This chapter focuses on women, who are HIV positive, from a global perspective. It illustrates more easily what makes groups of people, and in this case women, vulnerable and then consider vulnerability from a global health (GH) perspective using the chronic illness, HIV. The chapter presents some examples of situations that make women vulnerable to HIV and, once infected, vulnerable for life, and use a case-based approach to highlight women as a vulnerable population. It also focuses on the real ethical issues that occurred with each case, which one anticipate will help prepare the new GH nurse for practice in the global environment. The chapter demonstrates by using an exemplar of HIV-positive women, vulnerable populations exist both within and outside the United States. Reasons for vulnerability may include stigma, victimization, mental illness, migration, limited access to needed health care or food, or substance use.
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Healthy body image is critical to adolescent development, and teens often diet and worry about their weight and appearance. However, for some youth these concerns become fixed and distorted, resulting in psychopathology. Eating disorders, particularly binge-eating disorder, anorexia nervosa, and bulimia nervosa, are serious, complex chronic disorders, which can be life-threatening. Differential diagnoses for eating disorders include: cardiac valvular disease, malabsorption syndromes; inflammatory bowel disease; chronic infections; thyroid disease; hypopituitarism, Addison disease; central nervous system lesions; cancer; and other psychiatric disorders including depression, obsessive-compulsive disorder, anxiety, and substance abuse. Eating disorders are difficult to treat, especially when presenting with comorbid diagnoses, and treatment depends on the severity of the illness. Primary health care providers play a critical role in assessment, monitoring of treatment progress, screening for and managing medical complications, and coordinating care with psychiatric and nutritional professionals.
This chapter reviews prevention, including genetic counseling. It discusses genetic testing for diagnosis as opposed to screening and the treatment for genetic disease. Methods of prevention begin with education of the public and health care professionals and identification of those at risk. Genetic counseling is the process of helping people understand and adapt to the medical, psychological, and familial implications of genetic contributions to disease. The malignant cells often exhibit aneuploidy as well as translocations that are found only within the tumor cells. Genetic errors that arise from specific cell lines are somatic mutations. It is suggested that there is a thorough collection of family, genetic, and medical history for children entering the adoption process. Nurses may play a variety of roles in genetic counseling that reflect their preparation, area of practice, primary functions, and setting. The chapter explains the incidence of chromosome abnormalities.
The initial recognition of the need for a genetics referral may arise when a nurse suspects a genetic contribution to disease because of personal or family medical history and/or findings from a physical assessment. Family history is a valuable and cost-effective tool that is often underutilized in clinical practice. Many common genetic conditions result from complex interactions between genetic and environmental factors. It is critical to collect information about potential environmental exposures to help inform a patient’s risk assessment. Health care professionals should become familiar about toxic environmental agents that are common in their specific geographic location. A growing number of Food and Drug Administration (FDA) approved drugs have labeling that includes pharmacogenomic information, which can be used to optimize drug dosage and prevent adverse and life-threatening drug reactions in a patient or family member.
Nurses working in the field of obstetrics must have a greater depth and breadth of genetic knowledge over any other subspecialty. In gestation, nurses should include education on the effects of teratogens, prenatal screening options, and prenatal diagnoses. After delivery, early recognition of genetic disorders is important for immediate initiation of potentially life-saving therapies. Preconception education is a critical component of health care for women of reproductive age. The Centers for Disease Control and Prevention (CDC) recommend that all women of childbearing age consume 0.4 mg of folic acid daily to prevent neural tube defects (NTDs). Counseling can still be useful in terms of optimum pregnancy management in a setting best able to cope with any anticipated problems. Complex and multifaceted maternal and fetal factors influence the consequences of drugs, radiation, and chemical and infectious agents to the developing fetus.
This chapter focuses on the Scientific Revolution, a period of time roughly from the 16th to 17th centuries in which radical new developments and changes regarding the study of the natural world occurred as central to understand what science is. The development and establishment of what is usually taken to be the characteristic methodology of science has always been regarded as constitutive of the Scientific Revolution. The Scientific Revolution developed a “realist” view of mathematics in which it is believed that mathematical analysis reveals deeper truths about the world. During the Scientific Revolution, the naturalistic elements of magic were separated from other aspects of magic. In the most general terms, the Scientific Revolution introduced a completely different worldview, replacing a medieval/Renaissance teleological world with a modern mechanistic world. The Scientific Revolution is a complex phenomenon in itself and part of a larger complex social change in the West.
- Go to chapter: Next Steps Toward Practice Knowledge Development: An Emerging Epistemology in Nursing
This chapter focuses on introductory arguments about the Doctor of Nursing Practice (DNP) student and graduate’s clinical scholarship, a future practice-oriented nursing epistemology. It explores a model of scientific inquiry and stewardship for the nursing discipline through the development of a body of practice-oriented nursing knowledge to improve health. There is a very strong case to be made that the “good science” evolving from the DNP programs where nursing epistemology and practice knowledge development is valued is indeed being conducted within the framework of a Mode 2 knowledge production paradigm. Finally, there is an operational concern for how practice knowledge is made formal within the academy before it is then further synthesized, reduced, and disseminated in journal format and oral presentation. Practice knowledge generation only needs rigor, proper mentoring, an inquiring mind, and some creativity.
Objectives have been used for decades in nursing education to set the stage for what is expected of students and to guide faculty in planning teaching and assessment. However, nursing education is evolving and the timeworn practices used to write objectives must evolve as well. This chapter focuses on how to write broad behavioral objectives to support learning in a constructivist, learner-centered online environment to guide teaching and learning that are in step with today’s innovations in education and that follow the call for radical transformation in nursing education. Objectives focused on the desired learning outcomes or intended behavior changes, termed performance. The psychomotor domain is the skills domain in the narrow sense of the word, in that this domain provides a means of identifying outcomes that involve fine, manual, and gross motor movements.
The creation of the online course in the learning management system (LMS) requires a certain comfort with technology, but more important, consideration of interface design, or the computer-user interface with the goal of making the interface as user-friendly or intuitive as possible. Success in this endeavor depends on understanding the relationship of the syllabus and organization of the LMS. This chapter focuses on expanding on that information to create consistent navigation in the LMS week after week, taking advantage of the efficiencies available in most LMSs, and basic interface design principles. Interface design is also referred to as the computer-user interface. The LMS design should be intuitive and easily navigated so that students can focus on learning and not spend an undue amount of time locating information. In a constructivist, learner-centered teaching paradigm, the lecture as the primary means of teaching has fallen out of favor, especially when teaching online.
This chapter provides a guide to conducting a life history from conceptualization to dissemination. Life history is used to explain an individual’s understanding of social events, movements, and political causes, that is, how individual members of groups or institutions see certain events and how they experience and interpret those events. As it is unlikely that nurses will be conducting traditional fieldwork to gather life histories because of the extensive periods of time involved, the chapter describes the process for collecting focused life histories by researchers whose only purpose is to document the story of the participant and not to frame this life history within a broader ethnography. It considers life history as a sociocultural methodology and leave oral history on historical research and life review to the one on clinical literature.