bluuebunny/crossref_metadata_2025 huggingface dataset:
Valoración económica integral de los bienes y servicios ambientales ofertados por el ecosistema de manglar ubicado en la Ciénaga de la Virgen. Cartagena-Colombia.
Authors: Carbal Herrera Adolfo , Muñoz Carbal Johan , Solar Cumplido Lindyley
Published: September 2018

This project corresponds to a process of assessment of environmental goods and services (EGS) offered by the mangrove forest of the Cienaga de la Virgen, Cartagena de Indias, Colombia, exercise It allowed to demonstrate the potential of biological resources of the mangrove ecosystem under study. Methodologically the work of the review of characterizations made by CARDIQUE, allowing the identification of BSA offered by the ecosystem; then, variables are defined and parameters determining the monetary value of these; : followed various instruments as applied questionnaires and record formats by which the monetary value of the benefits determined economic order featuring mangrove being valued. The results show that the value of nontraded BSA determined by opportunity cost is higher than the value of BSA tradable, showing the preponderance of these for the balance of the area and the survival and development of the human species.
Bridge Programs: A Link between ESL and Content based courses. A Case Study
Authors: Davis Randy
Published: September 2018

This article is a case study that analyses the problems that many ESL and EFL students face when they transfer from ESL/EFL classes to academic classes in university level. It presents a revision of some of the present and past advanced English programs, followed by an Advanced English Program Model at the University of Specialties Holy Spirit in Guayaquil, Ecuador. We will make a thorough analysis of the three kinds of advanced English, which include: Accuracy and Fluency, English Structure (Grammar), Principles of Writing. Plus there will be a discussion on why and how a program of advanced English has to be developed. In conclusion, we will find the successful principles of an advanced English program not only for the students, but also for the institution.
Liderazgo transformacional en los docentes universitarios desde la perspectiva estudiantil. Estudio de caso
Authors: Pérez Ortega Giovanni , Guarín Herrera Lorena , Romo Morales Gerardo
Published: September 2018

A leader makes the transformation of the individual capacities possible, which he redirects towards the strengthening of the group capacities, and therefore face the challenges that the dynamic environments pose. Before the necessity to transform society, especially the professionals that are formed at Universidad Nacional de Colombia in Medellin, to face aforementioned changes, we developed a descriptive research of the qualitative-quantitative kind, which characterizes the transformational leadership perceived by the students of their teachers, which will derive in improvement of the action, motivation, and power processes according to Osgood scale. In total 155 interviews were made to students with a 70% or more progress in their curricular program, they were used to conclude that the teachers’ leadership looks for the development and growth of the students from their pedagogical actions, orienting and communicating and generating commitment with the goals and acting in such a way that it can be registered as a model for the students.
Anticoagulantes orales directos: monitorización y reversión, dos grandes dificultades
Authors: González Aguirre Irene , Carrillo Navarro María Claudia , Guerrero García Augusto
Published: September 2018

La tromboembolia representa una importante causa de morbimortalidad, siendo  la anticoagulación el pilar del tratamiento. Los anticoagulantes orales directos, constituyen  una opción que supera algunos de los  inconvenientes con warfarina, como la monitorización rutinaria.  No obstante con su inclusión en la práctica clínica, surgieron otras limitaciones: la dificultad para su medición cuando se requiere, debido a la poca disponibilidad y estandarización de pruebas hemostáticas; y  la falta de antídotos para reversión, frente a hemorrágicas severas. Sin embargo recientemente fue aprobado idarucizumab, un anticuerpo monoclonal que neutraliza al dabigatrán, no disponible en Colombia. Se concluye que estos fármacos,  son una opción atractiva, que requieren el desarrollo de pruebas diagnósticas y agentes de reversión específicos accesibles. 

Se realizó una búsqueda en bases de datos como Pubmed, Clinical Key, Embase, Evidence- Based MEDICINE, con las palabras clave dabigatrán, rivaroxabán, apixabán, monitorización, sangrado. Se incluyó literatura en idioma inglés y español entre 1998-2016.
Direccionamiento estratégico para la dinamización del sector salud en el departamento del Atlántico
Authors: Hernández Palma Hugo
Published: September 2018

En la actualidad, el sector salud del departamento del Atlántico atraviesa un momento de renovación y cambios, derivados del movimiento globalizado que viene tocando todos los sectores productivos del país. Lograr el fortalecimiento de las entidades vinculadas al sector salud, es una necesidad imperiosa, dada las grandes exigencias normativas y de control que se manejan hoy día, tanto a nivel nacional como internacional.  Por lo anterior, aspectos organizacionales y ligados directamente con la administración, planificación y diseño de estrategias se hacen indispensables en este tipo de organizaciones, a fin de lograr un nivel competitivo en la prestación de servicios.  A continuación, y con la finalidad de contrastar el escenario esperado con el actual, se revisarán diversas teorías referentes al direccionamiento estratégico y cómo este puede contribuir con la reorganización de estas entidades, proyectándolas a un futuro más productivo y enmarcado por la mejora continua.
Handover Algorithms in LTE Networks for Massive Means of Transport
Authors: Trejo Narváez Euler Adrián , Hernandez Bonilla Claudia Milena
Published: September 2018

Handover in LTE occurs when a device moves from the cell coverage serving it towards another; a process where the user established session must not be interrupted due to this cell change. Handovers in LTE are classified as hard ones, since the link with the serving cell is interrupted before establishing the new link with the target cell. This entails a larger failure risk and, consequently, a potential deterioration in the quality of service. This article presents a review of the handover algorithms in LTE, focusing on the ones oriented to massive means of transport. We show how the new algorithms offer a larger success in handovers, increasing the networkdata rate. This indicates that factors such as speed, position, and direction should be included in the algorithms to improve the handover in means of transport. We also present the algorithms focused on mobile relays such as an important study field for future research works.
Construction Site Layout Planning: Application of Multi-Objective Particle Swarm Optimization*
Authors: ORAL Mustafa , BAZAATI Siamak , AYDINLI Serkan , ORAL Emel
Published: September 2018

Construction Site Layout Planning (CSLP) comprises determining, sizing and placing of the temporary facilities within the boundaries of a construction site by considering many factors. Traveling distance between facilities and safety risks are two essential factors that need to be minimized while planning site layout of a construction project. Many studies treated CSLP as a single objective optimization problem. They have mainly focused on either diminishing the travel cost of resources on site without considering the safety aspect or vice versa. While a few of the studies have treated the problem as a multi-objective optimization problem, none of them included a risk assessment approach including crane-related constraints. Hence, a user-friendly CSLP model that includes a risk assessment approach for safety constraints is proposed by using a Multi-Objective Particle Swarm Optimization algorithm based on Pareto dominance approach to minimize both the construction safety risks of crane operated projects and the total traveling distance of the resources between temporary facilities.
Criando intimidade, recebendo visibilidade: novas práticas de persuasão na economia da fama
Authors: Campanella Bruno , Nantes Joana d'Arc de , Fernandes Paula
Published: September 2018

Este artigo analisa formas de negociação de intimidade e afeto entre ídolos e seus admiradores, dentro de ações que visam a promoção da celebridade. Nestas dinâmicas, a celebridade desenvolve um tipo de intimidade com seus fãs que os motiva a participar de verdadeiras cruzadas nas mídias sociais que objetivam a produção de maior atenção midiática para seu ídolo. As discussões apresentadas são baseadas no exame de estudos de caso envolvendo duas celebridades que adotam este tipo de estratégia de persuasão: a cantora Valesca Popozuda e a youtuber Kéfera Buchmann.
Morte no cartão postal: uma empresa, dois jornais e três vítimas
Authors: Amaral Márcia Franz , Nasi Lara
Published: September 2018

Analisamos as configurações da violência urbana nas narrativas jornalísticas de dois jornais da Infoglobo (O Globo e Extra) a partir da análise de capas e matérias sobre um caso de latrocínio de grande repercussão midiática. Investigamos como os personagens de vítima e de agressor compõem cada narrativa, relacionando-os às noções de Política da Piedade e da Vítima Virtual.  Concluímos que estão em jogo neste enredo vítimas de várias ordens: fatais, sociais e virtuais. O estudo evidencia como, para além do “fato em bruto”, as narrativas jornalísticas podem configurar um acontecimento de maneiras diferentes já que os jornais precisam se individualizar no mercado editorial e, portanto, dão inteligibilidades diversas para a experiência social da violência de acordo com projetos dramáticos diferentes.
As favelas cariocas nas chanchadas: de berço do samba a problema público
Authors: De Luna Freire Rafael , De Luna Freire Leticia
Published: September 2018

Este artigo traça um panorama histórico da representação das favelas cariocas nas comédias musicais cinematográficas brasileiras, conhecidas como chanchadas, dos anos 1930 ao início da década de 1960. Apontamos a presença mais constante da favela como cenário reproduzido em estúdio em números musicais das chanchadas lançadas até meados dos anos 1950. Tomando como marco o filme Depois eu conto (1956), a representação da favela passa a ser cada vez mais politizada no gênero. Em meio às polêmicas sobre as remoções das favelas e a atuação social da Igreja Católica na transformação deste tipo de habitação popular em “problema público”, analisamos Três colegas de batina (1961), em que uma favela adquire grande importância para sua trama, mas com um discurso ideológico distinto dos mais conhecidos filmes dos diretores do Cinema Novo.
GAMBARAN KLINIKOPATOLOGIK ASTROSITOMA HIGH GRADE
Authors: Kristiani Erna
Published: September 2018

Astrositoma merupakan glioma tersering. Tumor ini bisa mengenai  dewasa dan anak-anak.World Health Organization (WHO) mengelompokkan astrositoma menjadi 4 grade berdasarkan karakteristik histologik. Astrositoma high grade terdiri atas astrositoma anaplastik (grade III) dan glioblastoma (grade IV).

Data Departemen Patologi Anatomik Rumah Sakit Cipto Mangunkusumo (RSCM) tahun 2001-2010 melaporkan kejadian astrositoma sebanyak 179 kasus atau sekitar 20% dari seluruh tumor intrakranial, astrositoma anaplastik ditemukan sebanyak 12 kasus, dan  glioblastoma 42 kasus.

Seperti pada tumor otak lain, astrositoma high grade mengakibatkan gejala dan tanda gangguan neurologik fokal dan umum. Pemeriksaan radiologik pilihan adalah dengan Magnetic Resonance Imaging (MRI). Astrositoma anaplastik memberikan gambaran hypointense pada T1 dan hyperintense pada T2 dengan efek massa yang bervariasi. Karakteristik glioblastoma pada MRI berupa lesi iregular menyangat kontras di sekeliling nekrosis sentral (ring enhancement) dan edema vasogenik luas di sekitar tumor.

Astrositoma anaplastik secara histopatologik dicirikan dengan atipia inti, peningkatan selularitas, serta aktivitas proliferasi yang nyata. Glioblastoma secara histopatologik serupa dengan astrositoma anaplastik, disertai adanya proliferasi vaskular dan/atau nekrosis. Astrositoma anaplastik dan khususnya glioblastoma mempunyai variasi gambaran histologik yang beragam, antara lain varian small cell, granular cell, giant cell, dan gliosarcoma.
THE ROLE OF RADIOTHERAPY IN UTERINE CERVICAL CANCER
Authors: Kodrat Henry
Published: September 2018

Uterine cervical cancer is the most common cancer in Indonesia. The purpose of the review is to describe diagnosis and staging, the basic principles of radiotherapy, the role of radiotherapy in cervical cancer treatment, and radiotherapy side effects. The goal of radiotherapy in cervical cancer consists of definitive, adjuvant, and palliative. Effort to increase radiation response also develops by administered small dose of chemotherapy as a radiosensitizer.

Keywords: cancer, cervix, radiotherapy
Comparing The Who 1997 / Who Searo 2011 And Who 2009 Dengue Classification In Diagnosing Dengue Infection In Out-Patient Settings In Tangerang District, Banten Province, Indonesia
Authors: Cucunawangsih Cucunawangsih
Published: September 2018

The World Health Organization (WHO) 1997 / WHO (Regional Office of South-East Asia) SEARO 2011 and WHO 2009 dengue guideline emphasized different aspects. Indonesia as a limited resources hyperendemic area will a large number of patients hopitalized using the WHO 2009. This study compared the adult non severe dengue cases in out-patient settings using both classification. This retrospective cohort study on 85 patients found 48 dengue cases confirmed by reverse transcriptase polymerase chain reaction (RT-PCR) on the period of August 2011 – January 2012, in 5 out-patient settings health facilities. The sensitivity and spesificity of WHO 1997 / WHO SEARO 2011 were 48.93% and 23.68%, while the WHO 2009 were 78.72% and 68.42%. Out of 8 secondary infection patients, 25% in WHO 1997 / WHO SEARO 2011 and 0% in WHO 2009 were classified as the more severe form. The WHO 2009 shown higher sensitivity and specificity, but the WHO 1997 / WHO SEARO 2011 could diagnose more patient that would have suffered severe forms of dengue and also more secondary infection who have the probability of severe forms compared to WHO 2009.

Keywords: dengue, out-patient setting, world health organization
Sindrom-Guillain Barre Pada Pasien Demam Dengue
Authors: Puspitasari Vivien
Published: September 2018

Guillain-Barre syndrome is an acute poliradiculopathy that characterizes as flaccid limb weakness subsequently after an infection disease. It is scarcely found to be triggered by the dengue virus infection. Here in a case report of 48-year-old male, presented as an ascending weakness of both limbs, following 2 days fever. Anti-dengue examination was found to be positive.
Keywords: Guillain-Barre Syndrome, Dengue Fever
The Importance of Immunohistochemical Analysis in Silent Pituitary Adenoma
Authors: Harsono Ivan William , Stevina Nathania Victoria , Puspitasari Vivien , July Julius
Published: September 2018

Pituitary adenoma contributes to 15% of all intracranial neoplasm. It is usually following benign course and some of them are silent (asymptomatic clinically, but hormone-secreting). Silent adenoma usually found incidentally or when the patients show mass effect (neurological deficits). Many of histologically aggressive silent adenoma subtypes are associated with invasiveness, recurrence and progression to clinically functioning adenomas. Aggressive silent adenoma radiologically tends to invade in downward direction, invading bone, sinus cavernosus, parasellar region. The nature of aggressive silent adenoma subtypes is differing in nature compared to benign nature of pituitary adenoma and should be confirmed immunohistochemically to determine the prognosis and anticipate the risk of recurrence or progression. The case illustration show a real case of 46 years old female progressive headache and visual disturbance diagnosed with non-functional pituitary macroadenoma but positive for more than one immunochemistry biomarker (plurihormonal aggressive silent adenoma).
Tropical silviculture in dense African forest (Part 3)
Authors: Catinot René , Bossanyi Ilona
Published: September 2018

L’article présente la troisième partie de l’étude sur la sylviculture en forêt dense africaine. Dans les deux premières parties, l’auteur discutait des principales méthodes de foresterie développées jusque-là. Dans cette partie, il examine les causes d’échec. Il considère que le facteur déterminant pour le succès des plantations est la lumière du jour, que les jeunes plantules reçoivent généralement insuffisamment. L’auteur décrit ensuite le programme de recherche entrepris par le Centre technique forestier tropical (CTFT, centre technique maintenant intégré au Cirad) sur ce thème afin de déterminer la quantité de lumière délivrée par chaque système sylvicole, la quantité optimale de lumière demandée par chaque espèce étudiée et l’effet de l’illumination latérale. Ces études utilisent des calculs graphiques, des mesures aux instruments, et des dispositifs expérimentaux particuliers.
Vplivni dejavniki poseka v zasebnih gozdovih Slovenije v obdobju 1995-2014
Authors: Češarek Domen , Ficko Andrej , Bončina Andrej
Published: September 2018

We analyzed the characteristics of timber harvesting in private forests of Slovenia during the 1995-2014 period. The survey included forest sub-compartments that had been completely privately owned in the studied period (n = 16,234). With the multiple linear regression models we analyzed the influence of 9 natural, 4 forest-management and 3 socioeconomic variables on the amount of annual felling per hectare and the medium felled tree. We found that with the increase of the size of plots and forest property timber harvesting is increasing. Harvesting was positively influenced by the share of spruce in the growing stock, site productivity, distance to the forest edge, the openness and the share of beech in the growing stock. Harvesting was negatively influenced by inclination, distance to road and settlements, number of (co)owners, the share of spruce in the potential natural vegetation and the proportion of succession stages. The medium felled tree was positively influenced by site productivity, and most negatively by distance to the road.
Caring for Patients, Profession, and World The Social Activism of Lavinia Lloyd Dock
Authors: Ramos, Mary
Published: September 2018

Caring as a concept is widely discussed and debated within nursing. It is typically understood conceptually as a quality of a human interaction, usually the nurse’s interaction with a patient, client, family, or group (Gaut & Boykin, 1994; Eriksson, 1992; Leininger, 1980, 1984; Watson, 1985). Caring is culturally bound, laden with positive value. But common understanding may limit the scope of this foundational concept, for nursing, nurses, patients, and health care exist in societal context. As roles in health care are expanding and changing in light of health care reform, our professional adaptation is ideally based on caring relationships with individuals and also with institutions, populations and health care delivery systems. As with caring on an individual level, individual nurses have left an example of caring for society on a larger scale, literally a global level. Lavinia Lloyd Dock is an obvious example of international caring. This diminutive woman had a voice and intellect that has survived.

Nursing history is replete with stories of caring nurses, angels of mercy, somehow with a strength of character unreconciled to the ‘gentle spirit of Victorian womanhood.’ The political skill of nursing leaders a hundred years ago cannot be underestimated. The work of establishing nursing as a profession took untold tact, manipulation, pointed subservience, and an ability to withstand frustration at the hand of individuals, institutions, and a culture that held rather circumscribed roles and expectations for women. Certain women attacked the system in a direct fashion; Lavinia Dock was one of those.
Influencing the Caring Capacity of Leaders
Authors: Farrell, Pat , Nuttall, Gary
Published: September 2018

Over the past five years, we have been privileged to work with 130 leaders, as co-research participants, in discovering new approaches to leadership that will strengthen organizations in this time of shifting world values. For 28 of these leaders, we also have been privileged to study the organizations in which they work, and further, to observe the corporate culture with regard to connections between various employee groups and 1eaders. This paper is about our leadership enhancement process that we have developed for leader (board chairs, presidents, vice-presidents, and executive directors) in all sectors, including health care systems. Our process assists leaders to connect their intrapersonal behaviors to their interpersonal decision making behaviois - a process that influences their caring capacity. We also outline the framework that we have developed inductively, for the assessment of leaders’ intrapersonal and interper sonal decision making.We conclude with some of the outcomes of our process.
Quality of care and Critical Pathways: Brave New World?
Authors: Vezeau, Toni M.
Published: September 2018

Current approaches to standardization of care directly oppose quality of care in nursing. Popular approaches in the United States include care maps and critical pathways designed for the care of individuals. I believe nursing must resist, or at least reinterpret, present approaches that turn nursing care into a production line - only an economic metaphor.

The introduction of critical pathways and care maps has been heralded in nursing and hospital literature as the pivotal tool to ensure quality of care (Crummer & Carter, 1993; Goode, 1995; Hampton, 1993; Lynam, 1994; Tallon, 1995; Windle, 1994; Zander, 1992, 1995). These tools may also herald the loss of quality care defined within the nurse-patient relationship. I will grant that the tools can lead to cost-savings for the public, but I think at great potential loss to individuals. This paper will provide a critique of the current economic models guiding nursing care and suggest where nursing may need to deviate to keep within our social mandate to care.
Inner City Children: Health-as-Choice-to-Care
Authors: Arieux, Marianne
Published: September 2018

In an elementary school in the South Bronx, children are sheltered for a time from an environment which offers few comforts. Caring for and about the child has led to the development of a human science approach aimed at the child’s caring about his/her self. The intrapersonal aspect of self-care is the implicit focus, while the explicit focus is Health as Choice to Care.

Interventions which provide information while focusing directly on recognizing choices empower the child. Children who live in compromised environments are often viewed as having limited choices, but every day children make choices about what to eat, with whom to play, or whether to wear eyeglasses. Becoming aware of choices even within finite limitations, conveys the sense of power to change one’s experience. Begun as children, the caring for self by enhanced awareness of choice and information will, it is hoped, produce healthy, proud adults who can change the environment which they have endured.
Catlin’s Story- Realizing Caring Within Everyday Practice Through Guided Reflections
Authors: Johns, Christopher
Published: September 2018

Guided reflection is a developmental process to enable and empower practitioners [either as individuals or in small groups] to learn through reflection upon lived experience with the intention of realizing caring. Guided reflection is also a collaborative research process, whereby the educator/ researcher and practitioner can understand the contextual nature of desirable practice and the factors that limit achieving this practice.
Therapeutic Touch, Pain, and Caring: Implications for Nursing Practice
Authors: MacNeil Melanie S.
Published: September 2018

This descriptive study was to investigate therapeutic touch (TT) on adult tension headache pain. Ten tension headache pain sufferers were selected from a chiropractic clinic in southeastern Ontario. Subjects were randomly assigned to control and experimental groups using Rogers’ science of unitary human beings. An interview schedule, adapted from the Carboni Unitary Measurement Tool (1992), was administered before and after TT. Data were collected, recorded, and analyzed by the treatment group. Results suggested that one application of TT was useful in reducing tension headache pain in all subjects who received authentic TT. Strategies for implementing TT in nursing practice are offered.
The Role of Interpretation in Caring Science
Authors: Söderlund Maud
Published: September 2018

This article addresses the role of interpretation in research in caring sciences. Drawing on methodological suggestions from Hans-George Gadamer and Per-Johan Ödman, it shows a way of interpretation on an existential level. The methodology is focused, while a caring science paradigm serves both as a background and as a theoretical framework— as paradigmatic thinking using an abductive process. The authors interpret an excerpt from a narration of an interview with a relative of a person suffering from dementia. The results give substance to the drama of suffering and health, and will be presented in a later article.
Development of a Model of Nursing Education Grounded in Caring and Application to Online Nursing Education
Authors: Purnell Marguerite J.
Published: September 2018

This paper describes an innovative model for nursing education grounded in caring (MONEC). Based on nursing theory, the model and its online application in nursing education is supported by both the nursing and interdisciplinary research. Part I describes model underpinnings of the theory of, nursing as caring, the dance of caring persons as organizing pedagogy, and intentionality in nursing as transformative in aesthetic knowing. Part II describes an application of the model in creation of an online course and challenges in developing a unique, aesthetically wallpapered environment. Student responses to the environment are presented and implications for research and education are discussed.
A Psychoneuroimmunological View of the Healing Potential of Professional Caring in the Face of Human Suffering
Authors: Halldorsdottir Sigridur
Published: September 2018

What is healing? How can nurses promote it in the face of human suffering? These questions have been asked ever since Nightingale pondered these basic questions for nursing. Answering them is, in my view, answering one of the foundational questions of what is nursing. My own conclusion, from numerous studies, is that nursing is professional caring, involving the nurse’s competence, professional wisdom, caring, and ability in connecting with the patient, as well as the progressive self-development of the nurse. In this paper I reflect on the healing potential of professional caring from the patient’s perspective, in the light of research findings from psychoneuroimmunology.
Caring for Individuals Displaced by Hurricanes Katrina and Wilma: The Lived Experience of Student Nurses
Authors: Barry, Charlotte D. , Blum, Cynthia Ann , Purnell, Marguerite J.
Published: September 2018

The purpose of this phenomenological study is to explore the experience of caring for individuals and families left homeless and then displaced in the aftermath of destructive hurricanes. The nursing situations, which are reflective stories from the practice of seven undergraduate nursing students, were interpreted to uncover the meaning of caring for others who have experienced disastrous situations. The interpreted findings are three thematic threads that cut across all the texts: building connections to others, appreciating the wholeness of persons, and learning the meaning of caring in nursing. The wholeness of this inquiry is presented using a metaphor to describe the fullness of lives lived, despite being left homeless and displaced by disastrous hurricanes.
The Meaning of Spiritual Nursing Care for the Ill Individual with No Religious Affiliation
Authors: Creel Eileen
Published: September 2018

Phenomenology guided the researcher in uncovering the meaning of spiritual nursing care for 11 ill individuals with no religious affiliation. The participants experienced spiritual nursing care through the nurses’ extension of self, which occurred when the nurse saw the participants as unique individuals. Unfortunately, many participants experienced alienation by their nurses. An examination of programs of nursing education curricula at all levels for the inclusion of spiritual nursing care as a concept broader than that of religion is needed. Health initiatives would advance positive outcomes when including spiritual care in the total care needs of all patients.
Quality Virtues in Service
Authors: Andal, Elizabeth M.
Published: September 2018

In a materialistic society where economic returns in service are necessary for organizational survival, there is a need to frame the provision of patient care in the context of values—a set of ideals. Quality Virtues in Service (QVS) is the process of care delivery using virtue-driven, quality values. Virtues shape the foundation, fundamentals of patient service utilizing tools of the patient care trade: compassion, honesty, industry, and integrity. The QVS philosophy, model of service, and essential characteristics of the QVS provider are discussed. The expected outcomes or goals of QVS are listed so that healthcare providers can facilitate patient satisfaction, enhance quality of care using the QVS guidelines for practice, and reinforce professional commitment through virtue-driven supportive work interrelationships.
Terra Caritatis: Where Suffering Is Alleviated in an Atmosphere of Community
Authors: Söderlund, Maud
Published: September 2018

It is interesting to examine the concept of family care when describing relatives’ experience. This article presents a model of caring from relatives’ perspectives; it was developed using an abductive design composed of induction, deduction, and abduction. Reaching the infinite through the abductive process, it is possible to describe a model of caring from relatives’ perspectives being in the atmosphere of community where someone who really knows how it is, is present. Amodel named Terra Caritatis, through which suffering is alleviated in an atmosphere of solidarity, is developed and is presented in this article.
Nursing Research and Vulnerable Populations: The Contribution of Humanism
Authors: McCabe Janet Lynn
Published: September 2018

The past few decades have seen immense change in the conceptualization of vulnerability, resulting in members of vulnerable groups requesting that their subjective experiences be seen as valid. In response, researchers have proposed the use of emancipatory and participatory research; forms of research that would alter the traditional power relationships between researchers and their subjects. This article relates these developments specifically to nursing research and proposes that adopting a humanist philosophy could assist in achieving research that acknowledges vulnerable individuals and their personal experiences, challenges the current norm that puts researchers in control of the research agenda, and frames nursing practice according to caring science principles (ethos).
Perception of Caring: Patients, Nurses, Physicians, and Administrators
Authors: Abdullah Laila
Published: September 2018

The purpose of this study was to describe “caring” in the Pakistani culture from patients’ and healthcare teams’ points of view. This descriptive and qualitative study was conducted at Aga Khan University Hospital (AKUH). Caring encompassed the themes of efficiency, sensitivity to patient needs, and humanness according to responses of the combined sample.
Healing Presence Ceremony in Nursing Education
Authors: Coffman Sherrilyn
Published: September 2018

Nursing programs are searching for creative ways to help students develop themselves as caring practitioners. Faculty at Nevada State College created the Healing Presence Ceremony to inspire students and faculty to dedicate themselves to nursing. The focus of the ceremony is healing presence within nurse-patient and faculty-student relationships. The ceremony has become an annual event with positive evaluations by participants. Through public recognition, the ceremony has made explicit the program’s caring philosophy to the college and to the community at large.
Virtue and Health – Describing Virtue as a Path to the Inner Domain of Health
Authors: Wärnå-Furu, Carola , Lindholm, Lisbet , Eriksson, Katie
Published: September 2018

The aim of the study is to investigate the meaning that virtues have for human health and to develop a health-promoting model describing virtue as a path to the inner domain of health. The concept of virtue, in accordance with Aristotle’s theory of virtue, is used as the frame for interpretation. This investigation comprises an empirical study that avails itself of the Delphi method to collect data. The expert panel consisted of 10 experts in the field of nursing care. Abduction is the method that is used. The result is presented at four levels of interpretation and the final finding constitutes four theses, which comprise the virtues of wisdom, faith, courage, and love and a conceptual model.
Paradox of Hope in Patients Receiving Palliative Care: A Concept Analysis
Authors: Tanis, Sandra J. , DiNapoli, Pamela P.
Published: September 2018

Hope is a phenomenon that, although difficult to define, is experienced in various ways and to different degrees by individuals when confronted with a life-threatening illness. Often a paradox of hope exists in the same moment of time or along a continuum for a patient receiving palliative care. The purpose of this manuscript is to conceptually define the paradox of hope, to operationalize the concept, and to apply the concept to nursing practice. By providing a link between the paradox of hope and the practice of nursing, nurses have the potential to relieve patient suffering by fostering and supporting a patient’s concept of hope in receiving palliative care.
Caring Scholar Response To: Achieving Compassionate Excellence
Authors: Ray Marilyn A.
Published: September 2018

Acooperative accelerated baccalaureate program developed by the Schools of Nursing of University of Texas Health Science Center and University of Texas Medical Branch was designed to make available an on-line nursing program for second degree students to meet the increased demand for nurses in Texas. Faculty from both schools were committed to enhancing human caring in nursing education and practice by means of developing a joint curriculum devoted to the value of Compassionate Excellence. This response assesses the curricular courses and the evaluative highlights of the program in terms of the meaning, to the author, of Compassionate Excellence in nursing education.
Honors Programs as a Way to Grow the Discipline
Authors: Schumann Renae R.
Published: September 2018

Honors programs and courses can be characterized by large impersonal classes with differences in assignments and evaluation criteria compared to non-honors courses. This article begins to tell the story of a nursing honors program in which expert researchers and educators mentor highly motivated students, introducing them to nursing research and to faculty roles. The one-on-one relationships developed during the two-semester program encourage student growth and academic and career success. Mentored students are more confident in their ability to participate in clinical research and pursue advanced education.
Community Gardens for Health Promotion and Disease Prevention
Authors: Stein, Mary J.
Published: September 2018

People with limited socioeconomic resources have increased incidence of chronic diseases and fewer means of promoting health of body, mind, and spirit. There is evidence of an inverse relationship between access to resources and chronic disease; thus, healthcare providers in communities with few resources have unique challenges in health promotion. Community gardens provide an opportunity to participate in holistic health-promoting behavior. This article presents support for the belief that healthcare that promotes development of and participation in community gardens can improve the health of at-risk populations through better nutrition, physical activity, and connection to the natural world.
Empowered Caring: An Ethical Framework for Participatory Action Research
Authors: Parsons, Mickey L. , Robichaux, Catherine , Warner-Robbins, Carmen
Published: September 2018

Participatory action research (PAR), as a “new paradigm” approach, involves additional ethical and political issues beyond those encountered in empirical and interpretive models of science. This paper describes PAR methodology, a comprehensive ethical framework that is inclusive of the ethic of care and virtue, and applications with formerly incarcerated women.
Legal Caring: Preventing Retraumatization of Abused Children Through the Caring Nursing Interview Using Roach’s Six Cs
Authors: Gibson, Sandra E.
Published: September 2018

Child abuse, especially sexual abuse, is a harsh, common reality. Nurses are called upon to assist children who may become part of the justice system. The philosophy of Human Caring, by M. Simone Roach, is used as a lens to illuminate the importance of legal caring. Acaring non-traumatic nursing interview with a child that has undergone sexual abuse is presented. Acase study demonstrating the technique of skillful questioning of the child highlights how one U.S. state developed a statute and ordinance to protect the abused child from retraumatization and to maintain legal verbal evidence. Recommendations for successful approaches for legal caring in the initial stages of contact with the victim and family are outlined.
The Tune of Confirmation in Guiding Nurse Students
Authors: Aasen, Kari Hovland , Nåden, Dagfinn
Published: September 2018

The purpose of the article is to provide a deeper understanding of the guidance of nursing students from a caring science perspective. The methodological approach is Gadamerian (2004) hermeneutics. Interviews are used in sampling and analyzing data (Kvale, 1996). The main findings were confirmation, reflection, and authority. This article focuses on the phenomenon of confirmation only. The main aspects of confirmation are that it includes genuine interest and care, makes nursing students feel secure and is a key to development, strengthens the relationship in a group and between individuals, and is a good base for reflection.
Care Revisited: Family Resemblance as Context
Authors: Duke, Jan
Published: September 2018

Care and caring have been debated in the nursing literature formore than 30 years as concepts of importance to nursing. Nursing theorists in this arena have drawn on the work of other disciplines, particularly psychology and philosophy. This paper reviews the literature and suggests Wittgenstein’s notion of family resemblance as a way for the profession to resolve the ongoing dilemmas over definition, description, and measurement. The notion of family resemblance allows the profession to accept that the meaning of a term is in its use and that the uses of care in nursing are many.
Nurse-to-Nurse Caring Begins with Shift-to-Shift Report
Authors: Dean, Patrick J.
Published: September 2018

Shift-to-shift report is a pivotal moment in nursing where the type of report and the manner in which it is given can enhance or hinder the caring process. Like the invisible force of a butterfly wing, a shift-to-shift report can have unimaginable and quantum-like repercussions. An examination of literature leads to recommendations for changes in the concept and content of shift-to-shift reporting, and a recommendation that nurses demonstrate caring of each other before they begin patient, family, and inter-collegial caring.
Reflective Journaling: Innovative Strategy for Self-Awareness for Graduate Nursing Students
Authors: Williams, Gail B. , Gerardi, Margit B. , Gill, Sara L. , Soucy, Mark D. , Taliaferro, Donna H.
Published: September 2018

Structured self-reflective journaling has the potential to serve as a means of self-awareness and professional growth. The purpose of this study was to describe what graduate nursing students were coming to know about themselves via reflective journaling. The context was a graduate course in psychiatric nursing. Adescriptive exploratory design was conducted using qualitative methods. Content analysis was performed on journals of students enrolled in a graduate nursing course to identify prominent themes and patterns regarding the students’ perceptions of what they were coming to know about themselves as they worked in the psychiatric mental health area. Four themes emerged from the narrative content of the journals: becoming aware, feeling the pain, what I learned, and personal growth exists among colleagues. Caring is one way in which these relationships can be examined. In this study positive correlations were found between manager caring and peer caring and their relationship with RNs’ job satisfaction and intent to stay both in a position and the profession.
Development and Psychometric Evaluation of Patients’ Perceptions of Feeling Known by Their Nurses Scale
Authors: Somerville Jacqueline G.
Published: September 2018

Based upon four themes that emerged from a previous qualitative descriptive study (Somerville, 2003), 85 items were developed and submitted to nurse and patient experts for content validity, readability, and understandability. The resulting 77-item scale was administered to 327 patients and 296 complete surveys were analyzed. A four-component solution, consistent with the themes from the qualitative study, was devised using principal-component analysis (PCA) with Varimax rotation. A component loading cut-off was set at 0.3, resulting in a reliable and valid 48-item scale. This scale will aid nurse assessment of the impact of the current healthcare environment on the patient experience.
Teaching Theoretically Based Interventions: Use of Life Review
Authors: Hermanns, Melinda , Mastel-Smith, Beth , Lilly, Mary LuAnne , Deardorff, Kathy , Price, Carol
Published: September 2018

This manuscript discusses the process of teaching a theoretically based intervention, therapeutic life review, to student-listeners in an RN-BSN and RN-MSN program. Student-listener reflections are included and focus on their experience in this process.
When the World is White
Authors: Wilby Mary L.
Published: September 2018

This essay offers insights into racial disparities in the nursing profession and nursing education. Perspectives are offered on cultural competency and a Eurocentric worldview. Historical antecedents of whiteness are discussed and the links between race and status are noted.
Transforming Nursing Through Dialogical Relationships: A Pedagogy of Connectedness
Authors: Garno, Melissa
Published: September 2018

The purpose of this paper was to describe a pedagogy of connectedness for nursing education designed to increase personal transformation by teaching a caring ethic. Based on dialogical existentialism, nursing education can become more meaningful and engaging through attention given to the nature of relationships. Qualities inherent in a pedagogy of connectedness include discomfort, quietude, contemplation, and surrender. By attention to these qualities, students and educators can increase the likelihood that educational experiences will be more personally meaningful and transformative. The pedagogical challenge for faculty is to increase attention to these qualities and create the conditions for internal self-discovery and care for others through connectedness.
A Moral Framework for Caring in Nursing: Neo-Stoic Eudaemonism
Authors: Sumner, Jane
Published: September 2018

The traditional moral and ethical models utilized by the nursing profession are examined through a critical social theory lens to identify limitations or inappropriateness for application within the nurse-patient caring relationship. Classical ethical theories continue to have merit in the delivery of professional nursing, but within the context of practice, are system imposed. Neo-Stoic Eudaemonism, arising from an individual’s interiority, stimulates awareness of the nurse as an equal human in the relationship. This theory offers universality that is a-contextual. It can differentiate moral and ethical components of nursing practice and offers insight into nurses’ moral distress.
The Lived Experience of Clinical Simulation of Novice Nursing Students
Authors: Cordeau, Mary Ann
Published: September 2018

To effectively use clinical simulation for nursing education, the phenomenon must be understood from the perspective of the nursing student so learner centered teaching/learning strategies can be implemented to achieve desired outcomes. This study examined the lived experience of graded clinical simulation for novice nursing students. Using van Manen’s (1990) method for hermeneutic phenomenological investigation, the written descriptions of 19 novice nursing students were examined. Five thematic clusters; perceived anxiety, seeking and imagining, performing-in-the-moment, critiquing-the-performance, and preparing-for-nursing-practice emerged from the student descriptions of their lived experience of graded clinical simulation. Through understanding students’ perceptions and meanings of clinical simulation when designing, implementing, evaluating individual clinical simulations, this teaching/learning strategy will better meet student needs and learning outcomes.
A Descriptive Study of Learning through Confluent Education: An Opportunity To Enhance Nursing Students’ Caring, Empathy, and Presence with Clients from Different Cultures
Authors: Curtis, Mary P. , Jensen, Alice
Published: September 2018

Caring and empathy are important and valued attributes of nurses. The practice of teaching empathy and the techniques utilized by nursing faculty are difficult to describe and the outcomes are difficult to measure. This study explores how the intentional use of confluent education methods were implemented into an undergraduate community health nursing course in an effort to enhance caring and empathy of senior nursing students working with culturally diverse clients in the community
Comportment: A Caring Attribute in the Formation of an Intentional Practice
Authors: Roach, M. Simone , Maykut, Colleen
Published: September 2018

The attribute of comportment is intended to convey the nurse’s belief that dress and language reflect the professional’s respect for the patient, family, and colleagues. Comportment, as a caring attribute, has the potential to offer an opportunity to concurrently visually represent the intentionality of a nursing practice and demonstrate professionalism. Adherence to professional dress and address demonstrates respect for the dignity of a person as a human being. Registered nurses must demonstrate commitment to their caring practice by recognizing the need of the other as more important than their own need for self-expression.
Creating a Healing Environment: Nurse-to-Nurse Caring in the Critical Care Unit
Authors: France, Nancey E.M. , Byers, Dina , Kearney, Barbara , Myatt, Sharon U.
Published: September 2018

The purpose of this study was to explore with and empower nurses to create a healing environment. The study’s design was a combination study utilizing both quantitative and qualitative methods. The primary research question was, “How is the healing environment of the critical care units affected by the nurses’ trust and empowerment?” The Gibbs’TORI Self Scale and Gibbs’TORI Team Scale measured trust and Barrett’s Power as Knowing in Participation in Change Tool measured empowerment/power. The qualitative analyses revealed essential structures and a synthesis of unity triangulating with the quantitative results. There are implications for education, practice, and administration.