The purpose of this qualitative study was to develop a comprehensive understanding of Aboriginal women's experiences and perceptions of providing care to the elderly in geographically isolated communities (GIC). Research with Aboriginal women caregivers is essential as the population of Aboriginal elders is increasing, and Aboriginal women represent the majority of caregivers in their communities.
This study was guided by focused ethnography, which seeks an understanding of a sub-group within a cultural group by uncovering the less obvious expressions and behaviours of the sub-group members. Using one-on-one open-ended interviews and participant observation, 13 women from a number of Aboriginal communities in northern and southern Ontario participated in this study. Data analysis was conducted by reviewing transcripts of interviews to identify codes and themes.
Study findings revealed that four concentric circles represent the caring experiences of the Aboriginal women participants: the healers, the family, the Aboriginal community, and the non-Aboriginal community. Cultural values greatly informed participants' perceptions about caring for elderly persons in GIC. These values are represented in five themes: passing on traditions, being chosen to care, supporting the circle of healers, (re)establishing the circles of care, and accepting/refusing external resources.
The findings from this study have significant implications for healthcare practice and future research.
The objective of the present work was to detect and describe the new features characterizing the long-term stay of a corpse in seawater followed by its burial on earth. The bones of the skeletonized corpse were found to be covered with mussels and petrified sea worms that can serve as the indicators of staying the corps in seawater and its subsequent transportation from the sea coastline to the inland. These findings can be used to clarify the circumstances of death of the people found in the illegal burial places at the seacoast of maritime areas.
In this article, we discuss findings from an ethnographic study in which we explored experiences of access to primary care services from the perspective of Aboriginal people seeking care at an emergency department (ED) located in a large Canadian city. Data were collected over 20 months of immersion in the ED, and included participant observation and in-depth interviews with 44 patients triaged as stable and nonurgent, most of whom were living in poverty and residing in the inner city. Three themes in the findings are discussed: (a) anticipating providers' assumptions; (b) seeking help for chronic pain; and (c) use of the ED as a reflection of social suffering. Implications of these findings are discussed in relation to the role of the ED as well as the broader primary care sector in responding to the needs of patients affected by poverty, racialization, and other forms of disadvantage.
This article presents intensive psychiatric nurses' work and nursing care. The aim of the study was to describe expressions of cultural knowing in nursing care in psychiatric intensive care units (PICU). Spradley's ethnographic methodology was applied. Six themes emerged as frames for nursing care in psychiatric intensive care: providing surveillance, soothing, being present, trading information, maintaining security and reducing. These themes are used to strike a balance between turbulence and stability and to achieve equilibrium. As the nursing care intervenes when turbulence emerges, the PICU becomes a sanctuary that offers tranquility, peace and rest.
The authors emphasize the need in coordination when conducting expert examinations in investigation of accidents with a great number of victims. Coordination is of special importance for combined application of molecular-genetic technologies and standard forensic medical investigations. The experience in experts cooperation in investigation of terroristic bombing in Moscow underground on February 6, 2004, according to algorithm of combined use of conventional forensic medical methods and innovating techniques of molecular-genetic identification for personal identification of dead bodies in accidents with a great number of victims is demonstrated.
The Sinodont dental morphology pattern of NE Asia is today more complex and was so by 20,000 years ago, than the simplified Sundadonty of SE Asia-Oceania, and the very simplified pattern that evolved greater than 20,000 B.P. All Native Americans are Sinodonts. Intra--and inter-hemispheric statistical analyses of 28 dental traits in greater than 6000 N & S American and greater than 1100 NE Asian crania reveal three temporally stable American sub-patterns, suggesting prior evolution in Sino-Siberia. The hypothesized biocultural associations and migration episodes are: (1) "Upper Cave" Sinodonts with the generalized Chinese Microlithic Tradition reach the Arctic steppe via the Lena basin to become Paleo--and most later Indians. (2) Smaller-game-hunting Siberian Diuktaians cross to Alaska at forest-forming terminal land bridge times to become Paleo-Arctic and subsequent Na-Dene-speaking NW forest Indians. (3) Lower Amur basin-N Japan blade-makingfolk evolve a coastal culture on the way to the land bridge's SE terminus at Anangula-Umnak where the oldest skeletons of the dentally distinctive but variable Aleut-Eskimos have been found.
Centre for eHealth, Centre for Care Research, Southern Norway, Department of Health and Nursing Sciences, Faculty of Health and Sport Sciences, University of Agder, Post box 422, 4604, Kristiansand, Norway. firstname.lastname@example.org.
Telemedicine is changing traditional nursing care, and entails nurses performing advanced and complex care within a new clinical environment, and monitoring patients at a distance. Telemedicine practice requires complex disease management, advocating that the nurses' reasoning and decision-making processes are supported. Computerised decision support systems are being used increasingly to assist reasoning and decision-making in different situations. However, little research has focused on the clinical reasoning of nurses using a computerised decision support system in a telemedicine setting. Therefore, the objective of the study is to explore the process of telemedicine nurses' clinical reasoning when using a computerised decision support system for the management of patients with chronic obstructive pulmonary disease. The factors influencing the reasoning and decision-making processes were investigated.
In this ethnographic study, a combination of data collection methods, including participatory observations, the think-aloud technique, and a focus group interview was employed. Collected data were analysed using qualitative content analysis.
When telemedicine nurses used a computerised decision support system for the management of patients with complex, unstable chronic obstructive pulmonary disease, two categories emerged: "the process of telemedicine nurses' reasoning to assess health change" and "the influence of the telemedicine setting on nurses' reasoning and decision-making processes". An overall theme, termed "advancing beyond the system", represented the connection between the reasoning processes and the telemedicine work and setting, where being familiar with the patient functioned as a foundation for the nurses' clinical reasoning process.
In the telemedicine setting, when supported by a computerised decision support system, nurses' reasoning was enabled by the continuous flow of digital clinical data, regular video-mediated contact and shared decision-making with the patient. These factors fostered an in-depth knowledge of the patients and acted as a foundation for the nurses' reasoning process. Nurses' reasoning frequently advanced beyond the computerised decision support system recommendations. Future studies are warranted to develop more accurate algorithms, increase system maturity, and improve the integration of the digital clinical information with clinical experiences, to support telemedicine nurses' reasoning process.
This paper addresses the events at Beslan as a crisis point at which the postmodern celebration of difference spills into unbearable chaos. However this chaos turns out to show specific, dynamic or complex, self-organizing structures. Such dynamics, instead of obeying 'normal' ranges exhibit widely different scales of magnitude and intensity. Central to these interactions is the formation, however loose or opportunistic, of identities that also produce others: the formation of micro-ethnicities that state how the 'other' or out-group can be treated, mistreated or 'deconstructed'. At Beslan, this reaches a point of crisis which is both localized and universally challenging: it poses the problem of intolerability to a notion of democratic community and an epistemology premised on, and promising, pluralistic tolerance. The outcome is a realignment of sociology and the sociology of childhood along the axes of a model of human ecology.