Death and dying of newborns and children: relationships between nursing and family according to Travelbee

ABSTRACT Objective: Identify the nursing staff's perception of their relationship with families of newborns and children who are in the process of death and dying. Methods: Qualitative research, carried out in the Neonatal and Pediatric Intensive Care Unit of a public maternity hospital in Rio Grande do Norte, with 17 nursing professionals, through a semi-structured interview. After being transcribed, the data were subjected to Bardin's content analysis and interpreted in the light of the theory of Interpersonal Relations proposed by Travelbee. Results: Four categories emerged from the analysis: "Caring and welcoming people, feelings and stories"; "Reactions in the midst of pain: moving between acceptance and suffering"; "Communication of bad news: challenges and strategies"; "The weight of caring and suffering". Final considerations: Family assistance can be established using Travelbee's principles, as they offer timely theoretical support for nursing actions in the context of the process of death and dying.

Prevalence of crack cocaine use and its associated factors in patients treated in a specialized outpatient service

Background Despite the advance in studies addressing the use of crack cocaine, knowledge about the characteristics of users that seek treatment in the different modalities of care for substance use disorders is important to plan the operationalization of these services. Objective To analyze the prevalence and factors associated with the use of crack cocaine in outpatients. Method Cross-sectional study consisting in the analysis of the medical records of outpatients of a chemical dependency clinic located in the south of Brazil from 1999 to 2015. The Fisher’s exact test and the Poisson regression model were used to analyze the data. Results Medical records from 1,253 patients were analyzed, and 1,196 (95.5%) of them contained information on the use of crack cocaine. Use of this substance was reported by 47% (95% CI [44, 50]) of the outpatients. The risk group was composed of adults aged 20-39 years, with no income, who had three or more children, did not consume alcohol or marijuana, had continuous family assistance, spontaneously looked for the service, and had already been hospitalized or assisted at a therapeutic community or psychosocial center. Conclusion There is great demand for the outpatient care of crack cocaine users. It is crucial that the risk factors guide treatment planning.

How Retailers Support Consumers during the Pandemic: Kaufland Case Study

Brands’ perspectives on consumption and consumers have strongly changed during the pandemic because, lately, they have focused on medical care and innovation. The context of advertising campaigns requires a different approach with specific communication characteristics: safety, medical care, protection, family assistance. The present study focuses on the advertising discourse delivered by retailers on the market to answer consumers’ needs. There are two types of perspectives to be considered here: encouraging consumption to survive and looking for solutions and psychological support to get over de-socialisation and fears. Retailers turn from simple suppliers into innovative volunteers who concern themselves with how to diminish fears and insecurity. As a research method, I conducted a multimodal discourse analysis focused on the online advertisements running on Facebook and Instagram to unfold communication strategies, linguistic tools, brand values, and techniques of adaptation to the pandemic. The period considered relevant for this study was during the Romanian lockdown, between March 16 and May 16, 2020, plus another month afterward to observe the consequences of brands’ attitudes towards consumers. This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

Impact of MSME Assistance Program by East Java Province to Resolve the Economic Impacts of Covid-19

This paper aims to provide a perspective on assistance to MSMEs in East Java in the face of the Covid-19 pandemic. So far, MSMEs have been proven to be one of the economic drivers that accommodate the majority of workers in Indonesia. The existence of the Covid-19 Pandemic has depressed MSMEs throughout Indonesia and often have to go out of business. It seems that the government assistance that has been provided in the context of Covid-19 is still focused on individual or family assistance. Therefore, the authors consider MSMEs to be an essential factor in efforts to overcome the impact of Covid-19, especially in East Java. This paper uses the review literature as a method of data collection and research. The research results are expected to be an input for the Government, especially East Java Province, to consider the existence of capital assistance for MSME’s.

Targeting Families' Assistance: Evaluating Family and Employment Tax Credits in New Zealand's Tax-Benefit System

<p>In 2004 the Labour-led government announced a series of tax-benefit reforms (the Working for Families reforms) that will account for an estimated $1.17 billion per-annum of new spending when fully implemented by 1 April 2007. These reforms aim to both reduce rates of child poverty and improve financial incentives for paid work at low wages, particularly for caregivers. Changes to family and employment tax credits (the Family Assistance programmes) are central to these reforms. This study reviews methods for measuring the effectiveness of family and employment tax credits, evaluates the Working for Families reforms, and considers possible improvements to Working for Families. Questions that this study considers are: What roles should family and employment tax credits play in tax-benefit systems? How should family and employment tax credits be designed? Should eligibility for assistance reflect work effort as opposed to family structure? What lessons do historical and comparative perspectives on Working for Families provide? Will New Zealand's Working for Families reforms achieve the optimal design and role of family and employment tax credits? What improvements, if any, could be made to the Working for Families reforms? This study concludes that the Working for Families reforms represent significant income redistribution towards families with children but little change will be made to the overall design of the Family Assistance programmes, some of which have remained largely unchanged since 1986. Working for Families does not fully address the need to reform the Family Assistance programmes in the light of important social and economic changes that have taken place over the last two decades, such as the breakdown of the breadwinner model of social arrangements and the liberalisation of the labour market. This study thus considers a number of improvements to Working for Families, ranging from simplifying the structure of the Family Assistance Tax Credits to a more radical redesign of these programmes. This study concludes that more clearly established policy priorities and a greater understanding of the relative effectiveness of different tax-benefit instruments are required if New Zealand is to develop a tax-benefit system that achieves a desired level of redistribution to families with children at least economic cost.</p>

Targeting Families' Assistance: Evaluating Family and Employment Tax Credits in New Zealand's Tax-Benefit System

<p>In 2004 the Labour-led government announced a series of tax-benefit reforms (the Working for Families reforms) that will account for an estimated $1.17 billion per-annum of new spending when fully implemented by 1 April 2007. These reforms aim to both reduce rates of child poverty and improve financial incentives for paid work at low wages, particularly for caregivers. Changes to family and employment tax credits (the Family Assistance programmes) are central to these reforms. This study reviews methods for measuring the effectiveness of family and employment tax credits, evaluates the Working for Families reforms, and considers possible improvements to Working for Families. Questions that this study considers are: What roles should family and employment tax credits play in tax-benefit systems? How should family and employment tax credits be designed? Should eligibility for assistance reflect work effort as opposed to family structure? What lessons do historical and comparative perspectives on Working for Families provide? Will New Zealand's Working for Families reforms achieve the optimal design and role of family and employment tax credits? What improvements, if any, could be made to the Working for Families reforms? This study concludes that the Working for Families reforms represent significant income redistribution towards families with children but little change will be made to the overall design of the Family Assistance programmes, some of which have remained largely unchanged since 1986. Working for Families does not fully address the need to reform the Family Assistance programmes in the light of important social and economic changes that have taken place over the last two decades, such as the breakdown of the breadwinner model of social arrangements and the liberalisation of the labour market. This study thus considers a number of improvements to Working for Families, ranging from simplifying the structure of the Family Assistance Tax Credits to a more radical redesign of these programmes. This study concludes that more clearly established policy priorities and a greater understanding of the relative effectiveness of different tax-benefit instruments are required if New Zealand is to develop a tax-benefit system that achieves a desired level of redistribution to families with children at least economic cost.</p>

Occupational Disruption during the COVID-19 Pandemic: The Lived Experience of Community-Dwelling Older Adults

This qualitative descriptive study presents the experience of an abrupt disruption of daily activities among community-dwelling older adults during the early months of the COVID-19 pandemic. Sixteen older adults (age: 71 ± 6.4) were interviewed in April–June, 2020. Five themes were identified: (1) Understanding and applying COVID-19 guidelines: guidelines were clear and participants adhered closely to them, motivated mainly by fear; ageing-specific guidelines are needed. (2) Daily life during lockdown: the abrupt occupational disruption was managed by transitioning to virtual activities, and/or performing more activities at home. New daily activities were generally more sedentary and less meaningful. (3) Social context: family assistance aroused mixed feelings, as it compromised independence; limited compliance at the community level created stress. (4) Mood and affect: mood often fluctuated, and participants employed various coping strategies. (5) Aging: participants became more aware of their age and were concerned about negative health implications of adherence to COVID-19 guidelines.

Importance of Advance Care of Planning and its Measure in Palliative Care for Patients Nearing Bitter End: A Review

Background: Palliative care aims to reduce pain and suffering in patients and their families by a thorough assessment and treatment of physical, psychological, and spiritual symptoms. As a patient's death approaches, his or her symptoms may necessitate more aggressive palliation. Support for the dying patient's family should increase as comfort measures become more intense. Palliative care after a patient's death is largely concerned with bereavement and family assistance. Palliative care near the end of life requires assisting patients and their families in understanding the nature of their illness and prognosis. Palliative care professionals can assist patients and their families in determining appropriate medical care and aligning the patient's care goals with the healthcare team's aims. Finally, palliative care at the end of life requires determining the need for a medical proxy, advance directives, and resuscitation status. Physical pain, as well as substantial emotional, spiritual, and social misery, may be present in patients throughout their final hours and days. As death approaches, patients in their final days require careful symptom control, and families may need support and guidance. After the death is announced, the family is notified, and grieving support is provided, the care continues.

Impact of assistance on peritonitis due to breach in aseptic procedure in diabetic patients: A cohort study with the RDPLF data

Background: Diabetic patients often have physical impairment that could lead to manipulation errors in peritoneal dialysis (PD) and touch contamination. Nurse assistance in diabetic PD patients is known to help prevent peritonitis. We made the hypothesis that this lower risk of peritonitis was observed thanks to prevention of breach in aseptic procedure. We evaluated the impact of nurse-assisted PD on specific causes of peritonitis, especially on peritonitis due to a breach in aseptic procedure. Methods: This was a retrospective observational study of the data from the French Language Peritoneal Dialysis Registry. All diabetic patients older than age 18 years starting PD in France between 1 January 2012 and 31 December 2015 were included in the study. The event of interest was the first peritonitis event due to a breach in aseptic procedure. Death, kidney transplantation and peritonitis due to another mechanism were considered as competing events. We examined the association of the covariates with all the possible outcomes using a subdistribution hazard model developed for survival analysis in the presence of competing risks. Results: Four thousand one hundred one diabetic patients incident in PD were included in the study. At least one peritonitis event occurred in 1611 patients over the study period. A breach in aseptic procedure was reported in 441/1611 cases (27.3%): 209/575 (36.3%) in the self-care PD group, 56/217 (25.8%) in the family-assisted PD group and 176/819 (21.5%) in the nurse-assisted PD group. Both nurse and family assistance were associated with a lower risk of peritonitis due to breach in aseptic procedure in bivariate analysis. After adjustment on age, modified Charlson index, sex and diabetic nephropathy, patients treated by nurse-assisted PD (subdistribution hazard ratio (sd-HR) 0.52, 95% confidence interval (CI) 0.40–0.67) and those treated by family-assisted PD (sd-HR 0.70, 95% CI 0.51–0.95) had a lower likelihood of peritonitis due to a connection error compared to self-care PD in multivariate analysis. The modality of assistance was not associated with other causes of peritonitis in the multivariate analysis. Conclusion: While both nurse-assisted PD and family-assisted PD were associated with lower risk of peritonitis due to a breach in aseptic procedure compared to self-care PD in our study, the protective effect was greater with nurse assistance.

First-time motherhood and intergenerational solidarities during COVID-19

Objective: This study investigated the effects of the COVID-19 pandemic on intergenerational solidarities in Poland, specifically looking at flows between members of four family generations in the context of first-time motherhood. Background: Unlike other crises, which typically mean that family members rely on one another for support, the pandemic challenges the scope of family solidarities. Little is still known as to how families navigate the particular vulnerability of first-time mothers who might face obstacles in accessing family assistance during lockdowns. Method: The empirical material originates from a Qualitative Longitudinal Study (QLS) on transitions to motherhood in Poland (GEMTRA project, 2018-2021) and features case studies of intergenerational family triads (a first-time mother, her mother, and her grandmother). Two cases have been selected from a large pool of over 100 interviews conducted in two waves. Results: We argue that the crucial stage of family life reified in welcoming the first child serves as special grounds for examining how family support and intergenerational solidarities are maintained, altered, or prioritized during the COVID-19 pandemic. We demonstrate that distinct types of associational, affectual, consensual, functional, normative and structural solidarities are variably affected. Conclusion: We propose a new angle for identifying key support recipients within intergenerational solidarity flows in families during the crisis. Two directions of solidarity flows, towards younger and older generations, respectively, are presented.