transcripts ensued. Findings reveal that experiences of caregiving are not homogenous and access to services and supports are not universal across Canada. Five axes of difference were commonly raised by front-line palliative care providers when discussing important differences in family caregivers' experiences: culture, gender, geography, lifecourse stage, and material resources. Our findings reveal inequities with regard to accessing needed caregiver services and resources, including the CCB, based on these axes of difference. We contend that without considering diversity, patterns in vulnerability and inequity are overlooked, and thus continually reinforced in health policy. Based on our findings, we demonstrate that re-framing categorizations of caregivers can expose specific vulnerabilities and inequities while identifying implications for the CCB program as it is currently administered. From a policy perspective, this analysis demonstrates why diversity needs to be acknowledged in policy circles, including in relation to the CCB, and seeks to counteract single dimensional approaches for understanding caregiver needs at end-of-life. Such findings illustrate how diversity analysis can dramatically enhance evaluative health policy research.

Critically examining diversity in end-of-life family caregiving: implications for equitable caregiver support and Canada’s Compassionate Care Benefit

PubMed Central

2012-01-01

Introduction Family (i.e., unpaid) caregiving has long been thought of as a ‘woman’s issue’, which ultimately results not only in gendered, but also financial and health inequities. Because of this, gender-based analyses have been prioritized in caregiving research. However, trends in current feminist scholarship demonstrate that gender intersects with other axes of difference, such as culture, socio-economic status, and geography to create diverse experiences. In this analysis we examine how formal front-line palliative care providers understand the role of such diversities in shaping Canadian family caregivers’ experiences of end-of-life care. In doing so we consider the implications of these findings for a social benefit program aimed at supporting family caregivers, namely the Compassionate Care Benefit (CCB). Methods This analysis contributes to a utilization-focused evaluation of Canada’s CCB, a social program that provides job security and limited income assistance to Canadian family caregivers who take a temporary leave from employment to provide care for a dying family member at end-of-life. Fifty semi-structured phone interviews with front-line palliative care providers from across Canada were conducted and thematic diversity analysis of the transcripts ensued. Results Findings reveal that experiences of caregiving are not homogenous and access to services and supports are not universal across Canada. Five axes of difference were commonly raised by front-line palliative care providers when discussing important differences in family caregivers’ experiences: culture, gender, geography, lifecourse stage, and material resources. Our findings reveal inequities with regard to accessing needed caregiver services and resources, including the CCB, based on these axes of difference. Conclusions We contend that without considering diversity, patterns in vulnerability and inequity are overlooked, and thus continually reinforced in health policy. Based on our findings, we demonstrate that re-framing categorizations of caregivers can expose specific vulnerabilities and inequities while identifying implications for the CCB program as it is currently administered. From a policy perspective, this analysis demonstrates why diversity needs to be acknowledged in policy circles, including in relation to the CCB, and seeks to counteract single dimensional approaches for understanding caregiver needs at end-of-life. Such findings illustrate how diversity analysis can dramatically enhance evaluative health policy research. PMID:23116474

How policy makers can smooth the way for communication-and- resolution programs.

PubMed

Sage, William M; Gallagher, Thomas H; Armstrong, Sarah; Cohn, Janet S; McDonald, Timothy; Gale, Jane; Woodward, Alan C; Mello, Michelle M

2014-01-01

Communication-and-resolution programs (CRPs) in health care organizations seek to identify medical injuries promptly; ensure that they are disclosed to patients compassionately; pursue timely resolution through patient engagement, explanation, and, where appropriate, apology and compensation; and use lessons learned to improve patient safety. CRPs have existed for years, but they are being tested in new settings and primed for broad implementation through grants from the Agency for Healthcare Research and Quality. These projects do not require changing laws. However, grantees' experiences suggest that the path to successful dissemination of CRPs would be smoother if the legal environment supported them. State and federal policy makers should try to allay potential defendants' fears of litigation (for example, by protecting apologies from use in court), facilitate patient participation (for example, by ensuring access to legal representation), and address the reputational and economic concerns of health care providers (for example, by clarifying practices governing National Practitioner Data Bank reporting and payers' financial recourse following medical error).

[Anorexia, treating and caring for the mistreated body].

PubMed

Blanchet-Collet, Corinne; Moro, Marie Rose

2015-01-01

Anorexia is a complex, multifactorial disease, emerging during puberty and requiring cross-disciplinary care. The body, taken hostage, expresses psychological suffering and the patient's developmental impasse. Compassionate treatment and the care given to this mistreated and undernourished body facilitate the access to the psychological care and are an essential step towards recovery. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

Compassionate Values as a Resource during the Transition to College: Quiet Ego, Compassionate Goals, and Self-Compassion

ERIC Educational Resources Information Center

Wayment, Heidi A.; West, Taylor N.; Craddock, Emily B.

2016-01-01

This study examined the unique contributions of compassion-related values and skills on stress and life satisfaction in two samples of first-year college students. Quiet ego, a measure of a compassionate self-identity, was associated with using relatively more compassionate interpersonal goals relative to self-image goals. Self-compassion and, to…

Canada's Compassionate Care Benefit: views of family caregivers in chronic illness.

PubMed

Williams, Allison; Crooks, Valorie A; Stajduhar, Kelli I; Allan, Diane; Cohen, S Robin

2006-09-01

Based on a pilot evaluation of Canada's recently introduced Compassionate Care Benefit (CCB), the purpose of this paper is to highlight the experiences of family caregivers caring for people with non-malignant advanced chronic illness. Using Patton's (1997) utilization-focused evaluation approach, 25 telephone interviews were conducted with three groups of family caregivers: those who had successfully applied for the CCB; those who were unsuccessful in their applications; those who had never applied for the benefit. The CCB has a number of limitations, particularly for caregivers of patients diagnosed with non-malignant advanced chronic illness. The central limitations are: difficulties associated with accurate prognostication; limited definition of "family member"; insufficient length of the funding period. By modelling similar programmes internationally, such as those in Sweden, Norway, and the Netherlands, Canada would likely find the CCB to have greater relevance and accessibility to Canadian caregivers, particularly those caring for people with non-malignant advanced chronic illness.

Interpersonal goals and change in anxiety and dysphoria in first-semester college students.

PubMed

Crocker, Jennifer; Canevello, Amy; Breines, Juliana G; Flynn, Heather

2010-06-01

Two longitudinal studies examined the associations between interpersonal goals (i.e., self-image and compassionate goals) and anxiety and dysphoria (i.e., distress). In Study 1, 199 college freshmen (122 women, 77 men) completed 12 surveys over 12 weeks. Compassionate goals predicted decreased distress, and self-image goals predicted increased distress from pretest to posttest when distress was assessed as anxiety, dysphoria, or a composite, and when the goals were worded as approach goals, avoidance goals, or a composite. In Study 2, 115 first-semester roommate pairs (86 female and 29 male pairs) completed 12 surveys over 12 weeks. Compassionate and self-image goals predicted distress in same-week, lagged-week, and pretest-to-posttest analyses; effects of compassionate goals remained significant when the authors controlled for several known risk factors. Having clear goals consistently explained the association between compassionate goals but not self-image goals and distress. Results supported a path model in which compassionate goals predict increased support given to roommates, which predicts decreased distress. Results also supported a reciprocal association; chronic distress predicted decreased compassionate and increased self-image goals from pretest to posttest, and weekly distress predicted decreased compassionate goals the subsequent week. The results suggest that compassionate goals contribute to decreased distress because they provide meaning and increase support given to others. Distress, in turn, predicts change in goals, creating the potential for upward and downward spirals of goals and distress. (c) 2010 APA, all rights reserved).

Effects of compassion meditation on a psychological model of charitable donation.

PubMed

Ashar, Yoni K; Andrews-Hanna, Jessica R; Yarkoni, Tal; Sills, Jenifer; Halifax, Joan; Dimidjian, Sona; Wager, Tor D

2016-08-01

Compassion is critical for societal wellbeing. Yet, it remains unclear how specific thoughts and feelings motivate compassionate behavior, and we lack a scientific understanding of how to effectively cultivate compassion. Here, we conducted 2 studies designed to a) develop a psychological model predicting compassionate behavior, and b) test this model as a mediator of a Compassion Meditation (CM) intervention and identify the "active ingredients" of CM. In Study 1, we developed a model predicting compassionate behavior, operationalized as real-money charitable donation, from a linear combination of self-reported tenderness, personal distress, perceived blamelessness, and perceived instrumental value of helping with high cross-validated accuracy, r = .67, p < .0001. Perceived similarity to suffering others did not predict charitable donation when controlling for other feelings and attributions. In Study 2, a randomized controlled trial, we tested the Study 1 model as a mediator of CM and investigated active ingredients. We compared a smartphone-based CM program to 2 conditions-placebo oxytocin and a Familiarity intervention-to control for expectancy effects, demand characteristics, and familiarity effects. Relative to control conditions, CM increased charitable donations, and changes in the Study 1 model of feelings and attributions mediated this effect (pab = .002). The Familiarity intervention led to decreases in primary outcomes, while placebo oxytocin had no significant effects on primary outcomes. Overall, this work contributes a quantitative model of compassionate behavior, and informs our understanding of the change processes and intervention components of CM. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Developing compassionate leadership in health care: an integrative review

PubMed Central

de Zulueta, Paquita C

2016-01-01

Compassionate health care is universally valued as a social and moral good to be upheld and sustained. Leadership is considered pivotal for enabling the development and preservation of compassionate health care organizations. Strategies for developing compassionate health care leadership in the complex, fast-moving world of today will require a paradigm shift from the prevalent dehumanizing model of the organization as machine to one of the organizations as a living complex adaptive system. It will also require the abandonment of individualistic, heroic models of leadership to one of shared, distributive, and adaptive leadership. “Command and control” leadership, accompanied by stifling regulation, rigid prescriptions, coercive punishments, and/or extrinsic rewards, infuses fear into the system with consequent disempowerment and disunity within the workforce, and the attrition of innovation and compassion. It must be eschewed. Instead, leadership should be developed throughout the organization with collective holistic learning strategies combined with high levels of staff support and engagement. Culture and leadership are interdependent and synergistic; their codevelopment needs to be grounded in a sophisticated, scientifically based account of human nature held within a coherent philosophical framework reflected by modern organizational and leadership theories. Developing leadership for compassionate care requires acknowledging and making provision for the difficulties and challenges of working in an anxiety-laden context. This means providing appropriate training and well-being programs, sustaining high levels of trust and mutually supportive interpersonal connections, and fostering the sharing of knowledge, skills, and workload across silos. It requires enabling people to experiment without fear of reprisal, to reflect on their work, and to view errors as opportunities for learning and improvement. Tasks and relational care need to be integrated into a coherent unity, creating space for real dialog between patients, clinicians, and managers, so that together they can cocreate ways to flourish in the context of illness and dying. PMID:29355200

Developing compassionate leadership in health care: an integrative review.

PubMed

de Zulueta, Paquita C

2016-01-01

Compassionate health care is universally valued as a social and moral good to be upheld and sustained. Leadership is considered pivotal for enabling the development and preservation of compassionate health care organizations. Strategies for developing compassionate health care leadership in the complex, fast-moving world of today will require a paradigm shift from the prevalent dehumanizing model of the organization as machine to one of the organizations as a living complex adaptive system. It will also require the abandonment of individualistic, heroic models of leadership to one of shared, distributive, and adaptive leadership. "Command and control" leadership, accompanied by stifling regulation, rigid prescriptions, coercive punishments, and/or extrinsic rewards, infuses fear into the system with consequent disempowerment and disunity within the workforce, and the attrition of innovation and compassion. It must be eschewed. Instead, leadership should be developed throughout the organization with collective holistic learning strategies combined with high levels of staff support and engagement. Culture and leadership are interdependent and synergistic; their codevelopment needs to be grounded in a sophisticated, scientifically based account of human nature held within a coherent philosophical framework reflected by modern organizational and leadership theories. Developing leadership for compassionate care requires acknowledging and making provision for the difficulties and challenges of working in an anxiety-laden context. This means providing appropriate training and well-being programs, sustaining high levels of trust and mutually supportive interpersonal connections, and fostering the sharing of knowledge, skills, and workload across silos. It requires enabling people to experiment without fear of reprisal, to reflect on their work, and to view errors as opportunities for learning and improvement. Tasks and relational care need to be integrated into a coherent unity, creating space for real dialog between patients, clinicians, and managers, so that together they can cocreate ways to flourish in the context of illness and dying.

Advising Undergraduates in a Department of Soil Science and/or Agronomy.

ERIC Educational Resources Information Center

Lee, Gerhard B.

1987-01-01

Offers suggestions to advisers of undergraduate students in agriculture. Recommends that advisers be competent, concerned, compassionate, and provide an open-door attitude toward their advisees. Suggests that students be guided toward good study habits and participation in intern programs. (TW)

Developing and maintaining compassionate care in nursing.

PubMed

Henderson, Amanda; Jones, Jenny

2017-09-20

Compassionate care is a fundamental aspect of nursing, and is an important value that is embedded in nurses' professional standards and codes of practice. However, nurses may experience several challenges in their practice that can impede their ability to provide compassionate care. This article aims to support and guide nurses in developing their capacity to be compassionate. It explores concepts related to compassion, including compassion satisfaction, fatigue, literacy and self-compassion, and outlines strategies that nurses can implement to promote compassionate care. This article encourages nurses to identify their personal and professional values, to understand how these can influence their attitudes and behaviours. By raising awareness of these concepts, as well as the challenges and changing nature of compassion, it is hoped that nurses' capacity to provide compassionate care will be enhanced. ©2012 RCN Publishing Company Ltd. All rights reserved. Not to be copied, transmitted or recorded in any way, in whole or part, without prior permission of the publishers.

A new method for developing compassionate communities and cities movement-"Todos Contigo" Programme (We are All With You): experience in Spain and Latin America countries.

PubMed

Librada Flores, Silvia

2018-01-01

Todos Contigo (We are All With You) is a programme for social awareness, training, and implementation of care networks for citizens to support, accompany and care for those who face advanced chronic disease and end of life situations. From New Health Foundation this programme collaborates with the Public Health and Palliative Care International Charter of Compassionate Communities. It seeks to promote a new integrated palliative care model in the daily lives of individuals, to make families and health/social professionals the main promoters of compassionate communities and compassionate cities movement. This workshop aims to: (I) describe the methodology of the programme: required tools and steps for building and developing a compassionate city or community; (II) identify stakeholders and organizations to join the compassionate community as networking agents; (III) sharing experiences from the implementation of this project in various contexts while providing specific examples and lessons learned from the perspective of various roles; (IV) explain the process of becoming a part of the project and of getting the official recognition for being a compassionate city. This workshop aims to share a new methodology "Todos Contigo" (We are all with you) Programme for the development of compassionate communities and cities movement. We describe our experiences in Spain and Latin American countries. The method is based on creating community networks, carrying out social awareness and training programmes related to end of life care.

76 FR 13111 - Compassionate Allowances for Autoimmune Disease, Office of the Commissioner; Hearing

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-10

..., schizophrenia, and cardiovascular disease and multiple organ transplants, respectively. We will hold our next...] Compassionate Allowances for Autoimmune Disease, Office of the Commissioner; Hearing AGENCY: Social Security... Compassionate Allowance public hearings to help us identify the diseases and other serious medical conditions...

Walk in Balance: Training Crisis Intervention Team Police Officers as Compassionate Warriors

ERIC Educational Resources Information Center

Chopko, Brian A.

2011-01-01

Crisis Intervention Teams (CIT) were developed to enable law enforcement officers to effectively and compassionately respond to calls involving people experiencing psychiatric distress. Mental health professionals responsible for training CIT officers are in a unique position to promote the compassionate treatment of those experiencing psychiatric…

Compassionate Parenting as a Key to Satisfaction, Efficacy and Meaning Among Mothers of Children with Autism.

PubMed

Conti, Regina

2015-07-01

Two studies examine the role of compassionate and self-image parenting goals in the experience of mothers of children with autism. In Study 1, a comparison sample was included. Study 1 included measures of parenting goals, life satisfaction, family life satisfaction, parenting satisfaction, and meaning in life. Study 2 incorporated a measure of parenting efficacy. Study 1 showed that mothers of children with autism were higher than comparison mothers in compassionate parenting goals. In both studies, compassionate parenting predicted positive outcomes including higher parenting satisfaction (both studies), family life satisfaction, meaning in life (Study 1) and higher parenting efficacy (Study 2). These studies support the notion that compassionate parenting is a key to satisfaction for mothers of children with autism.

A research-based mantra for compassionate caring.

PubMed

Terry, Louise; Newham, Roger; Hahessy, Sinéad; Atherley, Siobhan; Babenko-Mould, Yolanda; Evans, Marilyn; Ferguson, Karen; Carr, Graham; Cedar, S H

2017-11-01

The United Kingdom introduced the Six C's strategy to help address deficits in approaching nursing care in a compassionate and caring manner. To identify the book, article, poem, film or play that most influenced nurse educators' understanding of care and compassion and to articulate a clearer understanding of compassionate caring. A qualitative study applying discourse analysis to respondents' questionnaires and their nominated narrative. 41 nurse educators working in 5 universities in the UK (n=3), Republic of Ireland and Canada participated. 39 items (10 books, 2 journal articles, 10 poems, 15 films and 2 plays) were nominated. The desire to understand others and how to care compassionately characterised choices. Three main themes emerged. Abandonment of, and failure to see, the suffering person was evident in 25 narratives. Connecting with others was shown in 25 narratives as being able to truly seeing the other person. Comforting others was supported by 37 narratives with examples of kindness and compassion. Published narratives are valuable in developing compassionate responses. An annotated list is provided with suggestions for educational uses to help develop compassionate caring in student nurses. Compassionate, caring nurses recognise that patients need them to: "See who I am; Be present with me; Do not abandon me." Copyright © 2017 Elsevier Ltd. All rights reserved.

Self-compassionate responses to aging.

PubMed

Allen, Ashley Batts; Leary, Mark R

2014-04-01

Evidence suggests that self-compassion may be beneficial to older adults who are struggling to cope with the aging process. The purpose of this study was to assess the thoughts of self-compassionate older adults and to determine whether self-compassionate thoughts relate to positive responses to aging. Participants (n = 121, M = 76.2 years, approximately 65% female) completed measures of self-compassion and self-esteem; were randomly assigned to write about a positive, negative, or neutral age-related event; and completed questions about the event and their reactions. Responses were coded for self-compassionate themes and emotional tone. Analyses indicated that self-compassion predicted positive responses to aging and that self-compassionate thoughts explained the relationship between trait self-compassion and emotional tone as well as the belief that one's attitude helped them cope with age-related events. Although older adults who were low versus high in self-compassion experienced similar age-related events, participants high in self-compassion thought about these events in ways that predicted positive outcomes. Encouraging older adults to be more self-compassionate may improve well-being in old age.

Enabling the flow of compassionate care: a grounded theory study.

PubMed

Tierney, Stephanie; Seers, Kate; Tutton, Elizabeth; Reeve, Joanne

2017-03-03

Compassion has become a topic of increasing interest within healthcare over recent years. Yet despite its raised profile, little research has investigated how compassionate care is enacted and what it means to healthcare professionals (HCPs). In a grounded theory study, we aimed to explore this topic from the perspective of people working with patients with type 2 diabetes - a long-term condition that involves repeated interactions with HCPs. Semi-structured interviews and focus groups were conducted between May and October 2015 with 36 participants, selected from a range of roles within healthcare. Data collection explored their understanding of compassionate care and experiences of it in practice. Analysis followed the constructivist approach of Charmaz, which recognises meaning as being created by the interaction of people working under specific sociocultural conditions. It moved from open to focused coding, and involved the development of memos and constant comparison. Our analysis revealed that wishing to provide compassionate care, on its own, was insufficient to ensure this transpired; HCPs needed to work in a setting that supported them to do this, which underpins our core concept - the compassionate care flow. Data suggested that to be sustained, this flow was energised via what participants described as 'professional' compassion, which was associated with the intention to improve patient health and participants' role within healthcare. The compassionate care flow could be enhanced by defenders (e.g. supportive colleagues, seeing the patient as a person, drawing on their faith) or depleted by drainers (i.e. competing demands on time and resources), through their impact on professional compassion. This paper presents a model of compassionate care based on the notion of flow. It looks at processes associated with this concept and how compassionate care is delivered within health settings. Our new understanding of this phenomenon will help those working in healthcare, including managers and policy makers, to consider and potentially offset disruption to the compassionate care flow.

Overcoming barriers in care for the dying: Theoretical analysis of an innovative program model.

PubMed

Wallace, Cara L

2016-08-01

This article explores barriers to end-of-life (EOL) care (including development of a death denying culture, ongoing perceptions about EOL care, poor communication, delayed access, and benefit restrictions) through the theoretical lens of symbolic interactionism (SI), and applies general systems theory (GST) to a promising practice model appropriate for addressing these barriers. The Compassionate Care program is a practice model designed to bridge gaps in care for the dying and is one example of a program offering concurrent care, a recent focus of evaluation though the Affordable Care Act. Concurrent care involves offering curative care alongside palliative or hospice care. Additionally, the program offers comprehensive case management and online resources to enrollees in a national health plan (Spettell et al., 2009).SI and GST are compatible and interrelated theories that provide a relevant picture of barriers to end-of-life care and a practice model that might evoke change among multiple levels of systems. These theories promote insight into current challenges in EOL care, as well as point to areas of needed research and interventions to address them. The article concludes with implications for policy and practice, and discusses the important role of social work in impacting change within EOL care.

42 CFR 130.40 - Reconsideration of denial of petitions.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 1 2010-10-01 2010-10-01 false Reconsideration of denial of petitions. 130.40 Section 130.40 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES COMPASSIONATE PAYMENTS RICKY RAY HEMOPHILIA RELIEF FUND PROGRAM Reconsideration Procedures § 130.40 Reconsideration of...

42 CFR 130.3 - Amount of payments.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 1 2010-10-01 2010-10-01 false Amount of payments. 130.3 Section 130.3 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES COMPASSIONATE PAYMENTS RICKY RAY HEMOPHILIA RELIEF FUND PROGRAM General Provisions § 130.3 Amount of payments. If there are sufficient amounts...

Perceptions of Helpfulness of Teachers in Didactic Courses

ERIC Educational Resources Information Center

Moate, Randall M.; Cox, Jane A.; Brown, Steven R.; West, Erin M.

2017-01-01

Thirty-five novice counselors completed a Q sort that assessed their perceptions of what was most helpful about teachers of didactic classes in their master's degree program. Participants perceived teachers who used a contextual teaching pedagogy and had an authentic, empathic, and compassionate way of being as helpful to their learning.

A qualitative exploration of responses to self-compassion in a non-clinical sample.

PubMed

Campion, Maxine; Glover, Lesley

2017-05-01

Research suggests that being self-compassionate can have myriad benefits, including life satisfaction, health-promoting behaviours and improved mental health. Given the possible advantages of being self-compassionate, it seems critical to explore how to promote this in the general population. This qualitative study aimed to understand responses to the idea of being compassionate to oneself within the general population. Semi-structured interviews were conducted in the North East of England between October 2014 and February 2015, they were analysed using thematic analysis. As part of an intervention study, non-clinical volunteers watched a psychoeducation video about the concept of self-compassion and then participated in one of four meditation exercises. Following this, participants were interviewed about their responses to the idea of being self-compassionate. Three themes were identified: Benefits of Self-Compassion; Being Self-Compassionate and Barriers to Self-Compassion. Participants believed that being self-compassionate would be beneficial, for both themselves and the world, but they believed that self-compassion would make them vulnerable and that others would judge them. Thus, participants were afraid to be the first ones to be self-compassionate and stated that, in order for self-compassion to be acceptable, we need to change the perspective of western culture. These findings underscore the importance of understanding society's role in a person's ability to be self-compassionate. In order to reap the benefits of self-compassion, we need to create a culture that accepts and encourages this. As practitioners, we are in a position to lead in self-compassion and to encourage other leaders to promote this as a preventative mental health strategy. © 2016 John Wiley & Sons Ltd.

Enhancing residents' compassionate communication to family members: A family systems breaking bad news simulation.

PubMed

Williams-Reade, Jacqueline; Lobo, Elsie; Whittemore, Abel Arvizú; Parra, Laura; Baerg, Joanne

2018-05-28

Surgical residents often need to break bad news (BBN) to patients and family members. While communication skills are a core competency in residency training, these specific skills are rarely formally taught. We piloted a simulation training to teach pediatric surgical residents how to compassionately BBN of an unexpected, traumatic pediatric death to surviving family members. This training was unique in that it was influenced by family systems theory and was a collaborative effort between our institution's surgery residency and medical family therapy (MedFT) programs. This study provides outcomes of surgery residents' communication skills, attitudes, and self-perceptions after a BBN simulation activity with standardized family members at a major academic teaching hospital. Each resident participated in two 30-min simulations and received feedback from observers. Outcome data were collected through self-assessments completed before, immediately after, and 6 months after the simulation. Participants were 15 surgery residents, and MedFT students served as simulated family members and trainers. A statistically significant change with medium to large effect sizes in participant self-reported perceptions of skill and confidence were documented and maintained over 6 months. Responses to open-ended questions supported practice changes in response to the training. This collaborative training promoted significant improvement in resident compassionate communication skills. The curriculum was highly valued by the learners and resulted in sustained application of learned skills with patients and families. Our novel approach was feasible with promising results that warrant further investigation and could be reproduced in other institutions with similar programs. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

28 CFR 572.40 - Compassionate release under 18 U.S.C. 4205(g).

Code of Federal Regulations, 2011 CFR

2011-07-01

.... 4205(g)) § 572.40 Compassionate release under 18 U.S.C. 4205(g). 18 U.S.C. 4205(g) was repealed... 28 Judicial Administration 2 2011-07-01 2011-07-01 false Compassionate release under 18 U.S.C. 4205(g). 572.40 Section 572.40 Judicial Administration BUREAU OF PRISONS, DEPARTMENT OF JUSTICE...

28 CFR 572.40 - Compassionate release under 18 U.S.C. 4205(g).

Code of Federal Regulations, 2010 CFR

2010-07-01

.... 4205(g)) § 572.40 Compassionate release under 18 U.S.C. 4205(g). 18 U.S.C. 4205(g) was repealed... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Compassionate release under 18 U.S.C. 4205(g). 572.40 Section 572.40 Judicial Administration BUREAU OF PRISONS, DEPARTMENT OF JUSTICE...

28 CFR 572.40 - Compassionate release under 18 U.S.C. 4205(g).

Code of Federal Regulations, 2014 CFR

2014-07-01

.... 4205(g)) § 572.40 Compassionate release under 18 U.S.C. 4205(g). 18 U.S.C. 4205(g) was repealed... 28 Judicial Administration 2 2014-07-01 2014-07-01 false Compassionate release under 18 U.S.C. 4205(g). 572.40 Section 572.40 Judicial Administration BUREAU OF PRISONS, DEPARTMENT OF JUSTICE...

28 CFR 572.40 - Compassionate release under 18 U.S.C. 4205(g).

Code of Federal Regulations, 2013 CFR

2013-07-01

.... 4205(g)) § 572.40 Compassionate release under 18 U.S.C. 4205(g). 18 U.S.C. 4205(g) was repealed... 28 Judicial Administration 2 2013-07-01 2013-07-01 false Compassionate release under 18 U.S.C. 4205(g). 572.40 Section 572.40 Judicial Administration BUREAU OF PRISONS, DEPARTMENT OF JUSTICE...

28 CFR 572.40 - Compassionate release under 18 U.S.C. 4205(g).

Code of Federal Regulations, 2012 CFR

2012-07-01

.... 4205(g)) § 572.40 Compassionate release under 18 U.S.C. 4205(g). 18 U.S.C. 4205(g) was repealed... 28 Judicial Administration 2 2012-07-01 2012-07-01 false Compassionate release under 18 U.S.C. 4205(g). 572.40 Section 572.40 Judicial Administration BUREAU OF PRISONS, DEPARTMENT OF JUSTICE...

Treatment patterns and clinical outcomes with pazopanib in patients with advanced soft tissue sarcomas in a compassionate use setting: results of the SPIRE study.

PubMed

Gelderblom, Hans; Judson, Ian R; Benson, Charlotte; Merimsky, Ofer; Grignani, Giovanni; Katz, Daniela; Freivogel, Klaus W; Stein, Dara; Jobanputra, Minesh; Mungul, Arron; Manson, Stephanie C; Sanfilippo, Roberta

2017-12-01

A named patient program (NPP) was designed to provide patients with advanced soft-tissue sarcoma (aSTS) access to pazopanib, a multitargeted tyrosine kinase inhibitor. The SPIRE study was a retrospective chart review of participating patients. Eligibility criteria for the NPP and SPIRE mirrored those of the pivotal phase-III study, PALETTE, which compared pazopanib with placebo in patients ≥18 years with aSTS and whose disease had progressed during or following prior chemotherapy or were otherwise unsuitable for chemotherapy. Outcomes of interest included treatment patterns, treatment duration, relative dose intensity, progression-free survival (PFS), overall survival (OS), clinical benefit rate, adverse events (AEs) and reasons for treatment discontinuation. A total of 211 patients were enrolled (median age 56 years; 60% female). Most patients received pazopanib in second- and third-line therapy (28.0% and 28.4%, respectively), followed by fourth line (19.0%) and ≥ fifth line (18.5%). The median duration of pazopanib treatment was 3.1 months (95% CI: 2.8-3.8), with a mean daily dose of 715 mg equating to 92% of recommended dose. Median OS was 11.1 months and clinical benefit rate was 46%. There was evidence of some clinical benefit across most histological subtypes. At study end, 40% of patients were alive and of these, 18% remained on pazopanib. Thirteen percent (13%) of patients discontinued pazopanib due to AEs. The SPIRE study demonstrated activity of pazopanib in heavily pretreated aSTS patients in a compassionate use setting. No new safety concerns were noted. Reassuringly, the relative dose intensity of pazopanib was 92%.

The Empower Program, K-2: Concrete Strategies for Positive Behavioral Support

ERIC Educational Resources Information Center

Baker, Rachel

2016-01-01

Let's face it--teaching can be stressful. In this generation of Common Core Standards and highstakes testing, educators are often left without the time to plan positive behavioral supports or the sanity to cultivate compassionate relationships with their students. Even though they understand the critical relationship between behavior and…

Biotechnology

DTIC Science & Technology

2001-01-01

The former Soviet Union dedicated many resources to its offensive biological weapons program, employing over 25,000 scientists, engineers, and...compassionate partner in international affairs. The proliferation of biological weapons is a real and growing concern. The Biological Weapons ...Convention Treaty (BWC) of 1972 prohibits the development, possession and use of biological weapons , but the treaty lacks a means of verifying compliance

Diabetes Stories: Use of Patient Narratives of Diabetes to Teach Patient-Centered Care

ERIC Educational Resources Information Center

Kumagai, Arno K.; Murphy, Elizabeth A.; Ross, Paula T.

2009-01-01

A critical component to instituting compassionate, patient-centered diabetes care is the training of health care providers. Our institution developed the Family Centered Experience (FCE), a comprehensive 2-year preclinical program based on longitudinal conversations with patients about living with chronic illness. The goal of the FCE is to explore…

Sexual Assault Nurse Examiners' Perceptions of the Revictimization of Rape Victims

ERIC Educational Resources Information Center

Maier, Shana L.

2012-01-01

While Sexual Assault Nurse Examiner programs have improved the treatment of rape victims by offering more compassionate and thorough treatment, SANEs believe victims continue to face revictimization by the medical, criminal justice and legal systems. The purpose of this research is to explore SANEs' perceptions of the revictimization of rape…

42 CFR 130.33 - How will the Secretary determine whether a petition is complete?

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 1 2010-10-01 2010-10-01 false How will the Secretary determine whether a petition is complete? 130.33 Section 130.33 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES COMPASSIONATE PAYMENTS RICKY RAY HEMOPHILIA RELIEF FUND PROGRAM Procedures for Filing and...

42 CFR Appendix C to Part 130 - Petition Form, Petition Instructions, and Documentation Checklist

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 1 2010-10-01 2010-10-01 false Petition Form, Petition Instructions, and Documentation Checklist C Appendix C to Part 130 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES COMPASSIONATE PAYMENTS RICKY RAY HEMOPHILIA RELIEF FUND PROGRAM Pt. 130, App. C Appendix...

42 CFR 130.35 - How and when will the Secretary pay a petition?

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 1 2010-10-01 2010-10-01 false How and when will the Secretary pay a petition? 130.35 Section 130.35 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES COMPASSIONATE PAYMENTS RICKY RAY HEMOPHILIA RELIEF FUND PROGRAM Procedures for Filing and Paying Complete...

42 CFR Appendix C to Part 130 - Petition Form, Petition Instructions, and Documentation Checklist

Code of Federal Regulations, 2011 CFR

2011-10-01

... Documentation Checklist C Appendix C to Part 130 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES COMPASSIONATE PAYMENTS RICKY RAY HEMOPHILIA RELIEF FUND PROGRAM Pt. 130, App. C Appendix C to Part 130—Petition Form, Petition Instructions, and Documentation Checklist ER31MY00.004...

One Principal's Approach to Hiring Staff for Athletic Programs.

ERIC Educational Resources Information Center

Irvine, Marion

1990-01-01

The principal at a Catholic coeducational preparatory high school describes her perfect coach as a gentleman or gentlewoman dedicated to truth and capable of inspiring respect and building self-esteem. The coach should be compassionate and encouraging, model concern and caring, and work untiringly to teach the life-long benefits of participation…

Balancing Punishment and Compassion for Seriously Ill Prisoners

PubMed Central

Williams, Brie A.; Sudore, Rebecca L.; Greifinger, Robert; Morrison, R. Sean

2011-01-01

Compassionate release is a mechanism to allow some eligible, seriously ill prisoners to die outside of prison before sentence completion. It became a matter of federal statute in 1984 and currently has been adopted by the majority of U.S. prison jurisdictions. Incarceration is justified on 4 principles: retribution, rehabilitation, deterrence, and incapacitation. Compassionate release derives from the theory that changes in health status may affect these principles and thus alter justification for incarceration and sentence completion. The medical profession is intricately involved in this process because eligibility for consideration for compassionate release is generally based on medical evidence. Due to an aging prison population, overcrowding, rising deaths in custody, and soaring criminal justice medical costs, many policy experts are calling for broader use of compassionate release. Yet, the medical eligibility criteria of many compassionate release guidelines – which often assume a definitive prognosis – are clinically flawed and procedural barriers may further limit their rational application. We propose changes to address these flaws. PMID:21628351

Right-to-Try Investigational Therapies for Incurable Disorders.

PubMed

Simmons, Zachary

2017-10-01

Patients with life-threatening disorders such as amyotrophic lateral sclerosis, for which only minimally effective medical therapies currently exist, often seek treatments not proven to be effective and not approved by regulatory agencies for use outside of experimental treatment trials. The expanded access (compassionate use) provisions of the US Food and Drug Administration (FDA) for access to such therapies are often perceived as being inadequate. In response, states have passed right-to-try laws designed to improve access to experimental therapies for patients willing to assume the risks associated with such treatments. This situation has resulted in conflicts between those who perceive access to such treatments as their right as autonomous individuals and those who believe that the principles of beneficence and nonmaleficence justify actions of physicians and regulators in controlling access to such treatments. A variety of factors also contribute to the inequitable distribution of such treatments. Better systems are needed to improve access to promising new treatments while protecting these vulnerable patients from the abuses associated with human research in the preregulatory era.

The vascular surgeon facing clinical ethical dilemmas (the VASCUETHICS Study): 'V'-shaped association between compassionate attitudes and professional seniority.

PubMed

Clará, A; Merino, J; Mateos, E; Ysa, A; Román, B; Vidal-Barraquer, F

2006-06-01

To evaluate the association between compassionate attitudes and seniority in vascular surgeons facing clinical ethical dilemmas (CED). (1) DESIGN: Cross-sectional. (2) SUBJECTS: Vascular surgeons (residents included) from the 28 vascular teaching departments of one European country. (3) MEASUREMENTS: Multidisciplinary team-designed, structured and self-administered questionnaire consisting of five clinical ethical dilemmas, of which four had conflict between compassion towards a 'small' or 'very costly' beneficial action vs. a reasonable but more 'pragmatic' allocation of health resources. Participants stated their degree of agreement with eight answers representing the two attitudes on a continuous scale. (4) STATISTICS: Cluster analysis and logistic regression model adjusted by confounding factors. Two hundred and fifty three vascular surgeons (median age 37 years, 74% male) from the 26 participating teaching vascular departments (public hospitals) completed the questionnaire (88% surgeons/department). Cluster analysis identified two groups of surgeons according to their pattern of answers: Group I (n=63) were mainly compassionate whereas Group II (n=180) were mainly pragmatic. The multivariate analysis disclosed, after adjusting for additional private practice, on call services and career status, a significant V-shaped relationship between the compassionate behaviour and seniority. Surgeons with 8-15 years experience were the least compassionate. The youngest and the most senior vascular surgeons were more prone to favour compassionate attitudes when facing clinical ethical dilemmas. Although both compassionate and pragmatic attitudes may be legitimate ethically, physicians not favouring compassion may be at risk of leaving the patient without an advocate within the health care system.

A qualitative study of key stakeholders' perspectives on compassion in healthcare and the development of a framework for compassionate interpersonal relations.

PubMed

Kneafsey, Rosie; Brown, Sarah; Sein, Kim; Chamley, Carol; Parsons, Joanne

2016-01-01

To report findings from a qualitative study of key stakeholders' perspectives on 'compassion' in the health care context. To present the 'Framework for Compassionate Interpersonal Relations'. Although many research articles, health policies and health care strategies identify compassion as an underpinning value and key component of health care quality, identifying a unified definition of compassion is challenging. For Higher Education Institutions implementing 'values-based' recruitment processes, a clearer understanding of this core concept is vital. Exploratory, qualitative design. Academic staff, health care students, clinicians and service users (n = 45), participated in nine focus groups where they were asked to define compassion in the context of health care. Data were transcribed verbatim and analysed using thematic analysis. Four overarching themes were drawn from the data. The first theme centred on the participants' definitions of compassion, while the second identified compassionate behaviours. The third theme related to the barriers and threats to compassionate practice and the fourth, focused on ways to support compassion in practice. Participants believed that the health care staff should be 'consistently compassionate', and were emphatic that compassion should not be substituted with a 'care without engagement' approach. The findings concur with other research, which identifies the link between compassion and empathy and the importance of establishing meaningful connections with others. While participants in this study recognised the pressures of health care work and accepted that the expectation of 'consistent compassion' was not necessarily realistic, it was still seen as an important goal. Participants held clear expectations regarding practitioners' communication skills and used these as a proxy for compassionate practice. The 'Framework for Compassionate Inter-personal Relations' may be used to promote reflection on the implementation of compassionate practice. It may also be used to highlight areas of focus when conducting values-based recruitment activities. © 2015 John Wiley & Sons Ltd.

Compassionate love buffers stress-reactive mothers from fight-or-flight parenting.

PubMed

Miller, Jonas G; Kahle, Sarah; Lopez, Monica; Hastings, Paul D

2015-01-01

The links among mothers' compassionate love for their child, autonomic nervous system activity, and parenting behavior during less and more challenging mother-child interactions were examined. Mothers expressed and reported less negative affect when they exhibited autonomic patterns of increased parasympathetic dominance (high parasympathetic and low sympathetic activation) or autonomic coactivation (high parasympathetic and high sympathetic activation) during the less challenging interaction and autonomic coactivation during the more challenging interaction. Compassionate love predicted less reported and observed negativity in mothers who showed increased sympathetic nervous system dominance (high sympathetic and low parasympathetic activation). Compassionate love appeared to help mothers, and particularly those who experienced strong physiological arousal during difficult parenting situations, establish positive socialization contexts for their children and avoid stress-induced adverse parenting.

Changing Relationship Growth Belief: Intrapersonal and Interpersonal Consequences of Compassionate Goals

PubMed Central

Canevello, Amy; Crocker, Jennifer

2010-01-01

The belief that difficulties can lead to growth in relationships, or growth belief, has consequences for relationships (e.g., Knee, 1998). But what predicts change in this belief? We hypothesized that compassionate goals to support others (Crocker & Canevello, 2008) predict increased growth belief through increased need satisfaction. In Study 1, 199 college freshmen reported their friendship growth belief and goals. In Study 2, 65 roommate pairs reported their roommate growth belief, goals, and need satisfaction. Across studies, compassionate goals predicted increased growth belief. In Study 2, goals predicted increased perceived mutual need satisfaction, which predicted increased growth belief. Additionally, partners’ compassionate goals predicted actors’ increased growth belief. Results suggest that growth beliefs are shaped by goals – own and others’. PMID:21949478

OA17 Compassionate communities: engaging with communities to support patients at end of life: a birmingham st. mary's hospice lived experience.

PubMed

Murungu, Diana; Woolf, Tina Swani Sarah

2015-04-01

Researchers carrying out a rebranding exercise for us in 2006 found that people from Black Asian and other Minority Ethnic (BAME) communities did not respond to their survey. This appeared to support anecdotal evidence from staff suggesting that the number of BAME patients accessing our services did not reflect the real need. To increase access to Hospice Care services for people from BAME communities. From April to July 2007 we used qualitative methods to carry out an exploratory study, to identify barriers to hospice care for patients from BAME communities. Currently we use community development methods to raise awareness of hospice services among BAME communities in Birmingham and Sandwell; while offering training and cultural/spiritual broker services to clinicians increasing their understanding of patients and families from these communities. There was no information about Hospice care services among people from BAME communities. Many people from BAME communities belong to cultural or spiritual groups whose members support each other during times of celebration, illness, death and bereavement. They refer to this support as 'our way of life'. Death, dying, and cancer are taboo subjects. In 2009 we set up the Compassionate Communities Project (CCP) within our Reaching People Programme (RPP) to increase access to our services for people from BAME communities. CCP enables community groups and service providers to work together in end of life. Representatives from BAME communities help train clinicians on supporting people from their communities in end of life. © 2015, Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

42 CFR 130.32 - How and when will the Secretary determine the order of receipt of petitions?

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 1 2010-10-01 2010-10-01 false How and when will the Secretary determine the order of receipt of petitions? 130.32 Section 130.32 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES COMPASSIONATE PAYMENTS RICKY RAY HEMOPHILIA RELIEF FUND PROGRAM Procedures for...

42 CFR 130.34 - How will the Secretary determine whether to pay a petition?

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 1 2010-10-01 2010-10-01 false How will the Secretary determine whether to pay a petition? 130.34 Section 130.34 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES COMPASSIONATE PAYMENTS RICKY RAY HEMOPHILIA RELIEF FUND PROGRAM Procedures for Filing and Paying...

Compassionate Love Buffers Stress-Reactive Mothers From Fight-or-Flight Parenting

PubMed Central

Miller, Jonas G.; Kahle, Sarah; Lopez, Monica; Hastings, Paul D.

2015-01-01

The links among mothers’ compassionate love for their child, autonomic nervous system activity, and parenting behavior during less and more challenging mother–child interactions were examined. Mothers expressed and reported less negative affect when they exhibited autonomic patterns of increased parasympathetic dominance (high parasympathetic and low sympathetic activation) or autonomic coactivation (high parasympathetic and high sympathetic activation) during the less challenging interaction and autonomic coactivation during the more challenging interaction. Compassionate love predicted less reported and observed negativity in mothers who showed increased sympathetic nervous system dominance (high sympathetic and low parasympathetic activation). Compassionate love appeared to help mothers, and particularly those who experienced strong physiological arousal during difficult parenting situations, establish positive socialization contexts for their children and avoid stress-induced adverse parenting. PMID:25329554

Going "social" to access experimental and potentially life-saving treatment: an assessment of the policy and online patient advocacy environment for expanded access.

PubMed

Mackey, Tim K; Schoenfeld, Virginia J

2016-02-02

Social media is fundamentally altering how we access health information and make decisions about medical treatment, including for terminally ill patients. This specifically includes the growing phenomenon of patients who use online petitions and social media campaigns in an attempt to gain access to experimental drugs through expanded access pathways. Importantly, controversy surrounding expanded access and "compassionate use" involves several disparate stakeholders, including patients, manufacturers, policymakers, and regulatory agencies-all with competing interests and priorities, leading to confusion, frustration, and ultimately advocacy. In order to explore this issue in detail, this correspondence article first conducts a literature review to describe how the expanded access policy and regulatory environment in the United States has evolved over time and how it currently impacts access to experimental drugs. We then conducted structured web searches to identify patient use of online petitions and social media campaigns aimed at compelling access to experimental drugs. This was carried out in order to characterize the types of communication strategies utilized, the diseases and drugs subject to expanded access petitions, and the prevalent themes associated with this form of "digital" patient advocacy. We find that patients and their families experience mixed results, but still gravitate towards the use of online campaigns out of desperation, lack of reliable information about treatment access options, and in direct response to limitations of the current fragmented structure of expanded access regulation and policy currently in place. In response, we discuss potential policy reforms to improve expanded access processes, including advocating greater transparency for expanded access programs, exploring use of targeted economic incentives for manufacturers, and developing systems to facilitate patient information about existing treatment options. This includes leveraging recent legislative attention to reform expanded access through the CURE Act Provisions contained in the proposed U.S. 21st Century Cures Act. While expanded access may not be the best option for the majority of individuals, terminally ill patients and their families nevertheless deserve better processes, policies, and availability to potentially life-changing information, before they decide to pursue an online campaign in the desperate hope of gaining access to experimental drugs.

42 CFR 130.30 - Who may file a petition for payment or an amendment to a petition?

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 1 2010-10-01 2010-10-01 false Who may file a petition for payment or an amendment to a petition? 130.30 Section 130.30 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES COMPASSIONATE PAYMENTS RICKY RAY HEMOPHILIA RELIEF FUND PROGRAM Procedures for Filing and...

NAPNAP Position Statement. Position Statement on Pediatric Health Care/Medical Home: Key Issues on Care Coordination, Transitions, and Leadership.

PubMed

2016-01-01

The National Association of Pediatric Nurse Practitioners (NAPNAP) affirms that the delivery of children's health care should be family-centered, accessible, comprehensive, coordinated, culturally appropriate, compassionate, and focused on the overall well-being of children and families. All qualified pediatric health care providers should collaborate in providing health care services for children in pediatric health care/medical homes. Interventions must address the concepts of family-centered partnerships, community-based systems, and transitional care from pediatric to adult services.

Leadership, Education and Awareness: A Compassionate Care Nursing Initiative.

PubMed

Simmonds, Anne H

2015-03-01

The Canadian Nurses' Association Code of Ethics (2008) and the College of Registered Nurses of Nova Scotia (CRNNS) Standards of Practice for Registered Nurses (CRNNS 2011) identify the provision of safe, compassionate, competent and ethical care as one of nursing's primary values and ethical responsibilities. While compassion has historically been viewed as the essence of nursing, there is concern that this has become an abstract ideal, rather than a true reflection of nursing practice. This paper describes a compassionate care initiative undertaken by the CRNNS and the initial outcomes of these educational workshops. This work is informed by an exploration of the multiplicity of factors that have brought this issue to the fore for nursing regulators, educators, administrators, the public as well as front-line staff. The two most significant areas of learning reported by workshop participants included understanding the connection between mindfulness, non-judgmental care and compassion/self-compassion and recognizing possibilities for action related to compassionate care, even in the face of personal and environmental constraints. Implications for nursing regulators and leaders include consideration of their roles and responsibilities in supporting nurses to meet professional practice standards, such as provision of compassionate care. Copyright © 2015 Longwoods Publishing.

Understanding suffering and giving compassion: the reach of socially engaged Buddhism into China.

PubMed

Kuah-Pearce, Khun Eng

2014-01-01

This paper will explore the social engagement of Buddhists through their active voluntary works - works that result in the development of a religious philanthropic culture. Through three case examples, this paper will examine how the sangha and individual Buddhists understand social suffering and compassion and attempt to integrate their understanding of Buddhist virtues and values in their daily life where the performance of voluntary works is seen as Buddhist spiritualism. In this process, the individuals seek to understand the key principles of Buddhism that are of direct relevance to their daily existence and their quest to be a compassionate self. Foremost are two notions of yebao (karma) and gan-en (gratitude) and how through compassionate practices and gratitude for those who accepted compassionate acts, they would be rewarded with good karma. Here, pursuing compassionate acts and the alleviation of social suffering is the pursuit of this-worldly spiritualism.

Six-year activity on approval of compassionate use of medicines by the Ethics Committee of the University Hospital of Bologna (Italy): time to update rules and recommendations.

PubMed

Montanaro, Nicola; Melis, Mauro; Proni, Stefania; Chiabrando, Giacomo; Motola, Domenico

2017-04-01

Compassionate use of forthcoming drugs has become an increasing pathway through which patients can take advantage of promising medicines. We aimed to analyse the main features of the requests of compassionate use submitted to the Independent Ethics Committee (IEC) of the University Hospital of Bologna in the period 2010-2015. The present analysis concerns the requests of compassionate use received by the IEC in the period 2010-2015. For each requested drug, we paired the date of the first request to our IEC with the date(s) of (a) submission to EMA, (b) CHMP positive opinion, and (c) European marketing authorization (if issued). In the period 2010-2015, our IEC received compassionate use requests for 610 patients. Most of the requests concerned patients suffering from solid or haematological cancers not responsive to first or second line of treatment. Sixty-five couples of medicine/clinical condition (corresponding to 56 individual medicines) were submitted to our IEC, and 62 of them regarded products following the centralised procedure at the EMA. Twenty-one out of the latter (34%) had already obtained CHMP positive opinion. Our results indicate that compassionate use of forthcoming medicines represents a not negligible portion of the therapies utilized in hospital care. The observed large resort to medicines still on trial may suggest that doctors are more aware with the potential benefits of the new drugs. However, this trend may also indicate an increasing marketing activity of the pharmaceutical industry, addressing to get the clinicians used to the upcoming medicines.

What Is the Impact of Online Training in Mind-Body Skills?

PubMed

Kemper, Kathi J; Lynn, Joanne; Mahan, John D

2015-10-01

Mind-body skills (MBS) training is popular, but in-person training can be inconvenient and costly. We assessed the impact of online MBS training on clinicians' and trainees' stress, mindfulness, and confidence in providing calm, compassionate care. This was a prospective cohort trial. Trainees entering medical school; graduate programs in nursing, social work, and dietetics; and residencies in family medicine and pediatrics at a large Midwestern academic health center were invited to complete online surveys before and 12 weeks after enrolling in online elective integrative health courses on MBS training or not. The elective offered no course credit and had no mandated deadlines for completion. At baseline, the 60 who engaged in MBS training were similar to the 43 who did not in terms of profession, gender, perceived stress levels, mindfulness, resilience, and compassion. MBS participants engaged in a median of 3 of 12 available modules with a bimodal distribution peaking at 1 to 2 and 12 modules. Twelve weeks later, those who participated in MBS showed significantly greater improvements in measures of stress, mindfulness, and confidence in providing calm, compassionate care than those who did not. Online elective training offers a feasible strategy to improve mindfulness, stress, and confidence in providing calm, compassionate care. Additional studies are needed to determine the impact of required versus elective courses, the optimal dosage and content of training, and the costs and benefits of online versus in-person training. © The Author(s) 2015.

Experience of care for mental health problems in the antenatal or postnatal period for women in the UK: a systematic review and meta-synthesis of qualitative research.

PubMed

Megnin-Viggars, Odette; Symington, Iona; Howard, Louise M; Pilling, Stephen

2015-12-01

Pregnancy and the first postnatal year can be a difficult and distressing period for women with mental health problems, particularly if they are not able to access appropriate and timely assessment and treatment. The aim of this systematic review was to synthesise qualitative evidence on experiences of care for women with (or at risk of developing) antenatal or postnatal mental health problems across a range of disorders (including non-psychotic mental disorders). Six electronic databases were searched for papers published from 2000 to April 2014. Thirty-nine studies were identified that met the inclusion criteria. Findings were synthesised using secondary framework and thematic analysis approaches. Seven key themes were identified across mental disorder groups: an unmet need for collaborative and integrated care; stigma and fears about loss of custody; healthcare professionals unable or unwilling to address psychological needs; focus on babies over mothers; importance of non-judgmental and compassionate support; an unmet need for information; importance of service user involvement in treatment decisions. Women's experience of accessing and engaging with care for mental health problems could be improved if given the opportunity to develop trusting relationships with healthcare professionals who acknowledge and reinforce the woman's role in caring for her baby in a non-judgmental and compassionate manner, and foster hope and optimism about treatment. Information for women, their families and healthcare professionals, and the provision of individualised care and treatment, are also crucial to enable full implementation of a person-centred programme of care.

[Compassionate care, a perpetual quest].

PubMed

Ghadi, Véronique; Terrien, Noémie; Antonini, Françoise

2016-05-01

The French Federation of Regional and Territorial Bodies for the Improvement of Health Practices and Organisations and the French National Authority for Health have produced a guide and tools devoted to the promotion of compassionate care in health institutions. The assessment of the use of the guide has shown increasing awareness of compassionate care on the part of institutions but a paradoxical exclusion of users from the approaches undertaken. An analysis of the reasons for this partial achievement of the objectives has resulted in a revision of the working methods and opens up new perspectives for development. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Online Training in Specific Meditation Practices Improves Gratitude, Well-Being, Self-Compassion, and Confidence in Providing Compassionate Care Among Health Professionals.

PubMed

Rao, Nisha; Kemper, Kathi J

2016-04-06

Mind-body practices that intentionally generate positive emotion could improve health professionals' well-being and compassion. However, the feasibility and impact of clinician training in these practices is unknown. Data were analyzed from 3 online modules offered to health professionals: (a) Gratitude, (b) Positive Word, and (c) Loving-kindness/Compassion meditation. Pairedttests were used to assess pre- to posttraining changes in gratitude (Gratitude Questionnaire), well-being (World Health Organization Well-Being Index), self-compassion (Neff's Self-Compassion Scale), and confidence in providing compassionate care (Confidence in Providing Calm, Compassionate Care Scale). The 177 enrollees included diverse practitioners (nurses, physicians, social workers, and others). Training was associated with statistically significant improvements in gratitude (38.3 ± 4.6 to 39.5 ± 3.3), well-being (16.4 ± 4.0 to 17.9 ± 4.2), self-compassion (39.5 ± 8.1 to 43.1 ± 7.6), and confidence in providing compassionate care (73.3 ± 16.4 to 80.9 ± 13.8;P< .001 for all comparisons). Brief, online training appeals to diverse health professionals and improves their gratitude, well-being, self-compassion, and confidence in providing compassionate care. © The Author(s) 2016.

Online Training in Specific Meditation Practices Improves Gratitude, Well-Being, Self-Compassion, and Confidence in Providing Compassionate Care Among Health Professionals

PubMed Central

Rao, Nisha; Kemper, Kathi J.

2016-01-01

Mind-body practices that intentionally generate positive emotion could improve health professionals’ well-being and compassion. However, the feasibility and impact of clinician training in these practices is unknown. Data were analyzed from 3 online modules offered to health professionals: (a) Gratitude, (b) Positive Word, and (c) Loving-kindness/Compassion meditation. Paired t tests were used to assess pre- to posttraining changes in gratitude (Gratitude Questionnaire), well-being (World Health Organization Well-Being Index), self-compassion (Neff’s Self-Compassion Scale), and confidence in providing compassionate care (Confidence in Providing Calm, Compassionate Care Scale). The 177 enrollees included diverse practitioners (nurses, physicians, social workers, and others). Training was associated with statistically significant improvements in gratitude (38.3 ± 4.6 to 39.5 ± 3.3), well-being (16.4 ± 4.0 to 17.9 ± 4.2), self-compassion (39.5 ± 8.1 to 43.1 ± 7.6), and confidence in providing compassionate care (73.3 ± 16.4 to 80.9 ± 13.8; P < .001 for all comparisons). Brief, online training appeals to diverse health professionals and improves their gratitude, well-being, self-compassion, and confidence in providing compassionate care. PMID:27055823

The paradox of compassionate work: a mixed-methods study of satisfying and fatiguing experiences of animal health care providers.

PubMed

Polachek, Alicia J; Wallace, Jean E

2018-03-01

Compassionate work appears paradoxical as it may provide great rewards, but may also come at great costs to care providers. This paper explores the paradox of compassionate work by examining what interactions contribute to compassion satisfaction and what interactions contribute to compassion fatigue. This mixed-methods, cross-sectional study uses qualitative interview data from animal health care providers (N = 20) to identify work interactions that they find satisfying or stressful. Quantitative survey data (N = 572) are used to test hypotheses generated from the interviews regarding predictors of compassion satisfaction and compassion fatigue. Interview transcripts were analyzed using a directed content analysis approach. Survey data were analyzed using ordinary least squares regression. The results highlight the complex nature of compassionate work. As hypothesized, making a difference to animals and building relationships with animal patients and human clients relate to greater compassion satisfaction. Human client barriers to animal care and witnessing client grief relate to greater compassion fatigue, as predicted. None of the predictors relate to less compassion fatigue, but forming relationships with animal patients relates to both greater compassion satisfaction and compassion fatigue. This paper enhances our understanding of provider-client-patient interactions and highlights the paradox of compassionate work.

Volunteer navigation partnerships: Piloting a compassionate community approach to early palliative care.

PubMed

Pesut, Barbara; Duggleby, Wendy; Warner, Grace; Fassbender, Konrad; Antifeau, Elisabeth; Hooper, Brenda; Greig, Madeleine; Sullivan, Kelli

2017-07-03

A compassionate community approach to palliative care provides important rationale for building community-based hospice volunteer capacity. In this project, we piloted one such capacity-building model in which volunteers and a nurse partnered to provide navigation support beginning in the early palliative phase for adults living in community. The goal was to improve quality of life by developing independence, engagement, and community connections. Volunteers received navigation training through a three-day workshop and then conducted in-home visits with clients living with advanced chronic illness over one year. A nurse navigator provided education and mentorship. Mixed method evaluation data was collected from clients, volunteer navigators, the nurse navigator, and other stakeholders. Seven volunteers were partnered with 18 clients. Over the one-year pilot, the volunteer navigators conducted visits in home or by phone every two to three weeks. Volunteers were skilled and resourceful in building connections and facilitating engagement. Although it took time to learn the navigator role, volunteers felt well-prepared and found the role satisfying and meaningful. Clients and family rated the service as highly important to their care because of how the volunteer helped to make the difficult experiences of aging and advanced chronic illness more livable. Significant benefits cited by clients were making good decisions for both now and in the future; having a surrogate social safety net; supporting engagement with life; and ultimately, transforming the experience of living with illness. Overall the program was perceived to be well-designed by stakeholders and meeting an important need in the community. Sustainability, however, was a concern expressed by both clients and volunteers. Volunteers providing supportive navigation services during the early phase of palliative care is a feasible way to foster a compassionate community approach to care for an aging population. The program is now being implemented by hospice societies in diverse communities across Canada.

Nursing praxis, compassionate caring and interpersonal relations: an observational study.

PubMed

Fry, Margaret; MacGregor, Casimir; Ruperto, Kate; Jarrett, Kate; Wheeler, Janet; Fong, Jacqueline; Fetchet, Wendy

2013-05-01

The Clinical Initiative Nurse (CIN) is a role that requires experienced emergency nurses to assess, initiate diagnostic tests, treat and manage a range of patient conditions. The CIN role is focused on the waiting room and to 'communicate the wait', initiate diagnostics or treatment and follow-up for waiting room patients. We aim to explore what emergency nurses' do in their extended practice role in observable everyday life in the emergency department (ED). The paper argues that compassionate caring is a core nursing skill that supports CIN interpersonal relations, despite the role's highly clinical nature. Sixteen non-participant observations were undertaken in three EDs in New South Wales, Australia. Nurses were eligible for inclusion if they had two years of emergency experience and had worked in the CIN role for more than one year. All CIN's that were observed were highly experienced with a minimum three year ED experience. The CIN observations revealed how compassionate caring was utilised by CIN's to quickly build a therapeutic relationship with patients and colleagues, and helped to facilitate core communication and interpersonal skills. While the CIN role was viewed as extended practice, the role relied heavily on compassionate care to support interpersonal relationships and to actualise extended practice care. The study supports the contribution made by emergency nurses and demonstrates how compassionate caring is central to nursing praxis. This paper also demonstrates that the CIN role utilises a complex mix between advanced clinical skills and compassion that supports interpersonal and therapeutic relationships. Further research is needed to understand how compassionate care can be optimised within nursing praxis and the duty of care between nurses and patients, nurses and other health care professionals so that future healthcare goals can be realised. Copyright © 2013 College of Emergency Nursing Australasia Ltd. All rights reserved.

Characteristics of women with nausea and vomiting of pregnancy who chose to continue compassionate use of placebo after a randomised trial.

PubMed

Matok, I; Umans, J; Feghali, M N; Clark, S; Caritis, S; Miodovnik, M; Hankins, G; Mattison, D R; Nordeng, H; Koren, G

2013-08-01

The placebo effect has not been characterised in pregnant women suffering from nausea and vomiting of pregnancy (NVP). Our aim was to characterise determinants of the placebo effect in women treated with placebo for NVP. We analysed data from a multicentre, double blind randomised controlled trial of Diclectin (delayed release doxylamine and pyridoxine) vs placebo for the treatment of NVP. A total of 127 women in the placebo arm and 130 in the active arm provided evaluable data for this analysis. Women who chose to continue placebo on a compassionate basis (n = 41) had significantly better improvement in symptoms of NVP and higher Wellbeing scores than those who did not ask to continue compassionate use. Results were similar in the active drug arm. The request to continue compassionate use of either placebo or active drug could be predicted by greater improvement in symptoms of NVP during the trial period.

Recreational 3,4-methylenedioxy-N-methylamphetamine (MDMA) or 'ecstasy' and self-focused compassion: Preliminary steps in the development of a therapeutic psychopharmacology of contemplative practices.

PubMed

Kamboj, Sunjeev K; Kilford, Emma J; Minchin, Stephanie; Moss, Abigail; Lawn, Will; Das, Ravi K; Falconer, Caroline J; Gilbert, Paul; Curran, H Valerie; Freeman, Tom P

2015-09-01

3,4-methylenedioxy-N-methylamphetamine (MDMA) produces diverse pro-social effects. Cognitive training methods rooted in Eastern contemplative practices also produce these effects through the development of a compassionate mindset. Given this similarity, we propose that one potential mechanism of action of MDMA in psychotherapy is through enhancing effects on intrapersonal attitudes (i.e. pro-social attitudes towards the self). We provide a preliminary test of this idea. Recreational MDMA (ecstasy) users were tested on two occasions, having consumed or not consumed ecstasy. Self-critical and self-compassionate responses to self-threatening scenarios were assessed before (T1) and after (T2) ecstasy use (or non-use), and then after compassionate imagery (T3). Moderating roles of dispositional self-criticism and avoidant attachment were examined. Separately, compassionate imagery and ecstasy produced similar sociotropic effects, as well as increases in self-compassion and reductions in self-criticism. Higher attachment-related avoidance was associated with additive effects of compassionate imagery and ecstasy on self-compassion. Findings were in line with MDMA's neuropharmacological profile, its phenomenological effects and its proposed adjunctive use in psychotherapy. However, although conditions were balanced, the experiment was non-blind and MDMA dose/purity was not determined. Controlled studies with pharmaceutically pure MDMA are still needed to test these effects rigorously. © The Author(s) 2015.

Celebrating indigenous communities compassionate traditions.

PubMed

Prince, Holly

2018-01-01

Living in a compassionate community is not a new practice in First Nations communities; they have always recognized dying as a social experience. First Nations hold extensive traditional knowledge and have community-based practices to support the personal, familial, and community experiences surrounding end-of-life. However, western health systems were imposed and typically did not support these social and cultural practices at end of life. In fact, the different expectations of western medicine and the community related to end of life care has created stress and misunderstanding for both. One solution is for First Nations communities to develop palliative care programs so that people can receive care at home amongst their family, community and culture. Our research project "Improving End-of-Life Care in First Nations Communities" (EOLFN) was funded by the Canadian Institutes of Health Research [2010-2015] and was conducted in partnership with four First Nations communities in Canada (see www.eolfn.lakeheadu.ca). Results included a community capacity development approach to support Indigenous models of care at end-of-life. The workshop will describe the community capacity development process used to develop palliative care programs in First Nations communities. It will highlight the foundation to this approach, namely, grounding the program in community values and principles, rooted in individual, family, community and culture. Two First Nations communities will share stories about their experiences developing their own palliative care programs, which celebrated cultural capacity in their communities while enhancing medical palliative care services in a way that respected and integrated with their community cultural practices. This workshop shares the experiences of two First Nations communities who developed palliative care programs by building upon community culture, values and principles. The underlying model guiding development is shared.

78 FR 13478 - Compassionate Release; Technical Changes

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-28

... (Bureau) makes a minor change to remove an administrative level of review from the processing of a... interim rule, the Bureau of Prisons (Bureau) makes a minor change to remove an administrative level of review from the processing of a Compassionate Release request packet. DATES: This rule is effective April...

Compassionate Love Buffers Stress-Reactive Mothers from Fight-or-Flight Parenting

ERIC Educational Resources Information Center

Miller, Jonas G.; Kahle, Sarah; Lopez, Monica; Hastings, Paul D.

2015-01-01

The links among mothers' compassionate love for their child, autonomic nervous system activity, and parenting behavior during less and more challenging mother-child interactions were examined. Mothers expressed and reported less negative affect when they exhibited autonomic patterns of increased parasympathetic dominance (high parasympathetic…

"ZEAL": An Aesthetic Revolution for Education

ERIC Educational Resources Information Center

Clark, Barbara A.; French, James Joss

2012-01-01

Educators are hesitant to venture into the unknown landscape within a child's heart and mind because they have throughout their education experienced the same non-compassionate teachers. This research proposes an awakening, making a wave for a new revolution of compassionate teachers that institutes aesthetic methodology to address relevant…

Compassionate Roots Begin with Babies

ERIC Educational Resources Information Center

Gonzalez-Mena, Janet

2010-01-01

Long before babies understand words, they understand touch. The first experience of compassion infants receive is gentle, caring touch, which gives a strong message, especially when accompanied by eye contact and a soft tone of voice. The kind of relationship a compassionate caregiver strives to develop with an infant creates attachment, an…

On Promoting Understanding and Equity through Compassionate Educational Practice: Toward a New Inclusion

ERIC Educational Resources Information Center

Bilias-Lolis, Evelyn; Gelber, Nicholas W.; Rispoli, Kristin M.; Bray, Melissa A.; Maykel, Cheryl

2017-01-01

This work offers a conceptual synthesis of several contemporary educational service delivery models that implicitly embed compassionate educational practices into supporting the learning and growth of diverse student populations. This manuscript discusses how such paradigms, such as culturally responsive positive behavior intervention and supports…

Ethics of trial drug use: to give or not to give?

PubMed Central

Ebunoluwa, Oduwole O.; Kareem, Fayemi A.

2017-01-01

The 2014 outbreak of Ebola viral disease in some West African countries, which later spread to the USA and Spain, has continued to be a subject of global public health debate. While there is no approved vaccine or drug for Ebola cure yet, moral questions of bioethical significance are emerging even as vaccine studies are at different clinical trial phases. This paper, through a normative and critical approach, focuses on the question of whether it is ethical to give any experimental drugs to Ebola victims in West Africa or not. Given the global panic and deadly contagious nature of Ebola, this paper argues on three major compassionate grounds that it is ethical to use experimental drugs on the dying African victims of Ebola. Besides respecting patients and family consent in the intervention process, this paper argues that the use of Ebola trial drugs on West African population will be ethical if it promotes the common good, and does not violate the fundamental principles of transparency and integrity in human research ethics. Using Kantian ethical framework of universality as a basis for moral defense of allowing access to yet approved drugs. This paper provides argument to strengthen the compassionate ground provisional recommendation of the WHO’s Strategic Advisory Group of Experts on Immunization (SAGE) on Ebola vaccines and vaccination. PMID:28367458

Ethics of trial drug use: to give or not to give?

PubMed

Ebunoluwa, Oduwole O; Kareem, Fayemi A

2016-01-01

The 2014 outbreak of Ebola viral disease in some West African countries, which later spread to the USA and Spain, has continued to be a subject of global public health debate. While there is no approved vaccine or drug for Ebola cure yet, moral questions of bioethical significance are emerging even as vaccine studies are at different clinical trial phases. This paper, through a normative and critical approach, focuses on the question of whether it is ethical to give any experimental drugs to Ebola victims in West Africa or not. Given the global panic and deadly contagious nature of Ebola, this paper argues on three major compassionate grounds that it is ethical to use experimental drugs on the dying African victims of Ebola. Besides respecting patients and family consent in the intervention process, this paper argues that the use of Ebola trial drugs on West African population will be ethical if it promotes the common good, and does not violate the fundamental principles of transparency and integrity in human research ethics. Using Kantian ethical framework of universality as a basis for moral defense of allowing access to yet approved drugs. This paper provides argument to strengthen the compassionate ground provisional recommendation of the WHO's Strategic Advisory Group of Experts on Immunization (SAGE) on Ebola vaccines and vaccination.

Compassionate access anti-tumour necrosis factor-α therapy for ulcerative colitis in Australia: the benefits to patients.

PubMed

Costello, S P; Ghaly, S; Beswick, L; Pudipeddi, A; Agarwal, A; Sechi, A; O'Connor, S; Connor, S J; Sparrow, M P; Bampton, P; Walsh, A J; Andrews, J M

2015-06-01

The efficacy of infliximab has been demonstrated in patients with both acute severe and moderate-severe ulcerative colitis (UC). However, there is a need for 'real-life data' to ensure that conclusions from trial settings are applicable in usual care. We therefore examined the national experience of anti-tumour necrosis factor-α (TNF-α) therapy in UC. Case notes review of patients with UC who had received compassionate access (CA) anti-TNF-α therapy from prospectively maintained inflammatory bowel disease databases of six Australian adult teaching hospitals. Patients either received drug for acute severe UC (ASUC) failing steroids (n = 29) or for medically refractory UC (MRUC) (n = 35). In ASUC, the treating physicians judged that anti-TNF-α therapy was successful in 20/29 patients (69%); in these cases, anti-TNF-α was able to be discontinued (after 1-3 infusions in 19/20 responders) as clinical remission was achieved. Consistent with this perceived benefit, only 7/29 (24%) subsequently underwent colectomy during a median follow up of 12 months (interquartile range (IQR) 5-16). Eight of the 35 patients with MRUC (23%) required colectomy during a median follow up of 28 months (IQR 11-43). The majority of these patients (20/35 or 57%) had anti-TNF-α therapy for ≥4 months, whereas, 27/29 (93%) of ASUC patients had CA for ≤3 months. These data show an excellent overall benefit for anti-TNF-α therapy in both ASUC and MRUC. In particular, only short-duration anti-TNF-α was required in ASUC. These real-life data thus support the clinical trial data and should lead to broader use of this therapy in UC. © 2015 Royal Australasian College of Physicians.

Associations of family characteristics with perceptions of care among parents of children with autism.

PubMed

Sobotka, S A; Francis, A; Vander Ploeg Booth, K

2016-01-01

Although autism spectrum disorder (ASD) is an increasingly common chronic disability, primary care provider (PCPs) report deficits in providing primary care for children with ASD, and parents report lapses in receipt of medical home services. In this study, we describe parental experiences with specific medical home components for their children with ASD. We analysed data from all children within the National Survey of Children with Special Health Care Needs database with ASD and a usual place for care (n = 2859). We evaluated the receipt of core medical home components: accessible, comprehensive, coordinated, family centred and compassionate and culturally sensitive care. Children were mean age 10.1 years, and respondents were 75% mothers and 95% reported having a primary care provider (PCP). Seventy-one percent reported care to be usually comprehensive, over three-fourths of respondents reported care to be family centred and compassionate and 87% reported care to be culturally sensitive. Of the parents who reported a need for care coordination (n = 1049), only 14% of parents reported usually getting the help they needed. More educated, English-speaking, non-Hispanic White mothers of older children supported by private insurance were more likely to report never getting as much help coordinating care as desired. Coordination with education services are especially important for children with ASD, yet 27% of parents reported dissatisfaction with PCPs' communication with schools or early intervention. Although parents report a high level of access to PCPs and places for care as well as receiving most core components of the medical home, care coordination activities are lacking for children with ASD. More resourced families are particularly likely to report unmet needs. © 2015 John Wiley & Sons Ltd.

Compassionate, Spiritual, and Creative Listening in Teaching and Learning

ERIC Educational Resources Information Center

Garrison, Jim

2010-01-01

Background/Context: Listening is largely overlooked in cultures constituted on the basis of the freedom of speech, such as we find in the United States and elsewhere. Purpose/Objective/Research Question/Focus of Study: The article explores compassionate listening as a creative spiritual activity. Such listening recognizes the suffering of others…

[Development the Japanese of the Self-Compassionate Reactions Inventory].

PubMed

Miyagawa, Yuki; Taniguchi, Junichi

2016-04-01

Self-compassion is defined as being compassionate towards the self in times of suffering, and is composed of the following three components: self-kindness, common humanity, and mindfulness. This article reports the development of the Japanese version of the Self-Compassionate Reactions Inventory (SCRI-J). The SCRI-J measures self-compassion based on the degree to which people choose self-compassionate reactions to 8 hypothetical hardships. Study 1: (N = 179) showed that the SCRI-J had sufficient internal consistency. In terms of its validity, results showed a positive correlation between the SCRI-J and the Japanese version of the Self-Compassion Scale, supporting its concurrent validity. In addition, the SCRI-J was positively correlated with self-esteem and negatively correlated with psychological stress responses. Moreover, the association between the SCRI-J and stress responses remained significant when the effect of self-esteem was removed. In Study 2 (N = 90), the SCRI-J demonstrated high test-retest reliability over 3 weeks. Overall, the present study indicates that the SCRI-J has sufficient reliability and validity as a new scale for self-compassion.

Compassionate love as a mechanism linking sacred qualities of marriage to older couples' marital satisfaction.

PubMed

Sabey, Allen K; Rauer, Amy J; Jensen, Jakob F

2014-10-01

Previous work has underscored the robust links between sanctification of marriage and marital outcomes, and recent developments in the literature suggest that compassionate love, which is important for intimate relationships, may act as a mediator of that relationship. Accordingly, the current study used actor-partner interdependence models to examine the relationship between a spiritual cognition (i.e., perceived sacred qualities of marriage) and marital satisfaction, and to determine whether that relationship is mediated by compassionate love, in a sample of older married couples (N = 64). Results revealed that wives' greater sacred qualities of marriage were significantly and positively linked to marital satisfaction on the part of both spouses, and that these links were partially mediated by couples' reports of compassionate love. These findings highlight the importance of moving beyond simply establishing the existence of the link between global markers of involvement of religion and marriage to understanding how specific spiritual cognitions may foster better relationship quality, especially among older couples. (PsycINFO Database Record (c) 2014 APA, all rights reserved).

Exploring the Classroom Practices That May Enable a Compassionate Approach to Financial Literacy Education

ERIC Educational Resources Information Center

Blue, Levon Ellen; O'Brien, Mia; Makar, Katie

2018-01-01

From an early age, children are faced with financial dilemmas and are expected to make effective financial decisions about money. In this paper, we explore the classroom practices that may enable a compassionate approach to financial literacy education. We observed an inquiry-based mathematics lesson in a Year 4 primary school classroom. The…

41 CFR 302-3.511 - What must we consider when determining return travel for immediate family member(s) for...

Code of Federal Regulations, 2012 CFR

2012-07-01

... when determining return travel for immediate family member(s) for compassionate reasons prior to... determining return travel for immediate family member(s) for compassionate reasons prior to completion of the service agreement? You must determine that the public interest requires the return of the immediate family...

41 CFR 302-3.511 - What must we consider when determining return travel for immediate family member(s) for...

Code of Federal Regulations, 2014 CFR

2014-07-01

... when determining return travel for immediate family member(s) for compassionate reasons prior to... determining return travel for immediate family member(s) for compassionate reasons prior to completion of the service agreement? You must determine that the public interest requires the return of the immediate family...

41 CFR 302-3.511 - What must we consider when determining return travel for immediate family member(s) for...

Code of Federal Regulations, 2013 CFR

2013-07-01

... when determining return travel for immediate family member(s) for compassionate reasons prior to... determining return travel for immediate family member(s) for compassionate reasons prior to completion of the service agreement? You must determine that the public interest requires the return of the immediate family...

41 CFR 302-3.511 - What must we consider when determining return travel for immediate family member(s) for...

Code of Federal Regulations, 2011 CFR

2011-07-01

... when determining return travel for immediate family member(s) for compassionate reasons prior to... determining return travel for immediate family member(s) for compassionate reasons prior to completion of the service agreement? You must determine that the public interest requires the return of the immediate family...

MEDICINAL CANNABIS LAW REFORM: LESSONS FROM CANADIAN LITIGATION.

PubMed

Freckelton, Ian

2015-06-01

This editorial reviews medicinal cannabis litigation in Canada's superior courts between 1998 and 2015. It reflects upon the outcomes of the decisions and the reasoning within them. It identifies the issues that have driven Canada's jurisprudence in relation to access to medicinal cannabis, particularly insofar as it has engaged patients' rights to liberty and security of the person. It argues that the sequence of medicinal schemes adopted and refined in Canada provides constructive guidance for countries such as Australia which are contemplating introduction of medicinal cannabis as a therapeutic option in compassionate circumstances for patients. In particular, it contends that Canada's experience suggests that strategies calculated to introduce such schemes in a gradualist way, enabling informed involvement by medical practitioners and pharmacists, and that provide for safe and inexpensive accessibility to forms of medicinal cannabis that are clearly distinguished from recreational use and unlikely to be diverted criminally maximise the chances of such schemes being accepted by key stakeholders.

Insights on compassion and patient-centred nursing in intensive care: A constructivist grounded theory.

PubMed

Jakimowicz, Samantha; Perry, Lin; Lewis, Joanne

2018-04-01

To explore patient-centred nursing, compassion satisfaction and compassion fatigue from intensive care nurses' perspectives. Compassion satisfaction and compassion fatigue can influence critical care nurses' decisions to either continue or leave the profession, and could impact the compassionate patient-centred nursing care patients receive during their ICU admission. This qualitative research design was informed by Charmaz's Grounded Theory Constructivist methodology. In-depth interviews were conducted with 21 critical care nurses of two ICUs in Australia during 2016. Interview data were analysed using grounded theory processes. Findings reflected positive and negative impacts on critical care nurses' ability to deal compassionately with their patients. Effects on patient-centred nursing and critical care nurses' own well-being were revealed. A core category of "Expectations" emerged, explaining the tension between critical care nurses' biomedical, clinical skills and knowledge versus compassionate, patient-centred nursing care. This tension was clarified and expanded in subcategories of "Life in the Balance," "Passion and Pressure," "Understanding and Advocacy" and "Tenacity and Fragility". Providing patient-centred nursing may enhance critical care nurses' experience of compassion satisfaction, in turn impacting delivery of compassionate patient-centred nursing to generate a virtuous circle. Critical care nurses who feel respected and supported by their management team and colleagues experience feelings of compassion satisfaction, leading to greater engagement and care towards their patient. Systematically addressing critical care nurses' needs to successfully balance biomedical with compassionate nursing care may lead to greater well-being in the critical care nursing workforce and improve patient experience of intensive care. © 2017 John Wiley & Sons Ltd.

A Descriptive Study to Identify Student Perceptions of How Compassionate Enrollment Affects Persistence at a Two-Year Institution

ERIC Educational Resources Information Center

Moore, Kimberly A.

2017-01-01

College students are failing to graduate at unacceptable rates (Camera, 2016; DeVore, 2016; Scherer & Anson, 2014; Schneider, 2008). If graduation is the goal, then retention is the means. The research study sought to understand a potential solution to the pervasive retention problem, by researching a new strategy, compassionate enrollment.…

Compassionate Parenting as a Key to Satisfaction, Efficacy and Meaning among Mothers of Children with Autism

ERIC Educational Resources Information Center

Conti, Regina

2015-01-01

Two studies examine the role of compassionate and self-image parenting goals in the experience of mothers of children with autism. In Study 1, a comparison sample was included. Study 1 included measures of parenting goals, life satisfaction, family life satisfaction, parenting satisfaction, and meaning in life. Study 2 incorporated a measure of…

From Compassionate Conservatism to Obamacare: Funding for the Ryan White Program During the Obama Administration.

PubMed

Hatcher, William; Pund, Britten; Khatiashvili, Giorgi

2016-11-01

To examine President Obama's fiscal commitment to the Ryan White Program (formerly Ryan White Comprehensive AIDS Resource Emergency Act), which provides funding for economically disadvantaged people and families affected by HIV. We analyzed budgetary request and congressional appropriation data from 2009 to 2016. The data are available from the Health Resources and Services Administration and the Henry J. Kaiser Family Foundation. Increased coverage for people living with HIV/AIDS provided by the Affordable Care Act most likely led the Obama administration to request small increases and at times decreases in funding for the Ryan White Program. Congress passed either small increases or decreases in appropriations for the Ryan White Program. Decreases or small increases in the Ryan White Program funding risk progress made in treating HIV among economically disadvantaged patients.

Dermal Coverage of Traumatic War Wounds

DTIC Science & Technology

2015-11-01

Meeting in Washington, DC in December 2014 and at the ASRM (American Society for Reconstructive Microsurgery ) Annual Meeting in the Bahamas in January...Society for Reconstructive Microsurgery ) Annual Meeting in the Bahamas in January 2015.  The first compassionate care case was presented by Dr. Fleming...for Reconstructive Microsurgery ) Annual Meeting in the Bahamas in January 2015. Moreover, the first compassionate care case was presented by Dr. Fleming

Exploring the classroom practices that may enable a compassionate approach to financial literacy education

NASA Astrophysics Data System (ADS)

Blue, Levon Ellen; O'Brien, Mia; Makar, Katie

2017-08-01

From an early age, children are faced with financial dilemmas and are expected to make effective financial decisions about money. In this paper, we explore the classroom practices that may enable a compassionate approach to financial literacy education. We observed an inquiry-based mathematics lesson in a Year 4 primary school classroom. The financial maths task asked students to decide on the best fundraising option for the school. We used the theory of practice architectures to analyse the interactions in the classroom in order to understand what may have enabled and constrained classroom practices. We found that classroom practices such as engaging with peers through positive and collaborative learning opportunities, making ethical, social and mathematical connections of the task, and considering the impact of financial decisions on others may enable a compassionate approach to financial literacy education.

Exploring the classroom practices that may enable a compassionate approach to financial literacy education

NASA Astrophysics Data System (ADS)

Blue, Levon Ellen; O'Brien, Mia; Makar, Katie

2018-06-01

From an early age, children are faced with financial dilemmas and are expected to make effective financial decisions about money. In this paper, we explore the classroom practices that may enable a compassionate approach to financial literacy education. We observed an inquiry-based mathematics lesson in a Year 4 primary school classroom. The financial maths task asked students to decide on the best fundraising option for the school. We used the theory of practice architectures to analyse the interactions in the classroom in order to understand what may have enabled and constrained classroom practices. We found that classroom practices such as engaging with peers through positive and collaborative learning opportunities, making ethical, social and mathematical connections of the task, and considering the impact of financial decisions on others may enable a compassionate approach to financial literacy education.

A new place for death with dignity: the golden room.

PubMed

Keegan, Lynn; Drick, Carole Ann

2011-12-01

In this article, the authors consider how professional nurses can strive to advance death and dying to the next level in our evolution of compassionate end-of-life practices. The authors focus on describing the development of a place for dying that allows for a peaceful, profound experience that honors and respects human dignity and elevates the human family. Actual places called the Golden Room or Golden Room Centers are proposed to accommodate dying persons and their loved ones at end of life as they make the transition from physical life. The authors detail and propose a return to the sacredness of death and dying through access to a place for the physical transition.

Proposal of a New Public Health End of Life approach for Brazil: how the Project EstaraoSeuLado-Primary Palliative Care is working and how it can help.

PubMed

Corrêa, Santiago

2018-01-01

Brazil has 206 million people, and 1.2 million deaths and 600,000 new cases of cancer per year. Palliative Care services are patchily distributed. The Family Health Strategy, made up from 41,000 primary care teams across Brazil forms a comprehensive primary care network. The Project EstaraoSeuLado-Primary Palliative Care developed working from Community Centers. We created a model based on compassionate communities, with community carers working alongside primary care teams. We identified people who need palliative care, gave them specific care and enrolled their carers into a program of monthly meetings called "Comunidade Cuidador". We discussed caring at end of life and provided skills training. During 2015 we ran 8 training programmes with an average of 10 carers. The major themes of discussion were carer burnout, dealing with denial and skills needed daily. The effect of these meetings was better relations between carers and professionals with expansion of the naturally occurring supportive network. The results of this project have been remarkable. The joint working of professionals and supportive networks together is recognised as being transformational. Carers themselves spread this approach by recommending it to others they know with life limiting illness. We will discuss the model and how it can be replicated more broadly across Brazil. Family Health teams can use tools of identification, evaluation and assessment working with networks including the community as an important part. We will propose a new model of End-of-Life Care to be adopted as national policy. We have implemented a compassionate community programme in the area of Rio Grande in Brazil. This has been a combination of primary care working in harmony with communities, providing education, resources and training to enhance the skill of communities to care for their dying. This is a necessary solution for Brazil, where resources and access to healthcare is limited. Our model is successful and increasing. We propose wider adoption of this model across Brazil and will present figures on the size of the challenge we face.

The Importance of Place and Time in Translating Knowledge About Canada's Compassionate Care Benefit to Informal Caregivers

PubMed Central

Dykeman, Sarah; Williams, Allison

2013-01-01

Canada's Compassionate Care Benefit (CCB), an employment insurance program designed to allow Canadian workers time off to care for a dying relative or friend, has had low uptake since its inception. Due to their role in working with family caregivers, social workers are one group of primary health care professionals who have been identified as benefiting from a knowledge translation campaign. Knowledge tools about the CCB have been developed through social worker input in a prior study. This article presents the findings of a qualitative exploratory intervention. Social workers (n = 8) utilized the tools for 6 months and discussed their experiences with them. Data analysis revealed references to time and space constraints in using to the tools, and demonstrated the impact of time geography on knowledge translation about the CCB. The results suggest that knowledge translation about the CCB could be targeted toward caregivers earlier on in the disease progression before the terminal diagnosis, and knowledge tools must be disseminated to more locations. These results may be valuable to policymakers and palliative care providers, as well as theorists interested in ongoing applications of time geography in knowledge translation and the consumption/production of care. PMID:24295098

Defibrotide for the Treatment of Hepatic Veno-Occlusive Disease: Final Results From the International Compassionate-Use Program.

PubMed

Corbacioglu, Selim; Carreras, Enric; Mohty, Mohamad; Pagliuca, Antonio; Boelens, Jaap Jan; Damaj, Gandhi; Iacobelli, Massimo; Niederwieser, Dietger; Olavarría, Eduardo; Suarez, Felipe; Ruutu, Tapani; Verdonck, Leo; Hume, Robin; Nejadnik, Bijan; Lai, Chinglin; Finetto, Giorgia; Richardson, Paul

2016-10-01

Hepatic veno-occlusive disease, also called sinusoidal obstruction syndrome (VOD/SOS), is an unpredictable and potentially fatal complication of hematopoietic cell transplantation (HCT) or nontransplantation-associated chemotherapy/radiotherapy. In cases of severe hepatic VOD/SOS, typically defined by associated multiorgan failure (MOF, also known as multiorgan dysfunction), mortality exceeds 80%. Preclinical and early clinical data have provided a rationale for defibrotide treatment in hepatic VOD/SOS. Based on this evidence and in recognition of the dismal prognosis for these patients, defibrotide was made available through an international multicenter compassionate-use program conducted from December 1998 to March 2009. Physicians participating in the program voluntarily provided demographic and outcome data for patients given defibrotide. Efficacy and safety analyses were performed using the data received for 710 treated patients. Defibrotide was given at 10, 25, 40, 60, or 80 mg/kg/day for a median of 15 days (range, 1 to 119 days). By Kaplan-Meier analysis, the estimated overall day +100 survival was 54% (58% in the 25 mg/kg/day dose group). Adverse events (AEs) were reported in 53% of patients. The most common AEs were MOF, progression of hepatic VOD/SOS, sepsis, and graft-versus-host disease, which were consistent with the AEs expected for this patient population. No clinically meaningful trends in AEs were identified by gender, age, or dose group. Safety and efficacy resultswere consistent with prior studies of defibrotide in hepatic VOD/SOS, and subgroup analyses lend support to the use of the 25 mg/kg/day dose. Copyright © 2016 The American Society for Blood and Marrow Transplantation. Published by Elsevier Inc. All rights reserved.

Empathic Concern and the Desire to Help as Separable Components of Compassionate Responding.

PubMed

Ministero, Lauren M; Poulin, Michael J; Buffone, Anneke E K; DeLury, Shane

2018-04-01

When do people experience versus regulate responses to compassion-evoking stimuli? We hypothesized that compassionate responding is composed of two factors-empathic concern and the desire to help-and that these would be differentially affected by perspective taking and self-affirmation. Exploratory (Study 1) and confirmatory (Study 2) factor analyses indicated that a compassion measure consisted of two factors corresponding to empathic concern and the desire to help. In Study 1 ( N = 237), participants with high emotion regulation ability reported less empathic concern for multiple children than for one, but perspective taking prevented this effect. In Study 2 ( N = 155), participants reported less desire to help multiple children, but only in the presence of self-affirmation. In both the studies, empathic concern predicted greater distress while the desire to help predicted greater chances of donating. Compassionate responding may consist of two separable facets that collapse under distinct conditions and that predict distinct outcomes.

Leptin Deficiency: Clinical Implications and Opportunities for Therapeutic Interventions

PubMed Central

Blüher, Susan; Shah, Sunali; Mantzoros, Christos S.

2017-01-01

The discovery of leptin has significantly advanced our understanding of the metabolic importance of adipose tissue and has revealed that both leptin deficiency and leptin excess are associated with severe metabolic, endocrine, and immunological consequences. We and others have shown that a prominent role of leptin in humans is to mediate the neuroendocrine adaptation to energy deprivation. Humans with genetic mutations in the leptin and leptin receptor genes have deregulated food intake and energy expenditure leading to a morbidly obese phenotype and a disrupted regulation in neuroendocrine and immune function and in glucose and fat metabolism. Observational and interventional studies in humans with (complete) congenital leptin deficiency caused by mutations in the leptin gene or with relative leptin deficiency as seen in states of negative energy balance such as lipoatrophy, anorexia nervosa, or exercise-induced hypothalamic and neuroendocrine dysfunction have contributed to the elucidation of the pathophysiological role of leptin in these conditions and of the clinical significance of leptin administration in these subjects. More specifically, interventional studies have demonstrated that several neuroendocrine, metabolic, or immune disturbances in these states could be restored by leptin administration. Leptin replacement therapy is currently available through a compassionate use program for congenital complete leptin deficiency and under an expanded access program to subjects with leptin deficiency associated with congenital or acquired lipoatrophy. In addition, leptin remains a potentially forthcoming treatment for several other states of energy deprivation including anorexia nervosa or milder forms of hypothalamic amenorrhea pending appropriate clinical trials. PMID:19730134

Leptin deficiency: clinical implications and opportunities for therapeutic interventions.

PubMed

Blüher, Susan; Shah, Sunali; Mantzoros, Christos S

2009-10-01

The discovery of leptin has significantly advanced our understanding of the metabolic importance of adipose tissue and has revealed that both leptin deficiency and leptin excess are associated with severe metabolic, endocrine, and immunological consequences. We and others have shown that a prominent role of leptin in humans is to mediate the neuroendocrine adaptation to energy deprivation. Humans with genetic mutations in the leptin and leptin receptor genes have deregulated food intake and energy expenditure leading to a morbidly obese phenotype and a disrupted regulation in neuroendocrine and immune function and in glucose and fat metabolism. Observational and interventional studies in humans with (complete) congenital leptin deficiency caused by mutations in the leptin gene or with relative leptin deficiency as seen in states of negative energy balance such as lipoatrophy, anorexia nervosa, or exercise-induced hypothalamic and neuroendocrine dysfunction have contributed to the elucidation of the pathophysiological role of leptin in these conditions and of the clinical significance of leptin administration in these subjects. More specifically, interventional studies have demonstrated that several neuroendocrine, metabolic, or immune disturbances in these states could be restored by leptin administration. Leptin replacement therapy is currently available through a compassionate use program for congenital complete leptin deficiency and under an expanded access program to subjects with leptin deficiency associated with congenital or acquired lipoatrophy. In addition, leptin remains a potentially forthcoming treatment for several other states of energy deprivation including anorexia nervosa or milder forms of hypothalamic amenorrhea pending appropriate clinical trials.

Don't volunteer for trouble.

PubMed

Gale, J

1997-01-01

Gone are the days when volunteer activity was limited to delivering flowers and mail to inpatient rooms. Today's volunteers extend the capacity of health care organizations to provide compassionate and caring service by staffing immunization programs, conducting health screening activities and more. With increased reliance on volunteers and increased responsibility placed on volunteers, it is important that they are protected from any personal liability that may be incurred while working on behalf of your organization. It is equally important that the organization is protected from liability incurred by the acts or omissions of its volunteers.

Developing a compassionate mind to enhance trauma-focused CBT with an adolescent female: a case study.

PubMed

Bowyer, Laura; Wallis, Jennifer; Lee, Deborah

2014-03-01

Shame and disgust are often associated with posttraumatic stress disorder (PTSD) following interpersonal traumas such as sexual assault. It has been suggested that individuals with high levels of shame might do less well in standard cognitive behavioural (CBT) interventions. To see whether applying compassion-focused therapy and developing a compassionate mind can enhance trauma-focused CBT in an adolescent with high levels of shame and disgust the way it has been shown to within the adult population. This single case study describes how trauma-focused CBT was enhanced by compassionate mind training. It details work using this approach with an adolescent female experiencing shame and disgust-based flashbacks. Treatment was provided for 20 sessions over 8 months. Symptoms of PTSD, depression and self-criticism, as well as the ability to self-soothe/reassure, were measured at assessment/start of treatment, mid- and end of treatment. Clinically significant reductions in PTSD, depressive, shame and self-attacking symptoms were found between assessment and completion of treatment. Clinically significant increases in self-reassurance were also reported. Following treatment, symptoms of PTSD and depression were sub-clinical. This case study suggests that developing a compassionate mind alongside trauma-focused CBT may be beneficial to adolescents experiencing shame and disgust with consideration for the young person's level of development and personal circumstances.

Compassionate presence: The meaning of hematopoietic stem cell transplant nursing.

PubMed

Sabo, Brenda M

2011-04-01

Within oncology, working with patients who are suffering or at end-of-life has been recognized repeatedly as stress-inducing, yet there is little agreement on what specifically nurses may experience as a result of their work. Further, research focused on caring work within the context of hematopoietic stem cell transplant (HSCT) nursing is almost non-existent. In light of the gap, this interpretative phenomenological study focused on enhancing the knowledge and understanding of the effect(s) of nursing work on the psychosocial health and well being of HSCT nurses. An interpretative phenomenological design grounded in the work of Heidegger and van Manen was used to explore nursing work among HSCT nurses. Twelve nurses from three Canadian tertiary healthcare facilities participated in multiple interviews and focus groups. Thematic analysis resulted in the emergence of four core themes and one overarching novel theme, compassionate presence. The discussion provides an overview of the novel finding, compassionate presence, which challenges the notion that working with individuals who are suffering or at end-of-life inevitably leads to adverse psychosocial effects. Implications for practice, education and research are also provided. Compassionate presence emerged to suggest a potential buffering effect against adverse consequences of HSCT nursing work. This finding underscored the value of the relationship as an integral component of nursing work. Copyright © 2010 Elsevier Ltd. All rights reserved.

Outcomes study of a customer relations educational program in dialysis practice.

PubMed

Schmidt, Jill

2006-01-01

In the fall of 2003, a customer relations staff educational program was instituted for use throughout Renal Care Group. After 1 year and 4 months, an outcomes study was implemented to evaluate and revise the program. The program is taught by the dialysis social worker to the rest of the dialysis health-care team to increase customer relations skills with the patients, their families, and dialysis coworkers. Today, more than ever, patients are seeking better quality health care not only in technical skills but also in compassionate care. Pretest and posttest scores from each training session indicated the necessity of this training and knowledge gained. Through a survey of instructors, strengths of the program were identified, as well as were areas that needed revision. In addition to providing helpful information, some of the main strengths of the program indicated by instructors were team building and problem solving. Revisions consisted primarily of shortening the modules and simplifying the program's use.

DAISY Nurses-Recognizing Clinical Expertise Through Certification.

PubMed

Sweeney, Cynthia Divens

2018-04-01

The DAISY Foundation is dedicated to recognizing nurses who provide compassionate, skilled, and extraordinary nursing care. Nominations for The DAISY Award are typically submitted in the form of a story. Stories are an opportunity to share with others what compassionate and extraordinary nursing care looks like and to recognize the individual nurses who provide that care. Clinical competence delivered with compassion is a hallmark of DAISY Award recipients. Professional certification provides an additional form of recognition of a nurse's clinical competence.

Exploring how mindfulness and self-compassion can enhance compassionate care.

PubMed

Barratt, Caroline

2017-01-18

Research suggests that the development of mindfulness and self-compassion may help to improve the well-being and resilience of professionals and students in the healthcare setting. This is reflected in the growth of mindfulness training for these individuals. Mindfulness is an important aspect of self-compassion, and healthcare professionals should be aware of the need to care for themselves when caring for others. This article explores the concepts of mindfulness and self-compassion and their relationship with, and ability to enhance, compassionate care.

Nursing practice: compassionate deception and the Good Samaritan.

PubMed

Tuckett, A

1999-09-01

This article reviews the literature on deception to illuminate the phenomenon as a background for an appraisal within nursing. It then describes nursing as a practice of caring. The character of the Good Samaritan is recommended as indicative of the virtue of compassion that ought to underpin caring in nursing practice. Finally, the article concludes that a caring nurse, responding virtuously, acts by being compassionate, for a time recognizing the prima facie nature of the rules or principles of truth telling.

Effectiveness and Safety of Vedolizumab Induction Therapy for Patients With Inflammatory Bowel Disease.

PubMed

Amiot, Aurelien; Grimaud, Jean-Charles; Peyrin-Biroulet, Laurent; Filippi, Jerome; Pariente, Benjamin; Roblin, Xavier; Buisson, Anthony; Stefanescu, Carmen; Trang-Poisson, Caroline; Altwegg, Romain; Marteau, Philippe; Vaysse, Thibaud; Bourrier, Anne; Nancey, Stephane; Laharie, David; Allez, Matthieu; Savoye, Guillaume; Moreau, Jacques; Gagniere, Charlotte; Vuitton, Lucine; Viennot, Stephanie; Aubourg, Alexandre; Pelletier, Anne-Laure; Bouguen, Guillaume; Abitbol, Vered; Bouhnik, Yoram

2016-11-01

Phase 3 trials have shown the efficacy of vedolizumab, which binds to integrin α4β7, in patients with Crohn's disease (CD) or ulcerative colitis (UC). We investigated the effectiveness and safety of vedolizumab in patients who failed anti-tumor necrosis factor therapy. From June through December 2014, there were 173 patients with CD and 121 patients with UC who were included in a multicenter nominative compassionate early access program granted by French regulatory agencies. This program provided patients with access to vedolizumab before it was authorized for marketing. Vedolizumab (300 mg) was administered intravenously at weeks 0, 2, and 6, and then every 8 weeks. Disease activity was assessed using the Harvey-Bradshaw Index for CD and the partial Mayo Clinic score for UC. We report results obtained after the 14-week induction phase. Among the 294 patients treated with vedolizumab (mean age, 39.5 ± 14.0 y; mean disease duration, 10.8 ± 7.6 y; concomitant steroids, 44% of cases), 276 completed the induction period, however, 18 discontinued vedolizumab because of a lack of response (n = 14), infusion-related reaction (n = 2), or infections (n = 2). At week 14, 31% of patients with CD were in steroid-free clinical remission and 51% had a response; among patients with UC, 36% were in steroid-free clinical remission and 50% had a response. No deaths were reported. Severe adverse events occurred in 24 patients (8.2%), including 15 (5.1%) that led to vedolizumab discontinuation (1 case of pulmonary tuberculosis and 1 rectal adenocarcinoma). In a cohort of patients with CD or UC who failed previous anti-tumor necrosis factor therapy, approximately one third of patients achieved steroid-free clinical remission after 14 weeks of induction therapy with vedolizumab. This agent had an acceptable safety profile in these patients. Copyright © 2016 AGA Institute. Published by Elsevier Inc. All rights reserved.

Teaching communication and compassionate care skills: an innovative curriculum for pre-clerkship medical students.

PubMed

Shield, Renée R; Tong, Iris; Tomas, Maria; Besdine, Richard W

2011-01-01

Physicians require communications training to improve effective and compassionate care. Clinicians discuss challenging communication issues in existing hospital "Schwartz Rounds." To improve communication skills, the Warren Alpert Medical School of Brown University designed "Schwartz Communication Sessions" for the mandatory 2-year pre-clerkship Doctoring course. Alongside learning interviewing, physical examination, and professionalism skills, the new Schwartz curriculum provides medical students with the rationale and proficiency for effective communication with patients, families and the healthcare team. First-year students experience a graduated curriculum of three sessions on themes such as empathy and professionalism using innovative methods. Sessions highlight cases and videos depicting successful and ineffective interactions, large and small group discussions, role play and skills practice, guest patient presentations, and multi-disciplinary panels. The second-year students' session focuses on communications with challenging patients. Students and faculty rate the sessions highly on effectiveness of enhancing communication skills, gaining perspective in healthcare communication, and appreciating the complexities of healthcare situations. Expansion of the program using case-based sessions for clerkship students is planned for a continuous and graduated experience. Integrating a pre-clerkship communications curriculum may help improve future physicians' interactions with patients and families. Implications of this curriculum for medical education are discussed.

Women's empowerment: Finding strength in self-compassion.

PubMed

Stevenson, Olivia; Allen, Ashley Batts

2017-03-01

Empowerment is often a desired outcome for health programs; however, it is rarely evaluated. One way to increase empowerment may be through self-compassion. The authors of the current study aimed to determine whether self-compassion and empowerment were positively related. Two hundred and five women (ages 18 to 48 years) were recruited from a pool of undergraduate students at a university in the southeastern United States in the summer/fall of 2012. Participants completed the study using Qualtrics, an online survey system. Participants wrote about a fight in a romantic relationship and were randomly assigned to write about the fight either self-compassionately or generally. Empowerment and perceptions of the fight were assessed as dependent measures. Hierarchical regression analyses investigated the relation of self-compassion, manipulated self-compassion, and their interaction with empowerment. A significant positive relationship was found between self-compassion and empowerment. However, manipulated self-compassion was not significantly related to empowerment. These findings suggested that self-compassion and empowerment were strongly related, but using a short-term self-compassion intervention may not be strong enough to influence empowerment. Empowerment-based practitioners may find empowerment increases more easily in women who are self-compassionate. If self-compassion is incorporated into empowerment settings, a long-term intervention may be necessary.

Gender as a Moderator of the Relation Between Age Cohort and Three-Dimensional Wisdom in Iranian Culture.

PubMed

Cheraghi, Fereshte; Kadivar, Parvin; Ardelt, Monika; Asgari, Ali; Farzad, Valiollah

2015-07-01

This study examined whether gender moderated the association between age cohort and the cognitive, reflective, and compassionate dimensions of wisdom, using an Iranian sample of 439 adults from three age cohorts: young (18-34), middle-aged (35-54), and older (55 and above). Results indicated that the interaction effect between gender and age cohort was significant for three-dimensional wisdom and all three wisdom dimensions. Compared with younger women and older men, older women tended to have less education and to score lower on the cognitive wisdom dimension, but they had similar average scores as older men on the compassionate wisdom dimension. Overall, the association between age and wisdom was only positive for men, due mainly to the positive relation between age and the reflective and compassionate wisdom dimensions for men after adjusting for education. The results are interpreted with reference to generation gaps, socialization of men versus women, and life experiences and opportunities. © The Author(s) 2015.

A call to include medical humanities in the curriculum of colleges of osteopathic medicine and in applicant selection.

PubMed

Hoff, Gary; Hirsch, Norma J; Means, J Jeffrey; Streyffeler, Lisa

2014-10-01

Medicine stands at a crossroad. Disruptive physician behavior has increased, and patient satisfaction has decreased. A growing body of knowledge demonstrates that the medical humanities assist in the creation of compassionate, resilient physicians. Incorporating medical humanities into the medical school curriculum promotes the development of compassionate, culturally sensitive physicians, and also encourages the development of resilience in health care professionals at a time when internal and external pressures on physicians are increasing. © 2014 The American Osteopathic Association.

Intuitive Intelligence, Self-regulation, and Lifting Consciousness

PubMed Central

Zayas, Maria

2014-01-01

This article explores the role of the heart in emotional experience, as well as how learning to shift the rhythms of the heart into a more coherent state makes it possible to establish a new inner baseline reference that allows access to our heart’s intuitive capacities and deeper wisdom. The nature and types of intuition and the connection between intuition and compassionate action are discussed. It is suggested that increased effectiveness in self-regulatory capacity and the resultant reorganization of memories sustained in the neural architecture facilitates a stable and integrated experience of self in relationship to others and to the environment, otherwise known as consciousness. The implications of meeting the increasingly complex demands of life with greater love, compassion, and kindness, thereby lifting consciousness, are considered. PMID:24808982

Social Reward and Empathy as Proximal Contributions to Altruism: The Camaraderie Effect

PubMed Central

2017-01-01

Natural selection favors individuals to act in their own interests, implying that wild animals experience a competitive psychology. Animals in the wild also express helping behaviors, presumably at their own expense and suggestive of a more compassionate psychology. This apparent paradox can be partially explained by ultimate mechanisms that include kin selection, reciprocity, and multilevel selection, yet some theorists argue such ultimate explanations may not be sufficient and that an additional “stake in others” is necessary for altruism’s evolution. We suggest this stake is the “camaraderie effect,” a by-product of two highly adaptive psychological experiences: social motivation and empathy. Rodents can derive pleasure from access to others and this appetite for social rewards motivates individuals to live together, a valuable psychology when group living is adaptive. Rodents can also experience empathy, the generation of an affective state more appropriate to the situation of another compared to one’s own. Empathy is not a compassionate feeling but it has useful predictive value. For instance, empathy allows an individual to feel an unperceived danger from social cues. Empathy of another’s stance toward one’s self would predict either social acceptance or ostracism and amplify one’s physiological sensitivity to social isolation, including impaired immune responses and delayed wound healing. By contrast, altruistic behaviors would promote well-being in others and feelings of camaraderie from others, thereby improving one’s own physiological well-being. Together, these affective states engender a stake in others necessary for the expression of altruistic behavior. PMID:27600591

How to practice person-centred care: A conceptual framework.

PubMed

Santana, Maria J; Manalili, Kimberly; Jolley, Rachel J; Zelinsky, Sandra; Quan, Hude; Lu, Mingshan

2018-04-01

Globally, health-care systems and organizations are looking to improve health system performance through the implementation of a person-centred care (PCC) model. While numerous conceptual frameworks for PCC exist, a gap remains in practical guidance on PCC implementation. Based on a narrative review of the PCC literature, a generic conceptual framework was developed in collaboration with a patient partner, which synthesizes evidence, recommendations and best practice from existing frameworks and implementation case studies. The Donabedian model for health-care improvement was used to classify PCC domains into the categories of "Structure," "Process" and "Outcome" for health-care quality improvement. The framework emphasizes the structural domain, which relates to the health-care system or context in which care is delivered, providing the foundation for PCC, and influencing the processes and outcomes of care. Structural domains identified include: the creation of a PCC culture across the continuum of care; co-designing educational programs, as well as health promotion and prevention programs with patients; providing a supportive and accommodating environment; and developing and integrating structures to support health information technology and to measure and monitor PCC performance. Process domains describe the importance of cultivating communication and respectful and compassionate care; engaging patients in managing their care; and integration of care. Outcome domains identified include: access to care and Patient-Reported Outcomes. This conceptual framework provides a step-wise roadmap to guide health-care systems and organizations in the provision PCC across various health-care sectors. © 2017 The Authors Health Expectations published by John Wiley & Sons Ltd.

Delta-9-tetrahydrocannabinol (THC) in the treatment of end-stage open-angle glaucoma.

PubMed

Flach, Allan J

2002-01-01

Evidence exists that the administration of cannabinoid derivatives can lower intraocular pressure. Some patients with glaucoma believe they are being deprived of a potentially beneficial treatment. Therefore, the Research Advisory Panel of California instituted the Cannabis Therapeutic Research Program to permit compassionate access to cannabinoid derivatives. Data about the potential therapeutic usefulness and toxicity of these agents were collected. This study reviews the results of this program with the specific aim of providing further direction for these investigational efforts. A survey of local ophthalmologists indicated an impressive interest in participating in and contributing patients with glaucoma unresponsive to treatment to this study. Appropriate patients were treated with either orally administered delta-9-tetrahydrocannabinol capsules or inhaled marijuana in addition to their existing therapeutic regimen. Although 20 ophthalmologists were approved as investigators, only nine patients were enrolled in the study. An initial decrease in intraocular pressure was observed in all patients, and the investigator's therapeutic goal was met in four of the nine patients. However, the decreases in intraocular pressure were not sustained, and all patients elected to discontinue treatment within 1 to 9 months for various reasons. This uncontrolled, unmasked, nonrandomized study does not permit definitive conclusions about the efficacy or toxicity of cannabinoids in the treatment of glaucoma. There is an impression that this treatment can lower intraocular pressure, but the development of tolerance and significant systemic toxicity appears to limit the usefulness of this potential treatment. Both patients and ophthalmologists greatly appreciated the opportunity to participate in this study.

Interventions for compassionate nursing care: A systematic review.

PubMed

Blomberg, Karin; Griffiths, Peter; Wengström, Yvonne; May, Carl; Bridges, Jackie

2016-10-01

Compassion has been identified as an essential element of nursing and is increasingly under public scrutiny in the context of demands for high quality health care. While primary research on effectiveness of interventions to support compassionate nursing care has been reported, no rigorous critical overview exists. To systematically identify, describe and analyse research studies that evaluate interventions for compassionate nursing care; assess the descriptions of the interventions for compassionate care, including design and delivery of the intervention and theoretical framework; and to evaluate evidence for the effectiveness of interventions. Published international literature written in English up to June 2015 was identified from CINAHL, Medline and Cochrane Library databases. Primary research studies comparing outcomes of interventions to promote compassionate nursing care with a control condition were included. Studies were graded according to relative strength of methods and quality of description of intervention. Narrative description and analysis was undertaken supported by tabulation of key study data including study design, outcomes, intervention type and results. 25 interventions reported in 24 studies were included in the review. Intervention types included staff training (n=10), care model (n=9) and staff support (n=6). Intervention description was generally weak, especially in relation to describing participants and facilitators, and the proposed mechanisms for change were often unclear. Most interventions were associated with improvements in patient-based, nurse-based and/or quality of care outcomes. However, overall methodological quality was low with most studies (n=16) conducted as uncontrolled before and after studies. The few higher quality studies were less likely to report positive results. No interventions were tested more than once. None of the studies reviewed reported intervention description in sufficient detail or presented sufficiently strong evidence of effectiveness to merit routine implementation of any of these interventions into practice. The positive outcomes reported suggest that further investigation of some interventions may be merited, but high caution must be exercised. Preference should be shown for further investigating interventions reported as effective in studies with a stronger design such as randomised controlled trials. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

Leading in times of trauma.

PubMed

Dutton, Jane E; Frost, Peter J; Worline, Monica C; Lilius, Jacoba M; Kanov, Jason M

2002-01-01

An employee is diagnosed with cancer or loses a family member unexpectedly. An earthquake destroys an entire section of a city, leaving hundreds dead, injured, or homeless. At time like these, managerial handbooks fail us. After all, leaders can't eliminate personal suffering, nor can they ask employees who are dealing with these crises to check their emotions at the door. But compassionate leadership can facilitate personal as well as organizational healing. Based on research the authors have conducted at the University of Michigan and the University of British Columbia's CompassionLab, this article describes what leaders can do to foster organizational compassion in times of trauma. They recount real-world examples, including a story of personal tragedy at Newsweek, natural disasters that affected Macy's and Malden Mills, and the events of September 11, 2001. During times of collective pain and confusion, compassionate leaders take some form of public action, however small, that is intended to ease people's pain and inspire others to act. By openly demonstrating their own humanity, executives can unleash a compassionate response throughout the whole company, increasing bonds among employees and attachments to the organization. The authors say compassionate leaders uniformly provide two things: a "context for meaning"--creating an environment in which people can freely express and discuss how they feel--and a "context for action"--creating an environment in which those who experience or witness pain can find ways to alleviate their own and others' suffering. A leader's competence in demonstrating and fostering compassion is vital, the authors conclude, to nourishing the very humanity that can make people--and organizations--great.

Outcome and hospital cost for infants weighing less than 500 grams: a tertiary centre experience in Taiwan.

PubMed

Hsieh, Wu-Shiun; Jeng, Suh-Fang; Hung, Yi-Li; Chen, Pau-Chung; Chou, Hung-Chieh; Tsao, Po-Nien

2007-09-01

To determine the outcome and hospital cost for infants weighing < or =500 g at a tertiary centre in Taiwan. We retrospectively reviewed the medical records of infants who were born alive with birthweight < or =500 g at the National Taiwan University Hospital from 1997 to 2004. Their outcome and hospital cost were analysed. A total of 168 infants were included for analysis that 146 of them died after compassionate care in the delivery room and 22 received postnatal resuscitation. The infants who received resuscitation were more likely to have higher birthweights, older gestational ages and multiple births compared with those who received compassionate care. After resuscitation, five of the infants died and 17 were admitted to neonatal intensive care unit (NICU) for further management. Subsequently, 12 infants died and five infants survived to discharge. Two infants were discharged against advice and died within days. After exclusion of those receiving compassionate care, the NICU survival rate was 22.7% and the long-term survival rate was 13.6%. The most common early morbidities were respiratory distress syndrome, intraventricular haemorrhage and patent ductus arteriosus, whereas the late morbidities included cholestatic jaundice, retinopathy of prematurity and chronic lung disease. The average total hospital costs for the NICU survivors with birthweight < or =500 g was US $42,411 and the average hospital cost per day was US $350. Exclusive compassionate care was given to the majority of the infants weighing < or =500 g in Taiwan. The survival rate remained low in these marginally viable infants.

Outcomes of Australian patients receiving non-funded anti-PD-1 immune checkpoint inhibitors for non-melanoma cancers.

PubMed

Tiu, Crescens; Wong, Annie; Herschtal, Alan; Mileshkin, Linda

2018-03-01

To characterize the outcomes of patients with nonmelanoma solid tumors receiving anti-PD-1 immunotherapy not funded by the Australian Pharmaceutical Benefits Scheme. Medical records of patients with metastatic nonmelanoma tumor diagnoses treated with anti-PD-1 (self-funded pembrolizumab or nivolumab through an access program) from January 1, 2014, to December 31, 2016, at Peter MacCallum Cancer Centre, were retrospectively reviewed. Events after December 31, 2016, were censored. Of 47 patients identified, 27 (57%) had lung cancer. Twenty-six had compassionate access to nivolumab (24 lung, one renal, one gastroesophageal with possible new lung primary). Median overall survival was 5.7 months. Eleven (23%) achieved a partial response; none had complete response. Twenty (43%) had disease progression on first imaging; 16 (48%) of these continued treatment beyond radiological progression, with three achieving subsequent partial responses. Ten (21%) were not re-staged mostly due to rapid deterioration or death. At 6 and 12 months, nine (20%) and two (4%) remained on treatment, respectively. Five (12%) discontinued treatment due to immune-related toxicities. Of 34 patients who died, 71% received treatment within the last month of life; 38% died in an acute hospital. None of 25 patients with poor Eastern Cooperative Oncology Group performance scores of 2-4 responded. The response rates and overall survival of patients with NSCLC, renal carcinoma and triple negative breast cancer of good performance status receiving anti-PD-1 therapy outside of a clinical trial are consistent with clinical trial data. However, patients with poor ECOG performance status are unlikely to respond. Careful patient selection and counseling about the potential outcomes of self-funding treatment in this setting is needed. © 2018 John Wiley & Sons Australia, Ltd.

The benefits of being self-compassionate on days when interactions with body-focused others are frequent.

PubMed

Kelly, Allison C; Miller, Kathryn E; Stephen, Elizabeth

2016-12-01

We examined whether a woman's level of self-compassion on a given day (within-persons) and over a week (between-persons) influenced her eating, body image, and affect in the face of frequent daily and/or weekly interactions with body-focused others. For seven nights, 92 female undergraduates reported on their daily social interactions, self-compassion, body image, eating, and affect. On days when women were less self-compassionate than usual, frequent interactions with body-focused others were associated with more body image concerns and negative affect, and less body appreciation and intuitive eating. However, these relationships were absent or inversed on days when women were more self-compassionate than usual. Self-compassion played a similar buffering role at the between-persons level. Results suggest that by treating themselves with a higher degree of self-compassion than what is typical for them, young women may be able to maintain healthier approaches to eating and body image when faced with body image threats. Copyright © 2016 Elsevier Ltd. All rights reserved.

"Tu Souffres, Cela Suffit": the compassionate hospital.

PubMed

Kearsley, John H; Youngson, Robin

2012-04-01

The authors propose that the characteristics of personal (individual) compassion may be extrapolated to the concept of corporate (organizational) compassion. Modern health care facilities attract staff members who are able to exercise varying degrees of compassion in their busy daily routines. However, little discussion has taken place on how health care organizations might best harness and integrate aspects of individual compassion to create an organization with compassion as a core value. We define three characteristics of a "compassionate hospital" as 1) the presence of a healing environment, 2) a sense of connection among people, and 3) a sense of purpose and identity. We suggest how a "top down" focus on compassion as a core value by clinical leaders could maximize the compassion of health care workers, and reduce the suffering expressed and/or experienced by health care workers and patients in today's health care facilities. The compassionate hospital concept is intended to act as a proposition for health policy researchers and decision-makers in health care so as to reduce the suffering of sick patients, and to restore a sense of well-being, meaning, and purpose among health care workers.

The Italian compassionate use of sofosbuvir in HCV patients waitlisted for liver transplantation: A national real-life experience.

PubMed

Martini, Silvia; Donato, Maria Francesca; Mazzarelli, Chiara; Rendina, Maria; Visco-Comandini, Ubaldo; Filì, Daniela; Gianstefani, Alice; Fagiuoli, Stefano; Melazzini, Mario; Montilla, Simona; Pani, Luca; Petraglia, Sandra; Russo, Pierluigi; Trotta, Maria Paola; Carrai, Paola; Caraceni, Paolo

2018-04-01

This study aimed to assess the real-life clinical and virological outcomes of HCV waitlisted patients for liver transplantation (LT) who received sofosbuvir/ribavirin (SOF/R) within the Italian compassionate use program. Clinical and virological data were collected in 224 patients with decompensated cirrhosis and/or hepatocellular carcinoma (HCC) receiving daily SOF/R until LT or up a maximum of 48 weeks. Of 100 transplanted patients, 51 were HCV-RNA negative for >4 weeks before LT (SVR12: 88%) and 49 negative for <4 weeks or still viraemic at transplant: 34 patients continued treatment after LT (bridging therapy) (SVR12: 88%), while 15 stopped treatment (SVR12: 53%). 98 patients completed SOF/R without LT (SVR12: 73%). In patients with advanced decompensated cirrhosis (basal MELD ≥15 and/or C-P ≥B8), a marked improvement of the scores occurred in about 50% of cases and almost 20% of decompensated patients without HCC reached a condition suitable for inactivation and delisting. These real-life data indicate that in waitlisted patients: (i) bridging antiviral therapy can be an option for patients still viraemic or negative <4 weeks at LT; and (ii) clinical improvement to a condition suitable for delisting can occur even in patients with advanced decompensated cirrhosis. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

The clinician's guide to autism.

PubMed

Harrington, John W; Allen, Korrie

2014-02-01

On the basis of the most recent epidemiologic research, Autism Spectrum Disorder (ASD) affects approximately 1% to 2% of all children. (1)(2) On the basis of some research evidence and consensus, the Modified Checklist for Autism in Toddlers isa helpful tool to screen for autism in children between ages 16 and 30 months. (11) The Diagnostic Statistical Manual of Mental Disorders, Fourth Edition, changes to a 2-symptom category from a 3-symptom category in the Diagnostic Statistical Manual of Mental Disorders, Fifth Edition(DSM-5): deficits in social communication and social interaction are combined with repetitive and restrictive behaviors, and more criteria are required per category. The DSM-5 subsumes all the previous diagnoses of autism (classic autism, Asperger syndrome, and pervasive developmental disorder not otherwise specified) into just ASDs. On the basis of moderate to strong evidence, the use of applied behavioral analysis and intensive behavioral programs has a beneficial effect on language and the core deficits of children with autism. (16) Currently, minimal or no evidence is available to endorse most complementary and alternative medicine therapies used by parents, such as dietary changes (gluten free), vitamins, chelation, and hyperbaric oxygen. (16) On the basis of consensus and some studies, pediatric clinicians should improve their capacity to provide children with ASD a medical home that is accessible and provides family-centered, continuous, comprehensive and coordinated, compassionate, and culturally sensitive care. (20)

Canada's Compassionate Care Benefit: is it an adequate public health response to addressing the issue of caregiver burden in end-of-life care?

PubMed

Williams, Allison M; Eby, Jeanette A; Crooks, Valorie A; Stajduhar, Kelli; Giesbrecht, Melissa; Vuksan, Mirjana; Cohen, S Robin; Brazil, Kevin; Allan, Diane

2011-05-18

An increasingly significant public health issue in Canada, and elsewhere throughout the developed world, pertains to the provision of adequate palliative/end-of-life (P/EOL) care. Informal caregivers who take on the responsibility of providing P/EOL care often experience negative physical, mental, emotional, social and economic consequences. In this article, we specifically examine how Canada's Compassionate Care Benefit (CCB)--a contributory benefits social program aimed at informal P/EOL caregivers--operates as a public health response in sustaining informal caregivers providing P/EOL care, and whether or not it adequately addresses known aspects of caregiver burden that are addressed within the population health promotion (PHP) model. As part of a national evaluation of Canada's Compassionate Care Benefit, 57 telephone interviews were conducted with Canadian informal P/EOL caregivers in 5 different provinces, pertaining to the strengths and weaknesses of the CCB and the general caregiving experience. Interview data was coded with Nvivo software and emerging themes were identified by the research team, with such findings published elsewhere. The purpose of the present analysis was identified after comparing the findings to the literature specific to caregiver burden and public health, after which data was analyzed using the PHP model as a guiding framework. Informal caregivers spoke to several of the determinants of health outlined in the PHP model that are implicated in their burden experience: gender, income and social status, working conditions, health and social services, social support network, and personal health practises and coping strategies. They recognized the need for improving the CCB to better address these determinants. This study, from the perspective of family caregivers, demonstrates that the CCB is not living up to its full potential in sustaining informal P/EOL caregivers. Effort is required to transform the CCB so that it may fulfill the potential it holds for serving as one public health response to caregiver burden that forms part of a healthy public policy that addresses the determinants of this burden.

Canada's Compassionate Care Benefit: Is it an adequate public health response to addressing the issue of caregiver burden in end-of-life care?

PubMed Central

2011-01-01

Background An increasingly significant public health issue in Canada, and elsewhere throughout the developed world, pertains to the provision of adequate palliative/end-of-life (P/EOL) care. Informal caregivers who take on the responsibility of providing P/EOL care often experience negative physical, mental, emotional, social and economic consequences. In this article, we specifically examine how Canada's Compassionate Care Benefit (CCB) - a contributory benefits social program aimed at informal P/EOL caregivers - operates as a public health response in sustaining informal caregivers providing P/EOL care, and whether or not it adequately addresses known aspects of caregiver burden that are addressed within the population health promotion (PHP) model. Methods As part of a national evaluation of Canada's Compassionate Care Benefit, 57 telephone interviews were conducted with Canadian informal P/EOL caregivers in 5 different provinces, pertaining to the strengths and weaknesses of the CCB and the general caregiving experience. Interview data was coded with Nvivo software and emerging themes were identified by the research team, with such findings published elsewhere. The purpose of the present analysis was identified after comparing the findings to the literature specific to caregiver burden and public health, after which data was analyzed using the PHP model as a guiding framework. Results Informal caregivers spoke to several of the determinants of health outlined in the PHP model that are implicated in their burden experience: gender, income and social status, working conditions, health and social services, social support network, and personal health practises and coping strategies. They recognized the need for improving the CCB to better address these determinants. Conclusions This study, from the perspective of family caregivers, demonstrates that the CCB is not living up to its full potential in sustaining informal P/EOL caregivers. Effort is required to transform the CCB so that it may fulfill the potential it holds for serving as one public health response to caregiver burden that forms part of a healthy public policy that addresses the determinants of this burden. PMID:21592383

A moral profession.

PubMed

Newham, Roger; Terry, Louise; Atherley, Siobhan; Hahessy, Sinead; Babenko-Mould, Yolanda; Evans, Marilyn; Ferguson, Karen; Carr, Graham; Cedar, S H

2017-01-01

Lack of compassion is claimed to result in poor and sometimes harmful nursing care. Developing strategies to encourage compassionate caring behaviours are important because there is evidence to suggest a connection between having a moral orientation such as compassion and resulting caring behaviour in practice. This study aimed to articulate a clearer understanding of compassionate caring via nurse educators' selection and use of published texts and film. This study employed discourse analysis. Participants and research context: A total of 41 nurse educators working in universities in the United Kingdom (n = 3), Ireland (n = 1) and Canada (n = 1) completed questionnaires on the narratives that shaped their understanding of care and compassion. The desire to understand others and how to care compassionately characterised educators' choices. Most narratives were examples of kindness and compassion. A total of 17 emphasised the importance of connecting with others as a central component of compassionate caring, 10 identified the burden of caring, 24 identified themes of abandonment and of failure to see the suffering person and 15 narratives showed a discourse of only showing compassion to those 'deserving' often understood as the suffering person doing enough to help themselves. These findings are mostly consistent with work in moral philosophy emphasising the particular or context and perception or vision as well as the necessity of emotions. The narratives themselves are used by nurse educators to help explicate examples of caring and compassion (or its lack). To feel cared about people need to feel 'visible' as though they matter. Nurses need to be alert to problems that may arise if their 'moral vision' is influenced by ideas of desert and how much the patient is doing to help himself or herself.

The Myth of the Lone Physician: Toward a Collaborative Alternative

PubMed Central

Saba, George W.; Villela, Teresa J.; Chen, Ellen; Hammer, Hali; Bodenheimer, Thomas

2012-01-01

Cultural values and beliefs about the primary care physician bolster the myth of the lone physician: a competent professional who is esteemed by colleagues and patients for his or her willingness to sacrifice self, accept complete responsibility for care, maintain continuity and accessibility, and assume the role of lone decision maker in clinical care. Yet the reality of current primary care models is often fragmented, impersonal care for patients and isolation and burnout for many primary care physicians. An alternative to the mythological lone physician would require a paradigm shift that places the primary care physician within the context of a highly functioning health care team. This new mythology better fulfills the collaborative, interprofessional, patient-centered needs of new models of care, and might help to ensure that the work of primary care physicians remains compassionate, gratifying, and meaningful. PMID:22412010

Improving the Spiritual Dimension of Whole Person Care: Reaching National and International Consensus

PubMed Central

Vitillo, Robert; Hull, Sharon K.; Reller, Nancy

2014-01-01

Abstract Two conferences, Creating More Compassionate Systems of Care (November 2012) and On Improving the Spiritual Dimension of Whole Person Care: The Transformational Role of Compassion, Love and Forgiveness in Health Care (January 2013), were convened with the goals of reaching consensus on approaches to the integration of spirituality into health care structures at all levels and development of strategies to create more compassionate systems of care. The conferences built on the work of a 2009 consensus conference, Improving the Quality of Spiritual Care as a Dimension of Palliative Care. Conference organizers in 2012 and 2013 aimed to identify consensus-derived care standards and recommendations for implementing them by building and expanding on the 2009 conference model of interprofessional spiritual care and its recommendations for palliative care. The 2013 conference built on the 2012 conference to produce a set of standards and recommended strategies for integrating spiritual care across the entire health care continuum, not just palliative care. Deliberations were based on evidence that spiritual care is a fundamental component of high-quality compassionate health care and it is most effective when it is recognized and reflected in the attitudes and actions of both patients and health care providers. PMID:24842136

Self-compassion and reactions to unpleasant self-relevant events: the implications of treating oneself kindly.

PubMed

Leary, Mark R; Tate, Eleanor B; Adams, Claire E; Allen, Ashley Batts; Hancock, Jessica

2007-05-01

Five studies investigated the cognitive and emotional processes by which self-compassionate people deal with unpleasant life events. In the various studies, participants reported on negative events in their daily lives, responded to hypothetical scenarios, reacted to interpersonal feedback, rated their or others' videotaped performances in an awkward situation, and reflected on negative personal experiences. Results from Study 1 showed that self-compassion predicted emotional and cognitive reactions to negative events in everyday life, and Study 2 found that self-compassion buffered people against negative self-feelings when imagining distressing social events. In Study 3, self-compassion moderated negative emotions after receiving ambivalent feedback, particularly for participants who were low in self-esteem. Study 4 found that low-self-compassionate people undervalued their videotaped performances relative to observers. Study 5 experimentally induced a self-compassionate perspective and found that self-compassion leads people to acknowledge their role in negative events without feeling overwhelmed with negative emotions. In general, these studies suggest that self-compassion attenuates people's reactions to negative events in ways that are distinct from and, in some cases, more beneficial than self-esteem. ((c) 2007 APA, all rights reserved).

Drinking and Desired Self-Images: Path Models of Self-Image Goals, Coping Motives, Heavy-Episodic Drinking, and Alcohol Problems

PubMed Central

Moeller, Scott J.; Crocker, Jennifer

2009-01-01

Coping motives for drinking initiate alcohol-related problems. Interpersonal goals, which powerfully influence affect, could provide a starting point for this relation. Here we tested effects of self-image goals (which aim to construct and defend desired self-views) and compassionate goals (which aim to support others) on heavy-episodic drinking and alcohol-related problems. Undergraduate drinkers (N=258) completed measures of self-image and compassionate goals in academics and friendships, coping and enhancement drinking motives, heavy-episodic drinking, and alcohol-related problems in a cross-sectional design. As predicted, self-image goals, but not compassionate goals, positively related to alcohol-related problems. Path models showed that self-image goals relate to coping motives, but not enhancement motives; coping motives then relate to heavy-episodic drinking, which in turn relate to alcohol-related problems. Self-image goals remained a significant predictor in the final model, which accounted for 34% of the variance in alcohol-related problems. These findings indicate that self-image goals contribute to alcohol-related problems in college students both independently and through coping motives. Interventions can center on reducing self-image goals and their attendant negative affect. PMID:19586150

Creating a palliative and end-of-life program in a cure-oriented pediatric setting: the zig-zag method.

PubMed

Harper, Joann; Hinds, Pamela S; Baker, Justin N; Hicks, Judy; Spunt, Sheri L; Razzouk, Bassem I

2007-01-01

Children living with and dying of advanced-stage cancer suffer physically, emotionally, and spiritually. Relief of their suffering requires comprehensive, compassionate palliative and end-of-life (EoL) care.However, an EoL care program might appear inconsistent with the mission of a pediatric oncology research center committed to seeking cures. Here the authors describe the methods used to achieve full institutional commitment to their EoL care program and those used to build the program's philosophical, research, and educational foundations after they received approval. The authors convened 10 focus groups to solicit staff perceptions of the hospital's current palliative and EoL care. They also completed baseline medical record reviews of 145 patient records to identify key EoL characteristics. The authors then crafted a vision statement and a strategic plan, implemented new research protocols,and established publication and funding trajectories. They conclude that establishing a state-of-the-art palliative and EoL program in a cure-oriented pediatric setting is achievable via consensus building and recruitment of diverse institutional resources.

The cycle of caring.

PubMed

Simons, Marj

2004-01-01

This article discusses areas where nurse leaders may make conscious and deliberate efforts to impact the organization's culture for caring. Leaders must first care for caregivers and have a commitment to their well-being. It is essential that we develop and engage in programs and activities that help staff with their personal struggles and propel them forward on the journey to being their best selves. We must seek to give them the skills and competencies necessary to work in a caring environment. Nurse leaders must facilitate the development and implementation of programs that foster a caring and compassionate culture. The author shares 2 programs that nourish the soul during difficult times for patients and their loved ones in the hospital setting-End-of-Life program and Massage Therapy program. Just as we care for those within our walls, we must also plan and deliver programs that promote health and well-being of our community. Such programs are an integral part of fulfilling our organization's mission of caring for the community. New and proven technologies advance our profession and contribute in invaluable ways to a healing environment; however, it is critical that we retain the art of caring, fundamental from the past and that helped to shape the profession of nursing.

Focusing on the "T" in LGBT: an online survey of related content in texas nursing programs.

PubMed

Walsh, David; Hendrickson, Sherry Garrett

2015-06-01

As nurses, we advocate for the most vulnerable and underserved, who, within the lesbian, gay, bisexual, and transgender (LGBT) community, are transgender individuals. Yet, the existence of LGBT education in nursing schools has not been examined. After approval by the university institutional review board, 113 nursing programs in Texas were surveyed between November 2013 and January 2014, with a 12-question, Web-based questionnaire. A Verisign certificate and 128-bit encryption program supported compliance with the Health Insurance Portability and Accountability Act of 1996. Nineteen percent of the surveys were returned. Ten (47.62%) of 21 respondents addressed transgender or transsexual individuals. Fifteen (71.43%) of 21 answered a free-text question to estimate the number of hours spent addressing LGBT content, reporting an average of 1.6 hours. Our study suggests that, in Texas, nursing students may not be receiving sufficient content, nor do they understand transgender health needs or how to best deliver competent, compassionate care to this population. Copyright 2015, SLACK Incorporated.

Contextual Facilitators and Maintaining of Compassion-Based Care: An Ethnographic Study.

PubMed

Babaei, Sima; Taleghani, Fariba; Keyvanara, Mahmoud

2017-01-01

Compassion is an important part of nursing. It fosters better relationships between nurses and their patients. Moreover, it gives patients more confidence in the care they receive. Determining facilitators of compassion are essential to holistic care. The purpose of this study was to explore these facilitators. This ethnographic study was conducted in 2014-2015 with 20 nurses, 12 patients, and 4 family members in the medical and surgical wards. Data collection was done through observations and in-depth semi-structured interviews with purposive sampling. The study was carried out in 15 months. Data analysis was performed using constant comparison based on Strauss and Corbin. Data analysis defined three main themes and eight subthemes as the fundamentals of compassion-based care. Nurses' personal factors with subcategories of personality, attitudes, and values and holistic view; and socio-cultural factors with subcategories of kindness role model, religious, and cultural values are needed to elicit compassionate behaviors. Initiator factors, with subcategories of patient suffering, patient communication demands, and patient emotional and psychological necessity are also needed to start compassionate behaviors. The findings of this study showed that nurses' communication with patients is nurse's duty in order to understand and respect the needs of patients. Attention should be paid to issues relating to compassion in nursing and practice educational programs. Indeed, creating a care environment with compassion, regardless of any shortcomings in the work condition, would help in the development of effective nursing.

Self-Compassion, Stress, and Coping

PubMed Central

Allen, Ashley Batts; Leary, Mark R.

2010-01-01

People who are high in self-compassion treat themselves with kindness and concern when they experience negative events. The present article examines the construct of self-compassion from the standpoint of research on coping in an effort to understand the ways in which people who are high in self-compassion cope with stressful events. Self-compassionate people tend to rely heavily on positive cognitive restructuring but do not appear to differ from less self-compassionate people in the degree to which they cope through problem-solving and distraction. Existing evidence does not show clear differences in the degree to which people who are low vs. high in self-compassion seek support as a coping strategy, but more research is needed. PMID:20686629

Why the Critics of Poor Health Service Delivery Are the Causes of Poor Service Delivery: A Need to Train the Policy-makers

PubMed Central

Harding, Nancy

2015-01-01

This comment on Professor Fotaki’s Editorial agrees with her arguments that training health professionals in more compassionate, caring and ethically sound care will have little value unless the system in which they work changes. It argues that for system change to occur, senior management, government members and civil servants themselves need training so that they learn to understand the effects that their policies have on health professionals. It argues that these people are complicit in the delivery of unethical care, because they impose requirements that contradict health professionals’ desire to deliver compassionate and ethical forms of care. PMID:26340498

Financial versus Non-Financial Incentives for Improving Patient Experience.

PubMed

Lee, Thomas H

2015-05-01

Delivering compassionate and coordinated care is a goal for all health care providers. Humans are not always consistent, though, both individually and collectively, and this is why everyone needs incentives to be at their best and to try to always be improving. The endlessly interesting question in patient experience is, what should those incentives look like? Should they be financial or nonfinancial? Dr. Thomas H. Lee explores what is most effective in regard to engaging and motivating physicians. While different approaches will work in different organizational cultures, financial incentives have their role in performance improvement. Compassionate coordinated care should be a social norm and be pursued by all health care organizations.

Patient-centered medical home model: do school-based health centers fit the model?

PubMed

Larson, Satu A; Chapman, Susan A

2013-01-01

School-based health centers (SBHCs) are an important component of health care reform. The SBHC model of care offers accessible, continuous, comprehensive, family-centered, coordinated, and compassionate care to infants, children, and adolescents. These same elements comprise the patient-centered medical home (PCMH) model of care being promoted by the Affordable Care Act with the hope of lowering health care costs by rewarding clinicians for primary care services. PCMH survey tools have been developed to help payers determine whether a clinician/site serves as a PCMH. Our concern is that current survey tools will be unable to capture how a SBHC may provide a medical home and therefore be denied needed funding. This article describes how SBHCs might meet the requirements of one PCMH tool. SBHC stakeholders need to advocate for the creation or modification of existing survey tools that allow the unique characteristics of SBHCs to qualify as PCMHs.

"The Adopted Children of ART": expert clients and role tensions in ART provision in Uganda.

PubMed

Kyakuwa, Margaret; Hardon, Anita; Goldstein, Zoe

2012-01-01

The implementation of the greater involvement of people living with HIV (GIPA) principle in Ugandan AIDS care is described by focusing on the engagement of expert clients in two rural health centers during a time of antiretroviral therapy (ART) scale-up. We contrast how the expert clients help overburdened nurses to manage the well-attended ART programs in the public and in the nongovernmental organization clinic. They are unpaid, but acquire preferential status in the ART program because of their knowledge of AIDS medicines (and its adverse effects) and because of the compassionate care that they provide. Despite the assistance provided, nurses in the public facility felt threatened in their professional status by these expert clients, who were seen to overstep the boundaries of their role. We pay particular attention to the double burden for HIV-positive nurses, who fear stigma, and (unlike the expert patients) keep their HIV status secret.

Benefits of Teaching Medical Students How to Communicate with Patients Having Serious Illness

PubMed Central

Ellman, Matthew S.; Fortin, Auguste H.

2012-01-01

Innovative approaches are needed to teach medical students effective and compassionate communication with seriously ill patients. We describe two such educational experiences in the Yale Medical School curriculum for third-year medical students: 1) Communicating Difficult News Workshop and 2) Ward-Based End-of-Life Care Assignment. These two programs address educational needs to teach important clinical communication and assessment skills to medical students that previously were not consistently or explicitly addressed in the curriculum. The two learning programs share a number of educational approaches driven by the learning objectives, the students’ development, and clinical realities. Common educational features include: experiential learning, the Biopsychosocial Model, patient-centered communication, integration into clinical clerkships, structured skill-based learning, self-reflection, and self-care. These shared features ― as well as some differences ― are explored in this paper in order to illustrate key issues in designing and implementing medical student education in these areas. PMID:22737055

Proposed changes to the reimbursement of pharmaceuticals and medical devices in Poland and their impact on market access and the pharmaceutical industry

PubMed Central

Badora, Karolina; Caban, Aleksandra; Rémuzat, Cécile; Dussart, Claude; Toumi, Mondher

2017-01-01

ABSTRACT In Poland, two proposed amendments to the reimbursement act are currently in preparation; these are likely to substantially change the pricing and reimbursement landscape for both drugs and medical devices. Proposed changes include: alignment of medical device reimbursement with that of pharmaceuticals; relaxing the strict reimbursement criteria for ultra-orphan drugs; establishment of an additional funding category for vaccines; introduction of compassionate use, and a simplified reimbursement pathway for well-established off-label indications; appreciation of manufacturers’ innovation and research and development efforts by creating a dedicated innovation budget; introduction of a mechanism preventing excessive parallel import; prolonged duration of reimbursement decisions and reimbursement lists; and increased flexibility in defining drug programmes. Both amendments are still at a draft stage and many aspects of the new regulations remain unclear. Nonetheless, the overall direction of some of the changes is already evident and warrants discussion due to their high expected impact on pharmaceutical and device manufacturers. Here we evaluate the main changes proposed to the reimbursement of drugs, vaccines, and medical devices, and examine the impact they are likely to have on market access and pharmaceutical industry in Poland. PMID:29081924

Drinking and desired self-images: path models of self-image goals, coping motives, heavy-episodic drinking, and alcohol problems.

PubMed

Moeller, Scott J; Crocker, Jennifer

2009-06-01

Coping motives for drinking initiate alcohol-related problems. Interpersonal goals, which powerfully influence affect, could provide a starting point for this relation. Here we tested effects of self-image goals (which aim to construct and defend desired self-views) and compassionate goals (which aim to support others) on heavy-episodic drinking and alcohol-related problems. Undergraduate drinkers (N=258) completed measures of self-image and compassionate goals in academics and friendships, coping and enhancement drinking motives, heavy-episodic drinking, and alcohol-related problems in a cross-sectional design. As predicted, self-image goals, but not compassionate goals, positively related to alcohol-related problems. Path models showed that self-image goals relate to coping motives, but not enhancement motives; coping motives then relate to heavy-episodic drinking, which in turn relate to alcohol-related problems. Self-image goals remained a significant predictor in the final model, which accounted for 34% of the variance in alcohol-related problems. These findings indicate that self-image goals contribute to alcohol-related problems in college students both independently and through coping motives. Interventions can center on reducing self-image goals and their attendant negative affect. Copyright (c) 2009 APA, all rights reserved.

Exploring compassion: implications for contemporary nursing. Part 2.

PubMed

Straughair, Collette

A range of contemporary political and professional literature endorse the principle of compassion in nursing as a core and underpinning philosophy fundamental to the profession. However, despite pledges to ensure that compassion lies at the heart of nursing, the concept has not been clearly defined. It is evident that uncovering the true meaning is complex and challenging owing to its subjective nature. In light of this, several implications must be considered. Effective student nurse recruitment is essential to ensure that the most appropriate individuals are selected. Contemporary marketing campaigns must be implemented, and recruitment strategies developed, which consider specific values and attitudes. Service user involvement in recruitment and selection, curriculum planning and learning and teaching strategies, and post-qualification education, can enhance nurses' understanding of the patient perspective and make headway in embedding compassion as a core nursing value. Additionally, effective role modelling in practice which demonstrates high-quality compassionate nursing care is essential. Nurses must be adequately supported in the clinical environment to facilitate compassionate behaviours and clinical leadership at all levels must uphold political and professional pledges to achieve this. Consideration of these implications for practice is essential to ensure that nurses are able to respond to patients with humanity and kindness, and deliver high-quality, compassionate care to all.

Nurturing compassion through care-giving and care-receiving: the changing moral economy of AIDs in China.

PubMed

Kuah-Pearce, Khun Eng; Guiheux, Gilles

2014-01-01

Based on the case study of an Aids clinic operated in Nanning by MSF, this paper looks at how one international NGO, Médecins Sans Frontières (MSF, or Doctors Without Borders), deals with the HIV-carrier patients in Nanning, the capital of Guangxi province in China. It explores the process of care-giving to the HIV patients by MSF employees (both foreign and local) and how the patients react to the 'care-receiving' provided by this foreign NGO. This is especially pertinent in China today as HIV-patients are the victims of discriminating policies and are still very much discriminated by the general population. MSF, viewed by the victims as a foreign NGO, is regarded as an organization seen as promoting a changing and compassionate attitude toward AIDs patients through their anonymous and non-discriminating practices. Through the practices and the discourse of MSF workers and the testimonies of the patients, this paper looks at how the moral economy of AIDs is evolving from a repressive and discriminative attitude towards the compassionate attention to individual suffering. As such, MSF, through its actions, is seen as one of the agents promoting attitudinal changes toward disadvantaged groups and is facilitating the emergence of an emotional and compassionate subject.

Building compassion literacy: Enabling care in primary health care nursing.

PubMed

Burridge, Letitia Helen; Winch, Sarah; Kay, Margaret; Henderson, Amanda

This paper introduces the concept of compassion literacy and discusses its place in nursing within the general practice setting. Compassion literacy is a valuable competency for sustaining the delivery of high quality care. Being compassion literate enables practice nurses to provide compassionate care to their patients and to recognise factors that may constrain this. A compassion literate practice nurse may be more protected from compassion fatigue and its negative consequences. Understanding how to enable self-compassion and how to support the delivery of compassionate care within the primary care team can enhance the care experienced by the patient while improving the positive engagement and satisfaction of the health professionals. The capacity to deliver compassionate care can be depleted by the day-to-day demands of the clinical setting. Compassion literacy enables the replenishing of compassion, but the development of compassion literacy can be curtailed by personal and workplace barriers. This paper articulates why compassion literacy should be an integral aspect of practice nursing and considers strategies for enabling compassion literacy to develop and thrive within the workplace environment. Compassion literacy is also a valuable opportunity for practice nurses to demonstrate their key role within the multidisciplinary team of general practice, directly enhancing the quality of the care delivered.

WA29 "we are all one" compassionate cities "a global community joined for care".

PubMed

Molina, Emilio Herrera; Flores, Silvia Librada

2015-04-01

The NewHealth Foundation, a Spanish non-for-profit organisation, is leading the project Compassionate Cities. "We are all one". The project aims to involve citizens in creating communities of care to help people at the end of life phase. To design and develop a practical model to engage communities in the process of improving the quality of public palliative care. To empower key advocates of end-of-life care. To evaluate communities' interventions, their feasibility and impact in terms of shared benefit for stakeholders. Identification and recruitment of key advocates of care. Design of an innovative model of compassionate cities. Define community of care activities through a triple-dimension methodology: [To Want - To Know - To Do]. An innovative model has been developed: The Collaborating Centre (schools, colleges, cultural centres, professional's associations, patient's associations, NGOs, brotherhoods, churches, etc.) organises the agenda of training events and promotes networking. Citizens set up "care clusters", becoming available to provide care. The Beneficiaries Centres (hospices, nursing homes, residential centres, patient organisations, hospitals, health and social care centres, etc.) contact the clusters when care needs of patients are identified. The palliative care specialist supports Compassionate Communities training and refer patients to clusters. Local Government (also a collaborating centre) encourages awareness campaigns and provides institutional support. Companies collaborate in promoting and funding the project. Six cities in Spain and 3 in Colombia have already been selected and local initiatives are already being promoted (more results to be provided at the Congress). This model supports people to become the real co-producers of services, as they know which services best respond to their needs. © 2015, Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Compassion in practice-Evaluating the awareness, involvement and perceived impact of a national nursing and midwifery strategy amongst healthcare professionals in NHS Trusts in England.

PubMed

O'Driscoll, Mike; Allan, Helen; Liu, Liang; Corbett, Kevin; Serrant, Laura

2018-03-01

To report the findings from an evaluation of the impact of the Compassion in Practice Vision and Strategy (National Health Service England (NHSE), 2012) on nursing, midwifery and care staff. The Compassion in Practice Vision and Strategy was a programme of work to highlight the importance of compassionate care following the Francis Report in 2013 into the deficits in care in an NHS Hospital Trust. It was launched by NHS England in 2012 at a time when fiscal cuts were introduced by the Department of Health in England. Mixed methods. Inferential statistics were used to test whether there were significant differences between staff at different levels of seniority with regard to awareness and involvement in Compassion in Practice Vision and Strategy and their attitudes to it. Awareness and involvement of staff in Compassion in Practice Vision and Strategy were high amongst middle and senior management but limited at ward level. Staff involvement in Compassion in Practice Vision and Strategy was limited due to a lack of awareness. Ward level staff who were aware and involved, perceived a lack of support and communication from senior leadership to deliver the Compassion in Practice Vision and Strategy. Results reveal professional anger, distress and resistance to the Compassion in Practice Vision and Strategy and a view of the programme as a top-down initiative which did not sufficiently recognise structural constraints on nurses' ability to deliver compassionate care. We discuss the implications of our findings for global nursing. Participants emphasised that compassion for patients is only sustainable where there is compassion for staff and many participants felt that they were not being treated with compassion. National Health Service England should strongly affirm that nurses and midwives in general provide compassionate care. Trust leadership should provide support for ward level staff who deliver compassionate care in difficult circumstances. © 2017 John Wiley & Sons Ltd.

Allergy and immunology in Africa: Challenges and unmet needs.

PubMed

El-Gamal, Yehia M; Hossny, Elham M; El-Sayed, Zeinab A; Reda, Shereen M

2017-11-01

The tremendous increase in allergy in the African continent cannot simply be explained by the change in public hygiene. There are many "prehygiene" communities with sewage-contaminated water supplies, helminth infestations, bare footedness, and poor housing, and still there is a high prevalence of allergic disease. Africans can be exposed to many risk factors facilitating severe asthma and wheezing, including airborne viruses, smoke, indoor dampness, cockroaches, and poor access to health care. Although the reporting on food allergy is inadequate to perform systematic reviews or meta-analyses, the available data suggest that food allergy is underdiagnosed. The rate of new HIV infections in high-prevalence settings in Africa remains unacceptably high. Although the annual number of new HIV infections in Sub-Saharan Africa has decreased lately, new HIV infections in the Middle East and North Africa region have increased; however, the current prevalence of 0.1% is still among the lowest globally. Africa is densely populated, and consanguineous mating is high in some areas of North and Sub-Saharan Africa. This allows for emergence of many autosomal recessive primary immunodeficiency diseases. There is urgent need for the establishment of primary immunodeficiency disease registries, stem cell transplantation facilities, and neonatal screening programs. To address these expanding problems and perform local cutting-edge research, Africans need to be empowered by motivated governments, dedicated funds, and compassionate scientific partnership. Copyright © 2017 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

Solidarity and compassion-prisoners as hospice volunteers in Poland.

PubMed

Krakowiak, Piotr; Deka, Renata; Janowicz, Anna

2018-04-01

Democracy in Eastern Europe arrived after a long fight with a communist regime, and the activities of medical volunteers have been developing in opposition to the existing then in Poland mentality called Homo Sovieticus. From 1981 onwards the Polish Hospice Movement there was inspired by practitioners and international experiences brought by visits of Dr. Cicely Saunders. The history of modern end-of-life care in Poland was connected to caring communities, which could be called compassionate, because of the volunteering of all hospice team members. When palliative medicine started to become a part of the national healthcare programme, the hospice movement was slowly losing its exceptional character of professionals working together with volunteers, accompanied by considerable involvement of church communities. The new way of talking about end-of-life care was proposed in XXI century, and promotion of volunteering was part of it. In Gdansk an innovative program to reintegrate prisoners into society through voluntary work with hospice patients began. Since 2008 the WHAT project was aimed at social reintegration of prisoners through voluntary activities in hospices and correctional institutions from around Poland. In June 2009 Poland was awarded a prestigious prize 'The Crystal Scales of Justice' by The Council of Europe for a project called Voluntary Service of the Convicted in Poland implementing an innovative form of cooperation among prisons, hospices and social welfare homes. The research involving prisoners performing hospice-palliative care volunteering indicates a diverse range of life goals from the inmates not involved in hospices. These innovative correctional programs truly help local communities and prisoners who are currently working in 40 hospices and 70 nursing homes, helping those in need. Adequately prepared inmates who proved to be effective volunteers could be an inspiration to all who want to make end-of-life care more social, more humane and a more universal duty of compassionate communities.

The Co-creation and Feasibility of a Compassion Training as a Follow-up to Mindfulness-Based Cognitive Therapy in Patients with Recurrent Depression.

PubMed

Schuling, Rhoda; Huijbers, Marloes; Jansen, Hetty; Metzemaekers, Renée; Den Brink, Erik Van; Koster, Frits; Van Ravesteijn, Hiske; Speckens, Anne

2018-01-01

The aim of this study was to assess the feasibility, acceptability and preliminary effectiveness of Mindfulness - Based Compassionate Living (MBCL) as a follow-up intervention to Mindfulness Based Cognitive Therapy in adults with recurrent depression. We conducted an uncontrolled study in 17 patients with recurrent depression, in two successive groups. The first group contained novices to compassion training ( N  = 14); in the second group, ten of these participated again, in addition to three new participants ( N  = 13). The overall group contained 15 females and 2 males, aged between 37 and 71. The MBCL program was qualitatively evaluated using post-intervention focus group interviews in both groups. In addition, self-report questionnaires assessing depressive symptoms, worry and both self-compassion and mindfulness skills were administered before and after MBCL. No patients dropped out of the intervention. Average attendance was 7.52 (SD 0.73) out of eight sessions. Helpful elements were theory on the emotion regulation systems, practicing self-compassion explicitly and embodiment of a compassionate attitude by the teachers. Unhelpful elements were the lack of a clear structure, lack of time to practice compassion for self and the occurrence of the so-called back draft effect. We adapted the program in accordance with the feedback of the participants. Preliminary results showed a reduction in depressive symptoms in the second group, but not in the first group, and an increase in self-compassion in both groups. Worry and overall mindfulness did not change. MBCL appears to be feasible and acceptable for patients suffering from recurrent depressive symptoms who previously participated in MBCT. Selection bias may have been a factor as only experienced and motivated participants were used; this, however, suited our intention to co-create MBCL in close collaboration with knowledgeable users. Examination of the effectiveness of MBCL in a sufficiently powered randomised controlled trial is needed.

Real-world results of ibrutinib in patients with relapsed or refractory chronic lymphocytic leukemia: data from 95 consecutive patients treated in a compassionate use program. A study from the Swedish Chronic Lymphocytic Leukemia Group

PubMed Central

Winqvist, Maria; Asklid, Anna; Andersson, PO; Karlsson, Karin; Karlsson, Claes; Lauri, Birgitta; Lundin, Jeanette; Mattsson, Mattias; Norin, Stefan; Sandstedt, Anna; Hansson, Lotta; Österborg, Anders

2016-01-01

Ibrutinib, a Bruton’s tyrosine kinase inhibitor is approved for relapsed/refractory and del(17p)/TP53 mutated chronic lymphocytic leukemia. Discrepancies between clinical trials and routine health-care are commonly observed in oncology. Herein we report real-world results for 95 poor prognosis Swedish patients treated with ibrutinib in a compassionate use program. Ninety-five consecutive patients (93 chronic lymphocytic leukemia, 2 small lymphocytic leukemia) were included in the study between May 2014 and May 2015. The median age was 69 years. 63% had del(17p)/TP53 mutation, 65% had Rai stage III/IV, 28% had lymphadenopathy ≥10cm. Patients received ibrutinib 420 mg once daily until progression. At a median follow-up of 10.2 months, the overall response rate was 84% (consistent among subgroups) and 77% remained progression-free. Progression-free survival and overall survival were significantly shorter in patients with del(17p)/TP53 mutation (P=0.017 and P=0.027, log-rank test); no other factor was significant in Cox proportional regression hazards model. Ibrutinib was well tolerated. Hematomas occurred in 46% of patients without any major bleeding. Seven patients had Richter’s transformation. This real-world analysis on consecutive chronic lymphocytic leukemia patients from a well-defined geographical region shows the efficacy and safety of ibrutinib to be similar to that of pivotal trials. Yet, del(17p)/TP53 mutation remains a therapeutic challenge. Since not more than half of our patients would have qualified for the pivotal ibrutinib trial (RESONATE), our study emphasizes that real-world results should be carefully considered in future with regards to new agents and new indications in chronic lymphocytic leukemia. PMID:27198718

Real-world results of ibrutinib in patients with relapsed or refractory chronic lymphocytic leukemia: data from 95 consecutive patients treated in a compassionate use program. A study from the Swedish Chronic Lymphocytic Leukemia Group.

PubMed

Winqvist, Maria; Asklid, Anna; Andersson, P O; Karlsson, Karin; Karlsson, Claes; Lauri, Birgitta; Lundin, Jeanette; Mattsson, Mattias; Norin, Stefan; Sandstedt, Anna; Hansson, Lotta; Österborg, Anders

2016-12-01

Ibrutinib, a Bruton's tyrosine kinase inhibitor is approved for relapsed/refractory and del(17p)/TP53 mutated chronic lymphocytic leukemia. Discrepancies between clinical trials and routine health-care are commonly observed in oncology. Herein we report real-world results for 95 poor prognosis Swedish patients treated with ibrutinib in a compassionate use program. Ninety-five consecutive patients (93 chronic lymphocytic leukemia, 2 small lymphocytic leukemia) were included in the study between May 2014 and May 2015. The median age was 69 years. 63% had del(17p)/TP53 mutation, 65% had Rai stage III/IV, 28% had lymphadenopathy ≥10cm. Patients received ibrutinib 420 mg once daily until progression. At a median follow-up of 10.2 months, the overall response rate was 84% (consistent among subgroups) and 77% remained progression-free. Progression-free survival and overall survival were significantly shorter in patients with del(17p)/TP53 mutation (P=0.017 and P=0.027, log-rank test); no other factor was significant in Cox proportional regression hazards model. Ibrutinib was well tolerated. Hematomas occurred in 46% of patients without any major bleeding. Seven patients had Richter's transformation. This real-world analysis on consecutive chronic lymphocytic leukemia patients from a well-defined geographical region shows the efficacy and safety of ibrutinib to be similar to that of pivotal trials. Yet, del(17p)/TP53 mutation remains a therapeutic challenge. Since not more than half of our patients would have qualified for the pivotal ibrutinib trial (RESONATE), our study emphasizes that real-world results should be carefully considered in future with regards to new agents and new indications in chronic lymphocytic leukemia. Copyright© Ferrata Storti Foundation.

Compassionate Allowances

MedlinePlus

... Report Fraud, Waste or Abuse Site Map Other Government Websites: Benefits.gov Disability.gov MyMoney.gov Regulations.gov USA.gov Other Government Sites Follow: Twitter Facebook YouTube Blog More Social ...

Can Self-Compassion Promote Healthcare Provider Well-Being and Compassionate Care to Others? Results of a Systematic Review.

PubMed

Sinclair, Shane; Kondejewski, Jane; Raffin-Bouchal, Shelley; King-Shier, Kathryn M; Singh, Pavneet

2017-07-01

This meta-narrative review, conducted according to the RAMESES (Realist And Meta-narrative Evidence Syntheses: Evolving Standards) standards, critically examines the construct of self-compassion to determine if it is an accurate target variable to mitigate work-related stress and promote compassionate caregiving in healthcare providers. PubMed, Medline, CINAHL, PsycINFO, and Web of Science databases were searched. Studies were coded as referring to: (1) conceptualisation of self-compassion; (2) measures of self-compassion; (3) self-compassion and affect; and (4) self-compassion interventions. A narrative approach was used to evaluate self-compassion as a paradigm. Sixty-nine studies were included. The construct of self-compassion in healthcare has significant limitations. Self-compassion has been related to the definition of compassion, but includes limited facets of compassion and adds elements of uncompassionate behavior. Empirical studies use the Self-Compassion Scale, which is criticised for its psychometric and theoretical validity. Therapeutic interventions purported to cultivate self-compassion may have a broader effect on general affective states. An alleged outcome of self-compassion is compassionate care; however, we found no studies that included patient reports on this primary outcome. We critically examine and delineate self-compassion in healthcare providers as a composite of common facets of self-care, healthy self-attitude, and self-awareness rather than a construct in and of itself. © 2017 The International Association of Applied Psychology.

About Survivorship

MedlinePlus

... that the cancer will come back after treatment Guilt about surviving, having lost friends and loved ones ... Cancer Recurrence Healthy Living Living With Chronic Cancer Making a Difference Survivor Artwork Survivorship Resources Trusted, compassionate ...

Compassionate Friends

MedlinePlus

... Online Communities Family Support Employees / Co-Workers About Leadership & Board Financial Information TCF Foundation Partnerships Media How ... To The Newly Bereaved What We Do Chapter Leadership Time has proven that in caring and sharing ...

Inspiring senior nurses to lead the delivery of compassionate care.

PubMed

Masterson, Abigail; Robb, Elizabeth; Gough, Pippa; Machell, Sue

2014-09-01

The enabling compassionate care in practice programme was an innovative development programme for bands 6 and 7 nurses working with older people in all settings. It was commissioned by the Department of Health from the Florence Nightingale Foundation. A total of 117 nurses participated. They included experienced and newly appointed clinical leaders from medicine, surgery, acute specialties, community services, mental health, emergency departments, hospices and care homes. All participants reported increases in their knowledge, understanding and practical application of the 6Cs; courage and confidence to lead; and ability to change practice. Participants also reported feeling reinvigorated and being brought back in touch with why they entered nursing. At the close of the programme most participants had already made small but significant changes in their areas for the benefit of frail older people.

Community mental health nurses' and compassion: an interpretative approach.

PubMed

Barron, K; Deery, R; Sloan, G

2017-05-01

WHAT IS KNOWN ON THE SUBJECT?: The concept of compassion is well documented in the healthcare literature but has received limited attention in mental health nursing. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: Mental health nurses struggle with defining compassion. The study, with its limitations, brings greater clarity to the meaning of compassion for community mental health nurses and NHS organizations. Mental health nurses need time to reflect on their provision of compassionate care. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: The study has shown that compassion is important for NHS healthcare management, frontline mental health nurses and policy-makers in UK, and there is potential for sharing practice and vision across NHS organisations. Mental health nurses could benefit from training to facilitate their understanding of compassionate practices. Emphasis should be placed on the importance of self-compassion and how this can be nurtured from the secure base of clinical supervision. Introduction There is increasing emphasis in policy, research and practice in the UK and internationally on the importance of caring in health care. Compassion needs to be at the core of all healthcare professionals' practice. Recently, health care has received negative attention through media and government reports which cite a lack of compassion in care. Rationale The concept of compassion has received limited attention in community mental health nursing. Aim Based on data taken from semi-structured interviews with community mental health nurses, this paper aims to describe interpretations and perspectives of compassion to gain insight and development of its meaning. Method A naturalistic, interpretive approach was taken to the study. Semi-structured interviews with nine mental health nurses were analysed using Burnard's 14-step model of thematic analysis. Findings The research illuminates the complexity of compassion and how its practice impacts on emotional responses and relationships with self, patients, colleagues and the employing organization. Participants identified difficulties engaging with compassionate practice whilst recognizing it as a driving force underpinning provision of care. Implications for practice Mental health nurses need to be supported to work towards a greater understanding of compassionate care for clinical practice and the need for self-compassion. © 2017 John Wiley & Sons Ltd.

Benefits of Implementing and Improving Collection of Sexual Orientation and Gender Identity Data in Electronic Health Records.

PubMed

Bosse, Jordon D; Leblanc, Raeann G; Jackman, Kasey; Bjarnadottir, Ragnhildur I

2018-06-01

Individuals in lesbian, gay, bisexual, and transgender communities experience several disparities in physical and mental health (eg, cardiovascular disease and depression), as well as difficulty accessing care that is compassionate and relevant to their unique needs. Access to care is compromised in part due to inadequate information systems that fail to capture identity data. Beginning in January 2018, meaningful use criteria dictate that electronic health records have the capability to collect data related to sexual orientation and gender identity of patients. Nurse informaticists play a vital role in the process of developing new electronic health records that are sensitive to the needs and identities of the lesbian, gay, bisexual, and transgender communities. Improved collection of sexual orientation and gender identity data will advance the identification of health disparities experienced by lesbian, gay, bisexual, and transgender populations. More inclusive electronic health records will allow providers to monitor risk behavior, assess progress toward the reduction of disparities, and provide healthcare that is patient and family centered. Concrete suggestions for the modification of electronic health record systems are presented, as well as how nurse informaticists may be able to bridge gaps in provider knowledge and discomfort through interprofessional collaboration when implementing changes in electronic health records.

Benefits of teaching medical students how to communicate with patients having serious illness: comparison of two approaches to experiential, skill-based, and self-reflective learning.

PubMed

Ellman, Matthew S; Fortin, Auguste H

2012-06-01

Innovative approaches are needed to teach medical students effective and compassionate communication with seriously ill patients. We describe two such educational experiences in the Yale Medical School curriculum for third-year medical students: 1) Communicating Difficult News Workshop and 2) Ward-Based End-of-Life Care Assignment. These two programs address educational needs to teach important clinical communication and assessment skills to medical students that previously were not consistently or explicitly addressed in the curriculum. The two learning programs share a number of educational approaches driven by the learning objectives, the students' development, and clinical realities. Common educational features include: experiential learning, the Biopsychosocial Model, patient-centered communication, integration into clinical clerkships, structured skill-based learning, self-reflection, and self-care. These shared features - as well as some differences - are explored in this paper in order to illustrate key issues in designing and implementing medical student education in these areas.

Perceived unsatisfactory care as a barrier to diabetes self-management for Coeur d'Alene tribal members with type 2 diabetes.

PubMed

Tiedt, Jane A; Sloan, Rebecca S

2015-05-01

The prevalence of diabetes and related complications are disproportionally higher in Native Americans. Diabetes self-management (DSM) is instrumental in preventing complications. The results presented here are a part of a larger hermeneutic phenomenology study to explore living with diabetes for one Pacific Northwest tribe. This study identified barriers to DSM within the worldview of the tribal people. Using purposive sampling, 10 Coeur d'Alene tribal members, ages 26 to 86 years, participated in in-depth interviews. Data interpretation used a three-step method leading to integrated themes across the transcripts. Perceived unsatisfactory care emerged as the major barrier to self-management, including communication barriers (distrust, misunderstanding, and educational methods) and organizational barriers (quality of care and access issues). Findings highlight the need to improve cross-cultural communication and calls for different approaches to diabetes education. Our profession is challenged to create new DSM and diabetes educational approaches for acceptable and compassionate cross-cultural nursing care. © The Author(s) 2014.

HIV-Related Stigma and Overlapping Stigmas Towards People Living With HIV Among Health Care Trainees in Canada.

PubMed

Wagner, Anne C; Girard, Todd; McShane, Kelly E; Margolese, Shari; Hart, Trevor A

2017-08-01

HIV continues to be a stigmatized disease, despite significant advances in care and concerted effort to reduce discrimination, stereotypes, and prejudice. Living with HIV is often associated with a multitude of overlapping and intersecting experiences which can, in and of themselves, also be stigmatized, and which may exacerbate HIV-related stigma. The consequences of these stigmatizing experiences are particularly impactful when the stigmatizing individual is a health care provider, as this can influence access to and quality of care. The current study empirically investigates a model of overlapping stigmas (homophobia, racism, sexism, stigma against injection drug use and stigma against sex work) potentially held by health care provider trainees in Canada to determine how these constructs overlap and intersect, and to assess whether HIV-related stigma may have unique attributes. Understanding overlapping stigmas can help inform targeted, stigma-informed training for health care trainees in order to provide effective, compassionate care for people living with HIV.

Barriers to disseminating brief CBT for voices from a lived experience and clinician perspective

PubMed Central

Hazell, Cassie M.; Strauss, Clara; Cavanagh, Kate

2017-01-01

Access to psychological therapies continues to be poor for people experiencing psychosis. To address this problem, researchers are developing brief interventions that address the specific symptoms associated with psychosis, i.e., hearing voices. As part of the development work for a brief Cognitive Behaviour Therapy (CBT) intervention for voices we collected qualitative data from people who hear voices (study 1) and clinicians (study 2) on the potential barriers and facilitators to implementation and engagement. Thematic analysis of the responses from both groups revealed a number of anticipated barriers to implementation and engagement. Both groups believed the presenting problem (voices and psychosis symptoms) may impede engagement. Furthermore clinicians identified a lack of resources to be a barrier to implementation. The only facilitator to engagement was reported by people who hear voices who believed a compassionate, experienced and trustworthy therapist would promote engagement. The results are discussed in relation to how these barriers could be addressed in the context of a brief intervention using CBT techniques. PMID:28575094

Loss of a child - resources

MedlinePlus

Child death - resources; Resources - loss of a child ... The following organizations are good resources for information on the loss of a child: The Compassionate Friends -- www.compassionatefriends.org Bereaved Parents of the USA -- www.bereavedparentsusa. ...

Compassionate Use Protocol for the Treatment of Autoinflammatory Syndromes

ClinicalTrials.gov

2018-04-17

Chronic Atypical Neutrophilic Dermatosis With Lipodystrophy and Elevated Temperature (CANDLE); Juvenile Dermatomyositis (JDM); Stimulator of Interferon Genes (STING)-Associated Vasculopathy With Onset During Infancy (SAVI); Aicardi-Goutières Syndrome (AGS)

Ideology and Palliative Care: Moral Hazards at the Bedside.

PubMed

Rhodes, Rosamond; Strain, James J

2018-01-01

Palliative care has had a long-standing commitment to teaching medical students and other medical professionals about pain management, communication, supporting patients in their decisions, and providing compassionate end-of-life care. Palliative care programs also have a critical role in helping patients understand medical conditions, and in supporting them in dealing with pain, fear of dying, and the experiences of the terminal phase of their lives. We applaud their efforts to provide that critical training and fully support their continued important work in meeting the needs of patients and families. Although we appreciate the contributions of palliative care services, we have noted a problem involving some palliative care professionals' attitudes, methods of decisionmaking, and use of language. In this article we explain these problems by discussing two cases that we encountered.

Hepatopathy-thrombocytopenia syndrome after actinomycin-D therapy: treatment with defibrotide.

PubMed

Martín-Lázaro, Juan F; Palanca, Daniel; Garcia-Iñiguez, Juan P; Madurga, Paula; Carboné, Ana

2013-02-01

We report a case of administration compassionate use defibrotide in a 13-year-old girl with Sinusoidal Obstructive Syndrome and thrombocytopenia, also known as Hepatopathy--Thrombocytopenia Syndrome (HTS) during chemotherapy for Wilms' tumor.

75 FR 62487 - Compassionate Allowances for Cardiovascular Disease and Multiple Organ Transplants, Office of the...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-12

... hearings concerned rare diseases, cancers, traumatic brain injury and stroke, early-onset Alzheimer's... held five hearings since December 2007. These hearings were on rare diseases, cancers, traumatic brain...

3 CFR 9002 - Proclamation 9002 of August 9, 2013. National Health Center Week, 2013

Code of Federal Regulations, 2014 CFR

2014-01-01

... partners in our efforts to reduce health disparities. From coast to coast, they coordinate care and build professional, compassionate health care teams focused on improving patient outcomes. My Administration has...

78 FR 14429 - American Red Cross Month, 2013

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-06

... in helping them get back on their feet. This month, we honor men and women who deliver relief to communities around the world, and we renew the compassionate spirit that continues to keep our country strong...

Parent's perceptions of health care providers actions around child ICU death: what helped, what did not.

PubMed

Brooten, Dorothy; Youngblut, Joanne M; Seagrave, Lynn; Caicedo, Carmen; Hawthorne, Dawn; Hidalgo, Ivette; Roche, Rosa

2013-02-01

To describe parents' perspectives of health care provider actions that helped or did not around the time of infant/child's intensive care unit (ICU) death. Semistructured interviews with 63 parents (Black, White, and Hispanic) 7 months post infant/child death were audio-recorded, transcribed, analyzed, and themes identified. What helped most: compassionate, sensitive staff; understandable explanations of infant's/child's condition; experienced, competent nurses; providers did everything to help infant/child; and parents' involvement in care decisions. What did not help: insensitive, nonsupportive staff; conflict between providers and parents; communication problems around the death; inexperienced nurses and doctors; parents not understanding child's disease, care, complications. Compassionate, sensitive staff and understandable explanations of children's conditions were most helpful; insensitive, nonsupportive staff least helpful by gender, racial group, or care setting. Conflict between providers and parents was most problematic for minority parents and mothers.

Role of nursing leadership in providing compassionate care.

PubMed

Quinn, Barry

2017-12-13

This article encourages nurses to explore the concept of leadership in the constantly changing field of health and social care. All nurses have an important role in leadership, and they should consider what type of leader they want to be and what leadership skills they might wish to develop. This article examines what leadership might involve, exploring various leadership styles and characteristics and how these could be applied in nurses' practice. A core component of nursing and nursing leadership is the ability to provide compassionate care. This could correspond with the idea of servant leadership, an approach that moves the leader from a position of power to serving the team and supporting individuals to develop their potential. ©2017 RCN Publishing Company Ltd. All rights reserved. Not to be copied, transmitted or recorded in any way, in whole or part, without prior permission of the publishers.

Beyond the Examination Room

PubMed Central

O'Malley, Ann S; Forrest, Christopher B

2002-01-01

OBJECTIVE To assess whether primary care performance of low-income women's primary care delivery sites is associated with the strength of their relationships with their physicians. DESIGN Random-digit-dial and targeted household telephone survey of a population-based sample. SETTING Washington, D.C. census tracts with ≥30% of households below 200% of federal poverty threshold. PARTICIPANTS Women over age 40 (N = 1,205), 82% of whom were African American. MEASUREMENTS AND MAIN RESULTS The response rate was 85%. Primary care performance was assessed using women's ratings of their systems' accessibility (organizational, geographic, and financial), continuity, comprehensiveness, and coordination. Respondents' ratings of trust in their physicians, communication with their physicians, and compassion shown by their physicians were used to operationalize the patient-physician relationship. Controlling for population and insurance characteristics, 4 primary care features were positively associated with women's trust in and communication with their physicians: continuity with a single clinician, organizational accessibility of the practice, comprehensive care, and coordination of specialty care services. Better organizational access, but not geographic or financial access, was associated with greater levels of trust, compassion, and communication (odds ratios [ORs], 3.2, 7.4, and 6.9, respectively; P≤ .01). Women who rated highest their doctor's ability to take care of all of their health care needs (highest level of comprehensiveness) had 11 times the odds of trusting their physician (P≤ .01) and 6 times the odds of finding their physicians compassionate and communicative (P≤ .01), compared to those with the lowest level of comprehensiveness. CONCLUSIONS Primary care delivery sites organized to be more accessible, to link patients with the same clinician for their visits, to provide for all of a woman's health care needs, and to coordinate specialty care services are associated with stronger relationships between low-income women and their physicians. Primary care systems that fail to emphasize these features of primary care may jeopardize the clinician-patient relationship and indirectly the quality of care and health outcomes. PMID:11903777

The cystic fibrosis gene: Medical and social implications for heterozygote detection

DOE Office of Scientific and Technical Information (OSTI.GOV)

Wilfond, B.S.; Fost, N.

1990-05-23

The primary goal of mass screening programs for cystic fibrosis carriers should be to allow people to make more informed reproductive decisions. However, previous experience with genetic screening programs, including those for phenylketonuria and sickle cell disease, have revealed complex problems including error, confusion, and stigmatization. These problems could be greater with cystic fibrosis, since more than 8 million Americans may be carriers and entrepreneurial interests can be expected to promote screening in what could become a billion-dollar industry. The present frequency of the detectable mutation ({Delta}F{sub 508}), 75%, will complicate the counseling process. The sensitivity of the test tomore » detect at-risk couples would be 56%. The cost of screening could be as much as $2.2 million for each cystic fibrosis birth avoided. Regardless of improvements in the detection rate, implementation of population screening should be delayed until pilot studies that demonstrate its safety and effectiveness are completed. While studies are in progress, preconception testing should be offered to adult relatives of cystic fibrosis patients as part of a comprehensive program following institutional review board approval for compassionate use.« less

Implementing incentivized practice to improve patient care in developing countries.

PubMed

Mohiuddin, Zia; Sanchez, Laura Rosemary; Alcantra, Jose Manuel; Shuaib, Waqas

2014-01-01

Faculty awards provide an incentive to encourage higher standards of personal performance, which closely reflects the quality of health care. We report the development and implementation of the first medical faculty award program in the region. Anonymous preaward survey evaluated responses to understand the overall state of our institution. Five awards were celebrated. An anonymous postaward survey gathered responses to evaluate the effectiveness of the program. A total of 60% (307/509) of preaward survey responses were collected. Among those, 92% (283/307) felt that employee recognition was important and 78% (240/307) felt that performance should be the deciding criteria for employee recognition. A 24% (20/85) of the faculty received the decade of excellence award and 13% (11/85) received the compassionate physician award. Best service award was granted to 7% (6/85) of the nominees. Postaward survey showed 68% (170/250) agreed that the award ceremony incentivized them to increase quality of personal performance. In summary, we feel that this transparent, objective, and peer-nominated awards program could serve as an incentivized model for health care providers to elevate the standards of personal performance, which in turn will benefit the advancement of patient care.

Working well in a culturally diverse team.

PubMed

Day-Calder, Mandy

2016-10-05

Cooperative working is a core part of the nursing role, and it involves respecting your colleagues' needs and values. If you are part of a diverse team, you may need to develop your cultural competence, treating everyone compassionately and respectfully.

What Time Is It on the Clock of the Universe?

ERIC Educational Resources Information Center

Ramdeholl, Dianne

2013-01-01

In the concluding chapter of this volume, the author critically reflects on the important implications outlined by other authors, and through raising questions, invites us to envision and work toward a more compassionate and humane world.

Business leadership as a spiritual discipline.

PubMed

Leigh-Taylor, C

2000-01-01

What motivates organizational leaders in their search for spirituality? They seek to integrate their inner journey with their day-to-day professional roles. This article describes how a course in spirituality for executives has provided tools to analyze and clarify intentions, avoid the traps of excessive greed and power, and make decisions that are both compassionate and effective. André L. Delbecq, DBA, the Thomas J. and Kathleen L. McCarthy Professor at the Leavey School of Business at Santa Clara University in California, offers seminars in spirituality for organizational leadership through the MBA program and the Center for Executive Development. Delbecq is the first to admit his surprise at the number of executives who have repeatedly asked for courses in spirituality. He talks about how his seminars have helped CEOs and other top executives achieve greater effectiveness in leading organizations.

Genetics Home Reference: isolated sulfite oxidase deficiency

MedlinePlus

... Metabolic Disorders (CLIMB) March of Dimes: Amino Acid Metabolism Disorders The Compassionate Friends GeneReviews (1 link) Isolated Sulfite Oxidase Deficiency ClinicalTrials.gov (1 link) ClinicalTrials.gov Scientific Articles on PubMed (1 link) PubMed OMIM (1 link) ...

The Yo me cuido® Program: Addressing Breast Cancer Screening and Prevention Among Hispanic Women.

PubMed

Davis, Jenna L; Ramos, Roberto; Rivera-Colón, Venessa; Escobar, Myriam; Palencia, Jeannette; Grant, Cathy G; Green, B Lee

2015-09-01

Breast cancer is less likely to be diagnosed at the earliest stage in Hispanic/Latino (Hispanic) women compared to non-Hispanic White women, even after accounting for differences in age, socioeconomic status, and method of detection. Moffitt Cancer Center created a comprehensive health education program called Yo me cuido (®) (YMC) to address and reduce breast cancer disparities among Spanish- and English-speaking Hispanic women by providing breast cancer and healthy lifestyles awareness and education, and promoting breast cancer screenings, reminders, and referrals for women 40 years and older. The purpose of this paper is to showcase the innovative approaches and methods to cancer prevention and early detection of the YMC program, and to promote it as an effective tool for improving outcomes in community health education, outreach, and engagement activities with Hispanic populations. Key components of the program include educational workshops, mammogram referrals, and a multimedia campaign. The YMC program is unique because of its approaches in reaching the Hispanic population, such as delivering the program with compassionate services to empower participants to live a healthier lifestyle. Additionally, direct follow-up for mammography screenings is provided by program staff. From 2011 to 2013, YMC has educated 2,226 women and 165 men through 93 workshops. About 684 (52 %) women ages 40 and older have had a screening mammogram within their first year of participating in the program. The YMC program is an innovative cancer education and outreach program that has demonstrated a positive impact on the lives of the Hispanic community in the Tampa Bay region.

Building a Sustainable Global Surgery Nonprofit Organization at an Academic Institution.

PubMed

Frisella, Margaret M

Surgical Outreach for the Americas is a 501(c)3 nonprofit organization providing surgical care to those in need in developing countries of the Western Hemisphere. Every year since its inception in 2008, teams of surgeons, nurses, and allied health professionals have traveled to areas of need and performed primarily hernia repair surgeries for those without access to affordable health care. Surgical Outreach for the Americas (SOfA) began as a general concept based on World Health Organization statistics claiming that 11% of the global burden of disease can be resolved via surgery. Armed with this information, a group of compassionate and selfless health care professionals planned the first trip, to the Dominican Republic, in January 2009. Building on what was first just an ambition to help others, we now also train surgeons, surgery residents, and nurses in the countries we serve. To date, SOfA has successfully treated 734 patients, with 899 total surgical procedures performed (693 of these under general anesthesia). These procedures include inguinal hernia, umbilical hernia, testicular masses, orchiectomies, and various general surgical procedures. Through the efforts of a great many talented individuals and robust fundraising efforts, the SOfA message continues to gain momentum. SOfA not only considers the health and well-being of the disadvantaged through capacity-building efforts but strives to educate and improve the skills of health care professionals in the countries we visit. Our goal is to increase the number of missions each year and begin a 2-fold educational program that (a) provides surgical resident education through participation in mission work and (b) provides local surgeon education in the areas served. Copyright © 2016. Published by Elsevier Inc.

Walls or Bridges: "No Gobbledygook": The International Psycho-Oncology Society 2017 Sutherland Award Lecture.

PubMed

Loscalzo, Matthew J

2018-05-01

Illness, health, and wellness happen in social contexts. The present political environment is highly divisive and plays to the most primitive fears of people. Never have the stakes been so high. History is replete with putative leaders who create walls that separate people in ways that inevitably leads to dehumanization, suffering, and eventually violence. Timely and openly shared psychosocial insights by experts in mental health into the evil consequences of "wall builders" are essential to the physical, mental, and spiritual health of individuals and nations. For health care professionals (in particular) to ignore the dangers posed by the ill equipped self-serving leaders who now dominate the news and exploit the dark psyche of the world stage would be at the very least unethical and at worst collusion in repeating the sins of the past. This article first recognizes the impact of leaders who, at great personal costs, have built bridges (with relentless compassion and courage) where only chasms existed before. Although international politics may seem like a universe away, in which people may (erroneously) feel powerless to influence change, our home health care settings can be dramatically improved and humanized by the application of universally accepted humanistic values. Health care, as it is practiced today, is an anachronism at multiple levels. Supportive care in general and psychosocial values specifically offer a more inclusive and realistic alternative. Based on an inclusive staff leadership model, a strategic, hands-on, practical, and compassionate approach to creating and implementing supportive care programs of excellence is described. Finally, potentially fruitful areas in which supportive care and psychosocial values can provide leadership as bridges to more accessible, affordable, and humanistic care are provided for contemplation. Copyright © 2018 John Wiley & Sons, Ltd.

Vatican is lone opponent of world conference's compromises on abortion.

PubMed

1994-09-07

Three years in the making, the draft program of action of the 1994 International Conference on Population and Development sets nonbinding policy guidelines to contain the world's population at 7.27 billion in 2015. Although the Vatican was pleased to see Pakistan put forward a compromise formula developed to appease Catholic and Muslim objectors of abortion, the Church was unprepared to accept the compromise immediately and requested further discussion. The Vatican's rejection drew a strong chorus of vocal disapproval from other conference delegates. Even Iran accepted the draft as a "perfect text," while Sweden grudgingly accepted it as a "rock-bottom compromise." With no Catholic countries objecting to the compromise, the Vatican stood alone in its refusal to compromise with the rest of the world's leaders and peoples. Germany, speaking for the European Union, warned that enough concessions had already been made. The rationale for Vatican opposition was unclear since the section explicitly rejects abortion as a means of family planning and urges countries to minimize both the incidence of unsafe abortion and abortion overall by improving family planning. Prevention of unwanted pregnancies must be given highest priority and women should have ready access to compassionate counselling, with abortion never promoted as a means of family planning. Moreover, there is no longer a reference to sexual health education, a plea to governments to review their laws and policies on abortion, and a call to consider women's health rather than relying upon criminal codes and punitive measures. Participants said the Vatican objected to a phrase stating that abortions, where legal, should be safe, while the Church representative argued that any suggestion that abortion is safe contradicts church doctrine on the sanctity of life.

Learning about Teachers through Film.

ERIC Educational Resources Information Center

Raimo, Angela; Devlin-Scherer, Roberta; Zinicola, Debra

2002-01-01

Analysis of films featuring teachers reveals a variety of roles portrayed: teacher as culture guardian, iconoclast/subverter, alien culture-bearer, change agent, learner, compassionate mentor, student advocate, maverick, and incompetent. Examination of these portrayals can prompt critical thinking about teacher responses to different social and…

Modeling Compassion in Critical, Justice-Oriented Teacher Education

ERIC Educational Resources Information Center

Conklin, Hilary Gehlbach

2008-01-01

As the work of teacher education becomes increasingly focused on the challenges of helping mostly white, monolingual, middle-class prospective teachers become compassionate, successful teachers of racially, culturally, linguistically, economically, and academically diverse students, some teacher educators struggle to find compassion for the…

Beyond Interpersonal Competence: Teaching and Learning Professional Skills in Sustainability

ERIC Educational Resources Information Center

Brundiers, Katja; Wiek, Arnim

2017-01-01

Successful careers in sustainability are determined by positive real-world change towards sustainability. This success depends heavily on professional skills in effective and compassionate communication, collaborative teamwork, or impactful stakeholder engagement, among others. These professional skills extend beyond content knowledge and…

Developing compassion through a relationship centred appreciative leadership programme.

PubMed

Dewar, Belinda; Cook, Fiona

2014-09-01

Recent attention in health care focuses on how to develop effective leaders for the future. Effective leadership is embodied in relationships and should be developed in and with staff and patients. This paper describes development, implementation and evaluation of an appreciative and relationship centred leadership programme carried out with 86 nursing staff covering 24 in-patient areas within one acute NHS Board in Scotland. The aim of the programme was to support staff to work together to develop a culture of inquiry that would enhance delivery of compassionate care. The 12 month Leadership Programme used the principles of appreciative relationship centred leadership. Within this framework participants were supported to explore relationships with self, patients and families, and with teams and the wider organisation using caring conversations. Participants worked within communities of practice and action learning sets. They were supported to use a range of structured tools to learn about the experience of others and to identify caring practices that worked well and then explore ways in which these could happen more of the time. A range of methods were used to evaluate impact of the programme including a culture questionnaire and semi structured interviews. Immersion crystallisation technique and descriptive statistics were used to analyse the data. Key themes included; enhanced self-awareness, better relationships, greater ability to reflect on practice, different conversations in the workplace that were more compassionate and respectful, and an ethos of continuing learning and improvement. The programme supported participants to think in different ways and to be reflective and engaged participants rather than passive actors in shaping the cultural climate in which compassionate relationship centred care can flourish. Multidisciplinary programmes where the process and outcomes are explicitly linked to organisational objectives need to be considered in future programmes. Copyright © 2014 Elsevier Ltd. All rights reserved.

Celebrating Teachers.

ERIC Educational Resources Information Center

Upham, Dayle

This essay presents a list of 11 qualities that outstanding teachers possess, including: (1) flexibility (being able to change plans at a moment's notice and make adjustments accordingly); (2) enthusiasm and energy (showing a drive to excite students and model positive behavior); (3) empathy (acting understanding and compassionate of parents as…

The mindful nurse leader: Advancing executive nurse leadership skills through participation in action learning.

PubMed

FitzPatrick, Kate; Doucette, Jeffrey N; Cotton, Amy; Arnow, Debra; Pipe, Teri

2016-10-01

In this second installment of a three-part series on mindfulness, we describe the process of producing video vignettes to illustrate how clinical nurses draw on the power of mindfulness to build their own resiliency while delivering compassionate care.

A resolution designating February 14, 2013, as "National Solidarity Day for Compassionate Patient Care".

THOMAS, 113th Congress

Sen. Lautenberg, Frank R. [D-NJ

2013-01-30

Senate - 02/14/2013 Resolution agreed to in Senate with an amendment and with a preamble by Unanimous Consent. (All Actions) Tracker: This bill has the status Agreed to in SenateHere are the steps for Status of Legislation:

Wrong Turn on School Reform

ERIC Educational Resources Information Center

Hess, Frederick M.; Petrilli, Michael J.

2009-01-01

In the run-up to the 2000 presidential election, candidate George W. Bush and his advisors made a strategic decision to appropriate educational rhetoric generally associated with Democrats and the left. This decision helped Bush present himself as "different kind of Republican" and a "compassionate conservative" and to…

Humor-A Rehabilitative Tool in the Post-Intensive Care of Young Adults With Acquired Brain Injury.

PubMed

O'Reilly, Kate

The aim of the study was to describe how paid carers use humor in providing compassionate post-intensive rehabilitation care to young adults with acquired brain injury (ABI) who are unable to perform or direct their own care. This is a qualitative study underpinned by symbolic interactionism. Paid carers in a residential aged care facility were interviewed. Interview data were analyzed using grounded theory methods of coding, comparative analysis, memoing, and theoretical sampling. With young adult's assent, paid carers appropriately used humor, at times even crude humor, as a rehabilitative tool to activate and elicit responses from young people with ABI who could not perform or direct their own care. The use of humor while caring for this population demonstrated that compassion still exists within nursing; however, it may not always be reverent. Humor may be an effective way to provide compassionate care and can be used as a rehabilitative tool to elicit responses from young people with ABI who have no means of verbal communication.

Parent’s Perceptions of Health Care Providers Actions Around Child ICU Death: What Helped, What Did Not

PubMed Central

Brooten, Dorothy; Youngblut, JoAnne M.; Seagrave, Lynn; Caicedo, Carmen; Hawthorne, Dawn; Hidalgo, Ivette; Roche, Rosa

2012-01-01

Purpose To describe parents’ perspectives of health care provider actions that helped or did not around the time of infant/child’s intensive care unit (ICU) death. Semistructured interviews with 63 parents (Black, White, and Hispanic) 7 months post infant/child death were audio-recorded, transcribed, analyzed, and themes identified. Findings What helped most: compassionate, sensitive staff; understandable explanations of infant’s/child’s condition; experienced, competent nurses; providers did everything to help infant/child; and parents’ involvement in care decisions. What did not help: insensitive, nonsupportive staff; conflict between providers and parents; communication problems around the death; inexperienced nurses and doctors; parents not understanding child’s disease, care, complications. Conclusions Compassionate, sensitive staff and understandable explanations of children’s conditions were most helpful; insensitive, nonsupportive staff least helpful by gender, racial group, or care setting. Conflict between providers and parents was most problematic for minority parents and mothers. PMID:22531149

Are doctors who have been ill more compassionate? Attitudes of resident physicians regarding personal health issues and the expression of compassion in clinical care.

PubMed

Roberts, Laura Weiss; Warner, Teddy D; Moutier, Christine; Geppert, Cynthia M A; Green Hammond, Katherine A

2011-01-01

Compassion is an attribute central to professionalism and modern clinical care, yet little is known about how compassion is acquired and preserved in medical training. We sought to understand whether personal illness experiences are thought by residents to foster compassion. The authors surveyed 155 (71% response rate) second- and third-year residents at the University of New Mexico School of Medicine regarding their views of the relationship of personal life experience with illness to compassion and empathy for patients. Residents believe that experience with personal health issues enhances physician compassion for patients. Residents who report more personal health concerns, such as physical or mental health problems and family health problems, endorse the connection between direct experience with illness and empathy. Health care trainees' own illness experiences may increase compassionate patient care practices and foster empathy. Copyright © 2011 The Academy of Psychosomatic Medicine. Published by Elsevier Inc. All rights reserved.

The Business, Ethics, and Quality Cases for Consumer Engagement in Nursing.

PubMed

Hassmiller, Susan; Bilazarian, Ani

2018-04-01

The aims of this study were to illustrate the quality, safety, cost-effectiveness, and ethics of consumer engagement initiatives and identify promising practices and leadership strategies used by nursing leaders. A literature review was performed with supplementary interviews conducted with 25 key nursing informants including nursing executives and chief nursing officers at acute care hospitals, community health centers, policy institutions, and quality and safety organizations. A narrative synthesis approach was used to identify and compare existing measures of consumer engagement and compassionate care in acute care settings. One-hour semistructured interviews were performed, and information was gathered by notes and audio recordings. Consumer engagement activities focusing on compassionate patient and provider interactions involving patients and family as partners on the care team are associated with increases in treatment savings and patient safety in terms of length of stay and reduced medication errors. Engagement initiatives support employee health and reduce compassion fatigue. Findings illustrate the impact of patients and family engagement in decision making and promising organizational practices that reinforce engagement.

Emotional Labour and Wellbeing: What Protects Nurses?

PubMed Central

Kinman, Gail; Leggetter, Sandra

2016-01-01

Although compassionate care has wide-ranging benefits for patients, it can be emotionally demanding for healthcare staff. This may be a particular problem for those with little experience in a caring role. This study utilises the job demands-resources model to examine links between “emotional labour” and emotional exhaustion in student nurses. In line with the triple-match principle—whereby interactive effects are more likely when job demands, resources, and outcomes are within the same qualitative domain—the protective role of emotional support and emotion-focused coping (i.e., emotional venting) in the relationship between emotional labour and exhaustion is also explored. An online questionnaire was completed by 351 student nurses with experience working in healthcare settings. A strong positive relationship was found between emotional labour and emotional exhaustion, and some support was found for the moderating effects of emotional support and emotion-focused coping. Ways to help student and qualified nurses develop the emotional resilience required to protect their wellbeing, while providing high-quality compassionate care to patients are considered. PMID:27916880

Addressing Medical Errors in Hand Surgery

PubMed Central

Johnson, Shepard P.; Adkinson, Joshua M.; Chung, Kevin C.

2014-01-01

Influential think-tank such as the Institute of Medicine has raised awareness about the implications of medical errors. In response, organizations, medical societies, and institutions have initiated programs to decrease the incidence and effects of these errors. Surgeons deal with the direct implications of adverse events involving patients. In addition to managing the physical consequences, they are confronted with ethical and social issues when caring for a harmed patient. Although there is considerable effort to implement system-wide changes, there is little guidance for hand surgeons on how to address medical errors. Admitting an error is difficult, but a transparent environment where patients are notified of errors and offered consolation and compensation is essential to maintain trust. Further, equipping hand surgeons with a guide for addressing medical errors will promote compassionate patient interaction, help identify system failures, provide learning points for safety improvement, and demonstrate a commitment to ethically responsible medical care. PMID:25154576

Compassion fatigue and burnout: what managers should know.

PubMed

Slatten, Lise Anne; David Carson, Kerry; Carson, Paula Phillips

2011-01-01

Most health care employees experience and are bolstered by compassion satisfaction as they deal with patients in need. However, the more empathetic a health care provider is, the more likely he or she will experience compassion fatigue. Compassion fatigue is a negative syndrome that occurs when dealing with the traumatic experiences of patients, and examples of symptoms include intrusive thoughts, sleeping problems, and depression. Compassion fatigue is different from burnout. Compassion fatigue is a rapidly occurring disorder for primary health care workers who work with suffering patients, whereas burnout, a larger construct, is a slowly progressing disorder for employees who typically are working in burdensome organizational environments. Managers can mitigate problems associated with compassion fatigue with a number of interventions including patient reassignments, formal mentoring programs, employee training, and a compassionate organizational culture. With burnout, health care managers will want to focus primarily on chronic organizational problems.

Culturally Considerate School Counseling: Helping without Bias

ERIC Educational Resources Information Center

Anderson, Kim L.

2010-01-01

The author brings her counseling expertise, personal experience, and compassionate perspective to this practical resource that cultivates "cultural competence"--essential for work with diverse populations. Expanding the definition of culture, this book addresses how biases have evolved in new and challenging ways, and provides strategies to help…

The concept of compassion within uk media generated discourse: A corpus informed analysis.

PubMed

Bond, Carmel; Stacey, Gemma; Field-Richards, Sarah; Callaghan, Patrick; Keeley, Philip; Lymn, Joanne; Redsell, Sarah; Spiby, Helen

2018-04-27

To examine how the concept of compassion is socially constructed within UK discourse, in response to recommendations that aspiring nurses gain care experience prior to entering nurse education. Following a report of significant failings in care, the UK government proposed prior care experience for aspiring nurses as a strategy to enhance compassion amongst the profession. Media reporting of this generated substantial online discussion, which formed the data for this research. There is a need to define how compassion is constructed through language as a limited understanding exists, of what compassion means in healthcare. This is important, for any meaningful evaluation of quality, compassionate practices. A corpus-informed discourse analysis. A 62626-word corpus of data was analysed using Laurence Anthony software 'AntCon', a free corpus analysis toolkit. Frequent words were retrieved and used as a focal point for further analysis. Concordance lines were computed and analysed in the context of which frequent word-types occurred. Patterns of language were revealed and interpreted through researcher immersion. Findings identified that compassion was frequently described in various ways as a natural characteristic attribute. A pattern of language also referred to compassion as something that was not able to be taught, but could be developed through the repetition of behaviours observed in practice learning. In the context of compassion, the word-type 'nurse' was used positively. This paper adds to important debates highlighting how compassion is constructed and defined in the context of nursing. Compassion is constructed as both an individual, personal trait and a professional behaviour to be learnt. Educational design could include effective interpersonal skills training, which may help enhance and develop compassion from within the nursing profession. Likewise, ways of thinking, behaving and communicating should also be addressed by established practitioners in order to maintain compassionate interactions between professionals as well as nurse-patient relationships. Future research should focus on how compassionate practice is defined by both health professionals and patients. In order to maintain nursing as an attractive profession to join, it is important that nurses are viewed as compassionate. This holds implications for professional morale, associated with the continued retention and recruitment of the future workforce. Existing ideologies within the practice placement, the prior care experience environment, as well as the educational and organisational design are crucial factors to consider, in terms of their influences on the expression of compassion in practice. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Ethical, legal and societal considerations on Zika virus epidemics complications in scaling-up prevention and control strategies.

PubMed

Tambo, Ernest; Madjou, Ghislaine; Khayeka-Wandabwa, Christopher; Olalubi, Oluwasogo A; Chengho, Chryseis F; Khater, Emad I M

2017-08-25

Much of the fear and uncertainty around Zika epidemics stem from potential association between Zika virus (ZIKV) complications on infected pregnant women and risk of their babies being born with microcephaly and other neurological abnormalities. However, much remains unknown about its mode of transmission, diagnosis and long-term pathogenesis. Worries of these unknowns necessitate the need for effective and efficient psychosocial programs and medical-legal strategies to alleviate and mitigate ZIKV related burdens. In this light, local and global efforts in maintaining fundamental health principles of moral, medical and legal decision-making policies, and interventions to preserve and promote individual and collectiveHuman Rights, autonomy, protection of the most vulnerable, equity, dignity, integrity and beneficence that should not be confused and relegated by compassionate humanitarian assistance and support. This paper explores the potential medical and ethical-legal implications of ZIKV epidemics emergency response packages and strategies alongside optimizing reproductive and mental health policies, programs and best practice measures. Further long-term cross-borders operational research is required in elucidating Zika-related population-based epidemiology, ethical-medical and societal implications in guiding evidence-based local and global ZIKV maternal-child health complications related approaches and interventions. Core programs and interventions including future Zika safe and effective vaccines for global Zika immunization program in most vulnerable and affected countries and worldwide should be prioritized.

Ring vaccination with rVSV-ZEBOV under expanded access in response to an outbreak of Ebola virus disease in Guinea, 2016: an operational and vaccine safety report.

PubMed

Gsell, Pierre-Stéphane; Camacho, Anton; Kucharski, Adam J; Watson, Conall H; Bagayoko, Aminata; Nadlaou, Séverine Danmadji; Dean, Natalie E; Diallo, Abdourahamane; Diallo, Abdourahmane; Honora, Djidonou A; Doumbia, Moussa; Enwere, Godwin; Higgs, Elizabeth S; Mauget, Thomas; Mory, Diakite; Riveros, Ximena; Oumar, Fofana Thierno; Fallah, Mosoka; Toure, Alhassane; Vicari, Andrea S; Longini, Ira M; Edmunds, W J; Henao-Restrepo, Ana Maria; Kieny, Marie Paule; Kéïta, Sakoba

2017-12-01

In March, 2016, a flare-up of Ebola virus disease was reported in Guinea, and in response ring vaccination with the unlicensed rVSV-ZEBOV vaccine was introduced under expanded access, the first time that an Ebola vaccine has been used in an outbreak setting outside a clinical trial. Here we describe the safety of rVSV-ZEBOV candidate vaccine and operational feasibility of ring vaccination as a reactive strategy in a resource-limited rural setting. Approval for expanded access and compassionate use was rapidly sought and obtained from relevant authorities. Vaccination teams and frozen vaccine were flown to the outbreak settings. Rings of contacts and contacts of contacts were defined and eligible individuals, who had given informed consent, were vaccinated and followed up for 21 days under good clinical practice conditions. Between March 17 and April 21, 2016, 1510 individuals were vaccinated in four rings in Guinea, including 303 individuals aged between 6 years and 17 years and 307 front-line workers. It took 10 days to vaccinate the first participant following the confirmation of the first case of Ebola virus disease. No secondary cases of Ebola virus disease occurred among the vaccinees. Adverse events following vaccination were reported in 47 (17%) 6-17 year olds (all mild) and 412 (36%) adults (individuals older than 18 years; 98% were mild). Children reported fewer arthralgia events than adults (one [<1%] of 303 children vs 81 [7%] of 1207 adults). No severe vaccine-related adverse events were reported. The results show that a ring vaccination strategy can be rapidly and safely implemented at scale in response to Ebola virus disease outbreaks in rural settings. WHO, Gavi, and the World Food Programme. Copyright © 2017 The Author(s). Published by Elsevier Ltd. This is an open access article under the CC BY 4.0 license. Published by Elsevier Ltd.. All rights reserved.

Trifluridine/Tipiracil (TAS-102) in Refractory Metastatic Colorectal Cancer: A Multicenter Register in the Frame of the Italian Compassionate Use Program.

PubMed

Cremolini, Chiara; Rossini, Daniele; Martinelli, Erika; Pietrantonio, Filippo; Lonardi, Sara; Noventa, Silvia; Tamburini, Emiliano; Frassineti, Giovanni Luca; Mosconi, Stefania; Nichetti, Federico; Murgioni, Sabina; Troiani, Teresa; Borelli, Beatrice; Zucchelli, Gemma; Dal Maso, Alessandro; Sforza, Vincenzo; Masi, Gianluca; Antoniotti, Carlotta; Di Bartolomeo, Maria; Miceli, Rosalba; Ciardiello, Fortunato; Falcone, Alfredo

2018-05-08

TAS-102 is indicated for patients with metastatic colorectal cancer (mCRC) previously treated with, or not considered candidates for, available therapies. Given the complete inefficacy in half of patients, the lack of predictive factors, the palliative setting, and the financial and clinical toxicity, optimizing the cost-benefit ratio is crucial. The "ColonLife" nomogram allows an estimate of the 12-week life expectancy of patients with refractory mCRC. We collected data from patients treated at eight Italian centers in the compassionate use program. Baseline characteristics of patients who were or were not progression free at 6 months were compared. The discriminative ability of the ColonLife nomogram was assessed. Among patients who received both TAS-102 and regorafenib, clinical outcomes of the two sequences were compared. This study included 341 patients. Six (2%) and 93 (27%) patients achieved response and disease stabilization, respectively. The median progression-free survival (PFS) was 2.4 months with an estimated 6-month PFS rate of 19%; the median overall survival (OS) was 6.2 months. An Eastern Cooperative Oncology Group performance status (ECOG PS) of 0, normal lactate dehydrogenase (LDH), and a time from the diagnosis of metastatic disease of >18 months were independently associated with higher chances of a patient being progression free at 6 months. The discriminative ability of ColonLife was confirmed. Among 121 patients who received both regorafenib and TAS-102, no differences in first or second PFS or OS were reported between the two sequences. One out of five patients achieves clinical benefit with TAS-102. ECOG PS, LDH, and time from diagnosis of metastatic disease may help to identify these patients. Excluding patients with very short life expectancy appears a reasonable approach. Improving the cost-efficacy ratio of TAS-102 in metastatic colorectal cancer is needed to spare useless toxicities in a definitely palliative setting. Eastern Cooperative Oncology Group performance status, lactate dehydrogenase levels, and time from the diagnosis of metastatic disease may help to identify patients more likely to achieve benefit. Properly designed prognostic tools (i.e., the "ColonLife" nomogram) may enable excluding from further treatments patients with very limited life expectancy. © AlphaMed Press 2018.

Patient Perspectives on the Experience of Being Newly Diagnosed with HIV in the Emergency Department/Urgent Care Clinic of a Public Hospital

PubMed Central

Christopoulos, Katerina A.; Massey, Amina D.; Lopez, Andrea M.; Hare, C. Bradley; Johnson, Mallory O.; Pilcher, Christopher D.; Fielding, Hegla; Dawson-Rose, Carol

2013-01-01

We sought to understand patient perceptions of the emergency department/urgent care (ED/UC) HIV diagnosis experience as well as factors that may promote or discourage linkage to HIV care. We conducted in-depth interviews with patients (n=24) whose HIV infection was diagnosed in the ED/UC of a public hospital in San Francisco at least six months prior and who linked to HIV care at the hospital HIV clinic. Key diagnosis experience themes included physical discomfort and limited functionality, presence of comorbid diagnoses, a wide spectrum of HIV risk perception, and feelings of isolation and anxiety. Patients diagnosed with HIV in the ED/UC may not have their desired emotional supports with them, either because they are alone or they are with family members or friends to whom they do not want to immediately disclose. Other patients may have no one they can rely on for immediate support. Nearly all participants described compassionate disclosure of test results by ED/UC providers, although several noted logistical issues that complicated the disclosure experience. Key linkage to care themes included the importance of continuity between the testing site and HIV care, hospital admission as an opportunity for support and HIV education, and thoughtful matching by linkage staff to a primary care provider. ED/UC clinicians and testing programs should be sensitive to the unique roles of sickness, risk perception, and isolation in the ED/UC diagnosis experience, as these things may delay acceptance of HIV diagnosis. The disclosure and linkage to care experience is crucial in forming patient attitudes towards HIV and HIV care, thus staff involved in disclosure and linkage activities should be trained to deliver compassionate, informed, and thoughtful care that bridges HIV testing and treatment sites. PMID:23991214

Compassionate Use of Triheptanoin (C7) for Inherited Disorders of Energy Metabolism

ClinicalTrials.gov

2018-05-02

Very Long-chain acylCoA Dehydrogenase (VLCAD) Deficiency; Carnitine Palmitoyltransferase Deficiencies (CPT1, CPT2); Mitochondrial Trifunctional Protein Deficiency; Long-chain Hydroxyacyl-CoA Dehydrogenase Deficiency; Glycogen Storage Disorders; Pyruvate Carboxylase Deficiency Disease; ACYL-CoA DEHYDROGENASE FAMILY, MEMBER 9, DEFICIENCY of; Barth Syndrome

Chemical Dependency, Denial, and the Academic Lifestyle.

ERIC Educational Resources Information Center

Donovan, Bruce E.

1990-01-01

The effects of problems with alcohol and other drugs are sometimes subtle, sometimes extravagant, and always debilitating. The tendency for individuals to deny their own problems makes the need for firm and compassionate colleagues more important. Intervention is a way of bringing sympathetic help to a colleague in distress. (MLW)

Issues in organ procurement, allocation, and transplantation.

PubMed

Nierste, Deborah

2013-01-01

Organ transplantation extends lives and improves health but presents complex ethical dilemmas for nurses caring for donors, recipients, and their families. This article overviews organ procurement and allocation, discusses ethical dilemmas in transplantation, and offers strategies from professional and biblical perspectives for coping with moral distress and maintaining compassionate care.

Design and Implementation of a Caring Curriculum in Nursing Education

ERIC Educational Resources Information Center

Ramirez, Becky

2009-01-01

Although the nursing profession has traditionally been associated with compassionate, patient, and caring behaviors, living in this advanced technological environment where patient related skills and tasks are often rushed caring behaviors are sometimes not seen. In order to improve high school nursing assistant student caring behaviors as well…

The Straight Path to Healing: Using Motivational Interviewing to Address Spiritual Bypass

ERIC Educational Resources Information Center

Clarke, Philip B.; Giordano, Amanda L.; Cashwell, Craig S.; Lewis, Todd F.

2013-01-01

Spiritual bypass is the avoidance of underlying emotional issues by focusing solely on spiritual beliefs, practices, and experiences. Motivational interviewing (MI) is a client-centered, compassionate approach to effectively addressing resistance among those who present with spiritual bypass. In this article, the authors provide background…

Critical Compassionate Pedagogy and the Teacher's Role in First-Generation Student Success

ERIC Educational Resources Information Center

Hao, Richie Neil

2011-01-01

Informed by Rosenberg's (2003) concept of nonviolent communication, the author's pedagogical perspective encourages educators to criticize institutional and classroom practices that ideologically place underserved students at disadvantaged positions. At the same time, this perspective urges teachers to be self-reflective of their actions through…

From Compassionate Ageism to Intergenerational Conflict?

ERIC Educational Resources Information Center

Binstock, Robert H.

2010-01-01

During the 50 years in which "The Gerontologist" has been publishing, the politics of aging in the United States has undergone distinct changes. The political behavior of older individuals has remained largely the same even though different birth cohorts have succeeded each other in populating the ranks of older people. But the politics…

Building Basic Therapeutic Skills: A Practical Guide for Current Mental Health Practice.

ERIC Educational Resources Information Center

Heaton, Jeanne Albronda

Each therapeutic contact provides unique opportunities to ameliorate suffering and cultivate change. This volume addresses the inherent struggle in therapy to create a therapeutic relationship and make the work compassionate, efficient, and effective. It provides assistance to students, supervisors, and educators in doing therapeutic work while…

Commentary: Latina Literacies in "Convivencia": Communal Spaces of Teaching and Learning

ERIC Educational Resources Information Center

Villenas, Sofia A.

2005-01-01

Inspired by Delgado-Gaitan's work with Latina mothers' stories of transformation, this commentary engages scholarship on the communal "mujer-" or womanist-oriented spaces of teaching and learning. The author explores themes of "convivencia" (communalism) centered on faith, spirituality, and humor central to creating compassionate spaces of…

78 FR 73083 - Compassionate Release

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-05

... district in which the inmate was sentenced; and the final decision is subject to the general supervision... rule making a technical change to the regulations on February 28, 2013 (78 FR 13478). We now withdraw... the inmate was sentenced; and (2) clarifying that the final decision is subject to the general...

Mentorship in Higher Education: Compassionate Approaches Supporting Culturally Responsive Pedagogy

ERIC Educational Resources Information Center

Lucey, Thomas A.; White, Elizabeth S.

2017-01-01

The development of culturally responsive teachers who value their students for their own stories and backgrounds represents a critical pursuit. Unfortunately, new teachers report feeling unprepared for racial and ethnic diversity in the classroom and find that coursework addressing these issues provides little help in classroom practice (Castro,…

The Call to Meaning through Service and Guardianship

ERIC Educational Resources Information Center

Gatto-Walden, Patricia

2012-01-01

Many intellectually gifted children have equally compassionately gifted hearts. They care deeply about the well-being of others around them and throughout the world. These caring children innately live the guiding principle of brotherhood and interdependence among all life. They worry for themselves, and they worry for others. Some days they…

In the Flow of Media, Religion, and Culture: A Case Study with TVbyGIRLS

ERIC Educational Resources Information Center

Bischoff, Claire; Bullen, Rebecca Richards; Nemer, Molly; Quednau, Rachel

2011-01-01

This article introduces TVbyGIRLS, a nonprofit organization supporting girls in the development of critical thinking, digital literacy and storytelling, leadership, compassionate collaboration, and social justice engagement. Religious educator Claire Bischoff interviews Rebecca Richards Bullen, TVbyGIRLS mentor, and Molly Nemer and Rachel Quednau,…

The International Ethics Conference: An Eye Opener

ERIC Educational Resources Information Center

Phuma, Ellemes

2010-01-01

In this text, Ellemes Phuma, shares her experience and the benefits she derived from the International Ethics Conference held at the University of Botswana (UB). As a graduate student in nursing at that university, she provides her perspective on professional responsibility, compassionate healthcare, and the ethical role that healthcare…

Business models and opportunities for cancer vaccine developers.

PubMed

Kudrin, Alex

2012-10-01

Despite of growing oncology pipeline, cancer vaccines contribute only to a minor share of total oncology-attributed revenues. This is mainly because of a limited number of approved products and limited sales from products approved under compassionate or via early access entry in smaller and less developed markets. However revenue contribution from these products is extremely limited and it remains to be established whether developers are breaking even or achieving profitability with existing sales. Cancer vaccine field is well recognized for high development costs and risks, low historical rates of investment return and high probability of failures arising in ventures, partnerships and alliances. The cost of reimbursement for new oncology agents is not universally acceptable to payers limiting the potential for a global expansion, market access and reducing probability of commercial success. In addition, the innovation in cancer immunotherapy is currently focused in small and mid-size biotech companies and academic institutions struggling for investment. Existing R&D innovation models are deemed unsustainable in current "value-for-money" oriented healthcare environment. New business models should be much more open to collaborative, networked and federated styles, which could help to outreach global, markets and increase cost-efficiencies across an entire value chain. Lessons learned from some developing countries and especially from South Korea illustrate that further growth of cancer vaccine industry will depends not only on new business models but also will heavily rely on regional support and initiatives from different bodies, such as governments, payers and regulatory bodies.

Business models and opportunities for cancer vaccine developers

PubMed Central

Kudrin, Alex

2012-01-01

Despite of growing oncology pipeline, cancer vaccines contribute only to a minor share of total oncology-attributed revenues. This is mainly because of a limited number of approved products and limited sales from products approved under compassionate or via early access entry in smaller and less developed markets. However revenue contribution from these products is extremely limited and it remains to be established whether developers are breaking even or achieving profitability with existing sales. Cancer vaccine field is well recognized for high development costs and risks, low historical rates of investment return and high probability of failures arising in ventures, partnerships and alliances. The cost of reimbursement for new oncology agents is not universally acceptable to payers limiting the potential for a global expansion, market access and reducing probability of commercial success. In addition, the innovation in cancer immunotherapy is currently focused in small and mid-size biotech companies and academic institutions struggling for investment. Existing R&D innovation models are deemed unsustainable in current “value-for-money” oriented healthcare environment. New business models should be much more open to collaborative, networked and federated styles, which could help to outreach global, markets and increase cost-efficiencies across an entire value chain. Lessons learned from some developing countries and especially from South Korea illustrate that further growth of cancer vaccine industry will depends not only on new business models but also will heavily rely on regional support and initiatives from different bodies, such as governments, payers and regulatory bodies. PMID:22894953

42 CFR 130.50 - Limitation on agent and attorney fees.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 1 2010-10-01 2010-10-01 false Limitation on agent and attorney fees. 130.50 Section 130.50 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES COMPASSIONATE... individual may not receive, for services rendered in connection with the petition of an individual under this...

42 CFR 130.50 - Limitation on agent and attorney fees.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 1 2011-10-01 2011-10-01 false Limitation on agent and attorney fees. 130.50 Section 130.50 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES COMPASSIONATE... individual may not receive, for services rendered in connection with the petition of an individual under this...

Wounded Leader: An Archetypal Embodiment of Compassionate Transcendent Leadership

ERIC Educational Resources Information Center

Mears, Kathryn

2009-01-01

The purpose of this study was to seek to further the formation of the emerging transcendent leadership model by exploring the archetypal image identified as wounded leader. The wounded leader archetype is introduced as a leadership style of influence that fits well within the framework of the transcendent leadership model. This study…

32 CFR 536.138 - Claims not payable under the Foreign Claims Act.

Code of Federal Regulations, 2011 CFR

2011-07-01

... solely on compassionate grounds; (e) Is a bastardy claim for child support expenses; (f) Is for any item... Department of Defense (DOD) directives, such as illegal war trophies. (g) Is for rent, damage, or other... damage, or personal injury or death caused by inhabitants of unfriendly foreign countries or by...

32 CFR 536.138 - Claims not payable under the Foreign Claims Act.

Code of Federal Regulations, 2010 CFR

2010-07-01

... solely on compassionate grounds; (e) Is a bastardy claim for child support expenses; (f) Is for any item... Department of Defense (DOD) directives, such as illegal war trophies. (g) Is for rent, damage, or other... damage, or personal injury or death caused by inhabitants of unfriendly foreign countries or by...

32 CFR 536.138 - Claims not payable under the Foreign Claims Act.

Code of Federal Regulations, 2014 CFR

2014-07-01

... solely on compassionate grounds; (e) Is a bastardy claim for child support expenses; (f) Is for any item... Department of Defense (DOD) directives, such as illegal war trophies. (g) Is for rent, damage, or other... damage, or personal injury or death caused by inhabitants of unfriendly foreign countries or by...

32 CFR 536.138 - Claims not payable under the Foreign Claims Act.

Code of Federal Regulations, 2013 CFR

2013-07-01

... solely on compassionate grounds; (e) Is a bastardy claim for child support expenses; (f) Is for any item... Department of Defense (DOD) directives, such as illegal war trophies. (g) Is for rent, damage, or other... damage, or personal injury or death caused by inhabitants of unfriendly foreign countries or by...

32 CFR 536.138 - Claims not payable under the Foreign Claims Act.

Code of Federal Regulations, 2012 CFR

2012-07-01

... solely on compassionate grounds; (e) Is a bastardy claim for child support expenses; (f) Is for any item... Department of Defense (DOD) directives, such as illegal war trophies. (g) Is for rent, damage, or other... damage, or personal injury or death caused by inhabitants of unfriendly foreign countries or by...

Ready to Make Nice: Parental Socialization of Young Sons' and Daughters' Prosocial Behaviors with Peers

ERIC Educational Resources Information Center

Hastings, Paul D.; McShane, Kelly E.; Parker, Richard; Ladha, Farriola

2007-01-01

In this study, the authors examined the extent to which maternal and paternal parenting styles, cognitions, and behaviors were associated with young girls' and boys' more compassionate (prototypically feminine) and more agentic (prototypically masculine) prosocial behaviors with peers. Parents of 133 preschool-aged children reported on their…

Ethics at the End of Life: A Teaching Tool

ERIC Educational Resources Information Center

Wallace, Cara L.; Thielman, Kara J.; Cimino, Andrea N.; Rueda, Heidi L. Adams

2017-01-01

Social workers rarely receive education and training in the areas of grief, bereavement, and death and dying, which may lead to difficulties in compassionately and ethically addressing concerns in end-of-life or grief-related contexts. This article presents actual and potential outcomes from three challenging end-of-life case studies using…

Stepping through the Daylight Gate: Compassionate Spaces for Learning in Higher Education

ERIC Educational Resources Information Center

Haynes, Joanna; Macleod-Johnstone, Emma

2017-01-01

This paper is concerned with troubling emotions felt or aroused in all aspects of academic practice, including teaching, learning, research and relationships. It discusses the emergent processes of a research group whose multidisciplinary interests coalesce around discomfort, disturbance and difficulty in the processes of higher education. We talk…

The Development of Compassionate and Caring Leadership among Adolescents

ERIC Educational Resources Information Center

Martinek, Tom; Schilling, Tammy; Hellison, Don

2006-01-01

Background: Fostering the innate need to lead, teach and care for others is fundamental to creating a just and moral society. The nurturing begins early in life and becomes especially vital during the adolescent years, when peer pressure and the need to belong are heightened. Unfortunately, many youths believe leadership is associated with being…

Diverse Voices: Middle Years Students' Insights into Life in Inclusive Classrooms

ERIC Educational Resources Information Center

Katz, Jennifer; Porath, Marion; Bendu, Charles; Epp, Brent

2012-01-01

Thirty-one middle school students (grades 4-7) were interviewed at length about their perspectives regarding academic and social inclusion of students with disabilities; the barriers they perceive to a compassionate, inclusive learning community; and what they believe helps overcome these barriers. In discussing the inclusion of students with…

Beyond Vulnerability: How the Dual Role of Patient-Health Care Provider Can Inform Health Professions Education

ERIC Educational Resources Information Center

Rowland, Paula; Kuper, Ayelet

2018-01-01

In order to prepare fully competent health care professionals, health professions education must be concerned with the relational space between patients and providers. Compassion and compassionate care are fundamental elements of this relational space. Traditionally, health professions educators and leaders have gone to two narrative sources when…

Family Physician Support for a Family With a Mentally Ill Member.

PubMed

McBride, J LeBron

2016-09-01

Mentally ill family members can have a formidable impact on the families in which they reside. Family physicians can intervene in powerful ways when they are sensitive to those who are mentally ill and their families and can provide much needed compassionate support. © 2016 Annals of Family Medicine, Inc.

Key Works on Teacher Response: An Anthology

ERIC Educational Resources Information Center

Straub, Richard, Ed.; Lunsford, Ronald, Ed.

2006-01-01

There is a special three-way balance in responding to student writing: one must be compassionate, have a vision for improvement, and be capable of confronting and cajoling students to help them maximize the possibilities of revision. This book presents some of the best examples of how writing teachers approach the delicate equilibrium of student…

Construction of Critically Transformative Education in the Tucson Unified School District

ERIC Educational Resources Information Center

Romero, Augustine F.; Sánchez, H. T.

2014-01-01

A critically transformative education continues to be at the center of Tucson Unified School District's (TUSD) equity and academic excellence mission. Through the use of the Social Transformation paradigm and the lesson learned from the implementation of the Critically Compassionate Intellectualism Model, TUSD once again created a cutting edge…

Fromm's Humanism and Child Poverty: Neoliberal Construction of the "Have-Not"

ERIC Educational Resources Information Center

Tulloch, Lynley

2015-01-01

Children are particularly vulnerable to structured inequalities in society. Building on the work of Erich Fromm (1900-1980), this article contends that modern (post)industrial capitalism corrupts the human capacity to operate in the "being mode"--that is, in altruistic and compassionate ways. Rather, within the individualistic logic of…

Contemporary Public Policy Influencing Children and Families: "Compassionate" Social Provision or the Regulation of "Others"?

ERIC Educational Resources Information Center

Cannella, Gaile S.; Swadener, Beth Blue

2006-01-01

Critical analysis of change in public policy within and across nations recognizes that the education and welfare of children, families, and all citizens is intertwined with economics, politics, and cultural discourse(s). In the United States, increasingly narrow media, judiciary, and academic discourses have supported legislative actions that…

Persuasion Detection in Conversation

DTIC Science & Technology

2010-03-01

From the Combating Terrorism Center at West Point, n.d...martyrdom contract provided by the Combating Terrorism Center at West Point (www.ctc.usma.edu). 13 Figure 1. Suicide Bomber Contract (From the...Combating Terrorism Center at West Point, n.d.) The translation of the document is as follows: In the Name of God the Most Compassionate and Merciful

A daily diary study of self-compassion, body image, and eating behavior in female college students.

PubMed

Kelly, Allison C; Stephen, Elizabeth

2016-06-01

Although self-compassion is associated with healthier body image and eating behavior, these findings have generally emerged at the between-persons level only. The present study investigated the unique contributions of within-person variability in self-compassion, and between-persons differences in self-compassion, to body image and eating behavior. Over seven days, 92 female college students completed nightly measures of self-compassion, self-esteem, dietary restraint, intuitive eating, body appreciation, body satisfaction, and state body image. Multilevel modeling revealed that within-persons, day-to-day fluctuations in self-compassion contributed to day-to-day fluctuations in body image and eating. Between-persons, participants' average levels of self-compassion across days contributed to their average levels of body image and eating over the week. Results generally held when controlling for within- and between-persons self-esteem. Evidently, the eating and body image benefits of self-compassion may come not only from being a generally self-compassionate person, but also from treating oneself more self-compassionately than usual on a given day. Copyright © 2016 Elsevier Ltd. All rights reserved.

The Business, Ethics, and Quality Cases for Consumer Engagement in Nursing

PubMed Central

Hassmiller, Susan; Bilazarian, Ani

2018-01-01

OBJECTIVE The aims of this study were to illustrate the quality, safety, cost-effectiveness, and ethics of consumer engagement initiatives and identify promising practices and leadership strategies used by nursing leaders. METHODS A literature review was performed with supplementary interviews conducted with 25 key nursing informants including nursing executives and chief nursing officers at acute care hospitals, community health centers, policy institutions, and quality and safety organizations. A narrative synthesis approach was used to identify and compare existing measures of consumer engagement and compassionate care in acute care settings. One-hour semistructured interviews were performed, and information was gathered by notes and audio recordings. RESULTS Consumer engagement activities focusing on compassionate patient and provider interactions involving patients and family as partners on the care team are associated with increases in treatment savings and patient safety in terms of length of stay and reduced medication errors. Engagement initiatives support employee health and reduce compassion fatigue. CONCLUSION Findings illustrate the impact of patients and family engagement in decision making and promising organizational practices that reinforce engagement. PMID:29470381

Grief and Solidarity Reactions 1 Week After an On-Campus Shooting.

PubMed

Wayment, Heidi A; Silver, Roxane Cohen

2018-03-01

The impact of interpersonal violence extends beyond the victims and perpetrator(s). The purpose of this research was threefold: (a) to identify whether college students' very early reactions to an on-campus shooting were associated with well-known predictors of distress, (b) to examine whether grief and distress reactions were distinguishable in the early days following a shooting, and (c) to investigate whether a compassionate self-identity was uniquely associated with grief but not distress. Beginning just 3 days after an early morning shooting that killed one student and injured three others, university students ( N = 408) completed an online questionnaire. Grief, but not distress, was associated with a sense of solidarity with other students and a compassionate self-identity. General distress was associated with prior mental health difficulties and exposure to the shooting. Acute stress was positively associated with being female, having prior mental health difficulties, media exposure, perceived similarity to victims, less victim blame, social support, and social strain. Results suggest that grief reactions that arise in the early days following a collective loss may serve as important psychosocial resources in coping with interpersonal violence.

A qualitative cancer screening study with childhood sexual abuse survivors: experiences, perspectives and compassionate care.

PubMed

Gesink, Dionne; Nattel, Lilian

2015-08-05

The childhood sexual abuse (CSA) survivor population is substantial and survivors have been identified as part of the population who were under-screened or never-screened for breast, cervical and colon cancer. Our objective was to learn CSA survivor perspectives on, and experiences with, breast, cervical and colon cancer screening with the intention of generating recommendations to help healthcare providers improve cancer screening participation. A pragmatic constructivist qualitative study involving individual, semistructured, in-depth interviews was conducted in January 2014. Thematic analysis was used to describe CSA survivor perspectives on cancer screening and identify potential facilitators for screening. A diverse purposive sample of adult female CSA survivors was recruited. The inclusion criteria were: being a CSA survivor, being in a stable living situation, where stable meant able to meet one's financial needs independently, able to maintain supportive relationships, having participated in therapy to recover from past abuse, and living in a safe environment. 12 survivors were interviewed whose ages ranged from the early 40s to mid-70s. Descriptive saturation was reached after 10 interviews. Interviews were conducted over the phone or Internet. CSA survivors were primarily from urban and rural Ontario, but some resided elsewhere in Canada and the USA. The core concept that emerged was that compassionate care at every level of the healthcare experience could improve cancer screening participation. Main themes included: desire for holistic care; unique needs of patients with dissociative identity disorder; the patient-healthcare provider relationship; appointment interactions; the cancer screening environment; and provider assumptions about patients. Compassionate care can be delivered by: building a relationship; practising respect; focusing attention on the patient; not rushing the appointment; keeping the environment positive and comfortable; maintaining patient dignity; sharing control whenever possible; explaining procedures; and using laughter to reduce power imbalance through shared humanity. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Measuring health care workers' perceptions of what constitutes a compassionate organisation culture and working environment: Findings from a quantitative feasibility survey.

PubMed

McSherry, Robert; Pearce, Paddy

2018-03-01

Health care organisation cultures and working environments are highly complex, dynamic and constantly evolving settings. They significantly influence both the delivery and outcomes of care. Phase 1 quantitative findings are presented from a larger three phase feasibility study designed to develop and test a Cultural Health Check toolkit to support health care workers, patients and organisations in the provision of safe, compassionate and dignified care. A mixed methods approach was applied. The Cultural Health Check Healthcare Workers Questionnaire was distributed across two National Health Service Hospitals in England, UK. Both hospitals allocated two wards comprising of older people and surgical specialities. The newly devised Cultural Health Check Staff Rating Scale Version 1 questionnaire was distributed to 223 health care workers. Ninety eight responses were returned giving a response rate of 44%. The Cultural Health Check Staff Rating Scale Version 1 has a significant Cronbach alpha of .775; this reliability scaling is reflected in all 16 items in the scale. Exploratory factor analysis identified two significant factors "Professional Practice and Support" and "Workforce and Service Delivery." These factors according to health care workers significantly impact on the organisation culture and quality of care delivered by staff. The Cultural Health Check Staff Rating Scale Version 1 questionnaire is a newly validated measurement tool that could be used and applied to gauge health care workers perceptions of an organisations level of compassion. Historically we have focused on identifying how caring and compassionate nurses, doctors and related allied health professionals are. This turns the attention on employers of nurses and other related organisations. The questionnaire can be used to gauge the level of compassion with a health care organisation culture and working environment. Nurse managers and leaders should focus attention regarding how these two factors are supported and resourced in the future. © 2017 John Wiley & Sons Ltd.

77 FR 6113 - Video Programming and Accessibility Advisory Committee; Announcement of Date of Next Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-07

... FEDERAL COMMUNICATIONS COMMISSION [DA 12-15] Video Programming and Accessibility Advisory.... SUMMARY: This document announces the next meeting of the Video Programming Accessibility Advisory... Commission regarding the provision of video description, access to emergency programming, and access to user...

The Society for Clinical Trials opposes US legislation to permit marketing of unproven medical therapies for seriously ill patients.

PubMed

2006-01-01

The proposed Bill S.1956 is a bad law. Wide early access to minimally tested treatments cannot be expected to lead to better or more compassionate care of the seriously ill patient. The long history of medicine is replete with treatments that initially seemed promising to patients, doctors, and especially to their own inventors, but which careful study revealed to be worthless or harmful. We understand the desperate plight of these patients and the importance of hope for them and their families. However, although the proposed law is portrayed as an effort to help patients in desperate need of treatment, in fact its effect would be to undermine the system of scientifically valid testing of new drugs that has been a bulwark of health care for several decades. The effect of the law would be to provide many more possible choices of treatment but much less information upon which to make the choice. Patients would be very unlikely to end up receiving an effective treatment. They would be much more likely to receive useless or possibly harmful treatments in the last days of their lives. The Society for Clinical Trials strongly opposes this legislation.

[Shift of focus in the financing of Hungarian drugs. Reimbursement for orphan drugs for treating rare diseases: financing of enzyme replacement therapy in Hungary].

PubMed

Szegedi, Márta; Molnár, Mária Judit; Boncz, Imre; Kosztolányi, György

2014-11-02

Focusing on the benefits of patients with rare disease the authors analysed the aspects of orphan medicines financed in the frame of the Hungarian social insurance system in 2012 in order to make the consumption more rational, transparent and predictable. Most of the orphan drugs were financed in the frame of compassionate use by the reimbursement system. Consequently, a great deal of crucial problems occurred in relation to the unconventional subsidized method, especially in the case of the highest cost enzyme replacement therapies. On the base of the findings, proposals of the authors are presented for access to orphan drugs, fitting to the specific professional, economical and ethical aspects of this unique field of the health care system. The primary goal is to provide a suitable subsidized method for the treatment of rare disease patients with unmet medical needs. The financial modification of orphans became indispensible in Hungary. Professionals from numerous fields dealing with rare disease patients' care expressed agreement on the issue. Transforming the orphan medicines' financial structure has been initiated according to internationally shared principles.

"Let me tell you about being a nurse".

PubMed

Thieman, LeAnn

2009-08-01

With the nursing shortage at crisis proportions, human resource directors and headhunters are working overtime to find creative ways to draw more women and men into our profession. But let's not forget the most powerful tool of all: ourselves. By role-modeling competent, compassionate nursing care, we're our own best recruiters. This nurse's story is just one example.

Finding Ways to Effectively Prevent Sexual Abuse by Youth

ERIC Educational Resources Information Center

Klein, Alisa; Tabachnick, Joan

2002-01-01

Youth with sexual behavior problems pose a complicated challenge to the society. Yet the society has succeeded in developing only a limited range of actions and attitudes to grapple with and prevent this problem. Very few of the social service and criminal justice systems have rallied to create compassionate models that not only address and…

BTTC Doctors and Institutions | Center for Cancer Research

Cancer.gov

BTTC Doctors and Institutions Committed to Discovering New Therapies The doctors and institutions who are participating in the BTTC are compassionate experts in their respective fields and are dedicated to finding new and effective therapies for the treatment of patients with brain tumors. Feel free to contact any of these outstanding facilities to make an appointment or

Leaving work at work: a balanced, compassionate, separate home life.

PubMed

Mendes, Aysha

We all know it's important to keep our work and home lives separate, but in an age of new media, of being constantly 'on', how can we do this in practice? These issues are even more acute for nurses, argues Aysha Mendes, since the emotional nature of their work makes 'switching off' all the harder.

78 FR 66638 - Extension of the Expiration Date for State Disability Examiner Authority To Make Fully Favorable...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-06

...-800-772-1213 or TTY 1-800-325-0778, or visit our Internet site, Social Security Online, at http://www... SOCIAL SECURITY ADMINISTRATION 20 CFR Parts 404 and 416 [Docket No. SSA-2013-0023] RIN 0960-AH59... Disability Determinations and Compassionate Allowances AGENCY: Social Security Administration. ACTION: Final...

Recognizing and honoring Howard University School of Law's 140-year legacy of social justice and its continued commitment to the training of capable and compassionate legal practitioners and scholars.

THOMAS, 111th Congress

Rep. Kilpatrick, Carolyn C. [D-MI-13

2009-07-28

House - 10/22/2009 Referred to the Subcommittee on Higher Education, Lifelong Learning, and Competitiveness. (All Actions) Tracker: This bill has the status Agreed to in HouseHere are the steps for Status of Legislation:

What is nursing care and who owns it?

PubMed

Hemingway, Ann

The Francis report into the failings at Mid Staffordshire, out last week, demands practical responses from all health professions if they are not to be repeated in other NHS providers. This article explores why nurses need to re-examine their philosophy of care and move beyond the notion of patient-centred care to develop a compassionate, humanising approach.

Heartsongs across the World: Using Literacy and Emotional Pedagogy to Empower Communities of Compassionate Learners

ERIC Educational Resources Information Center

Densmore-James, Susan; Yocum, Russell G.

2015-01-01

Whether stemming from dysfunctional families, abuse, emotional responses to societal violence, the threat of terrorism, school shootings, or escaping the day-to-day tedium that life places before us, today's learners are vulnerable to loss and the grief, sorrow, depression, and anger that accompany such loss. This essay, written from the lead…

Profile: Iora Health Transactional vs. relationship-based care.

PubMed

Howe, Michelle

2017-05-01

Last November, Nursing Management Congress2016 attendees experienced a one-of-a-kind keynote address when Zubin Damania, MD, took the stage. Through self-produced song and video, he explored the ethics of delivering compassionate care in our challenging healthcare system. Here, read about the Iora Health model that Dr. Damania celebrates as "having it right."

Maria Montessori on the Natural Formation of Character in Young Children

ERIC Educational Resources Information Center

Murphy, Madonna

2003-01-01

This paper examines this issue of character formation from the perspective of Maria Montessori. Her method has much to offer in developing more peaceful classrooms and helping to develop compassionate and caring citizens. Maria Montessori developed a complete philosophy of education based on her discovery that the child has a mind able to absorb…

Re-Imagining Democratic Citizenship Education: Towards a Culture of Compassionate Responsibility

ERIC Educational Resources Information Center

Davids, Nuraan; Waghid, Yusef

2012-01-01

Benhabib (2002:134) maintains that, in order for individuals to become democratic citizens they need to be exposed to at least three inter-related elements: collective identity, privileges of membership, and social rights and benefits. Through exposure to these three inter-related items it is hoped that, by means of the teaching and learning of…

Compassionate Senses of Place: Reflections from the River

ERIC Educational Resources Information Center

Schrader, Deb

2012-01-01

On the summer solstice of June 2010, a time of constant Arctic light, 14 conference delegates gathered in Yellowknife to fly further north past the tree line, and to a lake downstream of the frozen headwaters of the Mara River. The romance and reality of the conference group in that place--the caribou, muskox, bear and wolf encounters, their…

42 CFR 130.24 - What additional documentation may the Secretary require to resolve eligibility or payment issues?

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 1 2010-10-01 2010-10-01 false What additional documentation may the Secretary require to resolve eligibility or payment issues? 130.24 Section 130.24 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES COMPASSIONATE PAYMENTS RICKY RAY HEMOPHILIA RELIEF FUND...

Embracing Asperger's: A Primer for Parents and Professionals

ERIC Educational Resources Information Center

Bromfield, Richard

2011-01-01

Parents and teachers of children with Asperger's know only too well the feeling that they are not quite reaching the child, not quite hearing or getting it, not communicating just right, or at all. Offering rich insights into what Asperger's is like for the child himself or herself, this compassionate book will empower parents and teachers,…

Family-centred interventions by primary healthcare services for Indigenous early childhood wellbeing in Australia, Canada, New Zealand and the United States: a systematic scoping review.

PubMed

McCalman, Janya; Heyeres, Marion; Campbell, Sandra; Bainbridge, Roxanne; Chamberlain, Catherine; Strobel, Natalie; Ruben, Alan

2017-02-21

Primary healthcare services in Australia, Canada, New Zealand and the United States have embraced the concept of family-centred care as a promising approach to supporting and caring for the health of young Indigenous children and their families. This scoping review assesses the quality of the evidence base and identifies the published literature on family- centred interventions for Indigenous early childhood wellbeing. Fourteen electronic databases, grey literature sources and the reference lists of Indigenous maternal and child health reviews were searched to identify relevant publications from 2000 to 2015. Studies were included if the intervention was: 1) focussed on Indigenous children aged from conception to 5 years from the abovementioned countries; 2) led by a primary healthcare service; 3) described or evaluated; and 4) scored greater than 50% against a validated scale for family-centredness. The study characteristics were extracted and quality rated. Reported aims, strategies, enablers and outcomes of family-centredcare were identified using grounded theory methods. Eighteen studies (reported in 25 publications) were included. Three were randomised controlled studies; most were qualitative and exploratory in design. More than half of the publications were published from 2012 to 2015. The overarching aim of interventions was to promote healthy families. Six key strategies were to: support family behaviours and self- care, increase maternal knowledge, strengthen links with the clinic, build the Indigenous workforce, promote cultural/ community connectedness and advocate for social determinants of health. Four enablers were: competent and compassionate program deliverers, flexibility of access, continuity and integration of healthcare, and culturally supportive care. Health outcomes were reported for Indigenous children (nutritional status; emotional/behavioural; and prevention of injury and illness); parents/caregivers (depression and substance abuse; and parenting knowledge, confidence and skills); health services (satisfaction; access, utilization and cost) and community/cultural revitalisation. The evidence for family-centred interventions is in the early stages of development, but suggests promise for generating diverse healthcare outcomes for Indigenous children and their parents/caregivers, as well as satisfaction with and utilisation of healthcare, and community/cultural revitalisation. Further research pertaining to the role of fathers in family-centred care, and the effects and costs of interventions is needed.

Management of transfusional iron overload – differential properties and efficacy of iron chelating agents

PubMed Central

Kwiatkowski, Janet L

2011-01-01

Regular red cell transfusion therapy ameliorates disease-related morbidity and can be lifesaving in patients with various hematological disorders. Transfusion therapy, however, causes progressive iron loading, which, if untreated, results in endocrinopathies, cardiac arrhythmias and congestive heart failure, hepatic fibrosis, and premature death. Iron chelation therapy is used to prevent iron loading, remove excess accumulated iron, detoxify iron, and reverse some of the iron-related complications. Three chelators have undergone extensive testing to date: deferoxamine, deferasirox, and deferiprone (although the latter drug is not currently licensed for use in North America where it is available only through compassionate use programs and research protocols). These chelators differ in their modes of administration, pharmacokinetics, efficacy with regard to organ-specific iron removal, and adverse-effect profiles. These differential properties influence acceptability, tolerability and adherence to therapy, and, ultimately, the effectiveness of treatment. Chelation therapy, therefore, must be individualized, taking into account patient preferences, toxicities, ongoing transfusional iron intake, and the degree of cardiac and hepatic iron loading. PMID:22287873

Management of transfusional iron overload - differential properties and efficacy of iron chelating agents.

PubMed

Kwiatkowski, Janet L

2011-01-01

Regular red cell transfusion therapy ameliorates disease-related morbidity and can be lifesaving in patients with various hematological disorders. Transfusion therapy, however, causes progressive iron loading, which, if untreated, results in endocrinopathies, cardiac arrhythmias and congestive heart failure, hepatic fibrosis, and premature death. Iron chelation therapy is used to prevent iron loading, remove excess accumulated iron, detoxify iron, and reverse some of the iron-related complications. Three chelators have undergone extensive testing to date: deferoxamine, deferasirox, and deferiprone (although the latter drug is not currently licensed for use in North America where it is available only through compassionate use programs and research protocols). These chelators differ in their modes of administration, pharmacokinetics, efficacy with regard to organ-specific iron removal, and adverse-effect profiles. These differential properties influence acceptability, tolerability and adherence to therapy, and, ultimately, the effectiveness of treatment. Chelation therapy, therefore, must be individualized, taking into account patient preferences, toxicities, ongoing transfusional iron intake, and the degree of cardiac and hepatic iron loading.

Caring for the caregiver.

PubMed

Levy, Mitchell M

2004-07-01

There are certainly many coping behaviors that may assist ICU caregivers in the process of caring for themselves. Staff support groups,regular interdisciplinary meetings to discuss difficult cases,and bringing trained personnel into the intensive care unit (ICU)environment to offer staff training in communication and conflict resolution skills have been suggested as methods for alleviating caregiver stress. Combining these as well as other tools with a deeper look at the caregiver-patient relationship are important building blocks for creating a sane, healthy environment in the ICU. Over the next years, as the population ages, and as technologic advances continue, the critical care units will play an even more prominent role in health care. Given the threat posed by the severe nursing shortage, it becomes apparent that, to prepare for this increased need for critical care services, efforts must be directed to identify the sources of distress for ICU caregivers and develop focused training programs that alleviate the inevitably strains and pressures that arise in the process of compassionate caring for the critically ill.

From compassionate ageism to intergenerational conflict?

PubMed

Binstock, Robert H

2010-10-01

During the 50 years in which The Gerontologist has been publishing, the politics of aging in the United States has undergone distinct changes. The political behavior of older individuals has remained largely the same even though different birth cohorts have succeeded each other in populating the ranks of older people. But the politics of policies on aging-the organized interest and advocacy groups active in this arena, the tenor of public discourse about older people as beneficiaries of policies on aging, the national political agendas regarding public old-age benefits, and the broader U.S. political economy-have changed substantially over these five decades. Now, in the contexts of the aging of the baby boom and concerns about reducing large federal fiscal deficits (annual and cumulative), the politics of U.S. policies on aging may change considerably from those of yesterday and today. Is there a possibility of future intergenerational political conflict over taxes and expenditures for the major old-age benefit programs? If so, what might prevent or mitigate it?

43 CFR 17.550 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 43 Public Lands: Interior 1 2011-10-01 2011-10-01 false Program accessibility: Existing facilities....550 Program accessibility: Existing facilities. (a) General. The agency shall operate each program or... its existing facilities or every part of a facility accessible to and usable by handicapped persons...

49 CFR 28.150 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 49 Transportation 1 2011-10-01 2011-10-01 false Program accessibility: Existing facilities. 28.150....150 Program accessibility: Existing facilities. (a) General. The Department shall operate each program... Department to make each of its existing facilities accessible to and usable by individuals with handicaps; (2...

76 FR 2686 - Video Programming and Emergency Access Advisory Committee; Announcement of Establishment and...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-14

... FEDERAL COMMUNICATIONS COMMISSION [DA 10-2320] Video Programming and Emergency Access Advisory... appointment of members of the Video Programming and Emergency Access Advisory Committee (``Committee'' or... change of the Committee's popular name to the Video Programming Accessibility Advisory Committee (``VPAAC...

Welfare Reform: DOT Has Made Progress in Implementing the Job Access Program but Has Not Evaluated the Impact. Testimony before the Committee on Transportation and Infrastructure, Subcommittee on Highways and Transit, U.S. House of Representatives.

ERIC Educational Resources Information Center

Hecker, JayEtta Z.

A series of reviews of the Department of Transportation's (DOT's) Job Access and Reverse Commute (Job Access) Program explored DOT's and grantees' challenges in implementing the Job Access program and the status of DOT's program evaluation efforts. DOT and grantees faced significant challenges in implementing the Job Access program. DOT's process…

BTTC Doctors and Institutions | Center for Cancer Research

Cancer.gov

BTTC Doctors and Institutions Committed to Discovering New Therapies The doctors and institutions who are participating in the BTTC are compassionate experts in their respective fields and are dedicated to finding new and effective therapies for the treatment of patients with brain tumors. Feel free to contact any of these outstanding facilities to make an appointment or participate in a BTTC clinical trial.

Calmness Fosters Compassionate Connections: Integrating Mindfulness to Support Diverse Parents, Their Young Children, and the Providers Who Serve Them

ERIC Educational Resources Information Center

Shahmoon-Shanok, Rebecca; Stevenson, Howard Carlton

2015-01-01

This article introduces and recommends mindfulness as a significant resource for earliest childhood practice, especially for parents and providers. Mindfulness is defined as it is coming to be understood and used by increasing numbers of people and systems in North America. The article also addresses how mindfulness is sometimes expressed and…

3 CFR 8933 - Proclamation 8933 of February 28, 2013. American Red Cross Month, 2013

Code of Federal Regulations, 2014 CFR

2014-01-01

... 3 The President 1 2014-01-01 2014-01-01 false Proclamation 8933 of February 28, 2013. American Red... February 28, 2013 Proc. 8933 American Red Cross Month, 2013By the President of the United States of America... communities around the world, and we renew the compassionate spirit that continues to keep our country strong...

What's Love Got to Do with It?: Reflections on the Connection of Heart and Mind in Adult Learning

ERIC Educational Resources Information Center

Pond, Elizabeth K.

2014-01-01

As a psychotherapist and meditation instructor, this author was drawn to what mindfulness teachings say about function of mind and heart in learning. Sakyong Mipham (2003) teaches that the mind is naturally compassionate, open, and receptive. The question becomes, what prevents the arising of these inherent characteristics of love? These same…

Translating Maya Angelou's Theme, "We are more alike, my friends/Than we are unalike," into Effective Multicultural Study.

ERIC Educational Resources Information Center

Neman, Beth S.

Few would disagree that the essential purpose in multicultural studies is to promote compassionate understanding and to diminish hatred. The two basic approaches to this goal, celebrating differences and emphasizing unity, are suggested by Maya Angelou in her poem, "The Human Family." Most university courses do a good job of honoring…

Educating for Peace and Justice: Religious Dimensions, K-6. 8th Edition.

ERIC Educational Resources Information Center

McGinnis, James

This revised teacher's manual focuses on the need to develop compassionate concern in students if they are to be moved to action. The 12-step processes in the 8 units promote a personal relationship or friendship with the persons or groups involved. The units include: (1) "Of Dreams and Vision"; (2) "Interpersonal Peacemaking/Reconciliation"; (3)…

Proceedings of the Annual Meeting of the Association for Education in Journalism and Mass Communication (84th, Washington, DC, August 5-8, 2001). Visual Communication Division.

ERIC Educational Resources Information Center

Association for Education in Journalism and Mass Communication.

The Visual Communication section of the proceedings contains the following 8 selected papers: "Affect and Emotion: Eliciting Compassionate Response via Facial Affect in Visual Images" (Courtney Bennett); "A Study of the Persuasiveness of Animation When Used as Forensic Demonstrative Evidence" (Benjamin Allyn Meyer);…

Literacy and Social Justice: Understanding Student Perceptions and Conceptions about Literature

ERIC Educational Resources Information Center

Crosthwaite, Jennifer M.

2015-01-01

Literacy and learning is a social process, one that is both transformative, empowering, and can often lead to social change. The following study is based on the idea that literacy can be used as a tool not only to teach the basic skills of reading, but the skills for individuals to learn to be compassionate towards others, understand their…

Teaching Business Students about HIV and AIDS in the Workplace: Curriculum and Resources

ERIC Educational Resources Information Center

Miller, Alan N.

2008-01-01

The significant and increasing number of people in the U.S. and global work-forces who are infected with HIV or who have AIDS must be managed differently from those who are not infected and those who have other life-threatening diseases. Business schools can prepare their MBA students to effectively, legally, and compassionately manage people with…

Suicide and Black Adolescents: A Medical Dilemma

PubMed Central

Smith, James A.; Carter, James H.

1986-01-01

The psychosocial dynamics of black adolescent suicide are examined in light of the available literature and the authors' clinical experience. The authors contend that members of the medical profession who are in touch with the physical problems of black adolescents must become sensitive to the magnitude of the problem and assist with developing compassionate, bold, and responsible suicide prevention and treatment modalities. PMID:3491906

Cost of Stem Cell-Based Tissue-Engineered Airway Transplants in the United Kingdom: Case Series

PubMed Central

Culme-Seymour, Emily J.; Mason, Katrina; Vallejo-Torres, Laura; Carvalho, Carla; Partington, Leanne; Crowley, Claire; Hamilton, Nick J.; Toll, Ed C.; Butler, Colin R.; Elliott, Martin J.; Birchall, Martin A.; Lowdell, Mark W.

2016-01-01

Stem cell-based tissue-engineered tracheas are at an early stage in their product development cycle. Tens of patients have been treated worldwide in predominantly compassionate use settings, demonstrating significant promise. This potentially life-saving treatment is complex, and the cost and its implications for such treatments are yet to be fully understood. The costs are compounded by varying strategies for graft preparation and transplant, resulting in differing clinical and laboratory costs from different research groups. In this study, we present a detailed breakdown of the clinical and manufacturing costs for three of the United Kingdom (UK) patients treated with such transplants. All three patients were treated under Compassionate Use legislation, within the UK National Health Service (NHS) hospital setting. The total costs for the three UK patients treated ranged from $174,420 to $740,500. All three patients were in a state of poor health at time of treatment and had a number of complexities in addition to the restricted airway. This is the first time a cost analysis has been made for a tissue-engineered organ and provides a benchmark for future studies, as well as comparative data for use in reimbursement considerations. PMID:26559535

What Torture Survivors Teach Assessors About Being More Fully Human.

PubMed

Evans, F Barton

2016-01-01

This article illustrates the complex sociocultural components in the forensic psychological assessment of a young Ethiopian woman's claim for political asylum due to a well-founded fear of persecution and for relief under the Convention Against Torture. It draws attention to the subtle social and cultural influences in the practice of forensic psychological assessment with an emphasis of reflective practice, which is contextualized in the interpersonal theory of Sullivan. In the interpersonal approach, the essential work of the assessor is to pay careful attention to the microinteractions between the client and the assessor as reflections of the interpersonal (meaning social and cultural) processes, eschewing the illusion of objectivity. In this case study, I illustrate the particular cultural dilemmas for client and assessor in conducting a forensic assessment of psychological trauma, including cross-cultural, gender, and legal difficulties in arriving at an informed, objective, and compassionate assessment of an individual seeking asylum after an especially brutal experience of torture. I argue that collaborative therapeutic assessment methods adapted for forensic practice offer an approach to assessment of psychological trauma that provides more accurate and compassionate assessment than so-called neutral standard forensic assessment practice.

Cost of Stem Cell-Based Tissue-Engineered Airway Transplants in the United Kingdom: Case Series.

PubMed

Culme-Seymour, Emily J; Mason, Katrina; Vallejo-Torres, Laura; Carvalho, Carla; Partington, Leanne; Crowley, Claire; Hamilton, Nick J; Toll, Ed C; Butler, Colin R; Elliott, Martin J; Birchall, Martin A; Lowdell, Mark W; Mason, Chris

2016-02-01

Stem cell-based tissue-engineered tracheas are at an early stage in their product development cycle. Tens of patients have been treated worldwide in predominantly compassionate use settings, demonstrating significant promise. This potentially life-saving treatment is complex, and the cost and its implications for such treatments are yet to be fully understood. The costs are compounded by varying strategies for graft preparation and transplant, resulting in differing clinical and laboratory costs from different research groups. In this study, we present a detailed breakdown of the clinical and manufacturing costs for three of the United Kingdom (UK) patients treated with such transplants. All three patients were treated under Compassionate Use legislation, within the UK National Health Service (NHS) hospital setting. The total costs for the three UK patients treated ranged from $174,420 to $740,500. All three patients were in a state of poor health at time of treatment and had a number of complexities in addition to the restricted airway. This is the first time a cost analysis has been made for a tissue-engineered organ and provides a benchmark for future studies, as well as comparative data for use in reimbursement considerations.

When does the responsibility of our care end: bereavement.

PubMed

Penson, Richard T; Green, Kara M; Chabner, Bruce A; Lynch, Thomas J

2002-01-01

Shortly before his death in 1995, Kenneth B. Schwartz, a cancer patient at Massachusetts General Hospital, founded the Kenneth B. Schwartz Center. The Schwartz Center is a non-profit organization dedicated to supporting and advancing compassionate health care delivery, which provides hope to the patient, support to caregivers, and sustenance to the healing process. The center sponsors the Schwartz Center Rounds, a monthly multidisciplinary forum where caregivers reflect on important psychosocial issues faced by patients, their families, and their caregivers, and gain insight and support from fellow staff members. Two vignettes are presented of a caregiver's response to the death of a patient, contrasting the extremes of involved compassion for the family and fractured relationships. Grief for loss is an inevitable part of life and a common part of cancer care. Support of the bereaved may be one of the hardest tasks for cancer care professionals, who are confronted with the limits of modern medicine. There is a responsibility to provide grieving families with support and care; care that goes beyond the death. A compassionate response helps both those who suffer and those who care. Complicated and uncomplicated bereavement, grief reactions, resources for bereavement counseling, and the role of condolence letters are reviewed.

Extension of the Expiration Date for State Disability Examiner Authority To Make Fully Favorable Quick Disability Determinations and Compassionate Allowance Determinations. Final rule.

PubMed

2016-10-24

We are extending, until December 28, 2018, the expiration date of our disability examiner authority (DEA) rule, which authorizes State agency disability examiners to make fully favorable determinations without the approval of a State agency medical or psychological consultant in claims that we consider under our quick disability determination (QDD) and compassionate allowance (CAL) processes. This is our last extension of this rule because we will phase out the use of DEA during the extension period under section 832 of the Bipartisan Budget Act of 2015 (BBA). This extension provides us the time necessary to take all of the administrative actions we need to take in order to reinstate uniform use of medical and psychological consultants. The current rule will expire on November 11, 2016. In this final rule, we are changing the November 11, 2016 expiration or "sunset" date to December 28, 2018, extending the authority for 2 years and 1 month. This is the final extension of our DEA rule. On December 28, 2018, at the conclusion of this extension, the authority for this test will terminate. We are making no other changes.

Reconciling technology and humanistic care: Lessons from the next generation of physicians.

PubMed

Simpkin, Arabella L; Dinardo, Perry B; Pine, Elizabeth; Gaufberg, Elizabeth

2017-04-01

There is concern among physicians that the rising use of technology in medicine may have a negative impact on compassionate patient-centered care. This study explores medical student attitudes and ideas about technology in medicine in order to consider ways to achieve symbiosis between technology use and the delivery of humanistic, patient-centered care. This qualitative study uses data from 138 essays written by medical students in the United States and Canada responding to the prompt "Using a real life experience, describe how technology played a role, either negatively or positively, in the delivery of humanistic patient care." Data were analyzed for themes about technology and the impact on humanistic patient care. Seven themes emerged from the medical students' essays: Patient Perspective; Life-Giving versus Life-Prolonging; Boundaries between Human and Technology; Distancing versus Presence; Adapting to Change; Tools to Enhance Care; and Definitions of Technology. Listening to medical students lends insight into ways to integrate technology into the healthcare environment, to ensure that physicians' ability to deliver compassionate care is enhanced, not hindered. Utilizing perceptions of the next generation of physicians, educational and developmental strategies are proposed to ensure the successful integration of technology with humanistic patient-centered care.

47 CFR 76.1003 - Program access proceedings.

Code of Federal Regulations, 2014 CFR

2014-10-01

... MULTICHANNEL VIDEO AND CABLE TELEVISION SERVICE Competitive Access to Cable Programming § 76.1003 Program access proceedings. (a) Complaints. Any multichannel video programming distributor aggrieved by conduct... multichannel video programming distributor intending to file a complaint under this section must first notify...

47 CFR 76.1003 - Program access proceedings.

Code of Federal Regulations, 2012 CFR

2012-10-01

... MULTICHANNEL VIDEO AND CABLE TELEVISION SERVICE Competitive Access to Cable Programming § 76.1003 Program access proceedings. (a) Complaints. Any multichannel video programming distributor aggrieved by conduct... multichannel video programming distributor intending to file a complaint under this section must first notify...

47 CFR 76.1003 - Program access proceedings.

Code of Federal Regulations, 2013 CFR

2013-10-01

... MULTICHANNEL VIDEO AND CABLE TELEVISION SERVICE Competitive Access to Cable Programming § 76.1003 Program access proceedings. (a) Complaints. Any multichannel video programming distributor aggrieved by conduct... multichannel video programming distributor intending to file a complaint under this section must first notify...

47 CFR 76.1003 - Program access proceedings.

Code of Federal Regulations, 2010 CFR

2010-10-01

... MULTICHANNEL VIDEO AND CABLE TELEVISION SERVICE Competitive Access to Cable Programming § 76.1003 Program access proceedings. (a) Complaints. Any multichannel video programming distributor aggrieved by conduct... multichannel video programming distributor intending to file a complaint under this section must first notify...

47 CFR 76.1003 - Program access proceedings.

Code of Federal Regulations, 2011 CFR

2011-10-01

... MULTICHANNEL VIDEO AND CABLE TELEVISION SERVICE Competitive Access to Cable Programming § 76.1003 Program access proceedings. (a) Complaints. Any multichannel video programming distributor aggrieved by conduct... multichannel video programming distributor intending to file a complaint under this section must first notify...

45 CFR 1214.149 - Program accessibility: Discrimination prohibited.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 45 Public Welfare 4 2012-10-01 2012-10-01 false Program accessibility: Discrimination prohibited... PROGRAMS OR ACTIVITIES CONDUCTED BY ACTION § 1214.149 Program accessibility: Discrimination prohibited... of, be excluded from participation in, or otherwise be subjected to discrimination under any program...

76 FR 19356 - Video Programming and Accessibility Advisory Committee; Announcement of Date of Next Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-07

... FEDERAL COMMUNICATIONS COMMISSION [DA 11-390] Video Programming and Accessibility Advisory.... SUMMARY: This document announces the next meeting of the Video Programming Accessibility Advisory... Internet programming previously captioned on television, video description of television programming...

50 CFR 648.60 - Sea scallop access area program requirements.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 50 Wildlife and Fisheries 12 2013-10-01 2013-10-01 false Sea scallop access area program... Management Measures for the Atlantic Sea Scallop Fishery § 648.60 Sea scallop access area program requirements. (a) A limited access scallop vessel may only fish in the Sea Scallop Access Areas specified in...

50 CFR 648.60 - Sea scallop access area program requirements.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 50 Wildlife and Fisheries 12 2014-10-01 2014-10-01 false Sea scallop access area program... Management Measures for the Atlantic Sea Scallop Fishery § 648.60 Sea scallop access area program requirements. (a) A limited access scallop vessel may only fish in the Sea Scallop Access Areas specified in...

50 CFR 648.60 - Sea scallop area access program requirements.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 50 Wildlife and Fisheries 10 2011-10-01 2011-10-01 false Sea scallop area access program... Management Measures for the Atlantic Sea Scallop Fishery § 648.60 Sea scallop area access program requirements. (a) A limited access scallop vessel may only fish in the Sea Scallop Access Areas specified in...

50 CFR 648.60 - Sea scallop access area program requirements.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 50 Wildlife and Fisheries 12 2012-10-01 2012-10-01 false Sea scallop access area program... Management Measures for the Atlantic Sea Scallop Fishery § 648.60 Sea scallop access area program requirements. (a) A limited access scallop vessel may only fish in the Sea Scallop Access Areas specified in...

50 CFR 648.60 - Sea scallop area access program requirements.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 50 Wildlife and Fisheries 8 2010-10-01 2010-10-01 false Sea scallop area access program... Management Measures for the Atlantic Sea Scallop Fishery § 648.60 Sea scallop area access program requirements. (a) A limited access scallop vessel may only fish in the Sea Scallop Access Areas specified in...

After Access: Underrepresented Students' Postmatriculation Perceptions of College Access Capital

ERIC Educational Resources Information Center

Means, Darris R.; Pyne, Kimberly B.

2016-01-01

This qualitative study explores the perceived impact of college-going capital gained during participation in a college access program. In three, semistructured interviews spanning the first-year college experience, 10 first-year college students who participated in a college access program articulate the value of access programming and also raise…

The International Charter for Human Values in Healthcare: an interprofessional global collaboration to enhance values and communication in healthcare.

PubMed

Rider, Elizabeth A; Kurtz, Suzanne; Slade, Diana; Longmaid, H Esterbrook; Ho, Ming-Jung; Pun, Jack Kwok-hung; Eggins, Suzanne; Branch, William T

2014-09-01

The human dimensions of healthcare--core values and skilled communication necessary for every healthcare interaction--are fundamental to compassionate, ethical, and safe relationship-centered care. The objectives of this paper are to: describe the development of the International Charter for Human Values in Healthcare which delineates core values, articulate the role of skilled communication in enacting these values, and provide examples showing translation of the Charter's values into action. We describe development of the Charter using combined qualitative research methods and the international, interprofessional collaboration of institutions and individuals worldwide. We identified five fundamental categories of human values for every healthcare interaction--Compassion, Respect for Persons, Commitment to Integrity and Ethical Practice, Commitment to Excellence, and Justice in Healthcare--and delineated subvalues within each category. We have disseminated the Charter internationally and incorporated it into education/training. Diverse healthcare partners have joined in this work. We chronicle the development and dissemination of the International Charter for Human Values in Healthcare, the role of skilled communication in demonstrating values, and provide examples of educational and clinical programs integrating these values. The Charter identifies and promotes core values clinicians and educators can demonstrate through skilled communication and use to advance humanistic educational programs and practice. Copyright © 2014. Published by Elsevier Ireland Ltd.

Effects of mindfulness on maternal stress, depressive symptoms and awareness of present moment experience: A pilot randomised trial.

PubMed

Beattie, Jill; Hall, Helen; Biro, Mary Anne; East, Christine; Lau, Rosalind

2017-07-01

To determine the feasibility and acceptability and measure the effects of a mindfulness intervention compared to a pregnancy support program on stress, depressive symptoms and awareness of present moment experience. A pilot randomised trial using mixed methods. Forty-eight women attending a maternity service were randomly allocated to a mindfulness-based or pregnancy support program. Perceived Stress Scale, Edinburgh Postnatal Depression Scale, Mindfulness Attention Awareness Scale, and Birth Outcomes. Women's perceptions of the impact of the programs were examined via summative evaluation, interviews, diaries and facilitator field notes. Nine women in the mindfulness program and 11 in the pregnancy support program completed post-program measures. There were no statistically significant differences between groups. Of practical significance, was an improvement in measures for both groups with a greater improvement in awareness of present moment experience for the intervention group. The intervention group reported learning how to manage stressors, fear, anxiety, and to regulate their attention to be more present. The control group reported learning how to calm down when stressed which increased their confidence. Intervention group themes were: releasing stress, becoming aware, accepting, having options and choices, connecting and being compassionate. Control group themes were:managing stress, increasing confidence, connecting, focussing, being accepted, preparing. The feasibility and acceptability of the intervention was confirmed. Programs decreased women's self-reported stress in different ways. Women in the mindfulness program accepted themselves and their experiences as they arose and passed in the present moment, while those in the control group gained acceptance primarily from external sources such as peers. Mindfulness programs can foster an internalised locus of self-acceptance which may result in woman becoming less dependent on others for their wellbeing. Adequately powered RCTs, with an active control, long-term follow up and economic evaluation are recommended. Copyright © 2017 Elsevier Ltd. All rights reserved.

29 CFR 4907.150 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2010 CFR

2010-07-01

... IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE PENSION BENEFIT GUARANTY CORPORATION § 4907.150 Program accessibility: Existing facilities. (a) General. The agency shall operate each program or activity so that the program or activity, when viewed in its entirety, is readily accessible to and usable by handicapped...

50 CFR 550.149 - Program accessibility: Discrimination prohibited.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 50 Wildlife and Fisheries 11 2012-10-01 2012-10-01 false Program accessibility: Discrimination... Program accessibility: Discrimination prohibited. Except as otherwise provided in § 550.150, no qualified... discrimination under any program or activity conducted by the agency. ...

[Designing a software for drug management in special situations at a hospital's drug administration service].

PubMed

Sánchez Cuervo, Marina; Muñoz García, María; Gómez de Salazar López de Silanes, María Esther; Bermejo Vicedo, Teresa

2015-03-01

to describe the features of a computer program for management of drugs in special situations (off-label and compassionate use) in a Department of Hospital Pharmacy (PD). To describe the methodology followed for its implementation in the Medical Services. To evaluate their use after 2 years of practice. the design was carried out by pharmacists of the PD. The stages of the process were: selection of a software development company, establishment of a working group, selection of a development platform, design of an interactive Viewer, definition of functionality and data processing, creation of databases, connection, installation and configuration, application testing and improvements development. A directed sequential strategy was used for implementation in the Medical Services. The program's utility and experience of use were evaluated after 2 years. a multidisciplinary working group was formed and developed Pk_Usos®. The program works in web environment with a common viewer for all users enabling real time checking of the request files' status and that adapts to the management of medications in special situations procedure. Pk_Usos® was introduced first in the Oncology Department, with 15 oncologists as users of the program. 343 patients had 384 treatment requests managed, of which 363 are authorized throughout two years. PK_Usos® is the first software designed for the management of drugs in special situations in the PD. It is a dynamic and efficient tool for all professionals involved in the process by optimization of times. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

22 CFR 1005.150 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2010 CFR

2010-04-01

... THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE INTER-AMERICAN FOUNDATION § 1005.150 Program accessibility: Existing facilities. (a) General. The agency shall operate each program or activity so that the program or activity, when viewed in its entirety, is readily accessible to and usable by...

12 CFR 794.150 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2010 CFR

2010-01-01

... HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE NATIONAL CREDIT UNION ADMINISTRATION § 794.150 Program accessibility: Existing facilities. (a) General. The agency shall operate each program or activity so that the program or activity, when viewed in its entirety, is readily accessible to and usable by handicapped...

50 CFR 550.150 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2010 CFR

2010-10-01

... NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY MARINE MAMMAL COMMISSION § 550.150 Program accessibility: Existing facilities. (a) General. The agency shall operate each program or activity so that the program or activity, when viewed in its entirety, is readily accessible to and usable by...

28 CFR 39.150 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2010 CFR

2010-07-01

... NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE DEPARTMENT OF JUSTICE § 39.150 Program accessibility: Existing facilities. (a) General. The agency shall operate each program or activity so that the program or activity, when viewed in its entirety, is readily accessible to and usable by...

24 CFR 9.152 - Program accessibility: alterations of Property Disposition Program multifamily housing facilities.

Code of Federal Regulations, 2010 CFR

2010-04-01

... of Property Disposition Program multifamily housing facilities. 9.152 Section 9.152 Housing and Urban... URBAN DEVELOPMENT § 9.152 Program accessibility: alterations of Property Disposition Program multifamily...) in such a project shall be accessible for persons with hearing or vision impairments. If state or...

24 CFR 9.152 - Program accessibility: alterations of Property Disposition Program multifamily housing facilities.

Code of Federal Regulations, 2011 CFR

2011-04-01

... of Property Disposition Program multifamily housing facilities. 9.152 Section 9.152 Housing and Urban... URBAN DEVELOPMENT § 9.152 Program accessibility: alterations of Property Disposition Program multifamily...) in such a project shall be accessible for persons with hearing or vision impairments. If state or...

49 CFR 807.150 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 7 2010-10-01 2010-10-01 false Program accessibility: Existing facilities. 807... CONDUCTED BY THE NATIONAL TRANSPORTATION SAFETY BOARD § 807.150 Program accessibility: Existing facilities... not— (1) Necessarily require the agency to make each of its existing facilities accessible to and...

76 FR 57989 - Video Programming and Accessibility Advisory Committee; Announcement of Date of Next Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-19

... FEDERAL COMMUNICATIONS COMMISSION [DA 11-1527] Video Programming and Accessibility Advisory.... SUMMARY: This document announces the next meeting of the Video Programming Accessibility Advisory... Commission regarding video description, and the delivery of video description, access to emergency...

Hand Society and Matching Program Web Sites Provide Poor Access to Information Regarding Hand Surgery Fellowship.

PubMed

Hinds, Richard M; Klifto, Christopher S; Naik, Amish A; Sapienza, Anthony; Capo, John T

2016-08-01

The Internet is a common resource for applicants of hand surgery fellowships, however, the quality and accessibility of fellowship online information is unknown. The objectives of this study were to evaluate the accessibility of hand surgery fellowship Web sites and to assess the quality of information provided via program Web sites. Hand fellowship Web site accessibility was evaluated by reviewing the American Society for Surgery of the Hand (ASSH) on November 16, 2014 and the National Resident Matching Program (NRMP) fellowship directories on February 12, 2015, and performing an independent Google search on November 25, 2014. Accessible Web sites were then assessed for quality of the presented information. A total of 81 programs were identified with the ASSH directory featuring direct links to 32% of program Web sites and the NRMP directory directly linking to 0%. A Google search yielded direct links to 86% of program Web sites. The quality of presented information varied greatly among the 72 accessible Web sites. Program description (100%), fellowship application requirements (97%), program contact email address (85%), and research requirements (75%) were the most commonly presented components of fellowship information. Hand fellowship program Web sites can be accessed from the ASSH directory and, to a lesser extent, the NRMP directory. However, a Google search is the most reliable method to access online fellowship information. Of assessable programs, all featured a program description though the quality of the remaining information was variable. Hand surgery fellowship applicants may face some difficulties when attempting to gather program information online. Future efforts should focus on improving the accessibility and content quality on hand surgery fellowship program Web sites.

75 FR 34941 - Review of the Commission's Program Access Rules and Examination of Programming Tying Arrangements

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-21

... Commission's Program Access Rules and Examination of Programming Tying Arrangements AGENCY: Federal... Program Access Rules and Examination of Programming Tying Arrangements, MB Docket No. 07-198, FCC 10-17... information collection is contained in Sections 4(i), 303(r), and 628 of the Communications Act of 1934, as...

Lincoln, Lincoln, Bo Bincoln: Movies that Hail to the Chief

ERIC Educational Resources Information Center

Beck, Bernard

2013-01-01

In this article Abraham Lincoln is considered as an alternative to the usual type of patriot's hero. He reminds us of our great historical failings. He remains a figure of controversy, a national hero in only some corners of society. He is the heroic President who serves as the first compassionate defender of the downtrodden, and he is a hero…

Dealing with Disaster through Compassionate Giving: San Francisco Earthquake Survivors Write to President Theodore Roosevelt, January 3, 1909

ERIC Educational Resources Information Center

Hussey, Michael

2011-01-01

On January 3, 1909, Emily Hamilton and Louis Overstreet wrote to President Theodore Roosevelt begging his "leave to work under your Committee for the relief of the sufferers of Italy." The two were engaged and were willing to rush their marriage plans if the president needed them. Their letter was prompted by the powerful earthquake that…

Does a "Norm of Self-Interest" Discourage Prosocial Behavior? Rationality and Quid Pro Quo in Charitable Giving

ERIC Educational Resources Information Center

Simpson, Brent; Irwin, Kyle; Lawrence, Peter

2006-01-01

Previous studies by Holmes, Miller, and Lerner (2002) support the norm of self-interest and exchange fiction hypotheses. Together these arguments state that people want to act on compassionate feelings (e.g., by donating to charities) but are reluctant to do so if they cannot justify their behavior as being in line with their own self-interest.…

Beyond Sibling Rivalry: How To Help Your Children Become Cooperative, Caring, and Compassionate. An Owl Book.

ERIC Educational Resources Information Center

Goldenthal, Peter

Based on the premise that sibling relationships need to be viewed in the context of the family as a whole, this book provides practical guidelines and tools for parents to reduce friction between children and to resolve sibling conflict. Using many different types of family problems as examples, the book illustrates that how siblings relate to one…

One system's journey in creating a disclosure and apology program.

PubMed

Peto, Randolph R; Tenerowicz, Lynn M; Benjamin, Evan M; Morsi, Deborah S; Burger, Pamela K

2009-10-01

Patients experience adverse events more frequently than the public appreciates. A number of health systems have led the movement toward open, prompt, and compassionate disclosure of adverse events. In 2006 Baystate Health (BH) formed a disclosure advisory committee to design and implement an enhanced program to support prompt and skillful disclosure of adverse events. The proposed model for a disclosure and apology program resembled a consultation service, similar to a hospital ethics consultation service. BH hired an outside trainer to teach coaches/facilitators. Emotional support services were formalized and expanded not only for patients and families but also clinicians. THE EXPERIENCE SO FAR: Implementation of a formal disclosure and apology program has placed internal pressure on the organization to more promptly determine causality of adverse events and to respond to patient/family requests for information and/or assistance. Root causes and degree of system culpability are often not clear early after an event and sometimes are debated among the clinical team and the trained coaches/facilitators and risk managers. After a medical error, patients and families expect the organization to make changes to the system to prevent other patients from being harmed by the same mistake. To minimize the chance that patients and families feel that their suffering has been "in vain," health care systems will need to put systems in place to deliver on the promise to reduce the risk of future harm. Some of the challenges in sustaining such a program include the ability to promptly investigate, to accurately determine liability, to communicate empathetically even if unable to meet all patient/family expectations, and to ensure establishment of a just culture.

Online Training in Mind-Body Therapies: Different Doses, Long-term Outcomes.

PubMed

Kemper, Kathi J; Rao, Nisha; Gascon, Gregg; Mahan, John D

2017-10-01

There is a high rate of burnout among health professionals, driving diverse attempts to promote resilience and well-being to counter this trend. The purpose of this project was to assess the dose-response relationship between the number of hours of online mind-body skills training for health professionals and relevant outcomes a year later. Among 1438 registrants for online training (including up to 12 hours of training on mind-body practices) between December 2013 and November 2015, we analyzed responses from the first 10% who responded to an anonymous online survey between December 1, 2015 and February 1, 2016. Questions included the type and frequency of mind-body practice in the past 30 days and whether the online training had any impact on personal life or professional practice. Standardized measures were used to assess stress, mindfulness, confidence in providing compassionate care, and burnout. The 149 respondents represented a variety of ages and health professions; 55% completed one or more mind-body training modules an average of 14 months previously. Most (78%) engaged in one or more mind-body practices in the 30 days before the survey; 79% reported changes in self-care and 71% reported changes in the care of others as a result of participating. Increasing number of hours of training were significantly associated with practicing mind-body skills more frequently; increasing practice frequency was associated with less stress and burnout, which were associated with missing less work. Greater practice frequency was also associated with improvements in stress, mindfulness, and resilience, which were associated with increased confidence in providing compassionate care. Online training in mind-body therapies is associated with changes in self-reported behavior one year later; increasing doses of training are associated with more frequent practice which is associated with less stress, burnout, and missing work, and higher levels of mindfulness, resilience, and confidence in providing compassionate care. Additional studies are needed to compare mind-body skills training with other interventions designed to improve resilience and compassion while decreasing burnout in health professionals.

Effect of a wildlife conservation camp experience in China on student knowledge of animals, care, propensity for environmental stewardship, and compassionate behavior toward animals

NASA Astrophysics Data System (ADS)

Bexell, Sarah M.

The goal of conservation education is positive behavior change toward animals and the environment. This study was conducted to determine whether participation in a wildlife conservation education camp was effective in positively changing 8-12 year old students': (a) knowledge of animals, (b) care about animals, (c) propensity for environmental and wildlife stewardship, and (d) compassionate behavior toward animals. During the summer of 2005, 2 five-day camps were conducted at 2 zoological institutions in Chengdu, China. The camp curriculum was influenced by theory and research on the following: conservation psychology, social learning theory, empathy and moral development theory, socio-biological theory, constructivist theory, and conservation science. Camp activities were sensitive to Chinese culture and included Chinese conservation issues. Activities were designed to help children form bonds with animals and care enough about them to positively change their behavior toward animals and the environment. This mixed methods study triangulated quantitative and qualitative data from six sources to answer the following: (1) Did camp increase student knowledge of animals? (2) Did camp increase student caring about animals? (3) Did camp increase student propensity for environmental and wildlife stewardship? (4) Did camp affect student compassionate behavior toward animals? A conservation stewards survey revealed significant increases on pre-post, self-report of knowledge, care, and propensity. Pre-post, rubric-scored responses to human-animal interaction vignettes indicated a significant increase in knowledge, and stable scores on care and propensity. Qualitative data from student journals, vignettes, and end-of-camp questionnaires demonstrated knowledge, caring, and propensity, and revealed the emergent theme empathy. To address question 4, instructors tallied campers' behavior toward animals using a student behavior ethogram. Occurrence of positive behaviors was inconsistent, but negative behaviors decreased, indicating campers were more conscious of behaviors to avoid. Field notes helped determine that camps were implemented as planned, therefore not interfering with goals of the camp. This study contributes to an emerging and critical knowledge base of effective strategies to promote conservation behavior.

Increasing access and support for emergency management higher education programs.

PubMed

Cwiak, Carol L

2014-01-01

The number of emergency management higher education programs has grown dramatically since 1994 when the FEMA Higher Education Program was created to propagate and support such growth. Data collected annually since 2007 from emergency management higher education programs shows that these programs face some consistent challenges. These challenges were coupled with annual data on program access and support indicators via dimensional analysis to answer the questions: To what extent are the challenges linked to a lack of access or support? If there is linkage, what can be gleaned from these linkages that can help address the challenges through improving access and support? The analysis showed that lack of access to funding and resources, and lack of support from partner organizations, has an impact on emergency management higher education. Discussion of that impact is followed with detailed recommendations that are focused on strengthening both internal and external access and support relationships for emergency management higher education programs.

28 CFR 41.56 - General requirement concerning program accessibility.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 28 Judicial Administration 1 2010-07-01 2010-07-01 false General requirement concerning program accessibility. 41.56 Section 41.56 Judicial Administration DEPARTMENT OF JUSTICE IMPLEMENTATION OF EXECUTIVE... Determining Discriminatory Practices Program Accessibility § 41.56 General requirement concerning program...

32 CFR 1699.149 - Program accessibility: discrimination prohibited.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 32 National Defense 6 2012-07-01 2012-07-01 false Program accessibility: discrimination prohibited... SERVICE SYSTEM ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY SELECTIVE SERVICE SYSTEM § 1699.149 Program accessibility: discrimination prohibited. Except as...

45 CFR 606.50 - Program accessibility: Discrimination prohibited.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 3 2010-10-01 2010-10-01 false Program accessibility: Discrimination prohibited... SCIENCE FOUNDATION ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE NATIONAL SCIENCE FOUNDATION § 606.50 Program accessibility: Discrimination prohibited...

46 CFR 507.149 - Program accessibility: Discrimination prohibited.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 46 Shipping 9 2012-10-01 2012-10-01 false Program accessibility: Discrimination prohibited. 507... MARITIME COMMISSION § 507.149 Program accessibility: Discrimination prohibited. Except as otherwise... in, or otherwise be subjected to discrimination under any program or activity conducted by the agency. ...

Response to anti-programmed cell death protein-1 antibodies in men treated for platinum refractory germ cell cancer relapsed after high-dose chemotherapy and stem cell transplantation.

PubMed

Zschäbitz, Stefanie; Lasitschka, Felix; Hadaschik, Boris; Hofheinz, Ralf-Dieter; Jentsch-Ullrich, Kathleen; Grüner, Marcus; Jäger, Dirk; Grüllich, Carsten

2017-05-01

Treatment options for patients with platinum refractory metastatic germ cell tumours (GCT) relapsing after high-dose chemotherapy and autologous stem cell transplantation are limited and survival is poor. Antibodies directed against programmed cell death protein-1 (PD-1) and programmed cell death ligand-1 (PD-L1) are currently assessed within clinical trials. We present updated data on our experience with checkpoint inhibitors as a compassionate use off-label treatment attempt for highly-pretreated patients with GCT and provide an overview of the current literature on PD-L1 expression in this rare tumour entity. We analysed all patients with platinum refractory GCT treated with checkpoint inhibitors at our institutions between 2015 and 2017. Data were retrieved retrospectively from the patient charts. Seven patients were treated with nivolumab or pembrolizumab. Four patients received single-dose treatment and died shortly afterwards due to tumour progression; the remaining three patients received treatment for at least 6 months. No significant treatment toxicity was observed. Long-term tumour response was achieved in two of the three patients, both of them highly positive for PD-L1 staining. We consider checkpoint inhibition to be efficient in carefully selected patients with platinum refractory GCT. However, predictive markers associated with tumour response are not yet known and larger prospective clinical trials are warranted. Copyright © 2017 Elsevier Ltd. All rights reserved.

49 CFR 28.149 - Program accessibility: Discrimination prohibited.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 49 Transportation 1 2014-10-01 2014-10-01 false Program accessibility: Discrimination prohibited... § 28.149 Program accessibility: Discrimination prohibited. Except as otherwise provided in § 28.150, no... otherwise be subjected to discrimination under any program or activity conducted by the Department. ...

32 CFR 1699.149 - Program accessibility: discrimination prohibited.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 32 National Defense 6 2010-07-01 2010-07-01 false Program accessibility: discrimination prohibited... CONDUCTED BY SELECTIVE SERVICE SYSTEM § 1699.149 Program accessibility: discrimination prohibited. Except as... participation in, or otherwise be subject to discrimination under any program or activity conducted by the...

49 CFR 28.149 - Program accessibility: Discrimination prohibited.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 1 2010-10-01 2010-10-01 false Program accessibility: Discrimination prohibited... § 28.149 Program accessibility: Discrimination prohibited. Except as otherwise provided in § 28.150, no... otherwise be subjected to discrimination under any program or activity conducted by the Department. ...

45 CFR 2104.150 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2012 CFR

2012-10-01

... FINE ARTS ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE COMMISSION OF FINE ARTS § 2104.150 Program accessibility: Existing facilities. (a) General... of achieving program accessibility include— (i) Using audio-visual materials and devices to depict...

45 CFR 2104.150 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2010 CFR

2010-10-01

... FINE ARTS ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE COMMISSION OF FINE ARTS § 2104.150 Program accessibility: Existing facilities. (a) General... of achieving program accessibility include— (i) Using audio-visual materials and devices to depict...

45 CFR 2104.150 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2011 CFR

2011-10-01

... FINE ARTS ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE COMMISSION OF FINE ARTS § 2104.150 Program accessibility: Existing facilities. (a) General... of achieving program accessibility include— (i) Using audio-visual materials and devices to depict...

45 CFR 2104.150 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2013 CFR

2013-10-01

... FINE ARTS ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE COMMISSION OF FINE ARTS § 2104.150 Program accessibility: Existing facilities. (a) General... of achieving program accessibility include— (i) Using audio-visual materials and devices to depict...

45 CFR 2104.150 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2014 CFR

2014-10-01

... FINE ARTS ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE COMMISSION OF FINE ARTS § 2104.150 Program accessibility: Existing facilities. (a) General... of achieving program accessibility include— (i) Using audio-visual materials and devices to depict...

34 CFR 1200.149 - Program accessibility: Discrimination prohibited.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 34 Education 4 2011-07-01 2011-07-01 false Program accessibility: Discrimination prohibited. 1200...) NATIONAL COUNCIL ON DISABILITY ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE NATIONAL COUNCIL ON DISABILITY § 1200.149 Program accessibility: Discrimination...

A qualitative evaluation of the choice of traditional birth attendants for maternity care in 2008 Sierra Leone: implications for universal skilled attendance at delivery.

PubMed

Oyerinde, Koyejo; Harding, Yvonne; Amara, Philip; Garbrah-Aidoo, Nana; Kanu, Rugiatu; Oulare, Macoura; Shoo, Rumishael; Daoh, Kizito

2013-07-01

Maternal and newborn death is common in Sierra Leone; significant reductions in both maternal and newborn mortality require universal access to a skilled attendant during labor and delivery. When too few women use health facilities MDGs 4 and 5 targets will not be met. Our objectives were to identify why women use services provided by TBAs as compared to health facilities; and to suggest strategies to improve utilization of health facilities for maternity and newborn care services. Qualitative data from focus group discussions in communities adjacent to health facilities collected during the 2008 Emergency Obstetric and Newborn Care Needs Assessment were analyzed for themes relating to decision-making on the utilization of TBAs or health facilities. The prohibitive cost of services, and the geographic inaccessibility of health facilities discouraged women from using them while trust in the vast experience of TBAs as well as their compassionate care drew patients to them. Poor facility infrastructure, often absent staff, and the perception that facilities were poorly stocked and could not provide continuum of care services were barriers to facility utilization for maternity and newborn care. Improvements in infrastructure and the 24-hour provision of free, quality, comprehensive, and respectful care will minimize TBA preference in Sierra Leone.

We care don't we? Social workers, the profession and HIV/AIDS.

PubMed

Hall, Nigel

2007-01-01

The HIV/AIDS epidemic has impacted all levels of society from the individual to the macro-economic. The continuing spread of infection around the world means that traditional methods of care and support are put under extreme pressure and many families lose their capacity to cope. Social workers are involved in providing care, counseling and support to those affected, and in developing programmes and other interventions to prevent the spread of the disease. Prevention and behaviour change are vital, but access to treatment is an ethical imperative, particularly in developing countries where the epidemic is most prevalent. Social work is a profession uniquely situated to demonstrate leadership in multi-sectoral collaboration in responding to this pandemic. Consequently this paper briefly reviews the scale and current nature of the epidemic and then considers how social workers can help build more compassionate policies at an international level. Social workers can help to create awareness of the negative effects of poverty, tackle gender inequity, help build more effective coalitions and partnerships, and work with other concerned groups and organisations to end stigma and discrimination. Using case examples the paper considers how social workers can help develop caring strategies that improve the lives of those living with HIV and AIDS.

Standalone Internet speech restructuring treatment for adults who stutter: A phase I study.

PubMed

Erickson, Shane; Block, Susan; Menzies, Ross; O'Brian, Sue; Packman, Ann; Onslow, Mark

2016-08-01

This Phase I trial reports the results of a clinician-free Internet speech restructuring treatment for adults who stutter. The program consists of nine phases with concepts loosely based on the Camperdown Program. Twenty adults who stutter were recruited. They were given unlimited access to the program for 6 months. Primary outcome measures were the percentage of syllables stuttered and self-reported severity ratings. Five participants accessed all phases of the program, while another five accessed more than half the phases. The remaining 10 accessed between one and four phases. Four of five participants who accessed all phases reduced their stuttering frequency by more than 50% and an additional two participants who accessed more than half the phases also achieved similar reductions. These results were confirmed by self-reports of stuttering severity. Stuttering reductions were largely commensurate with the amount of the program accessed. As with other clinician-free programs in related health areas, maintaining adherence to the program's procedures was a significant issue. Nonetheless, this novel approach to treating stuttering has the potential to be a viable alternative for some clients and may help to address the significant access and relapse issues that affect treatment provision for adults who stutter.

36 CFR 1208.150 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2010 CFR

2010-07-01

... OR ACTIVITIES CONDUCTED BY THE NATIONAL ARCHIVES AND RECORDS ADMINISTRATION § 1208.150 Program accessibility: Existing facilities. (a) General. The agency shall operate each program or activity so that the program or activity, when viewed in its entirety, is readily accessible to and usable by individuals with...

45 CFR 2490.150 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2010 CFR

2010-10-01

... ACTIVITIES CONDUCTED BY THE JAMES MADISON MEMORIAL FELLOWSHIP FOUNDATION § 2490.150 Program accessibility: Existing facilities. (a) General. The agency shall operate each program or activity so that the program or activity, when viewed in its entirety, is readily accessible to and usable by individuals with handicaps...

31 CFR 17.149 - Program accessibility: Discrimination prohibited.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 31 Money and Finance: Treasury 1 2011-07-01 2011-07-01 false Program accessibility: Discrimination... DEPARTMENT OF THE TREASURY § 17.149 Program accessibility: Discrimination prohibited. Except as otherwise... participation in, or otherwise be subjected to discrimination under any program or activity conducted by the...

Realising the dream of becoming a nurse: Underrepresented BSc nursing students experiences.

PubMed

O'Brien, Brid; Graham, Margaret M; O'Sullivan, Deirdre

2017-07-01

This paper describes the experiences of underrepresented BSc nursing students in realising the dream of becoming a nurse in one university. In the past ten years, pre-registration nurse education has become established within higher education in Ireland. This development includes promoting access and inclusion of students from traditionally underrepresented groups in higher education. A third of nursing students currently access places on programmes through routes specifically designed for underrepresented groups. A qualitative descriptive study design provided an opportunity for student voices to be heard. Ethical approval was sought and granted. Eleven students were interviewed nearing completion of a four year BSc Nursing programme. Data analysis followed a thematic approach, in generating themes. Three themes emerged from the data: taking the first steps; finding a way and getting through. Findings highlight participants' challenges in balancing study, clinical practice and family life in achieving and realising their dream of becoming a nurse. This study illustrates the nature and complexities of participants' experiences throughout the BSc Nursing programmes towards becoming university graduates, eligible for registration as a nurse. Students from underrepresented groups bring rich and diverse life experiences in preparation for and becoming caring practitioners. It highlights the individuality within participants' experiences and draws attention to the value of personalised support for students. An opportunity to encourage the development of emotional intelligence needs to be fostered within nurse education programmes. Creating positive learning environments is critical to supporting student understanding of compassionate patient centred care. Findings have relevance for global curriculum design and structures to support individual student centred engagement. Further research is required to consider how best to support students from underrepresented groups. Copyright © 2017 Elsevier Ltd. All rights reserved.

The Actively Caring for People Movement at Virginia Tech and Beyond: Cultivating Compassion and Relationships in Residence Halls

ERIC Educational Resources Information Center

McCarty, Shane M.; Mullins, Taris G.; Geller, E. Scott; Shushok, Frank, Jr.

2013-01-01

A professor and a group of student leaders initiated the Actively Caring for People (AC4P) Movement to establish a more civil, compassionate, and inclusive culture by inspiring intentional acts of kindness. This article explores the AC4P Movement in a first-year residence hall at Virginia Tech and a second-year residence hall at University of…

The evolution of breast surgery: where technology and compassion meet.

PubMed

Fine, Richard E

2004-10-01

The origins and development of The American Society of Breast Surgeons are closely tied to technology. Innovative technical progress means less-invasive procedures, more precise diagnoses, more outpatient services, and--with all of this--less pain and stress for our patients. It means more compassionate breast care for women. The Society's mission revolves around improving all aspects of patient care, and this is where technology and compassion meet.

Humanising midwifery care.

PubMed

Way, Susan; Scammell, Janet

2016-03-01

Since the publication of the Francis Report (2013), providing care that is kind and compassionate is high on the agenda of all NHS services, including maternity. This article introduces the humanising values framework that explores aspects of what it is to be human and offers practical examples of how it can be incorporated into midwifery care. Susan Way and Janet Scammell consider the advantages of woman-centred care, highlighting the benefits of humanising care.

Student Voices: What Can Bystanders Do to Prevent Bullying of Students Who Are Different (or Perceived as Different) from Others?

ERIC Educational Resources Information Center

Nordseth, Anna; Vepachedu, Vikas; Shipman, Grant; Alayachew, David

2012-01-01

In this article, four students share their ideas on what bystanders can do to prevent bullying of students who are different or perceived as different from others. Anna Nordseth says what bystanders need to realize is how to recognize bullying and what a lasting effect it can have on the individuals involved. One bold, compassionate bystander can…

[Compassionate care for terminally ill term and preterm infants].

PubMed

Schulze, A; Wermuth, I

2007-04-01

Involvement of the family in decisions to withhold or withdraw intensive care and parental involvement in care planning for terminally ill infants does not aggravate or prolong parents' grief responses, their feelings of guilt, or the incidence of pathological grief responses. Effective physical pain and symptom management is critically important. Compassionate care plans, however, need to implement a number of other and equally important components. Parents are not uniform in their perceived needs to make various kinds of contacts with their dying infant. They should be allowed to make their individual choices regarding contact with their baby during that time. The perinatal loss of a twin infant appears to evoke no less serious stress and risks to parents' compared to the loss of a singleton. The disruption of family life during a perinatal loss affects siblings of the baby, and their specific needs should be acknowledged. Post-death or post-autopsy meetings with the family should routinely be scheduled a few weeks after death, and bereavement support should actively be offered. Parents need to be informed about differences to be expected between maternal and paternal grief responses. The risk of pathological grief variants and chronic grief should be mentioned to parents because professional help is required in such occurrence.

Medical student empathy: interpersonal distinctions and correlates.

PubMed

Jordan, Kevin D; Foster, Penni Smith

2016-12-01

Attention to interpersonal behaviors, communication, and relational factors is taking on increasing importance in medical education. Medical student empathy is one aspect of the physician-patient relationship that is often involved in beneficial interactions leading to improved clinical outcomes and patient satisfaction. As an interpersonal quality, empathy is a social behavior well-suited to be examined from an interpersonal perspective. The present study used the interpersonal theory of clinical, personality, and social psychology to examine the construct of empathy and theorize about likely interpersonal correlates. One hundred and sixty-three students from an academic health center in the southeastern United States participated in this study. The medical student version of the Jefferson Scale of Empathy was used to assess empathy and its factors: Perspective taking, compassionate care, and walking in the patient's shoes. Interpersonal assessments included the International Personality Item Pool-Interpersonal Circumplex, the Interpersonal Support Evaluation List, and the UCLA Loneliness Scale. Distinct interpersonal styles and correlates emerged among empathy and its factors. While all factors of empathy were related to interpersonal warmth, perspective taking and compassionate care were also associated with submissiveness. Of note, only walking in the patient's shoes was correlated with both social support and less loneliness. These findings are discussed in light of interpersonal theory with particular attention paid to the implications for medical education and professional development.

Trainee underperformance: a guide to achieving resolution.

PubMed

Rashid, Prem; Grills, Richard; Kuan, Melvyn; Klein, Deborah

2015-05-01

Underperformance and the disharmony it can cause are not commonly faced by trainees. However, when it occurs, a process to recognize and manage the issues compassionately must be put in place. A literature review was undertaken to outline processes and themes in addressing and resolving these types of issues. A PubMed search using 'surgical underperformance' and 'remedial teaching' was used as a broad template to find papers that illustrated key concepts. One thousand four hundred and fifteen papers were identified. In papers where the titles were in line with the stated topic, 294 abstracts were reviewed. Key papers were used to develop themes. Additional cross-referenced papers were also included where relevant. There can be a variety of reasons for trainee underperformance. The root cause is not always clear. Disharmony can result in a surgical unit during this time. The involved trainee as well as the members of the clinical unit may experience a variety of stressors. A systematic process of management can be used to evaluate the situation and bring some resolution to difficulties in working relationships. Early constructive intervention improves outcomes. There should be a process to systematically and compassionately resolve underlying issues. This paper outlines the disharmony that can result from trainee underperformance and offers guidance for resolution to those involved. © 2014 Royal Australasian College of Surgeons.

Self-compassion and emotional intelligence in nurses.

PubMed

Heffernan, Mary; Quinn Griffin, Mary T; Sister Rita McNulty; Fitzpatrick, Joyce J

2010-08-01

Nurses often provide care for patients and families who are suffering and where emotions are heightened. Compassion is an essential component of the care that nurses provide. Emotions play an important role in the relationship and communication between nurses, patients and families. Self-compassion is the ability to be compassionate to oneself, without this ability nurses might not be prepared to be compassionate to patients. Emotionally intelligent persons perceive themselves as confident, better able to understand, control and manage their emotions. The purpose of this descriptive, correlational study was to examine the relationship between self-compassion and emotional intelligence. Participants were 135 nurses. The setting for this study was a health system with hospitals located in Queens, Nassau and Suffolk counties of New York, USA. Three of the hospitals in the study are located in Queens and/or the Queens/Nassau border. Queens is the most culturally diverse community in the USA. The patients served, as well as the nursing staff, are reflective of this cultural and religious diversity. Results indicated a positive correlation between self-compassion and emotional intelligence (r = 0.55). Recommendations for future research include: exploration of self-compassion and emotional intelligence in nurses, and identification of the benefits of enhancing self-compassion and emotional intelligence in nurses.

OA38 From service delivery to community enablement: a public health approach to palliative care.

PubMed

McLoughlin, Kathleen; Rhatigan, Jim; Richardson, Marie; Lloyd, Rebecca

2015-04-01

: Milford Care Centre is the only hospice in Ireland to make a strategic decision to embrace a public health approach to palliative care, through the development, implementation and evaluation of the Compassionate Communities Project. This presentation seeks to examine why Milford made the decision to move toward a community enablement model, describes the development and implementation of the Compassionate Communities Project to date, presents key findings from recent evaluations and highlights our plans for the future. The presentation uses a reflective, story telling approach to meet it's aims, coupled with data and statistics gathered from the evaluations, and includes a new short film 'Tell Me' developed by recent Computer Science graduates for the Project to use to engage with communities during Café Conversations. The presentation will highlight the relevance of Health Promoting Palliative Care theory to the development of a three-tier model of programme activity, examine the challenges in implementing such an approach and will discuss the impact of upstream intervention to downstream service provision using case studies. © 2015, Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Regulatory Considerations for the Clinical and Research Use of Transcranial Direct Current Stimulation (tDCS): review and recommendations from an expert panel

PubMed Central

Fregni, F; Nitsche, MA; Loo, C.K.; Brunoni, AR; Marangolo, P; Leite, J; Carvalho, S; Bolognini, N; Caumo, W; Paik, NJ; Simis, M; Ueda, K; Ekhitari, H; Luu, P; Tucker, DM; Tyler, WJ; Brunelin, J; Datta, A; Juan, CH; Venkatasubramanian, G; Boggio, PS; Bikson, M

2014-01-01

The field of transcranial electrical stimulation (tES) has experienced significant growth in the past 15 years. One of the tES techniques leading this increased interest is transcranial direct current stimulation (tDCS). Significant research efforts have been devoted to determining the clinical potential of tDCS in humans. Despite the promising results obtained with tDCS in basic and clinical neuroscience, further progress has been impeded by a lack of clarity on international regulatory pathways. We therefore convened a group of research and clinician experts on tDCS to review the research and clinical use of tDCS. In this report, we review the regulatory status of tDCS, and we summarize the results according to research, off-label and compassionate use of tDCS in the following countries: Australia, Brazil, France, Germany, India, Iran, Italy, Portugal, South Korea, Taiwan and United States. Research use, off label treatment and compassionate use of tDCS are employed in most of the countries reviewed in this study. It is critical that a global or local effort is organized to pursue definite evidence to either approve and regulate or restrict the use of tDCS in clinical practice on the basis of adequate randomized controlled treatment trials. PMID:25983531

32 CFR 147.19 - The three standards.

Code of Federal Regulations, 2010 CFR

2010-07-01

...) The investigation standard for“Q” access authorizations and for access to top secret (including top secret Special Access Programs) and Sensitive Compartmented Information; (c) The reinvestigation standard... authorizations and for access to confidential and secret (including all secret-level Special Access Programs not...

47 CFR 79.109 - Activating accessibility features.

Code of Federal Regulations, 2014 CFR

2014-10-01

... ACCESSIBILITY OF VIDEO PROGRAMMING Apparatus § 79.109 Activating accessibility features. (a) Requirements... video programming transmitted in digital format simultaneously with sound, including apparatus designed to receive or display video programming transmitted in digital format using Internet protocol, with...

Gemcitabine and capecitabine as third- or later-line therapy for refractory advanced colorectal cancer: a retrospective study.

PubMed

Salgado, Mercedes; Reboredo, Margarita; Mendez, Juan Carlos; Quintero, Guillermo; Pellón, María Luz; Romero, Carlos; Jorge, Mónica; Montes, Ana Fernández; Valladares-Ayerbes, Manuel; Ramos, Manuel; Varela, Silvia; Alonso, Miguel Ángel

2013-09-01

To evaluate gemcitabine plus capecitabine as third-line or later-line therapy in patients with refractory advanced colorectal cancer (CRC) who maintain a good performance status (PS). We retrospectively evaluated patients who had failed at least two lines of therapy or had contraindication to standard therapy and received gemcitabine (1,000 mg/m(2), d1 biweekly) plus capecitabine (1,700 mg/m(2)/day, d1-7 every two weeks) in a compassionate use program. Thirty-nine patients were enrolled. The majority (85%) had ECOG PS 1. Gemcitabine plus capecitabine was administered as third- and fourth-line in 49% and 23% of patients, respectively; and as fifth-line or later-line in 28%. A clinical benefit of 21% was found. The median progression-free survival and overall survival were 3.0 and 7.3 months, respectively. Toxicity was mild to moderate, with no reported grade 4 toxicities. Gemcitabine plus capecitabine was safe and well-tolerated. While the efficacy of this regimen was modest in terms of response, the survival data were acceptable and consistent with previous publications on this setting.

Embedding Volunteer Activity into Paramedic Education.

PubMed

Ross, Linda; Kabidi, Sophia

2017-01-01

Paramedics require a wide range of skills that are beyond clinical or technical skills in order to meet the demands of the role and provide quality and compassionate care to patients. Non-technical or "soft" skills and attributes are generally challenging to teach and develop in the classroom setting. Volunteerism provides an opportunity for students to gain exposure to different communities and develop interpersonal skills. This cross-sectional study used one-on-one interviews with 12 third-year Bachelor of Emergency Health (Paramedic) students from Monash University, Australia, who completed a community volunteering program. Results suggest that paramedic students see volunteering as a highly valuable means of developing a number of skills crucial to their future roles and paramedic practice. Volunteering also provided students with an opportunity to learn about themselves and the broader community, develop confidence, and improve overall job-readiness and employability. This study demonstrates that embedding volunteering into paramedic education is an effective way to develop the broad range of paramedic attributes required for the role. These experiences allow students to make the important transition to a job-ready graduate paramedic who can provide holistic patient-centred care.

[Work process in Family Health Program: the potential of subjectivity of care for reconfiguration of the care model].

PubMed

Santos, Debora de Souza; Mishima, Silvana Martins; Merhy, Emerson Elias

2018-03-01

This is a study with a qualitative approach that aims to analyze the subjective dimension of the Family Health teams' practices conducted in order to reconfigure the care model, using the work process in health as the fundamental analytical category from the Marxist standpoint. The data gathering tool used was the focus group, applied in 13 Family Health teams in Maceió, Alagoas. Thematic analysis combined with principles of hermeneutics and dialectics was used for treatment and interpretation of the data. The results indicate that the user´s needs identified by the teams are multiple and permeated by a lack of sympathetic care, and that the user repeatedly wishes to be "heard." The teams show that they are open to the use of soft technologies of compassionate care, although they do not legitimate them as instruments of their work. Clinical knowledge and techniques are prioritized in the work process, which limits the potential of its subjective dimension in order to (re)configure a care model which attends the user´s needs and is sustained by integrated care.

22 CFR 1600.149 - Program accessibility: Discrimination prohibited.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 22 Foreign Relations 2 2014-04-01 2014-04-01 false Program accessibility: Discrimination prohibited. 1600.149 Section 1600.149 Foreign Relations JAPAN-UNITED STATES FRIENDSHIP COMMISSION ENFORCEMENT... STATES FRIENDSHIP COMMISSION § 1600.149 Program accessibility: Discrimination prohibited. Except as...

47 CFR 1.1849 - Program accessibility: Discrimination prohibited.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 47 Telecommunication 1 2011-10-01 2011-10-01 false Program accessibility: Discrimination... the Federal Communications Commission § 1.1849 Program accessibility: Discrimination prohibited. (a... benefits of, be excluded from participation in, or otherwise be subjected to discrimination under any...

ACCESS 1: Approximation Concepts Code for Efficient Structural Synthesis program documentation and user's guide

NASA Technical Reports Server (NTRS)

Miura, H.; Schmit, L. A., Jr.

1976-01-01

The program documentation and user's guide for the ACCESS-1 computer program is presented. ACCESS-1 is a research oriented program which implements a collection of approximation concepts to achieve excellent efficiency in structural synthesis. The finite element method is used for structural analysis and general mathematical programming algorithms are applied in the design optimization procedure. Implementation of the computer program, preparation of input data and basic program structure are described, and three illustrative examples are given.

Ombitasvir, paritaprevir, and ritonavir, with or without dasabuvir, plus ribavirin for patients with hepatitis C virus genotype 1 or 4 infection with cirrhosis (ABACUS): a prospective observational study.

PubMed

Petta, Salvatore; Marzioni, Marco; Russo, Pierluigi; Aghemo, Alessio; Alberti, Alfredo; Ascione, Antonio; Antinori, Andrea; Bruno, Raffaele; Bruno, Savino; Chirianni, Antonio; Gaeta, Giovanni Battista; Giannini, Edoardo G; Merli, Manuela; Messina, Vincenzo; Montilla, Simona; Perno, Carlo Federico; Puoti, Massimo; Raimondo, Giovanni; Rendina, Maria; Silberstein, Francesca Ceccherini; Villa, Erica; Zignego, Anna Linda; Pani, Luca; Craxì, Antonio

2017-06-01

We ran a compassionate use nationwide programme (ABACUS) to provide access to ombitasvir, paritaprevir, and ritonavir, with dasabuvir, plus ribavirin for hepatitis C virus (HCV) genotype 1 infection and ombitasvir, paritaprevir, and ritonavir, plus ribavirin for HCV genotype 4 infection in patients with cirrhosis at high risk of decompensation while approval of these regimens was pending in Italy. In this prospective observational study, we collected data from a compassionate use nationwide programme from March 17, 2014, to May 28, 2015. Patients with HCV genotype 1 infection and cirrhosis at high risk of decompensation were given coformulated ombitasvir (25 mg), paritaprevir (150 mg), and ritonavir (100 mg) once daily and dasabuvir (250 mg) twice daily for 12 weeks (patients with HCV genotype 1b infection) or 24 weeks (patients with HCV genotype 1a infection). Patients with HCV genotype 4 infection were given coformulated ombitasvir (25 mg), paritaprevir (150 mg), and ritonavir (100 mg) once per day for 24 weeks. All patients were given weight-based ribavirin. The primary efficacy endpoint was sustained virological response at week 12 after the end of treatment (SVR12), analysed by intention-to-treat. Univariate and multivariate logistic regression analyses were used to identify baseline characteristics associated with SVR12. Adverse events were recorded throughout the study. 728 (96%) of 762 patients with cirrhosis who were given ombitasvir, paritaprevir, and ritonavir, with or without dasabuvir, plus ribavirin therapy for 12 or 24 weeks achieved SVR12. Logistic regression analyses identified that bilirubin concentrations of less than 2 mg/dL were associated with SVR12 (odds ratio [OR] 4·76 [95% CI 1·83-12·3]; p=0·001). 166 (23%) of 734 patients included in safety analyses had an adverse event. 25 (3%) patients discontinued treatment because of adverse events. Asthenia was the most commonly reported adverse event, occurring in 36 (5%) patients. Our findings suggest that the safety and effectiveness of ombitasvir, paritaprevir, and ritonavir, with or without dasabuvir, plus ribavirin in patients with HCV genotype 1 or 4 infection and cirrhosis at high risk of decompensation in a real-life setting are similar to those reported in clinical trials. The concordance with clinical trials provides reassurance that the reported efficacy of this treatment in clinical trials will translate to its use in routine clinical practice. Dipartimento Biomedico di Medicina Interna e Specialistica dell'Universita di Palermo. Copyright © 2017 Elsevier Ltd. All rights reserved.

36 CFR 909.149 - Program accessibility: Discrimination prohibited.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 36 Parks, Forests, and Public Property 3 2010-07-01 2010-07-01 false Program accessibility: Discrimination prohibited. 909.149 Section 909.149 Parks, Forests, and Public Property PENNSYLVANIA AVENUE... CONDUCTED BY THE PENNSYLVANIA AVENUE DEVELOPMENT CORPORATION § 909.149 Program accessibility: Discrimination...

45 CFR 2301.149 - Program accessibility: Discrimination prohibited.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 4 2010-10-01 2010-10-01 false Program accessibility: Discrimination prohibited. 2301.149 Section 2301.149 Public Welfare Regulations Relating to Public Welfare (Continued) ARCTIC... CONDUCTED BY THE UNITED STATES ARCTIC RESEARCH COMMISSION § 2301.149 Program accessibility: Discrimination...

45 CFR 2301.149 - Program accessibility: Discrimination prohibited.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 45 Public Welfare 4 2011-10-01 2011-10-01 false Program accessibility: Discrimination prohibited. 2301.149 Section 2301.149 Public Welfare Regulations Relating to Public Welfare (Continued) ARCTIC... CONDUCTED BY THE UNITED STATES ARCTIC RESEARCH COMMISSION § 2301.149 Program accessibility: Discrimination...

Economic Impact of the Critical Access Hospital Program on Kentucky's Communities

ERIC Educational Resources Information Center

Ona, Lucia; Davis, Alison

2011-01-01

Context: In 1997, the Medicare Rural Hospital Flexibility Grant Program created the Critical Access Hospital (CAH) Program as a response to the financial distress of rural hospitals. It was believed that this program would reduce the rate of rural hospital closures and improve access to health care services in rural communities. Objective: The…

22 CFR 1600.151 - Program accessibility: New construction and alterations.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 22 Foreign Relations 2 2013-04-01 2009-04-01 true Program accessibility: New construction and alterations. 1600.151 Section 1600.151 Foreign Relations JAPAN-UNITED STATES FRIENDSHIP COMMISSION ENFORCEMENT... STATES FRIENDSHIP COMMISSION § 1600.151 Program accessibility: New construction and alterations. Each...

22 CFR 1600.151 - Program accessibility: New construction and alterations.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 22 Foreign Relations 2 2014-04-01 2014-04-01 false Program accessibility: New construction and alterations. 1600.151 Section 1600.151 Foreign Relations JAPAN-UNITED STATES FRIENDSHIP COMMISSION ENFORCEMENT... STATES FRIENDSHIP COMMISSION § 1600.151 Program accessibility: New construction and alterations. Each...

22 CFR 1600.151 - Program accessibility: New construction and alterations.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 22 Foreign Relations 2 2012-04-01 2009-04-01 true Program accessibility: New construction and alterations. 1600.151 Section 1600.151 Foreign Relations JAPAN-UNITED STATES FRIENDSHIP COMMISSION ENFORCEMENT... STATES FRIENDSHIP COMMISSION § 1600.151 Program accessibility: New construction and alterations. Each...

22 CFR 1600.151 - Program accessibility: New construction and alterations.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 22 Foreign Relations 2 2011-04-01 2009-04-01 true Program accessibility: New construction and alterations. 1600.151 Section 1600.151 Foreign Relations JAPAN-UNITED STATES FRIENDSHIP COMMISSION ENFORCEMENT... STATES FRIENDSHIP COMMISSION § 1600.151 Program accessibility: New construction and alterations. Each...

19 CFR 201.149 - Program accessibility: Discrimination prohibited.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 19 Customs Duties 3 2010-04-01 2010-04-01 false Program accessibility: Discrimination prohibited. 201.149 Section 201.149 Customs Duties UNITED STATES INTERNATIONAL TRADE COMMISSION GENERAL RULES OF... Conducted by the U.S. International Trade Commission § 201.149 Program accessibility: Discrimination...

19 CFR 201.150 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 19 Customs Duties 3 2010-04-01 2010-04-01 false Program accessibility: Existing facilities. 201.150 Section 201.150 Customs Duties UNITED STATES INTERNATIONAL TRADE COMMISSION GENERAL RULES OF... Conducted by the U.S. International Trade Commission § 201.150 Program accessibility: Existing facilities...

19 CFR 201.150 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 19 Customs Duties 3 2012-04-01 2012-04-01 false Program accessibility: Existing facilities. 201.150 Section 201.150 Customs Duties UNITED STATES INTERNATIONAL TRADE COMMISSION GENERAL RULES OF... Conducted by the U.S. International Trade Commission § 201.150 Program accessibility: Existing facilities...

19 CFR 201.150 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 19 Customs Duties 3 2014-04-01 2014-04-01 false Program accessibility: Existing facilities. 201.150 Section 201.150 Customs Duties UNITED STATES INTERNATIONAL TRADE COMMISSION GENERAL RULES OF... Conducted by the U.S. International Trade Commission § 201.150 Program accessibility: Existing facilities...

19 CFR 201.149 - Program accessibility: Discrimination prohibited.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 19 Customs Duties 3 2012-04-01 2012-04-01 false Program accessibility: Discrimination prohibited. 201.149 Section 201.149 Customs Duties UNITED STATES INTERNATIONAL TRADE COMMISSION GENERAL RULES OF... Conducted by the U.S. International Trade Commission § 201.149 Program accessibility: Discrimination...

19 CFR 201.150 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 19 Customs Duties 3 2013-04-01 2013-04-01 false Program accessibility: Existing facilities. 201.150 Section 201.150 Customs Duties UNITED STATES INTERNATIONAL TRADE COMMISSION GENERAL RULES OF... Conducted by the U.S. International Trade Commission § 201.150 Program accessibility: Existing facilities...

19 CFR 201.149 - Program accessibility: Discrimination prohibited.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 19 Customs Duties 3 2014-04-01 2014-04-01 false Program accessibility: Discrimination prohibited. 201.149 Section 201.149 Customs Duties UNITED STATES INTERNATIONAL TRADE COMMISSION GENERAL RULES OF... Conducted by the U.S. International Trade Commission § 201.149 Program accessibility: Discrimination...

19 CFR 201.149 - Program accessibility: Discrimination prohibited.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 19 Customs Duties 3 2011-04-01 2011-04-01 false Program accessibility: Discrimination prohibited. 201.149 Section 201.149 Customs Duties UNITED STATES INTERNATIONAL TRADE COMMISSION GENERAL RULES OF... Conducted by the U.S. International Trade Commission § 201.149 Program accessibility: Discrimination...

19 CFR 201.149 - Program accessibility: Discrimination prohibited.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 19 Customs Duties 3 2013-04-01 2013-04-01 false Program accessibility: Discrimination prohibited. 201.149 Section 201.149 Customs Duties UNITED STATES INTERNATIONAL TRADE COMMISSION GENERAL RULES OF... Conducted by the U.S. International Trade Commission § 201.149 Program accessibility: Discrimination...

19 CFR 201.150 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 19 Customs Duties 3 2011-04-01 2011-04-01 false Program accessibility: Existing facilities. 201.150 Section 201.150 Customs Duties UNITED STATES INTERNATIONAL TRADE COMMISSION GENERAL RULES OF... Conducted by the U.S. International Trade Commission § 201.150 Program accessibility: Existing facilities...

45 CFR 2490.150 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 45 Public Welfare 4 2013-10-01 2013-10-01 false Program accessibility: Existing facilities. 2490.150 Section 2490.150 Public Welfare Regulations Relating to Public Welfare (Continued) JAMES MADISON... ACTIVITIES CONDUCTED BY THE JAMES MADISON MEMORIAL FELLOWSHIP FOUNDATION § 2490.150 Program accessibility...

45 CFR 2490.150 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 45 Public Welfare 4 2012-10-01 2012-10-01 false Program accessibility: Existing facilities. 2490.150 Section 2490.150 Public Welfare Regulations Relating to Public Welfare (Continued) JAMES MADISON... ACTIVITIES CONDUCTED BY THE JAMES MADISON MEMORIAL FELLOWSHIP FOUNDATION § 2490.150 Program accessibility...

45 CFR 2490.150 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 45 Public Welfare 4 2014-10-01 2014-10-01 false Program accessibility: Existing facilities. 2490.150 Section 2490.150 Public Welfare Regulations Relating to Public Welfare (Continued) JAMES MADISON... ACTIVITIES CONDUCTED BY THE JAMES MADISON MEMORIAL FELLOWSHIP FOUNDATION § 2490.150 Program accessibility...

45 CFR 2490.150 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 45 Public Welfare 4 2011-10-01 2011-10-01 false Program accessibility: Existing facilities. 2490.150 Section 2490.150 Public Welfare Regulations Relating to Public Welfare (Continued) JAMES MADISON... ACTIVITIES CONDUCTED BY THE JAMES MADISON MEMORIAL FELLOWSHIP FOUNDATION § 2490.150 Program accessibility...

76 FR 66089 - Access Authorization Program for Nuclear Power Plants

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-25

... NUCLEAR REGULATORY COMMISSION [NRC-2011-0245] Access Authorization Program for Nuclear Power... Program for Nuclear Power Plants.'' This guide describes a method that NRC staff considers acceptable to... Regulations (10 CFR), section 73.56, ``Personnel Access Authorization Requirements for Nuclear Power Plants...

45 CFR 2301.150 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 4 2010-10-01 2010-10-01 false Program accessibility: Existing facilities. 2301.150 Section 2301.150 Public Welfare Regulations Relating to Public Welfare (Continued) ARCTIC RESEARCH... THE UNITED STATES ARCTIC RESEARCH COMMISSION § 2301.150 Program accessibility: Existing facilities. (a...

45 CFR 2301.150 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 45 Public Welfare 4 2011-10-01 2011-10-01 false Program accessibility: Existing facilities. 2301.150 Section 2301.150 Public Welfare Regulations Relating to Public Welfare (Continued) ARCTIC RESEARCH... THE UNITED STATES ARCTIC RESEARCH COMMISSION § 2301.150 Program accessibility: Existing facilities. (a...

HIV / AIDS, STDs and the workplace.

PubMed

Jackson, H

1995-01-01

Even though the workplace is ideal for promoting HIV/STD (sexually transmitted disease) prevention to benefit workers and employers, many workplaces are not convinced that they should be involved in HIV/AIDS and STD education, prevention, and support. They do not realize that time and money spent on health programs save them money. Perhaps they do not feel obligated to protect the health of their employees. The AIDS epidemic adversely affects society and the economy at both the macro and micro level. AIDS tends to strike the productive age group, thereby seriously affecting the workplace. In many Sub-Saharan African countries, at least 20% of the urban workforce may be infected with HIV. Persons living with HIV include top management, skilled professionals, general hands, and farm laborers. HIV/AIDS costs for formal employment are assumed through reduced productivity; increased costs of occupational benefits and social security measures; loss of skilled labor, professionals, and managerial expertise as well as the experience among workers; increased costs of training and recruitment; and low morale from stigmatization, discrimination, and subsequent industrial relation problems. Needed are comprehensive HIV/AIDS and STD workplace programs that ensure the rights of persons with HIV and compassionate treatment of these persons. Trade union or other labor representatives, management, and appropriate government departments should work together and build on existing health legislation and policy to bring about effective negotiation and policy development concerning AIDS and employment. Training of peer educators, support services (counseling, STD referral and/or treatment), community action, management commitment, monitoring and evaluation, and supportive workplace conditions make for effective comprehensive workplace programs. Successful programs operate in fishing villages in Tanzania, tea plantations in India, the University of Papua New Guinea, and Ugandan army camps.

[A listening support group for nursing staff].

PubMed

Lemoine, Dominique

2016-05-01

The feedback from a consultant nurse in a listening support group for health professionals shows that, for hospital nursing staff, the phenomenon of suffering in the workplace is a reality. In addition to providing help to professionals who request it, the missions of such a group are to promote discussion around psycho-social risks in the framework of a policy of compassionate care for staff. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

American Nurses Association. position statement on assisted suicide.

PubMed

1995-01-01

Nurses, individually and collectively, have an obligation to provide comprehensive and compassionate end-of-life care which includes the promotion of comfort and the relief of pain and, at times, forgoing life-sustaining treatments. The American Nurses Association (ANA) believes that the nurse should not participate in assisted suicide. Such an act is in violation of the Code for Nurses with Interpretive Statements (Code for Nurses) and the ethical traditions of the profession.

Clinical management of "entitled" clients.

PubMed

Kerr, Norine

2002-12-01

As this process occurs, the painful affects become toned down for the clients. By exploring the source of clients' painful affects, wounded self-esteem, fearful projections, and dysfunctional defenses, misguided entitlement can be undermined. Much of this work will occur in a formal psychotherapy process, but nurses can create healthy object relatedness. To do so, they must see beyond the provocative and offensive behaviors to the vulnerable individual within who desperately needs compassionate and intelligent nursing care.

Care, compassion and communication.

PubMed

Bloomfield, Jacqueline; Pegram, Anne

2015-02-20

Care, compassion and effective communication are essential elements of nursing, which must be demonstrated by all nurses and nursing students. These requirements form the basis of the first essential skills cluster, which stipulates key skills and behaviours that must be demonstrated to meet the standards for registration with the Nursing and Midwifery Council. This article discusses the core aspects of compassionate care and effective communication and, in doing so, uses examples to demonstrate their use within nursing.

A good daddy.

PubMed

Kannai, Ruth

2017-09-01

This personal narrative presents the imagined inner dialogue of my father, when caring for me as a young sickly child. It is a compassionate exercise in attempting to understand the remote inner emotional world of my father, a Holocaust survivor, as he contended with my ongoing medical challenges that perhaps triggered his traumatic memories from the war. I am the daughter who eventually grew up to be a physician herself. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Foot and Ankle Fellowship Websites: An Assessment of Accessibility and Quality.

PubMed

Hinds, Richard M; Danna, Natalie R; Capo, John T; Mroczek, Kenneth J

2017-08-01

The Internet has been reported to be the first informational resource for many fellowship applicants. The objective of this study was to assess the accessibility of orthopaedic foot and ankle fellowship websites and to evaluate the quality of information provided via program websites. The American Orthopaedic Foot and Ankle Society (AOFAS) and the Fellowship and Residency Electronic Interactive Database (FREIDA) fellowship databases were accessed to generate a comprehensive list of orthopaedic foot and ankle fellowship programs. The databases were reviewed for links to fellowship program websites and compared with program websites accessed from a Google search. Accessible fellowship websites were then analyzed for the quality of recruitment and educational content pertinent to fellowship applicants. Forty-seven orthopaedic foot and ankle fellowship programs were identified. The AOFAS database featured direct links to 7 (15%) fellowship websites with the independent Google search yielding direct links to 29 (62%) websites. No direct website links were provided in the FREIDA database. Thirty-six accessible websites were analyzed for content. Program websites featured a mean 44% (range = 5% to 75%) of the total assessed content. The most commonly presented recruitment and educational content was a program description (94%) and description of fellow operative experience (83%), respectively. There is substantial variability in the accessibility and quality of orthopaedic foot and ankle fellowship websites. Recognition of deficits in accessibility and content quality may assist foot and ankle fellowships in improving program information online. Level IV.

36 CFR 909.151 - Program accessibility: New construction and alterations.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 36 Parks, Forests, and Public Property 3 2010-07-01 2010-07-01 false Program accessibility: New construction and alterations. 909.151 Section 909.151 Parks, Forests, and Public Property PENNSYLVANIA AVENUE... CONDUCTED BY THE PENNSYLVANIA AVENUE DEVELOPMENT CORPORATION § 909.151 Program accessibility: New...

47 CFR 79.2 - Accessibility of programming providing emergency information.

Code of Federal Regulations, 2014 CFR

2014-10-01

...) BROADCAST RADIO SERVICES ACCESSIBILITY OF VIDEO PROGRAMMING Video Programming Owners, Providers, and... of programming providing emergency information. (1) Video programming distributors must make... or by using a method of visual presentation, as described in § 79.1. (2) Video programming...

Unique barriers and needs in weight management for obese women with fibromyalgia.

PubMed

Craft, Jennifer M; Ridgeway, Jennifer L; Vickers, Kristin S; Hathaway, Julie C; Vincent, Ann; Oh, Terry H

2015-01-01

The aim of this study was to identify barriers, needs, and preferences of weight management intervention for women with fibromyalgia (FM). Obesity appears in higher rates in women with fibromyalgia compared to the population at large, and no study to date has taken a qualitative approach to better understand how these women view weight management in relation to their disease and vice versa. We designed a qualitative interview study with women patients with FM and obesity. Women (N = 15) were recruited by their participation in a fibromyalgia treatment program (FTP) within the year prior. The women approached for the study met the following inclusion criteria: confirmed diagnosis of FM, age between 30 and 60 years (M = 51 ± 6.27), and body mass index (BMI) ≥ 30 (M = 37.88 ± 4.87). Patients completed questionnaire data prior to their participation in focus groups (N = 3), including weight loss history, physical activity data, the Revised Fibromyalgia Impact Questionnaire (FIQR), and the Patient Health Questionnaire 9-item (PHQ-9). Three focus group interviews were conducted to collect qualitative data. Consistent themes were revealed within and between groups. Patients expressed the complex relationships between FM symptoms, daily responsibilities, and weight management. Weight was viewed as an emotionally laden topic requiring compassionate delivery of programming from an empathetic leader who is knowledgeable about fibromyalgia. Patients view themselves as complex and different, requiring a specifically tailored weight management program for women with FM. Women with FM identify unique barriers to weight management, including the complex interrelationships between symptoms of FM and health behaviors, such as diet and exercise. They prefer a weight management program for women with FM that consists of an in-person, group-based approach with a leader but are open to a tailored conventional weight management program. Feasibility may be one of the biggest barriers to such a program both from an institutional and individual perspective. Copyright © 2015 Elsevier Inc. All rights reserved.

19 CFR 201.151 - Program accessibility: New construction and alterations.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 19 Customs Duties 3 2010-04-01 2010-04-01 false Program accessibility: New construction and alterations. 201.151 Section 201.151 Customs Duties UNITED STATES INTERNATIONAL TRADE COMMISSION GENERAL RULES... Activities Conducted by the U.S. International Trade Commission § 201.151 Program accessibility: New...

19 CFR 201.151 - Program accessibility: New construction and alterations.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 19 Customs Duties 3 2011-04-01 2011-04-01 false Program accessibility: New construction and alterations. 201.151 Section 201.151 Customs Duties UNITED STATES INTERNATIONAL TRADE COMMISSION GENERAL RULES... Activities Conducted by the U.S. International Trade Commission § 201.151 Program accessibility: New...

19 CFR 201.151 - Program accessibility: New construction and alterations.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 19 Customs Duties 3 2014-04-01 2014-04-01 false Program accessibility: New construction and alterations. 201.151 Section 201.151 Customs Duties UNITED STATES INTERNATIONAL TRADE COMMISSION GENERAL RULES... Activities Conducted by the U.S. International Trade Commission § 201.151 Program accessibility: New...

19 CFR 201.151 - Program accessibility: New construction and alterations.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 19 Customs Duties 3 2012-04-01 2012-04-01 false Program accessibility: New construction and alterations. 201.151 Section 201.151 Customs Duties UNITED STATES INTERNATIONAL TRADE COMMISSION GENERAL RULES... Activities Conducted by the U.S. International Trade Commission § 201.151 Program accessibility: New...

19 CFR 201.151 - Program accessibility: New construction and alterations.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 19 Customs Duties 3 2013-04-01 2013-04-01 false Program accessibility: New construction and alterations. 201.151 Section 201.151 Customs Duties UNITED STATES INTERNATIONAL TRADE COMMISSION GENERAL RULES... Activities Conducted by the U.S. International Trade Commission § 201.151 Program accessibility: New...

34 CFR 395.12 - Access to program and financial information.

Code of Federal Regulations, 2010 CFR

2010-07-01

... arrange a convenient time to assist in the interpretation of such financial data. ... 34 Education 2 2010-07-01 2010-07-01 false Access to program and financial information. 395.12... BLIND ON FEDERAL AND OTHER PROPERTY The State Licensing Agency § 395.12 Access to program and financial...

14 CFR 1251.550 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2013 CFR

2013-01-01

... NONDISCRIMINATION ON BASIS OF HANDICAP Enforcement of Nondiscrimination on the Basis of Handicap in Programs or... activity, when viewed in its entirety, is readily accessible to and usable by individuals with handicaps... accessible to and usable by individuals with handicaps; (2) In the case of historic preservation programs...

14 CFR 1251.550 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2012 CFR

2012-01-01

... NONDISCRIMINATION ON BASIS OF HANDICAP Enforcement of Nondiscrimination on the Basis of Handicap in Programs or... activity, when viewed in its entirety, is readily accessible to and usable by individuals with handicaps... accessible to and usable by individuals with handicaps; (2) In the case of historic preservation programs...

14 CFR § 1251.550 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2014 CFR

2014-01-01

... NONDISCRIMINATION ON BASIS OF HANDICAP Enforcement of Nondiscrimination on the Basis of Handicap in Programs or... activity, when viewed in its entirety, is readily accessible to and usable by individuals with handicaps... accessible to and usable by individuals with handicaps; (2) In the case of historic preservation programs...

14 CFR 1251.550 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2011 CFR

2011-01-01

... NONDISCRIMINATION ON BASIS OF HANDICAP Enforcement of Nondiscrimination on the Basis of Handicap in Programs or... activity, when viewed in its entirety, is readily accessible to and usable by individuals with handicaps... accessible to and usable by individuals with handicaps; (2) In the case of historic preservation programs...

14 CFR 1251.550 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2010 CFR

2010-01-01

... NONDISCRIMINATION ON BASIS OF HANDICAP Enforcement of Nondiscrimination on the Basis of Handicap in Programs or... activity, when viewed in its entirety, is readily accessible to and usable by individuals with handicaps... accessible to and usable by individuals with handicaps; (2) In the case of historic preservation programs...

75 FR 2583 - Over-the-Road Bus Accessibility Program Grants

Federal Register 2010, 2011, 2012, 2013, 2014

2010-01-15

... Transportation Equity Act for the 21st Century (TEA-21). The OTRB Accessibility Program makes funds available to... (TEA-21), Public Law 105-85 as amended by the Safe, Accountable, Flexible, Efficient, Transportation.... transportation system. TEA-21 authorized FTA's OTRB Accessibility Program to assist OTRB operators in complying...

Accessibility and content of individualized adult reconstructive hip and knee/musculoskeletal oncology fellowship web sites.

PubMed

Young, Bradley L; Cantrell, Colin K; Patt, Joshua C; Ponce, Brent A

2018-06-01

Accessible, adequate online information is important to fellowship applicants. Program web sites can affect which programs applicants apply to, subsequently altering interview costs incurred by both parties and ultimately impacting rank lists. Web site analyses have been performed for all orthopaedic subspecialties other than those involved in the combined adult reconstruction and musculoskeletal (MSK) oncology fellowship match. A complete list of active programs was obtained from the official adult reconstruction and MSK oncology society web sites. Web site accessibility was assessed using a structured Google search. Accessible web sites were evaluated based on 21 previously reported content criteria. Seventy-four adult reconstruction programs and 11 MSK oncology programs were listed on the official society web sites. Web sites were identified and accessible for 58 (78%) adult reconstruction and 9 (82%) MSK oncology fellowship programs. No web site contained all content criteria and more than half of both adult reconstruction and MSK oncology web sites failed to include 12 of the 21 criteria. Several programs participating in the combined Adult Reconstructive Hip and Knee/Musculoskeletal Oncology Fellowship Match did not have accessible web sites. Of the web sites that were accessible, none contained comprehensive information and the majority lacked information that has been previously identified as being important to perspective applicants.

Our Professional Responsibilities Relative to Human-Animal Interactions

PubMed Central

Bustad, L. K.; Hines, L.

1984-01-01

An interesting area with great potential for benefiting and enriching the lives and conditions of people and animals is opening to us in research, service and teaching. By working with colleagues in other disciplines, we can develop new and creative ways to realize the great promise inherent in people-animal interactions properly studied and utilized. Veterinarians who understand that a strong human-companion animal bond can augment people's mental and physical states will help develop sound and effective companion animal programs for individuals who are lonely or handicapped and for persons in the school systems of the community, as well as its hospices, nursing and convalescent homes, prisons and other institutions. Children experiencing the deep satisfaction of interacting with animals while young will more likely become responsible pet owners and advocates as adults. The image of the profession is enhanced when children and adults see veterinarians as concerned teachers and compassionate health professionals. We as professionals will be required not only to update our knowledge and skills, but to acquire new knowledge in fields of animal and human behavior, psychology and sociology. We are needed on interdisciplinary research teams to study human-animal interactions. We will also be asked to commit time and personal energies in community programs, sometimes with no remuneration. But if skilled health professionals like veterinarians do not take the lead in establishing sound, long-term companion animal programs in their own communities, everyone will suffer including the animals. How we, as individual professionals, respond will be an important reflection of our compassion and our humanity. PMID:17422458

75 FR 20034 - Over-the-Road Bus Accessibility Program Grants: Corrections

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-16

... DEPARTMENT OF TRANSPORTATION Federal Transit Administration Over-the-Road Bus Accessibility... ``Over-the-Road Bus Accessibility Program Grants,'' extends the application deadline, and allows... comply with the terms and conditions of the Special Warranty for the Over-the-Road Bus Accessibility...

Contributions and Challenges of Non-Professional Patient Care: A Key Component of Contemporary Canadian Healthcare.

PubMed

Montague, Terrence; Gogovor, Amédé; Ahmed, Sara; Torr, Emily; Aylen, John; Marshall, Lucas; Henningsen, Nadine; Nemis-White, Joanna

2015-01-01

The Canadian public is aging. Population levels of excellent, or very good, health are decreasing, and the prevalence of chronic diseases is increasing. Timely access to caring and respectful care from health professionals, with supporting information transfer, are key qualities in patients' sense of centricity and hope for best outcomes. Data from the 2013-2014 Health Care in Canada (HCIC) survey reveal, however, that 38% of such patients do not always, or often, access this support. The lack of timely access may be one underlying driver for non-professional caregivers to contribute to the care, as well as the personal and financial management, of family members or friends with chronic disease. Previous HCIC surveys, in 2005, 2006 and 2007, reported non-professional caregivers' prevalence in the adult public at 21, 23 and 26%, respectively, compared with 19% in the 2013-2014 survey. In all the surveys, a notable feature of non-professional care providers has been their universality of contribution, across age, sex, geography and time. Caregivers pay, however, a price. They have a lower level of self-related health, a higher incidence of chronic illness and net-negative impacts on relationships, career and finances, including use of personal savings (53%) and necessity of quitting their job (12%). Conversely, they infrequently claim available tax (12%) or compassionate care (11%) benefits. Interestingly, non-professional caregivers work in team-care settings with health professionals more frequently (29%) than patients in the general population with chronic illnesses (18%). Nonetheless, their current levels of always, or often, receiving assisting support (46%) and information (53%) from health professionals are lower than the respective results reported by the general public (65% and 68%). In conclusion, non-professional patient care in Canada is a common, longstanding and not-for-profit enterprise. It is more likely driven by altruistic caring or sense of duty that balance, or overwhelm, its associated personal, medical and financial burdens. In the short term, practical opportunities for enhancement include broader recognition of caregivers' contributions, their improved access to professional support and communication and wider use of available governmental financial support. All are likely to enhance both patient-centred care and lessen the practical burdens of caregivers. Things can be better.

The desired moral attitude of the physician: (III) care.

PubMed

Gelhaus, Petra

2013-05-01

In professional medical ethics, the physician traditionally is obliged to fulfil specific duties as well as to embody a responsible and trustworthy personality. In the public discussion, different concepts are suggested to describe the desired moral attitude of physicians. In a series of three articles, three of the discussed concepts are presented in an interpretation that is meant to characterise the morally emotional part of this attitude: "empathy", "compassion" and "care". In the first article of the series, "empathy" has been developed as a mainly cognitive and morally neutral capacity of understanding. In the second article, the emotional and virtuous core of the desired professional attitude-compassion-has been presented. Compassion as a professional attitude has been distinguished from a spontaneous feeling of compassion, and has been related to a general idea of man as vulnerable and solidary being. Thus, the dignity of the patient is safeguarded in spite of the asymmetry of compassion. In this article, the third concept of the triad-"care"-is presented. Care is conceived as an attitude as well as an activity which can be directed to different objects: if it is directed to another sentient being, it is regarded as intrinsically morally valuable; implying (1) the acceptance of being addressed, (2) a benevolent inclination to help and to foster, and (3) activity to realize this. There are different forms of benevolence that can underlie caring. With regard to the professional physician's ethos, the attitude of empathic compassion as developed in the two previous articles is proposed to be the adequate underlying attitude of care which demands the right balance between closeness and professionalism and the right form of attention to the person of the patient. 'Empathic compassionate care' does not, however, describe the whole of the desired attitude of a physician, but focuses on the morally-emotive aspects. In order to get also the cognitive and practical aspects of biomedicine into the picture, 'empathic compassionate care' has to be combined with an attitude of responsibility that is more directed to decision-making and outcome than a caring attitude alone can be. The reconstruction of the desired professional attitude in terms of "empathic compassionate care" and "responsibility" is certainly not the only possible description, but it is a detailed proposal in order to give an impulse for the discussion about the inner tacit values and the meaning of medicine and clinical healthcare professions.

International study on nurses' views and experiences of compassion.

PubMed

Papadopoulos, I; Zorba, A; Koulouglioti, C; Ali, S; Aagard, M; Akman, O; Alpers, L-M; Apostolara, P; Biles, J; Martín-García, Á; González-Gil, T; Kouta, C; Krepinska, R; Kumar, B N; Lesińska-Sawicka, M; Lopez, L; Malliarou, M; Nagórska, M; Nissim, S; Nortvedt, L; Oter-Quintana, C; Ozturk, C; Pangilinan, S B; Papp, K; Eldar Regev, O; Rubiano, F O; Tolentino Diaz, M Y; Tóthová, V; Vasiliou, M

2016-09-01

Compassion is considered the cornerstone of nursing practice. However, the recent failures in delivering high-quality compassionate nursing care in the UK's National Health Service have brought the topic of compassion to the attention of the public, service providers, policy makers and academics. The aim of this study was to explore the nurses' views and experiences of a number of compassion-related issues in nursing and describe similarities and differences at an international level as well as from the different nursing roles of the participating nurses. An exploratory, cross-sectional descriptive study, using the International Online Compassion Questionnaire. A total of 1323 nurses from 15 countries completed the questionnaire. The majority of participants (59.5%) defined compassion as "Deep awareness of the suffering of others and wish to alleviate it" but definitions of compassion varied by country. Of participants, 69.6% thought compassion was very important in nursing and more than half (59.6%) of them argued that compassion could be taught. However, only 26.8% reported that the correct amount and level of teaching is provided. The majority of the participants (82.6%) stated that their patients prefer knowledgeable nurses with good interpersonal skills. Only 4.3% noted that they are receiving compassion from their managers. A significant relationship was found between nurses' experiences of compassion and their views about teaching of compassion. Our study is unique in identifying the views and experiences of nurses from 15 different countries worldwide. The findings reveal that compassion is neither addressed adequately in nursing education nor supported in the practice environment by managers. Self-report bias was inherent to our survey study design. Furthermore, the individual cultural differences and similarities in the findings are difficult to extrapolate owing to the fact that our analysis was at country level, as well as at the level of the participating nurses. Understanding the influence of culture on nurses' views about compassion is critical in the current multicultural healthcare environment and merits further research. This will potentially drive changes in nursing education (ensuring that compassion is taught to nurses) and in the way healthcare leaders and managers foster a compassionate culture within their organizations (e.g. by leading by example and compassionate to their staff). © 2016 International Council of Nurses.

Access to Employee Wellness Programs and Use of Preventive Care Services Among U.S. Adults.

PubMed

Isehunwa, Oluwaseyi O; Carlton, Erik L; Wang, Yang; Jiang, Yu; Kedia, Satish; Chang, Cyril F; Fijabi, Daniel; Bhuyan, Soumitra S

2017-12-01

There is little research at the national level on access to employee wellness programs and the use of preventive care services. This study examined the use of seven preventive care services among U.S working adults with access to employee wellness programs. The study population comprised 17,699 working adults aged ≥18 years, obtained from the 2015 National Health Interview Survey. Multivariate logistic regression models examined the relationship between access to employee wellness programs and use of seven preventive care services: influenza vaccination, blood pressure check, diabetes check, cholesterol check, Pap smear test, mammogram, and colon cancer screening. Data analysis began in Fall 2016. Overall, 46.6% of working adults reported having access to employee wellness programs in 2015. Working adults with access to employee wellness programs had higher odds of receiving influenza vaccination (OR=1.57, 95% CI=1.43, 1.72, p<0.001), blood pressure check (OR=2.46, 95% CI=2.17, 2.78, p<0.001), diabetes check (OR=1.30, 95% CI=1.12, 1.50, p<0.001), cholesterol check (OR=1.48, 95% CI=1.33, 1.67, p<0.001), and mammogram (OR=1.57, 95% CI=1.24, 1.98, p<0.001). However, there was no significant difference between access to employee wellness programs and the use of Pap smear test and colon cancer screening services. Using a nationally representative sample of individuals, this study found a positive association between access to employee wellness programs and the use of preventive care services. The results support favorable policies to encourage implementing wellness programs in all worksites, especially those with <50 employees. Copyright © 2017 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

76 FR 26341 - Medicaid Program; Methods for Assuring Access to Covered Medicaid Services

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-06

... Medicare & Medicaid Services 42 CFR Part 447 Medicare Program; Methods for Assuring Access to Covered... Services 42 CFR Part 447 [CMS 2328-P] RIN 0938-AQ54 Medicaid Program; Methods for Assuring Access to... design the procedures for enrolling providers of such care, and to set the methods for establishing...

24 CFR 8.20 - General requirement concerning program accessibility.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 24 Housing and Urban Development 1 2010-04-01 2010-04-01 false General requirement concerning program accessibility. 8.20 Section 8.20 Housing and Urban Development Office of the Secretary, Department... requirement concerning program accessibility. Except as otherwise provided in §§ 8.21(c)(1), 8.24(a), 8.25...

Evaluation of Access, a Primary Care Program for Indigent Patients: Inpatient and Emergency Room Utilization.

ERIC Educational Resources Information Center

Davidson, Richard A.; Giancola, Angela; Gast, Andrea; Ho, Janice; Waddell, Rhondda

2003-01-01

Evaluated the impact of Accessing Community Care through Eastside Social Services (ACCESS), a program that provided indigent patients with free primary care, on inpatient admissions, emergency room (ER) visits, and subsequent charges. Data on 19 people before and after program enrollment showed significant decreases in ER visits following…

12 CFR 268.707 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2011 CFR

2011-01-01

... Programs and Activities Because of Physical or Mental Disability § 268.707 Program accessibility: Existing facilities. (a) General. The Board shall operate each program or activity so that the program or activity... can demonstrate would result in a fundamental alteration in the nature of a program or activity or in...

12 CFR 268.707 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Programs and Activities Because of Physical or Mental Disability § 268.707 Program accessibility: Existing facilities. (a) General. The Board shall operate each program or activity so that the program or activity... can demonstrate would result in a fundamental alteration in the nature of a program or activity or in...

The Veterans Choice Program (VCP): Program Implementation

DTIC Science & Technology

2017-01-05

Authorized under Section 101 of the Veterans Access, Choice, and Accountability Act of 2014 (VACAA), the Veterans Choice Program (VCP) is a new...country in spring 2014, 1 Congress passed the Veterans Access, Choice, and Accountability Act of 2014 (VACAA, P.L. 113-146, as amended). On August 7...Veterans Choice Program (VCP) Timeline Date Action August 7, 2014 The Veterans Access, Choice, and Accountability Act of 2014 (P.L. 113-146

Bridging the Gap between Access and Success: A Study of the Impact of an Access and Success Program on Academic Outcomes of Low-Income College Freshmen

ERIC Educational Resources Information Center

Collins, Sarah R.

2012-01-01

In response to the increasing cost of college, colleges and universities are leveraging financial aid and academic support services to implement access and success programs intended to help financially disadvantaged students afford and persist through a baccalaureate degree program. This research is a study of the efficacy of one such program at a…

A responsive evaluation of an Aboriginal nursing education access program.

PubMed

Curran, Vernon; Solberg, Shirley; LeFort, Sandra; Fleet, Lisa; Hollett, Ann

2008-01-01

Nursing education access programs have been introduced in a number of countries to address the shortage of healthcare providers of Aboriginal descent. An evaluation study of a nursing education access program in Labrador, Canada, was undertaken using a Responsive Evaluation approach. Interviews and focus groups with program stakeholders were conducted. Program effectiveness was influenced by culturally relevant curriculum, experiential and authentic learning opportunities, academic and social support, and the need for partnership building between stakeholders. The authors report key findings resulting from the Responsive Evaluation.

COBRA compliance: how employers can successfully meet today's complexities.

PubMed

Trimble, Jim

2003-03-01

Although the architects of COBRA had sound and compassionate motivations in place, administration of and compliance with this law are far from easy. COBRA assists employees that lose their jobs by allowing them to purchase insurance benefits from their former employer. Outsourcing COBRA administration can be the best way for some employers to cope with COBRA regulations, contingencies and paperwork and avoid legal fees and penalties. But look for COBRA providers that have a sound track record.

7 CFR 62.206 - Access to program documents and activities.

Code of Federal Regulations, 2010 CFR

2010-01-01

... (CONTINUED) LIVESTOCK, MEAT, AND OTHER AGRICULTURAL COMMODITIES (QUALITY SYSTEMS VERIFICATION PROGRAMS) Quality Systems Verification Programs Definitions Service § 62.206 Access to program documents and... SERVICE (Standards, Inspections, Marketing Practices), DEPARTMENT OF AGRICULTURE (CONTINUED) REGULATIONS...

A pilot study on the effects and feasibility of compassion-focused expressive writing in Day Hospice patients.

PubMed

Imrie, Susan; Troop, Nicholas A

2012-06-01

Research has found that writing about stress can confer physical and psychological health benefits on participants and that adopting a self-compassionate stance may have additional benefits. This pilot study evaluated a self-compassionate expressive writing intervention in a Day Hospice setting. Thirteen patients with life-limiting illnesses wrote on two occasions about recent stressful experiences. Half also received a self-compassion instruction for their writing. Outcome measures were taken at baseline and one week after the second writing session, and text analysis was used to identify changes in the types of words used, reflecting changes in psychological processes. Patients given the self-compassion instruction increased in their self-soothing and self-esteem in contrast to patients in the stress-only condition. Happiness broadly increased in both groups although reported levels of stress generally increased in patients given the self-compassion instruction but decreased in patients in the stress-only condition. Those given the self-compassion instruction also increased in their use of causal reasoning words across the two writing sessions compared with those in the stress-only condition. Expressive writing appears to be beneficial in patients at a hospice and was viewed as valuable by participants. The inclusion of a self-compassion instruction may have additional benefits and a discussion of the feasibility of implementing expressive writing sessions in a Day Hospice is offered.

Beyond vulnerability: how the dual role of patient-health care provider can inform health professions education.

PubMed

Rowland, Paula; Kuper, Ayelet

2018-03-01

In order to prepare fully competent health care professionals, health professions education must be concerned with the relational space between patients and providers. Compassion and compassionate care are fundamental elements of this relational space. Traditionally, health professions educators and leaders have gone to two narrative sources when attempting to better under constructs of compassion: patients or providers. Rarely have there been explorations of the perspectives of those who consider themselves as both patients and providers. In this study, we interviewed nineteen health care providers who self-disclosed as having had a substantive patient experience in the health care system. We engaged with these participants to better understand their experience of having these dual roles. Anchored in Foucault's concepts of subjectivity and Goffman's symbolic interactionism, the interviews in this study reveal practices of moving between the two roles of patient and provider. Through this exploration, we consider how it is that providers who have been patients understand themselves to be more compassionate whilst in their provider roles. Rather than describing compassion as a learnable behaviour or an innate virtue, we theoretically engage with one proposed mechanism of how compassion is produced. In particular, we highlight the role of critical reflexivity as an underexplored construct in the enactment of compassion. We discuss these findings in light of their implications for health professions education.

Practical compassions: repertoires of practice and compassion talk in acute mental healthcare.

PubMed

Brown, Brian; Crawford, Paul; Gilbert, Paul; Gilbert, Jean; Gale, Corinne

2014-03-01

This article reports an exploratory study of the concept of compassion in the work of 20 mental health practitioners in a UK Midlands facility. Using notions of practice derived from phenomenology and Bourdieusian sociology and notions of emotional labour we identify two contrasting interpretive repertoires in discussions of compassion. The first, the practical compassion repertoire, evokes the practical, physical and bodily aspects of compassion. It involves organising being with patients, playing games, anticipating disruption and taking them outside for cigarettes. Practitioners described being aware that these practical, bodily activities could lead to patients 'opening up', disclosing their interior concerns and enabling practical, compassionate mental health work to take place. In contrast, the second, organisational repertoire, concerns organisational constraints on compassionate practice. The shortage of staff, the record-keeping and internal processes of quality control were seen as time-greedy and apt to detract from contact with patients. The findings are discussed in relation to Bourdieu and Merleau-Ponty's phenomenological accounts of practice and habit and set in context in the growing interest in placing compassion centrally in healthcare. We also explore how the exercise of compassion in the way our participants describe it can afford the more effective exercise of medical power. © 2013 The Author. Sociology of Health & Illness © 2013 Foundation for the Sociology of Health & Illness/John Wiley & Sons Ltd.

JASPAR RESTful API: accessing JASPAR data from any programming language.

PubMed

Khan, Aziz; Mathelier, Anthony

2018-05-01

JASPAR is a widely used open-access database of curated, non-redundant transcription factor binding profiles. Currently, data from JASPAR can be retrieved as flat files or by using programming language-specific interfaces. Here, we present a programming language-independent application programming interface (API) to access JASPAR data using the Representational State Transfer (REST) architecture. The REST API enables programmatic access to JASPAR by most programming languages and returns data in eight widely used formats. Several endpoints are available to access the data and an endpoint is available to infer the TF binding profile(s) likely bound by a given DNA binding domain protein sequence. Additionally, it provides an interactive browsable interface for bioinformatics tool developers. This REST API is implemented in Python using the Django REST Framework. It is accessible at http://jaspar.genereg.net/api/ and the source code is freely available at https://bitbucket.org/CBGR/jaspar under GPL v3 license. aziz.khan@ncmm.uio.no or anthony.mathelier@ncmm.uio.no. Supplementary data are available at Bioinformatics online.

More than 5000 patients with metastatic melanoma in Europe per year do not have access to recommended first-line innovative treatments.

PubMed

Kandolf Sekulovic, L; Peris, K; Hauschild, A; Stratigos, A; Grob, J-J; Nathan, P; Dummer, R; Forsea, A-M; Hoeller, C; Gogas, H; Demidov, L; Lebbe, C; Blank, C; Olah, J; Bastholt, L; Herceg, D; Neyns, B; Vieira, R; Hansson, J; Rutkowski, P; Krajsova, I; Bylaite-Bucinskiene, M; Zalaudek, I; Maric-Brozic, J; Babovic, N; Banjin, M; Putnik, K; Weinlich, G; Todorovic, V; Kirov, K; Ocvirk, J; Zhukavets, A; Kukushkina, M; De La Cruz Merino, L; Ymeri, A; Risteski, M; Garbe, C

2017-04-01

Despite the efficacy of innovative treatments for metastatic melanoma, their high costs has led to disparities in cancer care among different European countries. We analysed the availability of these innovative therapies in Europe and estimated the number of patients without access to first-line recommended treatment per current guidelines of professional entities such as the European Society for Medical Oncology (ESMO), the European Organisation for Research and Treatment of Cancer (EORTC), the European Association of Dermato-Oncology (EADO), and European Dermatology Forum (EDF). Web-based online survey was conducted in 30 European countries with questions about the treatment schedules from 1st May 2015 to 1st May 2016: number of metastatic melanoma patients, registration and reimbursement of innovative medicines (updated data, as of 1st October 2016), percentage of patients treated and availability of clinical studies and compassionate-use programmes. The recommended BRAF inhibitor (BRAFi) + MEK inhibitor (MEKi) combination was both registered and fully reimbursed in 9/30 (30%) countries, and in 13/30 (43%) (all from Eastern Europe) not reimbursed. First-line immunotherapy with anti-PD1 antibodies was registered and fully reimbursed in 14/30 (47%) countries, while in 13/30 (43%) (all from Eastern Europe) not reimbursed. It was estimated that in Europe 19,600 patients with metastatic melanoma are treated, and 5238 (27%) do not have access to recommended first-line therapy. Significant correlation was found between human development index (HDI, UNDP report 2015), (r = 0.662; p < 0.001), health expenditure per capita (r = 0.695; p < 0.001) and the Mackenbach score of health policy performance (r = 0.765; p < 0.001) with the percentage of patients treated with innovative medicines and a number of reimbursed medicines. Great discrepancy exists in metastatic melanoma treatment across Europe. It is crucial to increase the awareness of national and European policymakers, oncological societies, melanoma patients' associations and pharma industry. Copyright © 2017 Elsevier Ltd. All rights reserved.

32 CFR 1906.149 - Program accessibility: Discrimination prohibited.

Code of Federal Regulations, 2011 CFR

2011-07-01

... INTELLIGENCE AGENCY ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE CENTRAL INTELLIGENCE AGENCY § 1906.149 Program accessibility: Discrimination prohibited...

32 CFR 1906.149 - Program accessibility: Discrimination prohibited.

Code of Federal Regulations, 2013 CFR

2013-07-01

... INTELLIGENCE AGENCY ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE CENTRAL INTELLIGENCE AGENCY § 1906.149 Program accessibility: Discrimination prohibited...

32 CFR 1906.149 - Program accessibility: Discrimination prohibited.

Code of Federal Regulations, 2012 CFR

2012-07-01

... INTELLIGENCE AGENCY ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE CENTRAL INTELLIGENCE AGENCY § 1906.149 Program accessibility: Discrimination prohibited...

32 CFR 1906.149 - Program accessibility: Discrimination prohibited.

Code of Federal Regulations, 2010 CFR

2010-07-01

... INTELLIGENCE AGENCY ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE CENTRAL INTELLIGENCE AGENCY § 1906.149 Program accessibility: Discrimination prohibited...

32 CFR 1906.149 - Program accessibility: Discrimination prohibited.

Code of Federal Regulations, 2014 CFR

2014-07-01

... INTELLIGENCE AGENCY ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE CENTRAL INTELLIGENCE AGENCY § 1906.149 Program accessibility: Discrimination prohibited...

Spanish-language community-based mental health treatment programs, policy-required language-assistance programming, and mental health treatment access among Spanish-speaking clients.

PubMed

Snowden, Lonnie R; McClellan, Sean R

2013-09-01

We investigated the extent to which implementing language assistance programming through contracting with community-based organizations improved the accessibility of mental health care under Medi-Cal (California's Medicaid program) for Spanish-speaking persons with limited English proficiency, and whether it reduced language-based treatment access disparities. Using a time series nonequivalent control group design, we studied county-level penetration of language assistance programming over 10 years (1997-2006) for Spanish-speaking persons with limited English proficiency covered under Medi-Cal. We used linear regression with county fixed effects to control for ongoing trends and other influences. When county mental health plans contracted with community-based organizations, those implementing language assistance programming increased penetration rates of Spanish-language mental health services under Medi-Cal more than other plans (0.28 percentage points, a 25% increase on average; P < .05). However, the increase was insufficient to significantly reduce language-related disparities. Mental health treatment programs operated by community-based organizations may have moderately improved access after implementing required language assistance programming, but the programming did not reduce entrenched disparities in the accessibility of mental health services.

Spanish-Language Community-Based Mental Health Treatment Programs, Policy-Required Language-Assistance Programming, and Mental Health Treatment Access Among Spanish-Speaking Clients

PubMed Central

McClellan, Sean R.

2013-01-01

Objectives. We investigated the extent to which implementing language assistance programming through contracting with community-based organizations improved the accessibility of mental health care under Medi-Cal (California’s Medicaid program) for Spanish-speaking persons with limited English proficiency, and whether it reduced language-based treatment access disparities. Methods. Using a time series nonequivalent control group design, we studied county-level penetration of language assistance programming over 10 years (1997–2006) for Spanish-speaking persons with limited English proficiency covered under Medi-Cal. We used linear regression with county fixed effects to control for ongoing trends and other influences. Results. When county mental health plans contracted with community-based organizations, those implementing language assistance programming increased penetration rates of Spanish-language mental health services under Medi-Cal more than other plans (0.28 percentage points, a 25% increase on average; P < .05). However, the increase was insufficient to significantly reduce language-related disparities. Conclusions. Mental health treatment programs operated by community-based organizations may have moderately improved access after implementing required language assistance programming, but the programming did not reduce entrenched disparities in the accessibility of mental health services. PMID:23865663

32 CFR 1906.150 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2012 CFR

2012-07-01

... INTELLIGENCE AGENCY ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE CENTRAL INTELLIGENCE AGENCY § 1906.150 Program accessibility: Existing facilities. (a...

32 CFR 1906.150 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2013 CFR

2013-07-01

... INTELLIGENCE AGENCY ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE CENTRAL INTELLIGENCE AGENCY § 1906.150 Program accessibility: Existing facilities. (a...

32 CFR 1906.150 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2014 CFR

2014-07-01

... INTELLIGENCE AGENCY ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE CENTRAL INTELLIGENCE AGENCY § 1906.150 Program accessibility: Existing facilities. (a...

32 CFR 1906.150 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2011 CFR

2011-07-01

... INTELLIGENCE AGENCY ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE CENTRAL INTELLIGENCE AGENCY § 1906.150 Program accessibility: Existing facilities. (a...

32 CFR 1906.150 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2010 CFR

2010-07-01

... INTELLIGENCE AGENCY ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE CENTRAL INTELLIGENCE AGENCY § 1906.150 Program accessibility: Existing facilities. (a...

47 CFR 79.2 - Accessibility of programming providing emergency information.

Code of Federal Regulations, 2013 CFR

2013-10-01

...) BROADCAST RADIO SERVICES CLOSED CAPTIONING AND VIDEO DESCRIPTION OF VIDEO PROGRAMMING § 79.2 Accessibility... information. (1) Video programming distributors must make emergency information, as defined in paragraph (a..., as described in § 79.1. (2) Video programming distributors and video programming providers must make...

32 CFR 1699.150 - Program accessibility: existing facilities.

Code of Federal Regulations, 2010 CFR

2010-07-01

... SYSTEM ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY SELECTIVE SERVICE SYSTEM § 1699.150 Program accessibility: existing facilities. (a) General. The agency shall operate each program or activity so that the program or activity, when viewed in its entirety, is...

50 CFR 648.262 - Effort-control program for red crab limited access vessels.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 50 Wildlife and Fisheries 8 2010-10-01 2010-10-01 false Effort-control program for red crab... UNITED STATES Management Measures for the Atlantic Deep-Sea Red Crab Fishery § 648.262 Effort-control program for red crab limited access vessels. (a) General. A vessel issued a limited access red crab permit...

Defibrotide: a review of its use in severe hepatic veno-occlusive disease following haematopoietic stem cell transplantation.

PubMed

Keating, Gillian M

2014-12-01

Defibrotide (Defitelio(®)) was recently approved in the EU for the treatment of severe hepatic veno-occlusive disease (VOD), also known as sinusoidal obstructive syndrome, in haematopoietic stem cell transplantation (HSCT) therapy. It is indicated in adults, adolescents, children and infants over 1 month of age. Defibrotide is also available in the US via an expanded-access protocol. Defibrotide is thought to protect endothelial cells and restore the thrombo-fibrinolytic balance in VOD. In a multicentre, phase III trial, the complete response rate by day +100 (primary endpoint) was significantly higher, and mortality at day +100 was significantly lower, in patients with severe hepatic VOD and multiorgan failure following HSCT who received intravenous defibrotide 6.25 mg/kg every 6 h than in a group of historical controls. The efficacy of defibrotide in severe hepatic VOD following HSCT was also supported by findings from a phase II dose-finding study, compassionate-use data and information provided from an independent transplant registry. Intravenous defibrotide was generally well tolerated in patients with severe hepatic VOD following HSCT, and was not associated with an increased risk of haemorrhagic adverse events. In conclusion, defibrotide is the only agent approved (in the EU) for use in severe hepatic VOD following HSCT and represents a useful advance in the treatment of this condition.

An Assessment of Pathology Resident Access to and Use of Technology: A Nationwide Survey.

PubMed

Vallangeon, Bethany D; Hawley, Jeffrey S; Sloane, Richard; Bean, Sarah M

2017-03-01

- Current technologies including digital slide scanners and handheld devices can revolutionize clinical practice and pathology graduate medical education (GME). The extent to which these technologies are used in pathology GME is unknown. - To determine the types of technologies used, usage amount, and how they are integrated into pathology residency/fellowship programs nationwide. - A 40-question online survey for residents/fellows was developed and administered via the Research Electronic Data Capture System after institutional review board approval. - Fifty-two program directors (37%) gave permission for participation. One-hundred seventy-one responses were received (18% response rate). Most respondents have access to personal technology (laptop = 78% [134 of 171]), smartphone = 81% [139 of 171], tablet = 49% [84 of 171]), and Web-based digital slide collections (82%, 141 of 171). Few residents are provided electronic devices by their programs (laptop = 22% [38 of 171], smartphone = 0.5% [1 of 171], and tablet = 12% [21 of 171]). Fifty-nine percent have access to digital slide scanners, 33% have access to a program-created database of digitized slides, and 52% use telepathology. Fifteen percent have access to asynchronous learning. Of those with access to video-recorded conferences, 89% review them. Program size was significantly positively correlated with resident access to program-provided laptops (P = .02) and tablets (P < .001), digital slide scanners (P = .01), and telepathology (P = .001). Of all devices, program-provided laptops are used most for professional work (60.5% use this device for more than 5 hours per day). - Most residents report access to multiple types of innovative technology, but incorporation of these tools within pathology training programs is highly variable. Opportunities for incorporating innovative technologies exist and could be further explored.

Open versus Controlled-Access Data | Office of Cancer Genomics

Cancer.gov

OCG employs stringent human subjects’ protection and data access policies to protect the privacy and confidentiality of the research participants. Depending on the risk of patient identification, OCG programs data are available to the scientific community in two tiers: open or controlled access. Both types of data can be accessed through its corresponding OCG program-specific data matrix or portal. Open-access Data

Access to health programs at the workplace and the reduction of work presenteeism: a population-based cross-sectional study.

PubMed

Bustillos, Arnaldo Sanchez; Trigoso, Oswaldo Ortiz

2013-11-01

To examine access to health programs at workplace as a determinant of presenteeism among adults. Data source was a subsample of the 2009-2010 Canadian Community Health Survey. The outcome was self-reported reduced activities at work (presenteeism). The explanatory variable was self-reported access to a health program at workplace. Logistic regression was used to measure the association between outcome and explanatory variables adjusting for potential confounders. Adjusting for sex, age, education, income, work stress, and chronic conditions, presenteeism was not associated with having access to a health program at workplace (adjusted odds ratio, 1.23; 95% confidence interval, 0.91 to 1.65). The odds of presenteeism were higher in workers who reported high work stress and those with chronic medical conditions. This study found that access to health programs at workplace is not significantly associated with a decline in presenteeism.

32 CFR 324.13 - Access to medical and psychological records.

Code of Federal Regulations, 2010 CFR

2010-07-01

... DEFENSE (CONTINUED) PRIVACY PROGRAM DFAS PRIVACY ACT PROGRAM Individual Access to Records § 324.13 Access... be provided, even if the individual is a minor, unless it is determined that access could have an... physician in accordance with guidance in Department of Defense 5400.11-R, ‘Department of Defense Privacy...

32 CFR 324.13 - Access to medical and psychological records.

Code of Federal Regulations, 2011 CFR

2011-07-01

... DEFENSE (CONTINUED) PRIVACY PROGRAM DFAS PRIVACY ACT PROGRAM Individual Access to Records § 324.13 Access... be provided, even if the individual is a minor, unless it is determined that access could have an... physician in accordance with guidance in Department of Defense 5400.11-R, ‘Department of Defense Privacy...

32 CFR 324.8 - Right of access.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 32 National Defense 2 2010-07-01 2010-07-01 false Right of access. 324.8 Section 324.8 National Defense Department of Defense (Continued) OFFICE OF THE SECRETARY OF DEFENSE (CONTINUED) PRIVACY PROGRAM DFAS PRIVACY ACT PROGRAM Individual Access to Records § 324.8 Right of access. The provisions of DoD...

Assured Access/Mobile Computing Initiatives on Five University Campuses.

ERIC Educational Resources Information Center

Blurton, Craig; Chee, Yam San; Long, Phillip D.; Resmer, Mark; Runde, Craig

Mobile computing and assured access are becoming popular terms to describe a growing number of university programs which take advantage of ubiquitous network access points and the portability of notebook computers to ensure all students have access to digital tools and resources. However, the implementation of such programs varies widely from…

24 CFR 9.152 - Program accessibility: alterations of Property Disposition Program multifamily housing facilities.

Code of Federal Regulations, 2012 CFR

2012-04-01

... of Property Disposition Program multifamily housing facilities. 9.152 Section 9.152 Housing and Urban... URBAN DEVELOPMENT § 9.152 Program accessibility: alterations of Property Disposition Program multifamily housing facilities. (a) Substantial alteration. If the agency undertakes alterations to a PDP multifamily...

24 CFR 9.152 - Program accessibility: alterations of Property Disposition Program multifamily housing facilities.

Code of Federal Regulations, 2014 CFR

2014-04-01

... of Property Disposition Program multifamily housing facilities. 9.152 Section 9.152 Housing and Urban... URBAN DEVELOPMENT § 9.152 Program accessibility: alterations of Property Disposition Program multifamily housing facilities. (a) Substantial alteration. If the agency undertakes alterations to a PDP multifamily...

45 CFR 1175.150 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2010 CFR

2010-10-01

... NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE NATIONAL ENDOWMENT FOR THE... program or activity so that the program or activity, when viewed in its entirety, is readily accessible to... of a program or activity or in undue financial and administrative burdens. In those circumstances...

31 CFR 17.150 - Program accessibility; Existing facilities.

Code of Federal Regulations, 2010 CFR

2010-07-01

...'s facilities that limit the physical accessibility of its programs or activities to individuals with... ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE... operate each program or activity so that the program or activity, when viewed in its entirety, is readily...

24 CFR 9.150 - Program accessibility: existing facilities.

Code of Federal Regulations, 2010 CFR

2010-04-01

... ACTIVITIES CONDUCTED BY THE DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT § 9.150 Program accessibility... shall operate each program or activity so that the program or activity, when viewed in its entirety, is... nature of a program or activity or in undue financial and administrative burdens. In those circumstances...

12 CFR 606.650 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2010 CFR

2010-01-01

... OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE FARM CREDIT... program or activity so that the program or activity, when viewed in its entirety, is readily accessible to... the nature of a program or activity or in undue financial and administrative burdens. In those...

40 CFR 12.150 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2010 CFR

2010-07-01

... NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE ENVIRONMENTAL PROTECTION... program or activity so that the program or activity, when viewed in its entirety, is readily accessible to... the nature of a program or activity or in undue financial and administrative burdens. In those...

45 CFR 1214.150 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2010 CFR

2010-10-01

... ACTIVITIES CONDUCTED BY ACTION § 1214.150 Program accessibility: Existing facilities. (a) General. The agency shall operate each program or activity so that the program or activity, when viewed in its entirety, is... fundamental alteration in the nature of a program or activity or in undue financial and administrative burdens...

22 CFR 1701.150 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2010 CFR

2010-04-01

... NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE UNITED STATES INSTITUTE OF... program or activity so that the program or activity, when viewed in its entirety, is readily accessible to... the nature of a program or activity or in undue financial and administrative burdens. In those...

77 FR 6479 - Leased Commercial Access; Development of Competition and Diversity in Video Programming...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-08

... Commercial Access; Development of Competition and Diversity in Video Programming Distribution and Carriage... contained in the Second Report and Order, FCC 11-119, pertaining to carriage of video programming vendors by multichannel video programming distributors (program carriage rules). This notice is consistent with the Secord...

47 CFR 1.1849 - Program accessibility: Discrimination prohibited.

Code of Federal Regulations, 2010 CFR

2010-10-01

... prohibited. 1.1849 Section 1.1849 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL PRACTICE AND... the Federal Communications Commission § 1.1849 Program accessibility: Discrimination prohibited. (a... interpreters, communication access realtime translation (CART) providers, transcribers, captioners, and readers...

32 CFR 1906.151 - Program accessibility: New construction and alterations.

Code of Federal Regulations, 2013 CFR

2013-07-01

... INTELLIGENCE AGENCY ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE CENTRAL INTELLIGENCE AGENCY § 1906.151 Program accessibility: New construction and...

32 CFR 1906.151 - Program accessibility: New construction and alterations.

Code of Federal Regulations, 2011 CFR

2011-07-01

... INTELLIGENCE AGENCY ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE CENTRAL INTELLIGENCE AGENCY § 1906.151 Program accessibility: New construction and...

32 CFR 1906.151 - Program accessibility: New construction and alterations.

Code of Federal Regulations, 2014 CFR

2014-07-01

... INTELLIGENCE AGENCY ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE CENTRAL INTELLIGENCE AGENCY § 1906.151 Program accessibility: New construction and...

32 CFR 1906.151 - Program accessibility: New construction and alterations.

Code of Federal Regulations, 2010 CFR

2010-07-01

... INTELLIGENCE AGENCY ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE CENTRAL INTELLIGENCE AGENCY § 1906.151 Program accessibility: New construction and...

32 CFR 1906.151 - Program accessibility: New construction and alterations.

Code of Federal Regulations, 2012 CFR

2012-07-01

... INTELLIGENCE AGENCY ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE CENTRAL INTELLIGENCE AGENCY § 1906.151 Program accessibility: New construction and...

Low-income individuals’ perceptions about fruit and vegetable access programs: A qualitative study

PubMed Central

Haynes-Maslow, Lindsey; Auvergne, Lauriane; Mark, Barbara; Ammerman, Alice; Weiner, Bryan J.

2015-01-01

Objective To examine how fruit and vegetable (F&V) programs address barriers to F&V access and consumption as perceived by low-income individuals. Design From 2011–2012 thirteen focus groups were used to better understand low-income individuals’ perceptions about F&V programs. Setting Five North Carolina counties at community-serving organizations. Participants Low-income participants ages 18 or older were included in the study. A majority were African American females with a high school education or less and received government assistance. Phenomenon of Interest Low-income individuals’ perceptions about how F&V access programs can reduce barriers and increase consumption. Analysis A socioecological framework guided data analysis, and 2 trained researchers coded transcripts, identified major themes, and summarized findings. Results A total of 105 participants discussed that mobile markets could overcome barriers such as availability, convenience, transportation, and quality/variety. Some were worried about safety in higher crime communities. Participants’ opinions about how successful food assistance programs were at overcoming cost barriers were mixed. Participants agreed that community gardens could increase access to affordable, conveniently located produce, but worried about feasibility/implementation issues. Implications for Research and Practice Addressing access barriers through F&V programs could improve consumption. Programs have the potential to be successful if they address multiple access barriers. (200 words). PMID:25910929

78 FR 37847 - Meeting of National Council on the Humanities

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-24

... 507 Digital Humanities: Room 402 Education Programs: Room M-07 Preservation and Access: Room 415.... Digital Humanities c. Education Programs d. Preservation and Access e. Public Programs f. Research...

45 CFR 2301.151 - Program accessibility: New construction and alterations.

Code of Federal Regulations, 2010 CFR

2010-10-01

...) ARCTIC RESEARCH COMMISSION ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE UNITED STATES ARCTIC RESEARCH COMMISSION § 2301.151 Program accessibility: New...

45 CFR 2301.151 - Program accessibility: New construction and alterations.

Code of Federal Regulations, 2011 CFR

2011-10-01

...) ARCTIC RESEARCH COMMISSION ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE UNITED STATES ARCTIC RESEARCH COMMISSION § 2301.151 Program accessibility: New...