Reflecting on Functioning in Trigger Happy America

ERIC Educational Resources Information Center

Wolfsdorf, Adam

2017-01-01

Trigger warnings are posing serious threats to the ways that English educators can teach at the university level. If Aristotle--and Hillis-Miller years later--argue that literature must arouse and bring about catharsis, then proponents of trigger warnings are anaesthetising the power of words and watering down their ability to incite emotional…

Physical Performance, Sex, and Race as Factors in the Attitude of Intermediate School Children Toward Physical Activity.

ERIC Educational Resources Information Center

Greensley, Roy J.; Gronbech, C. Eric

For this study, the physical performance levels of 73 children in grades 4-6 were assessed, and each individual was administered an adaptation of Kenyon's Attitude Toward Physical Activity (ATPA) survey. This instrument measured selected attitudes related to physical activities: social, health and fitness, risk, aesthetic, catharsis, ascetic,…

Educational Drama and the Dilemma of "False Catharsis": Lessons for Theory and Practice from a Study of Anti-Drug Plays in Israel

ERIC Educational Resources Information Center

Gesser-Edelsburg, Anat; Guttman, Nurit; Israelashvili, Moshe

2006-01-01

This study, initiated and funded by The Israel Anti-Drug Authority, investigated adolescents' reactions to professionally produced anti-drug plays, performed in 27 schools across Israel. The study included observations and the analyses of 20 professionally produced anti-drug plays performed during the school year and interviews with theatre…

Nurses' use of mobile instant messaging applications: A uses and gratifications perspective.

PubMed

Bautista, John Robert; Lin, Trisha T C

2017-10-01

To explore how and why mobile instant messaging applications are used by Filipino nurses as part of their work. Guided by the uses and gratifications theory, in-depth interviews with 20 staff nurses working in 9 hospitals (ie, 4 private and 5 public hospitals) in the Philippines were conducted in July 2015. Interview data were analysed through a phenomenological perspective to thematic analysis. Results show that mobile instant messaging applications such as Facebook Messenger and Viber were mostly used by staff nurses and these were accessed using their own smartphones. Thematic analysis indicates that they were used to meet staff nurses' need for information exchange, socialization, and catharsis. Moreover, user interactions vary depending on members within a chat group. For instance, communication via mobile instant messaging applications are much formal when superiors are included in a chat group. In general, the results show that mobile instant messaging applications are routinely used by Filipino staff nurses not only for clinical purposes (ie, information exchange) but also for non-clinical purposes (ie, socialization and catharsis). This paper ends with several practical and theoretical implications including future research directions. © 2017 John Wiley & Sons Australia, Ltd.

Final Results of Cilostazol-Aspirin Therapy against Recurrent Stroke with Intracranial Artery Stenosis (CATHARSIS).

PubMed

Uchiyama, Shinichiro; Sakai, Nobuyuki; Toi, Sono; Ezura, Masayuki; Okada, Yasushi; Takagi, Makoto; Nagai, Yoji; Matsubara, Yoshihiro; Minematsu, Kazuo; Suzuki, Norihiro; Tanahashi, Norio; Taki, Waro; Nagata, Izumi; Matsumoto, Masayasu

2015-01-01

To compare the effect of cilostazol plus aspirin versus aspirin alone on the progression of intracranial arterial stenosis (IAS), and to compare ischemic and hemorrhagic events in patients with symptomatic IAS, an investigator-driven, nationwide multicenter cooperative randomized controlled trial (CATHARSIS; ClinicalTrials.gov Identifier 00333164) was conducted. 165 noncardioembolic ischemic stroke patients with >50% stenosis in the responsible intracranial artery after 2 weeks to 6 months from the onset were randomly allocated to receive either cilostazol 200 mg/day plus aspirin 100 mg/day (n = 83, CA group) or aspirin 100 mg/day alone (n = 82, A group). The primary endpoint was the progression of IAS on magnetic resonance angiography at 2 years after randomization. Secondary endpoints were any vascular events, any cause of death, serious adverse events, new silent brain infarcts, and worsening of the modified Rankin Scale score. Progression of IAS was observed in 9.6% of the CA group patients and in 5.6% of the A group patients, with no significant intergroup difference (p = 0.53). The incidence of the secondary endpoints tended to be lower in the CA group compared with the A group, although the differences were not significant. By using exploratory logistic regression analysis adjusted for patient background characteristics, it was shown that the risk for certain combinations of secondary endpoints was lower in the CA group than in the A group [all vascular events and silent brain infarcts: odds ratio (OR) = 0.37, p = 0.04; stroke and silent brain infarcts: OR = 0.34, p = 0.04; all vascular events, worsening of modified Rankin Scale scores and silent brain infracts: OR = 0.41, p = 0.03]. Major hemorrhage was observed in 4 patients of the CA group and in 3 of the A group. Progression of IAS during the 2-year observation period appears to be less frequent than previously reported in stroke patients on antiplatelet agents after the acute phase, which could be due to the adequate control of risk factors, and because patients with stroke within 2 weeks after the onset were excluded. The results of the CATHARSIS trial suggest a potential utility of pharmacotherapies with cilostazol plus aspirin as well as of strict control of risk factors for the management of symptomatic IAS. Larger studies with higher statistical power are required to obtain conclusive results.

Anger biting. The hidden impulse.

PubMed

Walter, R D

1985-09-01

Based upon the paralogical reasoning of the anger-impulsive biter, this paper addresses the overload of emotional catharsis which can block a full memory of the biting event and suspend the logical infrastructure of rational behavior. In an effort to overcome these types of investigative difficulties, the paper suggests an approach to resolve dilemma through decompressing the emotional content into path ways of logical understanding. By offering a network of rationale hooks, the perpetrator becomes better equipped to acknowledge the deed.

1986 AMEDD (Army Medical Department) Clinical Psychology Short Course: Tripler Army Medical Center, Honolulu, Hawaii.

DTIC Science & Technology

1987-09-01

Chonsim. Isim-Chonsim means "my heart-your heart". It can be translated as telepathy but it emphasizes a deep empathic rapport between people which has a...tendency of delving into the unconscious and focused on emotional catharsis through patient verbalization and dream interpretations. During the period from...I notice also that it was far away from every thing else like another Planet almost Dream like. As I set there thinking how I would get Rid of this

Constipation and catharsis.

PubMed Central

Thompson, W. G.

1976-01-01

Constipation is endemic in the Western world. Stool consistence and associated symptoms are more important than stool frequency. The patient's attitude towards his bowel habit is also important. Exclusion of "organic" disease, reassurance and discussion of normal variations of bowel habit are necessary first steps in treatment. Adquate bulk in the stool must be ensured, either through diet or bulking agnets, and bowel retraining attempted. Laxatives should be reserved for episodes of constipation following enforced bedrest, or as a preparation for diagnostic procedures. Long-term use should be avoided. PMID:1268778

[Cancer related fatigue in patients with breast cancer after chemotherapy and coping style].

PubMed

Jiang, Pinglan; Wang, Shuhong; Jiang, Dongmei; Yu, Lingli

2011-04-01

To study the relevance between cancer related fatigue and coping styles in breast cancer patients after chemotherapy. A survey was conducted in 396 patients with breast cancer after chemotherapy on cancer related fatigue scale and Jalowiec coping scale, and the relation was analyzed. The rate of overall fatigue in breast cancer patients was 96.97%, mostly moderate fatigue. The rate of fatigue dimensions from high to low was physical fatigue, feeling fatigue and cognitive fatigue, respectively. The score of coping styles in patients with breast cancer after chemotherapy from high to low was optimistic coping, facing bravely, support seeking, self-reliance, emotional catharsis, avoidance, fatalism, and conservation. The most widely used coping style was optimistic coping style, and the least was emotional catharisis. There was a positive correlation between coping style of emotional catharsis and cancer related fatigue of all dimensions (P<0.01). There was a negative correlation between emotional fatigue and optimistic,facing bravely, support seeking, self-reliance, or conservation (P<0.05). There was also a negative correlation between physical fatigue and optimistic or support seeking (P<0.05), but there was a positive correlation between avoidance or fatalism and the dimensions of general fatigue, physical fatigue, and cognitive fatigue (P<0.05). There is prevalent cancer related fatigue in patients with breast cancer after chemotherapy. We should guide the patients to more active coping styles, to enhance the ability of psychological adaption in patients, reduce cancer related fatigue, and improve the quality of life.

Tales of resistance and other emancipatory functions of storytelling.

PubMed

Grassley, Jane S; Nelms, Tommie P

2009-11-01

Tales of resistance and other emancipatory functions of storytelling. This paper is the report of a study to explore how the process of storytelling might facilitate women's emancipatory knowing, using examples from women's breastfeeding stories. Storytelling, as an interactive process, can give women a way to explain pivotal life events, justify choices, examine reality and find meaning in experiences. Emancipatory functions of storytelling have been identified as contextual grounding, bonding with others, validating and affirming experiences, venting and catharsis, resisting oppression and educating others. Secondary data analysis was conducted in 2008 on breastfeeding stories originally gathered from 13 women from 2002 to 2004 for a feminist hermeneutic study of maternal breastfeeding confidence. The stories were re-examined through the lens of the emancipatory functions of storytelling. Illustrations of contextual grounding, validating and affirming experiences, venting and catharsis and acts of resistance were found in the breastfeeding stories and presented as exemplars of emancipatory knowing. Women revealed the difficulties they encountered breastfeeding, transforming these experiences as they discovered their meaning. They described collisions that occurred when personal, familial, healthcare professionals' or cultural expectations differed from their experience. The stories suggested possible liberation from old ideologies about breastfeeding as women redefined the difficulties they encountered. Storytelling has potential as a simple, yet profound, and powerful emancipatory intervention which nurses can use to help women in their care make sense of and transform experiences of health and illness. Storytelling may have global implications for nursing practice and research.

How music-inspired weeping can help terminally ill patients.

PubMed

Norton, Kay

2011-09-01

Music's power to improve the 'human condition' has been acknowledged since ancient times. Something as counter-intuitive as weeping in response to music can ameliorate suffering for a time even for terminally ill patients. Several benefits-including catharsis, communication, and experiencing vitality-can be associated with grieving in response to "sad" music. In addressing the potential rewards of such an activity for terminally ill patients, this author combines concepts from philosopher Jerrold R. Levinson's article, entitled "Music and Negative Emotion," an illustration from a major motion picture, and supporting research from medical reports and aesthetic writings. Carefully offering this experience is recommended for patients who retain the capacity to express preference.

Exposure to violent media: the effects of songs with violent lyrics on aggressive thoughts and feelings.

PubMed

Anderson, Craig A; Carnagey, Nicholas L; Eubanks, Janie

2003-05-01

Five experiments examined effects of songs with violent lyrics on aggressive thoughts and hostile feelings. Experiments 1, 3, 4 and 5 demonstrated that college students who heard a violent song felt more hostile than those who heard a similar but nonviolent song. Experiments 2-5 demonstrated a similar increase in aggressive thoughts. These effects replicated across songs and song types (e.g., rock, humorous, nonhumorous). Experiments 3-5 also demonstrated that trait hostility was positively related to state hostility but did not moderate the song lyric effects. Discussion centers on the potential role of lyric content on aggression in short-term settings, relation to catharsis and other media violence domains, development of aggressive personality, differences between long-term and short-term effects, and possible mitigating factors.

Therapeutic approaches for survivors of disaster.

PubMed

Austin, L S; Godleski, L S

1999-12-01

Common psychiatric responses to disasters include depression, PTSD, generalized anxiety disorder, substance-abuse disorder, and somatization disorder. These symptom complexes may arise because of the various types of trauma experienced, including terror or horror, bereavement, and disruption of lifestyle. Because different types of disaster produce different patterns of trauma, clinical response should address the special characteristics of those affected. Traumatized individuals are typically resistant to seeking treatment, so treatment must be taken to the survivors, at locations within their communities. Most helpful is to train and support mental health workers from the affected communities. Interventions in groups have been found to be effective to promote catharsis, support, and a sense of identification with the group. Special groups to be considered include children, injured victims, people with pre-existing psychiatric histories, and relief workers.

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.

Eluding Meaninglessness: A Note to Self in Regard to Camus, Critical Care, and the Absurd

PubMed Central

Papadimos, Thomas John

2014-01-01

Here I present a medical narrative, as a catharsis, regarding Albert Camus’s The Myth of Sisyphus in an attempt to elude meaninglessness in my difficult everyday practice of critical care medicine. It is well documented that physicians who practice critical care medicine are subject to burnout. The sense of despair that occasionally overwhelms me prompted my rereading of Camus’s classic text and caused me to recount his arguments that life is meaningless unless one is willing to take a leap of faith to the divine or, alternately, to commit suicide. This set up the examination of his third alternative, acceptance of a life without prima facie evidence of purpose and meaning, a view that may truly have some bearing on my professional life in the intensive care unit. PMID:24626076

[Reflections on the cause and consequences of exposure to violent presentations in children].

PubMed

Rauchfleisch, U

1997-01-01

The article deals with the questions why children and adolescents nowadays have an intensive use of violent videos and which are the consequences of this use. The motives of the use are compensation and flight of daily problems and of inner psychic emptiness, identification with grandiose heroes, the experience of anxiety-joy, protest against the parents' generation and the test of courage to obtain a social status in the peer group. The consequences of violent presentations can be understood by different psychological concepts as social cognitive learning theory, suggestion hypothesis, justification hypothesis, habituation hypothesis, catharsis theory, priming effect, arousal theory. These findings lead to the following consequences: Media critical lectures at school, governmental protection of children against harmful products, solution of the underlying social problems which lead to resignation and hopelessness in children and adolescent.

Self-efficacy as a unifying construct in nursing-social work collaboration with vulnerable populations.

PubMed

Washington, Olivia G M; Moxley, David P

2013-03-01

The authors consider self-efficacy practice as an organizing construct guiding nursing-social work action research in partnership with older homeless and formerly homeless African-American women. The authors, both academics who together have worked with members of this vulnerable population for a decade and a half, report on their unifying action research perspective immersed in self-efficacy theory. We examine how our adaptations of Bandura's classic four sources of self-efficacy form a distinctive intervention practice designed to help older African-American women emerge from homelessness. We amplify the incorporation of the four sources (vicarious experience and exposure to powerful role models, emotional arousal and accompanying catharsis, verbal persuasion, and role performance) into a grand strategy useful in working collaboratively with members of vulnerable populations, so they can achieve outcomes that improve their functional health, well-being and ultimately their quality of life. © 2012 Blackwell Publishing Ltd.

Autography as auto-therapy: psychic pain and the graphic memoir.

PubMed

Williams, Ian

2011-12-01

Over the last three decades, the graphic novel has developed both in sophistication and cultural importance, now being widely accepted as a unique form of literature (Versaci 2007). Autobiography has proved to be a successful genre within comics (the word is used in the plural to denote both the medium and the philosophy of the graphic form) and within this area a sub-genre, the memoir of the artist's own disease or suffering, sometimes known as the graphic pathology, has arisen (Green and Myers 2010). Storytelling and healing have been linked since ancient times, and the disclosure of ones story forms part of the psychotherapeutic treatment of trauma (Herman 1997). This paper will examine, in both graphic and textual form, whether, among the myriad reasons that one might embark upon the labour intensive work of making a graphic memoir, some artists might be seeking some form of healing or catharsis through their work.

[The function of team-meetings for treatment teams on child and adolescent psychiatric wards].

PubMed

Branik, Emil; Meng, Heiner

2006-01-01

In the daily work of multidisciplinary teams on child and adolescent psychiatric wards team-meetings play a central role to coordinate various treatment activities. In medical literature studies on the topic are lacking, and only few articles were found. The authors explore by a descriptive-hermeneutic analysis the numerous functions of meetings for the treatment team. To them belong catharsis, containment, reflection, regulation and integration. Psychodynamic, group dynamical and institutional factors will be described regarding their influence on the therapy management. Issues of power in institutions will be comprised in the discussion. The dialectical tension between professionalism and emotionality in the work with patients especially from the borderline-spectrum as well as between unity and diversity within the treatment team in regard to the different roles of each and everyone team member will be presented. Hints at how to manage these tensions will be given to preserve the therapeutical milieu on the ward.

'I Got it off my Chest': An Examination of how Research Participation Improved the Mental Health of Women Engaging in Transactional Sex.

PubMed

Felsher, Marisa; Wiehe, Sarah E; Gunn, Jayleen K L; Roth, Alexis M

2018-02-01

Ecologic momentary assessment (EMA) is a form of close-ended diary writing. While it has been shown that participating in a study that incorporates EMA improves mental health of participants, no study to date has examined the pathways through which benefits may occur. For 4-weeks, twice-daily EMAs and weekly interviews captured mood, daily activities and HIV risk behavior of 25 women who engage in transactional sex. Qualitative analysis of exit interviews was performed to examine how participation impacted women's mental health. The majority of participants felt that EMAs heightened awareness of emotions and behavior. Most reported experiencing catharsis from the interviews; specifically, from having a non-judgmental, trusting listener. Participants felt responsible for completing tasks, a sense of accomplishment for completing the study, and altruism. This study demonstrates there are direct benefits associated with participation in an EMA and interview study.

Qualitative analysis of experiences of members of a psychoeducational assertiveness group.

PubMed

Argyrakouli, Effi; Zafiropoulou, Maria

2007-04-01

This study describes qualitatively a psychoeducational assertiveness intervention for 20 women's perceptions of positive and negative experiences, undertaken to identify whether therapeutic mechanisms operating in group therapy as described by Yalom might be inferred. There were 14 90-min. weekly sessions organized around educational material. Two groups were conducted with 10 university women each (M= 20.9 yr., SD= 1.9). Qualitative analysis of the 20 interviews identified five of Yalom's therapeutic mechanisms, namely, self-understanding, universality, acceptance, catharsis, and self-disclosure. The positive experiences were group cohesiveness, self-understanding, self-disclosure, positive views about the self and learning, and cognitive benefits. Self-disclosing at the early stages of group development was the most frequently reported negative experience or difficulty in the group. Although participants stated they improved interpersonal communication skills, analysis suggested the cultural context was an important mediator of assertive behavior.

Inquiries into Malaysia's socio-technical disasters: recommendations and lessons learnt.

PubMed

Said, Aini Mat; Ahmadun, Fakhru'l-Razi; Abdul Kadir, Razali; Daud, Mohamed

2009-04-01

Most democratic countries hold inquiries into disasters. One of their key functions is to establish the cause of an event and to learn lessons in order to prevent a recurrence. In addition, they offer an opportunity for communal catharsis, permitting the public to vent anger, distress and frustration and to exert pressure for policy changes. Malaysia has experienced six landmark socio-technical disasters since 1968, which resulted in the proposal or amendment of various safety/emergency acts and regulations. The authors used a grounded theory approach utilising a constant comparative method to analyse the recommendations made by the inquiries into these events. Data indicate that social and technical recommendations comprise 85 and 15 per cent, respectively, of the total recommendations made by the inquiry committees. This paper offers suggestions for improving the management of inquiry tribunals, as they will remain a valuable source of information for society and corporations to learn from past incidents.

Positive experiences for participants in suicide bereavement groups: a grounded theory model.

PubMed

Groos, Anita D; Shakespeare-Finch, Jane

2013-01-01

Grounded Theory was used to examine the experiences of 13 participants who had attended psycho-educational support groups for those bereaved by suicide. Results demonstrated core and central categories that fit well with group therapeutic factors developed by I. D. Yalom (1995) and emphasized the importance of universality, imparting information and instilling hope, catharsis and self-disclosure, and broader meaning-making processes surrounding acceptance or adjustment. Participants were commonly engaged in a lengthy process of oscillating between loss-oriented and restoration-focused reappraisals. The functional experience of the group comprised feeling normal within the group, providing a sense of permission to feel and to express emotions and thoughts and to bestow meaning. Structural variables of information and guidance and different perspectives on the suicide and bereavement were gained from other participants, the facilitators, group content, and process. Personal changes, including in relationships and in their sense of self assisted participants to develop an altered and more positive personal narrative.

Individual differences in motives, preferences, and pathology in video games: the gaming attitudes, motives, and experiences scales (GAMES)

PubMed Central

Hilgard, Joseph; Engelhardt, Christopher R.; Bartholow, Bruce D.

2013-01-01

A new measure of individual habits and preferences in video game use is developed in order to better study the risk factors of pathological game use (i.e., excessively frequent or prolonged use, sometimes called “game addiction”). This measure was distributed to internet message boards for game enthusiasts and to college undergraduates. An exploratory factor analysis identified 9 factors: Story, Violent Catharsis, Violent Reward, Social Interaction, Escapism, Loss-Sensitivity, Customization, Grinding, and Autonomy. These factors demonstrated excellent fit in a subsequent confirmatory factor analysis, and, importantly, were found to reliably discriminate between inter-individual game preferences (e.g., Super Mario Brothers as compared to Call of Duty). Moreover, three factors were significantly related to pathological game use: the use of games to escape daily life, the use of games as a social outlet, and positive attitudes toward the steady accumulation of in-game rewards. The current research identifies individual preferences and motives relevant to understanding video game players' evaluations of different games and risk factors for pathological video game use. PMID:24058355

Individual differences in motives, preferences, and pathology in video games: the gaming attitudes, motives, and experiences scales (GAMES).

PubMed

Hilgard, Joseph; Engelhardt, Christopher R; Bartholow, Bruce D

2013-01-01

A new measure of individual habits and preferences in video game use is developed in order to better study the risk factors of pathological game use (i.e., excessively frequent or prolonged use, sometimes called "game addiction"). This measure was distributed to internet message boards for game enthusiasts and to college undergraduates. An exploratory factor analysis identified 9 factors: Story, Violent Catharsis, Violent Reward, Social Interaction, Escapism, Loss-Sensitivity, Customization, Grinding, and Autonomy. These factors demonstrated excellent fit in a subsequent confirmatory factor analysis, and, importantly, were found to reliably discriminate between inter-individual game preferences (e.g., Super Mario Brothers as compared to Call of Duty). Moreover, three factors were significantly related to pathological game use: the use of games to escape daily life, the use of games as a social outlet, and positive attitudes toward the steady accumulation of in-game rewards. The current research identifies individual preferences and motives relevant to understanding video game players' evaluations of different games and risk factors for pathological video game use.

Shift report: a ritual play on a residential adolescent psychiatric unit.

PubMed

Yonge, O

2008-01-01

The author conducted an ethnographic study of an adolescent residential psychiatric unit which revealed a category of behaviour--the shift report. A questionnaire was administered to staff to reveal further meanings. Reporting was found to schematize knowledge according to common referents, promote and validate insider roles through language, offer a means of personal reintegration and catharsis, and provide a forum for the symbolic enactment of democratic values which permeated every aspect of culture on the unit. Staff members were categorically in favour of their verbal and private shift report. There was little partitioning of informal and formal aspects of report in the interest of saving time. Instead, socializing and 'catching up' were important aspects of shift report and constituted a large part of team building. The informal nature of report, particularly in the use of language allowed staff to come to terms with frustrations rather than constituting patient stereotyping. As a ritual, the shift report fostered behavioural synchrony, individual empowerment and a democratic 'all-channel network' of communication. It is hoped that this account will encourage more practising nurses and managers to view their shift report as something more than a simple 'handover'; that is, a ritual play of core values, roles and relationships.

Bernese motive and goal inventory in exercise and sport: Validation of an updated version of the questionnaire.

PubMed

Schmid, Julia; Gut, Vanessa; Conzelmann, Achim; Sudeck, Gorden

2018-01-01

Target group-specific intervention strategies are often called for in order to effectively promote exercise and sport. Currently, motives and goals are rarely included systematically in the design of interventions, despite the key role they play in well-being and adherence to exercise. The Bernese motive and goal inventory (BMZI) allows an individual diagnosis of motives and goals in exercise and sport in people in middle adulthood. The purpose of the present study was to elaborate on the original BMZI and to modify the questionnaire in order to improve its psychometric properties. The study is based on data from two samples (sample A: 448 employees of companies and authorities; sample B: 853 patients of a medical rehabilitation programme). We applied confirmatory factor analysis and exploratory structural equation modelling. Overall, both the original and the updated BMZI had an acceptable to good validity and a good reliability. However, the revised questionnaire had slightly better reliability. The updated BMZI consists of 23 items and covers the following motives and goals: Body/Appearance, Contact, Competition/Performance, Aesthetics, Distraction/Catharsis, Fitness and Health. It is recommended as an economical inventory for the individual diagnosis of important psychological conditions for exercise and sport.

Factors related to coping strategies during Japanese physical therapy students' clinical practice.

PubMed

Higuchi, Daisuke; Echigo, Ayumi

2017-08-01

[Purpose] This study aimed to identify social skills and support that are related to the coping strategies Janpanese physical therapy students use during their clinical practice. [Subjects and Methods] Third-year students who were finished with their clinical practice participated. Self-administered questionnaires were used, including the daily life skill scale, social support scale, and tri-axial coping scale. Spearman's partial correlation coefficients were calculated between social skills, support of daily living, and coping strategies used during the clinical practice, while controlling for gender. [Results] A total of 56 completed questionnaires (median of age: 21 years; 27 males). Social skills during personal situations-knowledge summarization, self-esteem, and positive thinking-were significantly, positively correlated with planning and affirmative interpreting strategies to approach stressors regarding clinical practice, and negatively related to giving up strategies to avoid stressors. Intimacy, leadership, and empathy (social skills during interpersonal situations) were significantly, positively correlated with the following responses to approach stressors: catharsis, information gathering, and affirmative interpreting. Moreover, emotional/companionship social support was significantly, positively correlated with all avoidant coping strategies. [Conclusion] Japanese physical therapy students who had low personal and interpersonal social skills and excess emotional/companionship support in daily life tend to select avoidance, not approach, coping strategies during clinical practice.

The social construction of violence among Northern Plains tribal members with antisocial personality disorder and alcohol use disorder

PubMed Central

Jervis, Lori L.; Spicer, Paul; Belcourt, Annie; Sarche, Michelle; Novins, Douglas K.; Fickenscher, Alexandra; Beals, Janette

2015-01-01

Whereas recent reports from national studies have presented extremely high rates for many personality disorders in American Indian communities, persistent concerns about the meaning of these symptoms have left many troubled by these reports. American Indians as a group are known to suffer disproportionately from a number of violent experiences, but the dynamics of this violence have received little attention. This paper examines perspectives on violence in the lives of 15 northern plains tribal members who met criteria for antisocial personality disorder and comorbid alcohol use disorder. It explores how study participants constructed and understood their own violent encounters, as well as the motivations they described (characterized here as reputation, leveling, retaliation, catharsis, and self-defense). Violence was gendered in this study, with men generally presenting as perpetrators and women as victims. Men often described themselves as ready participants in a violent world, while women were quite clear that aggression for them was often simply required as they tried to defend themselves from male violence. While this analysis does not replace clinical analyses of violence in antisocial personality disorder, it does reveal an underlying cultural logic that may play a role in shaping the recourse to violence for that minority of individuals for whom it appears to be the obvious choice. PMID:24045407

Technology addiction's contribution to mental wellbeing: The positive effect of online social capital.

PubMed

Magsamen-Conrad, Kate; Billotte-Verhoff, China; Greene, Kathryn

2014-11-01

This research examines the effect of online social capital and Internet use on the normally negative effects of technology addiction, especially for individuals prone to self-concealment. Self-concealment is a personality trait that describes individuals who are more likely to withhold personal and private information, inhibiting catharsis and wellbeing. Addiction, in any context, is also typically associated with negative outcomes. However, we investigate the hypothesis that communication technology addiction may positively affect wellbeing for self-concealing individuals when online interaction is positive, builds relationships, or fosters a sense of community. Within these parameters, increased communication through mediated channels (and even addiction) may reverse the otherwise negative effects of self-concealment on wellbeing. Overall, the proposed model offers qualified support for the continued analysis of mediated communication as a potential source for improving the wellbeing for particular individuals. This study is important because we know that healthy communication in relationships, including disclosure, is important to wellbeing. This study recognizes that not all people are comfortable communicating in face-to-face settings. Our findings offer evidence that the presence of computers in human behaviors (e.g., mediated channels of communication and NCTs) enables some individuals to communicate and fos ter beneficial interpersonal relationships, and improve their wellbeing.

Technology addiction's contribution to mental wellbeing: The positive effect of online social capital

PubMed Central

Magsamen-Conrad, Kate; Billotte-Verhoff, China; Greene, Kathryn

2014-01-01

This research examines the effect of online social capital and Internet use on the normally negative effects of technology addiction, especially for individuals prone to self-concealment. Self-concealment is a personality trait that describes individuals who are more likely to withhold personal and private information, inhibiting catharsis and wellbeing. Addiction, in any context, is also typically associated with negative outcomes. However, we investigate the hypothesis that communication technology addiction may positively affect wellbeing for self-concealing individuals when online interaction is positive, builds relationships, or fosters a sense of community. Within these parameters, increased communication through mediated channels (and even addiction) may reverse the otherwise negative effects of self-concealment on wellbeing. Overall, the proposed model offers qualified support for the continued analysis of mediated communication as a potential source for improving the wellbeing for particular individuals. This study is important because we know that healthy communication in relationships, including disclosure, is important to wellbeing. This study recognizes that not all people are comfortable communicating in face-to-face settings. Our findings offer evidence that the presence of computers in human behaviors (e.g., mediated channels of communication and NCTs) enables some individuals to communicate and fos ter beneficial interpersonal relationships, and improve their wellbeing. PMID:25568591

The social construction of violence among Northern Plains tribal members with antisocial personality disorder and alcohol use disorder.

PubMed

Jervis, Lori L; Spicer, Paul; Belcourt, Annie; Sarche, Michelle; Novins, Douglas K; Fickenscher, Alexandra; Beals, Janette

2014-02-01

Whereas recent reports from national studies have presented extremely high rates for many personality disorders in American Indian communities, persistent concerns about the meaning of these symptoms have left many troubled by these reports. American Indians as a group are known to suffer disproportionately from a number of violent experiences, but the dynamics of this violence have received little attention. This paper examines perspectives on violence in the lives of 15 northern plains tribal members who met criteria for antisocial personality disorder and comorbid alcohol use disorder. It explores how study participants constructed and understood their own violent encounters, as well as the motivations they described (characterized here as reputation, leveling, retaliation, catharsis, and self-defense). Violence was gendered in this study, with men generally presenting as perpetrators and women as victims. Men often described themselves as ready participants in a violent world, while women were quite clear that aggression for them was often simply required as they tried to defend themselves from male violence. While this analysis does not replace clinical analyses of violence in antisocial personality disorder, it does reveal an underlying cultural logic that may play a role in shaping the recourse to violence for that minority of individuals for whom it appears to be the obvious choice.

Toward a refined view of aggressive fantasy as a risk factor for aggression: interaction effects involving cognitive and situational variables.

PubMed

Smith, Craig E; Fischer, Kurt W; Watson, Malcolm W

2009-01-01

Over three decades of research have established a positive connection between fantasizing about aggression and enacting aggression. Such findings have provided strong evidence against the catharsis view of aggressive fantasy. However, little attention has been paid to the potentially nuanced nature of the link between fantasy aggression and actual aggression. In the present article, we examined the influence of four variables in the aggressive fantasy-aggressive behavior link: gender, exposure to violence, fantasy absorption, and level of fantasy about harm befalling loved ones and the self (dysphoric fantasy). Using data from a diverse, community-based sample of 7-14-year olds and their mothers, we replicated the general finding that aggressive fantasy is positively associated with real-world aggressive behavior. However, we also found that the interaction of aggressive fantasy and exposure to violence related significantly to aggression, as did the relation between aggressive fantasy and dysphoric fantasy. When exposure to violence was low, even high levels of aggressive fantasizing did not predict aggressive behavior, and, when aggressive fantasizing was low, even high levels of exposure to violence did not predict aggressive behavior. Similarly, when dysphoric fantasy was high, the connection between fantasy aggression and real aggression was markedly attenuated. The implications of these findings for intervention efforts and future research are considered. Copyright 2009 Wiley-Liss, Inc.

Utility of minimal preparation ct colonography in detecting colorectal cancer in elderly and frail patients.

PubMed

Meiklejohn, D J; Ridley, L J; Ngu, M C; Cowlishaw, J L; Duller, A; Ridley, W

2018-06-11

Colorectal cancers result in substantial morbidity and mortality to Australian society each year. The usual investigation for bowel malignancyis optical colonoscopy (OC), withcomputed tomographic colonography (CTC) used as an alternative investigation. The catharsis and colon insufflation associated with these investigations pose a higher risk in the elderly and frail. Risks include perforation, serum electrolyte disturbance, and anaesthesia/sedation risks.Minimal preparation computed tomographic colonography (MPCTC) eliminates these risks. This paper audits a 6-year period ofMPCTC in an Australian tertiary referral hospital. 145 patients underwent MPCTC during the study period. There were 7 true positives, 2 false positives and 2 false negatives. Analysis of this population indicates a sensitivity of 0.78 (95% CI 0.51 - 1.05), specificity of 0.99 (95% CI 0.97 - 1.01), positive predictive value (PPV) of 0.78 (95% CI 0.51 - 1.05) and negative predictive value (NPV) of 0.99 (95% CI 0.97 - 1.01). These findings are concordant with other published studies. The auditconfirmsthatminimal preparation CT colonography is a reasonable alternative to OC and CTC in detecting colorectal cancer in symptomatic elderly and frail patients, without the procedural risks inherent inmore invasive investigations. For most patients MPCTC ruled out significant colorectal carcinoma with a high negative predictive value. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

The Art of Resilience: Photo-stories of Inspiration and Strength among People with HIV/AIDS.

PubMed

Kabel, Allison; Teti, Michelle; Zhang, Ni

2016-01-01

Using the visual arts to aid healing is a common therapy for people with critical illness, yet the use of art to improve the lives of people with HIV is under-utilized. Eight male and 20 female participants living with HIV in urban areas of the Midwest, U.S. participated in three group photovoice photo-sharing and discussion sessions, post-project individual interviews and a community photo exhibit. We used a grounded theory approach to analyze interview data, and identified three key themes: (1) health and wellness, (2) fear and stigma, and (3) restoring a threatened identity. Participants identified how taking photos, reflecting on and sharing them in focus groups helped them express themselves while living with and coping with HIV. Offering photography as form of expression is a way to foster strength and consequently, improve the lives of people living with HIV. Our participants benefitted from the process of telling their story with images. They were able to express positive aspects of their lives which could be a healthy form of catharsis in and of itself. Future research should continue to investigate how participants in participatory approaches like photovoice, actually do benefit from the research. Although we focused this analysis on resilience, photovoice is flexible and participants' responses to it are varied. Additional outcomes such as impact on mental and physical health, are worthy of additional exploration.

Qualitative analysis of bibliotherapy as a tool for adults who stutter and graduate students.

PubMed

Gerlach, Hope; Subramanian, Anu

2016-03-01

The purpose of this study was to investigate the use of bibliotherapy as a therapeutic tool for adults who stutter (AWS) and as an educational tool for graduate students in speech-language pathology. Bibliotherapy refers to the process of reading, reflecting upon, and discussing literature, often first person illness or disability narratives, to promote cognitive shifts in the way clients and clinicians conceptualize the experience of disability. Five AWS and six graduate students participated in supervised bibliotherapy using a stuttering memoir during therapy sessions. An inductive, qualitative analysis was utilized to analyze data collected from questionnaires and interviews. An additional deductive qualitative approach was utilized to explore how client data fit into an existing five-outcome model of bibliotherapy from the psychology literature. Graduate students reported developing essential clinical skills for working with clients who stutter, including an improved understanding of the experience of people who stutter and an increased ability to form and strengthen the therapeutic alliance. Clients reported experiencing shifts in the cognitive and affective components of the disorder. Imposing the five-outcome model on client data indicates that at least two clients in the current study experienced all five outcomes of bibliotherapy. These include client experiences of involvement, identification, catharsis, insight and universalism. Both graduate students and clients reported benefits from reading and discussing a memoir about stuttering. Bibliotherapy can be an effective tool in therapy and clinical education when used appropriately. Copyright © 2015 Elsevier Inc. All rights reserved.

Emergence of Yalom's therapeutic factors in a peer-led, asynchronous, online support group for family caregivers.

PubMed

Diefenbeck, Cynthia A; Klemm, Paula R; Hayes, Evelyn R

2014-01-01

Support groups fill a critical void in the health care system, harnessing the power of shared experiences to provide support to group members. Likewise, family caregivers fill a void in the health care system, providing billions in unpaid care to the chronically ill. Caregiver support groups offer an opportunity for alleviating the psychological burden of caregiving. The power of any group, including a support group, to foster psychological well-being lies in its ability to cultivate Yalom's therapeutic factors. Gaps in the literature remain regarding the ability of non-prototypical groups to promote therapeutic mechanisms of change. The purpose of this study was to determine if and when Yalom's therapeutic group factors emerged in a peer-led support group delivered in an asynchronous, online format. Qualitative content analysis utilizing deductive category application was employed. Participants' responses were coded and frequency counts were conducted. Results revealed that 9 of 11 therapeutic factors emerged over the course of the group, with Group Cohesiveness, Catharsis, Imparting of Information, and Universality occurring most often. Several factors, including Interpersonal Learning, Corrective Recapitulation of the Primary Family Group, Imitative Behavior, and Development of Socializing Techniques were absent or virtually absent, likely due to the peer-led format of the group. Progression of therapeutic factors over the course of the group is presented. Findings demonstrate the presence of a variety of Yalom's therapeutic factors in an asynchronous, peer-led online support group.

Resounding attachment: cancer inpatients' song lyrics for their children in music therapy.

PubMed

O'Callaghan, Clare; O'Brien, Emma; Magill, Lucanne; Ballinger, Elizabeth

2009-09-01

Scant attention focuses on supporting parent-child communication during the parents' cancer hospitalizations. Parents may struggle to remain emotionally available. Caregiver absences may threaten secure attachment relationships with infants and elicit problems amongst older children. Music therapists help many parents with cancer to compose songs for their children. Their lyric analysis may provide insight into song writing's communicative and therapeutic potential. Two song lyric groups were comparatively analyzed (based on grounded theory). One group included 19 songs written by 12 patients with the first author. Another included 16 songs written by 15 patients with three music therapists (including two authors), which were previously published or recorded for the public. Songs were composed by 20 mothers and seven fathers for at least 46 offspring. All parents had hematological or metastatic diseases. Qualitative inter-rater reliability was integrated. Comparable lyrical ideas in the two parent song groups included: love; memories; yearning for children; metaphysical presence (now and afterlife); loss and grief; the meaning and helpfulness of the children in their lives; hopes for and compliments about their children; encouragement; requests; personal reflections; existential beliefs; and suggestions about to whom the children can turn. Parents' song lyric messages may support their children during the parents' illnesses and through the children's developmental transitions and possible bereavement. Some parents use song writing for catharsis and to encourage their children's continuing attachment with them after death. Through promoting parent-child connectedness and emotional expression, therapeutic song writing can be a valuable oncologic supportive care modality.

Technical expertise as an ethical form: towards an ethics of distance.

PubMed

Girard, M

1988-03-01

The present article proceeds from the observation that the therapeutic relationship is basically unequal. This inequality essentially concerns the respective situation of the patient and his or her doctor vis-à-vis medical knowledge. A strict professionalism guarantees that this inequality remains factual and without essential value. Yet, if both partners unreflectively allow affectivity excessively to intrude into their relationship, their behaviour may then be inspired by subconscious, rather than rational, motives. In that case, the unverifiable allegations of philanthropy or paternalism may be used to rationalise a kind of 'medical sadism' which attempts to justify the will to humiliate the patient by means of the constraints inherent in medical care. The concept of ethical form is introduced as a non-verbal criterion of ethical reliability. It is mainly a way of training the will through the application of rationally justified rules of behaviour. In this context, it is suggested that an effort to remain constantly within the limits of professionalism represents a method of training for the achievement of some degree of ethical credibility in the therapeutic relationship. In the long term, such abstinence could constitute a sort of catharsis, and thereby help to reveal the non-rational motives in medical behaviour. Contrary to the belief prevailing in modern society, the established limits of medical knowledge are not so broad. The application of these limits would probably be the best method of preventing emotions from interfering undesirably in the therapeutic relationship.

Clinical Interpretations of Patient Experience in a Trial of Psilocybin-Assisted Psychotherapy for Alcohol Use Disorder.

PubMed

Bogenschutz, Michael P; Podrebarac, Samantha K; Duane, Jessie H; Amegadzie, Sean S; Malone, Tara C; Owens, Lindsey T; Ross, Stephen; Mennenga, Sarah E

2018-01-01

After a hiatus of some 40 years, clinical research has resumed on the use of classic hallucinogens to treat addiction. Following completion of a small open-label feasibility study, we are currently conducting a double-blind placebo-controlled clinical trial of psilocybin-assisted treatment of alcohol use disorder. Although treatment effects cannot be analyzed until the study is complete, descriptive case studies provide a useful window into the therapeutic process of psychedelic-assisted treatment of addiction. Here we describe treatment trajectories of three participants in the ongoing trial to illustrate the range of experiences and persisting effects of psilocybin treatment. Although it is difficult to generalize from a few cases, several qualitative conclusions can be drawn from the data presented here. Although participants often find it difficult to describe much of their psilocybin experience, pivotal moments tend to be individualized, extremely vivid, and memorable. Often, the qualitative content extends beyond the clinical problem that is being addressed. The participants discussed in this paper experienced acute and lasting alterations in their perceptions of self, in the quality of their baseline consciousness, and in their relationship with alcohol and drinking. In these cases, experiences of catharsis, forgiveness, self-compassion, and love were at least as salient as classic mystical content. Finally, feelings of increased "spaciousness" or mindfulness, and increased control over choices and behavior were reported following the drug administration sessions. Ultimately, psilocybin-assisted treatment appears to elicit experiences that are extremely variable, yet seem to meet the particular needs of the individual.

Clinical Interpretations of Patient Experience in a Trial of Psilocybin-Assisted Psychotherapy for Alcohol Use Disorder

PubMed Central

Bogenschutz, Michael P.; Podrebarac, Samantha K.; Duane, Jessie H.; Amegadzie, Sean S.; Malone, Tara C.; Owens, Lindsey T.; Ross, Stephen; Mennenga, Sarah E.

2018-01-01

After a hiatus of some 40 years, clinical research has resumed on the use of classic hallucinogens to treat addiction. Following completion of a small open-label feasibility study, we are currently conducting a double-blind placebo-controlled clinical trial of psilocybin-assisted treatment of alcohol use disorder. Although treatment effects cannot be analyzed until the study is complete, descriptive case studies provide a useful window into the therapeutic process of psychedelic-assisted treatment of addiction. Here we describe treatment trajectories of three participants in the ongoing trial to illustrate the range of experiences and persisting effects of psilocybin treatment. Although it is difficult to generalize from a few cases, several qualitative conclusions can be drawn from the data presented here. Although participants often find it difficult to describe much of their psilocybin experience, pivotal moments tend to be individualized, extremely vivid, and memorable. Often, the qualitative content extends beyond the clinical problem that is being addressed. The participants discussed in this paper experienced acute and lasting alterations in their perceptions of self, in the quality of their baseline consciousness, and in their relationship with alcohol and drinking. In these cases, experiences of catharsis, forgiveness, self-compassion, and love were at least as salient as classic mystical content. Finally, feelings of increased “spaciousness” or mindfulness, and increased control over choices and behavior were reported following the drug administration sessions. Ultimately, psilocybin-assisted treatment appears to elicit experiences that are extremely variable, yet seem to meet the particular needs of the individual. PMID:29515439

Beyond catharsis: the nuanced emotion of patient storytellers in an educational role.

PubMed

Roebotham, Taylor; Hawthornthwaite, Lisa; Lee, Lauren; Lingard, Lorelei A

2018-05-01

As health care organisations seek to cultivate patient and family-centred care, patient storytelling has emerged as a valued educational resource. However, repeatedly harnessing patient perspectives to educate health care professionals may have consequences. We need robust insight into what it means to be a patient storyteller in order to ensure ethical and appropriate engagement with patients as an educational resource. Constructivist grounded theory was used to explore the experience of patients involved in a storytelling curriculum as part of hospital staff continuing education. All 33 storytellers were invited by e-mail to participate in the study. Twenty-six storytellers responded to the invitation, and 25 could be scheduled to participate. Using theoretical sampling, semi-structured interviews were conducted and analysed in a process that was inductive, iterative and comparative. Participants described the central role of emotions in their storytelling experience, which varied from 1 to 25 tellings over a period of 1 month to 2 years. These emotions were shaped by the passage of time, repetition of storytelling and audience acknowledgement. However, emotion remained unpredictable and had lingering implications for storytellers' vulnerability. The multiple storytelling experiences of our participants and ongoing educational nature of their role provides unique insight into how emotions ebb and flow across tellings, how emotions can be both a surprise and a rhetorical strategy, and how emotions are influenced by audience acknowledgement. These findings contribute to an emerging conversation regarding the power and politics of selecting and using storytellers for organisational purpose. Implications include how we support patient storytellers in educational roles and how we can sustainably integrate patient storytelling into health professional education. © 2018 John Wiley & Sons Ltd and The Association for the Study of Medical Education.

Anxiety after miscarriage: a review of the empirical literature and implications for clinical practice.

PubMed

Brier, Norman

2004-06-01

Most practitioners now view a miscarriage as a significant psychosocial stressor that results in a high level of dysphoria and grief. Anxiety, although also commonly present, is less frequently considered and less frequently addressed. A review of the empirical literature was conducted to determine if anxiety after a miscarriage is elevated, and if risk is increased for particular types of anxiety syndromes. An attempt was also made to identify the types of interventions that have been found to be helpful in alleviating anxiety. An electronic search of the Medline and Psych Info databases were conducted using the keywords "miscarriage," "perinatal loss," "pregnancy loss," "anxiety," "trauma," and "stress." The searches were not intentionally circumscribed by date. Further searches were then carried out using references. Studies were subsequently included only if most women in a study sample experienced the pregnancy loss before 20 weeks' gestation. The literature was relatively limited. With respect to level of anxiety after a miscarriage, 4 studies were located that employed a matched comparison group design, and 3 that employed a follow-up design. Three studies that used a matched comparison design were located with respect to an increased risk for particular anxiety syndromes. A significant percentage of women experience elevated levels of anxiety after a miscarriage up until about 6 months post-miscarriage, and they are at increased risk for obsessive-compulsive and posttraumatic stress disorder. Practitioners, as part of routine care after a miscarriage, should screen for signs of anxiety as well as depression. When signs of anxiety are present, opportunities for catharsis, understanding, and legitimation are likely to be helpful, as is reassurance that the stress is likely to appreciably lessen over the next 6 months.

The influence of Cervantes on the future creator of psychoanalysis.

PubMed

Grinberg, L; Rodríguez, J F

1984-01-01

Our work is intended to recreate the origins of the 'future creator of psychoanalysis'. Cervantes had a decisive influence on Freud. Don Quixote occupied a central place during a period which we consider to be crucial in the creation of psychoanalysis; we refer to the summer of 1883 during which Freud confessed to Martha that he had become more interested in this book than in brain anatomy. In this work, Cervantes delves in-depth into problems which he had set out in The Colloquy of the Dogs, read by Freud in his adolescence when he was learning Spanish and which confronted some of the great psychoanalytic themes such as reality-fantasy, language, instinct and reason, traumatic situations, 'family romance', etc. These themes appear in a psychoanalytically structured dialogue in which one of the dogs, Berganza, tells his life story (in the form of catharsis) to the other dog, Cipión, with whom Freud identified himself. Basically, it is the psychotherapeutic model that Freud used with his own hysterical patients. Another dialogue which was essential for Freud was that of Don Quixote and Sancho Panza, due to the following major reasons (as well as others): For the clear discrimination between reality and fantasy as well as their interplay. Because madness is presented as a complex phenomenon, but intelligible in terms of human motives. For the penetrating description of the transition in Don Quixote from mania to depression. Because at that moment of his life, Freud himself was living through a personal conflict between his dreams of carrying out some scientific feat and the demands of attending to his mundane necessities.

Translating concerns into action: a detailed qualitative evaluation of an interdisciplinary intervention on medical wards

PubMed Central

Archer, Stephanie; Johnston, Maximillian J; Beveridge, Iain; Long, Susannah Jane; Athanasiou, Thanos; Sevdalis, Nick

2017-01-01

Objectives To understand how frontline reports of day-to-day care failings might be better translated into improvement. Design Qualitative evaluation of an interdisciplinary team intervention capitalising on the frontline experience of care delivery. Prospective clinical team surveillance (PCTS) involved structured interdisciplinary briefings to capture challenges in care delivery, facilitated organisational escalation of the issues they identified, and feedback. Eighteen months of ethnography and two focus groups were conducted with staff taking part in a trial of PCTS. Results PCTS fostered psychological safety—a confidence that the team would not embarrass or punish those who speak up. This was complemented by a hard edge of accountability, whereby team members would regulate their own behaviour in anticipation of future briefings. Frontline concerns were triaged to managers, or resolved autonomously by ward teams, reversing what had been well-established normalisations of deviance. Junior clinicians found a degree of catharsis in airing their concerns, and their teams became more proactive in addressing improvement opportunities. PCTS generated tangible organisational changes, and enabled managers to make a convincing case for investment. However, briefings were constrained by the need to preserve professional credibility, and staff found some comfort in avoiding accountability. At higher organisational levels, frontline concerns were subject to competition with other priorities, and their resolution was limited by the scale of the challenges they described. Conclusions Prospective safety strategies relying on staff-volunteered data produce acceptable, negotiated accounts, subject to the many interdisciplinary tensions that characterise ward work. Nonetheless, these strategies give managers access to the realities of frontline cares, and support frontline staff to make incremental changes in their daily work. These are goals for learning healthcare organisations. Trial registration ISRCTN 34806867. PMID:28385912

Neural Correlates of Hostile Jokes: Cognitive and Motivational Processes in Humor Appreciation

PubMed Central

Chan, Yu-Chen; Liao, Yi-Jun; Tu, Cheng-Hao

2016-01-01

Hostile jokes (HJs) provide aggressive catharsis and a feeling of superiority. Behavioral research has found that HJs are perceived as funnier than non-hostile jokes (NJs). The purpose of the present study was to identify the neural correlates of the interaction between type and humor by comparing HJs, NJs, and their corresponding hostile sentences (HSs) and non-hostile sentences (NSs). HJs primarily showed activation in the dorsomedial prefrontal cortex (dmPFC) and midbrain compared with the corresponding hostile baseline. Conversely, NJs primarily revealed activation in the ventromedial PFC (vmPFC), amygdala, midbrain, ventral anterior cingulate cortex, and nucleus accumbens (NAcc) compared with the corresponding non-hostile baseline. These results support the critical role of the medial PFC (mPFC) for the neural correlates of social cognition and socio-emotional processing in response to different types of jokes. Moreover, the processing of HJs showed increased activation in the dmPFC, which suggested cognitive operations of social motivation, whereas the processing of NJs displayed increased activation in the vmPFC, which suggested social-affective engagement. HJs versus NJs primarily showed increased activation in the dmPFC and midbrain, whereas NJs versus HJs primarily displayed greater activation in the amygdala and midbrain. The psychophysiological interaction (PPI) analysis demonstrated functional coupling of the dmPFC–dlPFC and midbrain–dmPFC for HJs and functional coupling of the vmPFC–midbrain and amygdala–midbrain–NAcc for NJs. Surprisingly, HJs were not perceived as funnier than NJs. Future studies could further investigate the neural correlates of potentially important traits of high-hostility tendencies in humor appreciation based on the psychoanalytic and superiority theories of humor. PMID:27840604

Preoperative psychological distress, coping and quality of life in Chinese patients with newly diagnosed gastric cancer.

PubMed

Hong, Jingfang; Wei, Zengzeng; Wang, Weili

2015-09-01

The purpose of this study was to investigate the prevalence of preoperative psychological distress and its relationship with coping style and quality of life in Chinese patients with newly diagnosed gastric cancer. Being newly diagnosed with cancer can be a source of psychological distress. Understanding the preoperative psychological distress may contribute to the development of appropriate interventions. This is a descriptive correlational survey study. The study was conducted in two teaching hospitals in Anhui province, China. A total of 165 patients with gastric cancer completed a battery of self-report questionnaires including the Distress Thermometer, the revised Chinese version of the Quality of Life Questionnaire-Stomach 22 and the Cancer Coping Modes Questionnaire. The prevalence of clinically significant preoperative psychological distress was 76·97% in this group. Statistically significant correlations were identified between the distress score and stomach pain, eating restrictions and anxiety subscale. Positive associations were found between the distress scores and four subdimensions of coping (avoidance and suppression, resignation, fantasy and catharsis), whereas a negative association was found between the distress scores and one subdimension of coping (Confrontation). There were also significant differences in the quality of life and coping style of patients who had different psychological distress statuses. These findings indicate a relatively high prevalence of preoperative psychological distress among Chinese patients with gastric cancer. Patients with clinically psychological distress were more likely to have poor quality of life and to demonstrate negative coping styles. Nursing professionals need to carefully assess the psychological status of patients with gastric cancer. Tailored interventions can be administered to help these patients appropriately cope with the disease and to enhance their quality of life. © 2015 John Wiley & Sons Ltd.

Smartphone self-monitoring to support self-management among people living with HIV: perceived benefits and theory of change from a mixed-methods randomized pilot study.

PubMed

Swendeman, Dallas; Ramanathan, Nithya; Baetscher, Laura; Medich, Melissa; Scheffler, Aaron; Comulada, W Scott; Estrin, Deborah

2015-05-01

Self-monitoring by mobile phone applications offers new opportunities to engage patients in self-management. Self-monitoring has not been examined thoroughly as a self-directed intervention strategy for self-management of multiple behaviors and states by people living with HIV (PLH). PLH (n = 50), primarily African American and Latino, were recruited from 2 AIDS services organizations and randomly assigned to daily smartphone (n = 34) or biweekly Web-survey only (n = 16) self-monitoring for 6 weeks. Smartphone self-monitoring included responding to brief surveys on medication adherence, mental health, substance use, and sexual risk behaviors, and brief text diaries on stressful events. Qualitative analyses examine biweekly open-ended user-experience interviews regarding perceived benefits and barriers of self-monitoring, and to elaborate a theoretical model for potential efficacy of self-monitoring to support self-management for multiple domains. Self-monitoring functions include reflection for self-awareness, cues to action (reminders), reinforcements from self-tracking, and their potential effects on risk perceptions, motivations, skills, and behavioral activation states. Participants also reported therapeutic benefits related to self-expression for catharsis, nonjudgmental disclosure, and in-the-moment support. About one-third of participants reported that surveys were too long, frequent, or tedious. Some smartphone group participants suggested that daily self-monitoring was more beneficial than biweekly due to frequency and in-the-moment availability. About twice as many daily self-monitoring group participants reported increased awareness and behavior change support from self-monitoring compared with biweekly Web-survey only participants. Self-monitoring is a potentially efficacious disruptive innovation for supporting self-management by PLH and for complementing other interventions, but more research is needed to confirm efficacy, adoption, and sustainability.

Neural Correlates of Hostile Jokes: Cognitive and Motivational Processes in Humor Appreciation.

PubMed

Chan, Yu-Chen; Liao, Yi-Jun; Tu, Cheng-Hao; Chen, Hsueh-Chih

2016-01-01

Hostile jokes (HJs) provide aggressive catharsis and a feeling of superiority. Behavioral research has found that HJs are perceived as funnier than non-hostile jokes (NJs). The purpose of the present study was to identify the neural correlates of the interaction between type and humor by comparing HJs, NJs, and their corresponding hostile sentences (HSs) and non-hostile sentences (NSs). HJs primarily showed activation in the dorsomedial prefrontal cortex (dmPFC) and midbrain compared with the corresponding hostile baseline. Conversely, NJs primarily revealed activation in the ventromedial PFC (vmPFC), amygdala, midbrain, ventral anterior cingulate cortex, and nucleus accumbens (NAcc) compared with the corresponding non-hostile baseline. These results support the critical role of the medial PFC (mPFC) for the neural correlates of social cognition and socio-emotional processing in response to different types of jokes. Moreover, the processing of HJs showed increased activation in the dmPFC, which suggested cognitive operations of social motivation, whereas the processing of NJs displayed increased activation in the vmPFC, which suggested social-affective engagement. HJs versus NJs primarily showed increased activation in the dmPFC and midbrain, whereas NJs versus HJs primarily displayed greater activation in the amygdala and midbrain. The psychophysiological interaction (PPI) analysis demonstrated functional coupling of the dmPFC-dlPFC and midbrain-dmPFC for HJs and functional coupling of the vmPFC-midbrain and amygdala-midbrain-NAcc for NJs. Surprisingly, HJs were not perceived as funnier than NJs. Future studies could further investigate the neural correlates of potentially important traits of high-hostility tendencies in humor appreciation based on the psychoanalytic and superiority theories of humor.

Talking Cure Models: A Framework of Analysis

PubMed Central

Marx, Christopher; Benecke, Cord; Gumz, Antje

2017-01-01

Psychotherapy is commonly described as a “talking cure,” a treatment method that operates through linguistic action and interaction. The operative specifics of therapeutic language use, however, are insufficiently understood, mainly due to a multitude of disparate approaches that advance different notions of what “talking” means and what “cure” implies in the respective context. Accordingly, a clarification of the basic theoretical structure of “talking cure models,” i.e., models that describe therapeutic processes with a focus on language use, is a desideratum of language-oriented psychotherapy research. Against this background the present paper suggests a theoretical framework of analysis which distinguishes four basic components of “talking cure models”: (1) a foundational theory (which suggests how linguistic activity can affect and transform human experience), (2) an experiential problem state (which defines the problem or pathology of the patient), (3) a curative linguistic activity (which defines linguistic activities that are supposed to effectuate a curative transformation of the experiential problem state), and (4) a change mechanism (which defines the processes and effects involved in such transformations). The purpose of the framework is to establish a terminological foundation that allows for systematically reconstructing basic properties and operative mechanisms of “talking cure models.” To demonstrate the applicability and utility of the framework, five distinct “talking cure models” which spell out the details of curative “talking” processes in terms of (1) catharsis, (2) symbolization, (3) narrative, (4) metaphor, and (5) neurocognitive inhibition are introduced and discussed in terms of the framework components. In summary, we hope that our framework will prove useful for the objective of clarifying the theoretical underpinnings of language-oriented psychotherapy research and help to establish a more comprehensive understanding of how curative language use contributes to the process of therapeutic change. PMID:28955286

[The influence of sodium bicarbonate combined with ulinastatin on cholinesterase activity for patients with acute phoxim pesticide poisoning].

PubMed

Zhao, Bo; Yang, Lanju; Xiao, Lei; Sun, Baoquan; Zou, Xianbao; Gao, Dongmei; Jian, Xiandong

2016-01-01

To observe the effect of sodium bicarbonate combined with ulinastatin on cholinesterase activity for patients with acute phoxim pesticide poisoning. A total of 67 eligible patients with acute phoxim pesticide poisoning, Who were admitted to the emeryency department of hospital from March 2011 to February 2014, Acording to different treatments au patients were randomly divided into the conventional treatment group (n=34) and the sodium bicarbonate+ulinastatin group (n=35) . The conventional treatment group were given thorough gastric lavage with water, the sodium bicarbonate + ulinastatin group were given gastric lavage with 2% sodium bicarbonate solution. Both groups were given such treatments as catharsis, administration of oxygen, fluid infusion, diuresis, and antidotes such as atropine and pralidoxime methylchloride. On the basis of comprehensive treatment, people in the sodium bicarbonate+ulinastatin group were given 5% sodium bicarbonate injection and ulinastatin. The clinical effect of the two groups were compared. The serum cholinesterase activity of the sodium bicarbonate+ulinastatin group was significantly higher than the conventional treatment group from the 5th day, and the difference was statistically significant (P<0.05) . The total atropine dosage, total pralidoxime methylchloride dosage and hospitalization days were better than the conventional treatment group, and the differences were statistically significant (P<0.05) . The difference in the time of atropinization between the two groups was not statistically significant (P>0.05) . The results of arterial blood pH, HCO3- of the sodium bicarbonate + ulinastatin group were higher than the conventional treatment group, and the difference of HCO3- at the 10th day was statistically significant (P<0.05) . Sodium bicarbonate combined with ulinastatin can improve the therapeutic effect and reduce complications in the treatment of acute phoxim pesticide poisoning, and have beneficial effects on the recovery of cholinesterase activity.

Smartphone self-monitoring to support self-management among people living with HIV: Perceived benefits and theory of change from a mixed-methods, randomized pilot study

PubMed Central

Swendeman, Dallas; Ramanathan, Nithya; Baetscher, Laura; Medich, Melissa; Scheffler, Aaron; Comulada, W. Scott; Estrin, Deborah

2015-01-01

BACKGROUND Self-monitoring by mobile phone applications offers new opportunities to engage patients in self-management. Self-monitoring has not been examined thoroughly as a self-directed intervention strategy for self-management of multiple behaviors and states by people living with HIV (PLH). METHODS PLH (n=50), primarily African-American and Latino, were recruited from two AIDS services organizations and randomly assigned to daily smartphone (n=34) or bi-weekly web-survey only (n=16) self-monitoring for six weeks. Smartphone self-monitoring included responding to brief surveys on medication adherence, mental health, substance use, and sexual risk behaviors, and brief text diaries on stressful events. Qualitative analyses examine bi-weekly, open-ended user-experience interviews regarding perceived benefits and barriers of self-monitoring, and to elaborate a theoretical model for potential efficacy of self-monitoring to support self-management for multiple domains. RESULTS Self-monitoring functions include reflection for self-awareness, cues to action (reminders), reinforcements from self-tracking, and their potential effects on risk perceptions, motivations, skills, and behavioral activation states. Participants also reported therapeutic benefits related to self-expression for catharsis, non-judgmental disclosure, and in-the-moment support. About one-third of participants reported that surveys were too long, frequent, or tedious. Some smartphone group participants suggested that daily self-monitoring was more beneficial than bi-weekly due to frequency and in-the-moment availability. About twice as many daily self-monitoring group participants reported increased awareness and behavior change support from self-monitoring compared to bi-weekly web-survey only participants. CONCLUSION Self-monitoring is a potentially efficacious disruptive innovation for supporting self-management by PLH and for complementing other interventions, but more research is needed to confirm efficacy, adoption and sustainability. PMID:25867783

Patrolling your blind spots: introspection and public catharsis in a medical school faculty development course to reduce unconscious bias in medicine.

PubMed

Hannah, Seth Donal; Carpenter-Song, Elizabeth

2013-06-01

Cultural competence education has been criticized for excessively focusing on the culture of patients while ignoring how the culture of medical institutions and individual providers contribute to health disparities. Many educators are now focusing on the role of bias in medical encounters and searching for strategies to reduce its negative impact on patients. These bias-reduction efforts have often been met with resistance from those who are offended by the notion that "they" are part of the problem. This article examines a faculty development course offered to medical school faculty that seeks to reduce bias in a way that avoids this problem. Informed by recent social-psychological research on bias, the course focuses on forms of bias that operate below the level of conscious awareness. With a pedagogical strategy promoting self-awareness and introspection, instructors encourage participants to discover their own unconscious biases in the hopes that they will become less biased in the future. By focusing on hidden forms of bias that everyone shares, they hope to create a "safe-space" where individuals can discuss shameful past experiences without fear of blame or criticism. Drawing on participant-observation in all course sessions and eight in-depth interviews, this article examines the experiences and reactions of instructors and participants to this type of approach. We "lift the hood" and closely examine the philosophy and strategy of course founders, the motivations of the participants, and the experience of and reaction to the specific pedagogical techniques employed. We find that their safe-space strategy was moderately successful, largely due to the voluntary structure of the course, which ensured ample interest among participants, and their carefully designed interactive exercises featuring intimate small group discussions. However, this success comes at the expense of considering the multidimensional sources of bias. The specific focus on introspection implies that prior ignorance, not active malice, is responsible for biased actions. In this way, the individual perpetrators of bias escape blame for their actions while the underlying causes of their behavior go unexplored or unaccounted for.

Lactulose vs polyethylene glycol 3350--electrolyte solution for treatment of overt hepatic encephalopathy: the HELP randomized clinical trial.

PubMed

Rahimi, Robert S; Singal, Amit G; Cuthbert, Jennifer A; Rockey, Don C

2014-11-01

Hepatic encephalopathy (HE) is a common cause of hospitalization in patients with cirrhosis. Pharmacologic treatment for acute (overt) HE has remained the same for decades. To compare polyethylene glycol 3350-electrolyte solution (PEG) and lactulose treatments in patients with cirrhosis admitted to the hospital for HE. We hypothesized that rapid catharsis of the gut using PEG may resolve HE more effectively than lactulose. The HELP (Hepatic Encephalopathy: Lactulose vs Polyethylene Glycol 3350-Electrolyte Solution) study is a randomized clinical trial in an academic tertiary hospital of 50 patients with cirrhosis (of 186 screened) admitted for HE. Participants were block randomized to receive treatment with PEG, 4-L dose (n = 25), or standard-of-care lactulose (n = 25) during hospitalization. The primary end point was an improvement of 1 or more in HE grade at 24 hours, determined using the hepatic encephalopathy scoring algorithm (HESA), ranging from 0 (normal clinical and neuropsychological assessments) to 4 (coma). Secondary outcomes included time to HE resolution and overall length of stay. A total of 25 patients were randomized to each treatment arm. Baseline clinical features at admission were similar in the groups. Thirteen of 25 patients in the standard therapy arm (52%) had an improvement of 1 or more in HESA score, thus meeting the primary outcome measure, compared with 21 of 23 evaluated patients receiving PEG (91%) (P < .01); 1 patient was discharged before final analysis and 1 refused participation. The mean (SD) HESA score at 24 hours for patients receiving standard therapy changed from 2.3 (0.9) to 1.6 (0.9) compared with a change from 2.3 (0.9) to 0.9 (1.0) for the PEG-treated groups (P = .002). The median time for HE resolution was 2 days for standard therapy and 1 day for PEG (P = .01). Adverse events were uncommon, and none was definitely study related. PEG led to more rapid HE resolution than standard therapy, suggesting that PEG may be superior to standard lactulose therapy in patients with cirrhosis hospitalized for acute HE. clinicaltrials.gov Identifier: NCT01283152.

Lactulose vs Polyethylene Glycol 3350-Electrolyte Solution for Treatment of Overt Hepatic Encephalopathy

PubMed Central

Rahimi, Robert S.; Singal, Amit G.; Cuthbert, Jennifer A.; Rockey, Don C.

2017-01-01

IMPORTANCE Hepatic encephalopathy (HE) is a common cause of hospitalization in patients with cirrhosis. Pharmacologic treatment for acute (overt) HE has remained the same for decades. OBJECTIVE To compare polyethylene glycol 3350–electrolyte solution (PEG) and lactulose treatments in patients with cirrhosis admitted to the hospital for HE. We hypothesized that rapid catharsis of the gut using PEG may resolve HE more effectively than lactulose. DESIGN, SETTING, AND PARTICIPANTS The HELP (Hepatic Encephalopathy: Lactulose vs Polyethylene Glycol 3350-Electrolyte Solution) study is a randomized clinical trial in an academic tertiary hospital of 50 patients with cirrhosis (of 186 screened) admitted for HE. INTERVENTIONS Participants were block randomized to receive treatment with PEG, 4-L dose (n = 25), or standard-of-care lactulose (n = 25) during hospitalization. MAIN OUTCOMES AND MEASURES The primary end point was an improvement of 1 or more in HE grade at 24 hours, determined using the hepatic encephalopathy scoring algorithm (HESA), ranging from 0 (normal clinical and neuropsychological assessments) to 4 (coma). Secondary outcomes included time to HE resolution and overall length of stay. RESULTS A total of 25 patients were randomized to each treatment arm. Baseline clinical features at admission were similar in the groups. Thirteen of 25 patients in the standard therapy arm (52%) had an improvement of 1 or more in HESA score, thus meeting the primary outcome measure, compared with 21 of 23 evaluated patients receiving PEG (91%) (P < .01); 1 patient was discharged before final analysis and 1 refused participation. The mean (SD) HESA score at 24 hours for patients receiving standard therapy changed from 2.3 (0.9) to 1.6 (0.9) compared with a change from 2.3 (0.9) to 0.9 (1.0) for the PEG-treated groups (P = .002). The median time for HE resolution was 2 days for standard therapy and 1 day for PEG (P = .01). Adverse events were uncommon, and none was definitely study related. CONCLUSIONS AND RELEVANCE PEG led to more rapid HE resolution than standard therapy, suggesting that PEG may be superior to standard lactulose therapy in patients with cirrhosis hospitalized for acute HE. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT01283152 PMID:25243839

[Effect of rhubarb as the main composition of sequential treatment in patients with acute paraquat poisoning: a prospective clinical research].

PubMed

Wang, Weizhan; Li, Jing; Ma, Guoying; Li, Na; Wang, Pu; Xiao, Qingmian; Li, Baiyan; Liu, Yongjian; Gao, Xun; Li, Wei

2015-04-01

To observe the effect of rhubarb as the main composition in the therapy for patients with acute paraquat poisoning (AP). A prospective randomized controlled trial was conducted. 128 patients with APP admitted to Harrison International Peace Hospital from March 2011 to December 2013 were randomly divided into western medicine control group (n = 64) and western medicine and traditional Chinese medicine (TCM) combination group (n = 64). All the patients were treated with repeated gastric lavage and oral kaolin. The patients in western medicine control group were given 20% mannitol and (or) magnesium sulfate for catharsis, early ( within 8 hours of admission ) hemoperfusion HP), and also given the routine combined therapy. In TCM combination group, in addition to the above treatment patients were given oral paraquat poisoning detoxification prescription No.1 every 2 hours for catharsis, which was composed of rhubarb 10 g, glauber salt 12 g, agrimony 12 g, and licorice 6 g. When green stool disappeared, detoxification therapy was changed to No. 2 compound once a day for 14 days, which was consisted of rhubarb 10 g, ginseng 6 g, agrimony 15 g, rhizoma chuanxiong 10 g, licorice 6 g. The poison volume, first dose of oral drug, time for the first HP, time of the first defecation, the time of last green stool, decontamination time, white blood cell count ( WBC ), C-reactive protein ( CRP ), arterial blood gas analysis, blood lactic acid ( Lac ), liver and kidney functions, myocardial enzyme spectrum, chest CT, adverse reaction, days of hospitalization, and mortality rate were observed in both groups. The levels of paraquat in plasma and urine were determined before treatment and 12 hours after poisoning in both groups. Sixty days after discharge, chest CT was taken for observation of pulmonary fibrosis. There were no significant differences in the poison volume, ingestion time and the time for the first HP between the two groups. Compared with western medicine control group, the first defecation time (hours: 3.94 ± 1.14 vs. 6.17 ± 1.52), the last time of green stool (hours: 36.90 ± 4.10 vs. 51.6 3 ± 4.91), and poison clean-up time from plasma (hours: 19.48 ± 3.63 vs. 23.84 ± 3.29) in combination with TCM group were significantly earlier (all P < 0.01). WBC, CRP, alanine aminotransferase (ALT), blood urea nitrogen (BUN), and serum creatinine (SCr) levels were gradually increased after admission in combination with TCM group, and they peaked on 5th day [WBC ( × 10⁹/L) : 15.35 ± 2.17 vs. 17.47 ± 2.09, CRP (mg/L): 32.62 ± 2.76 vs. 39.51 ± 2.45, ALT (U/L): 270.88 ± 11.06 vs. 334.67 ± 7.85, BUN (mmol/L): 13.29 ± 1.90 vs. 17.63 ± 1.42, SCr (μmol/L): 203.54 ± 18.40 vs. 251.53 ± 14.38, all P < 0.05 ], and then they declined; Lac after admission was gradually increased, and peaked at 7 days (mmol/L: 3.53 ± 0.21 vs. 3.82 ± 0.14, P < 0.05 ), and then it was decreased. Myocardial enzyme spectrum was increased after admission, and peaked on 3rd day [creatine kinase (CK, U/L): 192.09 ± 16.26 vs. 216.20 ± 11.96, creatine kinase isoenzyme enzyme ( K-MB, U/L): 39.03 ± 3.75 vs. 47.22 ± 5.84, both P < 0.05 ), and then they declined gradually. Arterial partial pressure of oxygen (PaO₂) and base excess (E) were gradually decreased after admission, down to trough on the 7th day after admission [PaO₂(mmHg, 1 mmHg = 0.133 kPa): 87.04 ± 2.37 vs. 84.93 ± 2.44, BE (mmol/L): -7.31 ± 2.31 vs. -9.18 ± 2.49, both P < 0.05 ], and then they were increased. At 12 hours after poisoning, paraquat contents in plasma and urine in combination with TCM group were significantly lower than those of the western medicine control group [plasma (ng/L): 0.83 ± 0.08 vs. 0.96 ± 0.10, urine (ng/L): 0.88 ± 0.09 vs. 0.97 ± 011, both P < 0.05]. The injury to lung tissue was significantly improved in combination with TCM group compared with that in the western medicine control group, and no serious adverse reactions was found, and the hospital stay time (days: 20.46 ± 6.07 vs. 29.73 ± 9.16) was significantly shortened (P < 0.01), and the mortality rate [ 35.9% (23/64) vs. 45.3% (29/64) ] was significantly lowered compared with western medicine control group (P < 0.05). In the combination with TCM group pulmonary fibrosis was lighter than that in the western medicine control group during the 60-day follow-up. The sequential treatment of No. 1 and No. 2 detoxification of APP, using rhubarb as the main drug, can effectively eliminate paraquat, reduce absorption of the toxin, prevent the development of multiple organ dysfunction syndrome (MODS) induced by the toxin, shorten the hospital stay days, and improve the prognosis of APP.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Stewart, Charles W.

Radioactive waste tank SY-101 is one of 177 big underground tanks that store waste from decades of plutonium production at the Hanford Nuclear Reservation in central Washington State. The chemical reactions and radioactivity in all the tanks make bubbles of flammable gas, mainly hydrogen along with a little methane and ammonia. But SY-101 was the most potent gas producer of all. Every few months the gas built up in the million gallons of extra-thick slurry until it suddenly came up in great rushing ''burps''. A few of the tank's larger burps let off enough gas to make the air spacemore » at the top of the tank flammable for a few hours. This flammable gas hazard became a dominating force in DOE nuclear waste management politics in the last two decades of the 20th century. It demanded the toil of scientists, managers, and officials from the time it was filled in 1980, until it was finally declared safe in January 2001. The tank seemed almost a personality--acting with violence and apparent malice, hiding information about itself, deceiving us with false indications, and sometimes lulling us into complacency only to attack in a new way. From 1990 through 1993, SY-101's flammable gas troubles were acknowledged as the highest priority safety issue in the entire DOE complex. Uncontrolled crust growth demanded another high-priority remedial effort from 1998 through April 2000. The direct cost of the bubbles, toils, and troubles was high. Overall, the price of dealing with the real and imagined hazards in SY-101 may have reached $250 million. The indirect cost was also high. Spending all this money fighting SY-101?s safety issues only stirred radioactive waste up and moved it around, but accomplished no cleanup whatever. Worse yet, the flammable gas problem spawned suspicions of a much wider danger that impeded and complicated cleanup in other 176 waste tanks for a decade. The real cleanup job has yet to be done. The SY-101 story is really about the collective experience of people, from pervasive misconception to grand insight, near miss to sweeping success, meddling interference to close teamwork, all on an uncommonly large scale. It was a necessary catharsis that transformed the entire Hanford culture from a closed defense production operation to an open environmental cleanup project. Its tight project discipline and close teamwork became the Hanford standard. The final remediation of SY-101 placed second in an international ''project of the year'' competition. Many consider SY-101 work the peak of their careers and measure all other experience by it. SY-101 defines some of the worst and the best of Hanford history. This book attempts to narrate and explain the whole vast story.« less

[A study of the 'effective' psychotherapist image and expectations about psychotherapy among the employees of hazardous occupations (policemen)].

PubMed

Agarkov, V A; Bronfman, S A; Maltseva, D Y

The objective of the present study was to estimate the expectations about psychotherapy in terms of social and medical rehabilitation among the employees of hazardous occupations suffering from the consequences of a psychological trauma. A total of 100 subjects employed by various departments of the Russian Ministry of Internal Affairs (MIA) were recruited to participate in the study. Their age varied from 19 to 35 (mean 25.8±3.6) years. The mean age of the 56 men and the 44 women was 25.8±3.7 years and 25.9±3.5 years respectively. The methods of research included a questionnaire study for the elucidation of psychotherapeutic expectations and psychotherapeutic experience, the diagnostic test for the assessment of the interpersonal relationships, and the NEO five-factor personality inventory (NEO-FFI). The results of the questionnaire studies designed to obtain the profile of expectations about psychotherapy among the entire sample suggested the positive attitude of the responders toward the therapeutic interventions with no significant preferences given to their specific type providing that they proved efficient. However, the averaged estimates for the subscales that implied self-exploration (e.g. inward orientation and catharsis) for the general sample proved somewhat lower than those for such subscales as outward orientation including advice, defensiveness, support, the development and practicing of concrete specific skills and techniques needed to facilitate dealing with particular problems and symptoms. Generally speaking, the participants of the present study positively evaluated the effectiveness of psychological aid designed to resolve the problems associated with psychic traumatization based on the relevant personal experience dictating the necessity to avoid factors and situations either reminiscent of those that had resulted in the psychotraumatic event or symbolizing it. Moreover, the patients exhibiting the signs of post-traumatic stress disorders (PTSD) suffere a number of abnormal changes in the cognitive and emotional spheres in the combination with enhanced physiological responsiveness. The results of the present study give evidence of the importance of taking into consideration the expectations of the patients suffering from the consequences of a psychological trauma as regards the results of psychotherapy as well as the mode of their personal interactions with the attending physicians which in its turn depend on the specific dynamics features of the disease and its overall clinical picture. In order to maintain a 'working alliance' between the patient of the given group and the psychotherapist, the latter should follow a certain pattern of interpersonal relationships with the patient which can be described by octants 2, 4-7 of the Interpersonal Relationship Diagnostics questionnaire. Also, the results obtained in the study can be used for the elaboration and implementation of the comprehensive psychotherapeutic and rehabilitative programs within the framework of health resort-based treatment programs for the employees of hazardous occupations who experience problems arising from the consequences of psychic trauma.

The USGS ``Did You Feel It?'' Internet-based Macroseismic Intensity Maps: Lessons Learned from a Decade of Online Data Collection (Invited)

NASA Astrophysics Data System (ADS)

Wald, D. J.; Quitoriano, V. R.; Hopper, M.; Mathias, S.; Dewey, J. W.

2010-12-01

Over the past decade, the U.S. Geological Survey’s “Did You Feel It?” (DYFI) system has automatically collected shaking and damage reports from Internet users immediately following earthquakes. This 10-yr stint of citizen-based science preceded the recently in vogue notion of "crowdsourcing" by nearly a decade. DYFI is a rapid and vast source of macroseismic data, providing quantitative and qualitative information about shaking intensities for earthquakes in the US and around the globe. Statistics attest to the abundance and rapid availability of these Internet-based macroseismic data: Over 1.8 million entries have been logged over the decade, and there are 30 events each with over 10,000 responses (230 events have over 1,000 entries). The greatest number of responses to date for an earthquake is over 78,000 for the April 2010, M7.2 Baja California, Mexico, event. Questionnaire response rates have reached 62,000 per hour (1,000 per min!) obviously requiring substantial web resource allocation and capacity. Outside the US, DYFI has gathered over 189,000 entries in 9,500 cities covering 140 countries since its global inception in late 2004. The rapid intensity data are automatically used in the Global ShakeMap (GSM) system, providing intensity constraints near population centers and in places without instrumental coverage (most of the world), and allowing for bias correction to the empirical prediction equations employed. ShakeMap has also been recently refined to automatically use macroseismic input data in their native form, and treat their uncertainties rigorously in concert with ground-motion data. Recent DYFI system improvements include a graphical user interface that allows seismic analysts to perform common functions, including map triggering and resizing , as well as sorting, searching, geocoding, and flagging entries. New web-based geolocation and geocoding services are being incorporated into DYFI for improving the accuracy of the users’ locations. A database containing the entire DYFI archive facilitates research by streamlining the selection, organization and export of data. For example, recent quantitative analyses of uncertainties of DYFI data provide confidence in their use: Averaging ten or more responses at a given location results in uncertainties of less than 0.2 intensity units. Systems comparable or complimentary to DYFI now operate in several countries, and collaborative efforts to uniformly collect and exchange data in near real time are being further explored. From our experience with DYFI, essential components of an Internet-based citizen science portal include i) easy-to-use forms, ii) instant feedback so that a user may see his contribution (validating their experience), iii) open space for first-person accounts (catharsis) and discussion of effects not covered in the questionnaire, and iv) routinely addressing user comments and questions. In addition, online user-friendly tools now include common searches, statistics, sorting of responses, time-entry histories, comparisons of data with empirical intensity estimates, and an easily-downloadable data format for researchers. A number of these functions were originally recommended by users, again emphasizing the need to attend to user feedback.