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Sample records for measuring complicated grief

  1. An Item Response Theory Analysis of a Measure of Complicated Grief

    ERIC Educational Resources Information Center

    Boelen, Paul A.; Hoijtink, Herbert

    2009-01-01

    Item response theory modeling was applied to the data of 1,321 bereaved individuals who completed the Dutch version of the Inventory of Complicated Grief-Revised (ICG-R)--a 29-item self-report measure of complicated grief (CG). The authors aimed to examine the information that each of the ICG-R items contributes to the measurement of overall CG…

  2. Treatment of complicated grief

    PubMed Central

    Rosner, Rita; Pfoh, Gabriele; Kotoučová, Michaela

    2011-01-01

    Following the death of a loved one, a small group of grievers develop an abnormal grieving style, termed complicated or prolonged grief. In the effort to establish complicated grief as a disorder in DSM and ICD, several attempts have been made over the past two decades to establish symptom criteria for this form of grieving. Complicated grief is different from depression and PTSD yet often comorbid with other psychological disorders. Meta-analyses of grief interventions show small to medium effect sizes, with only few studies yielding large effect sizes. In this article, an integrative cognitive behavioral treatment manual for complicated grief disorder (CG-CBT) of 25 individual sessions is described. Three treatment phases, each entailing several treatment strategies, allow patients to stabilize, explore, and confront the most painful aspects of the loss, and finally to integrate and transform their grief. Core aspects are cognitive restructuring and confrontation. Special attention is given to practical exercises. This article includes the case report of a woman whose daughter committed suicide. PMID:22893810

  3. Suicide bereavement and complicated grief.

    PubMed

    Tal Young, Ilanit; Iglewicz, Alana; Glorioso, Danielle; Lanouette, Nicole; Seay, Kathryn; Ilapakurti, Manjusha; Zisook, Sidney

    2012-06-01

    Losing a loved to suicide is one is one of life's most painful experiences. The feelings of loss, sadness, and loneliness experienced after any death of a loved one are often magnified in suicide survivors by feelings of quilt, confusion, rejection, shame, anger, and the effects of stigma and trauma. Furthermore, survivors of suicide loss are at higher risk of developing major depression, post-traumatic stress disorder, and suicidal behaviors, as well as a prolonged form of grief called complicated grief. Added to the burden is the substantial stigma, which can keep survivors away from much needed support and healing resources. Thus, survivors may require unique supportive measures and targeted treatment to cope with their loss. After a brief description of the epidemiology and circumstances of suicide, we review the current state of research on suicide bereavement, complicated grief in suicide survivors, and grief treatment for survivors of suicide. PMID:22754290

  4. Suicide bereavement and complicated grief

    PubMed Central

    Tal Young, Ilanit; Iglewicz, Alana; Glorioso, Danielle; Lanouette, Nicole; Seay, Kathryn; Ilapakurti, Manjusha; Zisook, Sidney

    2012-01-01

    Losing a loved to suicide is one is one of life's most painful experiences. The feelings of loss, sadness, and loneliness experienced after any death of a loved one are often magnified in suicide survivors by feelings of quilt, confusion, rejection, shame, anger, and the effects of stigma and trauma. Furthermore, survivors of suicide loss are at higher risk of developing major depression, post-traumatic stress disorder, and suicidal behaviors, as well as a prolonged form of grief called complicated grief. Added to the burden is the substantial stigma, which can keep survivors away from much needed support and healing resources. Thus, survivors may require unique supportive measures and targeted treatment to cope with their loss. After a brief description of the epidemiology and circumstances of suicide, we review the current state of research on suicide bereavement, complicated grief in suicide survivors, and grief treatment for survivors of suicide. PMID:22754290

  5. Treating Complicated Grief

    PubMed Central

    Simon, Naomi M.

    2015-01-01

    IMPORTANCE The death of a loved one is one of life’s greatest, universal stressors to which most bereaved individuals successfully adapt without clinical intervention. For a minority of bereaved individuals, grief is complicated by superimposed problems and healing does not occur. The resulting syndrome of complicated grief causes substantial distress and functional impairment even years after a loss, yet knowing when and how to intervene can be a challenge. OBJECTIVE To discuss the differential diagnosis, risk factors for and management of complicated grief based on available evidence and clinical observations. EVIDENCE REVIEW MEDLINE was searched from January 1990 to October 2012. Additional citations were procured from references of select research and review articles. Available treatment studies targeting complicated grief were included. RESULTS A strong research literature led to inclusion of complicated grief in the Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition) (termed persistent complex bereavement disorder as a subtype of other specified trauma and stressor-related disorders), although it is a condition for which more research is formally recommended, and there is still ongoing discussion about the optimal name and diagnostic criteria for the disorder. Reliable screening instruments are available, and the estimated prevalence rate is 7% of bereaved people. Randomized controlled data support the efficacy of a targeted psychotherapy including elements that foster resolution of complicating problems and facilitate the natural healing process. Preliminary studies suggest antidepressant medications may be helpful. CONCLUSION AND RELEVANCE Individuals with complicated grief have greater risk of adverse health outcomes, should be diagnosed and assessed for suicide risk and comorbid conditions such as depression and posttraumatic stress disorder, and should be considered for treatment. PMID:23917292

  6. Inventory of complicated spiritual grief: development and validation of a new measure.

    PubMed

    Burke, Laurie A; Neimeyer, Robert A; Holland, Jason M; Dennard, Sharon; Oliver, Linda; Shear, M Katherine

    2014-01-01

    Although spirituality often has been associated with better outcomes following bereavement, it can be significantly challenged by loss as well. Studies have shown that some bereaved individuals suffer profoundly not only in relation to the death of their loved one but also in their relationship with God and their faith community, a condition known as complicated spiritual grief (CSG). However, to date, in the absence of a simple, multidimensional, and well-validated measure of spiritual crisis following loss, investigators have measured CSG with nongrief-specific instruments. In this study, the authors tested the reliability and validity of a newly developed measure of CSG, called the Inventory of Complicated Spiritual Grief (ICSG). With 2 diverse samples of bereaved adult Christians (total n = 304), the authors found that the ICSG had strong internal consistency, and high test-retest reliability for both subscales in a subsample of participants. Analyses of both samples supported a 2-factor model, with one factor measuring Insecurity with God and the other assessing Disruption in Religious Practice. Analyses further supported the convergent and incremental validity of the 18-item ICSG relative to other theoretically similar instruments and measures of poor bereavement outcome, suggesting its usefulness in clinical research and practice. PMID:24524587

  7. Caregiving, bereavement and complicated grief

    PubMed Central

    Boerner, Kathrin; Schulz, Richard

    2010-01-01

    Most deaths are preceded by chronic illness and disability and the provision of support by family caregivers. The purpose of this article is to describe how the caregiving experience affects bereavement, with an emphasis on the relationship between challenging caregiving situations and difficult grieving processes – often referred to as `complicated grief'. The article starts with a brief summary of the general literature on caregiving and bereavement. It then defines complicated grief and discusses why some caregivers may struggle with the death of their loved one. Finally, it offers practical suggestions for what professionals can do to help caregivers both before and after the death has occurred. PMID:20463850

  8. Music therapy as grief therapy for adults with mental illness and complicated grief: a pilot study.

    PubMed

    Iliya, Yasmine A

    2015-01-01

    This randomized, controlled, mixed-methods pilot study examined the effectiveness and experiences of grief-specific music therapy, in addition to standard care, with adults (N=10) who have complicated grief (CG) and mental illness, as compared to standard care alone. The study tested Worden's (2009) theories of grief therapy as well as a new grief-specific music therapy intervention, based on Shear, Frank, Houck, and Reynolds' (2005) imaginal dialogue intervention and Austin's (2008) method of vocal psychotherapy. Results demonstrated that participants in the experimental group had a greater decrease of grief symptoms, as measured by the ICG-R, as compared with the control group. PMID:25730407

  9. Divergent Gene Expression Responses to Complicated Grief and Non-complicated Grief

    PubMed Central

    Irwin, Michael R.; Arevalo, Jesusa M. G.; Cole, Steven W.

    2014-01-01

    The “widowhood effect” (i.e., morbidity/mortality in recently bereaved spouses) may be related to changes in immune function, but little is known about the impact of bereavement on gene transcription in immune cells. This study examined how Complicated Grief and Non-complicated Grief responses to bereavement differentially affect leukocyte gene expression. Genome-wide transcriptional profiling and bioinformatic analyses were completed on 63 older adults. Thirty-six of them had lost their spouse/partner on average 2 years ago, and 27 were nonbereaved, married controls. Twelve of the bereaved participants met criteria for Complicated Grief. Compared to nonbereaved controls, bereavement (both Complicated Grief and Non-complicated Grief) was associated with upregulated expression of genes involved in general immunologic activation and a selective downregulation of genes involved in B lymphocyte responses. However, Complicated Grief and Non-complicated Grief differed markedly in their expression of Type I interferon-related transcripts, with Non-complicated Grief subjects showing substantial upregulation relative to nonbereaved controls and Complicated Grief subjects showing substantial downregulation. Bereavement significantly modulates immune function gene expression. The magnitude of bereavement-related distress (i.e., Complicated Grief vs. Non-complicated Grief) is linked to differential patterns of transcription factor activation and gene expression involved in innate antiviral responses. These findings provide a molecular framework for understanding the health effects of bereavement, as well as new insights into the particular gene modules that are most sensitive to the individual's psychological response to loss. PMID:24380850

  10. Complicated grief in Aboriginal populations

    PubMed Central

    Spiwak, Rae; Sareen, Jitender; Elias, Brenda; Martens, Patricia; Munro, Garry; Bolton, James

    2012-01-01

    To date there have been no studies examining complicated grief (CG) in Aboriginal populations. Although this research gap exists, it can be hypothesized that Aboriginal populations may be at increased risk for CG, given a variety of factors, including increased rates of all-cause mortality and death by suicide. Aboriginal people also have a past history of multiple stressors resulting from the effects of colonization and forced assimilation, a significant example being residential school placement. This loss of culture and high rates of traumatic events may place Aboriginal individuals at increased risk for suicide, as well as CG resulting from traumatic loss and suicide bereavement. Studies are needed to examine CG in Aboriginal populations. These studies must include cooperation with Aboriginal communities to help identify risk factors for CG, understand the role of culture among these communities, and identify interventions to reduce poor health outcomes such as suicidal behavior. PMID:22754293

  11. Complicated grief in Aboriginal populations.

    PubMed

    Spiwak, Rae; Sareen, Jitender; Elias, Brenda; Martens, Patricia; Munro, Garry; Bolton, James

    2012-06-01

    To date there have been no studies examining complicated grief (CG) in Aboriginal populations. Although this research gap exists, it can be hypothesized that Aboriginal populations may be at increased risk for CG, given a variety of factors, including increased rates of all-cause mortality and death by suicide. Aboriginal people also have a past history of multiple stressors resulting from the effects of colonization and forced assimilation, a significant example being residential school placement. This loss of culture and high rates of traumatic events may place Aboriginal individuals at increased risk for suicide, as well as CG resulting from traumatic loss and suicide bereavement. Studies are needed to examine CG in Aboriginal populations. These studies must include cooperation with Aboriginal communities to help identify risk factors for CG, understand the role of culture among these communities, and identify interventions to reduce poor health outcomes such as suicidal behavior. PMID:22754293

  12. Cognitive Functioning in Complicated Grief

    PubMed Central

    Hall, Charles A.; Butters, Meryl; Zisook, Sidney; Simon, Naomi; Corey-Bloom, Jody; Lebowitz, Barry D.; Begley, Amy; Mauro, Christine; Shear, M. Katherine

    2014-01-01

    Complicated grief (CG) is increasingly recognized as a debilitating outcome of bereavement. Given the intensity of the stressor, its chronicity, and its association with depression, it is important to know the impact CG may have on cognitive functioning. This exploratory and descriptive study examined global and domain-specific cognitive functioning in a help-seeking sample of individuals with CG (n=335) compared to a separately ascertained control sample (n=250). Cognitive functioning was assessed using the Montreal Cognitive Assessment (MoCA). Controlling for age, sex and education effects, CG participants had lower total MoCA, visuospatial and attention scores relative to control participants. The two groups did not differ significantly in the domains of executive function, language, memory or orientation. Age, sex, and education accounted for much of the variance in MoCA scores, while CG severity and chronicity accounted for a very small percentage of MoCA score variance. Major depression was not a significant predictor of MoCA scores. This study is consistent with previous work demonstrating lower attention and global cognitive performance in individuals with CG compared to control participants. This study newly identifies the visuospatial domain as a target for future studies investigating cognitive functioning in CG. PMID:25088285

  13. Informing the Symptom Profile of Complicated Grief

    PubMed Central

    Simon, Naomi M.; Wall, Melanie M.; Keshaviah, Aparna; Dryman, M. Taylor; LeBlanc, Nicole J.; Shear, M. Katherine

    2010-01-01

    Background Complicated Grief (CG) is under consideration as a new diagnosis in DSM5. We sought to add empirical support to the current dialogue by examining the commonly used Inventory of Complicated Grief (ICG) scale completed by 782 bereaved individuals. Methods We employed IRT analyses, factor analyses, and sensitivity and specificity analyses utilizing our full sample (n=782), and also compared confirmed CG cases (n=288) to non-cases (n=377). Confirmed CG cases were defined as individuals bereaved at least 6 months who were seeking care for CG, had an ICG ≥ 30, and received a structured clinical interview for CG by a certified clinician confirming CG as their primary illness. Non-cases were bereaved individuals who did not present with CG as a primary complaint (including those with depression, bipolar disorder, anxiety disorders and controls) and had an ICG<25. Results IRT analyses provided guidance about the most informative individual items and their association with CG severity. Factor analyses demonstrated a single factor solution when the full sample was considered, but within CG cases, six symptom clusters emerged: 1) yearning and preoccupation with the deceased, 2) anger and bitterness, 3) shock and disbelief, 4) estrangement from others, 5) hallucinations of the deceased, and 6) behavior change, including avoidance and proximity seeking. The presence of at least one symptom from three different symptom clusters optimized sensitivity (94.8%) and specificity (98.1%). Conclusions These data, derived from a diverse and predominantly clinical help seeking population, add an important perspective to existing suggestions for DSM5 criteria for CG. PMID:21284064

  14. Grief and mourning gone awry: pathway and course of complicated grief

    PubMed Central

    Shear, M. Katherine

    2012-01-01

    Complicated grief is a recently recognized condition that occurs in about 7% of bereaved people. People with this condition are caught up in rumination about the circumstances of the death, worry about its consequences, or excessive avoidance of reminders of the loss. Unable to comprehend the finality and consequences of the loss, they resort to excessive avoidance of reminders of the loss as they are tossed helplessly on waves of intense emotion. People with complicated grief need help, and clinicians need to know how to recognize the symptoms and how to provide help. This paper provides a framework to help clinicans understand bereavement, grief, and mourning. Evidence-based diagnostic criteria are provided to help clinicians recognize complicated grief, and differentiate it from depression as well as anxiety disorder. We provide an overview of risk factors and basic assumptions and principles that can guide treatment. PMID:22754284

  15. Complicated spiritual grief I: relation to complicated grief symptomatology following violent death bereavement.

    PubMed

    Burke, Laurie A; Neimeyer, Robert A

    2014-01-01

    Losing a loved one to violent death has been associated with poor mental health outcomes, including posttraumatic stress disorder, depression, and complicated grief (CG), a protracted, debilitating, and sometimes life-threatening reaction to loss. In addition, recent research suggests that traumatic loss can violate mourners' basic assumptive worldviews, and can precipitate a spiritual crisis following loss, also known as complicated spiritual grief (CSG). The present cross-sectional study investigated these multidimensional outcomes in a diverse sample of 150 grievers. The authors found that (a) violently bereaved individuals reported greater CG and CSG than did individuals bereaved by natural death; (b) CG and CSG were correlated across the larger sample, and yet are theoretically different constructs; and (c) specific cause of death (natural anticipated, natural sudden, homicide, suicide, or fatal accident) differentially predicted levels of CG and CSG. Implications of these findings for a clearer understanding of spiritual coping in the wake of troubling loss are noted, as well as for intervention with mourners struggling with clinical complications. PMID:24524589

  16. Complicated grief and related bereavement issues for DSM-5.

    PubMed

    Shear, M Katherine; Simon, Naomi; Wall, Melanie; Zisook, Sidney; Neimeyer, Robert; Duan, Naihua; Reynolds, Charles; Lebowitz, Barry; Sung, Sharon; Ghesquiere, Angela; Gorscak, Bonnie; Clayton, Paula; Ito, Masaya; Nakajima, Satomi; Konishi, Takako; Melhem, Nadine; Meert, Kathleen; Schiff, Miriam; O'Connor, Mary-Frances; First, Michael; Sareen, Jitender; Bolton, James; Skritskaya, Natalia; Mancini, Anthony D; Keshaviah, Aparna

    2011-02-01

    Bereavement is a severe stressor that typically incites painful and debilitating symptoms of acute grief that commonly progresses to restoration of a satisfactory, if changed, life. Normally, grief does not need clinical intervention. However, sometimes acute grief can gain a foothold and become a chronic debilitating condition called complicated grief. Moreover, the stress caused by bereavement, like other stressors, can increase the likelihood of onset or worsening of other physical or mental disorders. Hence, some bereaved people need to be diagnosed and treated. A clinician evaluating a bereaved person is at risk for both over-and under-diagnosis, either pathologizing a normal condition or neglecting to treat an impairing disorder. The authors of DSM IV focused primarily on the problem of over-diagnosis, and omitted complicated grief because of insufficient evidence. We revisit bereavement considerations in light of new research findings. This article focuses primarily on a discussion of possible inclusion of a new diagnosis and dimensional assessment of complicated grief. We also discuss modifications in the bereavement V code and refinement of bereavement exclusions in major depression and other disorders. PMID:21284063

  17. COMPLICATED GRIEF AND RELATED BEREAVEMENT ISSUES FOR DSM-5

    PubMed Central

    Shear, M. Katherine; Simon, Naomi; Wall, Melanie; Zisook, Sidney; Neimeyer, Robert; Duan, Naihua; Reynolds, Charles; Lebowitz, Barry; Sung, Sharon; Ghesquiere, Angela; Gorscak, Bonnie; Clayton, Paula; Ito, Masaya; Nakajima, Satomi; Konishi, Takako; Melhem, Nadine; Meert, Kathleen; Schiff, Miriam; O’Connor, Mary-Frances; First, Michael; Sareen, Jitender; Bolton, James; Skritskaya, Natalia; Mancini, Anthony D.; Keshaviah, Aparna

    2010-01-01

    Bereavement is a severe stressor that typically incites painful and debilitating symptoms of acute grief that commonly progresses to restoration of a satisfactory, if changed, life. Normally grief does not need clinical intervention. However, sometimes acute grief can gain a foothold and become a chronic debilitating condition called complicated grief. Moreover, the stress caused by bereavement, like other stressors, can increase the likelihood of onset or worsening of other physical or mental disorders. Hence some bereaved people need to be diagnosed and treated. A clinician evaluating a bereaved person is at risk for both over-and under-diagnosis, either pathologizing a normal condition or neglecting to treat an impairing disorder. The authors of DSM IV focused primarily on the problem of over-diagnosis, and omitted complicated grief because of insufficient evidence. We revisit bereavement considerations in light of new research findings. This paper focuses primarily on a discussion of possible inclusion of a new diagnosis and dimensional assessment of complicated grief. We also discuss modifications in the bereavement V code and refinement of bereavement exclusions in major depression and other disorders. PMID:21284063

  18. Complicated grief therapy as a new treatment approach

    PubMed Central

    Wetherell, Julie Loebach

    2012-01-01

    Complicated grief therapy (CGT) is a relatively new psychotherapy model designed to address symptoms of complicated grief. Drawn from attachment theory and with roots in both interpersonal therapy (IPT) and cognitive-behavioral therapy, CGT includes techniques similar to prolonged exposure (repeatedly telling the story of the death and in vivo exposure activities). The treatment also involves focusing on personal goals and relationships. CGT has been demonstrated to be effective in a trial in which participants with complicated grief were randomly assigned to CGT or IPT; individuals receiving CGT responded more quickly and were more likely to respond overall (51 % vs 28%). This article briefly summarizes the conceptual underpinnings of CGT, discusses the empirical evidence for its efficacy, describes its techniques, and presents a case example of a client treated in a 16-session manualized CGT protocol. The article concludes with a description of future research directions for CGT. PMID:22754288

  19. Progress in understanding grief, complicated grief, and caring for the bereaved.

    PubMed

    Love, Anthony W

    2007-12-01

    Grief occurs with loss of symbolically important connections and involves intense emotional reactions and changes to our experiences of self, the world, and the future. Individual responses reflect factors such as personality and life history, social context and cultural practices, and the symbolic magnitude of the loss. Grieving can be a relatively slow and uneven process, so applying prescriptive stages or goals to individuals' experiences can be unhelpful. Although most people are resilient in the face of loss and do not require special interventions, health professionals can contribute by empathic use of communication skills to facilitate the grieving process. A minority will struggle with their grief and experience prolonged, intense, or problematic reactions. Psychiatric comorbidities including depression and anxiety disorders can occur, and a distinct diagnosis of complicated grief disorder has been proposed. Health professionals can identify complicated grief reactions and ensure patients receive specialised treatment, including intensive grief therapy and medication where indicated. Assessment methods are summarised to assist health professionals in providing a continuum of care for those who are grieving. PMID:18386957

  20. Korean Version of Inventory of Complicated Grief Scale: Psychometric Properties in Korean Adolescents

    PubMed Central

    2016-01-01

    We aimed to validate the Inventory of Complicated Grief (ICG)-Korean version among 1,138 Korean adolescents, representing a response rate of 57% of 1,997 students. Participants completed a set of questionnaires including demographic variables (age, sex, years of education, experience of grief), the ICG, the Children's Depression Inventory (CDI) and the Lifetime Incidence of Traumatic Events-Child (LITE-C). Exploratory factor analysis was performed to determine whether the ICG items indicated complicated grief in Korean adolescents. The internal consistency of the ICG-Korean version was Cronbach's α=0.87. The test-retest reliability for a randomly selected sample of 314 participants in 2 weeks was r=0.75 (P<0.001). Concurrent validity was assessed using a correlation between the ICG total scores and the CDI total scores (r=0.75, P<0.001). The criterion-related validity based on the comparison of ICG total scores between adolescents without complicated grief (1.2±3.7) and adolescent with complicated grief (3.2±6.6) groups was relatively high (t=5.71, P<0.001). The data acquired from the 1,138 students was acceptable for a factor analysis (Kaiser-Meyer-Olkin Measure of Sampling Adequacy=0.911; Bartlett's Test of Sphericity, χ2=13,144.7, P<0.001). After omission of 3 items, the value of Cronbach's α increased from 0.87 for the 19-item ICG-Korean version to 0.93 for the 16-item ICG-Korean version. These results suggest that the ICG is a useful tool in assessing for complicated grief in Korean adolescents. However, the 16-item version of the ICG appeared to be more valid compared to the 19-item version of the ICG. We suggest that the 16-item version of the ICG be used to screen for complicated grief in Korean adolescents. PMID:26770046

  1. Korean Version of Inventory of Complicated Grief Scale: Psychometric Properties in Korean Adolescents.

    PubMed

    Han, Doug Hyun; Lee, Jung Jae; Moon, Duk-Soo; Cha, Myoung-Jin; Kim, Min A; Min, Seonyeong; Yang, Ji Hoon; Lee, Eun Jeong; Yoo, Seo Koo; Chung, Un-Sun

    2016-01-01

    We aimed to validate the Inventory of Complicated Grief (ICG)-Korean version among 1,138 Korean adolescents, representing a response rate of 57% of 1,997 students. Participants completed a set of questionnaires including demographic variables (age, sex, years of education, experience of grief), the ICG, the Children's Depression Inventory (CDI) and the Lifetime Incidence of Traumatic Events-Child (LITE-C). Exploratory factor analysis was performed to determine whether the ICG items indicated complicated grief in Korean adolescents. The internal consistency of the ICG-Korean version was Cronbach's α=0.87. The test-retest reliability for a randomly selected sample of 314 participants in 2 weeks was r=0.75 (P<0.001). Concurrent validity was assessed using a correlation between the ICG total scores and the CDI total scores (r=0.75, P<0.001). The criterion-related validity based on the comparison of ICG total scores between adolescents without complicated grief (1.2 ± 3.7) and adolescent with complicated grief (3.2 ± 6.6) groups was relatively high (t=5.71, P<0.001). The data acquired from the 1,138 students was acceptable for a factor analysis (Kaiser-Meyer-Olkin Measure of Sampling Adequacy=0.911; Bartlett's Test of Sphericity, χ(2)=13,144.7, P<0.001). After omission of 3 items, the value of Cronbach's α increased from 0.87 for the 19-item ICG-Korean version to 0.93 for the 16-item ICG-Korean version. These results suggest that the ICG is a useful tool in assessing for complicated grief in Korean adolescents. However, the 16-item version of the ICG appeared to be more valid compared to the 19-item version of the ICG. We suggest that the 16-item version of the ICG be used to screen for complicated grief in Korean adolescents. PMID:26770046

  2. Complicated grief in those bereaved by violent death: the effects of post-traumatic stress disorder on complicated grief.

    PubMed

    Nakajima, Satomi; Ito, Masaya; Shirai, Akemi; Konishi, Takako

    2012-06-01

    Violent death, such as homicide, accident, and suicide, is sudden, unexpected, and caused by intentional power, The prevalence of complicated grief among those bereaved by violent death is 12.5% to 78.0%. The factors affecting this prevalence rate are considered to be comorbid mental disorders, lack of readiness for the death, difficulty in making sense of the death, high level of negative appraisal about the self and others, and various social stressors. Post-traumatic stress disorder is, in particular, considered to contribute to the development of complicated grief by suppressing function of the medial prefrontal cortex and the anterior cingulate cortex, which works at facilitating the normal mourning process. An understanding of the mechanism and biological basis of complicated grief by violent death will be helpful in developing effective preventive intervention and treatment. PMID:22754294

  3. Complicated Grief and Associated Risk Factors Among Parents Following a Child’s Death in the Pediatric Intensive Care Unit

    PubMed Central

    Meert, Kathleen L.; Donaldson, Amy E.; Newth, Christopher J. L.; Harrison, Rick; Berger, John; Zimmerman, Jerry; Anand, K. J. S.; Carcillo, Joseph; Dean, J. Michael; Willson, Douglas F.; Nicholson, Carol; Shear, Katherine

    2012-01-01

    Objective To investigate the extent of complicated grief symptoms and associated risk factors among parents whose child died in a pediatric intensive care unit. Design Cross-sectional survey conducted by mail and telephone. Setting Seven children’s hospitals affiliated with the Collaborative Pediatric Critical Care Research Network from January 1, 2006, to June 30, 2008. Participants Two hundred sixty-one parents from 872 families whose child died in a pediatric intensive care unit 6 months earlier. Main Exposure Assessment of potential risk factors, including demographic and clinical variables, and parent psychosocial characteristics, such as attachment style, caregiving style, grief avoidance, and social support. Main Outcome Measure Parent report of complicated grief symptoms using the Inventory of Complicated Grief. Total scale range is from 0 to 76; scores of 30 or higher suggest complicated grief. Results Mean(SD)Inventory of Complicated Grief scores among parents were 33.7 (14.1). Fifty-nine percent of parents (95% confidence interval, 53%–65%) had scores of 30 or higher. Variables independently associated with higher symptom scores in multivariable analysis included being the biological mother or female guardian, trauma as the cause of death, greater attachment-related anxiety and attachment-related avoidance, and greater grief avoidance. Conclusions Parents who responded to our survey experienced a high level of complicated grief symptoms 6 months after their child’s death in the pediatric intensive care unit. However, our estimate of the extent of complicated grief symptoms may be biased because of a high number of nonresponders. Better understanding of complicated grief and its risk factors among parents will allow those most vulnerable to receive professional bereavement support. PMID:21041597

  4. Facets of Pejorative Self-Processing in Complicated Grief

    ERIC Educational Resources Information Center

    Golden, Ann-Marie J.; Dalgleish, Tim

    2012-01-01

    Objective: Complicated grief (CG) has been proposed as a psychiatric response to bereavement distinct from established mood and anxiety disorder diagnoses. Little is known about the nature of cognitive-affective processing in CG, nor any similarities or differences compared with the processing profiles associated with other emotional disorders.…

  5. Treatment of Complicated Grief Using Virtual Reality: A Case Report

    ERIC Educational Resources Information Center

    Botella, C.; Osma, J.; Palacios, A. Garcia; Guillen, V.; Banos, R.

    2008-01-01

    This is the first work exploring the application of new technologies, concretely virtual reality, to facilitate emotional processing in the treatment of Complicated Grief. Our research team has designed a virtual reality environment (EMMA's World) to foster the expression and processing of emotions. In this study the authors present a description…

  6. Predictors of Complicated Grief: A Systematic Review of Empirical Studies

    ERIC Educational Resources Information Center

    Lobb, Elizabeth A.; Kristjanson, Linda J.; Aoun, Samar M.; Monterosso, Leanne; Halkett, Georgia K. B.; Davies, Anna

    2010-01-01

    A systematic review of the literature on predictors of complicated grief (CG) was undertaken with the aim of clarifying the current knowledge and to inform future planning and work in CG following bereavement. Predictors of CG prior to the death include previous loss, exposure to trauma, a previous psychiatric history, attachment style, and the…

  7. Phenomenology and Correlates of Complicated Grief in Children and Adolescents

    ERIC Educational Resources Information Center

    Melhem, Nadine M.; Moritz, Grace; Walker, Monica; Shear, M. Katherine; Brent, David

    2007-01-01

    Objective: To describe the phenomenology of complicated grief (CG) in parentally bereaved children and adolescents and to examine its correlates. Method: This is a preliminary report from an ongoing 5-year, population-based, longitudinal study of the impact of parental loss on family members. Analyses of cross-sectional data at intake are…

  8. Assessment of Emotional Experience and Emotional Recognition in Complicated Grief

    PubMed Central

    Fernández-Alcántara, Manuel; Cruz-Quintana, Francisco; Pérez-Marfil, M. N.; Catena-Martínez, Andrés; Pérez-García, Miguel; Turnbull, Oliver H.

    2016-01-01

    There is substantial evidence of bias in the processing of emotion in people with complicated grief (CG). Previous studies have tended to assess the expression of emotion in CG, but other aspects of emotion (mainly emotion recognition, and the subjective aspects of emotion) have not been addressed, despite their importance for practicing clinicians. A quasi-experimental design with two matched groups (Complicated Grief, N = 24 and Non-Complicated Grief, N = 20) was carried out. The Facial Expression of Emotion Test (emotion recognition), a set of pictures from the International Affective Picture System (subjective experience of emotion) and the Symptom Checklist 90 Revised (psychopathology) were employed. The CG group showed lower scores on the dimension of valence for specific conditions on the IAPS, related to the subjective experience of emotion. In addition, they presented higher values of psychopathology. In contrast, statistically significant results were not found for the recognition of emotion. In conclusion, from a neuropsychological point of view, the subjective aspects of emotion and psychopathology seem central in explaining the experience of those with CG. These results are clinically significant for psychotherapists and psychoanalysts working in the field of grief and loss. PMID:26903928

  9. Internet-Based Exposure and Behavioral Activation for Complicated Grief and Rumination: A Randomized Controlled Trial.

    PubMed

    Eisma, Maarten C; Boelen, Paul A; van den Bout, Jan; Stroebe, Wolfgang; Schut, Henk A W; Lancee, Jaap; Stroebe, Margaret S

    2015-11-01

    This study examined the effectiveness and feasibility of therapist-guided Internet-delivered exposure (EX) and behavioral activation (BA) for complicated grief and rumination. Forty-seven bereaved individuals with elevated levels of complicated grief and grief rumination were randomly assigned to three conditions: EX (N=18), BA (N=17), or a waiting-list (N=12). Treatment groups received 6 homework assignments over 6 to 8weeks. Intention-to-treat analyses showed that EX reduced complicated grief, posttraumatic stress, depression, grief rumination, and brooding levels relative to the control group at posttreatment (d=0.7-1.2). BA lowered complicated grief, posttraumatic stress, and grief rumination levels at posttreatment (d=0.8-0.9). At 3-month follow-up, effects of EX were maintained on complicated grief and grief rumination (d=0.6-1.2), and for BA on complicated grief, posttraumatic stress, and grief rumination (d=0.8-0.9). EX reduced depression more strongly than BA (d=0.6). Completers analyses corroborated results for EX, and partially those for BA, but no group differences were detected. BA suffered from high dropout (59%), relative to EX (33%) and the waiting-list (17%). Feasibility appeared higher for EX than BA. Results supported potential applicability of online exposure but not behavioral activation to decrease complicated grief and rumination. PMID:26520217

  10. [Clinical case: Complicated grief in primary care. Care plan].

    PubMed

    Ruymán Brito-Brito, Pedro; Rodríguez-Ramos, Mercedes; Pérez-García-Talavera, Carlos

    2009-01-01

    This is the case of a 61-year-old patient woman that visits her nurse in Primary Health Care to get the control of blood pressure and glycemia. In the last two years has suffered the loss of her husband and of two brothers beside having lived through other vital stressful events that have taken her to a situation of complicated grief. The care plan is realized using the M. Gordon assessment system and standardized languages NANDA, NOC and NIC. The principal aims were the improvement of the depression level and the improvement in the affliction resolution. As suggested interventions were proposed to facilitate the grief and the derivation to a mental health unit. A follow-up of the patient was realized in nursing consultation at Primary health care to weekly intervals, in the beginning, and monthly, later. The evaluation of the care plan reflects an improvement in the criteria of Prigerson's complicated grief; an increase of the recreative activities; the retreat of the mourning that still she was guarding; as well as an improvement in the control of the blood pressure numbers. The attention of nurses before a case of complicated grief turns out to be complex. Nevertheless the suitable accomplishment of certain interventions orientated to facilitating the grief, with a follow-up in consultation, shows the efficiency. The difficulty in the boarding of the psychosocial problems meets increased at the moment of are necessary the nursing diagnostics adapted for every individual case. The work in group between nurses could improves the consensus. PMID:19854088

  11. Continuing Bonds, Risk Factors for Complicated Grief, and Adjustment to Bereavement

    ERIC Educational Resources Information Center

    Field, Nigel P.; Filanosky, Charles

    2010-01-01

    This study examined type of continuing bonds (CB) expression in relation to risk factors for complicated grief and measures of bereavement-related adjustment. Externalized CB expressions involving illusions and hallucinations with the deceased were distinguished from internalized CB expressions involving use of the deceased as an autonomy…

  12. Grief and its Complications in Individuals with Intellectual Disability

    PubMed Central

    Brickell, Claire; Munir, Kerim

    2011-01-01

    Bereavement and loss have significant impact on the lives of individuals with intellectual disability (ID). Although there is a growing impetus to define the symptoms of grief that predict long-term functional impairment, little is known about maladaptive grieving among individuals with ID. We examine the literature concerning the phenomenology of traumatic grief (TG) in the general population, along with what is known about the manifestations of grief in individuals with ID. We then apply modern theories of grief and grief resolution to individuals with ID in order to highlight potential areas of vulnerability in this population and to lay the groundwork for interventions that will facilitate their adaptation to loss. We provide a theoretical framework for the proposition that individuals (including children and adults) with ID are more susceptible to TG, based on an increased risk of secondary loss, barriers to communicating about the loss, and difficulty finding meaning in the loss. We conclude that individuals with ID should be considered as potential candidates for targeted bereavement interventions. Further research is required, however, in order to develop population-appropriate measurement scales for testing these hypotheses. PMID:18306095

  13. The Grief Evaluation Measure (GEM): An Initial Validation Study

    ERIC Educational Resources Information Center

    Jordan, John R.; Baker, John; Matteis, Margherite; Rosenthal, Saul; Ware, Eugenia S.

    2005-01-01

    This article describes the development of the Grief Evaluation Measure (GEM), a new instrument designed to screen for the development of a complicated mourning response in a bereaved adult. The GEM provides a quantitative and qualitative assessment of risk factors, including the mourner's loss and medical history, coping resources before and after…

  14. Continuing bonds, risk factors for complicated grief, and adjustment to bereavement.

    PubMed

    Field, Nigel P; Filanosky, Charles

    2010-01-01

    This study examined type of continuing bonds (CB) expression in relation to risk factors for complicated grief and measures of bereavement-related adjustment. Externalized CB expressions involving illusions and hallucinations with the deceased were distinguished from internalized CB expressions involving use of the deceased as an autonomy promoting secure base. 502 bereaved participants completed over the internet a CB measure assessing externalized and internalized CB along with various known risk-factor measures that included cause of death (i.e., violent vs. non-violent death), responsibility for the death, and attachment style as well as measures of psychological adjustment that included complicated grief symptoms, perceived physical health, and personal growth. As predicted, externalized CB was positively associated with violent death and responsibility for the death, whereas internalized CB was negatively associated with these risk factors as well as uniquely positively linked to personal growth. The implications of the findings for the role of CB in adjustment are discussed. PMID:24479173

  15. Complicated grief after traumatic loss: a 14-month follow up study.

    PubMed

    Kersting, Anette; Kroker, K; Steinhard, J; Lüdorff, K; Wesselmann, U; Ohrmann, P; Arolt, V; Suslow, T

    2007-12-01

    The traumatic loss of an unborn child after TOP due to fetal malformation and/or severe chromosomal disorders in late pregnancy is a major life-event and a potential source of serious psychological problems for those women. To obtain information on the course of grief following a traumatic loss, 62 women who had undergone TOP between the 15th and 32nd gestational week were investigated in a longitudinal study design and compared with 65 women after spontaneous delivery of a full-term healthy child. Grief, posttraumatic stress, depression, anxiety and psychiatric disorders were evaluated 14 days, 6 months and 14 months after the event, implementing validated self-report and clinician rated instruments. Compared to women after spontaneous delivery, women after induced TOP were significantly more stressed regarding all psychological outcomes at all three measuring points. Especially, 14 months after TOP 13.7% of the women fulfilled all criteria of a complicated grief diagnoses following Horowitz et al. (1997, Am J Psychiat 154:7904-7910). 16.7% were diagnosed as having a manifest psychiatric disorder according to DSM-IV. All in all, 25% of these women were critically affected by the traumatic loss. TOP for fetal anomaly is to be seen as a major life event, which causes complicated grief reactions and psychiatric disorders for a substantial number of women. PMID:17629729

  16. Suicidality and Bereavement: Complicated Grief as Psychiatric Disorder Presenting Greatest Risk for Suicidality

    ERIC Educational Resources Information Center

    Latham, Amy E.; Prigerson, Holly G.

    2004-01-01

    The influence of complicated grief (CG) on suicidality among bereaved adults was examined. The Yale Evaluation of Suicidality scale and the Inventory of Complicated Grief-Revised were administered to 309 bereaved adults in face-to-face interviews conducted at baseline (6.2 months post-loss) and at follow-up (10.8 months post-loss).…

  17. Internet-Based Cognitive-Behavioral Therapy for Complicated Grief: A Randomized Controlled Trial

    ERIC Educational Resources Information Center

    Wagner, Birgit; Knaevelsrud, Christine; Maercker, Andreas

    2006-01-01

    The present study investigates the efficacy of an Internet-based cognitive-behavioral therapy program for bereaved people suffering complicated grief. The program combines established methods of psychotherapy with new technology--therapists and patients communicated exclusively by e-mail. Bereaved individuals diagnosed with complicated grief (n =…

  18. A Nationwide Random Sampling Survey of Potential Complicated Grief in Japan

    ERIC Educational Resources Information Center

    Mizuno, Yasunao; Kishimoto, Junji; Asukai, Nozomu

    2012-01-01

    To investigate the prevalence of significant loss, potential complicated grief (CG), and its contributing factors, we conducted a nationwide random sampling survey of Japanese adults aged 18 or older (N = 1,343) using a self-rating Japanese-language version of the Complicated Grief Brief Screen. Among them, 37.0% experienced their most significant…

  19. COMPLICATED GRIEF SYMPTOMS IN ANXIETY DISORDERS: PREVALENCE AND ASSOCIATED IMPAIRMENT

    PubMed Central

    Marques, Luana; Bui, Eric; LeBlanc, Nicole; Porter, Eliora; Robinaugh, Donald; Dryman, Taylor; Nadal-Vicens, Mireya; Worthington, John; Simon, Naomi

    2014-01-01

    Background Previous research has identified high rates of comorbid anxiety disorders among individuals presenting with primary CG. In the present study, we examined the prevalence of comorbid CG in bereaved primary anxiety disorder (AD) patients compared to bereaved healthy controls. We also examined the impairment associated with comorbid CG in AD. Methods Participants were 242 bereaved adults (mean (SD) age = 41.5 (13.1), 44.2% women) with a primary AD diagnosis, including generalized anxiety disorder (GAD; n = 57), panic disorder (PD; n = 49), posttraumatic stress disorder (PTSD; n = 29), and generalized social anxiety disorder (GSAD; n = 107), as well as 155 bereaved healthy controls with no current DSM-IV Axis I diagnosis (mean (SD) age = 43.0 (13.6), 51.0% women). CG symptoms were measured using the 19-item inventory of complicated grief (ICG), with threshold CG defined as an ICG score of ≥30. Quality of life and functional impairment were assessed with the Quality of Life Enjoyment and Satisfaction Questionnaire (Q-LES-Q) and the Range of Impaired Functioning Tool (LIFE-RIFT), respectively. Results Participants with primary ADs had significantly higher rates of threshold CG symptoms than bereaved controls (12.0% vs. 0.65%; Fisher’s Exact P < 0.001). Rates of threshold CG were significantly elevated for each AD when compared to bereaved controls. After adjustment for age, sex, education, and comorbid major depressive disorder, threshold CG was associated with lower quality of life (β = −0.140, P = 0.023) and greater impairment (β = 0.141, P = 0.035) among individuals with AD. Conclusions Our findings suggest that threshold CG is of clinical relevance in bereaved individuals with a primary anxiety disorder. Screening for CG in patients with ADs may be warranted. PMID:23495105

  20. Grief

    MedlinePlus

    ... Bereavement References American Psychiatric Association. Diagnostic and statistical manual of mental disorders . 5th ed. Arlington, VA: American Psychiatric Publishing. 2013. Powell AD. Grief, bereavement, and adjustment disorders. ...

  1. A Study of Complicated Grief Symptoms in People with Intellectual Disabilities

    ERIC Educational Resources Information Center

    Dodd, P.; Guerin, S.; McEvoy, J.; Buckley, S.; Tyrrell, J.; Hillery, J.

    2008-01-01

    Introduction: Previous studies have shown a significant association between familial bereavement and the onset of challenging behaviours and psychopathology in people with intellectual disabilities (ID). However, little work has been done to accurately describe the specific symptoms of grief, in particular symptoms of complicated grief in this…

  2. Avoidance processes mediate the relationship between rumination and symptoms of complicated grief and depression following loss.

    PubMed

    Eisma, Maarten C; Stroebe, Margaret S; Schut, Henk A W; Stroebe, Wolfgang; Boelen, Paul A; van den Bout, Jan

    2013-11-01

    Ruminative coping has been associated with negative outcomes in bereavement. Rather than assuming it to be a problematic confrontation process, researchers have recently suggested rumination to be maladaptive through its links with avoidance processes. The main aim of this study was to examine, for the first time, whether the relationship between ruminative coping and symptoms of complicated grief and depression is mediated by avoidance processes (suppression, memory/experiential avoidance, behavioral avoidance, loss-reality avoidance). A sample of 282 adults (88% female, 12% male), bereaved on average 18 months previously, filled out three questionnaires at 6-month intervals. We assessed symptom levels, grief rumination, and trait rumination at baseline; avoidance processes after 6 months; and symptom levels after 12 months. When controlling for initial symptom levels, experiential avoidance mediated the link between grief rumination and complicated grief, and experiential avoidance and behavioral avoidance mediated the link between grief rumination and depression. Post hoc analyses showed suppression may also mediate the link between grief rumination and symptoms of complicated grief, but not depression. Loss-reality avoidance was no significant mediator of these relationships. This study provides initial evidence that rumination during bereavement increases and perpetuates symptoms of psychopathology, because it is linked with specific avoidance processes. Bereaved individuals with problematic grief and (chronic) rumination may benefit from therapy focused on countering avoidance tendencies. PMID:24364599

  3. Complicated grief after death of a relative in the intensive care unit.

    PubMed

    Kentish-Barnes, Nancy; Chaize, Marine; Seegers, Valérie; Legriel, Stéphane; Cariou, Alain; Jaber, Samir; Lefrant, Jean-Yves; Floccard, Bernard; Renault, Anne; Vinatier, Isabelle; Mathonnet, Armelle; Reuter, Danielle; Guisset, Olivier; Cohen-Solal, Zoé; Cracco, Christophe; Seguin, Amélie; Durand-Gasselin, Jacques; Éon, Béatrice; Thirion, Marina; Rigaud, Jean-Philippe; Philippon-Jouve, Bénédicte; Argaud, Laurent; Chouquer, Renaud; Adda, Mélanie; Dedrie, Céline; Georges, Hugues; Lebas, Eddy; Rolin, Nathalie; Bollaert, Pierre-Edouard; Lecuyer, Lucien; Viquesnel, Gérard; Léone, Marc; Chalumeau-Lemoine, Ludivine; Garrouste, Maïté; Schlemmer, Benoit; Chevret, Sylvie; Falissard, Bruno; Azoulay, Élie

    2015-05-01

    An increased proportion of deaths occur in the intensive care unit (ICU). We performed this prospective study in 41 ICUs to determine the prevalence and determinants of complicated grief after death of a loved one in the ICU. Relatives of 475 adult patients were followed up. Complicated grief was assessed at 6 and 12 months using the Inventory of Complicated Grief (cut-off score >25). Relatives also completed the Hospital Anxiety and Depression Scale at 3 months, and the Revised Impact of Event Scale for post-traumatic stress disorder symptoms at 3, 6 and 12 months. We used a mixed multivariate logistic regression model to identify determinants of complicated grief after 6 months. Among the 475 patients, 282 (59.4%) had a relative evaluated at 6 months. Complicated grief symptoms were identified in 147 (52%) relatives. Independent determinants of complicated grief symptoms were either not amenable to changes (relative of female sex, relative living alone and intensivist board certification before 2009) or potential targets for improvements (refusal of treatment by the patient, patient died while intubated, relatives present at the time of death, relatives did not say goodbye to the patient, and poor communication between physicians and relatives). End-of-life practices, communication and loneliness in bereaved relatives may be amenable to improvements. PMID:25614168

  4. The prevalence of complicated grief among Bam earthquake survivors in Iran.

    PubMed

    Ghaffari-Nejad, Alireza; Ahmadi-Mousavi, Mohammadreza; Gandomkar, Mohsen; Reihani-Kermani, Hamed

    2007-10-01

    Earthquake is a natural disaster, which causes many psychological problems in survivors. Complicated grief is one of these sequelae. A devastating earthquake with a magnitude of 6.3 on the Richter scale destroyed the city of Bam in Kerman Province, Iran. Twenty-six thousand people were killed. Many of the survivors should have developed psychological problems in the aftermath of the disaster. In this study, we examined the prevalence of complicated grief and its correlation with the demographic factors and some suggested contributing variables. In this cross-sectional study, 400 persons were selected by stratified multistage area sampling. The survivors were interviewed in their temporary residential camp. After evaluating their demographic data, they were evaluated with the inventory of complicated grief. The cut-off point was set to 25. The mean+/-SD age of the participants was 37.8+/-12.7 years. Complicated grief was detected in 304 (76%) of the respondents. Score of complicated grief was higher among women and in those with lower educational levels. Presence in the city during the earthquake, observing burial of corpses, destruction of residential homes during the earthquake, residential problem after the catastrophe, and loss of at least one of the first relatives during previous earthquakes were variables which were correlated with complicated grief. Existence of complicated grief in more than two-thirds of respondents requires more attention of mental health services. Rebuilding of homes and solving the residential problems of survivors are the factors, which could help survivors to find their mental health within a shorter period. PMID:17903061

  5. Identifying highly influential nodes in the complicated grief network.

    PubMed

    Robinaugh, Donald J; Millner, Alexander J; McNally, Richard J

    2016-08-01

    The network approach to psychopathology conceptualizes mental disorders as networks of mutually reinforcing nodes (i.e., symptoms). Researchers adopting this approach have suggested that network topology can be used to identify influential nodes, with nodes central to the network having the greatest influence on the development and maintenance of the disorder. However, because commonly used centrality indices do not distinguish between positive and negative edges, they may not adequately assess the nature and strength of a node's influence within the network. To address this limitation, we developed 2 indices of a node's expected influence (EI) that account for the presence of negative edges. To evaluate centrality and EI indices, we simulated single-node interventions on randomly generated networks. In networks with exclusively positive edges, centrality and EI were both strongly associated with observed node influence. In networks with negative edges, EI was more strongly associated with observed influence than was centrality. We then used data from a longitudinal study of bereavement to examine the association between (a) a node's centrality and EI in the complicated grief (CG) network and (b) the strength of association between change in that node and change in the remainder of the CG network from 6- to 18-months postloss. Centrality and EI were both correlated with the strength of the association between node change and network change. Together, these findings suggest high-EI nodes, such as emotional pain and feelings of emptiness, may be especially important to the etiology and treatment of CG. (PsycINFO Database Record PMID:27505622

  6. Complicated grief in help-seeking torture survivors in sub-Saharan African contexts.

    PubMed

    Higson-Smith, Craig

    2014-09-01

    Many help-seeking torture survivors in sub-Saharan Africa report sudden or violent bereavements, as well as risk factors associated with complicated grief. This mixed-methods article reviews 85 therapeutic client files from torture treatment centers in 3 countries in sub-Saharan Africa. Thirty-nine clients had lost loved ones and were at greater risk for depression (effect size 0.65) and thoughts of suicide (OR = 4.99). Qualitative analysis of case histories and interviews with clients elaborate the links between torture and complicated grief. Recommendations are offered for the treatment of complicated grief in sub-Saharan torture survivors, and implications for assessment, timing, and treatment duration are discussed. PMID:25089758

  7. Peritraumatic distress: its relationship to posttraumatic stress and complicated grief symptoms in sudden death survivors.

    PubMed

    Hargrave, Petrina A; Leathem, Janet M; Long, Nigel R

    2012-06-01

    Although sudden death has been linked to posttraumatic stress disorder (PTSD), its role in complicated grief (CG) and sudden death survivors is unknown. This questionnaire study investigated the role of peritraumatic distress in PTSD and CG symptoms in adults (n = 125) an average of 28.37 months (SD = 3.12) after a loved one's sudden death. The Peritraumatic Distress Inventory, Impact of Event Scale-Revised, and Inventory of Complicated Grief were administered to assess symptoms of peritraumatic distress, PTSD, and CG, respectively. Peritraumatic distress was the strongest correlate of both PTSD (β = .42, p < .001) and CG (β = .39, p < .001) symptoms, in a model containing current distress (Hopkins Symptom Checklist-21). Peritraumatic distress may be a key mechanism in the development of both PTSD and CG, therefore suddenly bereaved individuals reporting higher peritraumatic distress may be at risk of both adverse trauma and grief reactions. PMID:22685096

  8. Follow-Up Study of Complicated Grief among Parents Eighteen Months after a Child's Death in the Pediatric Intensive Care Unit

    PubMed Central

    Shear, Katherine; Newth, Christopher J.L.; Harrison, Rick; Berger, John; Zimmerman, Jerry; Anand, K.J.S.; Carcillo, Joseph; Donaldson, Amy E.; Dean, J. Michael; Willson, Douglas F.; Nicholson, Carol

    2011-01-01

    Abstract Objective We previously demonstrated that parents whose children die in a pediatric intensive care unit (PICU) have a high level of complicated grief symptoms 6 months after the death. In this study, we investigate the change in the extent of complicated grief symptoms among these parents between 6 and 18 months postdeath and identify factors predicting improvement. Methods One hundred thirty-eight parents of 106 children completed surveys at 6 and 18 months. Surveys included the Inventory of Complicated Grief (ICG), measures of grief avoidance, attachment, caregiving and social support, and demographics. Multivariable analysis was performed using generalized estimating equations to identify characteristics independently associated with improvement in ICG score. Results ICG scores were 33.4 ± 13.6 at 6 months and 28.0 ± 13.5 at 18 months, representing an improvement in ICG score of 5.4 + 8.0 (95% confidence interval [CI] 4.1–6.8, p < 0.001). Variables independently associated with greater improvement in ICG score included traumatic death and greater grief avoidance. Variables independently associated with less improvement included being the biological parent and having more responsive caregiving. Parents with one or two surviving children had more improvement in ICG score than those with no surviving children whereas parents with three or more surviving children had less improvement. Conclusion Complicated grief symptoms decrease among parents between 6 and 18 months after their child's death in the PICU; however, high symptom levels persists for some. Better understanding of the trajectory of complicated grief will allow parents at risk for persistent distress to receive professional support. PMID:21281122

  9. Treatment of Complicated Grief: A Comparison between Cognitive-Behavioral Therapy and Supportive Counseling

    ERIC Educational Resources Information Center

    Boelen, Paul A.; de Keijser, Jos; van den Hout, Marcel A.; van den Bout, Jan

    2007-01-01

    Few studies have examined treatments for complicated grief--a debilitating condition that can develop after the loss of a loved one. This study compared the effectiveness of cognitive-behavioral therapy with a nonspecific treatment with supportive counseling (SC). Using a minimization method, 54 mourners with clinically significant levels of…

  10. Predictors of Complicated Grief among Adolescents Exposed to a Peer's Suicide

    ERIC Educational Resources Information Center

    Melhem, Nadine M.; Day, Nancy; Shear, M. Katherine; Day, Richard; Reynolds, Charles F.; Brent, David

    2004-01-01

    The purpose of this article is to examine the predictors of complicated grief, depression, and post traumatic stress disorder (PTSD) among adolescents exposed to the suicide of a peer. One hundred and forty six peers of adolescent suicide victims were interviewed at 6, 12-18, and 36 months following the suicide. The roles of previous psychiatric…

  11. Complicated grief symptoms in caregivers of persons with lung cancer: the role of family conflict, intrapsychic strains, and hospice utilization.

    PubMed

    Kramer, Betty J; Kavanaugh, Melinda; Trentham-Dietz, Amy; Walsh, Matthew; Yonker, James A

    Guided by a stress process conceptual model, this study examines social and psychological determinants of complicated grief symptoms focusing on family conflict, intrapsychic strains, and the potential moderating effect of care quality and hospice utilization. Relying on data from 152 spouse and adult child lung cancer caregiver survey respondents, drawn from an ancillary study of the Assessment of Cancer CarE and SatiSfaction (ACCESS) in Wisconsin, hierarchical multiple regression analysis was used to examine determinants of complicated grief. After controlling for contextual factors and time since death, complicated grief symptoms were higher among caregivers with less education, among families with lower prior conflict but higher conflict at the end-of-life, who had family members who had difficulty accepting the illness, and who were caring for patients with greater fear of death. Additionally, hospice utilization moderated the effect of fear of death on complicated grief. Findings suggest that family conflict, intrapsychic strains, and hospice utilization may help to explain the variability found in complicated grief symptoms among bereaved caregivers. Implications for enhancing complicated grief assessment tools and preventative interventions across the continuum of cancer care are highlighted. PMID:21495532

  12. Treatment of complicated grief: a comparison between cognitive-behavioral therapy and supportive counseling.

    PubMed

    Boelen, Paul A; de Keijser, Jos; van den Hout, Marcel A; van den Bout, Jan

    2007-04-01

    Few studies have examined treatments for complicated grief--a debilitating condition that can develop after the loss of a loved one. This study compared the effectiveness of cognitive-behavioral therapy with a nonspecific treatment with supportive counseling (SC). Using a minimization method, 54 mourners with clinically significant levels of complicated grief were allocated to 1 of 3 treatment conditions: (a) a condition of 6 sessions of cognitive restructuring (CR) and 6 sessions of exposure therapy (ET; CR + ET), (b) a condition in which these interventions were applied in reversed order (ET + CR), and (c) 12 sessions of SC. Outcomes showed that the 2 cognitive-behavioral therapy conditions produced more improvement in complicated grief and general psychopathology than SC in the completers and intention-to-treat groups. Comparison of the cognitive-behavioral conditions showed that "pure" exposure was more effective than "pure" cognitive restructuring, that adding ET to CR led to more additional improvement than adding CR to ET, and that ET + CR was more efficacious than CR + ET. Effect sizes of ET + CR were encouraging and compare favorably with those found in earlier bereavement intervention studies. PMID:17469885

  13. Complicated spiritual grief II: a deductive inquiry following the loss of a loved one.

    PubMed

    Burke, Laurie A; Neimeyer, Robert A; Young, Amanda J; Bonin, Elizabeth Piazza; Davis, Natalie L

    2014-01-01

    Recent studies have revealed an association between complicated grief-a severe, prolonged response to the loss of a loved one-and complicated spiritual grief-a spiritual crisis following loss. Furthermore, bereavement research has benefitted from a number of studies using qualitative inquiry as a means of examining the experiences of individuals grieving a variety of types of losses. However, a gap in the literature remains in terms of the qualitative investigation of spiritual struggle following loss. Thus, using participants' written responses to open-ended questions along with systematic exploration of this topic with a five-member focus group, we designed this qualitative study to better understand the firsthand experiences of bereaved individuals who have suffered a crisis of faith after the death of a loved one. Specifically, our directed content analysis of bereaved focus group members' responses revealed 17 different common and salient themes subsumed in an overarching narrative of resentment and doubt toward God, dissatisfaction with the spiritual support received, and substantial changes in the bereaved person's spiritual beliefs and behaviors. Thus, our study clarified the construct of complicated spiritual grief, and laid the groundwork for development of more specific assessment and treatment of this condition. PMID:24524590

  14. Attachment, continuing bonds, and complicated grief following violent loss: testing a moderated model.

    PubMed

    Currier, Joseph M; Irish, Jennifer E F; Neimeyer, Robert A; Foster, Joshua D

    2015-01-01

    There is increasing consensus that mourners' general attachment security and ongoing sense of connectedness to the deceased figure prominently in adjustment to bereavement. However, the interplay between these variables has not been investigated thoroughly. We therefore studied 195 young adults who were bereaved by violent causes (homicide, suicide, and fatal accidents) in the previous 2 years, measuring their attachment-related insecurities (anxiety and avoidance), their specific ongoing attachment or "continuing bond" (CB) to the deceased, and their complicated grief (CG) symptomatology over the loss of this relationship. Analyses indicated that CBs were concurrently linked with greater CG symptomatology. However, other results also suggested that attachment could moderate the adaptiveness of maintaining a sense of connection to the deceased loved one. Specifically, CBs were less predictive of CG symptomatology for individuals with high anxiety and low avoidance, and most predictive of intense grieving for bereaved people whose attachment styles were more highly avoidant and minimally anxious. These findings suggest the relevance of evaluating the appropriateness of clinical techniques that emphasize or deemphasize the CB for mourners who differ in their styles of attachment. Such studies could potentially promote a better match of interventions to clients whose styles of coping are congruent with these procedures. PMID:25551174

  15. Hospice Services for Complicated Grief and Depression: Results from a National Survey

    PubMed Central

    Ghesquiere, Angela R.; Aldridge, Melissa D.; Johnson-Hürzeler, Rosemary; Kaplan, Daniel; Bruce, Martha L.; Bradley, Elizabeth

    2016-01-01

    OBJECTIVES To describe the prevalence of screening for complicated grief (CG) and depression in hospice and access to bereavement therapy and to examine whether screening and access to therapy varied according to hospice organizational characteristics or staff training and involvement. DESIGN Cross-sectional national survey conducted from 2008 to 2009. SETTING United States. PARTICIPANTS Hospices (N = 591). MEASUREMENTS Whether hospices screened for depression or CG at the time of death or provided access to bereavement therapy (individual or group). Organizational characteristics included region, chain status, ownership, and patient volume. Staffing-related variables included training length and meeting attendance requirements. RESULTS Fifty-five percent of hospices provided screening for CG and depression and access to bereavement therapy, 13% provided screening but not access to bereavement therapy, 24% provided access to bereavement therapy but not screening, and 8% neither screened nor provided access to bereavement therapy. Hospices with 100 patients per day or more were significantly more likely to provide screening and access to bereavement therapy. CONCLUSION Hospices appear to have high capacity to provide screening for CG and depression and to deliver group and individual therapy, but data are needed on whether screeners are evidence based and whether therapy addresses CG or depression specifically. Future work could build upon existing infrastructure to ensure use of well-validated screeners and evidence-based therapies. PMID:26456597

  16. Complicated grief and posttraumatic stress disorder in humans' response to the death of pets/animals.

    PubMed

    Adrian, Julie A Luiz; Deliramich, Aimee N; Frueh, B Christopher

    2009-01-01

    The present exploratory project represents a cross-sectional study designed to determine the percentage of people reporting significant symptoms of complicated grief (CG) and/or posttraumatic stress disorder (PTSD) in response to the death of companion pets/animals. Human participants (N = 106) were sampled from a veterinary clinic. Fifty-two percent of participants had lost one to three pets from natural causes, 60% had never lost a pet to euthanasia, and 37% had lost one to three pets to euthanasia. The study suggests that many people experience significant attachment to their pets/animals and experience significant features of grief reactions (about 20%) after the death of a pet/animal. However, the percentage of people experiencing major pathological disruption is relatively low (<5%-12%). Thus, subclinical levels of grief and sadness are relatively common human responses to the death of companion pets/animals and last 6 months or more for about 30% of those sampled. Severe pathological reactions do occur but are quite rare among human survivors. Implications for mental health clinicians working with affected populations are discussed. PMID:19807222

  17. Autobiographical memory specificity and symptoms of complicated grief, depression, and posttraumatic stress disorder following loss.

    PubMed

    Boelen, Paul A; Huntjens, Rafaele J C; van Deursen, Denise S; van den Hout, Marcel A

    2010-12-01

    This study examined the specificity and content of autobiographical memories among bereaved individuals. Self-report measures of bereavement-related distress and a standard and trait version of the Autobiographical Memory Test (AMT) were administered to 109 bereaved people. We examined associations of memory specificity with (a) demographic and loss-related variables and with (b) symptom-levels of complicated grief (CG), depression, and posttraumatic stress disorder (PTSD), (c) associations of the content of memories (related vs. unrelated to the loss/lost person) with symptoms, and (d) the degree to which associations of symptom-levels with memory specificity and content differed between the standard and trait version of the AMT. Findings showed that (a) memory specificity varied as a function of age, education, and kinship; (b) reduced memory specificity was significantly associated with symptom-levels of CG, but not depression and PTSD; (c) symptom-levels of CG and PTSD were associated with a preferential retrieval of specific memories that were related to the loss/lost person on the standard AMT, whereas all three symptom-measures were associated with preferential retrieval of loss-related specific memories on the trait AMT; and (d) on the trait AMT, but not the standard AMT, symptom-measures remained significantly associated with a preferential retrieval of loss-related specific memories, when controlling for relevant background variables. Among other things, these results show that reduced memory specificity is associated with self-reported CG-severity but not depression and PTSD following loss. Moreover, the results are consistent with recent research findings showing that memories tied to the source of an individual's distress (e.g., loss) are immune to avoidant processes involved in the standard reduced specificity effect. PMID:20394916

  18. Measuring Grief Following Miscarriage: Psychometric Properties of the Chinese Version of the Perinatal Grief Scale

    ERIC Educational Resources Information Center

    Lai, Beatrice P. Y.; Chung, Tony K. H.; Lee, Dominic T. S.; Kong, Grace W. S.; Lok, Ingrid H.

    2013-01-01

    Grief following miscarriage is a complex psychological response. This study was conducted to examine the psychometric properties of the Chinese version of the Perinatal Grief Scale (PGS). A total of 280 Chinese women completed the PGS immediately following a diagnosis of miscarriage (baseline) and were reassessed at 12 months follow-up. The factor…

  19. Predictors of Complicated Grief after a Natural Disaster: A Population Study Two Years after the 2004 South-East Asian Tsunami

    ERIC Educational Resources Information Center

    Kristensen, Pal; Weisaeth, Lars; Heir, Trond

    2010-01-01

    The authors examined predictors of complicated grief (CG) in Norwegians 2 years after bereavement in the 2004 South-East Asian tsunami. A cross-sectional postal survey retrospectively covering disaster experiences and assessing CG according to the Inventory of Complicated Grief yielded 130 respondents (35 directly disaster-exposed and 95 not…

  20. The impact of losing a child on the clinical presentation of complicated grief

    PubMed Central

    Zetumer, Samuel; Young, Ilanit; Shear, M. Katherine; Skritskaya, Natalia; Lebowitz, Barry; Simon, Naomi; Reynolds, Charles; Mauro, Christine; Zisook, Sidney

    2014-01-01

    Background It is unclear whether bereaved parents with Complicated Grief (CG) struggle with their grief differently than others with CG. This study addressed this question by comparing CG severity, CG-related symptoms, thoughts and behaviors, and comorbid psychiatric diagnoses of bereaved parents with CG to the diagnoses and symptoms of others with CG. Methods Baseline data from 345 participants enrolled in the Healing Emotions After Loss (HEAL) study, a multi-site CG treatment study, were used to compare parents with CG (n = 75) to others with CG (n = 275). Data from the parent group was then used to compare parents with CG who had lost a younger child (n = 24) to parents with CG who had lost an older child (n = 34). Demographic and loss-related data were also gathered and used to control for confounders between groups. Results Parents with CG demonstrated slightly higher levels of CG (p = .025), caregiver self-blame (p = .007), and suicidality (p = .025) than non-parents with CG. Parents who had lost younger children were more likely to have had a wish to be dead since the loss than parents who had lost older children (p = .041). Limitations All data were gathered from a treatment research study, limiting the of these results. No corrections were made for multiple comparisons. The comparison of parents who lost younger children to parents who lost older children was limited by a small sample size. Conclusions Even in the context of CG, the relationship to the deceased may have a bearing on the degree and severity of grief symptoms and associated features. Bereaved parents with CG reported more intense CG, self-blame, and suicidality than other bereaved groups with CG, though this finding requires confirmation. The heightened levels of suicidal ideation experienced by parents with CG, especially after losing a younger child, suggest the value of routinely screening for suicidal thoughts and behaviors in this group. PMID:25217759

  1. An Initial Assessment of the Psychometric Properties of the Complicated Grief Questionnaire for People with Intellectual Disabilities (CGQ-ID)

    ERIC Educational Resources Information Center

    Guerin, Suzanne; Dodd, Philip; Tyrell, Janette; McEvoy, John; Buckley, Sarah; Hillery, John

    2009-01-01

    Given the research evidence that people with intellectual disability (ID) do grieve following bereavement, the present study aimed to describe and gather preliminary psychometric data for a version of the Inventory of Complicated Grief [Prigerson, H. G., Maciejewski, P. K., Reynolds, C. F., Bierhals, A. J., Newsom, J. T., Fasiczka, A., et al.…

  2. Identifying bereaved subjects at risk of complicated grief: Predictive value of questionnaire items in a cohort study

    PubMed Central

    2011-01-01

    Background Bereavement is a condition which most people experience several times during their lives. A small but noteworthy proportion of bereaved individuals experience a syndrome of prolonged psychological distress in relation to bereavement. The aim of the study was to develop a clinical tool to identify bereaved individuals who had a prognosis of complicated grief and to propose a model for a screening tool to identify those at risk of complicated grief applicable among bereaved patients in general practice and palliative care. Methods We examined the responses of 276 newly bereaved individuals to a variety of standardised and ad hoc questionnaire items eight weeks post loss. Inventory of Complicated Grief (ICG-R) was used as a gold standard of distress at six months after bereavement. Receiver operating characteristic (ROC) curves analysis was performed for all scales and items regarding ICG-R score. Sensitivity, specificity and area under curve (AUC) were calculated for scales and items with the most promising ROC curve analyses. Results Beck's Depression Inventory (BDI) was the scale with the highest AUC (0.83) and adding a single item question ('Even while my relative was dying, I felt a sense of purpose in my life') gave a sensitivity of 80% and specificity of 75%. The positive/negative predictive values for this combination of questions were 70% and 85%, respectively. With this screening tool bereaved people could be categorized into three groups where group 1 had 7%, group 2 had 23% and group 3 had 64% propensity of suffering from complicated grief six months post loss. Conclusions This study shows that the BDI in combination with a single item question eight weeks post loss may be used for clinical screening for risk of developing complicated grief after six months. The feasibility and clinical implications of the screening tool has to be tested in a clinical setting. PMID:21575239

  3. Measuring Migratory Grief and Loss Associated with the Experience of Immigration

    ERIC Educational Resources Information Center

    Casado, Banghwa Lee; Hong, Michin; Harrington, Donna

    2010-01-01

    Objectives: The Migratory Grief and Loss Questionnaire (MGLQ) was designed to measure the grief experience associated with immigration. This article reports the development and psychometric properties of a Chinese-version of MGLQ. Methods: An exploratory factor analysis (EFA) using maximum likelihood extraction with varimax rotation was conducted…

  4. Factors Related to Complicated Grief among Bereaved Individuals after the Wenchuan Earthquake in China

    PubMed Central

    Hu, Xiao-Lin; Li, Xiao-Lin; Dou, Xin-Man; Li, Rong

    2015-01-01

    Background: The Wenchuan earthquake in China caused shock and grief worldwide. Sudden bereavement caused by the earthquake led to physical disorders as well as psychological disturbances in the bereaved individuals. The bereaved had a high risk for complicated grief (CG), which may have led to significant distress and impairment in their health. However, there was few available studies on CG among disaster-bereaved individuals in China after the disaster. The aim of this study was to identify factors (demographic characteristics and disaster-related variables) associated with symptoms of CG among the bereaved 18 months after the Wenchuan earthquake. Methods: This study was conducted with a cross-sectional design and a convenience sample of 271 bereaved individuals from three of the hardest hit areas. Data were collected by questionnaires and the instruments used in the study were: General questionnaire and Inventory of CG (ICG). Multivariate linear regression analysis was used to identify factors associated with symptoms of CG. Results: The mean score on ICG was 52.77 (standard deviation: 10.00). Being female and loss of a child were related to higher level of CG while having another child after the disaster and receiving psychological counseling experience were associated with lower level of CG. Forty-nine percent of the variance of CG was explained by these identified factors. Conclusions: Eighteen months after the Wenchuan earthquake, the symptoms of CG among the bereaved were higher than the previous studies with bereaved individuals. This study uncovers a vulnerable population of the bereaved at high risk for CG. Early assessments, targeted interventions, and policy support tailored for the disaster-bereaved individuals are necessary to identify and alleviate symptoms of CG and to improve their well-being. PMID:26021497

  5. Clinical correlates of complicated grief among individuals with acute coronary syndromes

    PubMed Central

    Pini, Stefano; Gesi, Camilla; Abelli, Marianna; Cardini, Alessandra; Lari, Lisa; Felice, Francesca; Di Stefano, Rossella; Mazzotta, Gianfranco; Bovenzi, Francesco; Bertoli, Daniele; Borelli, Lucia; Michi, Paola; Oligeri, Claudia; Balbarini, Alberto; Manicavasagar, Vijaya

    2015-01-01

    Objective The study aimed at exploring bereavement and complicated grief (CG) symptoms among subjects without a history of coronary heart disease (CHD) at the time of a first acute coronary syndrome (ACS) and to evaluate the relationship of CG symptoms and ACS. Method Overall, 149 subjects with ACS (namely, acute myocardial infarct with or without ST-segment elevation or unstable angina), with no previous history of CHD, admitted to three cardiac intensive care units were included and evaluated by the Structured Clinical Interview for Complicated Grief (SCI-CG), Hamilton Depression Rating Scale, Hamilton Anxiety Rating Scale, and the 36-item Short-Form Health Survey (MOS-SF-36). Results Of the total sample of 149 subjects with ACS, 118 (79.2%) met criteria for DSM-5 persistent complex bereavement disorder. Among these, subjects who lost a partner, child, or sibling were older (P=0.008), less likely to be working (P=0.032), and more likely to be suffering from hypertension (P=0.021), returned higher scores on the SCI-CG (P=0.001) and developed the index ACS more frequently between 12 and 48 months after the death than those who lost a parent or another relative (P≤0.0001). The occurrence of ACS 12–48 months (P=0.019) after the loss was positively correlated with SCI-CG scores. An inverse relationship with SCI-CG scores was observed for patients who experienced ACS more than 48 months after the loss (P=0.005). The SCI-CG scores significantly predicted lower scores on the “general health” domain of MOS-SF-36 (P=0.030), as well as lower scores on “emotional well-being” domain (P=0.010). Conclusion A great proportion of subjects with ACS report the loss of a loved one. Among these, the loss of a close relative and the severity of CG symptoms are associated with poorer health status. Our data corroborate previous data indicating a strong relationship between CG symptoms and severe cardiac problems. PMID:26504390

  6. Should prolonged grief be reclassified as a mental disorder in DSM-5?: reconsidering the empirical and conceptual arguments for complicated grief disorder.

    PubMed

    Wakefield, Jerome C

    2012-06-01

    The proposed changes to DSM-5 will create new categories of mental disorder (referred to here generically as Prolonged Grief Disorder'' [PGD]) to diagnose individuals experiencing prolonged intense grief reactions to the loss of a loved one. Individuals could be diagnosed even if they have no depressive or anxiety symptoms but only symptoms typical of grief (e.g., yearning, avoidance of reminders, disbelief, feelings of emptiness). The main challenge for such proposals is to establish that the proposed diagnostic criteria validly discriminate a genuine psychiatric disorder of grief from intense normal grief. With this test in mind, I evaluate the soundness of four empirical arguments and one conceptual argument that have been put forward to support such proposals: (1) PGD has discriminant validity because distinctive, pathognomonic symptoms distinguish it from normal grief; (2) PGD has discriminant validity because it identifies grief symptoms that are of greater absolute severity than in normal grief; (3) PGD has predictive validity because it implies a chronic, interminable process of grieving, thus a derailment of the normal process of grief resolution; (4) PGD has predictive validity because it predicts negative mental and physical health outcomes unlikely in normal grief; and (5) PGD has conceptual validity because grief is analogous to a wound or, alternatively, lengthy grief is analogous to a wound that does not heal. Upon close examination, each of these arguments turns out to have serious empirical or conceptual deficiencies. I conclude that the proposed diagnostic criteria for PGD fail to discriminate disorder from intense normal grief and are likely to yield massive false-positive diagnoses. Consequently, the proposal to add pathological grief categories to DSM-5 should be withdrawn pending further research to identify more valid criteria for diagnosing PGD. PMID:22652615

  7. Dream Content in Complicated Grief: A Window into Loss-Related Cognitive Schemas

    ERIC Educational Resources Information Center

    Germain, Anne; Shear, Katherine M.; Walsh, Colleen; Buysse, Daniel J.; Monk, Timothy H.; Reynolds, Charles F., III; Frank, Ellen; Silowash, Russell

    2013-01-01

    Bereavement and its accompanying psychological response (grief) constitute potent experiences that necessitate the reorganization of cognitive-affective representations of lost significant attachment figures during both wakefulness and dreaming. The goals of this preliminary study were to explore whether the dream content of 77 adults with…

  8. Measuring grief and loss after spinal cord injury: Development, validation and psychometric characteristics of the SCI-QOL Grief and Loss item bank and short form

    PubMed Central

    Kalpakjian, Claire Z.; Tulsky, David S.; Kisala, Pamela A.; Bombardier, Charles H.

    2015-01-01

    Objective To develop an item response theory (IRT) calibrated Grief and Loss item bank as part of the Spinal Cord Injury – Quality of Life (SCI-QOL) measurement system. Design A literature review guided framework development of grief/loss. New items were created from focus groups. Items were revised based on expert review and patient feedback and were then field tested. Analyses included confirmatory factor analysis (CFA), graded response IRT modeling and evaluation of differential item functioning (DIF). Setting We tested a 20-item pool at several rehabilitation centers across the United States, including the University of Michigan, Kessler Foundation, Rehabilitation Institute of Chicago, the University of Washington, Craig Hospital and the James J. Peters/Bronx Department of Veterans Affairs hospital. Participants A total of 717 individuals with SCI answered the grief and loss questions. Results The final calibrated item bank resulted in 17 retained items. A unidimensional model was observed (CFI = 0.976; RMSEA = 0.078) and measurement precision was good (theta range between −1.48 to 2.48). Ten items were flagged for DIF, however, after examination of effect sizes found this to be negligible with little practical impact on score estimates. Conclusions This study indicates that the SCI-QOL Grief and Loss item bank represents a psychometrically robust measurement tool. Short form items are also suggested and computer adaptive tests are available. PMID:26010969

  9. The Effectiveness of Family-Based Cognitive-Behavior Grief Therapy to Prevent Complicated Grief in Relatives of Suicide Victims: The Mediating Role of Suicide Ideation

    ERIC Educational Resources Information Center

    de Groot, Marieke; Neeleman, Jan; van der Meer, Klaas; Burger, Huibert

    2010-01-01

    Grief interventions are more effective for high risk individuals. The presence of suicide ideation following suicide bereavement was examined to determine whether it indicates a high risk status. Using data from a randomized controlled trial (n = 122) on the effectiveness of cognitive-behavior therapy, the effect of suicide ideation on the…

  10. Pilot study on traumatic grief treatment program for Japanese women bereaved by violent death.

    PubMed

    Asukai, Nozomu; Tsuruta, Nobuko; Saito, Azusa

    2011-08-01

    This pilot study aimed to refine a treatment approach for traumatic grief due to violent loss. Our Traumatic Grief Treatment Program, a modification of Shear's complicated grief treatment (Shear et al., 2005), comprises psychoeducation, in vivo exposure, imaginal exposure, discussion of memories about and imaginal conversation with the deceased. Thirteen of 15 Japanese women suffering from posttraumatic stress disorder (PTSD) due to traumatic grief completed 12 to 16 weekly individual sessions based on their therapists' recommendations. Assessment scales included the Inventory of Complicated Grief, the Impact of Event Scale-Revised, and the Center for Epidemiologic Studies Depression Scale. There was significant reduction in symptom severity at treatment end, and symptom levels remained low throughout the 12-month follow-up period. Based on Jacobson's Reliable Change Index, 46% showed change on all 3 measures. These findings suggest that our treatment model may be feasible for treating traumatic grief with PTSD in non-Western settings. PMID:21780192

  11. Predictive role of different dimensions of burden for risk of complicated grief in caregivers of terminally ill patients.

    PubMed

    Lai, Carlo; Luciani, Massimiliano; Morelli, Emanuela; Galli, Federico; Cappelluti, Roberta; Penco, Italo; Aceto, Paola; Lombardo, Luigi

    2014-03-01

    The aim of the study was to test whether high levels of caregiver burden, as other confirmed predictors, are associated with the risk of prolonged grief disorder in caregivers of terminally ill patients. A predictive study was carried out in order to test the hypothesis. A demographic schedule, the Prolonged Grief 12 (PG-12), the Toronto Alexithymia Scale, Hamilton Anxiety Rating Scale, Hamilton Depression Rating Scale, and Caregiver Burden Inventory were administered to 60 caregivers of 51 patients who were admitted in Hospice. In the regression analysis, difficulty in recognizing emotions, total burden, depression, and developmental burden dimension were significant predictors of PG-12 levels. Findings showed that feeling of deprivation of existential expectations represents the greater risk factor for the prolonged grief disorder, among the burden dimensions. PMID:23689368

  12. Coping Style Use Predicts Posttraumatic Stress and Complicated Grief Symptom Severity Among College Students Reporting a Traumatic Loss

    ERIC Educational Resources Information Center

    Schnider, Kimberly R.; Elhai, Jon D.; Gray, Matt J.

    2007-01-01

    Problem-focused coping, and active and avoidant emotional coping were examined as correlates of grief and posttraumatic stress disorder (PTSD) severity among 123 college students reporting the unexpected death of an immediate family member, romantic partner, or very close friend. The authors administered to participants, via the Internet, 5…

  13. Dreams of the Dead among Cambodian Refugees: Frequency, Phenomenology, and Relationship to Complicated Grief and Posttraumatic Stress Disorder

    ERIC Educational Resources Information Center

    Hinton, Devon E.; Field, Nigel P.; Nickerson, Angela; Bryant, Richard A.; Simon, Naomi

    2013-01-01

    The authors investigated the importance of dreams of the deceased in the experiencing of prolonged grief (PG) and posttraumatic stress disorder (PTSD) among Cambodian refugees who survived the Pol Pot genocide (1975-1979). Such dreams were frequent in the last month (52% of those surveyed), and most often involved a relative who died in the Pol…

  14. Lifetime mood symptoms and adult separation anxiety in patients with complicated grief and/or post-traumatic stress disorder: a preliminary report.

    PubMed

    Dell'Osso, Liliana; Carmassi, Claudia; Musetti, Laura; Socci, Chiara; Shear, M Katherine; Conversano, Ciro; Maremmani, Icro; Perugi, Giulio

    2012-08-15

    A minority of bereaved individuals experiences symptoms of complicated grief (CG) that are associated with significant distress and impairment. CG is currently under consideration for inclusion in the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-V) and a major issue is whether or not it can be differentiated from major depressive disorder (MDD) and post-traumatic stress disorder (PTSD). The purpose of this study is to compare the clinical features of CG with those of PTSD and CG+PTSD. A total sample of 116 patients (66 PTSD, 22 CG and 28 CG+PTSD) was recruited. Assessments included: Structured Clinical Interview for DSM-IV Axis-I disorders (SCID-I/P), Inventory of Complicated Grief (ICG), Adult Separation Anxiety Questionnaire (ASA-27), Work and Social Adjustment Scale (WSAS), and Mood Spectrum-Self Report (MOODS-SR) lifetime version. CG was strongly associated with female gender. MDD comorbidity was more common among patients with CG while bipolar disorder was highest among those with PTSD+CG. Patients with CG+PTSD reported significantly higher ASA-27 scores compared to patients with either CG or PTSD alone. Patients with CG+PTSD or PTSD alone reported significantly higher scores on the manic component of the MOODS-SR. No significant differences were reported in the WSAS scores. Our results support differences between CG and PTSD that are important for the consideration of including CG as a new disorder in the DSM-V. PMID:22436352

  15. Is prolonged grief distinct from bereavement-related posttraumatic stress?

    PubMed

    Golden, Ann-Marie J; Dalgleish, Tim

    2010-07-30

    Prolonged grief disorder (PGD) (previously called complicated grief (CG)) is proposed as a distinct post loss syndrome, with its own core symptoms. A key issue concerning the diagnostic validity of PGD is whether it can reliably be distinguished from related psychiatric outcomes following bereavement. This study therefore sought to determine whether the core symptoms of PGD could be distinguished from those of bereavement-related anxiety, depression and posttraumatic stress disorder (PTSD). Data were derived from a community sample of 223 bereaved adults in Croatia. PGD symptomatology was measured using the Revised Inventory of Complicated Grief. Depression and anxiety symptoms were measured using the Beck Depression and Anxiety Inventories, respectively. The intrusion and avoidance symptoms of PTSD were assessed using the Revised Impact of Event Scale. The distinctiveness of the five symptom clusters was examined using principal component analysis (PCA). Symptoms of prolonged grief, depression, anxiety, PTSD-intrusion, and PTSD-avoidance clustered together into five distinct factors. These results support the phenomenological distinctiveness of prolonged grief symptoms, from those of bereavement-related anxiety, depression and, for the first time, PTSD. PMID:20493535

  16. Dreams of the dead among Cambodian refugees: frequency, phenomenology, and relationship to complicated grief and posttraumatic stress disorder.

    PubMed

    Hinton, Devon E; Field, Nigel P; Nickerson, Angela; Bryant, Richard A; Simon, Naomi

    2013-09-01

    The authors investigated the importance of dreams of the deceased in the experiencing of prolonged grief (PG) and posttraumatic stress disorder (PTSD) among Cambodian refugees who survived the Pol Pot genocide (1975-1979). Such dreams were frequent in the last month (52% of those surveyed), and most often involved a relative who died in the Pol Pot period. Past month frequency was correlated with PG severity (r = .59) and PTSD severity (r = .52). The dreams were almost always deeply upsetting because the dreams indicated the deceased to be in a difficult spiritual state. Dreams of the deceased as a central component of PG and PTSD among Cambodian refugees is discussed. PMID:24521031

  17. Normal grief and complicated bereavement among traumatized Cambodian refugees: cultural context and the central role of dreams of the dead.

    PubMed

    Hinton, Devon E; Peou, Sonith; Joshi, Siddharth; Nickerson, Angela; Simon, Naomi M

    2013-09-01

    This article profiles bereavement among traumatized Cambodian refugees and explores the validity of a model of how grief and post-traumatic stress disorder (PTSD) interact in this group to form a unique bereavement ontology, a model in which dreams of the dead play a crucial role. Several studies were conducted at a psychiatric clinic treating Cambodian refugees who survived the Pol Pot genocide. Key findings included that Pol Pot deaths were made even more deeply disturbing owing to cultural ideas about "bad death" and the consequences of not performing mortuary rites; that pained recall of the dead in the last month was common (76 % of patients) and usually caused great emotional and somatic distress; that severity of pained recall of the dead was strongly associated with PTSD severity (r = .62); that pained recall was very often triggered by dreaming about the dead, usually of someone who died in the Pol Pot period; and that Cambodians have a complex system of interpretation of dreams of the deceased that frequently causes those dreams to give rise to great distress. Cases are provided that further illustrate the centrality of dreams of the dead in the Cambodian experiencing of grief and PTSD. The article shows that not assessing dreams and concerns about the spiritual status of the deceased in the evaluation of bereavement results in "category truncation," i.e., a lack of content validity, a form of category fallacy. PMID:23868080

  18. Normal Grief and Complicated Bereavement among Traumatized Cambodian Refugees: Cultural Context and the Central Role of Dreams of the Dead

    PubMed Central

    Hinton, Devon E.; Peou, Sonith; Joshi, Siddharth; Nickerson, Angela; Simon, Naomi

    2013-01-01

    This article profiles bereavement among traumatized Cambodian refugees and explores the validity of a model of how grief and PTSD interact in this group to form a unique bereavement ontology, a model in which dreams of the dead play a crucial role. Several studies were conducted at a psychiatric clinic treating Cambodian refugees who survived the Pol Pot genocide. Key findings included that Pol Pot deaths were made even more deeply disturbing owing to cultural ideas about “bad death” and the consequences of not performing mortuary rites; that pained recall of the dead in the last month was common (76% of patients) and usually caused great emotional and somatic distress; that severity of pained recall of the dead was strongly associated with PTSD severity (r = .62); that pained recall was very often triggered by dreaming about the dead, usually of someone who died in the Pol Pot period; and that Cambodians have a complex system of interpretation of dreams of the deceased that frequently causes those dreams to give rise to great distress. Cases are provided that further illustrate the centrality of dreams of the dead in the Cambodian experiencing of grief and PTSD. The article shows that not assessing dreams and concerns about the spiritual status of the deceased in the evaluation of bereavement results in “category truncation,” i.e., a lack of content validity, a form of category fallacy. PMID:23868080

  19. Parental Grief Responses and Personal Growth Following the Death of a Child

    ERIC Educational Resources Information Center

    Riley, Linda P.; LaMontagne, Lynda L.; Hepworth, Joseph T.; Murphy, Barbara A.

    2007-01-01

    Conceptualizing parental grief as a psychosocial transition, this cross-sectional study of bereaved mothers (N = 35) examined the relationship of dispositional factors, grief reactions, and personal growth. More optimistic mothers reported less intense grief reactions and less distress indicative of complicated grief. Additionally, mothers who…

  20. The grief process and job loss: a cross-sectional study.

    PubMed

    Archer, J; Rhodes, V

    1993-08-01

    This study assessed the applicability of the grief process to job loss. A pilot study of 10 unemployed men was used to establish a structured interview, and its content analysis, based on a description of the grief process derived from studies of bereavement. Other measures assessed the degree of attachment to the former job. The main study involved 60 men who had lost their jobs during the previous eight years. Individual grief items were found in some of these people, varying in frequency from 10 to 80 per cent. Principal components analysis revealed a general grief component, representing most of the specific items. Twenty-seven per cent of the sample fulfilled a criterion for a clear grief-like response. An overall grief score based on the interview answers was significantly correlated with three different measures of job attachment, and also with questionnaire measures of depression and anxiety. These measures were unrelated to the length of time since job loss, apparently providing no support for stage theories or for more general assumptions of adaptation. However, the cross-sectional nature of the sample complicates this conclusion. PMID:8401991

  1. Prevalence and Correlates of Self-Rated Posttraumatic Stress Disorder and Complicated Grief in a Community-Based Sample of Homicidally Bereaved Individuals.

    PubMed

    van Denderen, Mariëtte; de Keijser, Jos; Huisman, Mark; Boelen, Paul A

    2016-01-01

    People confronted with homicidal loss have to cope with separation distress, related to their loss, and traumatic distress, associated with the circumstances surrounding the death. These reactions are related to complicated grief (CG) and posttraumatic stress disorder (PTSD). The psychological effects for people who have lost someone through homicide, in terms of PTSD and CG, are largely unclear. This cross-sectional study (a) examined the prevalence of self-rated PTSD and self-rated CG in a community-based sample of 312 spouses, family members, and friends of homicide victims and (b) aimed to identify socio-demographic, loss-related, and perpetrator-related correlates of PTSD and CG. Participants were recruited via support organizations for homicidally bereaved individuals in the Netherlands (i.e., support group), and by casemanagers of a governmental organization, which offers practical, non-psychological, support to bereaved families (i.e., casemanager group). Prevalence of self-rated PTSD was 30.9% (support group) and 37.5% (casemanager group), prevalence of CG was 82.7% (support group) and 80.6% (casemanager group). PTSD and CG severity scores varied as a function of the relationship with the victim; parents were at greater risk to develop emotional problems, compared with other relatives of the victim. Time since loss was negatively associated with PTSD and CG scores. PMID:25389188

  2. Public attitudes about normal and pathological grief.

    PubMed

    Penman, Emma L; Breen, Lauren J; Hewitt, Lauren Y; Prigerson, Holly G

    2014-01-01

    Determining public expectations of grief is an important contributor to the debate differentiating normal from pathological grief. An international sample of 348 participants was randomly allocated to 1 of 12 conditions comprising a bereavement vignette and self-report items measuring grief expectations and social distance. Participants expected grief to decrease steadily between 2 weeks and 6 months then stabilize; however, time did not affect social distance. Gender of the bereaved and circumstances of death did not influence expectations, but did interact to influence social distance. These factors must be accounted for in determining a deviation from the norm in diagnostic nosology. PMID:24738705

  3. The Continuing Process of Parental Grief

    ERIC Educational Resources Information Center

    Arnold, Joan; Gemma, Penelope Buschman

    2008-01-01

    The death of a child is an incomprehensible and devastating loss. Grief for parents is lifelong, becoming the connection between parent and child. To extend and deepen current understanding of parental grief, a new survey instrument was developed, combining quantitative and qualitative measures. The qualitative findings from this combined…

  4. Children and grief

    MedlinePlus

    ... medlineplus.gov/ency/patientinstructions/000749.htm Children and grief To use the sharing features on this page, ... your own child, learn the normal responses to grief that children have and the signs when your ...

  5. An Investigation of the Relationship of Personality, Coping, and Grief Intensity among Bereaved Mothers

    ERIC Educational Resources Information Center

    Robinson, Tristan; Marwit, Samuel J.

    2006-01-01

    A mediational model of grief intensity (Meuser & Marwit, 2000) was examined in a population at risk for complicated grief. Coping strategies (emotion-oriented, task-oriented, and avoidance-oriented coping) were hypothesized to mediate the influence of personality factors (neuroticism and extraversion) on grief. Bereaved mothers (N =138) completed…

  6. Major Depression and Complicated Grief

    MedlinePlus

    ... and reactions are shaped by cultural and spiritual values as well as by the relationships among family members. It takes time for a bereaved family to regain its balance. It’s important that each family member be able to grieve ...

  7. Grief Processing and Deliberate Grief Avoidance: A Prospective Comparison of Bereaved Spouses and Parents in the United States and the People's Republic of China

    ERIC Educational Resources Information Center

    Bonanno, George A.; Papa, Anthony; Lalande, Kathleen; Zhang, Nanping; Noll, Jennie G.

    2005-01-01

    In this study, the authors measured grief processing and deliberate grief avoidance and examined their relationship to adjustment at 4 and 18 months of bereavement for 2 types of losses (spouse, child) in 2 cultures (People's Republic of China, United States). Three hypotheses were compared: the traditional grief work assumption, a conditional…

  8. Influences on grief among parentally bereaved adults.

    PubMed

    Carver, Kellye S; Hayslip, Bert; Gilley, Angela; Watts, Justin

    2014-01-01

    Although the parent-child relationship is significant throughout life, many changes occur as children grow, particularly during young adulthood. Parental loss and resulting grief during adulthood is likely influenced by many variables, including age, gender, relationship quality, and sex roles. In the present study, parentally bereaved adults completed measures assessing parental involvement, personal grief and adjustment, and sex role preferences. Analyses of covariance indicated that gender of the bereaved child was significant in predicting some aspects of grief, wherein females were more strongly impacted by the loss of a parent, irrespective of that parent's sex. However, the interaction of sex of parent and sex of child was also significant, suggesting that maternal loss may be particularly difficult for daughters. Results suggested that women may have a stronger emotional experience of grief and maintain closer bonds with a deceased mother. This may result from deeper emotional connections, feeling excluded by age peers, or vulnerability for rumination. PMID:25223308

  9. Understanding Grief & Loss.

    ERIC Educational Resources Information Center

    Parker, Judith

    1995-01-01

    Although death is the one certainty in life, death or the grieving process is rarely discussed. Grief includes physical, emotional, spiritual, and psychological reactions to loss, and is not limited to feelings about death. Grief can be the response to loss of home or country, separation or displacement, and changes resulting from new life stages.…

  10. The narrative dynamics of grief after homicide.

    PubMed

    Rynearson, Edward K

    2012-01-01

    The homicidal death of a loved one is horrific. Dying from homicide can be more sudden, frightening, and stigmatizing than natural dying and may be followed by a sub-type of prolonged grief complicated by vivid narrative reenactment of the dying, intense feelings of remorse, and nihilistic despair. After a literature review of grief after homicide, the author clarifies the salient narrative themes of homicidal dying and their specific effects on trauma and separation distress. A preliminary model is then developed and illustrated in a therapy case outlining a technique (imaginative exposure) to diminish the disabling fixation of reenactment imagery, remorse, and despair. PMID:23057248

  11. [Preventive measures of diabetic foot complications].

    PubMed

    Malacarne, Sarah; Chappuis, Bernhard; Egli, Marc; Hagon-Traub, Isabelle; Schimke, Katrin; Schönenweid, Claude; Peter-Riesch, Bettina

    2016-06-01

    Diabetic foot complications are a public health challenge and preventive measures although simple are often not enforced, as evidenced by the lack of decrease in the rate of ulcers and amputation in Switzerland. This article proposes a risk score to grade individual risk of the diabetic patient and an individualized prevention measures as this risk. We discuss the importance of collaboration of various specialists. Two areas are important, first the early involvement of specialists in revascularization because the diabetic population with feet at risk of ulcération risk nowadays primarily has neuro-ichemic ulcerations and also the close collaboration with podiatrists and orthopedic shoemakers who are full partners of the multidisciplinary team. PMID:27487677

  12. Children and grief

    MedlinePlus

    ... Accessed July 16, 2014. Helping Children Cope With Loss, Death, and Grief: Tips for Teachers and Parents. National Association of School Psychologists Web site. http://www.nasponline.org/resources/ ...

  13. Death and Grief

    MedlinePlus

    ... for Parents for Kids for Teens Teens Home Body Mind Sexual Health Food & Fitness Diseases & Conditions Infections Q& ... a death or loss. Grief can affect our body, mind, emotions, and spirit. People might notice or show ...

  14. Understanding Grief and Loss

    MedlinePlus

    ... Other common behaviors include restlessness and excessive activity. Religion and spirituality Grief and loss may also cause ... The grieving person’s age and gender The life history of the person who is grieving, including previous ...

  15. Grief and depression after miscarriage: their separation, antecedents, and course.

    PubMed

    Beutel, M; Deckardt, R; von Rad, M; Weiner, H

    1995-01-01

    Bereavement is a major risk factor for physical illness, grief, depression, and anxiety. In contrast to recent tendencies in the psychiatric literature to equate grief and depression, we propose that a careful discrimination between the two must be made for diagnostic, therapeutic, and investigative purposes. We report the results of a longitudinal study of a frequent but neglected event, miscarriage early in pregnancy, to make this point. Clinical criteria for differentiating grief and depressive reactions were developed based on phenomenological criteria and theoretical considerations. We hypothesized that the detrimental psychological and physical consequences occur only when the miscarriage was not mourned and resulted in a depressive reaction, but not in a grief reaction. In a controlled, representative study, 125 consecutive women were assessed shortly after their miscarriage (before the 20th week of gestation) and 6 months (N = 94) and 12 months (N = 90) later. Assessments included standardized questionnaires for life events, depression, physical complaints, anxiety, and a specific, multidimensional grief scale (Munich Grief Scale) that we had developed previously. Immediately after the miscarriage, the average anxiety and depression scores were elevated when compared with 80 pregnant and 125 age-matched community controls. Twenty percent of the patients who had miscarried showed a grief reaction, 12% showed a depressive reaction, and 20% responded with a combined depressive and grief reaction. The remaining women (48%) reported no changes in their emotional reactions. As predicted, longer-lasting psychological, social, and health status changes followed the initial depressive, but not the grief reactions. Depressive reactions were predicted by a history of previous depression, a lack of social resources, and an ambivalent attitude to the lost fetus. The grief measures were reliable and made it possible to discriminate between grief and depression. PMID

  16. Grief and Traumatic Grief in Children in the Context of Mass Trauma.

    PubMed

    Dyregrov, Atle; Salloum, Alison; Kristensen, Pål; Dyregrov, Kari

    2015-06-01

    Children who have had someone close die as a result of a mass trauma event such as war, armed conflict, acts of terror, political violence, torture, mass accidents, and natural disasters are at risk for biopsychosocial problems. Research on how to classify when grief becomes complicated or traumatic in children is scarce, and while functioning level may provide a good indication, assessing functioning may be difficult in mass trauma environments where routines and structure are often lacking. There are promising trauma- and grief-focused interventions for children post-mass trauma, which are mostly provided in school settings. However, more advanced multi-method interventions are needed that address grief and trauma in the context of the child's overall mental health, parent/caregiver role in assisting the child, family system issues, ways to provide safe caring environments amidst chaos and change, and interventions that take into account local consumer perspectives, including the voices of children. PMID:25940038

  17. Grief and Palliative Care: Mutuality

    PubMed Central

    Moon, Paul J

    2013-01-01

    Grief and palliative care are interrelated and perhaps mutually inclusive. Conceptually and practically, grief intimately relates to palliative care, as both domains regard the phenomena of loss, suffering, and a desire for abatement of pain burden. Moreover, the notions of palliative care and grief may be construed as being mutually inclusive in terms of one cueing the other. As such, the discussions in this article will center on the conceptualizations of the mutuality between grief and palliative care related to end-of-life circumstances. Specifically, the complementarity of grief and palliative care, as well as a controvertible view thereof, will be considered. PMID:25278758

  18. Communication During Grief.

    ERIC Educational Resources Information Center

    Larson, Charles U.

    The physical and psychological difficulties which accompany grief resulting from another's death are described, and the intrapersonal and interpersonal communication behaviors exhibited by bereaved individuals are outlined. The role of intrapersonal communication--the mourner communicating with himself--and interpersonal communication--the mourner…

  19. The Calculus of Grief

    ERIC Educational Resources Information Center

    Williams, Lee Burdette

    2010-01-01

    On a college campus, educators and students live on the edge of tragedy. They walk that edge everyday, aware that the possibility of death is always one misstep away. One careless move by any of the hundreds or thousands of them walking that edge, and their whole community falls into a canyon of grief from which they will climb only after weeks,…

  20. Grief, Bereavement, and Coping with Loss (PDQ)

    MedlinePlus

    ... sometimes described as bereaved. Grief is the normal process of reacting to the loss. Grief is the ... no reason. Grief is sometimes described as a process that has stages. There are several theories about ...

  1. The grief map

    NASA Astrophysics Data System (ADS)

    Monteiro, L. H. A.

    2014-12-01

    Grieving is a natural human reaction to a significant loss. According to a psychiatric model, this process is characterized by a typical sequence of psychological changes. Here, I propose a discrete-time dynamical system, called the grief map, in order to represent the grieving process. The corresponding bifurcation diagram, which exhibits stationary, periodic, and chaotic behavior, is related to the stages of this sorrowful journey occurring during about 12 months post-loss.

  2. Grief: Helping Young Children Cope

    ERIC Educational Resources Information Center

    Wood, Frances B.

    2008-01-01

    In their role as caregivers supporting the children they teach, it is important for teachers to understand the grieving process and recognize symptoms of grief. The author explains Elisabeth Kubler-Ross's five stages of grief and offers 10 classroom strategies to help young children cope with their feelings.

  3. Grief Casualties on Skid Row.

    ERIC Educational Resources Information Center

    Hughes, Cornelius; Fleming, Dagmar

    1991-01-01

    Case study research in shelter for homeless men revealed small, but notable, minority suffering from unresolved grief resulting from death of spouse, child, parent, or other immediate family member, or to painful divorce. Failure to cope with grief appeared to have robbed them of will to maintain their social standing. (Author/NB)

  4. Rapid Resolution of Grief with IV Infusion of Ketamine: A Unique Phenomenological Experience

    PubMed Central

    Gowda, Mahesh Ramanna; Srinivasa, Preethi; Kumbar, Prabha S.; Ramalingaiah, Vinay Hosagavi; Muthyalappa, Chandrashekar; Durgoji, Sumit

    2016-01-01

    Ketamine, a primarily FDA-approved anaesthetic agent is also used as recreational drug. Based on preclinical findings and later the clinical observations it is noted to have rapid antidepressant effect due to its mechanisms related to NMDA antagonism. In spite of established evidence of ketamine being effective in depression with significant role in treatment resistant cases as well, there was absolute dearth of literature regarding its utility in grief-related disorders. In this context we present a case of 28-year-old graduate male who presented to us in complicated grief following death of his wife due to obstetric complications. With the patient and immediate family members consenting for use of ketamine as off-label use, patient had single IV infusion of ketamine following which he had unique phenomenological experience ultimately resolving his grief in few minutes. Through this case we highlight the enormous therapeutic promise of ketamine in complicated grief. PMID:27011405

  5. Rapid Resolution of Grief with IV Infusion of Ketamine: A Unique Phenomenological Experience.

    PubMed

    Gowda, Mahesh Ramanna; Srinivasa, Preethi; Kumbar, Prabha S; Ramalingaiah, Vinay Hosagavi; Muthyalappa, Chandrashekar; Durgoji, Sumit

    2016-01-01

    Ketamine, a primarily FDA-approved anaesthetic agent is also used as recreational drug. Based on preclinical findings and later the clinical observations it is noted to have rapid antidepressant effect due to its mechanisms related to NMDA antagonism. In spite of established evidence of ketamine being effective in depression with significant role in treatment resistant cases as well, there was absolute dearth of literature regarding its utility in grief-related disorders. In this context we present a case of 28-year-old graduate male who presented to us in complicated grief following death of his wife due to obstetric complications. With the patient and immediate family members consenting for use of ketamine as off-label use, patient had single IV infusion of ketamine following which he had unique phenomenological experience ultimately resolving his grief in few minutes. Through this case we highlight the enormous therapeutic promise of ketamine in complicated grief. PMID:27011405

  6. Abnormal Grief: Should We Consider a More Patient-Centered Approach?

    PubMed

    Moayedoddin, Babak; Markowitz, John C

    2015-01-01

    Grief, the psychological reaction to the loss of a significant other, varies complexly in its cause, experience, evolution, and prognosis. Although most bereaved individuals experience a normal grieving process, some develop complicated grief (CG) or major depressive disorder (MDD). The DSM-5, which controversially altered the nosology, recognizes grief-related major depression (GRMD) as a diagnostic subtype if a patient meets MDD criteria two weeks post bereavement. The (DSM-5) tries to distinguish between grief and MDD, but remains a symptom-based, centered approach to grief that is not patient centered. This article reviews grief in its normal and abnormal dimensions. Using an illustrative clinical case in which interpersonal psychotherapy (IPT) was employed, we discuss the need for a more patient-centered approach to treating abnormal grief, considering the patient's personal history, perceptions, experiences of bereavement, and interpersonal environment. Clinical studies need to better identify subgroups of individuals susceptible to abnormal grief and to evaluate their response to early interventions. PMID:26802420

  7. Palliative Care Caregivers' Grief Mediators: A Prospective Study.

    PubMed

    Coelho, Alexandra M; Delalibera, Mayra A; Barbosa, António

    2016-05-01

    The aim of the study is to identify the mediators of complicated grief in a Portuguese sample of caregivers. Grief mediators were prospectively evaluated using a list of risk factors completed by the palliative care team members, during the predeath and bereavement period. More than 6 months after the death, we applied PG-13 to diagnose prolonged grief disorder (PGD). The sample was composed of 64 family caregivers. Factors associated with PGD were insecure and dependent relationship, unresolved family crisis, and the perceived deterioration and disfigurement of the patient. The results show relational factors are relevant, but we must consider the reciprocal influence among factors, as well as their impact on specific symptoms. PMID:25601321

  8. Resilience and vulnerability: prolonged grief in the bereaved spouses of marital partners who died of AIDS.

    PubMed

    Yu, Nancy Xiaonan; Chan, Cecilia L W; Zhang, Jianxin; Stewart, Sunita M

    2016-04-01

    Spousal bereavement is closely linked to prolonged grief, that is, significant adjustment symptoms that last for more than six months after the loss. This article focused on potential risk and protective factors that may influence bereavement outcomes. Participants in this study were surviving spouses of individuals who died of acquired immune deficiency syndrome (AIDS). These participants were themselves living with human immunodeficiency syndrome. In this cross-sectional study, 120 bereaved participants completed measures of grief, quality of dying and death of the deceased, negative conceptions of death resulting from AIDS, death attitudes, and personal resilience. The results showed that one-third (35.0%) of the bereaved participants reported grief levels above the prolonged grief cut-off scores, and can be categorized as the "prolonged grief" group. Although quality of dying and death was not associated with the intensity of grief, negative conceptions of death from AIDS, fear of death and resilience independently predicted grief symptoms in the regression models. Our findings provide insight into the grief process for the surviving spouse of AIDS victims in rural China. Since resilience is malleable, developing resilience interventions to enhance adjustment to bereavement may be a promising direction in grief counselling and therapies. PMID:26573556

  9. Prolonged grief: setting the research agenda

    PubMed Central

    Rosner, Rita

    2015-01-01

    Background Prolonged grief disorder is proposed for the International Classification of Diseases (ICD-11), though it was rejected as a diagnosis for DSM-5. Objective This review outlines findings and defines important areas for future research viewed from a lifespan perspective. Results The development and psychometric evaluation of measures for the new diagnosis is paramount, specifically for children and adolescents. Treatments need to be adapted for specific subgroups and research findings have to be disseminated into various professional settings. PMID:25994020

  10. Development and Validation of a Christian-Based Grief Recovery Scale

    ERIC Educational Resources Information Center

    Jen Der Pan, Peter; Deng, Liang-Yu F.; Tsai, S. L.; Chen, Ho-Yuan J.; Yuan, Sheng-Shiou Jenny

    2014-01-01

    The purpose of this study was to develop and validate a Christian-based Grief Recovery Scale (CGRS) which was used to measure Christians recovering from grief after a significant loss. Taiwanese Christian participants were recruited from churches and a comprehensive university in northern Taiwan. They were affected by both the Christian faith and…

  11. How to Deal with Grief

    MedlinePlus

    ... and confusion that comes from losing someone or something important to you. It is a natural part of life. Grief is a typical reaction to death, divorce, job loss, a move away from family and friends, or loss of ...

  12. Getting Help for Your Grief

    MedlinePlus

    ... Division of Geriatrics and Clinical Gerontology Division of Neuroscience FAQs Funding Opportunities Intramural Research Program Office of ... or they can be just generally for anyone learning to manage grief. Check with religious groups, a ...

  13. Anticipatory Grief: A Mere Concept?

    PubMed

    Moon, Paul J

    2016-06-01

    Anticipatory grief (AG) has been studied, debated, and written about for several decades. This type of grief is also recognized in hospice and palliative care (HPC). The question, however, is whether the reality of AG is sufficiently upheld by professionals at the point of concrete service delivery. In other words, is AG a mere concept or is everyday practice of HPC duly informed of AG as evidenced by the resulting care delivery? PMID:25712106

  14. Brief Eclectic Psychotherapy for Traumatic Grief (BEP-TG): toward integrated treatment of symptoms related to traumatic loss

    PubMed Central

    Smid, Geert E.; Kleber, Rolf J.; de la Rie, Simone M.; Bos, Jannetta B. A.; Gersons, Berthold P. R.; Boelen, Paul A.

    2015-01-01

    Background Traumatic events such as disasters, accidents, war, or criminal violence are often accompanied by the loss of loved ones, and may then give rise to traumatic grief. Traumatic grief refers to a clinical diagnosis of persistent complex bereavement disorder (PCBD) with comorbid (symptoms of) posttraumatic stress disorder (PTSD) and/or major depressive disorder (MDD) following confrontation with a traumatic loss. Trauma survivors, who are frequently from different cultural backgrounds, have often experienced multiple losses and ambiguous loss (missing family members or friends). Current evidence-based treatments for PTSD do not focus on traumatic grief. Objective To develop a treatment for traumatic grief combining treatment interventions for PTSD and PCBD that may accommodate cultural aspects of grief. Method To provide a rationale for treatment, we propose a cognitive stress model of traumatic grief. Based on this model and on existing evidence-based treatments for PTSD and complicated grief, we developed Brief Eclectic Psychotherapy for Traumatic Grief (BEP-TG) for the treatment of patients with traumatic grief. The treatment is presented along with a case vignette. Results Processes contributing to traumatic grief include inadequately integrating the memory of the traumatic loss, negative appraisal of the traumatic loss, sensitivity to matching triggers and new stressors, and attempting to avoid distress. BEP-TG targets these processes. The BEP-TG protocol consists of five parts with proven effectiveness in the treatment of PCBD, PTSD, and MDD: information and motivation, grief-focused exposure, memorabilia and writing assignments, finding meaning and activation, and a farewell ritual. Conclusion Tailored to fit the needs of trauma survivors, BEP-TG can be used to address traumatic grief symptoms related to multiple losses and ambiguous loss, as well as cultural aspects of bereavement through its different components. PMID:26154434

  15. Grief and Loss as Alzheimer's Progresses

    MedlinePlus

    ... or share your name. Grief and Loss as Alzheimer's Progresses Tweet Bookmark this page | Email | Print It ... and grief as their life is changed by Alzheimer's. You're entitled to these emotions and may ...

  16. The Grief Response Following a Homicide.

    ERIC Educational Resources Information Center

    Poussaint, Alvin F.

    Although grief reactions have been carefully examined, little information is available on the grief response following the murder of a loved one. Impressions of homicide survivors' grief reactions were obtained by the staff of a family support center who treated ten families that had experienced the loss of a family member by homicide.…

  17. Children and Grief. ERIC Digest.

    ERIC Educational Resources Information Center

    McEntire, Nancy

    Noting that the death of a loved one brings grief to children as well as adults, this Digest draws on research to examine how children respond to death and the role of parents and teachers in helping children cope with loss. The Digest delineates children's "tasks" during mourning that are essential to their adjustment to loss, such as accepting…

  18. Reading Guidance: Death and Grief.

    ERIC Educational Resources Information Center

    Smith, Alice Gullen

    1989-01-01

    Gives guidelines for the librarian using reading guidance (similar to bibliotherapy). Provides a nine-item annotated bibliography of novels for children and adolescents on the subject of death and grief. Appends an embryo list of categories suitable for content analysis of any file librarians might wish to keep on books suitable for use in this…

  19. Prediction of grief and HIV/AIDS-related burnout in volunteers.

    PubMed

    Nesbitt, W H; Ross, M W; Sunderland, R H; Shelp, E

    1996-04-01

    Burnout in volunteer workers in the HIV/AIDS area results in the loss of dedicated personnel, consequently straining the HIV/AIDS care delivery system. By assessing the predictors of burnout and grief this study describes the role of grief in HIV/AIDS volunteer burnout. Voluntary and anonymous questionnaires were sent to members of the Foundation for Interfaith Research and Ministry (FIRM), a multi-religious organization formed to provide volunteer work in HIV/AIDS care facilities around Houston, Texas. In 174 valid responses, grief was measured against work characteristics, burnout, rewards, stressors, and the general health questionnaire (GHQ). No significant relationship was found between grief and burnout; however, burnout in volunteers may be different from that in health care professionals for the following reasons: (1) volunteers choose to work in the HIV/AIDS area; (2) they have control over the time they spend volunteering; (3) volunteers are internally motivated to work in the HIV/AIDS area; and (4) if the volunteers do not enjoy the work, they can terminate their involvement with minimal cost. The best univariate predictors of grief are time spent as a volunteer and volunteer hours per week, where those who spend the most hours volunteering experience less grief The Reward/Stress measures most significantly associated with grief include empathy/self-knowing reward, emotional support reward, and emotional overload stress. The strongest predictors of grief in the regression analysis, which account for 21% of the variance, were time as a volunteer, emotional support, emotional overload, GHQ-somatic symptoms, and GHQ social dysfunction. The data suggest that in order to reduce grief special attention should be paid te allowing volunteers freely to express problems with emotional overload and workload adjustments, and providing clear emotional support as a reward. PMID:8861413

  20. Pathological Grief: Causes, Recognition, and Treatment

    PubMed Central

    Gort, George

    1984-01-01

    Although the incidence of pathological grief does not appear to be high, the morbidity and mortality of sufferers is significant. Because of attitudes about grieving and the reluctance to experience grief, patients may avoid sharing grief with the family physician, who may then fail to recognize pathological grief. This article discusses clinical manifestations and situations which can lead to pathological grief. The types of pathological grief—chronic, inhibited, delayed, and atypical—are also discussed, along with personality variables which predispose some people to difficult grieving. Failure to grieve may also lead to a higher incidence of physical disease and various forms of mental illness. In order to manage grief, the physician must encourage the patient to express all his feelings of sadness, anger, and guilt; reassure him that his anger and guilt are a normal reaction to loss; and later, give him permission to stop grieving. PMID:21279045

  1. The Spectrum of Grief: Identification and Management

    PubMed Central

    Barnes, Daphne

    1989-01-01

    Loss is a common human experience, and grief is frequently seen in a physician's office. Grief occurs not only after a death, but also during chronic or serious illness, infertility, divorce, job changes, surgery, rape, and so forth. Some patients somatize distress, presenting with physical symptoms rather than acknowledging their grief. Bereavement increases the risk of both psychiatric and physical disease and can exacerbate pre-existing illness. In the majority, grief resolves normally, but in some the process becomes morbid. The family physician is in a unique position to identify, educate, assess, and intervene with the grieving patient and his family. PMID:21248941

  2. Music therapy in grief resolution.

    PubMed

    Bright, R

    1999-01-01

    The multifaceted nature of grief and the enormous variation in individual clients' responses to losses make it necessary for therapists to have wide background knowledge and well-developed skills in counseling and/or psychotherapy. The author describes an innovative method of facilitating grief resolution using precomposed music that is significant to the patient after a major loss. In this method, music is of equal importance with verbal processing as part of the overall therapeutic approach. Musical improvization is also used as a primary tool to reflect back to, and affirm for, the patient the affective content of his or her life story. This approach requires the therapist to have particular musical skills and a wide repertoire of genres and specific musical pieces, as well as intuition. Several clinical vignettes illustrate the application of this approach. PMID:10589140

  3. Dream Work in Grief Therapy

    PubMed Central

    Noronha, Konrad Joseph

    2014-01-01

    Working with dreams is useful with grief and loss clients who present with dreams. Adlerian dream analysis is one-way of exploring dreams. It incorporates the life-style of the client. This case report demonstrates how Adlerian dream analysis was used with a client. Progress was noted in improved life-style once the client began to talk about her dream. PMID:25035561

  4. Impact of A Neonatal-Bereavement-Support DVD on Parental Grief: A Randomized Controlled Trial

    PubMed Central

    Rosenbaum, Joan L.; Smith, Joan R.; Yan, Yan; Abram, Nancy; Jeffe, Donna B.

    2014-01-01

    This study tested the effect of a neonatal-bereavement-support DVD on parental grief after their baby’s death in our Neonatal Intensive Care Unit compared with standard bereavement care (controls). Following a neonatal death, we measured grief change from 3- to 12-month follow-up using a mixed-effects model. Intent-to-treat analysis was not significant, but only 18 parents selectively watched the DVD. Thus, we subsequently compared DVD-viewers with DVD-non-viewers and controls. DVD-viewers reported higher grief at 3-month interviews compared with DVD-non-viewers and controls. Higher grief at 3 months was negatively correlated with social support and spiritual/religious beliefs. These findings have implications for neonatal-bereavement care. PMID:25530502

  5. Impact of a Neonatal-Bereavement-Support DVD on Parental Grief: A Randomized Controlled Trial.

    PubMed

    Rosenbaum, Joan L; Smith, Joan R; Yan, Yan; Abram, Nancy; Jeffe, Donna B

    2015-01-01

    This study tested the effect of a neonatal-bereavement-support DVD on parental grief after their baby's death in a Neonatal Intensive Care Unit compared with standard bereavement care (controls). Following a neonatal death, the authors measured grief change from a 3- to 12-month follow-up using a mixed-effects model. Intent-to-treat analysis was not significant, but only 18 parents selectively watched the DVD. Thus, we subsequently compared DVD viewers with DVD nonviewers and controls. DVD viewers reported higher grief at 3-month interviews compared with DVD nonviewers and controls. Higher grief at 3 months was negatively correlated with social support and spiritual/religious beliefs. These findings have implications for neonatal-bereavement care. PMID:25530502

  6. [Prolonged grief disorder: towards a new diagnostic category].

    PubMed

    Chiambretto, P

    2008-01-01

    The grief in response to loss of a significant is a normal, inevitable, experience of life. Nevertheless some people, even after a couple of months, do not succeed in integrating this experience in their daily life and remain stuck in a state of suffering condition that seriously extended in the time is functionally impairing. For long time psychology has focused on bereavement subsequent to the loss and the complications that can derive from the missing elaboration. The condition of prolonged grief has been object of a large debate in the past years, up to the individualization of a specific set of symptoms identified in a new diagnostic category: the Prolonged Grief Disorder (PGD). The PGD is featured as a condition of emotional distress and physical distress by the loss, not for the death, of a significant only, with daily involvement in all function areas. Our work given a short and non exhaustive overview of the cultural and scientific run that has brought to the collection of the evidences to insert the PGD as new diagnostic category in the DSM V and a comparison between the Post-Traumatic Stress Disorder (PTSD) and the Major Depressive Disorder (MDD) for better underlining similes, but above all differences among categories that subtend clinical conditions that can appear sometimes overlaps. PMID:19288776

  7. After Love: Attachment Styles and Grief Themes.

    ERIC Educational Resources Information Center

    Pistole, M. Carole

    1996-01-01

    Examines the association of attachment organization and recalled grief responses following the dissolution of a romantic relationship. Data based on college students' (N=118) responses resulted in four interpretable grief themes. Preoccupied attachment predicted self-reproach, fearful attachment predicted partner blame, whereas both fearful and…

  8. Integrating Buddhist Psychology into Grief Counseling

    ERIC Educational Resources Information Center

    Wada, Kaori; Park, Jeeseon

    2009-01-01

    The field of grief counseling has yet to see an integration of Buddhist psychology. Drawing on Buddhist psychology literature and Western models of grief, this article explores possible integrations of two approaches. To lay the foundation for this discussion, the authors introduced a brief overview of the history of Buddhism as well as a Buddhist…

  9. Grief and Loss: A Social Work Perspective

    ERIC Educational Resources Information Center

    Simpson, Jennifer E.

    2013-01-01

    Despite the wealth of research that exists in the area of death, grief, and loss, the scarcity of literature examining the impact upon social work practitioners is troubling. This article initially draws upon a case study to explore this impact through the theoretical framework of disenfranchised grief. Further comment is made regarding the…

  10. The Child in Grief: Implications for Teaching.

    ERIC Educational Resources Information Center

    Hare, Jan; And Others

    The purpose of this paper is to increase teachers' understanding of children's conceptualizations of death to enable them to respond to the symptoms of grief in both early and middle childhood. John Bowlby's theoretical framework of childhood mourning is elaborated, and research on teachers' facilitation of children's grief is briefly noted. The…

  11. Grief Counseling: A Review of the Literature

    ERIC Educational Resources Information Center

    Daneker, Darlene; Cashwell, Craig

    2005-01-01

    Grief counseling has grown over the past two decades to become a well respected specialty within the field of counseling. This article examines books, articles, and literature developed by leading agencies in the field. Grief counseling is an interdisciplinary field focusing on the clinical aspects of working with individuals involved in dying and…

  12. The Grief Account: Dimensions of a Contemporary Bereavement Genre

    ERIC Educational Resources Information Center

    Dennis, Michael Robert

    2008-01-01

    The genre of the grief account is identified to include published narratives of surviving grief. Thematic analysis of Andrew Holleran's (2006) "Grief: A Novel," Lolly Winston's (2004) "Good Grief: A Novel," Joan Didion's (2005) "The Year of Magical Thinking," and J. Canfield and M. V. Hansen's (2003) "Chicken Soup for the Grieving Soul: Stories…

  13. Grief Counseling: An Investigation of Counselors' Training, Experience, and Competencies

    ERIC Educational Resources Information Center

    Ober, Anne M.; Granello, Darcy Haag; Wheaton, Joe E.

    2012-01-01

    Grief is prevalent in counseling, but little is known about the current status of counselors' preparation and competencies to provide effective care. This exploratory study surveyed counselors (N = 369) on grief training, personal and professional experiences with grief, and grief counseling competence. Multiple regression analyses found training…

  14. Helping Foster Parents Cope with Separation, Loss, and Grief.

    ERIC Educational Resources Information Center

    Edelstein, Susan B.; Burge, Dorli; Waterman, Jill

    2001-01-01

    Discusses ways foster parents encounter loss and grief in their foster care experiences. Considers factors that affect the intensity of the loss and the healthy expression and resolution of the foster parents' grief; problems that can result when grief is not properly addressed; and ways professionals can help these caregivers with grief issues.…

  15. Sense-Making, Grief, and the Experience of Violent Loss: Toward a Mediational Model

    ERIC Educational Resources Information Center

    Currier, Joseph M.; Holland, Jason M.; Neimeyer, Robert A.

    2006-01-01

    Bereavement following violent loss by accident, homicide or suicide increases the risk for complications in grieving. This is the first study to examine a constructivist model of grief that proposes that sense-making, or the capacity to construct an understanding of the loss experience, mediates the association between violent death and…

  16. Parents' Grief in the Context of Adult Child Mental Illness: A Qualitative Review

    ERIC Educational Resources Information Center

    Richardson, Meg; Cobham, Vanessa; Murray, Judith; McDermott, Brett

    2011-01-01

    Research indicates that parents and other family members often grieve their child or relative's mental illness. This grief appears resultant from a profound sense of loss, which has been described as complicated and nonfinite (e.g., Atkinson in "Am J Psychiatry" 151(8):1137-1139, 1994; Davis and Schultz in "Soc Sci Med" 46(3):369-379, 1998; Jones…

  17. The Man I Once Knew: Grief and Inflammation in Female Partners of Veterans With Traumatic Brain Injury.

    PubMed

    Saban, Karen L; Mathews, Herbert L; Collins, Eileen G; Hogan, Nancy S; Tell, Dina; Bryant, Fred B; Pape, Theresa Louise Bender; Griffin, Joan M; Janusek, Linda Witek

    2016-01-01

    Grief, although traditionally conceptualized as a bereavement-related reaction, is also experienced by significant others in response to the profound cognitive and personality changes associated with a traumatic brain injury (TBI) in a loved one. Grief associated with the death of a loved one is related to increases in proinflammatory cytokines, yet it is not clear whether this is the case for grief experienced by individuals caring for a significant other with TBI. The purpose of this cross-sectional, exploratory study was to examine grief and its association with a proinflammatory cytokine, tumor necrosis factor α (TNF-α), in wives/partners caring for veterans with TBI. Participants completed written measures of grief, perceived stress, and depressive symptoms and provided morning saliva samples for TNF-α analysis. Participants reported levels of grief comparable to those reported in studies evaluating individuals grieving the death of a loved one. Path analysis revealed that grief was not associated with TNF-α; however, participants reporting high levels of blame/anger, a subscale of the grief scale, had higher levels of TNF-α. In addition, both grief and blame/anger were related to increased perceived stress and depressive symptoms; however, path analysis demonstrated that perceived stress and depressive symptoms did not mediate the influence of blame/anger on TNF-α. These findings suggest that blame/anger associated with grief may be related to the elevations in TNF-α exhibited by individuals caring for a loved one with TBI. PMID:25636402

  18. Social and cultural factors associated with perinatal grief in Chhattisgarh, India.

    PubMed

    Roberts, Lisa R; Montgomery, Susanne; Lee, Jerry W; Anderson, Barbara A

    2012-06-01

    Stillbirth is a globally significant public health problem with many medical causes. There are also indirect causal pathways including social and cultural factors which are particularly salient in India's traditional society. The purpose of this study was to explore women's perceptions of stillbirth and to determine how issues of gender and power, social support, coping efforts, and religious beliefs influence perinatal grief outcomes among poor women in rural Chhattisgarh, India. Structured interviews were done face-to-face in 21 randomly selected villages among women of reproductive age (N=355) who had experienced stillbirth (n=178) and compared to those who had not (n=177), in the Christian Hospital, Mungeli catchment area. Perinatal grief was significantly higher among women with a history of stillbirth. Greater perinatal grief was associated with lack of support, maternal agreement with social norms, and younger maternal age. These predictors must be understood in light of an additional finding-distorted sex ratios, which reflect gender discrimination in the context of Indian society. The findings of this study will allow the development of a culturally appropriate health education program which should be designed to increase social support and address social norms, thereby reducing psychological distress to prevent complicated perinatal grief. Perinatal grief is a significant social burden which impacts the health women. PMID:21956647

  19. Perinatal Grief in Latino Parents

    PubMed Central

    Whitaker, Claudia; Kavanaugh, Karen; Klima, Carrie

    2013-01-01

    Extensive research exists that describes the meaning of perinatal loss to some parents, but the experience of loss from the perspective of Latino parents is not clearly understood. Additionally, current perinatal bereavement practices used often to facilitate memory-making for parents (such as viewing or holding the baby, taking photographs, or collecting mementos) are based upon research done primarily with non-Latino families. Are these common practices appropriate for this population? Because there is a paucity of research on this topic, this article describes what has been written over the past 30 years on the topic of grief and perinatal loss in Latino culture. PMID:20975393

  20. Identifying Prolonged Grief Reactions in Children: Dimensional and Diagnostic Approaches

    PubMed Central

    Melhem, Nadine M.; Porta, Giovanna; Payne, Monica Walker; Brent, David A.

    2013-01-01

    Objective Children with prolonged grief reactions (PGR) have been found to be at increased risk for depression and functional impairment. Identifying and diagnosing PGR in children is challenging, as there are no available dimensional measures with established thresholds and no diagnostic criteria in the DSM-IV. We examine thresholds for the Inventory for Complicated Grief–Revised for Children (ICG-RC) and compare this dimensional approach to the proposed DSM-5 criteria for Persistent Complex Bereavement-Related Disorder. We also identify a screening tool for PGR. Method Parentally bereaved children, 8–17 years of age, were assessed at 9, 21, and 33 months after parental death. Receiver Operator Characteristics were used to establish the “best threshold” that would identify children with PGR and evaluate the proposed DSM-5 criteria cross-sectionally and longitudinally. Results A score of 68 or higher on the ICG-RC was found to have high sensitivity (0.942) and specificity (0.965) in differentiating cases with PGR from noncases at 9 months. We also identify a 6-item screening tool that consists of longing and yearning for the deceased, inability to accept the death, shock, disbelief, loneliness, and a changed world view. The proposed DSM-5 criteria only correctly identified 20% to 41.7% of cases with PGR at different timepoints. Conclusions For the identification of youth at risk for PGR, the dimensional approach outperformed the proposed categorical diagnostic criteria. We propose a brief screening scale that, if validated, can help clinicians identify bereaved children at risk for PGR, and guide the development of prevention and intervention strategies. PMID:23702449

  1. Lament: giving words to nurses' grief.

    PubMed

    Lick, Renee C

    2012-01-01

    Nurses are intimately present with people who are seriously ill, suffering and dying--giving rise to the need to cry out and give words to personal pain and grief. Practicing a regular rhythm of lament to God as found in the psalms of the Bible can assist nurses in coping with grief and prepare them to continue to care for the hurting with God's strength and hope. PMID:22866376

  2. Patterns of grief reaction after pregnancy loss.

    PubMed

    Lin, S X; Lasker, J N

    1996-04-01

    Analysis of three waves of Perinatal Grief Scale scores for 194 bereaved subjects over the course of two years revealed patterns of change different from those commonly noted in the literature. Less than half the sample matched the "normal" model; the rest exhibited non-normal patterns that did not fit the alternative psychological models. Demographic variables and pregnancy history, both before and after the loss, help explain some of the differences in direction of the grief response. PMID:9173804

  3. Normal grief and its correlates in Lubumbashi, an urban city in the Democratic Republic of Congo

    PubMed Central

    Joe, Katabwa Kabongo; Mapatano, Mala Ali; Manyonga, Tshibangu; Mwadianvita, Costa Kazadi; Valérien, Mutombo; Stanis, Wembonyama; Kavulu, Mukendi; Espérance, Kashala

    2016-01-01

    Introduction Grief is a universal experience faced at one time or another by most people during their lives. Response to grief and bereavement losses can lead to psychiatric disorders such as mood disorders, post traumatic responses, insomnia loss of appetite, anxiety, and depression. The aim of our study is to value in our community the physical and psychological complications of a normal grief. Methods We conducted a cross-sectional study from March 2012 to September 2012 in Lubumbashi, Democratic Republic of Congo. Two questionnaires, the Hamilton Anxiety Scale and the Beck Depression Inventory scale were used as screening tool. A snow ball sampling method was performed and the questionnaires were administered only to those who consented to participate in the study. Results A total of 78 subjects were included in the study of which 87.2% were aged between 14-50 years old. The majority of the subjects were female 65.4%, and about a quarter (28%) was unemployed. The main correlates of the grief reported in the present study were being treated as witchcraft or accused to be responsible of a death (68%), being rejected by family and not being allowed to inherit (32%). Being homeless was reported in 26%. The main psychological symptoms reported were psychological distress after 1 year (65%) and related physical health problems after the death (72%). Depression and mild anxiety were the most reported disorders, with respectively 92.3% and 74.4% of the subjects. Conclusion Grief in Lubumbashi is associated with a large number of psychological, social and health problems. Health problems such as gastric is, high blood pressure were often reported. Being accused of witchcraft remains the main social impact. Depression and anxiety were the most psychological problem associated with grief.

  4. The effectiveness of Grief-Help, a cognitive behavioural treatment for prolonged grief in children: study protocol for a randomised controlled trial

    PubMed Central

    2013-01-01

    Background There is growing recognition of a syndrome of disturbed grief referred to as prolonged grief disorder (PGD). PGD is mostly studied in adults, but clinically significant PGD symptoms have also been observed in children and adolescents. Yet, to date no effective treatment for childhood PGD exists. The aims of this study are: (1) to investigate the effectiveness of Grief-Help, a nine-session cognitive-behavioural treatment for childhood PGD, combined with five sessions of parental counselling, immediately after the treatment and at three, six and twelve months follow-up; (2) to examine tentative mediators of the effects of Grief-Help, (i.e., maladaptive cognitions and behaviours and positive parenting), and (3) to determine whether demographic variables, child personality, as well as symptoms of PGD, anxiety, and depression in parents moderate the treatment effectiveness. Methods/Design We will conduct a Randomised Controlled Trial (RCT) in which 160 children and adolescents aged 8–18 years are randomly allocated to cognitive behavioural Grief-Help or to a supportive counselling intervention; both treatments are combined with five sessions of parental counselling. We will recruit participants from clinics for mental health in the Netherlands. The primary outcome measure will be the severity of Prolonged Grief Disorder symptoms according to the Inventory of Prolonged Grief for Children (IPG-C). Secondary outcomes will include PTSD, depression and parent-rated internalizing and externalizing problems. Mediators like positive parenting and maladaptive cognitions and behaviours will be identified. We will also examine possible moderators including demographic variables (e.g. time since loss, cause of death), psychopathology symptoms in parents (PGD, anxiety and depression) and child personality. Assessments will take place in both groups at baseline, after the treatment-phase and three, six and twelve months after the post-treatment assessment. Discussion We

  5. Brief Information on Childhood Traumatic Grief for School Personnel

    ERIC Educational Resources Information Center

    National Child Traumatic Stress Network, 2008

    2008-01-01

    This information sheet summarizes material found in the "In-Depth General Information Guide to Childhood Traumatic Grief" and "In-Depth Information on Childhood Traumatic Grief for School Personnel." Childhood traumatic grief is a condition that some children develop after the death of a close friend or family member. Children who develop…

  6. Residential Grief Camps: An Initial Phenomenological Study of Staff Perspectives

    ERIC Educational Resources Information Center

    Brown, Tiffany B.; Kimball, Thomas G.

    2012-01-01

    Research has focused primarily on the impact of death on family functioning and the stages and tasks of grief, though little attention has been given to grief camps or the experiences of those who work there. This study explored the experiences of staff at a four-day overnight children's grief camp. Eight participants reported their experience of…

  7. Childhood Traumatic Grief Educational Materials for School Personnel

    ERIC Educational Resources Information Center

    National Child Traumatic Stress Network, 2004

    2004-01-01

    This guide to childhood traumatic grief for school personnel builds on the "In-Depth General Information Guide to Childhood Traumatic Grief" and the "Brief Information on Childhood Traumatic Grief" and should be read in conjunction with them. This guide for school personnel pays special attention to the reactions and symptoms school personnel…

  8. A Preliminary Investigation of Factors Associated with Job Loss Grief

    ERIC Educational Resources Information Center

    Brewington, Janice O.; Nassar-McMillan, Sylvia C.; Flowers, Claudia P.; Furr, Susan R.

    2004-01-01

    This study investigated relationships among factors hypothesized as related to job loss grief. A summary grief score correlated positively with time since job loss and number of dependents, and negatively with length of notice. Perceived reemployment prospects and income loss related positively to some grief index subscales, as did the condition…

  9. Financial Perils in Higher Education--Good Grief!

    ERIC Educational Resources Information Center

    Shaw, Kenneth A.; Britton, Thomas C.

    The premise that institutions pass through a grief process in adjusting to declining resources and radical changes, is proposed. In addition, strategies that administrators can use to respond to institutional grief are suggested. Elisabeth Kubler-Ross's paradigm of five grief stages/reactions to serious loss are described: denial, anger,…

  10. Goodbye Therapy: Use of Imagery Techniques for Problematic Grief Intervention.

    ERIC Educational Resources Information Center

    Brown, James C.

    This document addresses the issue of problematic grief reactions, reactions which tend to be more common than are often realized and which may be a source of "existential" anxiety. It presents a treatment model which can be used with any loss-elicited grief reaction including the acute grief reaction typically encountered subsequent to the death…

  11. Anticipatory Grief and AIDS: Strategies for Intervening with Caregivers.

    ERIC Educational Resources Information Center

    Walker, Rebecca J.; And Others

    1996-01-01

    Anticipatory grief may have beneficial effects for caregivers of people with HIV infection or AIDS. Illness duration, stigmatization, and multiple losses may impede the caregiver's ability to effectively engage in the grief process, however. Discusses the impact of these aspects of the disease on the anticipatory grief process and mourning tasks…

  12. Tweeting Prayers and Communicating Grief over Michael Jackson Online

    ERIC Educational Resources Information Center

    Sanderson, Jimmy; Cheong, Pauline Hope

    2010-01-01

    Death and bereavement are human experiences that new media helps facilitate alongside creating new social grief practices that occur online. This study investigated how people's postings and tweets facilitated the communication of grief after pop music icon Michael Jackson died. Drawing on past grief research, religion, and new media studies, a…

  13. Grief and Elective Abortion: Breaking the Emotional Bond?

    ERIC Educational Resources Information Center

    Peppers, Larry G.

    1988-01-01

    Used maternal-infant bonding as theoretical framework to examine grief and elective abortion in 80 women who terminated their pregnancies either by vacuum aspiration, dilitation and evacuation, or intrauterine induction. Found grief associated with elective abortion to be symptomatically similar to grief experienced following involuntary…

  14. Latinos and Anglos: Cultural Experiences of Grief Intensity.

    ERIC Educational Resources Information Center

    Grabowski, Jo-Anne; Frantz, Thomas T.

    1993-01-01

    Examined grief intensity among 50 Latino and 50 Anglo Americans. Latinos grieving sudden death had significantly greater grief intensity than Latinos grieving expected death and Anglos grieving either sudden or expected death. Funeral attendance, time since death, closeness of relationships had no significant effect on grief intensity, nor did…

  15. Grief Shortly after Suicide and Natural Death: A Comparative Study among Spouses and First-Degree Relatives

    ERIC Educational Resources Information Center

    de Groot, M. H.; de Keijser, J.; Neeleman, J.

    2006-01-01

    Chronic dysfunction after complicated grief is not rare and emphasizes the need to identify bereaved individuals at risk. Three months following bereavement, self-reported psychiatric and general health of 153 relatives of 74 suicides was worse than of 70 relatives of 39 natural deaths. Moreover, the felt need for professional help was higher…

  16. Grief and attitudes toward suicide in peers affected by a cluster of suicides as adolescents.

    PubMed

    Abbott, Caroline H; Zakriski, Audrey L

    2014-12-01

    Eighty-five young adults exposed to a cluster of peer suicides as adolescents completed measures of attitudes toward suicide, grief, and social support. Closeness to the peers lost to suicide was positively correlated with grief and the belief that suicide is not preventable, with grief further elevated in close individuals with high social support from friends. Overall, social support was related to healthy attitudes about suicide including preventability, yet it was also related to some stigmatizing beliefs. Compared with 67 young adults who had not been exposed to a suicide cluster, the exposed sample was more likely to think that suicide is normal but more likely to think of it as incomprehensible. PMID:24806293

  17. Childhood Traumatic Grief: A Multi-Site Empirical Examination of the Construct and Its Correlates

    ERIC Educational Resources Information Center

    Brown, Elissa J.; Amaya-Jackson, Lisa; Cohen, Judith; Handel, Stephanie; De Bocanegra, Heike Thiel; Zatta, Eileen; Goodman, Robin F.; Mannarino, Anthony

    2008-01-01

    This study evaluated the construct of childhood traumatic grief (CTG) and its correlates through a multi-site assessment of 132 bereaved children and adolescents. Youth completed a new measure of the characteristics, attributions, and reactions to exposure to death (CARED), as well as measures of CTG, posttraumatic stress disorder (PTSD),…

  18. Childhood Traumatic Grief: An Exploration of the Construct in Children Bereaved on September 11

    ERIC Educational Resources Information Center

    Brown, Elissa J.; Goodman, Robin F.

    2005-01-01

    This study is an exploration of the measurement and correlates of childhood traumatic grief (CTG). Eighty-three children of uniformed service personnel who died during the World Trade Center attack on September 11, 2001, were assessed using measures of demographic characteristics, trauma exposure (physical proximity, emotional proximity, and…

  19. Prolonged grief disorder and depression in a German community sample.

    PubMed

    Schaal, Susanne; Richter, Anne; Elbert, Thomas

    2014-01-01

    The aims of this study were to examine rates and risk factors for prolonged grief and to investigate the association between prolonged grief and depression. The authors interviewed a heterogeneous bereaved sample of 61 Germans, 6 of whom had prolonged grief and depression, respectively. The 2 syndromes were strongly linked to one another. Risk factors for prolonged grief were being a woman and having high levels of religious beliefs and low levels of satisfaction with one's religious beliefs, emotional closeness to the deceased, and unanticipated loss. Symptoms of prolonged grief may endure years post-loss and often overlap with depression. PMID:24758218

  20. Pediatric nurses' grief experience, burnout and job satisfaction.

    PubMed

    Adwan, Jehad Z

    2014-01-01

    Correlations among grief, burnout, and job satisfaction among highly satisfied pediatric nurses were examined using the Revised Grief Experience Inventory (RGEI), Maslach Burnout Inventory (MBI), and Index of Work Satisfaction (IWS). Results showed that grief had significant correlations; positive with burnout, negative with job satisfaction. RN's reported significantly higher emotional exhaustion if their primary patients died and higher guilt if patients died younger. Conclusions suggest a dynamic statistical interaction among nurses' grief, burnout, and job satisfaction representing a pathway to intention to leave their unit, organization, or nursing. Recommendations include implementation and evaluation of grief intervention and education programs. PMID:24582646

  1. Grief following pet and human loss: Closeness is key.

    PubMed

    Eckerd, Lizabeth M; Barnett, James E; Jett-Dias, Latishia

    2016-01-01

    The authors compared grief severity and its predictors in two equivalent college student samples who had experienced the death of a pet (n = 211) or a person (n = 146) within the past 2 years. The human death sample reported higher grief severity, p < .01, but effect sizes were small (ds = .28-.30). For both samples, closeness to the deceased was overwhelmingly the strongest predictor of grief severity; other predictors generally dropped out with closeness added to the model. Results highlight the importance of including closeness to deceased in grief research, and its centrality in understanding grief counseling clients. PMID:26766186

  2. Grief, consolation, and religions: a conceptual framework.

    PubMed

    Klass, Dennis

    2014-01-01

    Consolation is grief's traditional amelioration, but contemporary bereavement theory lacks a conceptual framework to include it. The article begins to develop that framework. The article argues that grief is inter-subjective, even at the biological level. Consolation and grief happen in the same inter-subjective space. Material from the histories of several religions sets the article in a cross-cultural and historical environment. The article examines consolation in interpersonal relationships, and then moves to consolation in cultural/religious resources that range from the literal image of God as an idealized parent to the abstract architecture of Brahm's Requiem. The most common consolation in the histories of religions comes within continuing bonds that are accessed in a wide variety of beliefs, rituals, and devotional objects. The article closes by briefly drawing the connection between consolation and faith. PMID:25084706

  3. The physician executive and professional grief.

    PubMed

    Gill, S L

    1989-01-01

    With the introduction of competitive forces and concommitant changes in health care reimbursement programs, physicians are experiencing profound disruption in their personal expectations and career plans. This article proposes that the loss of established professional traditions is no different, in terms of emotional and psychological impact, than the loss of a loved one. Thus, many physicians may need to complete grief work before they can functionally adapt to contemporary realities. The dynamics of loss, grief work, and functional adaptation are discussed, along with recommendations for supportive interventions to help individuals adjust to a competitive health care environment. PMID:10316379

  4. Grief Experiences and Expectance of Suicide

    ERIC Educational Resources Information Center

    Wojtkowiak, Joanna; Wild, Verena; Egger, Jos

    2012-01-01

    Suicide is generally viewed as an unexpected cause of death. However, some suicides might be expected to a certain extent, which needs to be further studied. The relationships between expecting suicide, feeling understanding for the suicide, and later grief experiences were explored. In total, 142 bereaved participants completed the Grief…

  5. Continuing Bonds and Grief: A Prospective Analysis

    ERIC Educational Resources Information Center

    Boelen, Paul A.; Stroebe, Margaret S.; Schut, Henk A. W.; Zijerveld, Annemieke M.

    2006-01-01

    Using data of 56 bereaved individuals, this study examined associations of various manifestations of continuing bonds, assessed at 7-12 months post-loss, with concurrent and prospective (9 months later) symptoms of grief and depression. Among other things it was found that, independent of initial symptom levels, manifestations of continuing bonds…

  6. Grief as a Social Emotion: Theoretical Perspectives

    ERIC Educational Resources Information Center

    Jakoby, Nina R.

    2012-01-01

    The article explores a sociological perspective on grief as a social emotion. Focusing on the social bond with the deceased, the self-concept of the survivor or the power of feeling rules, general sociological theories of emotions (symbolic interactionism, structural theory, behavioral theory) have the potential to deepen the understanding of…

  7. Treating Childhood Traumatic Grief: A Pilot Study.

    ERIC Educational Resources Information Center

    Cohen, Judith A.; Mannarino, Anthony P.; Knudsen, Kraig

    2004-01-01

    Objective: To examine the potential efficacy and specific timing of treatment response of individual child and parent trauma-focused cognitive-behavioral therapy for childhood traumatic grief (CTG), a condition in which trauma symptoms impinge on the child's ability to successfully address the normal tasks of grieving. Method: Twenty-two children…

  8. Grief and loss in the workplace.

    PubMed

    Albert, P L

    2001-09-01

    Throughout history, death and loss have given rise to social ceremonies and commemorative activities that note the death, recognize the place the person occupied in society, and assist the bereaved through the process of grief. Each culture faces death with its own definition of "appropriate" social-emotional reactions, and when death occurs, it provides the occasion for socially conditioned grief reactions and mourning practices. Historically, such practices have incorporated a set of interrelated people, the majority of whom were very knowledgeable of the customs and their purposes. In such a setting, it was possible for close kin, friends, distant kin, and acquaintances to come together to share their loss and grief. However, people may experience a loss that does not fit a socially recognized and sanctioned role. Grief for these people may have to remain private. Although they may have experienced an intense loss, personally or professionally, they may not be given time off from work or have the opportunity to talk about the meaning of their loss. In our modern, compartmentalized society, social ceremonies and commemorative activities tend to be limited primarily to a small circle of the "proper" bereaved individuals. This separation has helped to create a subset of grievers whose legitimacy may not be recognized by society as a whole and whose needs are often not addressed. PMID:11949458

  9. Coping with Your Loss and Grief.

    ERIC Educational Resources Information Center

    Oregon State Univ., Corvallis. Cooperative Extension Service.

    This guide offers advice to help people cope with a variety of losses, including losses associated with divorce, retirement, relocation, disability, or illness, and the loss of a pet, financial security, independence, or control and decision making. It discusses what one can expect when one suffers a loss and how to handle grief. Common reactions…

  10. Grief and Horses: Putting the Pieces Together

    ERIC Educational Resources Information Center

    Symington, Ashley

    2012-01-01

    The effectiveness of grief counseling may be enhanced through the utilization of equine-assisted psychotherapy (EAP). An experiential, solution-focused, and natural approach, EAP provides clients with the opportunity to discover solutions to challenges that exist within themselves. Counselors and equine specialists team with horses to provide a…

  11. Grief among Healthcare Workers: A Comparative Study.

    ERIC Educational Resources Information Center

    Lerea, L. Eliezer; LiMauro, Barbara F.

    1982-01-01

    Examined the prevalence and nature of grief in response to patient suffering, loss, or death among healthcare workers. Skilled nursing facility personnel remembered experiencing bereavement in response to crises of their geriatric patients. Mourning occurred among virtually all general hospital personnel who usually serve younger patients. (Author)

  12. A randomized open trial assessing the feasibility of behavioral activation for pathological grief responding.

    PubMed

    Papa, Anthony; Sewell, M Todd; Garrison-Diehn, Christina; Rummel, Clair

    2013-12-01

    This study investigated the feasibility of using behavioral activation to treat enduring postbereavement mental health difficulties using a two-arm, multiple baseline design comparing an immediate start group to a delayed start group at baseline, 12-, 24-, and 36-weeks postrandomization. Participants received 12-14 sessions of behavioral activation within a 12-week intervention period starting immediately after the first assessment or after 12weeks for the delayed start group. Prolonged grief, posttraumatic stress, and depression symptoms were assessed as outcomes. Compared with no treatment, behavioral activation was associated with large reductions in prolonged, complicated, or traumatic grief; posttraumatic stress disorder; and depression symptoms in the intent-to-treat analyses. Seventy percent of the completer sample at posttreatment and 75 percent at follow-up responded to treatment with 45 percent at posttreatment and 40 percent at follow-up being classified as evidencing high-end state functioning at 12-week follow-up. PMID:24094789

  13. Non-invasive measurement of skin autofluorescence to evaluate diabetic complications.

    PubMed

    Yamanaka, Mikihiro; Matsumura, Takeshi; Ohno, Rei-Ichi; Fujiwara, Yukio; Shinagawa, Masatoshi; Sugawa, Hikari; Hatano, Kota; Shirakawa, Jun-Ichi; Kinoshita, Hiroyuki; Ito, Kenji; Sakata, Noriyuki; Araki, Eiichi; Nagai, Ryoji

    2016-03-01

    Although the accumulation of advanced glycation end-products (AGEs) of the Maillard reaction in our body is reported to increase with aging and is enhanced by the pathogenesis of lifestyle-related diseases such as diabetes, routine measurement of AGEs is not applied to regular clinical diagnoses due to the lack of conventional and reliable techniques for AGEs analyses. In the present study, a non-invasive AGEs measuring device was developed and the association between skin AGEs and diabetic complications was evaluated. To clarify the association between the duration of hyperglycemia and accumulation of skin fluorophores, diabetes was induced in mice by streptozotocin. As a result, the fluorophore in the auricle of live mice was increased by the induction of diabetes. Subsequent studies revealed that the fingertip of the middle finger in the non-dominant hand is suitable for the measurement of the fluorescence intensity by the standard deviation value. Furthermore, the fluorescence intensity was increased by the presence of diabetic microvascular complications. This study provides the first evidence that the accumulation of fluorophore in the fingertip increases with an increasing number of microvascular complications, demonstrating that the presence of diabetic microvascular complications may be predicted by measuring the fluorophore concentration in the fingertip. PMID:27013780

  14. Non-invasive measurement of skin autofluorescence to evaluate diabetic complications

    PubMed Central

    Yamanaka, Mikihiro; Matsumura, Takeshi; Ohno, Rei-ichi; Fujiwara, Yukio; Shinagawa, Masatoshi; Sugawa, Hikari; Hatano, Kota; Shirakawa, Jun-ichi; Kinoshita, Hiroyuki; Ito, Kenji; Sakata, Noriyuki; Araki, Eiichi; Nagai, Ryoji

    2016-01-01

    Although the accumulation of advanced glycation end-products (AGEs) of the Maillard reaction in our body is reported to increase with aging and is enhanced by the pathogenesis of lifestyle-related diseases such as diabetes, routine measurement of AGEs is not applied to regular clinical diagnoses due to the lack of conventional and reliable techniques for AGEs analyses. In the present study, a non-invasive AGEs measuring device was developed and the association between skin AGEs and diabetic complications was evaluated. To clarify the association between the duration of hyperglycemia and accumulation of skin fluorophores, diabetes was induced in mice by streptozotocin. As a result, the fluorophore in the auricle of live mice was increased by the induction of diabetes. Subsequent studies revealed that the fingertip of the middle finger in the non-dominant hand is suitable for the measurement of the fluorescence intensity by the standard deviation value. Furthermore, the fluorescence intensity was increased by the presence of diabetic microvascular complications. This study provides the first evidence that the accumulation of fluorophore in the fingertip increases with an increasing number of microvascular complications, demonstrating that the presence of diabetic microvascular complications may be predicted by measuring the fluorophore concentration in the fingertip. PMID:27013780

  15. The "How" and "When" of Parental Loss in Adulthood: Effects on Grief and Adjustment.

    PubMed

    Hayslip, Bert; Pruett, Jessica H; Caballero, Daniela M

    2015-01-01

    In order to evaluate the role of cause of death on the grief responses of parentally bereaved young and middle-aged adults, 400 individuals completed measures assessing their experiences and feelings surrounding the loss of a parent. Respondents included 247 young adults and 155 middle-aged adults. Cause of death was categorized as acute or anticipated with 209 participants reporting the parent's death as acute, while anticipated death was reported by 191 individuals. Results suggested that gender of the adult child and age level of the participant were important factors contributing to the grief response, and women were found to have more difficulty adjusting to the loss of a parent as well as demonstrating a more intense grief response. Young adults were found to be more impacted by the loss of a parent than were middle-aged adults. Those who were single or separated were similarly more impacted versus those who were married, where more young adults were single/separated and more middle-aged adults were married. Cause of death was only mildly influential in influencing responses to parental loss and did not interact with other studied variables. These results point to the importance of support from others in coping with a parent's death as well as for the counseling of bereaved persons who may be at risk for difficulties in coping with the death of a parent and enable a more precise understanding of individual grief processes across the adult lifespan. PMID:26152024

  16. Factors associated with grief and depression following the loss of a child: a multivariate analysis.

    PubMed

    Harper, Mairi; O'Connor, Rory C; O'Carroll, Ronan E

    2014-01-01

    The present study aims to explore the factors which are associated with grief and depression outcomes in a group of bereaved parents in the first few years following the loss of a child. Sixty-four participants were recruited from bereavement support organisations, between two and 59 months post loss, mean 30 months (SD = 15). They completed a questionnaire packet which comprised standard instruments measuring grief, depression, coping styles, continuing bonds and optimism/pessimism, as well as a number of specific bereavement-related questions. Univariate analyses were conducted to establish which factors were associated with grief and depression. Those which were statistically significant were then entered into multivariate analyses to establish their relative importance. High levels of avoidance and depression and lower levels of cognitive restructuring (benefit finding) were associated with higher grief symptoms, whereas higher levels of avoidance and alcohol/substance use were associated with higher depression symptoms. The present study highlights the relative importance of different coping strategies adopted by this group of bereaved parents, compared to the relative unimportance of circumstances around the loss, e.g. sudden or violent death. The use of alcohol and other substances by bereaved parents requires urgent attention as a potentially life-threatening maladaptive coping strategy. The call for further research into risk factors for bereaved parents is emphasised. PMID:23802736

  17. Distinctiveness of prolonged grief disorder symptoms among survivors of the Great East Japan Earthquake and Tsunami.

    PubMed

    Tsutsui, Takumi; Hasegawa, Yukako; Hiraga, Masashi; Ishiki, Mikihito; Asukai, Nozomu

    2014-06-30

    Prolonged Grief Disorder (PGD) has been proposed for diagnostic classification as an independent psychiatric disorder. Previous research has investigated it in relation to other axis I disorders in order to determine whether it could be considered an independent nosological entity. The distinctiveness of this condition was apparent in cases of ordinary bereavement and in those following human-made disasters. However, this disorder may be expanded to include bereavement resulting from natural disasters. The present study aims to explore the differences between this disorder and posttraumatic stress disorder or major depressive disorder as experienced after the Great East Japan Earthquake and Tsunami. The subjects were 82 hospital workers. Each type of disorder was assessed by means of the Inventory of Complicated Grief, the Impact of Event Scale-Revised, and the Center for Epidemiological Studies Depression Scale. Exploratory factor analysis showed 3 dimensions, with PGD items independently clustering in the same dimension. Our findings support the uniqueness of PGD even in a post-natural disaster situation in a non-Western culture and warrant grief intervention for high-risk bereaved survivors. PMID:24661977

  18. Live Discharge from Hospice and the Grief Experience of Dementia Caregivers.

    PubMed

    Wladkowski, Stephanie P

    2016-01-01

    When an individual has dementia, family members are involved in many care transitions in their roles as caregivers. One such transition is the 'live' discharge from hospice services. This occurs when an individual no longer meets eligibility criteria. This can be difficult for caregivers who have been anticipating an end to understand in the context of their grief process. This qualitative study (N = 24) explored the experience of caregivers of adults with dementia, including Alzheimer's disease, who experienced a 'live' discharge from hospice. Specifically, the experience of grief is examined. Results from this study highlight the complexity of caring for someone with a terminal disease and the grief experience in end-of-life care as caregivers struggle to understand the individual's terminal prognosis as temporary. This is further complicated for caregivers who must resume caregiving responsibilities or assume a new caregiving role after experiencing a loss of hospice services. Finally, hospice social workers are well positioned to offer emotional and other concrete support to caregivers who experience a 'live' discharge. PMID:27143573

  19. Disenfranchised grief: the loss of an adolescent romantic relationship.

    PubMed

    Kaczmarek, M G; Backlund, B A

    1991-01-01

    This paper identifies the conclusion of a romantic relationship as a significant loss for adolescents. The grief response initiated by this loss is frequently disenfranchised by adults and peers. Adolescent grief symptomatology as well as strategies for surviving a loss are outlined. PMID:1927658

  20. Rhetorical Dimensions of the Post-September Eleventh Grief Process

    ERIC Educational Resources Information Center

    Schwartzman, Roy; Tibbles, David

    2005-01-01

    This essay examines Presidential rhetoric and popular culture practices in light of the stages of grief enumerated by Elisabeth Kubler-Ross. The authors find a consistent retrenchment of grief into the anger phase, where the pain of losing national invulnerability is transferred to externalized aggression. Reconciliation is suggested by means of…

  1. Strengthening Grief Support for Children with Developmental Disabilities

    ERIC Educational Resources Information Center

    Sormanti, Mary; Ballan, Michelle S.

    2011-01-01

    Although a sizable literature investigates and describes children's grief, the majority of information focuses on typically developing children. Far less has been published about the loss and grief of children with developmental disabilities (DD), even though this population experiences significant and multiple losses, increasing their…

  2. Grief and Loss Education: Recommendations for Curricular Inclusion

    ERIC Educational Resources Information Center

    Doughty Horn, Elizabeth A.; Crews, Judith A.; Harrawood, Laura K.

    2013-01-01

    Currently, the Council for Accreditation of Counseling and Related Educational Programs (2009) does not require course work on grief and loss, and it is possible for counselors to practice without any formal training in the area. The purpose of this article is to highlight the need for additional grief and loss education in the curriculum, provide…

  3. Resolving Child and Adolescent Traumatic Grief: Creative Techniques and Interventions

    ERIC Educational Resources Information Center

    Edgar-Bailey, Meredith; Kress, Victoria E.

    2010-01-01

    This article presents a review of creative interventions that can be helpful in facilitating the resolution of traumatic grief in children and adolescents. Traumatic grief is conceptualized as a condition in which a person loses a close loved one (e.g., a parent or a sibling) in a traumatic manner, and ensuing trauma-related symptoms disrupt the…

  4. Coping with Grief: Guidelines and Resources for Assisting Children

    ERIC Educational Resources Information Center

    Heath, Melissa Allen; Leavy, Deon; Hansen, Kristina; Ryan, Katherine; Lawrence, Lacey; Sonntag, Amy Gerritsen

    2008-01-01

    This article provides basic information for school-based mental health professionals, teachers, staff, and administrators to support students coping with grief, and more specifically, grief related to death. The information is consolidated into guidelines and key points in providing support; suggested children's books and activities; Web sites…

  5. Supporting Students with Autism Spectrum Disorder through Grief and Loss

    ERIC Educational Resources Information Center

    Hume, Kara; Regan, Tara; Megronigle, Laura; Rhinehalt, Charlene

    2016-01-01

    All student populations require support from school staff during times of grief and loss. The grief process is highly personalized and depends on multiple factors, including the type of bond and relationship with the person, the student's prior experience of loss, and the age and developmental stage of the student (Quinn-Lee, 2014). Grief…

  6. Continuing Relationships with the Deceased: Disentangling Bonds and Grief

    ERIC Educational Resources Information Center

    Schut, Henk A. W.; Stroebe, Margaret S.; Boelen, Paul A.; Zijerveld, Annemieke M.

    2006-01-01

    Some studies of the relationship between continuing bonds and grief intensity have claimed that continuing bonds lead to poor adaptation to bereavement. However, operationalizations of continuing bonds and grief intensity appear to overlap conceptually. Thus, it is still unclear what character the connection between continuing bonds and grief…

  7. Grief Counseling Groups in a Medium-Security Prison

    ERIC Educational Resources Information Center

    Olson, Margaret J.; McEwen, Margaret A.

    2004-01-01

    The authors discuss their facilitation of four grief counseling groups with male inmates in a state prison over a two-year period. Worden's Tasks of Mourning were used as a guide for the group process. Disenfranchised grief and gender and cultural issues in grieving are explored. Catalytic exercises are described, and written feedback from inmates…

  8. Personal Fear of Death and Grief in Bereaved Mothers

    ERIC Educational Resources Information Center

    Barr, Peter; Cacciatore, Joanne

    2008-01-01

    The study explored the relation of fear of death (Multidimensional Fear of Death Scale) to maternal grief (Perinatal Grief Scale-33) following miscarriage, stillbirth, neonatal death, or infant/child death. The 400 women participants were recruited from the website, e-mail lists, and parent groups of an organization that supports bereaved parents.…

  9. John Bowlby's Model of Grief and the Problem of Identification.

    ERIC Educational Resources Information Center

    Klass, Dennis

    1988-01-01

    Asserts that John Bowlby's model of grief is inadequate to account for phenomena associated with most grief. Also examines work of Freud and the Freudians, and works of Parkes, Raphael, and Worden. Suggests possible modifications in the Bowlby model by reviewing the work of Attig, Lopata, and Marris. (Author/NB)

  10. Use of Puppets to Treat Traumatic Grief: A Case Study.

    ERIC Educational Resources Information Center

    Carter, Stephanie R.

    1987-01-01

    Presents the case study of a 10-year-old boy treated for grief following the traumatic witnessing of his father's murder. Describes using nondirective play therapy with puppets to help the child work out feelings of guilt, anger, and grief. (ABB)

  11. The Grief Grapevine: Facebook Memorial Pages and Adolescent Bereavement

    ERIC Educational Resources Information Center

    Frost, Mardi

    2014-01-01

    How adolescents use the social networking site Facebook to express grief is a growing area of research. In reviewing current literature, it is evident that many questions still remain unanswered. Additionally, this ever-evolving platform for grief, mourning and bereavement may hold many implications for educators, policy developers and school…

  12. Radical Acceptance: A Nondual Psychology Approach to Grief and Loss

    ERIC Educational Resources Information Center

    Theriault, Brian

    2012-01-01

    This article explores the application of nondual psychology in transforming grief and loss into the experience of nondual consciousness. Nondual consciousness is the collapse of the dualistic notions of self and other through the direct realization of the stateless state of no-self. The experience of grief and loss serves as a catalyst to this…

  13. Post-Abortion Counseling: Helping To Heal the Grief.

    ERIC Educational Resources Information Center

    Tentoni, Stuart C.

    A university health center has experienced an increase in the number of women undergoing elective abortion which resulted in their seeking counseling services to assist them in dealing with overwhelming feelings of guilt and grief. The loss of a pregnancy is often followed by a typical grief reaction that occurs after any bereavement. In working…

  14. "It May Not Be Pretty, but It's Honest": Examining Parental Grief on the Callapitter Blog

    ERIC Educational Resources Information Center

    DeGroot, Jocelyn M.; Carmack, Heather J.

    2013-01-01

    Following the death of a child, parents are turning to alternative means of communication to express their grief. In this instrumental case study, the authors explore how 1 woman, Amy Ambrusko, communicates her grief experience on her blog, emotionally negotiating loss and parental grief. Guided by M. S. Miles's (1984) parental grief model, the…

  15. A Short-Term Grief and Loss Therapy Group: Group Members' Experiences.

    ERIC Educational Resources Information Center

    Toth, Paul L.

    1997-01-01

    Reports on an evaluative study of a short-term grief and loss therapy group (N=5) conducted at a university's counseling center. Examines brief group psychotherapy and grief-related factors. Student scores on a grief instrument showed mixed results, with most grief scores remaining stable or dropping. (RJM)

  16. Three-dimensional measurement of small mechanical parts under a complicated background based on stereo vision

    SciTech Connect

    Ren Zhiguo; Liao Jiarui; Cai Lilong

    2010-04-01

    We present an effective method for the accurate three-dimensional (3D) measurement of small industrial parts under a complicated noisy background, based on stereo vision. To effectively extract the nonlinear features of desired curves of the measured parts in the images, a strategy from coarse to fine extraction is employed, based on a virtual motion control system. By using the multiscale decomposition of gray images and virtual beam chains, the nonlinear features can be accurately extracted. By analyzing the generation of geometric errors, the refined feature points of the desired curves are extracted. Then the 3D structure of the measured parts can be accurately reconstructed and measured with least squares errors. Experimental results show that the presented method can accurately measure industrial parts that are represented by various line segments and curves.

  17. Good Grief: The Part of Arts in Healing Loss and Grief

    ERIC Educational Resources Information Center

    Buser, Trevor J.; Buser, Juleen K.; Gladding, Samuel T.

    2005-01-01

    This manuscript considers the way that several creative media--including music, videography, visual arts, literature, drama, play, and altar-making--can be utilized in assisting the multifaceted grief process of clients. In particular, attention is given to the ability of creative media to enable clients to maintain a connection to the deceased,…

  18. Helping Children in Times of Need: Grief, Loss, Separation & Divorce. A Handbook for Parents Assisting Children through Grief and Loss.

    ERIC Educational Resources Information Center

    Parker, Judith A.

    Although a world of uncertainty and continual change is difficult to explain to children, by exploring and discussing the process of grief, parents can begin to understand the significance and necessity of the grief process and help their children to cope with difficult events. This booklet offers parents advice on how to talk with children about…

  19. Application of adaptive optics in complicated and integrated spatial multisensor system and its measurement analysis

    NASA Astrophysics Data System (ADS)

    Ding, Quanxin; Guo, Chunjie; Cai, Meng; Liu, Hua

    2007-12-01

    Adaptive Optics Expand System is a kind of new concept spatial equipment, which concerns system, cybernetics and informatics deeply, and is key way to improve advanced sensors ability. Traditional Zernike Phase Contrast Method is developed, and Accelerated High-level Phase Contrast Theory is established. Integration theory and mathematical simulation is achieved. Such Equipment, which is based on some crucial components, such as, core optical system, multi mode wavefront sensor and so on, is established for AOES advantageous configuration and global design. Studies on Complicated Spatial Multisensor System Integratation and measurement Analysis including error analysis are carried out.

  20. Grief and Women: Stillbirth in the Social Context of India

    PubMed Central

    Roberts, Lisa R.; Anderson, Barbara A.; Lee, Jerry W.; Montgomery, Susanne B.

    2015-01-01

    INTRODUCTION Few in Western society would argue the potentially devastating impact of stillbirth related grief; but in many developing countries where stillbirth remains the highest in the world, perinatal grief is barely recognized as an issue. The purpose of this study was to explore how poor, rural central Indian women perceive and cope with stillbirths. METHODS Seventeen key informant interviews and two focus groups (N = 33) with local health care providers, family members, and women who experienced stillbirth were conducted over a 1-month period in 2011 and then systematically coded for emerging themes using grounded theory methods to explore how women experienced stillbirth. RESULTS Although usually never talked about and not recognized as an issue, perinatal grief emerged as a significant shared experience by all. The perceptions of stillbirth-related grief emerged in three major themes and bear evidence of gender and power issues and indicate that local social norms negatively factor heavily into their perinatal grief experiences. DISCUSSION The findings in this richly textured study add to the limited literature regarding rural, central Indian women's experiences with stillbirth and factors influencing their resulting perinatal grief. In light of the void of recognition of this phenomenon in Indian society, a better understanding of the context in which poor Indian women experience perinatal grief will be a first step toward developing much needed culturally rooted interventions to positively impact the women's abilities to better cope with stillbirth in the context of their realities. PMID:26594592

  1. Long-Term Effects of the Family Bereavement Program on Multiple Indicators of Grief in Parentally Bereaved Children and Adolescents

    ERIC Educational Resources Information Center

    Sandler, Irwin N.; Ma, Yue; Tein, Jenn-Yun; Ayers, Tim S.; Wolchik, Sharlene; Kennedy, Cara; Millsap, Roger

    2010-01-01

    Objectives: This article reports on results from a randomized experimental trial of the effects of the Family Bereavement Program (FBP) on multiple measures of grief experienced by parentally bereaved children and adolescents over a 6-year period. Method: Participants were 244 youths (ages 8-16, mean age = 11.4 years) from 156 families that had…

  2. The grief experience of prison inmate hospice volunteer caregivers.

    PubMed

    Supiano, Katherine P; Cloyes, Kristin G; Berry, Patricia H

    2014-01-01

    Correctional institutions are obligated to provide end-of-life care to a population with complex medical needs. Prison hospices are increasingly being formed to address this demand. Few empirical studies have examined the impact of caring for dying inmates on the hospice inmate volunteers, who, in several prison health care systems, provide direct care. In this study, experiences of the inmate hospice volunteers with death were investigated to illuminate their grief processes. Understanding the bereavement needs of hospice volunteers and how prison hospice volunteers navigate grief and remain committed to providing excellent hospice care can inform the grief processes and practices of hospice care professionals. PMID:24628143

  3. Anticipatory grief in patients with cancer.

    PubMed

    Hottensen, Dory

    2010-02-01

    Patients and their loved ones often experience anticipatory grief when learning of a diagnosis of advanced or terminal cancer. Anticipatory grief can be a response to threats of loss of ability to function independently, loss of identity, and changes in role definition, which underlie fear of death. Dealing with multiple losses is a primary task that the dying patient must face. When an oncologist delivers bad news, the patient and family members often hear the same discussion through different filters, which can lead to conflict and dysfunction. By providing a supportive and safe environment, oncology nurses can help patients and their loved ones understand that their feelings are common and are experienced by others in similar situations and assist them with developing coping strategies and in redefining their roles within the family and in the outside world. In addition, an important goal at this time is to help the patients reframe "hope" realistically so they may have the opportunity for personal growth as well as reconciliation of primary relationships toward the end of life. PMID:20118035

  4. Measurement of gait speed in older adults to identify complications associated with frailty: A systematic review.

    PubMed

    Pamoukdjian, Frederic; Paillaud, Elena; Zelek, Laurent; Laurent, Marie; Lévy, Vincent; Landre, Thierry; Sebbane, Georges

    2015-11-01

    Several frailty screening tests in older cancer patients were developed but their statistical performance is low. We aimed to assess whether measurement of usual gait speed (GS) alone could be used as a frailty screening test in older cancer patients. This systematic review was conducted on "pub med" between 1984 and 2014 and included reviews and original studies. Eligibility criteria were: GS over a short distance, alone or included in composite walking tests (Timed Get Up and Go test: TGUG, Short Physical Performance Battery: SPPB) in older people (aged 65 and over) living in a community setting and predictive value of GS on medical complications associated with frailty. 46 articles were finally selected. GS alone is consensual and recommended for screening sarcopenia in elderly. A slow GS is predictive of early death, disability, falls and hospitalization/institutionalization in older people living in a community setting. GS alone is comparable to composite walking tests that do not provide additional information on the medical complications associated with frailty. Despite few studies in geriatric oncology, GS seems to predict overall survival and disability. We suggest GS over 4m (at a threshold of 1m/s) as a new frailty screening test in older cancer patients (65 and over) to guide the implementation of a comprehensive geriatric assessment during the initial management phase or during follow-up. Prospective cohort studies are needed to validate this algorithm and compare it with other screening tool. PMID:26362356

  5. Predictors of grief in bereaved family caregivers of person's with Alzheimer's disease: a prospective study.

    PubMed

    Romero, Melissa M; Ott, Carol H; Kelber, Sheryl T

    2014-01-01

    The purpose of this prospective study was to identify factors in 66 spouses and adult child caregivers of person's with Alzheimer's disease prior to the death that predicted higher levels of grief in bereavement. A hierarchical regression model was tested. Predeath grief, dysfunctional coping, depression, social support, and decreased positive states of mind explained 54.7% of the variance in postdeath grief. Factors that contributed significantly to postdeath grief included predeath grief and depression. Results from this study indicate that risk factors for postdeath grief can be predicted prior to the death. PMID:24666146

  6. The grief response to mid-trimester fetal loss.

    PubMed

    Lindberg, C E

    1992-06-01

    This descriptive study examines the grief response of mothers who experienced a fetal loss in the middle trimester of pregnancy. Twenty mothers who lost a baby through spontaneous abortion or perinatal death within 1 year participated in this study. Data were collected by mailed questionnaires. All characteristics typical of the grief response were identified, including despair, anger or hostility, guilt, loss of control, rumination, depersonalization, somatization, and death anxiety. Comparison of the study population to a group of parents who suffered the loss of a child and to a group of women who had suffered the death of a close relative demonstrated that the study group presented a grief response similar in nature and intensity to the two normative groups. This study supports previous studies that indicated the existence of grief after mid-trimester fetal loss. Replication of this study with a larger sample is recommended to further support these findings. PMID:1522436

  7. Efficacy of metacognitive therapy for prolonged grief disorder: protocol for a randomised controlled trial

    PubMed Central

    Wenn, Jenine; O'Connor, Moira; Breen, Lauren J; Kane, Robert T; Rees, Clare S

    2015-01-01

    Introduction Studies of effective psychotherapy for individuals suffering from the effects of prolonged grief disorder (PGD) are scarce. This paper describes the protocol for an evaluation of a metacognitive therapy programme designed specifically for PGD, to reduce the psychological distress and loss of functioning resulting from bereavement. Methods and analysis The proposed trial comprises three phases. Phase 1 consists of a review of the literature and semistructured interviews with key members of the target population to inform the development of a metacognitive therapy programme for Prolonged Grief. Phase 2 involves a randomised controlled trial to implement and evaluate the programme. Male and female adults (N=34) will be randomly assigned to either a wait list or an intervention group. Measures of PGD, anxiety, depression, rumination, metacognitions and quality of life will be taken pretreatment and posttreatment and at the 3-month and 6-month follow-up. The generalised linear mixed model will be used to assess treatment efficacy. Phase 3 will test the social validity of the programme. Discussion This study is the first empirical investigation of the efficacy of a targeted metacognitive treatment programme for PGD. A focus on identifying and changing the metacognitive mechanisms underpinning the development and maintenance of prolonged grief is likely to be beneficial to theory and practice. Ethics Ethics approval was obtained from Curtin University Human Research Ethics Committee (Approval number HR 41/2013.) Trial registration number ACTRN12613001270707. PMID:26646828

  8. [Grief, depression and anxiety after spontaneous abortion--a study of systematic evaluation and factors of influence].

    PubMed

    Beutel, M; Deckardt, R; Schaudig, K; Franke, S; Zauner, R

    1992-05-01

    Recent studies demonstrate profound and long-lasting adverse psychological and family sequelae of a spontaneous abortion. However, decisive issues of quality, course and determinants cannot be answered sufficiently due to shortcomings of research (e.g. lack of representative samples and adequate measures, reliance on cross-sectional study designs). Grief reactions and their determinants are differentiated in relation to depressiveness and anxiety in 86 patients from a longitudinal study, employing the Perinatal Grief Scale (Thoedter et al. 1988) and standardized symptom checklists. For the majority of the women, around the 10th week of gestation, the embryo is psychologically represented in fantasies, dreams and concrete arrangements in reality. Immediately after the abortion, these women react with painful feelings of "active grief" and "despair". Additional stresses in the pregnancy and lack of social support predict "self-reproachful coping". Women with recurrent abortions who have no children show depressive reactions. Retrospectively, these also present more anxiety and depressive moods during pregnancy. Results support reliability and validity of the grief scale. Implications for counselling and psychotherapy of women after a spontaneous abortion are discussed with respect to these risk constellations. PMID:1488507

  9. "It may not be pretty, but it's honest": examining parental grief on the Callapitter blog.

    PubMed

    DeGroot, Jocelyn M; Carmack, Heather J

    2013-01-01

    Following the death of a child, parents are turning to alternative means of communication to express their grief In this instrumental case study, the authors explore how 1 woman, Amy Ambrusko, communicates her grief experience on her blog, emotionally negotiating loss and parental grief. Guided by M. S. Miles's (1984) parental grief model, the authors argue that the Callapitter blog serves as a case study illustration of online parental grief. Specifically, Ambrusko displays parental grief in three ways: (re)questioning reality, experiencing discursive and corporeal guilt, and rationalizing a "new normal." This analysis highlights the changing nature of communicating about grief and underscores how grief blogs challenge contemporary social death rules. PMID:24517565

  10. Do Grief Self-Help Books Convey Contemporary Perspectives on Grieving?

    ERIC Educational Resources Information Center

    Dennis, Michael Robert

    2012-01-01

    Grief therapy and psychology literatures of the modern Western world conceptualized bereavement and grief as processes to be "worked through" so that other relationships could be pursued. In the last decade or so, however, grief theorists have endorsed the value of attaining new meaning(s) and continuing bonds with our lost loved ones instead of…

  11. Grief Counseling Groups for Adolescents Based on Re-Membering Practices

    ERIC Educational Resources Information Center

    Granados, Stephanie; Winslade, John; De Witt, Megan; Hedtke, Lorraine

    2009-01-01

    Focusing on "re-membering" practices is new to grief counseling. Traditional approaches to grief counseling are guided by the concepts of stages or tasks, usually to move the person toward accepting the reality of loss and to "say goodbye" to their deceased loved one. This alternative approach to grief counseling, driven by social constructionism…

  12. Grief and Loss in Schools: A Perspective for School Social Workers

    ERIC Educational Resources Information Center

    Massat, Carol Rippey; Moses, Helene; Ornstein, Eric

    2008-01-01

    Students and other members of a school community frequently experience grief and loss. This article uses a dual process model to describe students' grief and loss. It also describes the manifestations of grief at different stages of children's development, as well as interventions at different levels of the school environment. The ability to help…

  13. Acts of Resistance: Breaking the Silence of Grief Following Traffic Crash Fatalities

    ERIC Educational Resources Information Center

    Breen, Lauren J.; O'Connor, Moira

    2010-01-01

    Theoretical arguments and empirical evidence demonstrate the limited utility of a narrow construction of "normal" grief. Sudden and violent death, the young age of the deceased, and perceptions of death preventability are associated with grief reactions that extend beyond an expected grief response. Interviews were conducted with 21 adults…

  14. Surgical Fracture Repair in Chronic Renal Failure Patients on Hemodialysis An Analysis of Complications and Hospital Quality Measures.

    PubMed

    Vaswani, Ravi; Manoli, Arthur; Goch, Manoli; Egol, Kenneth

    2016-06-01

    In end stage renal disease (ESRD) patients on hemodialysis (HD), it is known that renal bone disease has a negative impact on postoperative complication rate of fracture repair compared to non-ESRD patients. Previous studies have examined complications following surgical hip fracture repair in ESRD patients on HD. However, there is paucity of information outside of hip fracture repair. This study was undertaken to investigate complications associated with surgical fracture repair in ESRD patients on hemodialysis and to compare quality measures with a control group for various fracture types. Data of all consecutive ESRD patients on HD was collected prospectively starting in 2013. Charts of 2,558 ESRD patients on HD from 2010 to 2013 were also reviewed. Thirty-four patients who underwent surgical fracture repair were included in the study. Additionally, 1,000 patients without ESRD who underwent fracture repair were also identified, and a random sample of 267 patients was selected for inclusion as a control group. Primary outcomes were major complications as defined by the Clavien-Dindo complication rating system for orthopaedic surgery. Secondary outcomes were minor complications, defined by the same method. Demographic information and hospital quality measures, such as hospital length of stay (LOS) and discharge disposition, were also collected. There were no differences between the two groups in terms of BMI, ethnicity, or gender distribution. The ESRD patients were older than control patients (62.6 versus 46.8 years; p > 0.01). Overall, the complication rate in the ESRD group was 14.7% compared to 3% in the control group (p < 0.05) while the rate of major complications was similar (5.8% versus 2.2%, p = 0.2). The rate of minor complications was higher in the ESRD group though this did not reach statistical significance (8.8% versus 1%, p = 0.07). Median LOS was significantly higher in the ESRD group (15.9 versus 6.4 days; p < 0.01), and patients in the ESRD group

  15. [A Clinical Case of Grief Hallucination through the Mourning Work Normal Grief and Spiritual Care].

    PubMed

    Kurotori, Isaku; Kato, Satoshi

    2015-01-01

    Auditory or visual hallucinations of a deceased person are well known in the normal course of the bereavement process. According to DSM-5, this symptom is included in the associated features supporting diagnosis of persistent complex bereavement disorder. In Japan, however, little is known about these hallucinatory experiences during grieving, and few reports on their prevalence are available. Here, we have reported a clinical case of such experiences following the loss of a spouse. A 66-year-old patient presented to the outpatient department with insomnia after her husband's death. She was preoccupied with a sense of loss and absolute loneliness. One day, she confessed to regularly encountering her husband's ghost at night; the ghost was distinguishable from a dream and provided the bereaved wife with some degree of comfort. The appearances lasted for 15 months and occurred several times a week without disturbing her social functioning. She gradually became aware that her husband was returning from the spirit world to give her solace. Her treatment was focused on resolving her conflicting feelings concerning her grief at his death and her relief at his no longer suffering from disease. While accepting her experiences, she started to review the days they spent together and appreciated his attachment. Therefore she completed the work of mourning and the ghost no longer appeared. One year after the departure of the ghost, she still attends the hospital regularly and there has been no recurrence. A reconstruction of her internal world leads us to conclude that the support of normal grief with such hallucinations prevents the intense experience of loss from generating pathological grief. Furthermore, we suggest reconsidering the importance of the mourning work and the inclusion of both the bereaved and deceased person in the medical context. PMID:26642726

  16. Too complicated for the field? Measuring quality of care in humanitarian aid settings

    PubMed Central

    Kersten, Roland; Bosse, Götz; Dörner, Frank; Slavuckij, Andrej; Fernandez, Gustavo; Marx, Michael

    2013-01-01

    While quality of care is a major concern in the western world, not many studies investigate this topic in low-income countries. Even less is known about the quality of care in humanitarian aid settings, where additional challenges from natural or manmade disasters contribute to additional challenges. This study tried to address this gap by introducing a new approach to systematically measure quality of care in a project of Médecins Sans Frontières (MSF) in Agok area, between South Sudan and Sudan. Our objective was to obtain a valid snapshot of quality of care for a MSF project in three weeks that has the potential to serve as a baseline for quality improvement strategies. The evaluation followed a cross-sectional study design to assess structural, process and outcome quality according to Donabedian's criteria of quality of care. A bundle of well-established methods for collection of quantitative and qualitative data was used to assess the project by following a triangulated mixed-methods approach. Mean structural quality scored 73% of expected performance level and mean process quality 59%. The overall mortality rate for the hospital was 3.6%. On average, less complicated cases got a better level of care than patients who were seriously ill. Significant motivational issues were discovered in staff interviews potentially affecting quality of care. The tool appeared to be quick, feasible and effective in judging quality of care in the selected project. To tap the whole potential of the approach a re-evaluation should be carried out to assess the effectiveness of implemented improvement strategies in Agok. To confirm the usefulness of the approach, more studies are needed covering the variety of different humanitarian aid settings. PMID:23683715

  17. Chronic Grief Management for Dementia Caregivers in Transition: Intervention Development and Implementation

    PubMed Central

    Paun, Olimpia; Farran, Carol J.

    2013-01-01

    Research reveals that Alzheimer’s disease (AD) caregivers (CGs) do not relinquish their role after placing a family member in long-term care. Caregivers report increased emotional upset around the time of placement, with sustained losses over time leading to chronic grief. Chronic grief increases caregivers’ risk for depression and suicide. There are no documented interventions designed to decrease CGs chronic grief post placement. The Chronic Grief Management Intervention (CGMI) builds on existing evidence to target caregiver chronic grief in the transition of a family member into long-term care. The intervention is structured into three major components: 1) knowledge, 2) skill in communication and conflict resolution, and 3) chronic grief mangement skill. The 12-week intervention was pilot tested with thirty four caregivers for feasibility and preliminary effects on caregiver skill, knowledge, chronic grief, and depression. This article presents a general study description while focusing on the development and implementation of the CGMI. PMID:22084962

  18. Grief experiences of 3 caregiving wives of veterans with dementia.

    PubMed

    Ford, James L; Linde, Brittany D; Gigliotti, Christina; Kim, Kye Y

    2013-03-01

    Three wives share their experiences of caregiving for husbands with dementia. The 3 husbands, aged 51, 71, and 84, developed dementia following years of devoted military service. To present lived experiences of caregiving wives', meanings attributed to caregiving are investigated, variations in caregiving and grieving experiences are explored, and therapeutic implications are offered. Through case study approach and with issues of caregiver grief considered, we introduce life course and ambiguous loss theoretical perspectives. Emergent qualitative themes and quantitative inventory ratings indicate significant differences in caregiver grief response depend on care-recipient age. Practice implications and directions for future care recipient, age-related research are presented. PMID:22611236

  19. Rumination and avoidance as predictors of prolonged grief, depression, and posttraumatic stress in female widowed survivors of war.

    PubMed

    Morina, Nexhmedin

    2011-12-01

    This study examined independent contributions of rumination and experiential avoidance in predicting symptoms of psychological distress among female widowed survivors of war. A decade after the war in Kosovo, 100 widowed survivors of war completed measures of rumination, experiential avoidance, depression, posttraumatic stress, and prolonged grief. Results showed that both rumination and experiential avoidance significantly predicted the symptom severity of prolonged grief, depression, and posttraumatic stress. Furthermore, rumination accounted for additional variance above and beyond experiential avoidance and vice versa. Finally, the interaction of rumination and experiential avoidance did not provide significant explanatory power over and above the individual main effects. These findings suggest that rumination and experiential avoidance may be significant factors in understanding and treating psychological distress following exposure to potentially traumatic events and loss due to violence. PMID:22134449

  20. Helping People Cope with Tragedy and Grief: Information, Resources & Linkages.

    ERIC Educational Resources Information Center

    Walz, Garry R., Ed.; Kirkman, Chris J.

    Following the horrific experiences of September 11th, 2001, efforts were undertaken to gather information to provide counselors with the help they need for counseling those in the face of tragedy. With this publication, information about trauma and grief counseling becomes readily available. Guides for responding to tragedies are included from…

  1. Music Therapy with Bereaved Youth: Expressing Grief and Feeling Better

    ERIC Educational Resources Information Center

    McFerran, Katrina

    2011-01-01

    Music therapy is a promising intervention with bereaved youth. In comparison to other programs, it appears particularly effective for promoting the resolution of grief-related feelings; providing opportunities to express and release feelings through musical participation. Descriptions from music therapy participants are supported by research…

  2. Teachers' Perceptions of Their Role Facing Children in Grief

    ERIC Educational Resources Information Center

    Dyregrov, Atle; Dyregrov, Kari; Idsoe, Thormod

    2013-01-01

    A questionnaire was sent to teachers in the western part of Norway to survey the attitudes and thoughts teachers have about grief in young people and how they look upon their supportive role. A total of 138 school personnel answered the questionnaire, a 44.5% response rate. In addition six focus group interviews were conducted to get in-depth…

  3. Grief and Needs of Adults with Acquired Visual Impairments

    ERIC Educational Resources Information Center

    Murray, Shirley A.; McKay, Robert C.; Nieuwoudt, Johan M.

    2010-01-01

    This report aims to illuminate the complex phenomenon of grief and the needs experienced throughout the time course of their impairments by adults with acquired visual impairments. The study applied a phenomenological research strategy using 10 case studies of South African adults, visually impaired within and beyond six years. Qualitative…

  4. Designing and Conducting Grief Workshops for College Students

    ERIC Educational Resources Information Center

    Vickio, Craig J.

    2008-01-01

    If colleges and universities are truly committed to promoting the well-being of their students and fostering their academic success, they must attend to the needs of grieving students. One way to do this is to invite students to use the university's counseling services following the death of a loved one. However, although grief counseling can be…

  5. The Stigmatized Deaths in Jonestown: Finding a Locus for Grief

    ERIC Educational Resources Information Center

    Moore, Rebecca

    2011-01-01

    This article considers the stigmatized deaths in Jonestown, Guyana, in 1978, in which more than 900 Americans died of mass murder and suicide, and how this led to the disenfranchisement of grief. It examines the rituals of exclusion by which bodies were handled and describes the experiences of Jonestown survivors. It then looks at the ways in…

  6. Innovative Moments in Grief Therapy: Reconstructing Meaning Following Perinatal Death

    ERIC Educational Resources Information Center

    Alves, Daniela; Mendes, Ines; Goncalves, Miguel M.; Neimeyer, Robert A.

    2012-01-01

    This article presents an intensive analysis of a good outcome case of constructivist grief therapy with a bereaved mother, using the Innovative Moments Coding System (IMCS). Inspired by M. White and D. Epston's narrative therapy, the IMCS conceptualizes therapeutic change as resulting from the elaboration and expansion of unique outcomes (or as we…

  7. Strengthening Grief Support for Adolescents Coping with a Peer's Death

    ERIC Educational Resources Information Center

    Balk, David E.; Zaengle, Donna; Corr, Charles A.

    2011-01-01

    This article offers suggestions for strengthening school-based grief support following an adolescent's death. Such interventions must be considered within the context of: (a) development during adolescence; (b) the role of peers in adolescent development; and (c) the fact that an adolescent peer's death is a non-normative life crisis in developed…

  8. Process Model of Grief Therapy in an Alcohol Treatment Program.

    ERIC Educational Resources Information Center

    Martin, Sherri; Privette, Gayle

    1989-01-01

    Discusses a psychoeducational, experiential group for members of an alcohol treatment program which addressed loss, personal reaction to loss, and grief as a healing process. Explores the relationship between grieving and addiction, and presents the protocol for the group experience. (Author)

  9. Grief in Two Guises: "Mourning and Melancholia" Revisited

    ERIC Educational Resources Information Center

    Green, Viviane

    2013-01-01

    This paper is a re-reading of Freud's classic paper. The themes of mourning and melancholia are viewed in relation to children and adolescents with illustrations from case histories. Mourning is interpreted in a broader sense: not only as grief (both expectable and traumatic) but as a response to the developmental process itself as phases of…

  10. Supporting Children with Traumatic Grief: What Educators Need to Know

    ERIC Educational Resources Information Center

    Cohen, Judith A.; Mannarino, Anthony P.

    2011-01-01

    Following traumatic deaths children may develop Childhood Traumatic Grief (CTG), a condition in which trauma symptoms interfere with adaptive child grieving. Educators have an important role in supporting children who have CTG. Key contributions that educators can make are to (a) recognize CTG symptoms in school settings; (b) refer children for…

  11. Scrapbooking as an Intervention for Grief Recovery with Children

    ERIC Educational Resources Information Center

    Williams, Kristie; Lent, Jonathan

    2008-01-01

    This article describes scrapbooking in the context of bereavement counseling. For the purposes of this article, scrapbooking combines many different types of art-related therapy interventions into one concrete format to utilize in counseling with children who are working to overcome grief or trauma related to the loss of a parent. A case…

  12. The Emotional Experience of School Change: Resistance, Loss, and Grief.

    ERIC Educational Resources Information Center

    Marshak, David

    1996-01-01

    Ignoring the emotional experience of school change may unintentionally sabotage rational planning. Reinventing schools means attending to educators' emotional experience, particularly their expectations, sense of loss, and resulting grief. School norms must be transformed so that teachers and administrators can have meaningful conversations about…

  13. Grief and Mourning Reactions Following Abortion and Miscarriage.

    ERIC Educational Resources Information Center

    Widener, Anmarie J.

    1996-01-01

    Explores current research on psychological reactions following induced and spontaneous abortions. Provides examples of studies wherein researchers have used a loss model to understand this experience. Explores possible reasons for the apparent inattention to grief reactions following this type of loss and offers an alternative approach to the loss…

  14. The Grief Group: A University and Hospice Collaboration

    ERIC Educational Resources Information Center

    O'Neill, Daniel; Fry, Michele

    2013-01-01

    This report describes a joint effort of a community hospice and a university counseling center to provide a campus grief group for university students led by a hospice counselor and a counseling center clinical psychologist. Hospice provided a curriculum outlining topics and activities for each of the group's six meetings. Notices announcing…

  15. Religiosity Related to Grief Levels of Bereaved Mothers and Fathers.

    ERIC Educational Resources Information Center

    Bohannon, Judy Rollins

    1991-01-01

    Examined religiosity and bereaved mothers' (n=143) and fathers' (n=129) scores on Grief Experience Inventory. High church attendance had significant inverse relationship with death anxiety. Mothers who attended church more frequently reported significantly less loss of control, rumination, depersonalization, and optimism/despair. Church attendance…

  16. Elevated Rates of Prolonged Grief Disorder in African Americans

    ERIC Educational Resources Information Center

    Goldsmith, B.; Morrison, R. S.; Vanderwerker, L. C.; Prigerson, H. G.

    2008-01-01

    The prevalence of Prolonged Grief Disorder (PGD) in non-Whites is currently unknown. This study was performed to explore the prevalence of PGD in African Americans (AAs). Multivariable analysis of two studies of recently bereaved individuals found AAs to have significantly higher rates of PGD than Whites (21% [14 of 66] vs. 12% [55 of 471],…

  17. Parental Grief Following the Brain Death of a Child: Does Consent or Refusal to Organ Donation Affect Their Grief?

    ERIC Educational Resources Information Center

    Bellali, Thalia; Papadatou, Danai

    2006-01-01

    The purpose of this study was to investigate the grieving process of parents who were faced with the dilemma of donating organs and tissues of their underage brain dead child, and to explore the impact of their decision on their grief process. A grounded theory methodology was adopted and a semi-structured interview was conducted with 11 bereaved…

  18. Parentally Bereaved Children's Grief: Self-System Beliefs as Mediators of the Relations between Grief and Stressors and Caregiver-Child Relationship Quality

    ERIC Educational Resources Information Center

    Wolchik, Sharlene A.; Ma, Yue; Tein, Jenn-Yun; Sandler, Irwin N.; Ayers, Tim S.

    2008-01-01

    We investigated whether 3 self-system beliefs--fear of abandonment, coping efficacy, and self-esteem--mediated the relations between stressors and caregiver-child relationship quality and parentally bereaved youths' general grief and intrusive grief thoughts. Cross-sectional (n = 340 youth) and longitudinal (n = 100 youth) models were tested. In…

  19. [Avoidance of complications in oncological surgery of the pelvic region : combined oncosurgical and plastic reconstruction measures].

    PubMed

    Beier, J P; Croner, R S; Lang, W; Arkudas, A; Schmitz, M; Göhl, J; Hohenberger, W; Horch, R E

    2015-03-01

    Prevention of perioperative and postoperative complications resulting from surgical oncology in the pelvic region remains a major interdisciplinary challenge. With modern interdisciplinary concepts joining forces of various surgical specialties, tumor resection can be sufficiently carried out with wide margins and the patients benefit from reduced morbidity even in complex situations. As an example chronic fistulation and secretion from the presacral cavity and sinus may result as potential sequelae from intra-abdominal and intrapelvic tumor resection, especially when neoadjuvant multimodal therapies have been applied. This can be prevented by simultaneous transplantation of for example transpelvic vertical rectus abdominis myocutaneous (VRAM) flap transfer, while extensive perineal skin and soft tissue defects may also be simultaneously reconstructed. In cases of malignant soft tissue tumors in the pelvic region a staged surgical procedure can be performed with a period of time between tumor resection and reconstruction. Thus, a histological R0 status can be secured prior to plastic reconstruction surgery in order to increase oncological safety. In cases of postresectional exposition of e. g. pelvic or femoral vessels or intrapelvic and intra-abdominal organs simultaneous flap procedure is mandatory.The reconstructive armamentarium of the plastic surgeon should contain not only pedicled but also free microsurgical flaps so that no compromise in terms of the extent of the oncological resection has to be accepted. At the same time perioperative and postoperative complications may be avoided and the patient quality of life can be preserved even in more complex cases. PMID:25620285

  20. The relative importance of avoidance and restoration-oriented stressors for grief and depression in bereaved parents.

    PubMed

    Harper, Mairi; O'Connor, Rory C; O'Carroll, Ronan E

    2015-01-01

    Previous research has identified a number of individual risk factors for parental bereavement including the sex of the parent, the sex of the child, avoidance-focussed coping style and time since death. These factors emerged from research where variables were tested univariately and their relative importance is currently unknown. The current research, therefore, aims to investigate which risk factors are important, multivariately, for the outcomes of grief and depression in parents following the death of their child. Psychosocial measures were completed by 106 bereaved parents four years post-loss, recruited from death records in Scotland. The cause of the child's death included long-term illness and stillbirths as well as sudden and violent deaths. In multivariate regression analyses, depression was predicted by higher avoidance-focussed coping and higher number of restoration-oriented stressors such as relationship difficulties, problems at work and financial issues. Grief was predicted by higher avoidance, restoration stressors and level of continuing bonds. The present study adds to the knowledge about the phenomenon of parental bereavement with participants recruited directly from death records rather than through support, clinical or obituary sources. Factors previously found to be associated with outcomes when tested univariately such as sudden, violent death or sex of the parent were not significant when tested multivariately. This study highlights that different vulnerability factors exist for grief and depression in bereaved parents. PMID:25495761

  1. Managing Loss and Change: Grief Interventions for Dementia Caregivers in a CBT-Based Trial.

    PubMed

    Meichsner, Franziska; Schinköthe, Denise; Wilz, Gabriele

    2016-05-01

    Dementia caregivers often experience loss and grief related to general caregiver burden, physical, and mental health problems. Through qualitative content analysis, this study analyzed intervention strategies applied by therapists in a randomized-controlled trial in Germany to assist caregivers in managing losses and associated emotions. Sequences from 61 therapy sessions that included interventions targeting grief, loss, and change were transcribed and analyzed. A category system was developed deductively, and the intercoder reliability was satisfactory. The identified grief intervention strategies were recognition and acceptance of loss and change,addressing future losses,normalization of grief, and redefinition of the relationship Therapists focused on identifying experienced losses, managing associated feelings, and fostering acceptance of these losses. A variety of cognitive-behavioral therapy-based techniques was applied with each strategy. The findings contribute to understanding how dementia caregivers can be supported in their experience of grief and facilitate the development of a manualized grief intervention. PMID:26311735

  2. Online survey as empathic bridging for the disenfranchised grief of pet loss.

    PubMed

    Packman, Wendy; Carmack, Betty J; Katz, Rachel; Carlos, France; Field, Nigel P; Landers, Craig

    2014-01-01

    The current cross-cultural study investigated grief reactions of bereaved individuals following the death of a pet. We used qualitative methodology to compare, analyze, and report responses of U.S. and French Canadian participants to the last open-ended question on our online pet loss survey. We explored the degree to which our data illustrated pet loss as disenfranchised grief and asked whether there are differences and commonalities in the expression of grief between the two samples. Four major themes emerged: lack of validation and support; intensity of loss; nature of the human pet relationship; and continuing bonds. Findings confirm that, for both the U.S. and French Canadian participants, pet loss is often disenfranchised grief and there are ways to facilitate expressions of grief. Many participants wrote that the survey was therapeutic. Our survey allowed participants to express their grief in an anonymous, safe way by serving as empathic bridging and a willingness to help others. PMID:25304868

  3. Grief and trauma intervention for children after disaster: exploring coping skills versus trauma narration.

    PubMed

    Salloum, Alison; Overstreet, Stacy

    2012-03-01

    This study evaluated the differential effects of the Grief and Trauma Intervention (GTI) with coping skills and trauma narrative processing (CN) and coping skills only (C). Seventy African American children (6-12 years old) were randomly assigned to GTI-CN or GTI-C. Both treatments consisted of a manualized 11-session intervention and a parent meeting. Measures of trauma exposure, posttraumatic stress symptoms, depression, traumatic grief, global distress, social support, and parent reported behavioral problems were administered at pre, post, 3 and 12 months post intervention. In general, children in both treatment groups demonstrated significant improvements in distress related symptoms and social support, which, with the exception of externalizing symptoms for GTI-C, were maintained up to 12 months post intervention. Results suggest that building coping skills without the structured trauma narrative may be a viable intervention to achieve symptom relief in children experiencing trauma-related distress. However, it may be that highly distressed children experience more symptom relief with coping skills plus narrative processing than with coping skills alone. More research on the differential effects of coping skills and trauma narration on child distress and adaptive functioning outcomes is needed. PMID:22317753

  4. Anticipatory Grief in New Family Caregivers of Persons with Mild Cognitive Impairment and Dementia

    PubMed Central

    Garand, Linda; Lingler, Jennifer H.; Deardorf, Kaitlyn E.; DeKosky, Steven T.; Schulz, Richard; Reynolds, Charles F.; Dew, Mary Amanda

    2011-01-01

    Anticipatory grief is the process of experiencing normal phases of bereavement in advance of the loss of a significant person. To date, anticipatory grief has been examined in family caregivers to individuals who have had Alzheimer’s Disease (AD) an average of 3 to 6 years. Whether such grief is manifested early in the disease trajectory (at diagnosis) is unknown. Using a cross-sectional design, we examined differences in the nature and extent of anticipatory grief between family caregivers of persons with a new diagnosis of mild cognitive impairment (MCI, n=43) or AD (n=30). We also determined whether anticipatory grief levels were associated with caregiver demographics, caregiving burden, depressive symptoms and marital quality. Mean anticipatory grief levels were high in the total sample, with AD caregivers endorsing significantly more anticipatory grief than MCI caregivers. In general, AD caregivers endorsed difficulty functioning whereas MCI caregivers focused on themes of “missing the person” they once knew. Being a female caregiver, reporting higher levels of objective caregiving burden and higher depression levels each bore independent, statistically significant relationships with anticipatory grief. Given these findings, family caregivers of individuals with mild cognitive deficits or a new AD diagnosis may benefit from interventions specifically addressing anticipatory grief. PMID:21946013

  5. Do grief self-help books convey contemporary perspectives on grieving?

    PubMed

    Dennis, Michael Robert

    2012-01-01

    Grief therapy and psychology literatures of the modern Western world conceptualized bereavement and grief as processes to be "worked through" so that other relationships could be pursued. In the last decade or so, however, grief theorists have endorsed the value of attaining new meaning(s) and continuing bonds with our lost loved ones instead of "moving on from," "letting go of" or "achieving closure from" them. This article tracks the evolution of thought pertaining to this shift and examines its relevance to grief self-help books that may offer Americans guidance in the ways of grieving. PMID:24567996

  6. Grieving online: newcomers' constructions of grief in an online support group.

    PubMed

    Varga, Mary Alice; Paulus, Trena M

    2014-01-01

    Research into peer conversations in online grief support groups remains scarce. The authors used discourse analysis to examine 107 initial posts to one such group to examine how newcomers constructed their initial posts to display their eligibility for membership. The authors identified three discursive features: formulating unusual stories of loss, describing uncontrollable emotional and physical states, and engaging in "troubles telling." These discursive patterns illustrate how grief is constructed in ways that may simultaneously conform to and resist norms around grief that exist offline. Implications for practitioners include the need to support individuals through validation of their "nonnormal" grief. PMID:24758214

  7. Grief and growth of bereaved siblings as related to attachment style and flexibility.

    PubMed

    Cohen, Orit; Katz, Michael

    2015-01-01

    This study examined the relationship between attachment style, coping flexibility, military/non-military cause of death, levels of grief reactions and posttraumatic growth (PTG), in 150 bereaved adult siblings in Israel. Insecurely attached participants, 72% of the sample, reported more grief and less PTG than did securely attached ones. Highly avoidant individuals exhibited the least amount of PTG. Securely attached siblings were more flexible and flexibly coping participants reported less grief and higher PTG. Cause of death was not related to grief and PTG. Discussion of these findings yields conditions enabling PTG after a sibling loss. PMID:25719968

  8. Pregnancy Complications: Shoulder Dystocia

    MedlinePlus

    ... unit (NICU) Birth defects & other health conditions Loss & grief Tools & Resources Frequently asked health questions Ask our ... date Ovulation calendar 39 weeks is best Order bereavement materials News Moms Need Blog News & Media News ...

  9. Fathers' grief after the death of a child.

    PubMed

    Aho, Anna Liisa; Tarkka, Marja-Terttu; Astedt-Kurki, Päivi; Kaunonen, Marja

    2006-07-01

    The purpose of this study was to describe fathers' grief and the changes the death of a child has brought to fathers' lives. Participants included eight fathers who had lost a child. The data were collected using a questionnaire with open-ended questions and by interviews. Content analysis was used as a means of data analysis. The grief of the fathers manifested itself individually and dynamically and also in various anticipatory feelings and in physical, social, and behavioural reactions. The death of the child brought both positive and negative changes to the fathers' lives. Mental health nurses should be aware that depression and other mental illness, as well as unemployment and financial problems, were reported by some of the study participants. PMID:16923735

  10. The virtual dream: rewriting stories of loss and grief.

    PubMed

    Neimeyer, Robert A; Torres, Carlos; Smith, Douglas C

    2011-08-01

    In this article, the authors introduce the virtual dream, a technique that entails writing a brief spontaneous dreamlike story on themes of loss, using a flexible set of assigned elements of setting and characterization to scaffold the writing. After providing several examples of virtual dreams written by workshop participants, the authors analyze the frequency of important narrative features in a diverse sample of 143 stories to demonstrate the feasibility and reliability of coding such accounts for clinical or research purposes. Finally, we conclude with some remarks on the therapeutic use of the virtual dream, whether as a prompt for personal reflection on themes of loss, as an exercise in the context of grief workshops or support groups, or as a homework assignment in grief counseling or therapy. PMID:24501842

  11. Innovative moments in grief therapy: reconstructing meaning following perinatal death.

    PubMed

    Alves, Daniela; Mendes, Inês; Gonçalves, Miguel M; Neimeyer, Robert A

    2012-10-01

    This article presents an intensive analysis of a good outcome case of constructivist grief therapy with a bereaved mother, using the Innovative Moments Coding System (IMCS). Inspired by M. White and D. Epston's narrative therapy, the IMCS conceptualizes therapeutic change as resulting from the elaboration and expansion of unique outcomes (or as we prefer, innovative moments), referring to experiences not predicted by the problematic or dominant self-narrative. The IMCS identifies and tracks the occurrence of 5 different types of innovative moments: action, reflection, protest, re-conceptualization, and performing change. Results documented the process of meaning reconstruction over the 6 sessions of treatment, and demonstrated the feasibility and reliability of analyzing narrative change in this form of grief therapy, opening it to comparison with other approaches. PMID:24563928

  12. Challenges in measuring complications and death due to invasive Salmonella infections.

    PubMed

    Qamar, Farah Naz; Azmatullah, Asma; Bhutta, Zulfiqar A

    2015-06-19

    Despite the highest burden of Typhoid fever in children globally, exact estimates of morbidity and mortality are lacking due to scarcity of published data. Despite a high prevalence and a socioeconomic burden in developing countries, published data with morbidity and mortality figures are limited especially Africa and South American regions. Data from the community is insufficient and most case fatality estimates are extrapolations from hospital based studies that do not cover all geographical regions, and include cases which may or not be culture confirmed, MDR resistant or sensitive cases, or from mixed populations of age (adults and children). Complications of typhoid such as intestinal perforation, bone marrow suppression, and encephalopathy are dependent on MDR/Fluoroquinolone resistant Salmonella infection, comorbidities such as malnutrition, and health-care access. Data is again insufficient to estimate the true burden of Typhoid Fever in different regions and groups of populations. Although there has been a rapid decline in cases in developed countries with the advent of improved sanitization, timely and easy access to health care and laboratories, this is still not the case in the developing countries where Typhoid deaths are still occurring. The way forward is to develop rapid and cost effective point of care diagnostic tests, put in place validated clinical algorithms for suspected clinical cases, and design prospective, and community based studies in different groups, implement maintenance of electronic health records in large public sector hospitals and regions to identify populations that will benefit most from the implementation of vaccine. Policies on public health education and typhoid vaccine may help to reduce morbidity and mortality due to the disease. PMID:25921727

  13. Storyboarding used as an aid to explore grief.

    PubMed

    2016-07-01

    Yvonne Dexter, writing in Nursing Children and Young People, discusses the use of storyboarding and its use as a reflective practice aid. As children's nurses are among the child health professionals most directly affected by childhood death, storyboarding can provide nursing students with a safe environment to reflect on their feelings about the death of a child. Ms Dexter considers the potential for its use in practice, for example in clinical supervision and classroom settings, to manage grief. PMID:27380710

  14. The grief response in the partners of women who miscarry.

    PubMed

    Johnson, M P; Puddifoot, J E

    1996-12-01

    Research over the last two decades has revealed that significant psychological effects may ensue for women who suffer spontaneous abortion. The psychological impact on their male partners has been largely overlooked. This paper examines the psychological impact on the male partners of 126 British women who suffered miscarriage. Higher than anticipated levels of grief and stress were found on the Perinatal Grief Scale and the Impact of Events Scale respectively, indicating that these men were strongly affected by the miscarriage. The duration of the pregnancy prior to miscarriage, and the experience of confirmatory imaging of the foetus via routine ultrasound scan, were factors related to raised levels of grief and stress. A small number of semi-structured interviews appeared to confirm that some men displayed symptoms of Bowlby's (1961) first stage of bereavement. These were modified by differences in the expected role behaviour of men, but in other respects were comparable to the findings of a recent study of an Australian cohort of women who miscarried (Conway, 1995). PMID:8989980

  15. Social Practices of Encountering Death: A Discussion of Spiritual Health in Grief and the Significance of Worldview

    ERIC Educational Resources Information Center

    Sagberg, Sturla; Roen, Ingebrigt

    2011-01-01

    This article presents cases from informal situations of grief and a project called "I and death". These cases suggest that different worldviews affect the process of grief, and that children often do not get the support they need in terms of spiritual care. This affects attitudes towards grief in adulthood. Social practices of encountering death…

  16. Symptoms of prolonged grief, depression, and adult separation anxiety: distinctiveness and correlates.

    PubMed

    Boelen, Paul A

    2013-05-15

    Research has shown that prolonged grief disorder (PGD) is a disorder distinct from other disorders including major depression and posttraumatic stress disorder (PTSD). This study aimed to extend this research by examining the distinctiveness of symptoms of PGD relative to symptoms of adult separation anxiety disorder, also taking into account depression. Data were available from 205 bereaved individuals who completed measures tapping these symptoms together with a complementary measure of mental and physical health. Findings showed that symptoms of PGD, depression, and adult separation anxiety disorder were better conceptualized as distinct dimensions instead of a unitary dimension of distress. Correlations between the three symptom clusters were moderate to large. Cause of loss was the single variable that was associated with all three symptom clusters with loss due to violent cause giving rise to more severe symptoms. All three symptom clusters were associated with lower concurrent mental and physical health. PMID:23068081

  17. The Nature of Grief: Loss of Love Relationships in Young Adulthood.

    ERIC Educational Resources Information Center

    Robak, Rostyslaw W.; Weitzman, Steven P.

    1998-01-01

    Grieving following the loss of a romantic relationship in young adulthood was examined (N=148). Sex differences, disenfranchisement of grief by others, beliefs about loss, who initiated breakup, and recovery time were studied. Findings point to the importance of recognizing grief reactions in counseling and psychotherapy with young adults. (EMK)

  18. Coping with Loss and Grief through Online Support Groups. ERIC/CASS Digest.

    ERIC Educational Resources Information Center

    Gary, Juneau M.; Remolino, Linda

    Current technology enables people to cope with grief through participation in online support groups from the comfort and privacy of their home. The three aspects of grief are emotional, physical, and behavioral. Facing the void left and dealing with the feelings of isolation after the loss of a loved one can be accomplished through online support…

  19. Observing a Client's Grieving Process: Bringing Logical Positivism into Qualitative Grief Counselling Research

    ERIC Educational Resources Information Center

    Wilson, John; Gabriel, Lynne; James, Hazel

    2014-01-01

    This positional paper originates from our need as researcher/practitioners to establish a meaningful epistemological framework for research into bereaved people's journey through loss and grief over time. We describe how the field of grief research has a long and established biological basis, in keeping with a positivist epistemology.…

  20. A Pilot Study of Modified Cognitive-Behavioral Therapy for Childhood Traumatic Grief (CBT-CTG)

    ERIC Educational Resources Information Center

    Cohen, Judith A.; Mannarino, Anthony P.; Staron, Virginia R.

    2006-01-01

    Objective: This pilot study evaluated outcomes for a modified 12-session protocol of cognitive-behavioral therapy for childhood traumatic grief (CBT-CTG) conducted between March 2004 and October 2005. CTG is an emerging condition characterized by a combination of posttraumatic stress and unresolved grief symptoms. This two-module treatment model…

  1. Engaging Parents of Students with Disabilities: Moving beyond the Grief Model

    ERIC Educational Resources Information Center

    Allred, Keith W.

    2015-01-01

    Educators in many Western nations have used the Kübler-Ross stage model of grief for five decades as a lens to explain parental response to disability. A recent article in "Improving Schools," representing this deficit model, asserted that the grief lens is useful in understanding parent's response to learning that their child qualified…

  2. Use of Bibliotherapy in the Treatment of Grief and Loss: A Guide to Current Counseling Practices

    ERIC Educational Resources Information Center

    Briggs, Cynthia A.; Pehrsson, Dale-Elizabeth

    2008-01-01

    Grief is a complex and dynamic process influencing individuals of all ages. This article provides an overview of historical and contemporary constructs of grief counseling. Bibliotherapy, a creative counseling tool, is presented as an appropriate intervention when counseling grieving clients. Guidelines for using bibliotherapy with grieving…

  3. Evaluation of Individual and Group Grief and Trauma Interventions for Children Post Disaster

    ERIC Educational Resources Information Center

    Salloum, Alison; Overstreet, Stacy

    2008-01-01

    This study evaluated a community-based grief and trauma intervention for children conducted postdisaster. Fifty six children (7 to 12 years old) who reported moderate to severe levels of symptoms of posttraumatic stress were randomly assigned to group or individual treatment. Treatment consisted of a manualized 10-session grief- and trauma-focused…

  4. Parental Reactions to the Special Education Individual Education Program Process: Looking through the Lens of Grief

    ERIC Educational Resources Information Center

    Haley, Melinda; Hammond, Helen; Ingalls, Lawrence; Marín, Merranda Romaro

    2013-01-01

    Parental grief reactions have typically been examined in situations where parents have a child diagnosed with a major medical or mental health condition. This study used the grief and loss model as conceptualized by Kubler-Ross (1969), Lamb (1988), and Kubler-Ross and Kessler (2005) as a foundation in examining parental reactions when a child has…

  5. Caregiver Grief in Terminal Illness and Bereavement: A Mixed-Methods Study

    ERIC Educational Resources Information Center

    Waldrop, Deborah P.

    2007-01-01

    Caregivers experience multiple losses during the downhill trajectory of a loved one's terminal illness. Using mixed methods, this two-stage study explored caregiver grief during a terminal illness and after the care recipient's death. Caregiver grief was a state of heightened responsiveness during end-stage care: anxiety, hostility, depression,…

  6. Distinguishing Symptoms of Grief and Depression in a Cohort of Advanced Cancer Patients

    ERIC Educational Resources Information Center

    Jacobsen, Juliet C.; Zhang, Baohui; Block, Susan D.; Maciejewski, Paul K.; Prigerson, Holly G.

    2010-01-01

    Several studies have shown that the symptoms of grief are different from symptoms of depression among bereaved family members. This study is an attempt to replicate this finding among advanced cancer patients and examine clinical correlates of patient grief and depression. Analyses were conducted on data from interviews with 123 advanced cancer…

  7. Predictors of Grief and Depressed Mood among Gay Men Following an Aids-Related Loss

    ERIC Educational Resources Information Center

    Wayment, Heidi A.; Kemeny, Margaret E.

    2004-01-01

    This prospective study examined the unique predictors of grief and depressed mood in a sample of gay men (34 HIV positive, 69 HIV negative) who lost a close friend to AIDS. Individuals low in self-esteem reported greater depressed mood but no differences in grief following the death. Individuals with personality factors that predispose toward…

  8. Postabortion Grief: Evaluating the Possible Efficacy of a Spiritual Group Intervention

    ERIC Educational Resources Information Center

    Layer, Susan Dyer; Roberts, Cleora; Wild, Kelli; Walters, Jan

    2004-01-01

    Objective: Although not every woman is negatively affected by an abortion, researchers have identified a subgroup of women susceptible to grief and trauma. The primary providers for postabortion grief (PAG) groups are community faith-based agencies. Principle features of PAG are shame and post-traumatic stress disorder (PTSD) symptoms. Method:…

  9. Beyond Broken Bonds and Broken Hearts: The Bonding of Theories of Attachment and Grief.

    ERIC Educational Resources Information Center

    Noppe, Illene C.

    2000-01-01

    Presents a developmental model integrating attachment theory and cognitive developmental approaches in order to further understanding of the processes involved in loss and grief. Considers the relevance of attachment theory to understanding grief and research evidence for the role of continuing attachment bonds after death as a strategy for…

  10. Parents' Grief Following Pregnancy Loss: A Comparison of Mothers and Fathers.

    ERIC Educational Resources Information Center

    Stinson, Kandi M.; And Others

    1992-01-01

    Examined gender differences in bereavement following miscarriage, ectopic pregnancy, stillbirth, and neonatal death. Interviewed 56 couples using Perinatal Grief Scale. Women scored significantly higher than men on most dimensions of grief at two months, one year, and two years postloss, except on dimension indicating most serious consequences of…

  11. Death and Grief: A Plan for Principals to Deal with Tragedy Affecting the School Community.

    ERIC Educational Resources Information Center

    Powers, Harry L.

    1987-01-01

    Spurred by the "Challenger" space shuttle tragedy, this article provides principals with guidelines for informing individual students about family deaths and dealing with grief affecting the entire school community. Thorough preparation can reduce intensity and misconceived actions associated with grief and demonstrate administrative leadership.…

  12. Grief among Surviving Family Members of Homicide Victims: A Causal Approach.

    ERIC Educational Resources Information Center

    Sprang, M. Virginia; And Others

    1993-01-01

    Proposed causal model to delineate predictors of self-reported grief among surviving family members of homicide victims. Evaluated model using data from survey of members of "Victims of Violence" support groups. Results generally supported model and indicated that correlates of grief differed across gender-specific subgroups in terms of their…

  13. Staff Grief Resolution and Care for the Elderly: Artificial Intelligence Analysis.

    ERIC Educational Resources Information Center

    Seibert, Phyllis M.; Pastorello, Thomas

    Literature on health professionals describes the problems associated with unresolved or poorly resolved grief. Previous research has indicated that the most important reason why health professionals stay in their jobs is their relationship to patients. This study examined how nursing home personnel resolve their grief following deaths of clients.…

  14. The Relationship of Resilience with Attitude toward Grief in University Students

    ERIC Educational Resources Information Center

    Celik, Seher Balci

    2013-01-01

    The purpose of this study is to reveal whether university students' level of resilience differ by gender and attitude toward grief, and to identify to what extent resilience predicts attitude toward grief. 259 students studying at Ondokuz Mayis University participated in the study. The average age of the participants was 20.27 plus or minus…

  15. The influence of marital quality and attachment styles on traumatic grief and depressive symptoms.

    PubMed

    van Doorn, C; Kasl, S V; Beery, L C; Jacobs, S C; Prigerson, H G

    1998-09-01

    Few studies have examined the relationship between marital quality and adjustment to the impending loss of a terminally ill spouse. Most studies of marital quality and grief have been based on retrospective reports of the marriage rather than pre-loss assessments. Here, we tested the pre-loss cross-sectional effects of having a security-enhancing marriage on traumatic grief and depressive symptoms among 59 caregivers aged 50 and over of terminally ill spouses. We also examined whether insecure attachment styles were associated with traumatic grief and depressive symptoms. Findings suggest that security-increasing marriages and insecure attachment styles put spouses at risk for elevated traumatic grief symptoms. Results also indicate that marital quality and attachment style did not interact and that neither was significantly associated with depressive symptoms. The differences in the relationship of marital quality and attachment styles to the two outcomes suggest that the etiology of traumatic grief and depressive symptoms may be distinct. PMID:9741563

  16. Exploiting loss?: ethical considerations, boundaries, and opportunities for the study of death and grief online.

    PubMed

    Carmack, Heather J; DeGroot, Jocelyn M

    More people are turning to the Internet to communicate about dying, death, and grief experiences. This theoretical article explores the ethical dilemmas, challenges, and opportunities presented to researchers interested in exploring how death and grief are communicated online. Weaving together the literatures of computer-mediated communication and thanatology (dying and death), we discuss the ways in which many common ethical dilemmas uniquely manifest related to death and grief. We also explore the emotional impact studying death and grief online has on researchers and the importance of thinking about researcher emotions on scholars who study these issues. We end with recommendations of how to move forward in the dialogue about ethics and studying death and grief online. PMID:24968619

  17. Incorporating corrosion measurement in hip wear simulators: An added complication or a necessity?

    PubMed

    Neville, Anne; Hesketh, James; Beadling, Andrew R; Bryant, Michael G; Dowson, Duncan

    2016-05-01

    Corrosion is not routinely considered in the assessment of the degradation or the lifetime of total hip replacement bearing surfaces. Biomechanical simulations are becoming ever more complex and are taking into account motion cycles that represent activities beyond a simple walking gait at 1 Hz, marking a departure from the standard ISO BS 14242. However, the degradation is still very often referred to as wear, even though the material loss occurs due to a combination of tribological and corrosion processes and their interactions. This article evaluates how, by incorporating real-time corrosion measurements in total hip replacement simulations, pre-clinical evaluations and research studies can both yield much more information and accelerate the process towards improved implants. PMID:27160560

  18. Developing a Blended Course on Dying, Loss, and Grief

    PubMed Central

    Kavanaugh, Karen; Andreoni, V. Ann; Wilkie, Diana J.; Burgener, Sandra; Buschmann, MaryBeth Tank; Henderson, Gloria; Hsiung, Yi-Fang Yvonne; Zhao, Zhongsheng

    2010-01-01

    An important component of end-of-life education is to provide health professionals with content related to dying, loss, and grief. The authors describe the strategies used to develop and offer a blended course (integration of classroom face-to-face learning with online learning) that addressed the sensitive and often emotional content associated with grieving and bereavement. Using Kolb’s experiential learning theory, a set of 4 online learning modules, with engaging, interactive elements, was created. Course evaluations demonstrated the success of the blended course in comparison to the traditional, exclusive face-to-face approach. PMID:19412055

  19. Long-term effects of the Family Bereavement Program on spousally bereaved parents: Grief, mental health problems, alcohol problems, and coping efficacy.

    PubMed

    Sandler, Irwin; Tein, Jenn-Yun; Cham, Heining; Wolchik, Sharlene; Ayers, Tim

    2016-08-01

    This study reports on the findings from a 6-year follow-up of a randomized trial of the Family Bereavement Program (FBP) on the outcomes for spousally bereaved parents. Spousally bereaved parents (N = 131) participated in the trial in which they were randomly assigned to receive the FBP (N = 72) or literature control (N = 59). Parents were assessed at four time points: pretest, posttest, and 11-month and 6-year follow-up. They reported on mental health problems, grief, and parenting at all four time periods. At the 6-year follow-up, parents reported on additional measures of persistent complex bereavement disorder, alcohol abuse problems, and coping efficacy. Bereaved parents in the FBP as compared to those in the literature control had lower levels of symptoms of depression, general psychiatric distress, prolonged grief, and alcohol problems, and higher coping efficacy (for mothers) at the 6-year follow-up. Multiple characteristics of the parent (e.g., gender, age, and baseline mental health problems) and of the spousal death (e.g., cause of death) were tested as moderators of program effects on each outcome, but only 3 of 45 tests of moderation were significant. Latent growth modeling found that the effects of the FBP on depression, psychiatric distress, and grief occurred immediately following program participation and were maintained over 6 years. Mediation analysis found that improvement in positive parenting partially mediated program effects to reduce depression and psychiatric distress, but had an indirect effect to higher levels of grief at the 6-year follow-up. Mediation analysis also found that improved parenting at the 6-year follow-up was partially mediated by program effects to reduce depression and that program effects to increase coping efficacy at the 6-year follow-up was partially mediated through reduced depression and grief and improved parenting. FBP reduced mental health problems, prolonged grief, and alcohol abuse, and increased coping

  20. Traumatic grief and traumatic stress in survivors 12 years after the genocide in Rwanda.

    PubMed

    Mutabaruka, Jean; Séjourné, Nathalène; Bui, Eric; Birmes, Philippe; Chabrol, Henri

    2012-10-01

    The relationship between exposure to traumatic events and traumatic grief and the role of mediating and moderating variables [peritraumatic distress, post traumatic stress disorder (PTSD) symptoms and symptoms of depression] were studied in survivors of the genocide of Batutsi in Rwanda in 1994. One hundred and two survivors (70 women, mean age 45 ± 7.53 years) participated in this retrospective study. All of them had lost a member of their family. The severity of traumatic exposure (Comprehensive Trauma Inventory), peritraumatic distress (Peritraumatic Distress Inventory), current PTSD symptoms (PTSD Checklist), depressive symptoms (Beck Depression Inventory) and traumatic grief symptoms (Inventory of Traumatic Grief) was evaluated. A hierarchical multiple regression analysis was then conducted to examine the relative contribution of each variable to the symptoms of traumatic grief. The severity of traumatic exposure was related to traumatic grief symptoms (B=0.06, R=0.6, R(2) =0.36 and ß=0.6, t=7.54, p=0.00). The Baron and Kenny procedure (1986) (including three separate regressions), along with the Sobel test, was used to test mediation effects. Peritraumatic distress and PTSD symptoms may be mediating variables between traumatic exposure and traumatic grief. Traumatic grief is a complex but assessable entity, where previous distress and suffering result from both psychological trauma and the loss of a loved one. PMID:22282057

  1. Negotiating grief and trauma in the coronial jurisdiction.

    PubMed

    Trabsky, Marc; Baron, Paula

    2016-03-01

    This article is placed within the wider context of lawyer wellbeing research, which evidences abnormally high levels of depression, substance abuse and suicide among the legal profession. To date, however, relatively few works have sought to explore the phenomenon of lawyer distress in particular segments of the legal services industry. This article seeks to explore and understand the affective experiences of legal professionals working in the coronial jurisdiction. It examines the ways in which solicitors, barristers and coroners negotiate grief and trauma in the performance of a public role. The point of departure is an enduring conflict between the responsibilities of office and the cultivation of intimate relations. In exploring the likelihood of distress among legal personnel in the coronial jurisdiction, this article looks not only to research on the wellbeing of legal personnel, but to the literature on vicarious or secondary trauma reactions and compassion fatigue among professions dealing with trauma. In examining the different ways in which legal personnel manage and negotiate grief and trauma, the article draws on the sociological concept of intimate citizenship to suggest that the operational model of the court, informal networks among professionals and strong personal relationships may serve to ameliorate distress. PMID:27323636

  2. Hidden Trauma, Quiet Drama: The Prominence and Consequence of Complicated Grief among College Students

    ERIC Educational Resources Information Center

    Cox, Bradley E.; Dean, Jessica G.; Kowalski, Robin

    2015-01-01

    Previous studies suggest the loss of a loved one is a common experience among college students. This paper draws from 2 independent but complementary studies to (a) update statistics regarding the scale of student grieving, (b) characterize the short and long term consequences of loss among college students, and (c) identify factors that deter…

  3. An open trial of 'grief-help': a cognitive-behavioural treatment for prolonged grief in children and adolescents.

    PubMed

    Spuij, Mariken; Dekovic, Maja; Boelen, Paul A

    2015-01-01

    In the past years, there is growing recognition of a syndrome of disturbed grief referred to as prolonged grief disorder (PGD). Although mostly studied in adults, clinically significant PGD symptoms have also been observed in children and adolescents. To date, no effective treatment for childhood PGD yet exists. We recently developed a nine-session cognitive-behavioural treatment for childhood PGD combined with five sessions of parental counselling. In the current article, we present outcomes of treatment of 10 consecutive children and adolescents turning to our university clinic with elevated PGD symptoms as their primary problem and main reason to seek therapy. Patients were significantly improved at post-treatment, with large improvements in self-rated PGD and post-traumatic stress (effect sizes > 0.8) and small to moderate improvement in depression and parent-rated internalizing and externalizing problems (0.2 < effect sizes < 0.8). Additional predictor analysis of outcomes suggested that, among other things, this treatment approach is less efficacious for children and adolescents further removed from loss and those confronted with suicidal loss. That said, the treatment appears promising, and controlled evaluation is clearly indicated. PMID:24227661

  4. Suicide survivors' mental health and grief reactions: a systematic review of controlled studies.

    PubMed

    Sveen, Carl-Aksel; Walby, Fredrik A

    2008-02-01

    There has been a debate over several decades whether suicide survivors experience more severe mental health consequences and grief reactions than those who have been bereaved through other causes of death. This is the first systematic review of suicide survivors' reactions compared with survivors after other modes of death. Studies were identified by searching the PsychINFO and MEDLINE databases. Forty-one studies met the eligibility criteria. A qualitative data analysis was performed. There were no significant differences between survivors of suicide and other bereaved groups regarding general mental health, depression, PTSD symptoms, anxiety, and suicidal behavior. The results regarding the overall level of grief are less clear, depending on whether general grief instruments or suicide-specific instruments are used. Considering specific grief variables, suicide survivors report higher levels of rejection, shame, stigma, need for concealing the cause of death, and blaming than all other survivor groups. PMID:18355105

  5. Diphtheria Complications

    MedlinePlus

    ... Search The CDC Cancel Submit Search The CDC Diphtheria Note: Javascript is disabled or is not supported ... message, please visit this page: About CDC.gov . Diphtheria Home About Diphtheria Causes and Transmission Symptoms Complications ...

  6. Graduate students' self assessment of competency in grief education and training in core accredited rehabilitation counseling programs

    NASA Astrophysics Data System (ADS)

    Cicchetti, Richard Jude

    The study examined whether 93 master's level rehabilitation counselor trainees from select Midwestern CORE-accredited schools report having been adequately trained to identify and work with clients who are having grief-related issues from a loss or disability. Using the Grief Counseling Competency Scale (GCCS), participants showed a wide range of scores regarding personal competency related to grief; however, scores tended to be low when examining skills and knowledge relating to grief, with most respondents scoring between "this barely describes me" and "this somewhat describes me." Although presence or history of a disability was found to be related to personal competency, a number of variables were not related, including: gender, age, race/ethnicity, course work in grief theories and grief interventions, practica/internship setting, and attitudes toward people with disabilities. Implications for further research are discussed.

  7. End-of-life issues: difficult decisions and dealing with grief.

    PubMed

    Loomis, Beth

    2009-06-01

    People face many challenging psychosocial and spiritual issues as they approach the end of their lives, and caregivers need advice on how to help them. Choosing among treatment options, handling grief, addressing unfinished business, and coping with loss of self-sufficiency are difficult for the dying person, and caregivers must deal with surrogate decision making, raw emotions in the patient and in family members, and the caregivers' own grief. Listening and coping skills are discussed. PMID:19463678

  8. Languages of Grief: a model for understanding the expressions of the bereaved

    PubMed Central

    Corless, Inge B.; Limbo, Rana; Bousso, Regina Szylit; Wrenn, Robert L.; Head, David; Lickiss, Norelle; Wass, Hannelore

    2014-01-01

    The aim of this work is to provide an overview of the key features of the expressions of grief. Grief is a response to loss or anticipated loss. Although universal, its oral and nonverbal expression varies across cultures and individuals. Loss is produced by an event perceived to be negative to varying degrees by the individuals involved and has the potential to trigger long-term changes in a person's cognitions and relationships. The languages used by the bereaved to express grief differ from the language used by professionals, creating dissonance between the two. Data were obtained from English language Medline and CINAHL databases, from professional and personal experiences, interviews with experts, and exploration of cemetery memorials. Blog websites and social networks provided additional materials for further refinement of the model. Content analysis of the materials and agreement by the authors as to the themes resulted in the development of the model. To bridge the gap between professional language and that used by the bereaved, a Languages of Grief model was developed consisting of four Modes of Expression, four Types of Language, plus three Contingent Factors. The Languages of Grief provides a framework for comprehending the grief of the individual, contributing to clinical understanding, and fruitful exploration by professionals in better understanding the use of languages by the bereaved. Attention to the Modes of Expression, Types of Language, and Contingent Factors provides the professional with a richer understanding of the grieving individual, a step in providing appropriate support to the bereaved. The Languages of Grief provides a framework for application to discrete occurrences with the goal of understanding grief from the perspective of the bereaved. PMID:25750773

  9. A pilot study on the effectiveness of anticipatory grief therapy for elderly facing the end of life.

    PubMed

    Cheng, Joanna Oi-Yue; Lo, Raymond; Chan, Faye; Woo, Jean

    2010-01-01

    This pilot study evaluates the benefits of anticipatory grief therapy (AGT) for day hospice patients and long-term care (LTC) residents with cancer and non-malignant chronic diseases. Twenty-six elderly people (69.2 percent female; average age 81.8 years) participated in experiential, expressive activities and discussions during AGT. The McGill Quality of Life Questionnaire-Hong Kong version and the 15-item Geriatrics Depression Scale (Chinese version) were administered immediately before and after AGT, and at a four-week follow-up. Focus groups were held to collect qualitative feedback. Significant post-AGT improvements were found in physical (Z = -2.12, p < 0.05), psychological (Z = -2.22, p < 0.05), and total quality of life measures (Z = -2.66, p < 0.01), and in depression levels (Z = -2.49, p < 0.05). Emergent qualitative themes included grief and existential concerns, pros and cons of reminiscence, reflection and affirmation of meaning through expressive art, perceived benefits of AGT, and comments and suggestions for improving AGT in the future. We conclude that AGT delivered in both day hospice and LTC settings could be acceptable, feasible, and useful for elderly people facing the end of life. PMID:21268518

  10. "Please Know That You Are Not Alone with Your Pain": Responses to Newcomer Posts in an Online Grief Support Forum.

    PubMed

    Paulus, Trena M; Varga, Mary Alice

    2015-01-01

    In an effort to better understand how the Internet can provide support to bereaved individuals, this discourse analysis study examined the responses to 107 initial posts in an online grief support group to understand how newcomers' bids for group membership were taken up by current members. Discursive features included validation and empathy through second stories, constructing grief through descriptions, and accepting bids for membership through advice giving and invitations to return to the group. These features illustrate how grief and being a griever are constructed in an online context and how they deviate from the "normal" grief expectations in the offline world. PMID:26024251

  11. Quality Control Measures over 30 Years in a Multicenter Clinical Study: Results from the Diabetes Control and Complications Trial / Epidemiology of Diabetes Interventions and Complications (DCCT/EDIC) Study

    PubMed Central

    Arends, Valerie L.; Danis, Ronald P.; Diminick, Lisa; Klumpp, Kandace A.; Morrison, Anthony D.; Soliman, Elsayed Z.; Steffes, Michael W.; Cleary, Patricia A.

    2015-01-01

    Implementation of multicenter and/or longitudinal studies requires an effective quality assurance program to identify trends, data inconsistencies and process variability of results over time. The Diabetes Control and Complications Trial (DCCT) and the follow-up Epidemiology of Diabetes Interventions and Complications (EDIC) study represent over 30 years of data collection among a cohort of participants across 27 clinical centers. The quality assurance plan is overseen by the Data Coordinating Center and is implemented across the clinical centers and central reading units. Each central unit incorporates specific DCCT/EDIC quality monitoring activities into their routine quality assurance plan. The results are reviewed by a data quality assurance committee whose function is to identify variances in quality that may impact study results from the central units as well as within and across clinical centers, and to recommend implementation of corrective procedures when necessary. Over the 30-year period, changes to the methods, equipment, or clinical procedures have been required to keep procedures current and ensure continued collection of scientifically valid and clinically relevant results. Pilot testing to compare historic processes with contemporary alternatives is performed and comparability is validated prior to incorporation of new procedures into the study. Details of the quality assurance plan across and within the clinical and central reading units are described, and quality outcomes for core measures analyzed by the central reading units (e.g. biochemical samples, fundus photographs, ECGs) are presented. PMID:26529311

  12. Grief-Processing-Based Psychological Intervention for Children Orphaned by AIDS in Central China: A Pilot Study

    ERIC Educational Resources Information Center

    Lin, Xiuyun; Fang, Xiaoyi; Chi, Peilian; Li, Xiaoming; Chen, Wenrui; Heath, Melissa Allen

    2014-01-01

    A group of 124 children orphaned by AIDS (COA), who resided in two orphanages funded by the Chinese government, participated in a study investigating the efficacy of a grief-processing-based psychological group intervention. This psychological intervention program was designed to specifically help COA process their grief and reduce their…

  13. College Students' Comfort Level Discussing Death with Faculty and Perceptions of Faculty Support for Grief-Affected Students

    ERIC Educational Resources Information Center

    Hedman, A. S.

    2012-01-01

    Students' comfort discussing death with faculty, views regarding faculty's likelihood to provide accommodations to grief-affected students, and perceived empathy of faculty were assessed. Undergraduate students (n = 371) attending a Midwestern university completed the Student Survey on Grief Issues. Twenty-six percent reported the death of at…

  14. Grief and Personal Growth Experience of Spouses and Adult-Child Caregivers of Individuals with Alzheimer's Disease and Related Dementias

    ERIC Educational Resources Information Center

    Ott, Carol H.; Sanders, Sara; Kelber, Sheryl T.

    2007-01-01

    Purpose: The purpose of this study was to describe the grief and personal growth experience of spouses and adult children of individuals with Alzheimer's disease and related dementias and the factors contributing to these experiences. Design and Methods: We used a modification of the Marwit-Meuser-Sanders Caregiver Grief model to examine the…

  15. Being Under the Umbrella of Persistent Grief: Experiences of Survivors of Bam Earthquake.

    PubMed

    Tirgari, Batool; Azzizadeh Forouzi, Mansooreh; Malakian, Lila

    2016-05-01

    The loss of a loved one is a highly stressful event that nearly everyone experiences. Multiple losses can leave relatives feeling overwhelmed or stuck in their grief, a phenomenon commonly referred to as bereavement overload. This study aimed to elucidate the meaning of prolonged grief from the viewpoint of the survivors of the Bam earthquake (Iran, December 2003) 11 years after the earthquake in south eastern Iran. Family members who lost loved ones in the Bam earthquake were considered potential participants. A total of 12 survivors participated in this study. The interviews were analyzed with Ricoeur's phenomenological hermeneutic method. The meaning of prolonged grief was comprehensively understood as "being under the umbrella of persistent grief." This can be divided into four themes: experiencing a divine and painful destiny, experiencing heartbreaking goodbye with loved ones, losing all hopes and dreams, and being in a state of fragile peace. The results in this study suggest survivors of the Bam earthquake grief can be moderated by adequate crisis-related coping resources such as social, cultural, and religious supports. These supports are clearly important to survivors' post-earthquake recovery. PMID:27172233

  16. Prolonged grief disorder and depression in widows due to the Rwandan genocide.

    PubMed

    Schaal, Susanne; Elbert, Thomas; Neuner, Frank

    2009-01-01

    Should pathological grief be viewed as a nosological category, separate from other forms of mental diseases? Diagnostic criteria for "Prolonged Grief Disorder" (PGD) have recently been specified by Prigerson and her coworkers. We interviewed a total of 40 widows who had lost their husbands during the Rwandan genocide in 1994. We assessed Major Depression using the Mini-International Neuropsychiatric Interview (M.I.N.I.) and prolonged grief reactions with the PG-13. In order to examine the distinctiveness of the two syndromes we performed a multitrait correlational matrix analysis using modified versions of Generalized Proximity Functions (GPFs). 12.5% (n = 5) of the sample fulfilled the criteria for a diagnosis of PGD; 40% (n = 16) met criteria for Major Depressive Episode. The two syndromes were strongly associated. No discriminant validity was found between the two constructs suggesting that PGD may rather be an appearance of depression than a separate nosological entity. PMID:19791517

  17. Grief in the initial adjustment process to the continuing care retirement community.

    PubMed

    Ayalon, Liat; Green, Varda

    2012-12-01

    This paper examined the transition to continuing care retirement communities (CCRCs) within the framework of anticipatory and disenfranchised grief. Qualitative interviews with 29 residents and 19 adult children were conducted. Three major thematic categories emerged from the data. The first theme reflected ambivalence, dialectics or uncertainty about the CCRC as manifested by the various names assigned to it by respondents. The second theme reflected the acknowledgement of present and anticipatory losses and grief in response to the move. The final theme reflected respondents' disenfranchisement of their grief and loss and their view of the transition in a positive light. In their early adjustment period, residents and adult children are ambivalent about the transition, but often refrain from acknowledging their losses openly because of the image of the CCRC as a status symbol. Open acknowledgement of losses associated with the transition might be beneficial. PMID:22939535

  18. After the death of a friend: Young Men’s grief and masculine identities

    PubMed Central

    Creighton, Genevieve; Oliffe, John L.; Butterwick, Shauna; Saewyc, Elizabeth

    2015-01-01

    Young men can have an uncomfortable relationship with grief. Socially constructed masculine ideals dictate that men be stoic in the aftermath of loss, most often expressing their sadness and despair as anger. Perhaps because of alignment to such masculine ideals little research has been done to explore young men’s grief – and chronicle the ways they think about loss, their responses and how they go about describing their identities after a tragic event. Using qualitative individual interviews and photo elicitation methods, we investigated the ways in which 25 men aged 19–25 grieved the accidental death of a male friend. The study was conducted from April 2010–December 2011. Causes of death were diverse, and included motor vehicle accidents, adventure sports, drug overdose and fights. The findings revealed men’s predominant grief responses as emptiness, anger, stoicism and sentimentality. Participants’ description of their grief responses illustrated the ways in which they struggled to reconcile feelings of vulnerability and manly ideals of strength and stoicism. We gained insight into men’s grief practices by looking at the ways in which they aligned themselves with a post-loss masculine identity. These identities, which included the adventurer, father-figure and the lamplighter, revealed gender-specific processes through which men understood and actively dealt with their tragic loss. The results offer novel insights to men’s grief and identity work that may serve to affirm other men’s experiences as well as guide counselling services targeted to young men. PMID:23517702

  19. Illustrating an integrated typology of meaning reconstruction in discourse: grief-related disclosures.

    PubMed

    Kunkel, Adrianne; Dennis, Michael Robert; Garner, Benjamin

    2014-01-01

    A typology of meaning reconstruction in grief-related discourse is offered as an extension to extant approaches to meaning making as a factor in relieving distress. Sensemaking, acceptance or resignation without understanding, realization of benefits via positive reappraisal, and realignment of roles and relationships are advanced as the 4 types of meaning reconstruction that are formed by the 4 intersections of Park's ( 2010 ) categorical distinctions in meaning making (i.e., searching for comprehensibility/searching for significance and assimilation/accommodation). Interpretive analysis of grief-related texts from an emotional disclosure study reveals 25 themes across the 4 types. Related theoretical insights and practical implications are discussed. PMID:24611585

  20. Negotiating governance in virtual worlds: grief play, hacktivism, and LeakOps in Second Life®

    NASA Astrophysics Data System (ADS)

    Bakioğlu, Burcu S.

    2012-12-01

    The acts of transgression in cyberspace have grown in visibility with grief play and griefing in virtual worlds. Briefly defined, griefing is the intentional harassment of other players. This paper argues that in recent years, griefing has developed from a set of trolling practices that manifests itself as offensive language and tasteless pranks into political initiatives with hacktivist undertones. Because the tactical nature of role-playing and gaming provides the anonymity and the cunningness required for hacktivistic initiatives, griefing bears the potential to take part in the transgressive politics of civil disobedience. Arguing that grief play and griefing are tactical uses of media that lead to transgressive politics, this paper will examine the role of such activities in influencing virtual politics. In order to demonstrate how this transformation has occurred, this paper will discuss the birth of vigilante organizations, specifically, that of Justice League Unlimited (JLU), and the operation conducted against them by The Wrong Hands. The said operation, whose intention was to leak JLU's secret papers, Brainiac Wiki, exposed a grid-wide surveillance operation that the vigilante group was conducting in Second Life®.

  1. The experience of high levels of grief in caregivers of persons with Alzheimer's disease and related dementia.

    PubMed

    Sanders, Sara; Ott, Carol H; Kelber, Sheryl T; Noonan, Patricia

    2008-01-01

    An abundance of literature on caregivers of individuals with dementia has been written since the mid-1980s. However, most of this literature focused on the experience of stress, burden, and depression in caregivers, thus excluding the grief experience that also accompanies the caregiving experience. The purpose of this multimethod study is to describe the lived experience of 44 spouses and adult children who are caregivers of persons with Alzheimer's disease and related dementias (ADRD) and scored high on the Marwit and Meuser Caregiver Grief Inventory, Short Form (MM-CGI-SF). This study presents qualitative results from a mixed-methods descriptive study (N = 201). Seven themes emerged from the qualitative data that detailed the caregiving experience of the individuals with high grief: (a) yearning for the past, (b) regret and guilt, (c) isolation, (d) restricted freedom, (e) life stressors, (f) systemic issues, and (g) coping strategies. The first 2 themes reflect grief reactions, whereas isolation, restricted freedom, life stressors, and systemic issues possessed elements of both grief and caregiver burden and stress. Coping strategies used by this group of caregivers included spiritual faith, social supports, and pets. Quantitative analysis confirmed that these themes are unique to individuals with high levels of grief compared with those with moderate/low levels of grief, except for the coping strategies of social support and spiritual faith. Caregivers with high levels of grief may benefit from supportive interventions that are based on reducing feelings of isolation, lack of freedom, and increased guilt and regret, while also addressing feelings of loss. Interventions that facilitate building a supportive network are suggested. Using a screening tool such as the MM-CGI-SF will help in identifying caregivers with high levels of grief who may be in need of additional support. PMID:18958942

  2. Avoiding Complications in Gigantomastia.

    PubMed

    Kling, Russell E; Tobler, William D; Gusenoff, Jeffrey A; Rubin, J Peter

    2016-04-01

    Gigantomastia is a disabling condition for patients and presents unique challenges to plastic surgeons. Presentation can occur throughout different phases of life, and treatment often begins with nonoperative measures; however, the most effective way to relieve symptoms is surgical breast reduction. Because of the large amount of tissue removed, surgeons can encounter different intraoperative and postoperative complications. By understanding this disease process and these complications, surgeons can attempt to minimize their occurrences. The authors present an overview of the cause, preoperative evaluation, techniques, and outcomes. Additionally, they present outcomes data from their center on 40 patients. PMID:27012802

  3. [Anticipatory grief in adolescents and young adults coping with parental cancer].

    PubMed

    Gross, Juliane; Jantzer, Vanessa; Stute, Fridrike; Parzer, Peter; Brunner, Romuald; Willig, Katrin; Schuller-Roma, Bärbel; Keller, Monika; Herzog, Wolfgang; Romer, Georg; Resch, Franz

    2012-01-01

    By the current state of research, it cannot be answered clearly how adolescents experience anticipatory grief and if and to which extent this process differs from anticipatory grief of adults. The present study will fill this gap by providing both a quantitative and a qualitative description of anticipatory grief processes. Therefore, 74 adolescents and young adults (11-21 years), whose parents have suffered from cancer, completed an adapted version of the "Trauerfragebogen" (Weiser u. Ochsmann, 2002). Additionally a subsample of n = 38 took part in a qualitative guided interview. Based on these interviews, 16 categories were formed, that were assigned to two types of stressors. Beside communication and prioritization of family, different symptoms of grief were the central category in the loss-oriented type, where fears of loss, compassion and concern were of crucial importance. Also categories of the restoration-oriented type were strongly present. Thus, it seems that young people generally manage to accept their new role in the stressful family situation and they have a series of coping mechanisms available to do so. This was also reflected in the quantitative data, were the subscale "Inner Strength" reached the highest value. In the counselling of adolescents with cancer-diseased parents, both loss-oriented and restoration-oriented processes should equally be recognized and encouraged. PMID:22950336

  4. Couples at Risk Following the Death of Their Child: Predictors of Grief versus Depression

    ERIC Educational Resources Information Center

    Wijngaards-de Meij, Leoniek; Stroebe, Margaret; Schut, Henk; Stroebe, Wolfgang; van den Bout, Jan; van der Heijden, Peter; Dijkstra, Iris

    2005-01-01

    This longitudinal study examined the relative impact of major variables for predicting adjustment (in terms of both grief and depression) among bereaved parents following the death of their child. Couples (N = 219) participated 6, 13, and 20 months postloss. Use of multilevel regression analyses enabled assessment of the impact of several…

  5. Mourning Child Grief Support Group Curriculum: Preschool Edition. Denny the Duck Stories.

    ERIC Educational Resources Information Center

    Lehmann, Linda; Jimerson, Shane R.; Gaasch, Ann

    The Mourning Child Preschool grief support curriculum is intended for use with preschool children who have experienced the death of someone special to them. It is designed for use by professionals who work in schools, hospitals, hospices, mental health agencies, or any setting that serves bereaved children. The curriculum contains lesson plans for…

  6. Building a Network of Grief Support on College Campuses: A National Grassroots Initiative

    ERIC Educational Resources Information Center

    Fajgenbaum, David; Chesson, Benjamin; Lanzi, Robin Gaines

    2012-01-01

    About one in four college students report grieving the death of a family member or close friend within the past year. Although grief may be difficult at any time, there are several factors unique to the college age and environment that can make it particularly difficult. These factors include geographic distance from home and usual support…

  7. Development and Preliminary Evaluation of a Cognitive-Behavioral Intervention for Perinatal Grief

    ERIC Educational Resources Information Center

    Bennett, Shannon M.; Ehrenreich-May, Jill; Litz, Brett T.; Boisseau, Christina L.; Barlow, David H.

    2012-01-01

    Perinatal loss, typically defined as fetal death beyond 20 weeks gestation through infant death 1-month postpartum, is a potentially traumatizing experience for parents occurring in approximately 1% of births in the United States. Although many women recover, 15% to 25% have enduring grief-related symptomatology and functional impairment.…

  8. Features of Prolonged Grief Symptoms in Chinese and Swiss Bereaved Parents.

    PubMed

    Xiu, Daiming; Maercker, Andreas; Woynar, Stefanie; Geirhofer, Bettina; Yang, Yuting; Jia, Xiaoming

    2016-09-01

    This study investigates clinical expressions of prolonged grief in samples of 32 Chinese and 33 Swiss bereaved parents, according to the proposed International Classification of Diseases, 11th Revision model of prolonged grief disorder (PGD). Sex differences and predictors (cultural attitudes, sense of coherence, and posttraumatic growth) of PGD were analyzed. In result, after controlling for sociodemographic and loss-related sample differences, both samples showed similar PGD symptom profiles, with Swiss parents exhibiting more severe grief-related preoccupation and Chinese parents exhibiting some accessory symptoms and functional impairment to a greater extent. Multivariate analyses revealed for the Chinese sample primary predictions of PGD by life satisfaction, general health and one's world view (social cynicism) and for the Swiss sample by female sex, sense of coherence, and life satisfaction. The findings substantiate the basic appropriateness of the International Classification of Diseases, 11th Revision PGD in distinct cultural groups and may contribute to a better understanding of grief expression and its potential predictors across different cultures. PMID:27253073

  9. Suicide Survivors' Mental Health and Grief Reactions: A Systematic Review of Controlled Studies

    ERIC Educational Resources Information Center

    Sveen, Carl-Aksel; Walby, Fredrik A.

    2008-01-01

    There has been a debate over several decades whether suicide survivors experience more severe mental health consequences and grief reactions than those who have been bereaved through other causes of death. This is the first systematic review of suicide survivors' reactions compared with survivors after other modes of death. Studies were identified…

  10. Understanding Parental Grief as a Response to Mental Illness: Implications for Practice

    ERIC Educational Resources Information Center

    Penzo, Jeanine A.; Harvey, Pat

    2008-01-01

    Parents who are raising children with mental illness struggle with feelings of grief and loss. Kubler-Ross' (1969) stages of grieving (denial, anger, bargaining, depression, and acceptance) are examined as experienced by parents raising children with chronic mental illness. Practice implications for social workers who are working with children and…

  11. A Systemic Approach to Facilitating Family Grief Resolution Following the Death of a Child.

    ERIC Educational Resources Information Center

    Charkow, Wendy B.

    This paper provides counselors and other helping professionals with tools for assessment of and intervention in grieving families that have suffered the loss of a child or fetus through illness, accident, violence, or miscarriage. Helping professionals who don't specialize in grief issues can especially benefit from this information, as many…

  12. Prolonged grief among traumatically bereaved relatives exposed and not exposed to a tsunami.

    PubMed

    Johannesson, Kerstin Bergh; Lundin, Tom; Hultman, Christina M; Fröjd, Thomas; Michel, Per-Olof

    2011-08-01

    Numerous studies on the mental health consequences of traumatic exposure to a disaster compare those exposed to those not exposed. Relatively few focus on the effect of the death of a close relative caused by the disaster-suffering a traumatic bereavement. This study compared the impact on 345 participants who lost a close relative in the 2004 Indian Ocean tsunami, but who were themselves not present, to 141 who not only lost a relative, but also were themselves exposed to the tsunami. The focus was on psychological distress assessed during the second year after the sudden bereavement. Findings were that exposure to the tsunami was associated with prolonged grief (B = 3.81) and posttraumatic stress reactions (B = 6.65), and doubled the risk for impaired mental health. Loss of children increased the risk for psychological distress (prolonged grief: B = 6.92; The Impact of Event Scale-Revised: B = 6.10; General Health Questionnaire-12: OR = 2.34). Women had a higher frequency of prolonged grief. For men, loss of children presented a higher risk for prolonged grief in relation to other types of bereavement (B = 6.36 vs. loss of partner). Further long-term follow-up could deepen the understanding of how recovery after traumatic loss is facilitated. PMID:21818785

  13. Prolonged grief and depression after unnatural loss: Latent class analyses and cognitive correlates.

    PubMed

    Boelen, Paul A; Reijntjes, Albert; J Djelantik, A A A Manik; Smid, Geert E

    2016-06-30

    This study sought to identify (a) subgroups among people confronted with unnatural/violent loss characterized by different symptoms profiles of prolonged grief disorder (PGD) and depression, and (b) socio-demographic, loss-related, and cognitive variables associated with subgroup membership. We used data from 245 individuals confronted with the death of a loved one due to an accident (47.3%), suicide (49%) or homicide (3.7%). Latent class analysis revealed three classes of participants: a resilient-class (25.3%), a predominantly PGD-class (39.2%), and a combined PGD/Depression-class (35.5%). Membership in the resilient-class was predicted by longer time since loss and lower age; membership in the combined class was predicted by lower education. Endorsement of negative cognitions about the self, life, the future, and one's own grief-reactions was lowest in the Resilient-class, intermediate in the PGD-class, and highest in the combined PGD/Depression-class. When all socio-demographic, loss-related, and cognitive variables were included in multinomial regression analyses predicting class-membership, it was found that negative cognitions about one's grief was the only variable predicting membership of the PGD-class. Negative cognitions about the self, life, and grief predicted membership of the combined PGD/Depression-class. These findings provide valuable information for the development of interventions for different subgroups of bereaved individuals confronted with unnatural/violent loss. PMID:27138832

  14. Disciplinary Wounds: Has Grief become the Identified Patient for a Field Gone Awry?

    ERIC Educational Resources Information Center

    Granek, Leeat

    2013-01-01

    In the last few decades, grief and loss research in the psychological domain has focused almost exclusively on its dysfunctional nature. I examine what is underneath these questions about pathology and suggest that our discipline is suffering from an attachment wound where we have dissociated from our historical roots when it comes to the study of…

  15. Trauma, Grief and Depression in Nairobi Children After the 1998 Bombing of the American Embassy

    ERIC Educational Resources Information Center

    Pfefferbaum, Betty; North, Carol S.; Doughty, Debby E.; Pfefferbaum, Rose L.; Dumont, Cedric E.; Pynoos, Robert S.; Gurwitch, Robin H.; Ndetei, David

    2006-01-01

    Despite the increasingly dangerous world where trauma and loss are common, relatively few studies have explored traumatic grief in children. The 1998 American Embassy bombing in Nairobi, Kenya, provided an unfortunate opportunity to examine this topic. This report describes findings in 156 children who knew someone killed in the incident, assessed…

  16. Understanding Funeralization and Post-Funeralization Rituals: The Facilitation of Grief Work.

    ERIC Educational Resources Information Center

    Camp, Delpha; Bolton, Christopher

    Although thanatologists agree that grieving is essential in adjusting to the loss of a loved one, numerous questions about what facilitates the grieving process remain. To examine the relationship between funeral and post-funeral ritual and grief adjustment, 50 widowed persons (47 females, 3 males) were interviewed and completed two life…

  17. The Winding Valley of Grief: When a Dog Guide Retires or Dies

    ERIC Educational Resources Information Center

    Schneider, Katherine Standish

    2005-01-01

    Schools that train dog guides work hard to help their clients bond with their new partners, but during the initial training, little is said about the other end of the process, for example, when it is time to say good-bye. When people return for subsequent dogs, a grief group or individual counseling may be offered, but the focus remains on moving…

  18. Associations between Prolonged Grief Disorder, Depression, Posttraumatic Stress Disorder, and Anxiety in Rwandan Genocide Survivors

    ERIC Educational Resources Information Center

    Schaal, Susanne; Dusingizemungu, Jean-Pierre; Jacob, Nadja; Neuner, Frank; Elbert, Thomas

    2012-01-01

    A number of studies have demonstrated that symptoms of prolonged grief disorder (PGD) represent a symptom cluster distinct from bereavement-related depression, anxiety, and posttraumatic stress disorder (PTSD). The aim of the present study was to confirm and extend these findings using the most recent criteria defining PGD. The authors interviewed…

  19. Old Pain or New Pain: A Social Psychological Approach to Recurrent Grief.

    ERIC Educational Resources Information Center

    Brabant, Sarah

    1990-01-01

    Draws on work of George Herbert Mead to question premise that acute grief that continues or reoccurs two or more years following loss of loved one is pathological. Suggests that onset of intense pain years after loss may be response to "new" death or loss. (Author/NB)

  20. The Impact of Anticipatory Grief on Caregiver Burden in Dementia Caregivers

    ERIC Educational Resources Information Center

    Holley, Caitlin K.; Mast, Benjamin T.

    2009-01-01

    Purpose: Interest in anticipatory grief (AG) has typically focused on terminal diseases such as cancer. However, the issues involved in AG are unique in the context of dementia due to the progressive deterioration of both cognitive and physical abilities. The current study investigated the nature of AG in a sample of dementia caregivers and…

  1. Art Therapy Applications of Dolls in Grief Recovery, Identity, and Community Service

    ERIC Educational Resources Information Center

    Feen-Calligan, Holly; McIntyre, Barbara; Sands-Goldstein, Margaret

    2009-01-01

    This article reviews the history of dollmaking that is relevant to art therapy, and the application of dolls as therapeutic media in clinical and educational settings. The authors describe their experiences using dollmaking in the resolution of grief, in professional identity construction, and in community service. The article addresses the…

  2. Authority from Grief, Presence and Place in the Making of Roadside Memorials

    ERIC Educational Resources Information Center

    Clark, Jennifer; Franzmann, Majella

    2006-01-01

    Those who make memorials for the victims of motor vehicle crashes assume an authority to do so that stems from three main elements of experience: the overwhelming empowerment of grief; the belief that the presence of the deceased can be felt and recognized; and the understanding that the place where life was lost is a special place for…

  3. Metabolomics in diabetic complications.

    PubMed

    Filla, Laura A; Edwards, James L

    2016-04-22

    With a global prevalence of 9%, diabetes is the direct cause of millions of deaths each year and is quickly becoming a health crisis. Major long-term complications of diabetes arise from persistent oxidative stress and dysfunction in multiple metabolic pathways. The most serious complications involve vascular damage and include cardiovascular disease as well as microvascular disorders such as nephropathy, neuropathy, and retinopathy. Current clinical analyses like glycated hemoglobin and plasma glucose measurements hold some value as prognostic indicators of the severity of complications, but investigations into the underlying pathophysiology are still lacking. Advancements in biotechnology hold the key to uncovering new pathways and establishing therapeutic targets. Metabolomics, the study of small endogenous molecules, is a powerful toolset for studying pathophysiological processes and has been used to elucidate metabolic signatures of diabetes in various biological systems. Current challenges in the field involve correlating these biomarkers to specific complications to provide a better prediction of future risk and disease progression. This review will highlight the progress that has been made in the field of metabolomics including technological advancements, the identification of potential biomarkers, and metabolic pathways relevant to macro- and microvascular diabetic complications. PMID:26891794

  4. Disenfranchised grief and nonfinite loss as experienced by the families of death row inmates.

    PubMed

    Jones, Sandra J; Beck, Elizabeth

    The families of death row inmates experience grief and loss issues that have been neglected by scholars and clinicians alike. The issues found in this population are unique and require our understanding. The present study uses the concepts of disenfranchised grief and nonfinite loss to uncover the pain experienced by the children and other family members who have a loved one on death row. Kenneth Doka's (1989) concept of disenfranchised grief is utilized to bring attention to the ways in which the circumstances surrounding an execution leave the family members of those condemned to death outside of the "grieving rules" that exist in the United States. Family members are disenfranchised from their grief, as society does not socially validate their pain. The loss that they feel is also nonfinite (Bruce & Schultz, 2001) in that it is continuous and denies the families all of the hopes, dreams, and expectations that they had for their loved one who now sits on death row. The qualitative interview method was utilized by the authors of this study to gather data from 26 family members of death row inmates who are incarcerated along the East Coast of the United States. The reactions of this group of family members are varied and complex, yet they include the following common responses: social isolation due to stigma and their own feelings of criminalization, intensified family conflict between family members who grieve differently from one another, diminished self-esteem, shame, diffused and specific feelings of guilt, and a chronic state of despair. This study explores virtually untapped terrain. An examination of the microlevel effects of the death penalty on families provides insight in to the area of death and dying, especially as it is related to disenfranchised loss and nonfinite grief. In addition, this study provides insight into the death penalty and its effects. PMID:18186424

  5. Posttraumatic stress disorder and prolonged grief in refugees exposed to trauma and loss

    PubMed Central

    2014-01-01

    Background While a large proportion of conflict-affected populations have been dually exposed to trauma and loss, there is inadequate research identifying differential symptom profiles related to bereavement and trauma exposure in these groups. The objective of this study were to (1) determine whether there are distinct classes of posttraumatic stress disorder (PTSD) and prolonged grief disorder (PGD) symptoms in bereaved trauma survivors exposed to conflict and persecution, and (2) examine whether particular types of refugee experiences and stressors differentially predict symptom profiles. Methods Participants were 248 Mandaean adult refugees who were assessed at an average of 4.3 years since entering Australia following persecution in Iraq. PTSD, PGD, trauma exposure, adjustment difficulties since relocation, and English proficiency were measured. Latent class analysis was used to elucidate symptom profiles of PTSD and PGD in this sample. Results Latent class analysis revealed four classes of participants: a combined PTSD/PGD class (16%), a predominantly PTSD class (25%), a predominantly PGD class (16%), and a resilient class (43%). Whereas membership in the PTSD/PGD class was predicted by exposure to traumatic loss, those in the PGD class were more likely to have experienced adaptation difficulties since relocation, and individuals in the PTSD class were more likely to have experienced difficulties related to loss of culture and support. Conclusions This study provides evidence that specific symptom patterns emerge following exposure to mass trauma and loss. These profiles are associated with distinct types of traumatic experiences and post-migration living difficulties. These results have substantial public health implications for assessment and intervention following mass trauma. PMID:24712883

  6. Medical complications following splenectomy.

    PubMed

    Buzelé, R; Barbier, L; Sauvanet, A; Fantin, B

    2016-08-01

    Splenectomy is attended by medical complications, principally infectious and thromboembolic; the frequency of complications varies with the conditions that led to splenectomy (hematologic splenectomy, trauma, presence of portal hypertension). Most infectious complications are caused by encapsulated bacteria (Meningococcus, Pneumococcus, Hemophilus). These occur mainly in children and somewhat less commonly in adults within the first two years following splenectomy. Post-splenectomy infections are potentially severe with overwhelming post-splenectomy infection (OPSI) and this justifies preventive measures (prophylactic antibiotics, appropriate immunizations, patient education) and demands prompt antibiotic management with third-generation cephalosporins for any post-splenectomy fever. Thromboembolic complications can involve both the caval system (deep-vein thrombophlebitis, pulmonary embolism) and the portal system. Portal vein thrombosis occurs more commonly in patients with myeloproliferative disease and cirrhosis. No thromboembolic prophylaxis is recommended apart from perioperative low molecular weight heparin. However, some authors choose to prescribe a short course of anti-platelet medication if the post-splenectomy patient develops significant thrombocytosis. Thrombosis of the portal or caval venous system requires prolonged warfarin anticoagulation for 3 to 6 months. Finally, some studies have suggested an increase in the long-term incidence of cancer in splenectomized patients. PMID:27289254

  7. Hypoglycemia: The neglected complication

    PubMed Central

    Kalra, Sanjay; Mukherjee, Jagat Jyoti; Venkataraman, Subramanium; Bantwal, Ganapathi; Shaikh, Shehla; Saboo, Banshi; Das, Ashok Kumar; Ramachandran, Ambady

    2013-01-01

    Hypoglycemia is an important complication of glucose-lowering therapy in patients with diabetes mellitus. Attempts made at intensive glycemic control invariably increases the risk of hypoglycemia. A six-fold increase in deaths due to diabetes has been attributed to patients experiencing severe hypoglycemia in comparison to those not experiencing severe hypoglycemia Repeated episodes of hypoglycemia can lead to impairment of the counter-regulatory system with the potential for development of hypoglycemia unawareness. The short- and long-term complications of diabetes related hypoglycemia include precipitation of acute cerebrovascular disease, myocardial infarction, neurocognitive dysfunction, retinal cell death and loss of vision in addition to health-related quality of life issues pertaining to sleep, driving, employment, recreational activities involving exercise and travel. There is an urgent need to examine the clinical spectrum and burden of hypoglycemia so that adequate control measures can be implemented against this neglected life-threatening complication. Early recognition of hypoglycemia risk factors, self-monitoring of blood glucose, selection of appropriate treatment regimens with minimal or no risk of hypoglycemia and appropriate educational programs for healthcare professionals and patients with diabetes are the major ways forward to maintain good glycemic control, minimize the risk of hypoglycemia and thereby prevent long-term complications. PMID:24083163

  8. Forgotten grievers: an exploration of the grief experiences of bereaved grandparents (part 2).

    PubMed

    Gilrane-McGarry, Ursula; O Grady, Tom

    2012-04-01

    The death of a child is a traumatic family life event. Although parental bereavement has received substantial attention, little research has focused on the grief experiences of bereaved grandparents. The aims of this Irish national study were to identify and describe the bereavement experiences of grandparents following the death of their grandchild and to explore their needs and supports throughout. A previous paper provided background to the study, covered the methods used in depth, and presented one of the three key findings: 'cumulative pain'. The present paper discusses the remaining two findings: factors that facilitate and factors that inhibit the resolution of the cumulative pain. Several factors were perceived by the bereaved grandparents as being either helpful or unhelpful in easing the pain of their grief. Among these were acknowledgment of the deceased grandchild and the grandparents themselves, the relationship with the bereaved son or daughter, family dynamics, and support mechanisms. PMID:22584389

  9. Does the work role of Catholic clergy in Ireland contribute to the disenfranchisement of their grief?

    PubMed

    Mooney, Dearbhla

    2015-09-01

    While bereavement-related compassion fatigue and burnout have been studied in many helping professions, this researcher has found no peer-reviewed articles based specifically on bereavement experiences of Roman Catholic (RC) clergy in Ireland and only a handful on experiences of other religious ministers worldwide. There is a clear gap in research with regard to clergy experiences of personal or professional grief, the possible effects this may have on them, or the supports they use to help them cope. Peer support, some form of mentoring/supervision, and debriefing may help clergy to recognize their own grief, have it acknowledged by others, and recognize their personal strengths and limitations. While prevention of burnout is important to individual clergy, it is also vital for the health of the wider Church and formal support structures may be necessary as part of the Church's duty of care towards its clergy. PMID:26463852

  10. Constructions of Mexican American family grief after the death of a child: an exploratory study.

    PubMed

    Doran, Gerry; Downing Hansen, Nancy

    2006-04-01

    Using a collective case study ethnographic approach, nine individuals comprising three Mexican American families were interviewed about their family bereavement experiences after the death of a child. All families were Catholic, had surviving siblings, and had had three or more years to grieve their loss when interviewed. The deceased children ranged in age from 3 to 14, and all experienced sudden, traumatic, nonsuicide deaths. To provide a broader, contextual picture of their grief experiences, four individuals who supported these family members after the loss were also interviewed. Unique grief experiences were identified, and eight common themes emerged, reflecting the ways in which family members maintained their bond to the deceased: dreams, storytelling, keepsakes, sense of presence, faith-based connections, proximity connections, ongoing rituals, and pictorial remembrances. The cultural implications of family bereavement are highlighted. PMID:16719572

  11. Pleuropulmonary complications of pancreatitis

    PubMed Central

    Kaye, Michael D.

    1968-01-01

    Pancreatitis, in common with many other upper abdominal diseases, often leads to pleuropulmonary complications. Radiological evidence of pleuropulmonary abnormality was found in 55% of 58 cases examined retrospectively. The majority of such abnormalities are not specific for pancreatitis; but a particular category of pleural effusions, rich in pancreatic enzymes, is a notable exception. A patient with this type of effusion, complicated by a spontaneous bronchopleural fistula and then by an empyema, is reported. The literature relating to pancreatic enzyme-rich pleural effusions (pathognomonic of pancreatitis) is reviewed. Of several possible mechanisms involved in pathogenesis, transdiaphragmatic lymphatic transfer of pancreatic enzymes, intrapleural rupture of mediastinal extensions of pseudocysts, and diaphragmatic perforation are the most important. The measurement of pleural fluid amylase, at present little employed in this country, has considerable diagnostic value. Enzyme-rich effusions are more commonly left-sided, are often blood-stained, are frequently associated with pancreatic pseudocysts, and—if long standing—may be complicated by a bronchopleural fistula. Images PMID:4872925

  12. Disenfranchised grief following a non-fatal road traffic incident: a case study exploring a mother's experience.

    PubMed

    Rahman, Shaminah; De Souza, Joanna

    2014-07-01

    This case study explores a scenario that was observed by a final year nursing student on placement in a paediatric emergency department, in a busy London teaching hospital. A mother appeared distressed following the news that her son who had survived a road traffic incident with minimal impact to his cognitive and physical abilities, was stable enough to be transferred to the children's medical ward. Whilst this appeared to be positive for supporting figures in her life and the emergency practitioners involved, observation and discussion with the mother revealed that her distress was related to her experience of losses that were undetected by those around her. This included losses related to her son's future and the loss of her previous world. Amongst the plethora of theories about how we as humans react to loss and change, one theory which could explain the mother's grief suggests that it was disenfranchised, i.e. it was not acknowledged or validated by society. There are consequences of disenfranchised grief, such as a lack of social support leading to a higher risk of adverse psychological outcomes. Nurses in the emergency department can help resolve negative outcomes for patients and families experiencing disenfranchised grief. The key steps are to have knowledge of disenfranchised grief to be able to detect it, and then to validate it as a form of grief. PMID:24183108

  13. Complications in Eyelid Surgery.

    PubMed

    Karimnejad, Kaveh; Walen, Scott

    2016-05-01

    Eyelid surgery consists of challenging reconstructive and cosmetic procedures. Because of the complex anatomy and corresponding vital functions of the upper and lower eyelids, the avoidance of eyelid complications is of vital importance. Complications after eyelid surgery include basic complications (infection, granuloma) and vision-threatening complications. Preoperative history, physical examination, surgical planning, and meticulous surgical technique must be undertaken to prevent complications after eyelid surgery. In addition, patient knowledge, expectations, and motivations must be determined before surgery is performed. PMID:27105805

  14. Measurement of extracellular vesicles as biomarkers of consequences or cause complications of pathological states, and prognosis of both evolution and therapeutic safety/efficacy.

    PubMed

    Amiral, Jean; Seghatchian, Jerard

    2016-08-01

    Utility of EVs, as biomarkers of cause or consequence of various pathological complications, and prognosis of blood components' therapy in terms of safety/efficacy and their potential associated hazards, primed by EVs involvements in pro-inflammatory, immunomodulatory and activations of both pro/anti-coagulatory and others associated pathways, as well as various cellular cross talks, are highlighted as the fundamental. Today EVs are becoming the "buzz" words of the current diagnosis, development and research [DDR] strategies, with the aim of ensuring safer therapeutic approaches in the current clinical practices, also incorporating their potential in long term cost effectiveness in health care systems. The main focus of this manuscript is to review the current opinions in some fundamental areas of EVs involvements in health and diseases. Firstly, our goal is highlighting what are EVs/MVs/MPs and how are they generated in physiology, pathology or blood products; classification and significance of EVs generated in vivo; followed by consequences and physiological/pathological induced effects of EVs generation in vivo. Secondly, specific cell origin EVs and association with malignancy; focus on EVs carrying TF and annexin V as a protective protein for harmful effects of EVs, and associations with LA; and incidence of anti-annexin V antibodies are also discussed. Thirdly, utility of EVs is presented: as diagnostic tools of disease markers; prognosis and follow-up of clinical states; evaluation of therapy efficacy; quality and risk assessment of blood products; followed by the laboratory tools for exploring, characterizing and measuring EVs, and/or their associated activity, using our own experiences of capture based assays. Finally, in perspective, the upcoming low volume sampling, fast, reliable and reproducibility and friendly use laboratory tools and the standardization of measurement methods are highlighted with the beneficial effects that we are witnessing in both

  15. Central line complications

    PubMed Central

    Kornbau, Craig; Lee, Kathryn C; Hughes, Gwendolyn D; Firstenberg, Michael S

    2015-01-01

    Central venous access is a common procedure performed in many clinical settings for a variety of indications. Central lines are not without risk, and there are a multitude of complications that are associated with their placement. Complications can present in an immediate or delayed fashion and vary based on type of central venous access. Significant morbidity and mortality can result from complications related to central venous access. These complications can cause a significant healthcare burden in cost, hospital days, and patient quality of life. Advances in imaging, access technique, and medical devices have reduced and altered the types of complications encountered in clinical practice; but most complications still center around vascular injury, infection, and misplacement. Recognition and management of central line complications is important when caring for patients with vascular access, but prevention is the ultimate goal. This article discusses common and rare complications associated with central venous access, as well as techniques to recognize, manage, and prevent complications. PMID:26557487

  16. Using Multidimensional Grief Theory to Explore Effects of Deployment, Reintegration, and Death on Military Youth and Families

    PubMed Central

    Kaplow, Julie B.; Layne, Christopher M.; Saltzman, William R.; Cozza, Stephen J.; Pynoos, Robert S.

    2015-01-01

    To date, the U.S. military has made major strides in acknowledging and therapeutically addressing trauma and Posttraumatic Stress Disorder (PTSD) in service members and their families. However, given the nature of warfare and high rates of losses sustained by both military members (e.g., deaths of fellow unit members) and military families (e.g., loss of a young parent who served in the military), as well as the ongoing threat of loss that military families face during deployment, we propose that a similar focus on grief is also needed to properly understand and address many of the challenges encountered by bereaved service members, spouses, and children. In this article, we describe a newly developed theory of grief (Multidimensional Grief Theory) and apply it to the task of exploring major features of military-related experiences during the phases of deployment, reintegration, and the aftermath of combat death—especially as they impact children. We also describe implications for designing preventive interventions during each phase and conclude with recommended avenues for future research. Primary aims are to illustrate: (1) the indispensable role of theory in guiding efforts to describe, explain, predict, prevent, and treat maladaptive grief in military service members, children, and families; (2) the relevance of multidimensional grief theory for addressing both losses due to physical death as well as losses brought about by extended physical separations to which military children and families are exposed during and after deployment; and (3) a focus on military-related grief as a much-needed complement to an already-established focus on military-related PTSD. PMID:23760905

  17. Using multidimensional grief theory to explore the effects of deployment, reintegration, and death on military youth and families.

    PubMed

    Kaplow, Julie B; Layne, Christopher M; Saltzman, William R; Cozza, Stephen J; Pynoos, Robert S

    2013-09-01

    To date, the US military has made major strides in acknowledging and therapeutically addressing trauma and post-traumatic stress disorder (PTSD) in service members and their families. However, given the nature of warfare and high rates of losses sustained by both military members (e.g., deaths of fellow unit members) and military families (e.g., loss of a young parent who served in the military), as well as the ongoing threat of loss that military families face during deployment, we propose that a similar focus on grief is also needed to properly understand and address many of the challenges encountered by bereaved service members, spouses, and children. In this article, we describe a newly developed theory of grief (multidimensional grief theory) and apply it to the task of exploring major features of military-related experiences during the phases of deployment, reintegration, and the aftermath of combat death--especially as they impact children. We also describe implications for designing preventive interventions during each phase and conclude with recommended avenues for future research. Primary aims are to illustrate: (1) the indispensable role of theory in guiding efforts to describe, explain, predict, prevent, and treat maladaptive grief in military service members, children, and families; (2) the relevance of multidimensional grief theory for addressing both losses due to physical death as well as losses brought about by extended physical separations to which military children and families are exposed during and after deployment; and (3) a focus on military-related grief as a much-needed complement to an already-established focus on military-related PTSD. PMID:23760905

  18. Bereaved adults' evaluations of grief management messages: effects of message person centeredness, recipient individual differences, and contextual factors.

    PubMed

    Rack, Jessica J; Burleson, Brant R; Bodie, Graham D; Holmstrom, Amanda J; Servaty-Seib, Heather

    2008-01-01

    This study identifies grief management strategies that bereaved adults evaluate as more and less helpful, assesses whether the person centeredness of these strategies explains their helpfulness, and determines whether strategy helpfulness varies as a function of demographic, personality, and situational factors. Participants (105 bereaved young adults) assessed the helpfulness of 16 grief management strategies; these strategies were coded for their degree of person centeredness. Strategy person centeredness was strongly correlated with helpfulness. Strategy helpfulness varied as a function of participant gender and the disruptiveness of the decedent's death, but not as a function of need for cognition or decedent closeness. PMID:18767235

  19. Chickenpox (Varicella) Complications

    MedlinePlus

    ... for Varicella Complications . Serious complications from chickenpox include bacterial infections of the skin and soft tissues in children including Group A streptococcal infections pneumonia infection or inflammation of the brain (encephalitis, cerebellar ...

  20. Extraintestinal Complications: Kidney Disorders

    MedlinePlus

    ... Extraintestinal Complications: Kidney Disorders Go Back Extraintestinal Complications: Kidney Disorders Email Print + Share The kidneys filter the ... but some less serious ones occur more frequently. Kidney stones These are probably the most commonly encountered ...

  1. Pregnancy Complications: Anemia

    MedlinePlus

    ... Close X Home > Complications & Loss > Pregnancy complications > Anemia Anemia E-mail to a friend Please fill in ... anemia at a prenatal care visit . What causes anemia? Usually, a woman becomes anemic (has anemia) because ...

  2. Pregnancy Complications: Preexisting Diabetes

    MedlinePlus

    ... Home > Complications & Loss > Pregnancy complications > Preexisting diabetes Preexisting diabetes E-mail to a friend Please fill in ... and your baby are healthy. What is preexisting diabetes? About 9 out of 100 women (9 percent) ...

  3. Use of Contemporary Film as a Medium for Teaching an Online Death and Grief Course.

    PubMed

    Head, Barbara A; Smith, Lisa C

    2016-01-01

    Online education is becoming commonplace in the academic world. Schools now offer totally online degree programs or provide a hybrid of face-to-face and online courses for fulfilling academic requirements. Developing courses and teaching online requires instructors to rethink the educational paradigms they have relied upon in the past. The Net Generation of learners brings a different set of expectations, styles, and needs to the classroom than those of previous generations; this mandates that instructors redesign courses and use contemporary teaching modalities. This article describes how film was successfully used as the primary medium to teach a graduate online Social Work course, Death and Grief. PMID:27462949

  4. Hair implant complications.

    PubMed

    Hanke, C W; Norins, A L; Pantzer, J G; Bennett, J E

    1981-04-01

    Four men who underwent hair implantation for pattern baldness were treated for complications such as infection, foreign-body reaction, pruritus, and scarring. The complications were similar to those reported with synthetic modacrylic fiber implants that have been used for the same purpose. Although we believe this is the first article to report complications from hair implants, the illogical basis of the procedure suggests that complications will occur in many unsuspecting patients who undergo hair implantation. PMID:7009899

  5. Complications of skin biopsy

    PubMed Central

    Abhishek, Kumar; Khunger, Niti

    2015-01-01

    Skin biopsy is the most commonly performed procedure by the dermatologist. Though it is a safe and easy procedure yet complications may arise. Post operative complications like wound infection and bleeding may occur. It is essential to keep the potential complications of skin biopsy in mind and be meticulous in the technique, for better patient outcomes. PMID:26865792

  6. Complications of Strabismus Surgery

    PubMed Central

    Olitsky, Scott E.; Coats, David K.

    2015-01-01

    All surgeries carry risks of complications, and there is no way to avoid ever having a complication. Strabismus surgery is no different in this regard. There are methods to reduce the risk of a complication during or after surgery, and these steps should always be taken. When a complication occurs, it is important to first recognize it and then manage it appropriately to allow for the best outcome possible. This article will discuss some of the more common and/or most devastating complications that can occur during or after strabismus surgery as well as thoughts on how to avoid them and manage them should they happen. PMID:26180463

  7. Changes over time in the quality of life, prolonged grief and family strain of family caregivers of patients in vegetative state: A pilot study.

    PubMed

    Bastianelli, Alessia; Gius, Erminio; Cipolletta, Sabrina

    2016-05-01

    This study explored changes over time and in the internal standards of the quality of life, prolonged grief and family strain of informal caregivers of patients in vegetative state. Data obtained from 52 caregivers showed high levels of prolonged grief and family strain, and low quality of life. A decrease of caregivers' quality of life and an increase of family strain were found by adopting a response shift procedure. Only prolonged grief did not change during time. Clinical intervention with the caregivers of vegetative state patients should be differentiated on the basis of the duration of the caring experience. PMID:24984718

  8. Size acceptance as a grief process: observations from psychotherapy with lesbian feminists.

    PubMed

    Courtney, Jeanne

    2008-01-01

    Based on observations from my psychotherapy practice, I apply Kubler-Ross' five stages of grief (denial, anger, bargaining, depression, and acceptance) to the process a woman goes through when she learns about size acceptance and lets go of the unrealistic wish to make her body size conform to fat-phobic societal ideals of female beauty. Clients' presentations, therapeutic interventions, and countertransference are discussed for each stage. Lesbian feminists are likely to embrace size acceptance politics but may retain negative feelings about their own body size. In the bargaining stage, they may confound health concerns with body image issues, and it is important in their therapy to provide a holding environment that can tolerate ambivalence. My own depression stage was marked by countertransference that caused me to avoid the topic of body image with my clients. Therapists can help women in the size acceptance grief process by exploring their own evolving feelings about body image, bringing up the topic, and providing a non-judgmental holding environment. PMID:19042744

  9. Associations between prolonged grief disorder, depression, posttraumatic stress disorder, and anxiety in Rwandan genocide survivors.

    PubMed

    Schaal, Susanne; Dusingizemungu, Jean-Pierre; Jacob, Nadja; Neuner, Frank; Elbert, Thomas

    2012-02-01

    A number of studies have demonstrated that symptoms of prolonged grief disorder (PGD) represent a symptom cluster distinct from bereavement-related depression, anxiety, and posttraumatic stress disorder (PTSD). The aim of the present study was to confirm and extend these findings using the most recent criteria defining PGD. The authors interviewed a total of 400 orphaned or widowed survivors of the Rwandan genocide. The syndromes were strongly linked to each other with a high comorbidity. Principal axis factoring resulted in the emergence of 4 different factors. The symptoms of depression, along with the cognitive, emotional, and behavioral symptoms of PGD, loaded on the first factor, symptoms of anxiety on the second factor, symptoms of PTSD on the third factor, and the separation distress symptoms of PGD on the fourth factor. This indicates that the concept of PGD includes symptoms that are conceptually related to depression. However, the symptom cluster of separation distress presents a grief-specific dimension that may surface unrelated to depressive symptoms. PMID:24567983

  10. The prevalence, comorbidity and risks of prolonged grief disorder among bereaved Chinese adults.

    PubMed

    He, Li; Tang, Suqin; Yu, Wei; Xu, Wei; Xie, Qiuyuan; Wang, Jianping

    2014-10-30

    Few epidemiological studies have investigated prolonged grief disorder (PGD) in the general population of Asian countries, including China. The aim of this study was to explore the rates and risks of PGD, and the association between PGD, post-traumatic stress disorder (PTSD), depression and anxiety in bereaved Chinese adults. The PG-13, PTSD Checklist-Civilian Version (PCL-C), Zung Self-Rating Depression Scale (SDS) and Zung Self-Rating Anxiety Scale (SAS) were administered to 445 subjects. Prevalence within the general population of China was 1.8% (i.e., 8/445). Among the eight subjects who met the PGD diagnosis, 75%, 87.5% and 75% scored above the cut-off point on the PCL-C, SDS and SAS, respectively, although a portion remained free from comorbidity. ANOVA, correlation analysis and stepwise multiple regression analysis demonstrated that kinship to deceased, age of the deceased, religion belief and cause of death were predictive of prolonged grief. A small proportion of bereaved persons may exhibit PGD. There is a substantial but far from complete overlap between PGD and the other three diagnoses. Bereaved parents and the widowed have high risk of PGD. These findings highlight the need for prevention, diagnosis and treatment for PGD patients. PMID:24924526

  11. Mummification in a Chinese patient with grief: a morbid symptom or a cultural practice?

    PubMed

    So, J; Leung, C M

    2013-12-01

    Mummification was first described by Gorer in 1965 as a feature of grief in which the deceased individual's belongings and, in extreme cases, his or her corpse are preserved as if he or she was still alive and, often, the grieving person acts as if the deceased will return at a later date. Little research has been done on the cultural differences of patients demonstrating mummification. In the Asian community, a common belief is that there is life after death. The spirits of the dead are believed to exist in the human world, and ancestral worship is a common practice among Chinese people. Gorer believed that mummification was a maladaptation of unresolved grief in a ritual-less society. While this may possibly be true in western societies, this theory does not necessarily comply with Chinese practices. This case study discusses the psychopathology of mummification in a grieving Chinese patient and explores the importance of considering cultural influences in assessing the morbidity of this symptom. PMID:24374489

  12. The grief reactions of nursing students related to the sudden death of a classmate.

    PubMed

    Jiang, Ru-Shang; Chou, Chuan-Chiang; Tsai, Pi-Lan

    2006-12-01

    More than one-thousand adolescents are killed in accidents in Taiwan every year. Developmental factors shape young people's various reactions and responses to the death of their peers. While counseling research has been conducted in a few studies to address this issue of general bereavement, there remains a need for more knowledge on the grieving process and the needs of undergraduate nurse students who experience the loss of a classmate. The purpose of this study was to explore nursing student fears of death and their grief reactions in such a situation. The phenomenological method was used to uncover the meanings of eleven 19-year-old female nursing students' feelings and narratives about their grieving process in relation to the loss of a classmate, who died in a car accident. All interviews were tape recorded and then transcribed. Descriptions were analyzed using Colaizzi's phenomenological methodology (Colaizzi, 1978). The following core themes emerged from the data: morbid anxiety, helplessness after death, fear of disappearance, and thinking of one's own future. The study also found that, while nursing students could cope with their grief, they rarely shared their feeling with others. Young nursing students require careful step-by-step caring to pass successfully through the grieving process. In view of this gap, this study aspires to serve as a useful reference in understanding the sense of loss felt by grieving young people and providing effective and individualized bereavement counseling to nursing students. PMID:17345757

  13. Modification and Factor Analysis of the Grief Experience Inventory in Non-Death Loss/Bereavement Situations.

    ERIC Educational Resources Information Center

    Zinner, Ellen S.; And Others

    1991-01-01

    Administered Grief Experience Inventory (GEI) to 102 mothers of brain-injured adolescents and young adults across 3 years postinjury. Factor analysis of data was computed and compared to factors derived from original GEI General Reference Group (n=135). Found strikingly similar factor structures between modified nondeath form and original GEI.…

  14. Religiosity is an important part of coping with grief in pregnancy after a traumatic second trimester loss.

    PubMed

    Cowchock, F S; Ellestad, S E; Meador, K G; Koenig, H G; Hooten, E G; Swamy, G K

    2011-12-01

    Women (n = 15) who were pregnant after a traumatic late pregnancy loss (termination because of fetal death or serious anomalies) completed psychometric screening tests and scales, including the Perinatal Grief Scale (PGS), the Impact of Event Scale (IES), the Duke Depression Inventory (DDI), the Generalized Anxiety Disorder-7 (GAD), and the Hoge Scale for Intrinsic Religiosity (IR). Despite a mean elapsed time since the prior loss of 27 (range, 7-47) months, half (7/15, 47%) of the combined groups had high levels of grief on the PGS. Multiple positive scores on psychometric tests were frequent: Sixty percent (9/15) had high scores on the PGS Active Grief subscale or on the IES. Forty percent (6/15) had a high score on the DDI, and 17% (3/15) on the GAD. IR scores significantly and negatively correlated with scores on the Despair subscale of the PGS. The results from this pilot study suggest that high levels of grief and PTS symptoms are significant problems for pregnant women who have suffered late loss of a wanted pregnancy. Religiosity may play an important part in maternal coping during these stressful pregnancies. PMID:21861239

  15. Assessing the Role of Attachment to God, Meaning, and Religious Coping as Mediators in the Grief Experience

    ERIC Educational Resources Information Center

    Kelley, Melissa M.; Chan, Keith T.

    2012-01-01

    Research has examined the relationship of styles of attachment to others and meaning with grief and the stress-related growth process. Less has been written on styles of attachment to God and patterns of religious coping and how these constructs may impact adjustment in persons dealing with loss. This study examines the roles of attachment to God,…

  16. Teaching a Combined Course on Grief and Bereavement for BSW and MSW Students: Strategies, Content, and Evaluation

    ERIC Educational Resources Information Center

    Bethel, Joyous C.

    2005-01-01

    This paper will address the development and offering of two combined (BSW and MSW) courses in Grief and Bereavement. This is a description of the purposes, educational units, and assignments for both courses. In addition, there is discussion of the learning environment to include educational strategies to promote both didactic and experiential…

  17. "Dulling the Edges": Young Men's Use of Alcohol to Deal With Grief Following the Death of a Male Friend

    ERIC Educational Resources Information Center

    Creighton, Genevieve; Oliffe, John; Matthews, Jennifer; Saewyc, Elizabeth

    2016-01-01

    Background: The death of a male friend can be challenging for men because expressions of grief can be governed and restrained by dominant ideals of masculinity. It is common for young men to engage in health risk practices, such as alcohol overuse, to deal with feelings of sadness. Objective: This qualitative study investigated the ways that young…

  18. Bereaved Adults' Evaluations of Grief Management Messages: Effects of Message Person Centeredness, Recipient Individual Differences, and Contextual Factors

    ERIC Educational Resources Information Center

    Rack, Jessica; Burleson, Brant; Bodie, Graham; Holmstrom, Amanda; Servaty-Seib, Heather

    2008-01-01

    This study identifies grief management strategies that bereaved adults evaluate as more and less helpful, assesses whether the person centeredness of these strategies explains their helpfulness, and determines whether strategy helpfulness varies as a function of demographic, personality, and situational factors. Participants (105 bereaved young…

  19. Relational Learning in Social Work Education: Transformative Education for Teaching a Course on Loss, Grief and Death

    ERIC Educational Resources Information Center

    Konrad, Shelley Cohen

    2010-01-01

    This article explores the relational learning model for teaching clinical social work practice. Evaluations of a course on loss, grief, and death illustrate that relational learning methods enhanced students' relational and communicative knowledge and skills, and contributed to a transformative learning process. Relational learning is a method of…

  20. The Experience of High Levels of Grief in Caregivers of Persons with Alzheimer's Disease and Related Dementia

    ERIC Educational Resources Information Center

    Sanders, Sara; Ott, Carol H.; Kelber, Sheryl T.; Noonan, Patricia

    2008-01-01

    An abundance of literature on caregivers of individuals with dementia has been written since the mid-1980s. However, most of this literature focused on the experience of stress, burden, and depression in caregivers, thus excluding the grief experience that also accompanies the caregiving experience. The purpose of this multimethod study is to…

  1. Validation of the Perinatal Grief Scale for Use in Chinese Women Who Have Experienced Recent Reproductive Loss

    ERIC Educational Resources Information Center

    Yan, Elsie; Tang, Catherine So-Kum; Chung, Tony

    2010-01-01

    The primary objective of this research was to validate the short version of the Perinatal Grief Scale (SVPGS) in the Chinese population. The Chinese SVPGS was administered to a sample of Chinese women who had experienced recent reproductive loss (N = 314). The results of the confirmatory factor analysis rejected the original 3-factor model…

  2. Surgical Complications of Gynecologic Surgery

    PubMed Central

    Weekes, Leroy R.; Gandhi, Shobhana Anil; Gandhi, Anil Krishnakumar

    1977-01-01

    Complications of gynecological surgery are considerable and when reviewed in detail are almost frightening. There is no substitute for experience and intimate knowledge of the intricate pelvic structures in health and disease. Anyone who is active in the field is sooner or later going to experience some difficulty whether it be due to his miscalculation or to innate conditions in the patient which are beyond his/her control. It is the responsibility of the pelvic surgeon to recognize the complication and apply proper corrective measures. The patient should not be given false hopes of sure success nor should she be deprived of whatever hope for success does exist. PMID:572875

  3. Complicated Perianal Sepsis.

    PubMed

    Mitra, Abhishek; Yadav, Amitabh; Mehta, Naimish; Varma, Vibha; Kumaran, Vinay; Nundy, Samiran

    2015-12-01

    Management of benign anorectal conditions like abscesses and haemorrhoids is usually uneventful. However, complicated perianal complications can result and have sparsely been reported in literature. Hereby, we report a series of seven patients who presented with rare sequelae like necrotising fasciitis, intraperitoneal or retroperitoneal involvement. All patients responded well to surgical management. Accordingly, complicated perianal sepsis warrants a timely and aggressive surgical intervention. PMID:27011454

  4. Facial Filler Complications.

    PubMed

    Woodward, Julie; Khan, Tanya; Martin, John

    2015-11-01

    The use of facial fillers has greatly expanded over the past several years. Along with increased use comes a rise in documented complications, ranging from poor cosmetic result to nodules, granulomas, necrosis, and blindness. Awareness of the potential types of complications and options for management, in addition to the underlying facial anatomy, are imperative to delivering the best patient care. This article defines the complications and how to treat them and provides suggestions to avoid serious adverse outcomes. PMID:26505541

  5. Complications of nephrotic syndrome.

    PubMed

    Park, Se Jin; Shin, Jae Il

    2011-08-01

    Nephrotic syndrome (NS) is one of the most common glomerular diseases that affect children. Renal histology reveals the presence of minimal change nephrotic syndrome (MCNS) in more than 80% of these patients. Most patients with MCNS have favorable outcomes without complications. However, a few of these children have lesions of focal segmental glomerulosclerosis, suffer from severe and prolonged proteinuria, and are at high risk for complications. Complications of NS are divided into two categories: disease-associated and drug-related complications. Disease-associated complications include infections (e.g., peritonitis, sepsis, cellulitis, and chicken pox), thromboembolism (e.g., venous thromboembolism and pulmonary embolism), hypovolemic crisis (e.g., abdominal pain, tachycardia, and hypotension), cardiovascular problems (e.g., hyperlipidemia), acute renal failure, anemia, and others (e.g., hypothyroidism, hypocalcemia, bone disease, and intussusception). The main pathomechanism of disease-associated complications originates from the large loss of plasma proteins in the urine of nephrotic children. The majority of children with MCNS who respond to treatment with corticosteroids or cytotoxic agents have smaller and milder complications than those with steroid-resistant NS. Corticosteroids, alkylating agents, cyclosporin A, and mycophenolate mofetil have often been used to treat NS, and these drugs have treatment-related complications. Early detection and appropriate treatment of these complications will improve outcomes for patients with NS. PMID:22087198

  6. Complications of Transjugular Biopsies

    PubMed Central

    Navuluri, Rakesh; Ahmed, Osman

    2015-01-01

    Transvenous biopsy was first performed in 1964 by Charles Dotter. Now routinely performed in the liver and kidney by interventional radiologists, the transjugular approach to biopsy has assumed a central role in coagulopathic patients. Major arterial complications from transjugular liver and renal biopsy are rare. In this article, the authors describe such complications in both organs that necessitated selective endovascular coil embolization. PMID:25762847

  7. Complications in knee arthroscopy.

    PubMed

    Reigstad, Ole; Grimsgaard, Christian

    2006-05-01

    All simple arthroscopic procedures during 1999 through 2001 performed at Baerum community hospital were retrospectively examined. Procedures were excluded when being part of more complex procedures. A total of 876 procedures performed on 785 patients were left for examination. Complications were registered from the patient record and all received a written questionnaire or phone call. The answer was obtained from 97.6%. The overall complications rate was low, giving total of 5.00%. A total of 0.68% of the complications had therapeutic consequences. There were two superficial infections, one thromboembolic event/pulmonary embolus and one reoperation due to scar tissue. Other complications were considered minor, and had none or little consequence for the patient comprising preoperative bradycardial episodes, asthmatic events, subcutaneous infusion of total intravenous anaesthetics (TIVA), instrument breakage and conversion to arthrotomi. Postoperatively registered complications included swelling, haemarthros, portal bleeding and fistulation, temporary sensory loss and longstanding pain. Duration of surgery was the only predicting factor for postoperative complications. Simple arthroscopic surgery is safe and has few serious complications. The use of TIVA or tourniquet does not increase the morbidity or complication rate, and prophylaxis against thromboembolism was not necessary. PMID:16208459

  8. "Complicating" Educational Administrators.

    ERIC Educational Resources Information Center

    Bell, Colleen S.

    Administrators desiring to lead organizations that will adapt and survive in a complex environment like today's public schools need to develop what Karl Weick calls "complicated" understanding of "requisite variety." The law of requisite variety states that a diverse and complicated environment demands similar diversity from its inhabitants if…

  9. Pellagra complicating Crohn's disease.

    PubMed Central

    Zaki, I.; Millard, L.

    1995-01-01

    We report a 53-year-old patient with clinical features of pellagra as a complication of Crohn's disease. His symptoms improved rapidly on taking oral nicotinic acid and vitamin B complex. We suggest the paucity of reported cases of pellagra in Crohn's disease is a reflection of poor recognition of this complication. Images Figure PMID:7567761

  10. COMPLICATIONS IN HIP ARTHROSCOPY

    PubMed Central

    Contreras, Marcos Emílio Kuschnaroff; Hoffmann, Rafael Barreiros; de Araújo, Lúcio Cappelli Toledo; Dani, William Sotau; José Berral, Francisco

    2015-01-01

    Objectives: To determine the prevalence of complications in a series of consecutive cases of hip arthroscopy; to assess the progression of the sample through a learning curve; and to recognize the causes of complications in arthroscopic hip operations. Method: 150 consecutive cases that underwent hip arthroscopy between May 2004 and December 2008 were evaluated. The complications encountered were classified in three ways: organic system affected, severity and groups of 50 consecutive cases. The data were analyzed by means of descriptive statistics and Fisher's exact test. Results: We observed 15 complications in this study (10%): ten were neurological, two were osteoarticular, one was vascular-ischemic and two were cutaneous. In the classification of severity, three were classified as major, 12 as intermediate and none as minor. The incidence of complications over the course of the learning curve did not present any statistically significant difference (p = 0.16). Conclusions: Hip arthroscopy is a surgical procedure that involves low morbidity, but which presents complications in some cases. These complications are frequently neurological and transitory, and mainly occur because of joint traction. The complication rate did not decrease with progression of our sample. PMID:27022521

  11. Prolonged grief following the recent death of a daughter among mothers who experienced distal losses during the Khmer Rouge era: Validity of the prolonged grief construct in Cambodia.

    PubMed

    Field, Nigel P; Strasser, Judith; Taing, Sopheap; Horiuchi, Shoko; Chhim, Sotheara; Packman, Wendy

    2014-09-30

    This study addressed the validity of the prolonged grief (PG) construct in a Cambodian context. Eighty mothers who lost a young adult daughter stemming from a crowd stampede incident during the annual water festival were interviewed at the six-month post-loss point along with a control group of similarly aged women who were not recently bereaved. Both groups were assessed for PG, PTSD, anxiety, and depression symptoms and well as for the number of distal losses experienced during the Khmer Rouge (KR) regime - knowing that all the women were old enough to have lived through the KR regime. Support for the discriminant validity of PG was shown in a factor analysis in which its core symptoms were distinguished from anxiety, depression, and PTSD symptoms. Also, support was found for its incremental validity as shown in the unique sensitivity of PG in distinguishing the two groups when controlling for the other symptoms. Lastly, a positive relationship was found between the number of distal deaths experienced during the KR regime and PG symptom severity among the group of recently bereaved mothers, providing support for the predictive validity of PG. Implications as well as study limitations are discussed. PMID:24863868

  12. Complications in septoplasty.

    PubMed

    Rettinger, Gerhard; Kirsche, Hanspeter

    2006-11-01

    The most frequent complications of septoplasty are deformities, infections, and perforations. The effects of each of these complications, however, can be very different. Dislocations and deformities of the septum may result not only in an impaired airway but also in visible deformities of the entire nasal base and dorsum. A patient who underwent septoplasty can be "stigmatized." Infections may lead not only to septal abscess but also to endocranial complications such as meningitis or septicemia with endocarditis. Permanent perforations of the nasal septum can result in significant symptoms if they are located in the anterior part of the nose. Surgical closure is the treatment of choice, with a high success rate if the patients are selected properly. Besides these three major types of complications there are many others, from smell disturbances to blindness. Causes, prevention, and correction of selected complications are presented and data of the recent literature reported. PMID:17131271

  13. Anorexia nervosa - medical complications.

    PubMed

    Mehler, Philip S; Brown, Carrie

    2015-01-01

    In contrast to other mental health disorders, eating disorders have a high prevalence of concomitant medical complications. Specifically, patients suffering from anorexia nervosa (AN) have a litany of medical complications which are commonly present as part of their eating disorders. Almost every body system can be adversely, affected by this state of progressive malnutrition. Moreover, some of the complications can have permanent adverse effects even after there is a successful program of nutritional rehabilitation and weight restoration. Within this article we will review all body systems affected by AN. There is also salient information about both, how to diagnose these medical complications and which are the likely ones to result in permanent sequelae if not diagnosed and addressed early in the course of AN. In a subsequent article, the definitive medical treatment for these complications will be presented in a clinically practical manner. PMID:25834735

  14. Good grief: bereavement literature for young adults and A Monster Calls.

    PubMed

    Day, Giskin

    2012-12-01

    Recent years have seen a proliferation of critically acclaimed novels for young adults dealing with bereavement. This is part of a 'bereavement turn'--a contemporary cultural movement to examine publicly our attitudes to death and grieving. This paper examines the narrative strategies in Patrick Ness's award-winning novel A Monster Calls to look at the ways in which the psychic burden of the impending loss of a parent through cancer is managed. The book draws on conventions of children's literature to create a sense of familiarity that helps to balance the emotional stress of the story. The Kübler-Ross stages of grief serve as a heuristic that helps the story deliver catharsis in spite of its inevitably traumatic subject matter. A Monster Calls is an important addition to the canon of fictional pathography. PMID:23139394

  15. Effects of directed written disclosure on grief and distress symptoms among bereaved individuals.

    PubMed

    Lichtenthal, Wendy G; Cruess, Dean G

    2010-07-01

    Bereavement-specific written disclosure trials have generally demonstrated null effects, but these studies have not directed the focus of writing. This randomized controlled trial compared directed writing that focused on either sense-making or benefit-finding, both associated with adjustment to loss, to traditional, non-directed emotional disclosure and a control condition. Bereaved undergraduates (n = 68) completed three 20-min writing sessions over 1 week. Intervention effects were found on prolonged grief disorder, depressive, and posttraumatic stress symptoms 3 months postintervention, and the benefit-finding condition appeared particularly efficacious. Physical health improved over time in all treatment groups. Findings suggested that directing written disclosure on topics associated with adjustment to bereavement may be useful for grieving individuals. PMID:24482856

  16. Helping nurses cope with grief and compassion fatigue: an educational intervention.

    PubMed

    Houck, Dereen

    2014-08-01

    Oncology nurses may experience intense physical and emotional exhaustion, identified in the literature as symptoms of cumulative grief and compassion fatigue, with significant consequences for both nurses and organizations. The first step in preventing these consequences is recognition. Organizations should provide nurses with resources including education, counseling, and opportunities to grieve. Nurses need to learn the importance of work-life balance, self-care strategies, and communication skills. Using recommendations from the literature, an educational intervention was designed with the purpose of providing nurses with knowledge, skills, and resources to practice effective self-care and recognize when assistance is needed. The program's objective was to help nurses develop the coping skills and inner resources necessary to maintain their emotional and physical health. PMID:25095300

  17. Complications in late pregnancy.

    PubMed

    Meguerdichian, David

    2012-11-01

    Complications of late pregnancy are managed infrequently in the emergency department and, thus, can pose a challenge when the emergency physician encounters acute presentations. An expert understanding of the anatomic and physiologic changes and possible complications of late pregnancy is vital to ensure proper evaluation and care for both mother and fetus. This article focuses on the late pregnancy issues that the emergency physician will face, from the bleeding and instability of abruptio placentae to the wide spectrum of complications and management strategies encountered with preterm labor. PMID:23137403

  18. Anesthetic Complications and Deaths

    PubMed Central

    Pender, John W.

    1968-01-01

    Anesthesiologists should fully inform patients of the possible complications from anesthesia. For rapport with the patient, with whom they usually have no acquaintance until a day or so before an operative procedure, the anesthesiologist should enlist the help of the internist or surgeon who already has established an atmosphere of trust. The extent of morbidity and minor complications from anesthesia has not been adequately recorded. One out of every 1,000 to 2,000 anesthetized patients dies of complications primarily due to or contributed to by anesthesia. Leading causes of death vary from study to study and from year to year. PMID:5652756

  19. [Complications of hip arthroscopies].

    PubMed

    Dienst, M; Grün, U

    2008-11-01

    Surgical complications of hip arthroscopies are rare in the hands of experienced hip arthroscopists. However, when performed by beginners and in more demanding situations such as marginal distraction of the head and socket and technically advanced procedures, the risk increases. This report describes possible complications which may happen during positioning and traction, portal placement, and diagnostic and therapeutic procedures. Possible causes of soft tissue lesions of the portal area, perineum and foot, intra-articular lesions of the labrum and cartilage, direct and traction-related indirect neurovascular lesions, and other rare complications are analyzed. PMID:18854972

  20. Complications of Pathologic Myopia.

    PubMed

    Cho, Bum-Joo; Shin, Joo Young; Yu, Hyeong Gon

    2016-01-01

    Pathologic myopia (PM) is one of the leading causes of visual impairment worldwide. The pathophysiology of PM is not fully understood, but the axial elongation of the eye followed by chorioretinal thinning is suggested as a key mechanism. Pathologic myopia may lead to many complications such as chorioretinal atrophy, foveoschisis, choroidal neovascularization, rhegmatogenous retinal detachment, cataract, and glaucoma. Some complications affect visual acuity significantly, showing poor visual prognosis. This article aims to review the types, pathophysiology, treatment, and visual outcome of the complications of PM. PMID:26649982

  1. Pertussis (Whooping Cough) Complications

    MedlinePlus

    ... CDC Cancel Submit Search The CDC Pertussis (Whooping Cough) Note: Javascript is disabled or is not supported ... friendly Fact Sheet Pertussis Vaccination Pregnancy and Whooping Cough Clinicians Disease Specifics Treatment Clinical Features Clinical Complications ...

  2. Complications of Measles (Rubeola)

    MedlinePlus

    ... Links Measles and Rubella Initiative World Health Organization Pan American Health Organization Complications of Measles Language: English ... Links Measles and Rubella Initiative World Health Organization Pan American Health Organization Language: English Español (Spanish) File ...

  3. Infection and Other Complications

    MedlinePlus

    ... Stage 3 Infection and Other Complications NLN Position Papers Lymphedema Awareness Campaign Education Kits Educational Videos What ... Patients (8) LymphLink Articles (175) FAQ's (6) Position Papers (9) LSAP Perspective (9) Become a member now » ...

  4. [Complications of cocaine addiction].

    PubMed

    Karila, Laurent; Lowenstein, William; Coscas, Sarah; Benyamina, Amine; Reynaud, Michel

    2009-06-20

    Addiction is a chronic relapsing disorder characterized by repetitive and compulsive drug-seeking behavior and drug abuse despite negative health or social consequences. Cocaine addiction is a significant worldwide public health problem, which has somatic, psychological, psychiatric, socio-economic and judicial complications. Some of the most frequent complications are cardiovascular effects (acute coronary syndrome, cardiac arrhythmias, increased blood pressure); respiratory effects (fibrosis, interstitial pneumonitis, pulmonary hypertension, alveolar haemorrhage, asthma exacerbation; emphysema), neurological effects (strokes, aneurysms, seizures, headaches); risk for contracting HIV/AIDS, hepatitis B and C, sexual transmitted disease and otolaryngologic effects. Other complications are not discussed here. The vast majority of studies indicate that there are cognitive deficits induced by cocaine addiction. Attention, visual and working memories, executive functioning are affected in cocaine users. Psychiatric complications found in clinical practice are major depressive disorders, cocaine-induced paranoia, cocaine-induced compulsive foraging and panic attacks. PMID:19642439

  5. Intestinal Complications of IBD

    MedlinePlus

    ... treated with topical creams or sitz baths. MALABSORPTION & MALNUTRITION Another complication in people with Crohn’s disease is ... the gut that absorbs most nutrients. Malabsorption and malnutrition usually do not develop unless the disease is ...

  6. Obstetric (nonfetal) complications.

    PubMed

    Shanbhogue, Alampady K P; Menias, Christine O; Lalwani, Neeraj; Lall, Chandana; Khandelwal, Ashish; Nagar, Arpit

    2013-11-01

    Pregnancy predisposes women to a wide array of obstetric and gynecological complications which are often complex, challenging and sometimes life-threatening. While some of these are unique to pregnancy, a few that occur in nonpregnant women are more common during pregnancy. Imaging plays a crucial role in the diagnosis and management of pregnancy-related obstetric and gynecologic complications. Ultrasonography and magnetic resonance imaging confer the least risk to the fetus and should be the preferred examinations for evaluating these complications. Multidetector computed tomography should be used after carefully weighing the risk-benefit ratio based on the clinical condition in question. Interventional radiology is emerging as a preferred, noninvasive or minimally invasive treatment option that can obviate surgery and its antecedent short term and long term complications. Knowledge of appropriateness of imaging and image guided intervention is necessary for accurate patient management. PMID:24210440

  7. [Neurological complications in uremia].

    PubMed

    Fong, Chin-Shih

    2008-06-01

    Neurological complications due to the uremic state or hemodialysis, contribute to the important cause of mortality in patients with uremia. Despite continuous advances in uremic treatment, many neurological complications of uremia, like uremic encephalopathy, peripheral neuropathy and myopathy fail to fully respond to hemodialysis. Moreover, hemodialysis or kidney transplantation may even induce neurological complications. Hemodialysis can directly or indirectly be associated with Wernicke's encephalopathy, dialytic dementia, dysequilibrium syndrome, cerebrovascular accidents, osmotic myelinolysis and mononeuropathy. Renal transplantation can give rise to rejection encephalopathy and acute femoral neuropathy. The use of immunosuppressive drugs after renal transplantation can cause reversible posterior leukoencephalopathy encephalopathy. The clinical, pathophysiological and therapeutical aspects of central nervous system, peripheral nervous system and myopathy complications in uremia are reviewed. PMID:18686653

  8. Tetanus: Symptoms and Complications

    MedlinePlus

    ... Links Tetanus Vaccination Maternal and Neonatal Tetanus Elimination Symptoms and Complications Recommend on Facebook Tweet Share Compartir ... the muscles of the jaw, or "lockjaw". Tetanus symptoms include: Headache Jaw cramping Sudden, involuntary muscle tightening ...

  9. [Type 2 diabetes complications].

    PubMed

    Schlienger, Jean-Louis

    2013-05-01

    People with type 2 diabetes are at increased risk of many complications, which are mainly due to complex and interconnected mechanisms such as hyperglycemia, insulino-resistance, low-grade inflammation and accelerated atherogenesis. Cardi-cerebrovascular disease are frequently associated to type 2 diabetes and may become life threatening, particularly coronaropathy, stroke and heart failure. Their clinical picture are sometimes atypical and silencious for a long time. Type 2 diabetes must be considered as an independent cardiovascular risk factor. Nephropathy is frequent in type 2 diabetes but has a mixed origin. Now it is the highest cause of end-stage renal disease. Better metabolic and blood pressure control and an improved management of microalbuminuria are able to slowdown the course of the disease. Retinopathy which is paradoxically slightly progressive must however be screened and treated in these rather old patients which are globally at high ophthalmologic risk. Diabetic foot is a severe complication secondary to microangiopathy, microangiopathy and neuropathy. It may be considered as a super-complication of several complications. Its screening must be done on a routine basis. Some cancer may be considered as an emerging complication of type 2 diabetes as well as cognitive decline, sleep apnea syndrome, mood disorders and bone metabolism impairments. Most of the type 2 diabetes complications may be prevented by a strategy combining a systematic screening and multi-interventional therapies. PMID:23528336

  10. Complications of foam sclerotherapy.

    PubMed

    Cavezzi, A; Parsi, K

    2012-03-01

    Foam sclerotherapy may result in drug and/or gas-related complications of a generalized or localized nature. Significant complications include anaphylactic/anaphylactoid reactions (very rare), deep vein thrombosis (1-3%), stroke (0.01%), superficial venous thrombosis (4.4%), tissue necrosis (variable frequency), oedema (0.5%) and nerve damage (0.2%). Cosmetic complications include telangiectatic matting (15-24%) and pigmentation (10-30%). Patent foramen ovale and other cardio-pulmonary right-to-left shunts seem to play a role in the systemic gas-related complications. In conclusion, foam sclerotherapy is characterized by an overall high degree of safety, though special attention should be given to the embolic and thrombotic complications. Good technique, adequate imaging, general precautions and compliance with post-treatment instructions may help avoid some of the adverse events and an appropriate early intervention may minimize possible sequelae. Higher volumes of sclerosant foam have been attributed to local and distant thrombotic complications and should be avoided. PMID:22312067

  11. On complicity theory.

    PubMed

    Kline, A David

    2006-04-01

    The received account of whistleblowing, developed over the last quarter century, is identified with the work of Norman Bowie and Richard DeGeorge. Michael Davis has detailed three anomalies for the received view: the paradoxes of burden, missing harm and failure. In addition, he has proposed an alternative account of whistleblowing, viz., the Complicity Theory. This paper examines the Complicity Theory. The supposed anomalies rest on misunderstandings of the received view or misreadings of model cases of whistleblowing, for example, the Challenger disaster and the Ford Pinto. Nevertheless, the Complicity Theory is important for as in science the contrast with alternative competing accounts often helps us better understand the received view. Several aspects of the received view are reviewed and strengthened through comparison with Complicity Theory, including why whistleblowing needs moral justification. Complicity Theory is also critiqued. The fundamental failure of Complicity Theory is its failure to explain why government and the public encourage and protect whistleblowers despite the possibility of considerable harm to the relevant company in reputation, lost jobs, and lost shareholder value. PMID:16609713

  12. Complicated Bereavement: Definitions, Diagnosis, and Implications.

    ERIC Educational Resources Information Center

    Beckwith, Susan G.

    Grief is a natural response to loss. Bereavement is a universal biopsychosocial phenomenon, yet each individual has unique ways of expressing their loss. This recognition raises the question as to when the range of symptoms are typical and require no therapeutic intervention and when psychotherapeutic intervention is indicated. At present no…

  13. Confronting Grief.

    ERIC Educational Resources Information Center

    Bensley, Loren B.; Bertsch, Donald P.

    1987-01-01

    Since no school district is immune to death, the concepts of death and dying, stress management, and suicide should be worked into the curriculum beginning in the fourth grade. Advice is given concerning planning for potential tragedy, responding to a student's or staff member's death, and establishing memorials. Two figures cite teenage suicide…

  14. Reef grief

    NASA Astrophysics Data System (ADS)

    2011-10-01

    As the first of the world's ecosystems faces extermination at our hands, coral reef ecologist Peter Sale -- Assistant Director of the Institute of Water, Environment and Health at the United Nations University in Ontario, Canada, and author of Our Dying Planet (published this autumn) -- talks to Nature Climate Change.

  15. Do circumstances of the death matter? Identifying socioenvironmental risks for grief-related psychopathology in bereaved youth.

    PubMed

    Kaplow, Julie B; Howell, Kathryn H; Layne, Christopher M

    2014-02-01

    We examined bereaved children's and surviving caregivers' psychological responses following the death of the other caregiver as a function of the stated cause of death. Participants included 63 parentally bereaved children and 38 surviving caregivers who were assessed using self-report instruments and in-person interviews. Surviving caregivers reported the causes of death as resulting from sudden natural death (34.9%), illness (33.3%), accident (17.5%), and suicide (14.3%). Results revealed differences between caregiver-reported versus child-reported cause of death, particularly in cases of suicide. Children who lost a caregiver due to a prolonged illness exhibited higher levels of both maladaptive grief (d = 3.13) and posttraumatic stress symptoms (PTSS; d = 3.33) when compared to children who lost a caregiver due to sudden natural death (e.g., heart attack). In contrast, surviving caregivers did not differ in their levels of maladaptive grief and PTSS as a function of the cause of death; however, caregivers bereaved by sudden natural death reported higher levels of depression than those bereaved by prolonged illness (d = 1.36). Limited sample size prevented analysis of outcomes among those bereaved by suicide or accident. These findings suggest that anticipated deaths may contain etiologic risk factors for maladaptive grief and PTSS in children. PMID:24478197

  16. "So truly afflicting and distressing to me his sorrowing mother": expressions of maternal grief in eighteenth-century Philadelphia.

    PubMed

    McMahon, Lucia

    2012-01-01

    In 1781, Lowry Wister produced an eight-page account of her three-year son’s death from small pox. Lowry Wister’s narrative offers important insights into the emotional landscape of mothering, mourning, and religion in late eighteenth-century America. Religious and cultural prescriptions stressed restraint throughout the mourning process, and in particular admonished women to avoid excessive displays of grief. Lowry Wister’s emotional struggles as a “sorrowing mother” enable us to examine the relationship between individual experiences and prescribed expressions of grief and mourning. While eighteenth-century conventions stressed quiet resignation to God’s will, emerging cultural changes increasingly enabled – indeed, encouraged – women to give public voice to their private emotions. By the nineteenth century, sentimental views of childhood, along with a culture of mourning, inspired parents – especially mothers – to give full expression to intense feelings of loss and sorrow. Lowry Wister’s narrative reveals how women responded to and negotiated various religious, cultural and literary conventions that shaped their understandings of motherhood and mourning. Her narrative illustrates the various ways in which individual women challenged cultural norms and helped usher in new forms of emotional and literary expression. Comparisons of Wister’s narrative to other eighteenth-century women’s writings on grief and mourning further illuminate the interplay between cultural convention and individual expression. PMID:22457896

  17. Hemorheology in complicated hypertension.

    PubMed

    Cicco, G; Vicenti, P; Stingi, G D; Tarallo; Pirrelli, A

    1999-01-01

    During essential and secondary arterial hypertension it is possible to observe changes in microcirculation perfusion associated with a reduction in tissue oxygenation due in part to hemorheological changes such as an increase in blood viscosity or the formation of the red blood cell "rouleaux" which favour an increase in peripheral resistance and can cause or worsen arterial hypertension. We studied 21 healthy subjects (11 male and 10 female aged 42 +/- 4) and 26 hypertensive subjects (14 male and 12 female aged 49 +/- 3). The patients were non smokers and non suffering from respiratory or haemathological pathologies. They were not undergoing antihypertensive or vasodilatory pharmaceutical treatment. The patients suffered from mild hypertension (II WHO) with Peripheral Occlusive Arterial Disease (POAD II "a" acc. to Leriche-Fontaine class.). The patients showed an increase in cholesterolaemia (6.42 +/- 0.81 mmol/l) and trygliceridaemia (2.73 +/- 0.09 mmol/l) at an average level. The patients were studied in standard conditions with a constant temperature of 22 degrees C. We measured SBP, DBP, MBP, and the HR. We also measured the elongation index (EI) (with shear stress range 0.30 to 30 pascals) using LORCA, acc. to Hardeman method (1994), in order to study the erythrocyte deformability and aggregation kinetics in dynamic condition. To evaluate deformability in static conditions we calculated the Erythrocyte Morphologic Index (EMI), acc. to Forconi method, via the bowl/discocyte ratio (for 100 red blood cells fixed in glutaraldehyde at 0.3% and observed with an optical microscope under immersion in glycerol). Peripheral oxygenation was taken transcutaneously (TcpO2). To establish the level of vascular disease we used the Regional Perfusion Index (RPI = TcpO2 foot/TcpO2 subclavean) and doppler guided Winsor Index (WI). The Student "t" test and linear regression were used for the statistical analysis. Our data confirm a reduction in peripheral tissue oxygenation in

  18. Gastrointestinal complications of diabetes mellitus

    PubMed Central

    Krishnan, Babu; Babu, Shithu; Walker, Jessica; Walker, Adrian B; Pappachan, Joseph M

    2013-01-01

    Diabetes mellitus affects virtually every organ system in the body and the degree of organ involvement depends on the duration and severity of the disease, and other co-morbidities. Gastrointestinal (GI) involvement can present with esophageal dysmotility, gastro-esophageal reflux disease (GERD), gastroparesis, enteropathy, non alcoholic fatty liver disease (NAFLD) and glycogenic hepatopathy. Severity of GERD is inversely related to glycemic control and management is with prokinetics and proton pump inhibitors. Diabetic gastroparesis manifests as early satiety, bloating, vomiting, abdominal pain and erratic glycemic control. Gastric emptying scintigraphy is considered the gold standard test for diagnosis. Management includes dietary modifications, maintaining euglycemia, prokinetics, endoscopic and surgical treatments. Diabetic enteropathy is also common and management involves glycemic control and symptomatic measures. NAFLD is considered a hepatic manifestation of metabolic syndrome and treatment is mainly lifestyle measures, with diabetes and dyslipidemia management when coexistent. Glycogenic hepatopathy is a manifestation of poorly controlled type 1 diabetes and is managed by prompt insulin treatment. Though GI complications of diabetes are relatively common, awareness about its manifestations and treatment options are low among physicians. Optimal management of GI complications is important for appropriate metabolic control of diabetes and improvement in quality of life of the patient. This review is an update on the GI complications of diabetes, their pathophysiology, diagnostic evaluation and management. PMID:23772273

  19. [Consequences and complications of obesity].

    PubMed

    Simon-Vermot, I; Keller, U

    2000-08-01

    Obesity increases the risk of metabolic complications such as diabetes, dyslipidemia, systemic hypertension and cardiovascular disease. These are mainly responsible for the increased mortality of obese people. Other metabolic consequences of obesity are: gallstones, steatosis of the liver and the polycystic ovary syndrome. Beside the body mass index the distribution of body fat is important. Centralized obesity, as measured by the waist-to-hip circumference ratio (WHR), is associated with increased mortality and morbidity. Insulin resistance and hyperinsulinaemia seem to play a central role in the pathogenesis of this association. Obesity has not only metabolic complications. There is a relationship between obesity and impaired respiratory function. Furthermore is obesity a risk factor for osteoarthrosis of the knee, the hip and even the hand and for pulmonary embolism and venous thrombosis. Obesity can also lead to psycho-social problems such as depression, social discrimination and isolation. PMID:11026085

  20. Post dengue neurological complication.

    PubMed

    Hasliza, A H; Tohid, H; Loh, K Y; Santhi, P

    2015-01-01

    Dengue infection is highly endemic in many tropical countries including Malaysia. However, neurological complications arising from dengue infection is not common; Gullain-Barre syndrome (GBS) is one of these infrequent complications. In this paper, we have reported a case in which a 39-year-old woman presented with a neurological complication of dengue infection without typical symptoms and signs of dengue fever. She had a history of acute gastroenteritis (AGE) followed by an upper respiratory tract infection (URTI) weeks prior to her presentation rendering GBS secondary to the post viral URTI and AGE as the most likely diagnosis. Presence of thrombocytopenia was the only clue for dengue in this case. PMID:27099661

  1. Complications of dental surgery.

    PubMed

    Lillich, J D

    1998-08-01

    Both retrospective data and clinical experience indicate that complications of dental surgery are occasionally encountered and, to some extent, are inevitable. Many of the reported complications related to dental surgery such as incomplete removal of diseased teeth or removal of the wrong tooth can be avoided with sound preoperative planning and intraoperative technique. Diseased teeth should be properly identified prior to and during surgery. In addition, complete removal of the diseased tooth must be performed. Use of intraoperative radiographic examination to confirm the location of the diseased tooth and to document its removal cannot be overemphasized. Iatrogenic fracture of the maxillary or mandibular alveolar walls or palatine bone can be avoided by proper placement of the dental punch. The chances of developing incisional drainage or secondary sinusitis can be reduced by use of appropriate systemic antibiotics. These factors should guide the surgical approach to dental surgery to reduce the likelihood of developing common complications. PMID:9742671

  2. Complications of cataract surgery.

    PubMed

    Chan, Elsie; Mahroo, Omar A R; Spalton, David J

    2010-11-01

    Modern cataract surgery is safe in more than 95 per cent of patients. In the small number of cases where a serious complication occurs, the most common is an intra-operative posterior capsular rupture. This can lead to vitreous loss or a dropped nucleus and can increase the risk of post-operative cystoid macular oedema or retinal detachment. Post-operatively, posterior capsular opacification is the most common complication and can be readily treated with a YAG capsulotomy. The most devastating complication is endophthalmitis, the rate of which is now significantly decreased through the use of intracameral antibiotics. As a clinician, the most important step is to assess the patient pre-operatively to predict higher risk individuals and to counsel them appropriately. In these patients, various pre- or intra-operative management steps can be taken in addition to routine phacoemulsification to optimise their visual outcome. PMID:20735786

  3. Osteoarticular complications of brucellosis.

    PubMed Central

    Colmenero, J D; Reguera, J M; Fernández-Nebro, A; Cabrera-Franquelo, F

    1991-01-01

    Two hundred and sixty three patients with a diagnosis of brucellosis between January 1984 and December 1987 were studied prospectively. Sixty five patients (25%) developed osteoarticular complications. These patients had a more prolonged course than those with no complications. Spondylitis in 38 (58%) and sacroiliitis in 29 (45%) were the most prevalent. There were no significant laboratory, serological, or bacteriological differences between patients with and without osteoarticular complications. At diagnosis 47 patients (72%) showed radiographic abnormalities, commonly in axial sites but rarely in peripheral sites. Radionuclide bone scan was positive with no radiographic abnormalities in 17 (26%) of cases. Fifty seven patients received medical treatment alone, 51 (89%) being cured with a single course of treatment. Treatment failed or there was a relapse in six patients (11%), of whom five had spondylitis. Eight of the 65 patients (12%), all of whom had spondylitis and paravertebral or epidural abscesses, also required surgical treatment. Images PMID:1994863

  4. Late complications of tracheotomy.

    PubMed

    Wood, D E; Mathisen, D J

    1991-09-01

    Complications of tracheotomy are largely preventable. Although some authors cite these complications as indications for prolonged endotracheal intubation to avoid tracheotomy, others believe that the laryngotracheal complications of prolonged endotracheal intubation warrant early tracheotomy. Obviously, unnecessary tracheotomies should not be performed, and the controversy regarding the timing of conversion of endotracheal intubation to tracheotomy is handled in an earlier article in this issue. We feel, however, that a properly performed tracheotomy has a low incidence of complications that are more easily managed than are the complex laryngotracheal complications of prolonged endotracheal intubation. Significant post-tracheotomy tracheal stenosis occurs in 8% of patients and is secondary to an overly large tracheotomy stoma or damage at the tracheostomy tube cuff site. Stoma stenosis can be minimized by not making an overly large tracheal stoma and by prevention of undue leverage on the tracheostomy tube. Cuff stenosis can be minimized by the use of the high-volume low-pressure cuffs with careful prevention of overdistention of the cuff. Bronchoscopic dilatation, laser resection, and Silastic T-tube placement provide control of the airway until definitive surgical resection and reconstruction can be performed safely. Tracheoesophageal fistula is an uncommon but life-threatening complication that can be prevented by avoiding overdistention of the tracheostomy tube cuff and by avoiding the concomitant use of a stiff nasogastric tube. These patients are best managed conservatively until they are able to be weaned from a ventilator. A single-stage repair of both the esophagus and the trachea should then be done. Tracheoinnominate artery fistula can be avoided by correct placement of the tracheostomy stoma through the second and third tracheal rings rather than lower in the trachea and by avoidance of overinflation of tracheostomy tube cuffs. PMID:1934960

  5. Intradialytic complications during hemodialysis.

    PubMed

    Davenport, Andrew

    2006-04-01

    With the advent of developments and advances in hemodialysis machine technology, dialysate water purification, and dialyzers, the clinical spectrum of intradialytic complications has changed over the decades. In the pioneering days of hemodialysis, patients could develop allergic reactions to dialyzer membranes, sterilizing and reprocessing agents, coupled with machines that could not accurately control ultrafiltration rates, and chemically and bacterially contaminated dialysate. Whereas today, although cardiovascular problems remain the most common intradialytic complication, these are mainly due to the time restraints of trying to cope with excessive dialytic weight gains and achieve target dry weight on a thrice weekly schedule, coupled with an aging elderly dialysis population with increasing co-morbidity. PMID:16623668

  6. Narrative reconstruction therapy for prolonged grief disorder—rationale and case study

    PubMed Central

    Peri, Tuvia; Hasson-Ohayon, Ilanit; Garber, Sharon; Tuval-Mashiach, Rivka; Boelen, Paul A.

    2016-01-01

    Background Prolonged grief disorder (PGD) is a potentially disabling condition affecting approximately 10% of bereaved people. It has been suggested that the impaired integration of the loss memory, as expressed in recurrent memories of the loss and disorganization of memory, is involved in the development of PGD. Narrative reconstruction (NR), originally designed for the treatment of posttraumatic stress disorder (PTSD) in an integrative therapy module, and consisting of exposure to the loss memory, detailed written reconstruction of the loss memory narrative and an elaboration of the personal significance of that memory for the bereaved, has been shown to be effective in the treatment of intrusion symptoms. Objective In light of findings that cognitive behavior therapy (CBT), including cognitive restructuring and exposure, is effective in the treatment of PGD, we suggest the implementation of a somewhat novel therapy module, NR, for the treatment of intrusive phenomena in bereaved patients. Method The rationale for the implementation of NR for PGD and a case study of the treatment of a woman suffering from PGD after the death of her father are presented. Therapy took place in a university outpatient training clinic. Results Evaluations conducted before and after treatment and at a 3-month follow-up demonstrated the effectiveness of NR in reducing symptoms of PGD and depression. The analysis of spontaneous narratives recorded before and after treatment showed an increased organization of the narratives. Conclusions This case report demonstrates an adaptation of NR for the treatment of PGD. The results provide preliminary support for the effectiveness of NR for PGD. The significance of the study and its limitations are discussed. Highlights of the article Prolonged grief disorder (PGD) affects approximately ten percent of bereaved people. Narrative Reconstruction (NR), an integrative therapy module originally used for PTSD patients, was adapted for PGD. NR consists

  7. [Complications in the therapy of spontaneous pneumothorax].

    PubMed

    Eggeling, S

    2015-05-01

    The therapy of spontaneous pneumothorax is a common necessity in hospitals of all care hierarchies In addition to sufficient primary treatment by placement of a thorax drainage, knowledge of complicationg constellations, recognition of complications and irregular courses during the therapy of spontaneous pneumothorax are of fundamental importance for achieving a satisfactory treatment outcome. Furthermore, the enlightenment of patients regarding the pathogenesis of the disease, possible measures for influencing the recurrence rate and information about future behavioral and lifestyle modifications are important. The principal complications during hospital treatment can be subdivided into complications of the surgical placement of the thorax drain and relief of the pleural cavity, problems in the management of treatment of the pleural negative pressure, the possibly demanding management of a persisting air leak and the individualized decision-making with respect to an interventional or operative procedure. The most common complicating constellations and possible complications during the inpatient hospital stay are described, the. PMID:25995086

  8. Complicating Methodological Transparency

    ERIC Educational Resources Information Center

    Bridges-Rhoads, Sarah; Van Cleave, Jessica; Hughes, Hilary E.

    2016-01-01

    A historical indicator of the quality, validity, and rigor of qualitative research has been the documentation and disclosure of the behind-the-scenes work of the researcher. In this paper, we use what we call "methodological data" as a tool to complicate the possibility and desirability of such transparency. Specifically, we draw on our…

  9. Cardiovascular Complications of Pregnancy

    PubMed Central

    Gongora, Maria Carolina; Wenger, Nanette K.

    2015-01-01

    Pregnancy causes significant metabolic and hemodynamic changes in a woman’s physiology to allow for fetal growth. The inability to adapt to these changes might result in the development of hypertensive disorders of pregnancy (hypertension, preeclampsia or eclampsia), gestational diabetes and preterm birth. Contrary to previous beliefs these complications are not limited to the pregnancy period and may leave permanent vascular and metabolic damage. There is in addition, a direct association between these disorders and increased risk of future cardiovascular disease (CVD, including hypertension, ischemic heart disease, heart failure and stroke) and diabetes mellitus. Despite abundant evidence of this association, women who present with these complications of pregnancy do not receive adequate postpartum follow up and counseling regarding their increased risk of future CVD. The postpartum period in these women represents a unique opportunity to intervene with lifestyle modifications designed to reduce the development of premature cardiovascular complications. In some cases it allows early diagnosis and treatment of chronic hypertension or diabetes mellitus. The awareness of this relationship is growing in the medical community, especially among obstetricians and primary care physicians, who play a pivotal role in detecting these complications and assuring appropriate follow up. PMID:26473833

  10. Complications and Treatments

    MedlinePlus

    ... successfully cure SCD. Complications from hydroxyurea therapy and stem cell transplants are rare but can be serious or life-threatening. People with SCD and their families should ask their doctors about the benefits and risks of each. Read more about treatment ...

  11. Complicating Visual Culture

    ERIC Educational Resources Information Center

    Daiello, Vicki; Hathaway, Kevin; Rhoades, Mindi; Walker, Sydney

    2006-01-01

    Arguing for complicating the study of visual culture, as advocated by James Elkins, this article explicates and explores Lacanian psychoanalytic theory and pedagogy in view of its implications for art education practice. Subjectivity, a concept of import for addressing student identity and the visual, steers the discussion informed by pedagogical…

  12. Pulmonary complications of hepatic diseases

    PubMed Central

    Surani, Salim R; Mendez, Yamely; Anjum, Humayun; Varon, Joseph

    2016-01-01

    Severe chronic liver disease (CLD) may result from portal hypertension, hepatocellular failure or the combination of both. Some of these patients may develop pulmonary complications independent from any pulmonary pathology that they may have. Among them the hepatopulmonary syndrome (HPS), portopulmonary hypertension (PPH) and hepatic hydrothorax (HH) are described in detail in this literature review. HPS is encountered in approximately 15% to 30% of the patients and its presence is associated with increase in mortality and also requires liver transplantation in many cases. PPH has been reported among 4%-8% of the patient with CLD who have undergone liver transplantation. The HH is another entity, which has the prevalence rate of 5% to 6% and is associated in the absence of cardiopulmonary disease. These clinical syndromes occur in similar pathophysiologic environments. Most treatment modalities work as temporizing measures. The ultimate treatment of choice is liver transplant. This clinical review provides basic concepts; pathophysiology and clinical presentation that will allow the clinician to better understand these potentially life-threatening complications. This article will review up-to-date information on the pathophysiology, clinical features and the treatment of the pulmonary complications among liver disease patients. PMID:27468192

  13. Complications of percutaneous vertebroplasty

    PubMed Central

    Saracen, Agnieszka; Kotwica, Zbigniew

    2016-01-01

    Abstract Percutaneous vertebroplasty (PVP) is a minimally invasive procedure widely used for the treatment of pain due to vertebral fractures of different origins—osteoporotic, traumatic, or neoplastic. PVP is minimally invasive, but the complications are not rare; however, they are in most cases not significant clinically. The most frequent is cement leakage, which can occur onto veins, paravertebral soft tissue, into the intervertebral disk, or to the spinal canal, affecting foraminal area or epidural space. We analyzed results of treatment and complications of vertebroplasty performed with the use of polimethylomethylacrylate cement (PMMA) on 1100 vertebrae, with a special regard to the severity of complication and eventual clinical manifestation. One thousand one hundred PVP were analyzed, performed in 616 patients. There were 468 (76%) women and 148 men (24%), 24 to 94-year old, mean age 68 years. From 1100 procedures, 794 treated osteporotic and 137 fractures due to malignant disease, 69 PVP were made in traumatic fractures. One hundred patients had painful vertebral hemangiomas. Seven hundred twenty-six (66%) lesions were in thoracic, and 374 (34%) in lumbar area. Results of treatment were assessed using 10 cm Visual Analogue Scale (VAS) 12 hours after surgery, 7 days, 30 days, and then each 6 months, up to 3 years. Before surgery all patients had significant pain 7 to 10 in VAS scale, mean 8.9 cm. Twelve  hours after surgery 602 (97.7%) reported significant relief of pain, with mean VAS of 2,3 cm. Local complications occurred in 50% of osteoporotic, 34% of neoplastic, 16% of traumatic fractures, and 2% of vertebral hemangiomas. The most common was PMMA leakage into surrounding tissues—20%; paravertebral vein embolism—13%; intradiscal leakage—8%; and PMMA leakage into the spinal canal—0.8%. Results of treatment did not differ between patients with and without any complications. From 104 patients who had chest X-ray or CT study performed

  14. Brief psychotherapy for unresolved grief in an 82-year-old-man.

    PubMed

    Hunter, A J

    1981-01-01

    This man experienced in old age the torment that occurs when early fantasies that underly anxieties are enacted in real life. His elderly wife, when she became confused, ordered their son to drive him from the marital home. When the wife died, the son kept the news from the husband until after the burial. These acts created in reality the fantasy of a reversed oedipal situation, with the son succeeding as a competitor for his father's wife. If the father had resolved his own oedipal strivings satisfactorily, presumably he would not have feared such competition. But there seemed to have been some early environmental failure that had prevented him from integrating in the process of maturation his own wishes for his mother and his fears of his father. Yet, despite the patient's advanced years, the early failure situation seemed to fade as he used the therapy not only to work through his grief, but also as an opportunity to experience anew in the transference a more facilitating environmental adaptation to his needs. PMID:7347753

  15. Care arrangement, grief, and psychological problems among children orphaned by AIDS in China

    PubMed Central

    Zhao, Guoxiang; Li, Xiaoming; Fang, Xiaoyi; Zhao, Junfeng; Yang, Hongmei; Stanton, Bonita

    2007-01-01

    The China Ministry of Health has estimated that there are at least 100,000 AIDS orphans in China. The UNICEF China Office estimates that between 150,000 and 250,000 additional children will be orphaned by AIDS over the next five years. However, limited data are available regarding the socio-demographic characteristics, care arrangement, barriers to appropriate grief resolution and psychological problems among AIDS orphans in China. In this article, we review secondary data and reports from scientific literature, government, non-governmental organizations, and public media regarding children orphaned by AIDS in China to address their living situation, bereavement process, and psychological problems. Our review suggests that AIDS orphans in China are living in a stressful environment with many orphans struggling with psychological problems and unmet basic needs such as food, shelter, education, and medical care. Based on our review, we suggest that future studies should address the psychosocial needs of AIDS orphans in China and develop health promotion programs to mitigate the negative impact of parental death on the physical and psychosocial well-being of these orphans. PMID:18058390

  16. A space for mothers: grief as identity construction on memorial websites created by SIDS parents.

    PubMed

    Finlay, Christopher J; Krueger, Guenther

    2011-01-01

    In this article we conduct a textual analysis of memorial websites created by mothers who have experienced a loss due to sudden infant death syndrome (SIDS). Using an online Internet ethnographic approach, we reviewed a series of 20 sites in an attempt to analyze the motivations of the site creators as manifested in their online projects. We spent time on the sites, moving through all facets of them, following links, and experiencing them the way a visitor would encounter them. In this virtual exploration we uncovered personal narratives, community building, religious imagery, and numerous examples of social networking. We also analyzed guest books in order to understand who visits these sites and their reasons for doing so. We conclude that development of these sites are a process that helps some mothers in their grief and gives them a focus and activity that is helpful and perhaps healing. More importantly perhaps is the potential for community building and networking that this type of activity allows. As an extension of a real-world memorial such as a gravesite, a virtual mourning space provides more in the way of these types of communications. Our work suggests that memorial websites constructed by SIDS parents help in meaning and identity reconstruction after loss. PMID:21748920

  17. Peritraumatic Distress and Dissociation in Prolonged Grief and Posttraumatic Stress Following Violent and Unexpected Deaths.

    PubMed

    Boelen, Paul A

    2015-01-01

    This study examined associations between the violence of a loss and the suddenness of a loss and symptom levels of prolonged grief disorder (PGD) and posttraumatic stress disorder (PTSD) after the death of a loved one. A further aim was to investigate whether peritraumatic distress (i.e., fear, helplessness, and horror) and peritraumatic dissociation mediate the emotional impact of violent losses and unexpected losses. We obtained self-reported data from 265 individuals bereaved in the previous 3 years by losses due to violent causes (17%) or illness (83%). Outcomes showed that participants who experienced violent losses (due to homicide, suicide, or accident) reported more PGD symptoms and PTSD symptoms compared to those confronted with illness loss. In this latter group, greater perceived unexpectedness was positively associated with PGD severity and PTSD severity. Multiple mediation analyses showed that the impact of violent loss and unexpectedness of the loss on PGD severity and PTSD severity was fully mediated by peritraumatic distress and dissociation; peritraumatic helplessness and peritraumatic dissociation (but not peritraumatic fear and horror) emerged as unique mediators. Findings suggest that both violent and unexpected losses exacerbate postloss psychopathology, which is at least partially because of such losses yielding more intense acute helplessness and dissociative responses. PMID:26156555

  18. The Journey through Grief: Insights from a Qualitative Study of Electronic Health Record Implementation

    PubMed Central

    McAlearney, Ann Scheck; Hefner, Jennifer L; Sieck, Cynthia J; Huerta, Timothy R

    2015-01-01

    Objective To improve understanding of facilitators of EHR system implementation, paying particular attention to opportunities to maximize physician adoption and effective deployment. Data Sources/Study Setting Primary data collected from 47 physician and 35 administrative key informants from six U.S. health care organizations identified because of purported success with EHR implementation. Study Design We conducted interviews and focus groups in an extensive qualitative study. Data Collection/Extraction Methods Verbatim transcripts were analyzed both deductively and inductively using the constant comparative method. Principal Findings Conceptualizing EHR adoption as loss through the lens of Kübler-Ross's five stages of grief model may help individuals and organizations more effectively orient to the challenge of change. Coupled with Kotter's eight-step change management framework, we offer a structure to facilitate organizations' movement through the EHR implementation journey. Combining insights from these frameworks, we identify 10 EHR strategies that can help address EHR implementation barriers. Conclusions Loss is one part of change often overlooked. Addressing it directly and compassionately can potentially facilitate the EHR implementation journey. We offer a summarized list of deployment strategies that are sensitive to these issues to support physician transition to new technologies that will bring value to clinical practice. PMID:25219627

  19. The influence of personality disorder indication, social support, and grief on alcohol and cocaine use among HIV-positive adults coping with AIDS-related bereavement.

    PubMed

    Hansen, Nathan B; Cavanaugh, Courtenay E; Vaughan, Ellen L; Connell, Christian M; Tate, David C; Sikkema, Kathleen J

    2009-04-01

    Substance use is prevalent among HIV-positive adults and linked to a number of adverse health consequences; however little is known about risk and protective factors that influence substance use among HIV-positive adults coping with AIDS-related bereavement. Using structural equation modeling (SEM), male gender, diagnostic indications of antisocial and borderline personality disorders (PD), and grief severity were tested as risk factors, and social support as a protective factor, for alcohol and cocaine use among a diverse sample of 268 HIV-positive adults enrolled in an intervention for AIDS-related bereavement. Results indicated that the hypothesized model fit the study data. Male gender, PD indication, and social support had direct effects on substance use. PD had significant indirect effects on both alcohol and cocaine use, mediated by social support, but not by grief. Finally, both PD and social support had significant, but opposite, effects on grief. Implications for intervention and prevention efforts are discussed. PMID:17846878

  20. Genetics of diabetes complications.

    PubMed

    Doria, Alessandro

    2010-12-01

    A large body of evidence indicates that the risk for developing chronic diabetic complications is under the control of genetic factors. Previous studies using a candidate gene approach have uncovered a number of genetic loci that may shape this risk, such as the VEGF gene for retinopathy, the ELMO1 gene for nephropathy, and the ADIPOQ gene for coronary artery disease. Recently, a new window has opened on identifying these genes through genome-wide association studies. Such systematic approach has already led to the identification of a major locus for coronary artery disease on 9p21 as well three potential genes for nephropathy on 7p, 11p, and 13q. Further insights are expected from a broader application of this strategy. It is anticipated that the identification of these genes will provide novel insights on the etiology of diabetic complications, with crucial implications for the development of new drugs to prevent the adverse effects of diabetes. PMID:20835900

  1. Mediastinal dysgerminoma complicating pregnancy

    PubMed Central

    Manikandan, K; Veena, P; Elamurugan, S; Soundararaghavan, S

    2012-01-01

    Malignancy complicating pregnancy represents one of the most challenging clinical situations. Lack of evidence and the presence of the dependent fetus contribute to the management dilemma. A 26-year-old primigravida presented at 23 weeks of gestation with a bulging substernal mass. Fine-needle aspiration was reported as mediastinal dysgerminoma. She was treated with weekly bleomycin and three weekly cisplatin and etoposide (BEP). Maternal neutropenia after 11 weeks of bleomycin required colony stimulator factor. Fetal growth restriction necessitated delivery at 31 weeks. Significant clinical and radiological tumour regression was noted after chemotherapy. Postnatally mother received external beam radiotherapy but the disease worsened two weeks after the completion of radiotherapy. Mediastinal dysgerminoma differs from the ovarian counterpart and therefore therapeutic success reports on ovarian germ cell tumours complicating pregnancy cannot be extrapolated. The safety of the BEP regimen for the fetus is yet to be established.

  2. Complications of Lyme borreliosis.

    PubMed

    Cooke, W D; Dattwyler, R J

    1992-01-01

    Lyme borreliosis is the multisystem infectious disease caused by the spirochete Borrelia burgdorferi. Complications of this infection can involve many organ systems, especially the skin, joints, nervous system, and heart. These manifestations may be acute, or evolve slowly over months or years. Diagnosis is not always straightforward, and is currently hampered by lack of a specific serologic assay. This review discusses the syndromes associated with Lyme borreliosis and addresses issues of diagnosis and treatment. PMID:1580609

  3. Thrombophilia and Pregnancy Complications

    PubMed Central

    Simcox, Louise E.; Ormesher, Laura; Tower, Clare; Greer, Ian A.

    2015-01-01

    There is a paucity of strong evidence associated with adverse pregnancy outcomes and thrombophilia in pregnancy. These problems include both early (recurrent miscarriage) and late placental vascular-mediated problems (fetal loss, pre-eclampsia, placental abruption and intra-uterine growth restriction). Due to poor quality case-control and cohort study designs, there is often an increase in the relative risk of these complications associated with thrombophilia, particularly recurrent early pregnancy loss, late fetal loss and pre-eclampsia, but the absolute risk remains very small. It appears that low-molecular weight heparin has other benefits on the placental vascular system besides its anticoagulant properties. Its use is in the context of antiphospholipid syndrome and recurrent pregnancy loss and also in women with implantation failure to improve live birth rates. There is currently no role for low-molecular weight heparin to prevent late placental-mediated complications in patients with inherited thrombophilia and this may be due to small patient numbers in the studies involved in summarising the evidence. There is potential for low-molecular weight heparin to improve pregnancy outcomes in women with prior severe vascular complications of pregnancy such as early-onset intra-uterine growth restriction and pre-eclampsia but further high quality randomised controlled trials are required to answer this question. PMID:26633369

  4. Keratomycosis complicating pterygium excision.

    PubMed

    Merle, Harold; Guyomarch, Jérôme; Joyaux, Jean-Christophe; Dueymes, Maryvonne; Donnio, Angélique; Desbois, Nicole

    2011-01-01

    The authors describe a case of keratomycosis that appeared after the exeresis of a pterygium. A 48-year-old patient had been referred with a red right eye associated with an abscess of the cornea along the ablation zone of the pterygium. The surgery had been performed a month beforehand. The abscess was 6 mm high and 4 mm wide. The authors instigated a treatment that included amphotericin B (0.25%) after noticing a clinical aspect evoking a fungal keratitis and finding several septate filaments on direct examination. On day 10, a Fusarium dimerum was isolated on Sabouraud agar. After 15 days of treatment, the result was favorable and the size of the ulceration as well as the size of the abscess had progressively decreased. The antifungal treatment was definitively stopped at 14 weeks. Infectious-related complications of the pterygium surgery are rare and are essentially caused by bacterial agents. Secondary infections by fungus are rare. There have been two previous cases reported: one that appeared 15 years after radiotherapy and another that appeared at 3 weeks post surgery, consecutive to the use of mitomycin C. To the authors' knowledge, this is the first case of a keratomycosis due to F. dimerum reported that complicated the exeresis of a pterygium without the use of an adjuvant antihealing treatment. Pterygium surgery is a common procedure; nevertheless, ophthalmologists need to be aware of the existence of potential infectious complications. PMID:22034566

  5. Keratomycosis complicating pterygium excision

    PubMed Central

    Merle, Harold; Guyomarch, Jérôme; Joyaux, Jean-Christophe; Dueymes, Maryvonne; Donnio, Angélique; Desbois, Nicole

    2011-01-01

    The authors describe a case of keratomycosis that appeared after the exeresis of a pterygium. A 48-year-old patient had been referred with a red right eye associated with an abscess of the cornea along the ablation zone of the pterygium. The surgery had been performed a month beforehand. The abscess was 6 mm high and 4 mm wide. The authors instigated a treatment that included amphotericin B (0.25%) after noticing a clinical aspect evoking a fungal keratitis and finding several septate filaments on direct examination. On day 10, a Fusarium dimerum was isolated on Sabouraud agar. After 15 days of treatment, the result was favorable and the size of the ulceration as well as the size of the abscess had progressively decreased. The antifungal treatment was definitively stopped at 14 weeks. Infectious-related complications of the pterygium surgery are rare and are essentially caused by bacterial agents. Secondary infections by fungus are rare. There have been two previous cases reported: one that appeared 15 years after radiotherapy and another that appeared at 3 weeks post surgery, consecutive to the use of mitomycin C. To the authors’ knowledge, this is the first case of a keratomycosis due to F. dimerum reported that complicated the exeresis of a pterygium without the use of an adjuvant antihealing treatment. Pterygium surgery is a common procedure; nevertheless, ophthalmologists need to be aware of the existence of potential infectious complications. PMID:22034566

  6. Genetics of diabetes complications.

    PubMed

    Alkayyali, Sami; Lyssenko, Valeriya

    2014-10-01

    Chronic hyperglycemia and duration of diabetes are the major risk factors associated with development of micro- and macrovascular complications of diabetes. Although it is believed that hyperglycemia induces damage to the particular cell subtypes, e.g., mesangial cells in the renal glomerulus, capillary endothelial cells in the retina, and neurons and Schwann cells in peripheral nerves, the exact mechanisms underlying these damaging defects are not yet well understood. Clustering of micro- and macrovascular complications in families of patients with diabetes suggests a strong genetic susceptibility. However, until now only a handful number of genetic variants were reported to be associated with either nephropathy (ACE, ELMO1, FRMD3, and AKR1B1) or retinopathy (VEGF, AKR1B1, and EPO), and only a few studies were carried out for genetic susceptibility to cardiovascular diseases (ADIPOQ, GLUL) in patients with diabetes. It is, therefore, obvious that the accumulation of more data from larger studies and better phenotypically characterized cohorts is needed to facilitate genetic discoveries and unravel novel insights into the pathogenesis of diabetic complications. PMID:25169573

  7. [Respiratory complications after transfusion].

    PubMed

    Bernasinski, M; Mertes, P-M; Carlier, M; Dupont, H; Girard, M; Gette, S; Just, B; Malinovsky, J-M

    2014-05-01

    Respiratory complications of blood transfusion have several possible causes. Transfusion-Associated Circulatory Overload (TACO) is often the first mentioned. Transfusion-Related Acute Lung Injury (TRALI), better defined since the consensus conference of Toronto in 2004, is rarely mentioned. French incidence is low. Non-hemolytic febrile reactions, allergies, infections and pulmonary embolism are also reported. The objective of this work was to determine the statistical importance of the different respiratory complications of blood transfusion. This work was conducted retrospectively on transfusion accidents in six health centers in Champagne-Ardenne, reported to Hemovigilance between 2000 and 2009 and having respiratory symptoms. The analysis of data was conducted by an expert committee. Eighty-three cases of respiratory complications are found (316,864 blood products). We have counted 26 TACO, 12 TRALI (only 6 cases were identified in the original investigation of Hemovigilance), 18 non-hemolytic febrile reactions, 16 cases of allergies, 5 transfusions transmitted bacterial infections and 2 pulmonary embolisms. Six new TRALI were diagnosed previously labeled TACO for 2 of them, allergy and infection in 2 other cases and diagnosis considered unknown for the last 2. Our study found an incidence of TRALI 2 times higher than that reported previously. Interpretation of the data by a multidisciplinary committee amended 20% of diagnoses. This study shows the imperfections of our system for reporting accidents of blood transfusion when a single observer analyses the medical records. PMID:24814817

  8. Parenteral nutrition: risks, complications, and management.

    PubMed

    Worthington, Patricia H; Gilbert, Karen A

    2012-01-01

    Parenteral nutrition is a life-saving modality, but one that also carries risks for potentially life-threatening complications. Comprehensive management of patients receiving parenteral nutrition includes careful selection of candidates, individualizing formulas to meet patients' unique needs, monitoring response to therapy, and implementing strategies designed to avoid complications. Measures to mitigate the risk of central line-associated bloodstream infections are particularly important. As with all complex therapies, a collaborative, multidisciplinary approach promotes optimal outcomes. PMID:22222292

  9. Perinatal Complications and Aging Indicators by Midlife

    PubMed Central

    Caspi, Avshalom; Ambler, Antony; Belsky, Daniel W.; Chapple, Simon; Cohen, Harvey Jay; Israel, Salomon; Poulton, Richie; Ramrakha, Sandhya; Rivera, Christine D.; Sugden, Karen; Williams, Benjamin; Wolke, Dieter; Moffitt, Terrie E.

    2014-01-01

    BACKGROUND: Perinatal complications predict increased risk for morbidity and early mortality. Evidence of perinatal programming of adult mortality raises the question of what mechanisms embed this long-term effect. We tested a hypothesis related to the theory of developmental origins of health and disease: that perinatal complications assessed at birth predict indicators of accelerated aging by midlife. METHODS: Perinatal complications, including both maternal and neonatal complications, were assessed in the Dunedin Multidisciplinary Health and Development Study cohort (N = 1037), a 38-year, prospective longitudinal study of a representative birth cohort. Two aging indicators were assessed at age 38 years, objectively by leukocyte telomere length (TL) and subjectively by perceived facial age. RESULTS: Perinatal complications predicted both leukocyte TL (β = −0.101; 95% confidence interval, −0.169 to −0.033; P = .004) and perceived age (β = 0.097; 95% confidence interval, 0.029 to 0.165; P = .005) by midlife. We repeated analyses with controls for measures of family history and social risk that could predispose to perinatal complications and accelerated aging, and for measures of poor health taken in between birth and the age-38 follow-up. These covariates attenuated, but did not fully explain the associations observed between perinatal complications and aging indicators. CONCLUSIONS: Our findings provide support for early-life developmental programming by linking newborns’ perinatal complications to accelerated aging at midlife. We observed indications of accelerated aging “inside,” as measured by leukocyte TL, an indicator of cellular aging, and “outside,” as measured by perceived age, an indicator of declining tissue integrity. A better understanding of mechanisms underlying perinatal programming of adult aging is needed. PMID:25349321

  10. Cryptococcal meningitis complicating sarcoidosis

    PubMed Central

    Leonhard, Sonja E.; Fritz, Daan; van de Beek, Diederik; Brouwer, Matthijs C.

    2016-01-01

    Abstract Background: Cryptococcal meningitis is an uncommon but severe complication of sarcoidosis. Methods: We present 2 patients with cryptococcal meningitis complicating sarcoidosis and compared findings with 38 cases reported in the literature. Results: When analyzing our patients and 38 cases reported in the literature, we found that median age of sarcoidosis patients with cryptococcal meningitis was 39 years (range 30–48); 27 of 33 reported cases (82%) had a history of sarcoidosis. Only 16 of 40 patients (40%) received immunomodulating therapy at the time of diagnosis of cryptococcal meningitis. The diagnosis of cryptococcal meningitis was delayed in 17 of 40 patients (43%), mainly because of the initial suspicion of neurosarcoidosis. Cerebrospinal fluid (CSF) examination showed mildly elevated white blood cell count (range 23–129/mm3). Twenty-nine of 32 cases (91%) had a positive CSF culture for Cryptococcus neoformans and 25 of 27 cases (93%) had a positive CSF C neoformans antigen test. CD4 counts were low in all patients in whom counts were performed (84–228/mL). Twelve patients had an unfavorable outcome (32%), of which 7 died (19%) and 24 patients (65%) had a favorable outcome. The rate of unfavorable outcome in patients with a delayed diagnosis was 7 of 17 (41%) compared to 5 of 28 (21%) in patients in whom diagnosis was not delayed. Conclusion: Cryptococcal meningitis is a rare but life-threatening complication of sarcoidosis. Patients were often initially misdiagnosed as neurosarcoidosis, which resulted in considerable treatment delay and worse outcome. CSF cryptococcal antigen tests are advised in patients with sarcoidosis and meningitis. PMID:27583871

  11. Complications of Macular Peeling.

    PubMed

    Asencio-Duran, Mónica; Manzano-Muñoz, Beatriz; Vallejo-García, José Luis; García-Martínez, Jesús

    2015-01-01

    Macular peeling refers to the surgical technique for the removal of preretinal tissue or the internal limiting membrane (ILM) in the macula for several retinal disorders, ranging from epiretinal membranes (primary or secondary to diabetic retinopathy, retinal detachment…) to full-thickness macular holes, macular edema, foveal retinoschisis, and others. The technique has evolved in the last two decades, and the different instrumentations and adjuncts have progressively advanced turning into a safer, easier, and more useful tool for the vitreoretinal surgeon. Here, we describe the main milestones of macular peeling, drawing attention to its associated complications. PMID:26425351

  12. Complicated Burn Resuscitation.

    PubMed

    Harrington, David T

    2016-10-01

    More than 4 decades after the creation of the Brooke and Parkland formulas, burn practitioners still argue about which formula is the best. So it is no surprise that there is no consensus about how to resuscitate a thermally injured patient with a significant comorbidity such as heart failure or cirrhosis or how to resuscitate a patient after an electrical or inhalation injury or a patient whose resuscitation is complicated by renal failure. All of these scenarios share a common theme in that the standard rule book does not apply. All will require highly individualized resuscitations. PMID:27600129

  13. Complications of Macular Peeling

    PubMed Central

    Asencio-Duran, Mónica; Manzano-Muñoz, Beatriz; Vallejo-García, José Luis; García-Martínez, Jesús

    2015-01-01

    Macular peeling refers to the surgical technique for the removal of preretinal tissue or the internal limiting membrane (ILM) in the macula for several retinal disorders, ranging from epiretinal membranes (primary or secondary to diabetic retinopathy, retinal detachment…) to full-thickness macular holes, macular edema, foveal retinoschisis, and others. The technique has evolved in the last two decades, and the different instrumentations and adjuncts have progressively advanced turning into a safer, easier, and more useful tool for the vitreoretinal surgeon. Here, we describe the main milestones of macular peeling, drawing attention to its associated complications. PMID:26425351

  14. Complications of denver shunt.

    PubMed

    Perera, Eranga; Bhatt, Shweta; Dogra, Vikram S

    2011-01-01

    Hepatic hydrothorax secondary to transdiaphragmatic spread of peritoneal fluid can cause respiratory discomfort to the patient. Draining of hydrothorax helps relieve these symptoms. Pleurovenous shunt (Denver shunt) is a relatively non-invasive method of shunting the pleural fluid to the central venous system. Reported complications of pleurovenous shunts are shunt failure, pulmonary edema, post shunt coagulopathy, deep vein thrombosis, and infection. We report a rare case of a leak at the venous end of the catheter that was placed within the right internal jugular vein, resulting in a large collection in the neck. PMID:21915387

  15. Medical complications of prematurity.

    PubMed

    Allen, M C; Jones, M D

    1986-03-01

    The improved survival of extremely premature infants has generated intense interest in the quality of life of the survivors. This review focuses on the major long-term complications of prematurity (developmental disability, retinopathy of prematurity, chronic lung disease) and concludes with an overview of the broader spectrum of morbidity. Severe impairment (cerebral palsy, mental retardation, retrolental fibroplasia, severe chronic lung disease) fortunately occurs in a small proportion of survivors. However, the prevalence of the lesser morbidities (minimal cerebral dysfunction/learning disability, poor growth, postneonatal illnesses, rehospitalization) is less clearly defined. These problems all have an impact on families, and on medical and educational services. PMID:2935764

  16. [Complications after hip osteotomy].

    PubMed

    Renner, L; Perka, C; Zahn, R

    2014-01-01

    Complex deformities of the acetabulum are one of the most common reasons for secondary pelvic osteoarthritis. One option of treatment is osteotomy of the acetabulum close to the joint. The correction of the spatially reduced roof of the femoral head resulting from pelvic dysplasia can minimize the risk of developing secondary osteoarthritis or reduce the progression of an already existing osteoarthritis. The Ganz periacetabular osteotomy (PAO) and Tönnis triple osteotomy procedures are the predominant methods used to correct hip dysplasia in adolescents. Both are complex procedures which bear specific risks and complications, thus requiring very experienced surgeons. PMID:24356819

  17. Avoidance and Management of Stomal Complications

    PubMed Central

    Kwiatt, Michael; Kawata, Michitaka

    2013-01-01

    The construction of an intestinal stoma is fraught with complications and should not be considered a trivial undertaking. Serious complications requiring immediate reoperations can occur, as can minor problems that will subject the patient to daily and nightly distress. Intestinal stomas undoubtedly will dramatically change lifestyles; patients will experience physiologic and psychologic detriment with stoma-related problems, however minor they may seem. Common complications include poor stoma siting, high output, skin irritation, ischemia, retraction, parastomal hernia (PH), and prolapse. Surgeons should be cognizant of these complications before, during, and after stoma creation, and adequate measures should be taken to avoid them. In this review, the authors highlight these often seen problems and discuss management and prevention strategies. PMID:24436659

  18. Intracranial complications following mastoidectomy.

    PubMed

    Migirov, Lela; Eyal, Ana; Kronenberg, Jona

    2004-01-01

    Mastoidectomy is a common surgical procedure in otology. However, postoperative complications of various degrees of severity may occur. We present 4 children who underwent mastoidectomy for middle ear and mastoid disease and developed postoperative intracranial complications. One child was operated on for brain abscess 1 week after the initial mastoidectomy. Another child appeared with seizures 5 days after the initial mastoidectomy and a subdural empyema was drained during revision surgery. Large bone defects with exposed middle cranial fossa dura were found at revision surgery in both cases and Proteus vulgaris and methicillin-resistant Staphylococcus aureus were isolated from the mastoid and abscess cavities in these children. A small epidural collection was diagnosed in the third patient 2 days after initial mastoid surgery and was managed with intravenous antibiotics only. The other child was found to have sigmoid sinus thrombosis the day after mastoidectomy that was performed for nonresponsive acute mastoiditis. This child received both intravenous antibiotics and anticoagulants. Timely revision surgery, combinations of third- or fourth-generation cephalosporins with vancomycin or metronidazole and the addition of anticoagulants in cases of sinus thrombosis can lead to full recovery. PMID:15689642

  19. Complications after third molar surgery.

    PubMed

    Pitekova, L; Satko, I; Novotnakova, D

    2010-01-01

    The authors describe the incidence of postoperative complications after the surgical removal of third molars, most common postoperative complications and their symptoms as well as risk factors leading to greater incidence of postoperative complications (Ref. 17). Full Text (Free, PDF) www.bmj.sk. PMID:20568422

  20. Neurological complications of transplantation.

    PubMed

    Pustavoitau, Aliaksei; Bhardwaj, Anish; Stevens, Robert

    2011-01-01

    Recipients of solid organ or hematopoietic cell transplants are at risk of life-threatening neurological disorders including encephalopathy, seizures, infections and tumors of the central nervous system, stroke, central pontine myelinolysis, and neuromuscular disorders-often requiring admission to, or occurring in, the intensive care unit (ICU). Many of these complications are linked directly or indirectly to immunosuppressive therapy. However, neurological disorders may also result from graft versus host disease, or be an expression of the underlying disease which prompted transplantation, as well as injury induced during radiation, chemotherapy, surgery, and ICU stay. In rare cases, neuroinfectious pathogens may be transmitted with the transplanted tissue or organ. Diagnosis may be a challenge because clinical symptoms and findings on neuroimaging lack specificity, and a biological specimen or tissue diagnosis is often needed for definitive diagnosis. Management is centered on preventing further neurological injury, etiology-targeted therapy, and balancing the benefits and toxicities of specific immunosuppressive agents. PMID:21764765

  1. Neuromuscular complications in cancer.

    PubMed

    Grisold, W; Grisold, A; Löscher, W N

    2016-08-15

    Cancer is becoming a treatable and even often curable disease. The neuromuscular system can be affected by direct tumor invasion or metastasis, neuroendocrine, metabolic, dysimmune/inflammatory, infections and toxic as well as paraneoplastic conditions. Due to the nature of cancer treatment, which frequently is based on a DNA damaging mechanism, treatment related toxic side effects are frequent and the correct identification of the causative mechanism is necessary to initiate the proper treatment. The peripheral nervous system is conventionally divided into nerve roots, the proximal nerves and plexus, the peripheral nerves (mono- and polyneuropathies), the site of neuromuscular transmission and muscle. This review is based on the anatomic distribution of the peripheral nervous system, divided into cranial nerves (CN), motor neuron (MND), nerve roots, plexus, peripheral nerve, the neuromuscular junction and muscle. The various etiologies of neuromuscular complications - neoplastic, surgical and mechanic, toxic, metabolic, endocrine, and paraneoplastic/immune - are discussed separately for each part of the peripheral nervous system. PMID:27423586

  2. Complicated bile duct stones.

    PubMed

    Roy, Ashwin; Martin, Derrick

    2013-01-01

    Common bile duct stones (CBDSs) are solid deposits that can either form within the gallbladder or migrate to the common bile duct (CBD), or form de novo in the biliary tree. In the USA around 15% of the population have gallstones and of these, 3% present with symptoms annually. Because of this, there have been major advancements in the management of gallstones and related conditions. Management is based on the patient's risk profile; young and healthy patients are likely to be recommended for surgery and elderly patients with comorbidities are usually recommended for endoscopic procedures. Imaging of gallstones has advanced in the last 30 years with endoscopic retrograde cholangiopancreatography evolving from a diagnostic to a therapeutic procedure in removing CBDSs. We present a complicated case of a patient with a CBDS and periampullary diverticulum and discuss the techniques used to diagnose and remove the stone from the biliary system. PMID:23946532

  3. [Cardiovascular complications of obesity].

    PubMed

    Cascella, Teresa; Giallauria, Francesco; Tafuri, Domenico; Lombardi, Gaetano; Colao, Annamaria; Vigorito, Carlo; Orio, Francesco

    2006-12-01

    Obesity is one of the major coronary risk factor representing an increasingly important worldwide health problem. The increased prevalence of obesity among younger population is likely to have long-term implications for cardiovascular disease (CVD). Obesity plays a central role in the insulin resistance syndrome and contributes to increase the risk of atherosclerotic CVD. The present review will examine the relationships among cardiovascular risk factors during the childhood-adolescence-adulthood transition. In fact, the relationship between obesity (especially visceral obesity) and CVD appears to develop at a relatively young age. The foremost physical consequence of obesity is atherosclerotic cardiovascular disease and polycystic ovary syndrome represents an intriguing example of obesity-related cardiovascular complications affecting young women. PMID:17312846

  4. Complicated bile duct stones

    PubMed Central

    Roy, Ashwin; Martin, Derrick

    2013-01-01

    Common bile duct stones (CBDSs) are solid deposits that can either form within the gallbladder or migrate to the common bile duct (CBD), or form de novo in the biliary tree. In the USA around 15% of the population have gallstones and of these, 3% present with symptoms annually. Because of this, there have been major advancements in the management of gallstones and related conditions. Management is based on the patient's risk profile; young and healthy patients are likely to be recommended for surgery and elderly patients with comorbidities are usually recommended for endoscopic procedures. Imaging of gallstones has advanced in the last 30 years with endoscopic retrograde cholangiopancreatography evolving from a diagnostic to a therapeutic procedure in removing CBDSs. We present a complicated case of a patient with a CBDS and periampullary diverticulum and discuss the techniques used to diagnose and remove the stone from the biliary system. PMID:23946532

  5. A Theoretical Study of the Hidden Wounds of War: Disenfranchised Grief and the Impact on Nursing Practice

    PubMed Central

    Aloi, Janice A.

    2011-01-01

    Combat veterans face enormous challenges upon the return to civilian life, one of which is the ability to integrate incidences of death and killing into a healthy postdeployment life. This paper presents the lived experience of grief and loss resulting from the trauma of war. Social constructionist theory, due to its emphasis on meaning-making, serves as the theoretical framework. The effects of inhibited mourning due to the inability to mourn in combat and lack of nurturing upon returning home are described. Personal excerpts derived from interviews of warfare from veterans that experienced death and killing are presented. It is suggested that combat veterans experience a unique form of grief and therefore require a style of grieving that differs from those that have not served on the battlefield. Regardless of the point of care, nurses are positioned to help with the challenges of readjustment. A better understanding of combat veterans as a disenfranchised group would enable nurses to intervene in ways that contribute to the readjustment process. PMID:22007331

  6. A randomized controlled trial of an internet-based therapist-assisted indicated preventive intervention for prolonged grief disorder.

    PubMed

    Litz, Brett T; Schorr, Yonit; Delaney, Eileen; Au, Teresa; Papa, Anthony; Fox, Annie B; Morris, Sue; Nickerson, Angela; Block, Susan; Prigerson, Holly G

    2014-10-01

    This trial assessed the feasibility, acceptability, tolerability, and efficacy of an Internet-based therapist-assisted cognitive-behavioral indicated prevention intervention for prolonged grief disorder (PGD) called Healthy Experiences After Loss (HEAL). Eighty-four bereaved individuals at risk for PGD were randomized to either an immediate treatment group (n = 41) or a waitlist control group (n = 43). Assessments were conducted at four time-points: prior to the wait-interval (for the waitlist group), pre-intervention, post-intervention, 6 weeks later, and 3 months later (for the immediate group only). Intent-to-treat analyses indicated that HEAL was associated with large reductions in prolonged grief (d = 1.10), depression (d = .71), anxiety (d = .51), and posttraumatic stress (d = .91). Also, significantly fewer participants in the immediate group met PGD criteria post-intervention than in the waitlist group. Pooled data from both groups also yielded significant reductions and large effect sizes in PGD symptom severity at each follow-up assessment. The intervention required minimal professional oversight and ratings of satisfaction with treatment and usability of the Internet interface were high. HEAL has the potential to be an effective, well-tolerated tool to reduce the burden of significant pre-clinical PGD. Further research is needed to refine HEAL and to assess its efficacy and mechanisms of action in a large-scale trial. PMID:25113524

  7. A Randomized Controlled Trial of an Internet-Based Therapist-Assisted Indicated Preventive Intervention for Prolonged Grief Disorder

    PubMed Central

    Litz, Brett T.; Schorr, Yonit; Delaney, Eileen; Au, Teresa; Papa, Anthony; Fox, Annie B.; Morris, Sue; Nickerson, Angela; Block, Susan; Prigerson, Holly G.

    2014-01-01

    This trial assessed the feasibility, acceptability, tolerability, and efficacy of an Internet-based therapist-assisted cognitive-behavioral indicated prevention intervention for prolonged grief disorder (PGD) called Healthy Experiences After Loss (HEAL). Eighty-four bereaved individuals at risk for PGD were randomized to either an immediate treatment group (n = 41) or a waitlist control group (n=43). Assessments were conducted at four time-points: prior to the wait-interval (for the waitlist group), pre-intervention, post-intervention, 6 weeks later, and 3 months later (for the immediate group only). Intent-to-treat analyses indicated that HEAL was associated with large reductions in prolonged grief (d=1.10), depression (d=.71), anxiety (d=.51), and posttraumatic stress (d=.91). Also, significantly fewer participants in the immediate group met PGD criteria post-intervention than in the waitlist group. Pooled data from both groups also yielded significant reductions and large effect sizes in PGD symptom severity at each follow-up assessment. The intervention required minimal professional oversight and ratings of satisfaction with treatment and usability of the Internet interface were high. HEAL has the potential to be an effective, well-tolerated tool to reduce the burden of significant pre-clinical PGD. Further research is needed to refine HEAL and to assess its efficacy and mechanisms of action in a large-scale trial. PMID:25113524

  8. Grief and burial in the American Southwest: the role of evolutionary theory in the interpretation of mortuary remains.

    PubMed

    MacDonald, D H

    2001-10-01

    Evolutionary theory, in consort with Marxism and processualism, provides new insights into the interpretation of grave-good variation. Processual interpretations of burial sites in the American Southwest cite age, sex, or social rank as the main determinants of burial-good variation. Marxist theorists suggest that mortuary ritual mediates social tension between an egalitarian mindset and an existing social inequality. Evolutionary theory provides a supplementary explanatory framework. Recent studies guided by kin-selection theory suggest that humans grieve more for individuals of high reproductive value and genetic relatedness. Ethnographic examples also show that individuals mourn more intensively and, thus, place more social emphasis on burials of individuals of highest reproductive value (young adults). Analysis of grave goods from La Ciudad, a Hohokam site in the American Southwest, supports the hypothesis that labor value, reproductive value, and grief contributed to grave-good differentiation. At La Ciudad, individuals between the ages of 10 and 20 possessed more and higher-quality grave goods on average than any other age group. Grief at the loss of a young adult of high reproductive and labor value may facilitate explanation of mortuary variation at La Ciudad, as well as other sites in the greater Southwest and beyond. PMID:20043376

  9. Keeping the Music Alive: Using the "Grief and Hope Box" with Adult Offenders with Co-Occurring Mental Health and Substance Use Issues

    ERIC Educational Resources Information Center

    Gee, Robert; Springer, Paul; Bitar, George; Drew, Faith; Graff, Chad

    2005-01-01

    Individuals with co-occurring mental health and substance use disorder (COD) present unique challenges for counselors. When individuals are incarcerated, they suffer unique forms of losses, including the loss and grief of their family members. In addition, they often struggle with stigma and cultural stereotypes that are oppressive and…

  10. Treating maladaptive grief and posttraumatic stress symptoms in orphaned children in Tanzania: group-based trauma-focused cognitive-behavioral therapy.

    PubMed

    O'Donnell, Karen; Dorsey, Shannon; Gong, Wenfeng; Ostermann, Jan; Whetten, Rachel; Cohen, Judith A; Itemba, Dafrosa; Manongi, Rachel; Whetten, Kathryn

    2014-12-01

    This study was designed to test the feasibility and child clinical outcomes for group-based trauma-focused cognitive behavior therapy (TF-CBT) for orphaned children in Tanzania. There were 64 children with at least mild symptoms of grief and/or traumatic stress and their guardians who participated in this open trial. The TF-CBT for Child Traumatic Grief protocol was adapted for use with a group, resulting in 12 weekly sessions for children and guardians separately with conjoint activities and 3 individual visits with child and guardian. Using a task-sharing approach, the intervention was delivered by lay counselors with no prior mental health experience. Primary child outcomes assessed were symptoms of grief and posttraumatic stress (PTS); secondary outcomes included symptoms of depression and overall behavioral adjustment. All assessments were conducted pretreatment, posttreatment, and 3 and 12 months after the end of treatment. Results showed improved scores on all outcomes posttreatment, sustained at 3 and 12 months. Effect sizes (Cohen's d) for baseline to posttreatment were 1.36 for child reported grief symptoms, 1.87 for child-reported PTS, and 1.15 for guardian report of child PTS. PMID:25418514

  11. Treating Unresolved Grief and Posttraumatic Stress Symptoms in Orphaned Children in Tanzania: Group-based Trauma-focused Cognitive Behavioral Therapy

    PubMed Central

    O’Donnell, Karen; Dorsey, Shannon; Gong, Wenfeng; Ostermann, Jan; Whetten, Rachel; Cohen, Judith A.; Itemba, Dafrosa; Manongi, Rachel; Whetten, Kathryn

    2015-01-01

    The study was designed to test the feasibility and child clinical outcomes for a group-based application of Trauma-focused Cognitive Behavior Therapy (TF-CBT) for orphaned children with unresolved grief in Moshi, Tanzania. Sixty-four orphaned children with at least mild symptoms of unresolved grief and/or traumatic stress and their guardians participated in the open trial. The evidence-based TF-CBT protocol was adapted for group delivery, resulting in 12 weekly sessions for child and guardians separately with conjoint activities and three individual visits. Using a task-sharing approach, the intervention was delivered by lay counselors with no prior mental health experience. Primary outcomes assessed were symptoms of unresolved grief and posttraumatic stress (PTS); secondary outcomes included symptoms of depression and overall behavioral adjustment. All assessments were conducted pre-treatment, post-treatment, and 3- and 12-months after the end of treatment. Results showed improved scores on all outcomes post-treatment, sustained at 3 and 12 months. Effect sizes (Cohen’s d) for baseline to post-treatment were 1.36 for child reported grief symptoms; 1.87 for child-reported PTS, and 1.15 for caregiver report of child PTS. PMID:25418514

  12. Grief and Bereavement Issues and the Loss of a Companion Animal: People Living with a Companion Animal, Owners of Livestock, and Animal Support Workers

    ERIC Educational Resources Information Center

    Chur-Hansen, Anna

    2010-01-01

    Companion animals play various roles in people's lives and these roles can impact on loss, grief, bereavement and mourning when the animal has been lost, whether that is through death, when missing, or when relinquished. This paper considers not only companion animal owners, but also those who own farm animals and those who work in animal service…

  13. The Central Role of Meaning in Adjustment to the Loss of a Child to Cancer: Implications for the Development of Meaning-Centered Grief Therapy

    PubMed Central

    Lichtenthal, Wendy G.; Breitbart, William

    2015-01-01

    Purpose of review This review describes research on meaning and meaning-making in parents who lost a child to cancer, suggesting the need for a meaning-centered therapeutic approach to improve their sense of meaning, purpose, and identity and to help with management of prolonged grief symptoms. Recent findings Several studies have demonstrated that parents bereaved by cancer experience unique meaning related challenges associated with the caregiving and illness experience, including struggles with making sense of their loss, benefit-finding, their sense of identity and purpose, disconnection from sources of meaning, and sustaining a sense of meaning in their child’s life. Meaning-Centered Grief Therapy, adapted from Meaning-Centered Psychotherapy, directly addresses these issues, highlighting the choices parents have in how they face their pain, how they honor their child and his/her living legacy, the story they create, and how they live their lives. Summary Given the important role that meaning plays in adjustment to the loss of a child to cancer, a meaning-focused approach such as Meaning-Centered Grief Therapy, may help improve parents’ sense of meaning and grief symptoms. It seems particularly appropriate for parents who lost a child to cancer because it does not pathologize their struggles and directly targets issues they frequently face. PMID:25588204

  14. Ocular complications of diabetes mellitus

    PubMed Central

    Sayin, Nihat; Kara, Necip; Pekel, Gökhan

    2015-01-01

    Diabetes mellitus (DM) is a important health problem that induces ernestful complications and it causes significant morbidity owing to specific microvascular complications such as, retinopathy, nephropathy and neuropathy, and macrovascular complications such as, ischaemic heart disease, and peripheral vasculopathy. It can affect children, young people and adults and is becoming more common. Ocular complications associated with DM are progressive and rapidly becoming the world’s most significant cause of morbidity and are preventable with early detection and timely treatment. This review provides an overview of five main ocular complications associated with DM, diabetic retinopathy and papillopathy, cataract, glaucoma, and ocular surface diseases. PMID:25685281

  15. Ocular complications of diabetes mellitus.

    PubMed

    Sayin, Nihat; Kara, Necip; Pekel, Gökhan

    2015-02-15

    Diabetes mellitus (DM) is a important health problem that induces ernestful complications and it causes significant morbidity owing to specific microvascular complications such as, retinopathy, nephropathy and neuropathy, and macrovascular complications such as, ischaemic heart disease, and peripheral vasculopathy. It can affect children, young people and adults and is becoming more common. Ocular complications associated with DM are progressive and rapidly becoming the world's most significant cause of morbidity and are preventable with early detection and timely treatment. This review provides an overview of five main ocular complications associated with DM, diabetic retinopathy and papillopathy, cataract, glaucoma, and ocular surface diseases. PMID:25685281

  16. Postoperative Complications: Looking Forward to a Safer Future.

    PubMed

    Tevis, Sarah E; Kennedy, Gregory D

    2016-09-01

    Colorectal surgery patients frequently suffer from postoperative complications. Patients with complications have been shown to be at higher risk for mortality, poor oncologic outcomes, additional complications, and worse quality of life. Complications are increasingly recognized as markers of quality of care with more use of risk-adjusted national surgical databases and increasing transparency in health care. Quality improvement work in colorectal surgery has identified methods to decrease complication rates and improve outcomes in this patient population. Future work will continue to identify best practices and standardized ways to measure quality of care. PMID:27582650

  17. Dermatological complications of obesity.

    PubMed

    García Hidalgo, Linda

    2002-01-01

    Obesity is a health problem of considerable magnitude in the Western world. Dermatological changes have been reported in patients with obesity, including: acanthosis nigricans and skin tags (due to insulin resistance); hyperandrogenism; striae due to over extension; stasis pigmentation due to peripheral vascular disease; lymphedema; pathologies associated with augmented folds; morphologic changes in the foot anatomy due to excess load; and complications that may arise from hospitalization. Acanthosis nigricans plaques can be managed by improved control of hyperinsulinemia; the vitamin D3 analog calcipitriol has also been shown to be effective. Skin tags can be removed by snipping with curved scissors, by cryotherapy or by electrodesiccation. Hyperandrogenism, a result of increased production of endogenous androgens due to increased volumes of adipose tissue (which synthesizes testosterone) and hyperinsulinemia (which increases the production of ovarian androgens) needs to be carefully assessed to ensure disorders such as virilizing tumors and congenital adrenal hyperplasia are treated appropriately. Treatment of hyperandrogenism should be centred on controlling insulin levels; weight loss, oral contraceptive and antiandrogenic therapies are also possible treatment options. The etiology of striae distensae, also known as stretch marks, is yet to be defined and treatment options are unsatisfactory at present; striae rubra and alba have been treated with a pulsed dye laser with marginal success. The relationship between obesity and varicose veins is controversial; symptoms are best prevented by the use of elastic stockings. Itching and inflammation associated with stasis pigmentation, the result of red blood cells escaping into the tissues, can be treated with corticosteroids. Lymphedema is associated with dilatation of tissue channels, reduced tissue oxygenation and provides a culture medium for bacterial growth. Lymphedema treatment is directed towards reducing the

  18. Complications of pediatric trauma.

    PubMed

    Czerwinski, S J

    1991-09-01

    MSOF is a life-threatening complication of trauma. The body is a dynamic interrelated group of systems that work together efficiently. Changes in one system generally have a widespread impact, and soon the entire system is changed. In children with MSOF, the normal equilibrium that is maintained between organ systems does not exist. Generalized disruption of organ functions occur, and the body attempts to compensate and regain its homeostasis. This activity will often benefit certain organs and harm others. If the disruption continues and compensation fails, organ dysfunction occurs and general chaos reigns. Medical and nursing interventions are directed toward supporting individual organ systems before failure occurs. Attempts to provide this support for one system can cause adverse effects to occur in other systems. Although this is a potential result of medical and nursing interventions, often there is no other choice. It is essential that nurses be aware of the systemic consequences of these interventions and carefully evaluate them. Although overall mortality rates are high, children have a better chance for survival than adults. Expert nursing assessments, interventions, and evaluations are essential to maximize this outcome. More research in the area of MSOF in children is necessary, with specific attention to nursing management and the effect on patient outcome. PMID:1883588

  19. Pregnancy complicating Wegener's granulomatosis

    PubMed Central

    Soh, May Ching; Hart, Hamish H; Bass, Eileen; Wilkinson, Lucille

    2009-01-01

    Pregnancy associated with Wegener's granulomatosis is rare. Therapeutic options are limited. There is a paucity of published literature to guide clinical decision-making in these complex patients. Two cases are presented. Firstly, a 33-year-old woman with generalized Wegener's in remission and off all medications presented with a flare in the third trimester with haemoptysis, raised C-reactive protein and c-anti-neutrophilic cytoplasmic antibody (c-ANCA) levels. Her care was complicated by florid steroid-induced psychosis. With deteriorating disease control, she was treated with pulsed-intravenous cyclophosphamide with a good response. She delivered a healthy baby at 38 weeks. She had a severe postpartum flare. Secondly, a 37-year-old woman with limited Wegener's in remission for the last two years and off all treatment became pregnant after pre-conception counselling. A normal baby was delivered at term. An exhaustive review of all published literature on Wegener's activity in pregnancy is presented along with therapeutic options and recommendations.

  20. Hematologic complications of pregnancy.

    PubMed

    Townsley, Danielle M

    2013-07-01

    Pregnancy induces a number of physiologic changes that affect the hematologic indices, either directly or indirectly. Recognizing and treating hematologic disorders that occur during pregnancy is difficult owing to the paucity of evidence available to guide consultants. This review discusses specifically the diagnosis and management of benign hematologic disorders occurring during pregnancy. Anemia secondary to iron deficiency is the most frequent hematologic complication and is easily treated with oral iron formulations; however, care must be taken not to miss other causes of anemia, such as sickle cell disease. Thrombocytopenia is also a common reason for consulting the hematologist, and distinguishing gestational thrombocytopenia from immune thrombocytopenia (ITP), preeclampsia, HELLP syndrome (hemolysis, elevated liver enzymes, and low platelets), or thrombotic thrombocytopenic purpura (TTP) is essential since the treatment differs widely. Occasionally the management of mother and infant involves the expeditious recognition of neonatal alloimmune thrombocytopenia (NAIT), a condition that is responsible for severe life-threatening bleeding of the newborn. Additionally, inherited and acquired bleeding disorders affect pregnant women disproportionately and often require careful monitoring of coagulation parameters to prevent bleeding in the puerperium. Finally, venous thromboembolism (VTE) during pregnancy is still largely responsible for mortality during pregnancy, and the diagnosis, treatment options and guidelines for prevention of VTE during pregnancy are explored. PMID:23953339

  1. Hematologic Complications of Pregnancy

    PubMed Central

    Townsley, Danielle M.

    2013-01-01

    Pregnancy induces a number of physiologic changes that affect the hematologic indices, either directly or indirectly. Recognizing and treating hematologic disorders that occur during pregnancy is difficult owing to the paucity of evidence available to guide consultants. This paper specifically reviews the diagnosis and management of benign hematologic disorders occurring during pregnancy. Anemia secondary to iron deficiency is the most frequent hematologic complication and is easily treated with oral iron formulations,; however care must be taken not to miss other causes of anemia, such as sickle cell disease. Thrombocytopenia is also a common reason for consulting the hematologist and distinguishing gestational thrombocytopenia from immune thrombocytopenia (ITP), preeclampsia, HELLP syndrome, or thrombotic thrombocytopenic purpura (TTP) is essential since the treatment differs widely. Occasionally the management of mother and infant involves the expeditious recognition of neonatal alloimmune thrombocytopenia (NAIT), a condition that is responsible for severe life-threatening bleeding of the newborn. Additionally, inherited and acquired bleeding disorders affect pregnant women disproportionately and often require careful monitoring of coagulation parameters in order to prevent bleeding in the puerperium. Finally, venous thromboembolism (VTE) during pregnancy is still largely responsible for mortality during pregnancy and the diagnosis, treatment options and guidelines for prevention of VTE during pregnancy are explored. PMID:23953339

  2. Clearinghouse: Diagnostic Categories and Obstetric Complication Histories in Disturbed Children

    ERIC Educational Resources Information Center

    McNeil, Thomas F.; Wiegerink, Ronald

    1971-01-01

    No significant differences in the obstetric complication measures were found among the various diagnostic groupings of 61 psychologically or behaviorally disturbed children, nor between any complication measures and any of the three disturbed behavior patterns identified (psychotic withdrawal, acting-out aggression, organic signs). (KW)

  3. Infantile hemangiomas, complications and treatments.

    PubMed

    Cheng, Carol Erin; Friedlander, Sheila Fallon

    2016-03-01

    Infantile hemangiomas (IHs) are the most common vascular tumors of infancy. While the majority regress without the need for intervention, approximately 10%, often site dependent, can cause serious complications and require treatment. IH complications can be categorized as life threatening, obstructive, ulcerative or disfiguring. Life threatening complications include airway and hepatic IHs. Functional complications obstructing vital structures or impairing function include periocular, nasal, labial, parotid, auricular, and breast IHs. Local complications arise from ulceration or those in cosmetically sensitive areas. Therapeutic options for complicated IHs include pharmacologic (topical or systemic), surgical, or laser interventions. Topical agents are best employed for small, superficial, and localized IHs; while systemic therapy is reserved for larger IHs and those with more aggressive growth characteristics with propranolol as first-line therapy. PMID:27607318

  4. Nutritional Predictors of Complications Following Radical Cystectomy

    PubMed Central

    Johnson, David C.; Riggs, Stephen B.; Nielsen, Matthew E.; Matthews, Jonathan E.; Woods, Michael E.; Wallen, Eric M.; Pruthi, Raj S.; Smith, Angela B.

    2016-01-01

    Purpose To determine the impact of preoperative nutritional status on the development of surgical complications following cystectomy using the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP). Methods We performed a retrospective review of the NSQIP 2005–2012 Participant Use Data Files. ACS-NSQIP collects data on 135 variables, including pre- and intraoperative data and 30-day post-operative complications and mortality on all major surgical procedures at participating institutions. Preoperative albumin (<3.5 or >3.5 g/dl), weight loss 6 months before surgery (>10%), and BMI were identified as nutritional variables within the database. The overall complication rate was calculated and predictors of complications were identified using multivariable logistic regression models. Results 1,213 patients underwent cystectomy for bladder cancer between 2005–2012. The overall 30-day complication rate was 55.1% (n=668). While 14.7% (n=102) had a preoperative albumin <3.5 g/dL, 3.4% had >10% weight loss in the 6 months prior to surgery, and the mean BMI was 28 kg/m2. After controlling for age, sex, medical comorbidities, medical resident involvement, operation year, operative time and prior operation, only albumin <3.5g/dl was a significant predictor of experiencing a postoperative complication (p=0.03). This remained significant when albumin was evaluated as a continuous variable (p=0.02) Conclusions Poor nutritional status measured by serum albumin is predictive of an increased rate of surgical complications following radical cystectomy. This finding supports the importance of preoperative nutritional status in this population and highlights the need for the development of effective nutritional interventions in the preoperative setting. PMID:25240535

  5. Complications related to pubic hair removal

    PubMed Central

    DEMARIA, Andrea L.; FLORES, Marissa; HIRTH, Jacqueline M.; BERENSON, Abbey B.

    2014-01-01

    Objectives We investigated the prevalence and correlates of complications related to pubic hair removal among a diverse clinical sample of women attending a public clinic. Study Design Women (aged 16 to 40 years) who received care from April to June 2012 at two publicly funded clinics completed an anonymous, self-administered questionnaire (n=369). After excluding women with missing data, analyses were conducted on 333 women. Additional measures were retrieved through a medical chart review. Chi-square and multivariable logistic regression were used to analyze participant characteristics, pubic hair removal behaviors, and complications related to pubic hair removal. Results Most women (87%) admitted to current removal of at least some pubic hair, while the remainder responded that they had removed pubic hair in the past. Under or normal weight women were more likely to report total pubic hair removal than overweight or obese women. The majority (60%) had experienced at least one health complication due to removal, of which the most common were epidermal abrasion and ingrown hairs. Black and Hispanic women were less likely than white women to report complications. Overweight or obese women were almost twice as likely to report a complication and almost 3 times as likely if they were also total removers. Only 4% had seen a healthcare provider for a complication related to hair removal and only 4% discussed safe removal practices with their doctor. Conclusions Minor complications commonly occur as a result of pubic hair removal. Gynecological visits could provide a safe environment for women to discuss pubic hair removal practices. PMID:24486227

  6. Pulmonary Complications of Drug Abuse

    PubMed Central

    Gottlieb, Leon S.; Boylen, Thomas C.

    1974-01-01

    Complications resulting from drug abuse more frequently affect the lung than any other organ. The spectrum of pulmonary complications associated with drug abuse is wide. The current practice of using mixtures of drugs is mainly responsible for the increase in pulmonary complications. The chief complications observed in a series of 241 drug abuse patients were aspiration pneumonitis (12.9 percent), pulmonary edema (10.0 percent), and pneumonia (7.5 percent). ImagesFigure 1.Figure 2.Figure 3.Figure 4.Figure 5.Figure 6.Figure 7.Figure 8.Figure 9.Figure 10. PMID:4812215

  7. Inflatable penile prosthesis (IPP): diagnosis of complications.

    PubMed

    Hartman, Robert P; Kawashima, Akira; Takahashi, Naoki; LeRoy, Andrew J; King, Bernard F

    2016-06-01

    Inflatable penile prostheses are a common treatment for erectile dysfunction that is unresponsive to less-invasive measures. Complications can arise at the time of the placement of the prosthesis or at a later date. Complications may be related to infection and/or mechanical failure of one or more of the prosthesis components including cylinder, reservoir, pump, and tubing. Mechanical failure includes kinking, migration, and aneurysmal dilation of the cylinder, erosion of the tunica albuginea of the corpora cavernosum by the cylinder, disconnection of the tubing, and migration of the reservoir. MRI of the entire components with the cylinders in both flaccid and inflated states is the best imaging modality available to image patients with suspected implant complications. PMID:26907716

  8. Prevalence and comorbidity of prolonged grief disorder in a sample of caregivers of patients in a vegetative state.

    PubMed

    Guarnerio, Chiara; Prunas, Antonio; Della Fontana, Irene; Chiambretto, Paola

    2012-03-01

    Previous studies have shown that Prolonged Grief Disorder (PGD), Post-traumatic Stress Disorder (PTSD) and major depression are autonomous nosological entities. The present study aims at further analyzing the relationship among them in a sample of caregivers of patients in Vegetative State (VS) or Minimally Conscious State (MCS). We also investigated factors predicting the development of PGD. We sampled 40 Caregivers of patients in VS or MCS consecutively admitted to long-term care units. Caregivers were administered the PG-12, the Depression Questionnaire, the SCID I and the Davidson Trauma Scale. Six participants (15%) fulfilled the criteria for PGD, 25% (N = 10) for depression and 25% (N = 10) for PTSD. Although significant correlations emerged among symptom domains of the three disorders, no relevant association was found between a diagnosis of PGD, depression and PTSD. The severity of PTSD symptoms was found to be predictive of PGD. Clinical implications are discussed. PMID:21691850

  9. Anticipatory grief among close relatives of persons with dementia in comparison with close relatives of patients with cancer.

    PubMed

    Johansson, Asa K; Sundh, Valter; Wijk, Helle; Grimby, Agneta

    2013-02-01

    Close relatives of persons with dementia self-reported reactions on the Anticipatory Grief Scale (AGS), were observed by nurses (Study I), and compared with relatives of cancer patients in a study using the same methodology (Study II). Study I showed an overall stressful situation including feelings of missing and longing, inability to accept the terminal fact, preoccupation with the ill, tearfulness, sleeping problems, anger, loneliness, and a need to talk. The ability to cope was, however, reported high. Self-assessments and nurses' observations did not always converge, e.g. for the acceptance of the illness. The reactions of the relatives in the dementia and the cancer groups showed more similarities than dissimilarities. However, the higher number of responding spouses in the cancer group may have influenced the outcome. PMID:22495791

  10. Complications of Laparoscopic Gynecologic Surgery

    PubMed Central

    Fuentes, Mariña Naveiro; Naveiro Rilo, José Cesáreo; Paredes, Aida González; Aguilar Romero, María Teresa; Parra, Jorge Fernández

    2014-01-01

    Background and Objectives: To analyze the frequency of complications during laparoscopic gynecologic surgery and identify associated risk factors. Methods: A descriptive observational study was performed between January 2000 and December 2012 and included all gynecologic laparoscopies performed at our center. Variables were recorded for patient characteristics, indication for surgery, length of hospital stay (in days), major and minor complications, and conversions to laparotomy. To identify risk factors and variables associated with complications, crude and adjusted odds ratios were calculated with unconditional logistic regression. Results: Of all 2888 laparoscopies included, most were procedures of moderate difficulty (adnexal surgery) (54.2%). The overall frequency of major complications was 1.93%, and that of minor complications was 4.29%. The level of technical difficulty and existence of prior abdominal surgery were associated with a higher risk of major complications and conversions to laparotomy. Conclusion: Laparoscopic gynecologic surgery is associated with a low frequency of complications but is a procedure that is not without risk. Greater technical difficulty and prior surgery were factors associated with a higher frequency of complications. PMID:25392659

  11. [Urinary complications after anorectal surgery].

    PubMed

    Iusuf, T; Sârbu, V; Cristache, C; Popescu, R; Botea, F; Panait, L

    2000-01-01

    The prevalence of urinary complications after various anorectal operations was studied in a group of 273 patients. The overall prevalence of urinary complications was 26.7%; most of these complications affected men between 41 and 50, mainly after hemorrhoidectomy. In 10.6% of patients, bladder catheterization was needed. These urinary complications result from nervous reflexes originating from the anus and determined by the operative trauma and/or rectal distinction. In the treatment of these urinary complications, the role of the muses is essential for reassuring the patients. Parasympathomimetic drugs are often efficient. Urinary catheterization must be delayed until the 18th hour. Fluid restriction may be useful to prevent urinary retention. PMID:14870531

  12. Pregnancy complicated by heart disease in Nepal

    PubMed Central

    Chhetri, Shailaja; Shrestha, Nikesh Raj; Pilgrim, Thomas

    2014-01-01

    Objective To investigate the prevalence, characteristics and maternal and perinatal outcomes of pregnancies complicated by heart disease. Design Prospective single-centre registry. Setting Tertiary care teaching hospital in eastern Nepal. Patients Pregnant women presenting to the antenatal clinic and/or labour room between 1 March 2012 and 31 March 2013. Main outcome measures Prevalence, characteristics, and maternal and perinatal outcomes of pregnancies complicated by heart disease. Results Fifty-three out of 9463 pregnancies (0.6%) were complicated by cardiac disease. Proportions of acquired, congenital and arrhythmic heart disease amounted to 89%, 9% and 2%, respectively. Rheumatic heart disease (RHD) was the most frequent cardiac disease complicating pregnancy (n=47). Among 45 women with RHD continuing pregnancy until delivery, 30 (67%) were primigravidae. The predominant valvular pathology was mitral stenosis (62%), followed by mitral regurgitation (21%) and aortic regurgitation (13%). Twenty women (44%) underwent elective or emergency caesarean section. Maternal and fetal/perinatal mortality of pregnancies complicated by RHD amounted to 4% and 16%, respectively. New York Heart Association (NYHA) functional class III or class IV (HR 6.0, 95% CI 1.2 to 29.1, p=0.026), pulmonary hypertension (HR 9.1, 95% CI 1.6 to 51.5, p=0.012) and severe mitral stenosis (HR 7.0, 95% CI 1.4 to 34.4, p=0.017) were identified as predictors of maternal or fetal/perinatal mortality in an univariate analysis. Conclusions Rheumatic mitral stenosis was the most frequent heart disease complicating pregnancy in a consecutive cohort from a teaching hospital in Nepal. Exercise intolerance, pulmonary hypertension and severe mitral stenosis were identified as predictors of maternal or fetal/perinatal mortality. PMID:27326158

  13. Cerebrovascular Complications After Heart Transplantation

    PubMed Central

    Alejaldre, Aída; Delgado-Mederos, Raquel; Santos, Miguel Ángel; Martí-Fàbregas, Joan

    2010-01-01

    Neurological complications in orthotopic heart transplantation represent a major cause of morbidity and mortality despite successful transplantation. The most frequent perioperative neurological complications are delirium or encephalopathy. In this period cerebrovascular complication ranges between 5-11%. After the perioperative period, the 5-year stroke risk after cardiac transplantation is 4.1%. In a retrospective study conducted with 314 patients who underwent cardiac transplantation, it was found that 20% of cerebrovascular complications occurred within the first two weeks after transplantation, while 80% occurred in the late postoperative phase. Of these, ischemic stroke is the most common subtype. In the perioperative periode, hemodynamic instability, cardiac arrest, extracorporeal circulation over 2 hours, prior history of stroke, and carotid stenosis greater than 50% have been reported to be risk factors for the occurrence of cerebrovascular complications. Perioperative cerebrovascular complications are associated with higher mortality and poor functional outcome at one year follow-up. After the perioperative period, the only factor that has been significantly associated with an increased risk of cerebrovascular complications is a history of prior stroke, either ischemic or hemorrhagic. Other associated factors include unknown atrial fibrillation, septic emboli from endocarditis, cardiac catheterization and perioperative hemodynamic shock. According to the TOAST etiologic classification, the most prevalent etiologic subtype of ischemic stroke is undetermined cause. PMID:21804780

  14. Management and complications of stomas.

    PubMed

    Bafford, Andrea C; Irani, Jennifer L

    2013-02-01

    Stomas are created for a wide range of indications such as temporary protection of a high-risk anastomosis, diversion of sepsis, or permanent relief of obstructed defecation or incontinence. Yet this seemingly benign procedure is associated with an overall complication rate of up to 70%. Therefore, surgeons caring for patients with gastrointestinal diseases must be proficient not only with stoma creation but also with managing postoperative stoma-related complications. This article reviews the common complications associated with ostomy creation and strategies for their management. PMID:23177069

  15. PEG tubes: dealing with complications.

    PubMed

    Malhi, Hardip; Thompson, Rosie

    A percutaneous endoscopic gastronomy tube can be used to deliver nutrition, hydration and medicines directly into the patient's stomach. Patients will require a tube if they are unable to swallow safely, putting them at risk of aspiration of food, drink and medicines into their lungs. It is vital that nurses are aware of the complications that may arise when caring for a patient with a PEG tube. It is equally important that nurses know how to deal with these complications or from where tc seek advice. This article provides a quick troubleshooting guide to help nurses deal with complications that can arise with PEG feeding. PMID:26016095

  16. Pulmonary complications of cystic fibrosis.

    PubMed

    Ng, M Y; Flight, W; Smith, E

    2014-03-01

    The life expectancy of patients with cystic fibrosis (CF) has steadily increased over recent decades with a corresponding increase in the frequency of complications of the disease. Radiologists are increasingly involved with managing and identifying the pulmonary complications of CF. This article reviews the common manifestations of CF lung disease as well as updating radiologists with a number of less well-known complications of the condition. Early and accurate detection of the pulmonary effects of CF are increasingly important to prevent irreversible lung damage and give patients the greatest possibility of benefiting from the new therapies becoming available, which correct the underlying defect causing CF. PMID:24361142

  17. “Dulling the edges”: Young Men’s use of alcohol to deal with grief following the death of a male friend

    PubMed Central

    Creighton, Genevieve; Oliffe, John; Matthews, Jennifer; Saewyc, Elizabeth

    2015-01-01

    Background The death of a male friend can be challenging for men because expressions of grief can be governed and restrained by dominant ideals of masculinity. It is common for young men to engage in health risk practices, such as alcohol overuse, to deal with feelings of sadness. Objective This qualitative study investigated the ways that young men use alcohol in the process of grieving the accidental death of a male friend. Methods Participants included 35 men 19–25 years old, and 22 men, ages 26–35 who participated in individual semi-structured interviews between 2010–2012. Results Methodology informed by grounded theory and narrative analysis was used to analyse and interpret the transcribed interviews, focusing on the ways that men used alcohol in the grief process. Through data analysis we inductively derived three themes: 1) Using Alcohol to Dull the Pain and 2) Using Alcohol to Purge Sadness, and 3) Troubled Drinking. Conclusions This study provides evidence to show that men’s binge drinking following tragic loss is a means to express emotion and connect with others. Health interventions for young men who have lost a male peer need to be sensitive to gendered norms that inform grief practices and work with them to discern pathways toward recovery that promote long term wellness. PMID:26202615

  18. Long term complications of diabetes

    MedlinePlus

    ... this page: //medlineplus.gov/ency/patientinstructions/000327.htm Long term complications of diabetes To use the sharing ... sores and infections. If it goes on too long, your toes, foot, or leg may need to ...

  19. Liver Transplant: Complications/Medications

    MedlinePlus

    ... can develop a complication requiring return to the operating room for repair or other procedures to open up the new connections. Rejection: Your immune system helps fight infections. It does this by recognizing ...

  20. Medical complications of anorexia nervosa.

    PubMed

    Shuttleworth, E; Sharma, S; Lal, S; Allan, P J

    2016-05-01

    Anorexia nervosa is a psychiatric disorder with potential life-threatening medical sequelae. This article reviews the principal medical complications associated with anorexia nervosa, highlights associated diagnostic pitfalls and emphasizes the importance of a multidisciplinary approach to management. PMID:27166107

  1. Coal workers pneumoconiosis, complicated (image)

    MedlinePlus

    ... of the lungs. Diseases which may explain these X-ray findings include complicated coal workers pneumoconiosis (CWP), silico-tuberculosis, disseminated tuberculosis, metastatic lung cancer, and other diffuse infiltrative pulmonary diseases.

  2. Diabetic Complications and Amputation Prevention

    MedlinePlus

    ... two complications of diabetes: nerve damage (neuropathy) and poor circulation. Neuropathy causes loss of feeling in your ... you may not detect an injury or irritation. Poor circulation in your feet reduces your ability to ...

  3. Uncommon complications of laparoscopic sterilisation.

    PubMed

    Denton, G W; Schofield, J B; Gallagher, P

    1990-05-01

    We present three unusual complications of laparoscopic sterilisation with clinical presentation, pathology and management. We discuss the possible aetiological factors, pathogenesis and clinical importance in relation to each case. PMID:2141462

  4. Uncommon complications of laparoscopic sterilisation.

    PubMed Central

    Denton, G. W.; Schofield, J. B.; Gallagher, P.

    1990-01-01

    We present three unusual complications of laparoscopic sterilisation with clinical presentation, pathology and management. We discuss the possible aetiological factors, pathogenesis and clinical importance in relation to each case. PMID:2141462

  5. The management of complicated glaucoma

    PubMed Central

    Clement, C I; Goldberg, Ivan

    2011-01-01

    Complicated glaucomas present considerable diagnostic and management challenges. Response to treatment can be unpredictable or reduced compared with other glaucomas. However, target intraocular pressure and preservation of vision may be achieved with selected medical, laser and surgical treatment. The evidence for such treatment is expanding and consequently affords clinicians a better understanding of established and novel techniques. Herein we review the mechanisms involved in the development of complicated glaucoma and the current evidence supporting its management. PMID:21150026

  6. Unusual Complications of Quinalphos Poisoning

    PubMed Central

    Viswanathan, Stalin

    2013-01-01

    This 40-year-old man was treated for suicidal quinalphos 25%EC consumption. He developed intermediate syndrome with normal response to repetitive nerve stimulation, pancreatitis with high enzyme elevations, and normal computed tomography and excreted black, brown, and orange urine sequentially over the first nine days of hospitalization. The last complication has not been previously reported with any organophosphate compound. He finally succumbed to complication of ventilator associated pneumonia related septic shock and ventricular tachycardia. PMID:23762661

  7. Neurologic Complications in Percutaneous Nephrolithotomy

    PubMed Central

    Basiri, Abbas; Soltani, Mohammad Hossein; Kamranmanesh, Mohammadreza; Tabibi, Ali; Mohsen Ziaee, Seyed Amir; Nouralizadeh, Akbar; Sharifiaghdas, Farzaneh; Poorzamani, Mahtab; Gharaei, Babak; Ozhand, Ardalan; Lashay, Alireza; Ahanian, Ali; Aminsharifi, Alireza; Sichani, Mehrdad Mohammadi; Asl-Zare, Mohammad; Ali Beigi, Faramarz Mohammad; Najjaran, Vahid; Abedinzadeh, Mehdi

    2013-01-01

    Purpose Percutaneous nephrolithotomy (PCNL) has been the preferred procedure for the removal of large renal stones in Iran since 1990. Recently, we encountered a series of devastating neurologic complications during PCNL, including paraplegia and hemiplegia. There are several reports of neurologic complications following PCNL owing to paradoxical air emboli, but there are no reports of paraplegia following PCNL. Materials and Methods We retrospectively reviewed the medical records of patients who had undergone PCNL in 13 different endourologic centers and retrieved data related to neurologic complications after PCNL, including coma, paraplegia, hemiplegia, and quadriplegia. Results The total number of PCNL procedures in these 13 centers was 30,666. Among these procedures, 11 cases were complicated by neurologic events, and four of these cases experienced paraplegia. All events happened with the patient in the prone position with the use of general anesthesia and in the presence of air injection. There were no reports of neurologic complications in PCNL procedures performed with the patient under general anesthesia and in the prone position and with contrast injection. Conclusions It can be assumed that using room air to opacify the collecting system played a major role in the occurrence of these complications. Likewise, the prone position and general anesthesia may predispose to these events in the presence of air injection. PMID:23526482

  8. Ileal cannulation and associated complications in dogs.

    PubMed

    Hill, R C; Ellison, G W; Burrows, C F; Bauer, J E; Carbia, B

    1996-02-01

    Accurate measurement of small intestinal digestibility is important in dogs because it allows the formulation of pet foods that provide optimal nutrition at minimal cost. Digestibility measured by comparing nutrient intake to fecal excretion in intact animals does not distinguish small intestinal digestion from large intestinal bacterial fermentation. Ileal cannulation allows small intestinal digestion to be measured alone by comparing nutrient intake with ileal excretion of chyme. Nevertheless, ileal cannulation and its associated complications are not well documented in dogs. We describe the implantation of a simple T-cannula in the ileum of nine dogs for an average duration of 26 weeks. Established cannulas were well tolerated, and one dog retained the cannula for 14 months. Nevertheless, ileal effluent proved extremely caustic, and the incidence of complications in the immediate postoperative period was high. Only one dog had an unremarkable postoperative course. Complications included abscessation and cannula extrusion, followed by severe excoriation and ulceration of the skin. This excoriation could be prevented only by immediate surgical closure of the fistula. Chronic ileal cannulation is therefore a viable technique in dogs, but careful monitoring of the cannula site is essential. Dogs should be subjected to this procedure only if adequate veterinary and nursing care is available. It is preferable to maintain a colony of long-term cannulated dogs rather than to implant cannulas as needed. PMID:8699825

  9. Complications of surgical intervention in adult lumbar scoliosis.

    PubMed

    Christiansen, Peter A; LaBagnara, Michael; Sure, Durga R; Shaffrey, Christopher I; Smith, Justin S

    2016-09-01

    If nonoperative measures are unsuccessful in managing the pain and disability of adult spinal deformities, surgical correction may provide the potential for significant improvement in a patient's quality of life. However, these procedures have a relatively high risk of complications. Identifying patients that may benefit from surgical intervention requires a thorough understanding of potential complications and managing the risks of any individual patient. Complications do not necessarily result in poor outcomes, and good outcomes are not always complication free. Higher risk patients potentially have more to gain, even if they experience complications. With the rapidly expanding senior population and expanded capabilities to manage high-risk patients, it is helpful to consider the lessons provided by ever expanding databases of outcome measures to refine the surgical decision-making process. PMID:27411528

  10. Complications of fast neutron therapy.

    PubMed

    Cohen, L

    1998-01-01

    The purpose of the study was to identify the tissues and organs at risk following high-energy neutron-beam therapy for selected radioresistant tumors, estimating the separate probabilities of both normal tissue injury and of tumor recurrence, each in relation to the absorbed dose. Published statistical and anecdotal reports on the incidence of serious complications observed following fast neutron treatment directed to the cranium, head and neck, chest, upper abdomen, pelvis, and extremities are reviewed and dose-response parameters derived using bivariate probit or logistic analyses. We then calculate the conditional probability of uncomplicated control (PUC) at various doses, assuming that tumor cure and late injury are stochastically independent events. The median effective doses and coefficients of variation, derived for neutron irradiation of human brain and spinal cord, oropharynx, lung, stomach and bowel, rectum and bladder, and extremities, are tabulated and tentative "tolerance limits" estimated. Tolerance doses are shown to depend on several factors including beam quality, chemical composition, cell cycling rate, fraction-size, and follow-up time. In patients followed over 5 years, safe tolerance doses appear to range from < 14 GY for the central nervous system up to 22 GY in the oropharynx and mandible. Given well-determined dose-response data for specific normal tissues and the associated tumors, the separate probabilities of tumor control and of normal tissue injury at a given dose can be estimated. The particular treatment scheme yielding the highest PUC can usually be identified. The maximum PUC for neutron therapy, compared with other modalities, is a measure of both efficacy and safety for the procedure under study and thus provides a useful guide for comparing various modalities and treatment plans and for designing more effective treatment strategies. PMID:9670290

  11. Laparoscopic morcellator-related complications.

    PubMed

    Milad, Magdy P; Milad, Elizabeth A

    2014-01-01

    Morcellation at laparoscopy is a commonly used minimally invasive method to extract bulky tissue from the abdomen without extending abdominal incisions. Despite widespread use of morcellation, complications still remain underreported and poorly understood. We performed a systematic review of surgical centers in the United States to identify, collate and update the morcellator-related injuries and near misses associated with powered tissue removal. We searched articles on morcellator-related injuries published from 1993 through June 2013. In addition, all cases reported to MedSun and the FDA device database (MAUDE) were evaluated for inclusion. We used the search terms "morcellation," "morcellator," "parasitic," and "retained" and model name keywords "Morcellex," "MOREsolution," "PlasmaSORD," "Powerplus," "Rotocut," "SAWALHE," "Steiner," and "X-Tract." During the past 15 years, 55 complications were identified. Injuries involved the small and large bowels (n = 31), vascular system (n = 27), kidney (n = 3), ureter (n = 3), bladder (n = 1), and diaphragm (n = 1). Of these injuries, 11 involved more than 1 organ. Complications were identified intraoperatively in most patients (n = 37 [66%]); however, the remainder were not identified until up to 10 days postoperatively. Surgeon inexperience was a contributing factor in most cases in which a cause was ascribed. Six deaths were attributed to morcellator-related complications. Nearly all major complications were identified from the FDA device database and not from the published literature. The laparoscopic morcellator has substantially expanded our ability to complete procedures using minimally invasive techniques. Associated with this opportunity have been increasing reports of major and minor intraoperative complications. These complications are largely unreported, likely because of publication bias associated with catastrophic events. Surgeon experience likely confers some protection against these injuries

  12. Fluorosis and periostitis deformans as complications of prolonged voriconazole treatment.

    PubMed

    Rad, Babak; Saleem, Mohamed; Grant, Susan; Florkowski, Christopher; Coates, Penelope; Gordon, David; Rankin, Wayne

    2015-09-01

    We describe a case of development of painful periostitis deformans in a 39-year-old woman who was receiving long-term voriconazole treatment for Aspergillus infection as a complication of orthotopic liver transplant. Measurement of fluoride levels strongly supports fluorosis to be the mechanism of the voriconazole-induced periostitis deformans and supports the concept that such measurements might be of use in predicting this complication of long-term voriconazole treatment. PMID:25587196

  13. Complications

    MedlinePlus

    ... My Health Advisor Tools To Know Your Risk Alert Day Diabetes Basics Home Symptoms Diagnosis America's Diabetes ... Volunteer Center American Diabetes Month® American Diabetes Association Alert Day® Become a Member Advocacy Home Take Action ...

  14. Factors associated with immediate abortion complications.

    PubMed Central

    Ferris, L E; McMain-Klein, M; Colodny, N; Fellows, G F; Lamont, J

    1996-01-01

    OBJECTIVE: To identify factors associated with increased risk of immediate complications from induced abortion. DESIGN: Retrospective analysis of a provincial database. SETTING: All Ontario general hospitals in which abortions are performed and all free-standing abortion clinics in Ontario. POPULATION: Women in Ontario aged 15 to 44 years who underwent an induced abortion in the province (without concurrent sterilization) between Jan. 1, 1992, and Dec. 31, 1993. OUTCOME MEASURES: Recording of complications at the time of the procedure, gestational age, type of procedure, place of abortion (hospital or clinic), and patient's age, parity and history of previous abortion (spontaneous or induced). RESULTS: During the study period 83 469 abortions were performed that met our inclusion criteria. Immediate complications were reported in 571 cases (0.7%). Multivariate logistic regression analysis revealed that, after other variables were controlled for, the patient's age, parity and history of previous abortions (spontaneous or induced) were not significant risk factors for immediate complications; however, gestational age, method of abortion and place of abortion were significant risk factors (p < 0.001). The odds ratio (OR) for having a complication from abortion was 1.3 (95% confidence interval [CI] 1.02 to 1.63) between 9 and 12 weeks, compared with having one after abortion at 9 weeks or earlier, and increased to 3.3 (95% CI 2.23 to 5.00) after abortion between 17 and 20 weeks. Compared with surgical dilatation and curettage (D&C), instillation of saline and instillation of prostaglandins were more likely to be associated with immediate complications (OR 24.0, 95% CI 13.22 to 43.70, and OR 11.7, 95% CI 6.43 to 21.18, respectively), whereas both suction D&C and insertion of a laminaria tent were less likely to be associated with immediate complications (OR 0.4, 95% CI 0.26 to 0.67, and OR 0.3, 95% CI 0.19 to 0.52, respectively). Compared with women who had an abortion

  15. Septic complications of hemorrhoidal banding.

    PubMed

    Quevedo-Bonilla, G; Farkas, A M; Abcarian, H; Hambrick, E; Orsay, C P

    1988-05-01

    Rubber band ligation is an efficacious and cost-effective alternative to conventional hemorrhoidectomy for symptomatic internal hemorrhoids. Even though the well-recognized complications of bleeding and thrombosis occur infrequently, far more serious septic complications have only recently been described, as evidenced in five of our patients: four cases were serious enough to necessitate surgical intervention, and one patient died. Pain followed by urinary dysfunction with or without toxic symptoms should alert the physician to the probability of localized perianal or systemic sepsis. Acute awareness of these rare but potentially life-threatening complications and immediate aggressive treatment is mandatory if death is to be prevented. Rubber band ligation of internal hemorrhoids need not be abandoned; however, the indications should be clear, the technique mastered, and a close patient follow-up maintained. PMID:3358691

  16. Neurologic Complications in Infective Endocarditis

    PubMed Central

    Morris, Nicholas A.; Matiello, Marcelo; Samuels, Martin A.

    2014-01-01

    Neurologic complications of infective endocarditis (IE) are common and frequently life threatening. Neurologic events are not always obvious. The prediction and management of neurologic complications of IE are not easily approached algorithmically, and the impact they have on timing and ability to surgically repair or replace the affected valve often requires a painstaking evaluation and joint effort across multiple medical disciplines in order to achieve the best possible outcome. Although specific recommendations are always tailored to the individual patient, there are some guiding principles that can be used to help direct the decision-making process. Herein, we review the pathophysiology, epidemiology, manifestations, and diagnosis of neurological complications of IE and further consider the impact they have on clinical decision making. PMID:25360207

  17. Neurological complications of underwater diving.

    PubMed

    Rosińska, Justyna; Łukasik, Maria; Kozubski, Wojciech

    2015-01-01

    The diver's nervous system is extremely sensitive to high ambient pressure, which is the sum of atmospheric and hydrostatic pressure. Neurological complications associated with diving are a difficult diagnostic and therapeutic challenge. They occur in both commercial and recreational diving and are connected with increasing interest in the sport of diving. Hence it is very important to know the possible complications associated with this kind of sport. Complications of the nervous system may result from decompression sickness, pulmonary barotrauma associated with cerebral arterial air embolism (AGE), otic and sinus barotrauma, high pressure neurological syndrome (HPNS) and undesirable effect of gases used for breathing. The purpose of this review is to discuss the range of neurological symptoms that can occur during diving accidents and also the role of patent foramen ovale (PFO) and internal carotid artery (ICA) dissection in pathogenesis of stroke in divers. PMID:25666773

  18. [Pulmonary hemorrhage complicating transthoracic puncture].

    PubMed

    Febvre, M; de Fenoyl, O; Capron, F; Vadrot, D; Rochemaure, J

    1989-01-01

    Fine needle transthoracic aspiration (FNTA) of pulmonary opacities under guidance of computerized tomography (CT) is a simple procedure yielding conclusive results in many patients with malignant lung tumours. The small caliber of the needles utilized and the CT control make this increasingly popular procedure both accurate and safe. Yet a number of complications have occurred; most of them were benign (e.g. pneumothorax) but some were potentially dangerous (e.g. pulmonary haemorrhage), so that the pros and cons of the procedure must carefully be weighed. We report the case of a patient in whom FNTA was complicated by copious haemoptysis and a pulmonary haematoma clearly visible at CT. The literature concerning the potential complications of transthoracic puncture is reviewed. PMID:2633295

  19. Pulmonary Complications due to Esophagectomy

    PubMed Central

    Shirinzadeh, Abulfazl; Talebi, Yashar

    2011-01-01

    Introduction Esophageal carcinoma is the scourge of human beings. Pulmonary complications in patients who have undergone operation are common (20-30% of cases) and there are no suitable tools and ways to predict these complications. Methods During a period of 10 years, from March 1998 to February 2007, 200 patients (150 male and 50 female) underwent Esophagectomy due to esophageal carcinoma in thoracic surgery ward retrospectively. Complications include the length of hospitalization, mechanical ventilation, morbidity and mortality. Patients’ risk factors include age, preoperative chemo-radiotherapy, stage of the disease and preoperative spirometry condition. Results We grouped our patients into three categories: Normal (FEV1 ≥ 80% predicted), mildly impaired (FEV1 65% to 79% predicted), more severely impaired (FEV1 < 65% predicted).Although almost all patients had radiographic pulmonary abnormalities, significant pulmonary complications occurred in 40 patients (20%) which underwent Esophagectomy. Pleural effusion and atelectasia in 160 patients (80%). 24 patients needed chest-tube insertion. 20 patients (10%) developed ARDS. 14 patients (7%) developed chylothorax. 20 patients (10%) of patients died during their postoperative hospital stay. 30 patients (15%) required mechanical ventilation for greater than 48 hours. Conclusion We reviewed a number of preoperative clinical variables to determine whether they contributed to postoperative pulmonary complications as well as other outcomes. In general, age, impaired pulmonary function especially in those patients with FEV1 less than 65% predicted was associated with prolonged hospital length of stay (LOS). In fact pulmonary complications rate after Esophagectomy are high and there was associated mortality and morbidity. PMID:24250962

  20. TAVR: Imaging Spectrum of Complications.

    PubMed

    Singh, Satinder P; Alli, Oluseun; Melby, Spencer; Lessar, Massoud; Sasse, Mark; Booker, Julian; Davies, James

    2015-11-01

    Transcatheter aortic valve replacement has recently become a suitable alternative for senile aortic stenosis in patients not suitable for surgery. With growing operative experience, appropriate patient selection, advances in imaging evaluation, and technical refinements, the outcomes have improved. Despite its less invasive nature, a unique set of complications and events are encountered during the transcatheter aortic valve replacement procedure and in the postoperative period. Knowledge of these complications, their prompt detection, and quick adequate treatment are critical in reducing the mortality and morbidity. PMID:26488207