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Sample records for measuring complicated grief

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

    ERIC Educational Resources Information Center

    Boelen, Paul A.; Hoijtink, Herbert

    2009-01-01

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

  2. Bereavement and Complicated Grief

    PubMed Central

    Ghesquiere, Angela; Glickman, Kim

    2013-01-01

    Bereavement is a common experience in adults age 60 and older. Loss of a loved one usually leads to acute grief characterized by yearning and longing, decreased interest in ongoing activities, and frequent thoughts of the deceased. For most, acute grief naturally evolves into a state of integrated grief, where the bereaved is able to reengage with everyday activities and find interest or pleasure. About 7% of bereaved older adults, however, will develop the mental health condition of Complicated Grief (CG). In CG, the movement from acute to integrated grief is derailed, and grief symptoms remain severe and impairing. This article reviews recent publications on the diagnosis of CG, risk factors for the condition, and evidenced-based treatments for CG. Greater attention to complicated grief detection and treatment in older adults is needed. PMID:24068457

  3. Suicide bereavement and complicated grief.

    PubMed

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

    2012-06-01

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

  4. Suicide bereavement and complicated grief

    PubMed Central

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

    2012-01-01

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

  5. Treating Complicated Grief

    PubMed Central

    Simon, Naomi M.

    2015-01-01

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

  6. Complicated grief in late life

    PubMed Central

    Miller, Mark D.

    2012-01-01

    Complicated grief (CG) is a syndrome that affects 10% to 20% of grievers regardless of age, although proportionally more will face the death of loved ones in late life, CG is characterized by preoccupying and disabling symptoms that can persist for decades such as an inability to accept the death, intense yearning or avoidance, frequent reveries, deep sadness, crying, somatic distress, social withdrawal, and suicidal ideation. This syndrome is distinct from major depression and post-traumatic stress disorder, but CG maybe comorbid with each. This communication will focus on the impact of CG in late life (over age 60) and will include a case vignette for illustrating complicated grief therapy. PMID:22754292

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

    PubMed Central

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

    2014-01-01

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

  8. Complicated Grief and Suicidal Ideation in Adult Survivors of Suicide

    ERIC Educational Resources Information Center

    Mitchell, Ann M.; Kim, Yookyung; Prigerson, Holly G.; Mortimer, Mary Kay

    2005-01-01

    While the prevalence of complicated grief has been demonstrated to be elevated in survivors of suicide, the association between complicated grief and suicidal ideation among adult survivors of suicide has not been explored. The purpose of the present study is to examine the association between complicated grief and suicidal ideation in suicide…

  9. Symptoms of Major Depression and Complicated Grief

    MedlinePlus

    ... Loss of a Loved One Symptoms of major depression and complicated grief Depression It’s common for people to have sadness, pain, ... might be getting worse—going into a major depression. About 1 in 5 bereaved people will develop ...

  10. [Complicated Grief in DSM-5 era].

    PubMed

    Carmassi, Claudia; Conversano, Ciro; Pinori, Marialisa; Bertelloni, Carlo Antonio; Dalle Luche, Riccardo; Gesi, Camilla; Dell'Osso, Liliana

    2016-01-01

    An increasing number of data has been recently focused on recognizing pathological grief reactions and on the distinction from physiological processes. Particularly, several studies have supported Complicated Grief (CG) as an independent disorder, in order to define the failure of spontaneous physiological mourning resolution. Upon these studies, the latest edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) with the name of "Persistent Complex Bereavement Disorder". This article aims at retracing the history of clinical research about the physiological and psychopathological processes related to grief and aims at presenting the main scientific studies that have described the features of the CG defining it as a distinct disorder. Similarities and distinctions among CG and Depression, Posttraumatic Stress Disorder and Adjustment Disorder were also reported.

  11. Insomnia and complicated grief symptoms in bereaved college students.

    PubMed

    Hardison, Heather Gaines; Neimeyer, Robert A; Lichstein, Kenneth L

    2005-01-01

    In this study, we extended previous research by concentrating on sleep- and grief-related symptoms in a cohort of bereaved college students, in view of the potential for each of these problems to exacerbate the other. A sample of 815 college students completed the Inventory of Complicated Grief (H. G. Prigerson & S. C. Jacobs, 2001), along with an assessment of diagnostic criteria for insomnia and associated sleep behaviors. As predicted, the rate of insomnia was significantly higher (22%) in the bereaved sample than in a nonbereaved comparison group (17%), a difference that was particularly pronounced in terms of middle insomnia. Also as hypothesized, bereaved insomniacs reported higher complicated grief scores than bereaved noninsomniacs, and several specific sleep variables (including sleep-onset insomnia related to nighttime rumination about the loss and sleep-maintenance insomnia associated with dreaming of the deceased) were significantly related to complicated grief symptomatology.

  12. Child and adolescent homicide survivors. Complicated grief and altered worldviews.

    PubMed

    Vigil, Gloria J; Clements, Paul T

    2003-01-01

    The act of homicide may influence the worldviews of children and adolescents. Problematic beliefs of uncertainty, inadequacy, perceiving the world as dangerous, self-denial, and lack of control can contribute to complicated grief in children and adolescents, and can potentially disrupt their normal psychosocial growth and development. Mental health professionals' understanding of grief after the homicide of a family member enhances their ability to intervene with and support young people struggling to cope with and adapt to a sudden loss.

  13. Complicated grief therapy as a new treatment approach

    PubMed Central

    Wetherell, Julie Loebach

    2012-01-01

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

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

    PubMed Central

    2016-01-01

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

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

    PubMed

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

    2012-06-01

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

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

    PubMed Central

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

    2012-01-01

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

  17. [Bereavement and complicated grief: towards a definition of Prolonged Grief Disorder for DSM-5].

    PubMed

    Lombardo, Luigi; Lai, Carlo; Luciani, Massimiliano; Morelli, Emanuela; Buttinelli, Elena; Aceto, Paola; Lai, Silvia; D'Onofrio, Marianna; Galli, Federico; Bellizzi, Fernando; Penco, Italo

    2014-01-01

    Mourning is a natural response to a loss and a condition which most people experience several times during their lives. Most individuals adjust adequately to the loss of a relative, neverthless, a small but noteworthy proportion of bereaved individuals experience a syndrome of prolonged psychological distress in relation to bereavement. Prolonged distress and disability in connection with bereavement has been termed Complicated Grief (CG) or Prolonged Grief Disorder (PGD). The purpose of this paper is to analyze the literature on loss and mourning making a review of the main studies published between 1993 and 2013, identified through a search conducted on Medline/PubMed, in order to describe the epidemiological and clinical aspects of "normal" grief and "complicated" grief, pointing out the path of the clinical definition of PGD and proposed diagnostic criteria for inclusion in the next edition of the Diagnostic and Statistic Manual of Mental Disorders, Fifth edition (DSM-5). The two main diagnostic systems proposed by Horowitz and Prigerson are also compared.

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

    ERIC Educational Resources Information Center

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

    2007-01-01

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

  19. Group Composition and Group Therapy for Complicated Grief

    ERIC Educational Resources Information Center

    Piper, William E.; Ogrodniczuk, John S.; Joyce, Anthony S.; Weideman, Rene; Rosie, John S.

    2007-01-01

    This prospective study investigated the impact of group composition on the outcome of 2 forms of time-limited, short-term group therapy (interpretive, supportive) with 110 outpatients from 18 therapy groups, who presented with complicated grief. The composition variable was based on the patient's level of quality of object relations. The higher…

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

    ERIC Educational Resources Information Center

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

    2010-01-01

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

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

    ERIC Educational Resources Information Center

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

    2008-01-01

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

  2. Facets of Pejorative Self-Processing in Complicated Grief

    ERIC Educational Resources Information Center

    Golden, Ann-Marie J.; Dalgleish, Tim

    2012-01-01

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

  3. Complicated grief after suicide bereavement and other causes of death.

    PubMed

    Tal, Ilanit; Mauro, Christine; Reynolds, Charles F; Shear, M Katherine; Simon, Naomi; Lebowitz, Barry; Skritskaya, Natalia; Wang, Yuanjia; Qiu, Xin; Iglewicz, Alana; Glorioso, Danielle; Avanzino, Julie; Wetherell, Julie Loebach; Karp, Jordan F; Robinaugh, Don; Zisook, Sidney

    2016-11-28

    The authors compared baseline demographic characteristics, clinical features, and grief-related thoughts, feelings, and behaviors of individuals bereaved by suicide, accident/homicide and natural causes participating in a complicated grief (CG) treatment clinical trial. Severity of CG and depression and current depression diagnosis did not vary by loss type. After adjusting for baseline demographic features, time since death and relationship to the deceased, those with CG after suicide had the highest rates of lifetime depression, preloss passive suicidal ideation, self-blaming thoughts, and impaired work and social adjustment. Even among this treatment-seeking sample of research participants with CG, suicide survivors may face unique challenges.

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

    PubMed Central

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

    2016-01-01

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

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

    ERIC Educational Resources Information Center

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

    2005-01-01

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

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

    PubMed

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

    2009-01-01

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

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

    ERIC Educational Resources Information Center

    Field, Nigel P.; Filanosky, Charles

    2010-01-01

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

  8. Grief and its Complications in Individuals with Intellectual Disability

    PubMed Central

    Brickell, Claire; Munir, Kerim

    2011-01-01

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

  9. Grief

    MedlinePlus

    American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders . 5th ed. Arlington, VA: American Psychiatric Publishing. 2013. Powell AD. Grief, bereavement, and adjustment disorders. ...

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

    ERIC Educational Resources Information Center

    Mizuno, Yasunao; Kishimoto, Junji; Asukai, Nozomu

    2012-01-01

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

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

    ERIC Educational Resources Information Center

    Wagner, Birgit; Knaevelsrud, Christine; Maercker, Andreas

    2006-01-01

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

  12. An initial assessment of the psychometric properties of the Complicated Grief Questionnaire for People with Intellectual Disabilities (CGQ-ID).

    PubMed

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

    2009-01-01

    Given the research evidence that people with intellectual disability (ID) do grieve following bereavement, the present study aimed to describe and gather preliminary psychometric data for a version of the Inventory of Complicated Grief [Prigerson, H. G., Maciejewski, P. K., Reynolds, C. F., Bierhals, A. J., Newsom, J. T., Fasiczka, A., et al. (1995). Inventory of Complicated Grief: A scale to measure maladaptive symptoms of loss. Psychiatry Research, 59, 65-79] adapted for use with this population. Carers completed the Complicated Grief Questionnaire for People with ID (CGQ-ID) for 76 individuals with ID, half of whom had experienced a parental bereavement within the last 2 years. The final scale and subscales (Separation Distress and Traumatic Grief) showed very good internal and inter-rater reliability and distinguished between the two groups. While the findings suggest that the CGQ-ID is suitable for identifying complicated grief-type symptoms among adults with ID, further research must be conducted to ascertain whether the findings can be replicated.

  13. Parental control, partner dependency, and complicated grief among widowed adults in the community.

    PubMed

    Johnson, Jeffrey G; Zhang, Baohui; Greer, Joseph A; Prigerson, Holly G

    2007-01-01

    Data from the Yale Bereavement Study, a community-based longitudinal study, were used to investigate the association of 192 widowed individuals' recollections of parenting affection and control during childhood with dependency on the deceased spouse and the development of severe grief symptoms following bereavement. The hypothesis that dependency on the deceased spouse mediates the association of parental affection and control during childhood with the development of severe grief following bereavement was investigated. Findings indicated that a high level of perceived parental control during childhood was associated with elevated levels of dependency on the deceased spouse and with symptoms of complicated grief. Dependency on the deceased spouse mediated the association of perceived parental control with the development of complicated grief following bereavement.

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

    PubMed Central

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

    2011-01-01

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

  15. Confirming the Distinctiveness of Complicated Grief from Depression and Anxiety among Adolescents

    ERIC Educational Resources Information Center

    Dillen, Let; Fontaine, Johnny R. J.; Verhofstadt-Deneve, Leni

    2009-01-01

    Studies in adult populations have shown that symptoms of complicated grief (CG) constitute a form of bereavement-related distress distinct from symptoms of depression and anxiety. The purpose of this article is to replicate these findings in two samples of bereaved adolescents by investigating the latent structure of symptoms of CG, anxiety, and…

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

    ERIC Educational Resources Information Center

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

    2004-01-01

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

  17. The Daily Life of Complicated Grief Patients--What Gets Missed, What Gets Added?

    ERIC Educational Resources Information Center

    Monk, Timothy H.; Houck, Patricia R.; Shear, M. Katherine

    2006-01-01

    Many patients with complicated grief suffer severe symptoms for several years after the loss, interfering with daily life. We sought to determine which elements of a patient's daily routine were likely to be missed or added. Sixty-four patients completed a diary each evening for 2 weeks. The diary asked whether each of 13 daily life activities…

  18. The younger sibling of PTSD: similarities and differences between complicated grief and posttraumatic stress disorder

    PubMed Central

    Maercker, Andreas; Znoj, Hansjörg

    2010-01-01

    Just as traumatic experiences may lead to posttraumatic stress disorder (PTSD) in some individuals, grief may also be a serious health concern for individuals who have experienced bereavement. At present, neither the DSM-IV nor the ICD-10 recognizes any form of grief as a mental disorder. The aim of this review is to summarize recent advances in definition, assessment, prevention, and treatment of complicated grief disorder (CGD) and to compare CGD with PTSD. Four areas are identified to be of importance to clinicians and researchers: (a) the recently proposed consensus criteria of CGD for DSM-V and ICD-11, (b) available assessment instruments, (c) recent prevention and treatment techniques and related effectiveness studies, and (d) emerging disorder models and research on risks and protective factors. This review focuses on the similarities and differences between CGD and PTSD and highlights how a PTSD-related understanding aids the investigation and clinical management of CGD. PMID:22893801

  19. The Role of Defense Mechanisms, Personality and Demographical Factors on Complicated Grief following Death of a loved one by Cancer

    PubMed Central

    Rahimian Boogar, Isaac; Talepasand, Siavash

    2015-01-01

    Objective: Identification of the risk factors and psychological correlates of prolonged grief disorder is vital for health promotions in relatives of persons who died of cancer. The aim of this research was to investigate the role of defense mechanisms, character dimension of personality and demographic factors on complicated grief following a loss of a family member to cancer. Method: A number of 226 persons who had lost a family member to cancer in a cancer institute at Tehran University of Medical Science were selected through compliance sampling and completed the Inventory of complicated Grief-Revised (ICG-R), the Defense Styles Questionnaire (DSQ), the Character dimension of Temperament and Character Inventory (TCI), and the Demographical questionnaire. Data were analyzed by stepwise multiple regression analysis, using the PASW version 18. Results: Findings revealed that neurotic defense style had a significant positive predictive role in the complicated grief; and cooperativeness, age of the deceased person, self-transcendence and mature defense style had a significant negative predictive role in complicated grief (p<0.001). R2 was 0.73 for the final model (p<.001). Conclusion: The results revealed that two character dimensions (low cooperativeness and self-transcendence), high neurotic defense style and young age of the deceased person were involved in the psychopathological course of the complicated and prolonged grief. It was concluded that personality characteristics of the grieving persons and demographics of the deceased person should be addressed in designing tailored interventions for complicated grief. PMID:26884783

  20. Cohesion and outcome in short-term psychodynamic groups for complicated grief.

    PubMed

    Kipnes, Dianne R; Piper, William E; Joyce, Anthony S

    2002-10-01

    This study used two measures of cohesion for the process analysis of 12 short-term, time-limited groups for complicated grief. The measures had similar theoretical definitions but differed in terms of rater source (member vs. observer), measurement score (mean of items vs. global rating), and rating unit (individual vs. group). We examined the relationship between the measures, assessed the development of cohesion over the life of the group, and evaluated each measure's relationship to outcome. A principal components analysis with each measure yielded one cohesion component, which supported a unidimensional model; however, the two cohesion components were independent of each other, which supported a multidimensional model. Repeated measures analyses indicated that observer-rated cohesion developed in a quadratic manner (v pattern) across sessions, while member-rated cohesion developed in a linear manner. The object focus (the group, other members, the therapist) of the members' ratings determined whether cohesion increased or decreased across sessions. No significant relationships between cohesion and outcome were identified. Implications of the findings for the understanding of group cohesion are considered.

  1. An exploration of associations between separation anxiety in childhood and complicated grief in later life.

    PubMed

    Vanderwerker, Lauren C; Jacobs, Selby C; Parkes, Colin Murray; Prigerson, Holly G

    2006-02-01

    Recent studies have suggested that the vulnerability to complicated grief (CG) may be rooted in insecure attachment styles developed in childhood. The aim of this study was to examine the etiologic relevance of childhood separation anxiety (CSA) to the onset of CG relative to major depressive disorder, posttraumatic stress disorder, and generalized anxiety disorder in bereaved individuals. The Structured Clinical Interview for the DSM-IV, Inventory of Complicated Grief-Revised, and CSA items from the Panic Agoraphobic Spectrum Questionnaire were administered to 283 recently bereaved community-dwelling residents at an average of 10.6 months postloss. CSA was significantly associated with CG (OR = 3.2; 95% CI, 1.2-8.9), adjusting for sex, level of education, kinship relationship to the deceased, prior history of psychiatric disorder, and history of childhood abuse. CSA was not significantly associated with major depressive disorder, posttraumatic stress disorder, or generalized anxiety disorder.

  2. Understanding and Treating Complicated Grief: What Can We Learn from Posttraumatic Stress Disorder?

    PubMed Central

    Ehlers, Anke

    2013-01-01

    The paper outlines possible parallels between the phenomenology and treatment of complicated grief and PTSD. In particular, it explores how treatment procedures used in Cognitive Therapy for PTSD (Ehlers & Clark, 2000) may be adapted for the treatment of complicated grief. Stimulus Discrimination may be helpful in breaking the link between everyday triggers and “felt presence” memories of the deceased. Memory Updating procedures may help the patient accept that the deceased is no longer alive and no longer suffering. Reclaiming your Life procedures may help the patient access autobiographical memories that are not linked to the deceased and counteract beliefs about the value of life without the deceased. The paper further addresses the necessity of specifying the idiosyncratic beliefs that prevent coming to terms with the death, of understanding the relationship between beliefs and coping strategies, and of distinguishing memories from rumination. PMID:23814410

  3. The Influence of Anxiety Sensitivity on a Wish to Die in Complicated Grief.

    PubMed

    Baker, Amanda W; Goetter, Elizabeth M; Bui, Eric; Shah, Riva; Charney, Meredith E; Mauro, Christine; Shear, M Katherine; Simon, Naomi M

    2016-04-01

    Individuals with complicated grief are at elevated risk of suicidal thoughts. Anxiety sensitivity has recently emerged as a risk factor of suicide. This study aimed to investigate a possible association between anxiety sensitivity and a wish to die in individuals with complicated grief. Participants were evaluated for participation in a treatment study and completed an ancillary questionnaire-based study. Participants were 51 bereaved adults evaluated (age: mean, 54 [SD, 13.6] years; 78% [n = 40] women). Logistic regression was used to examine the relationship between anxiety sensitivity and a wish to die. Overall, anxiety sensitivity was associated with a wish to die at the level of a medium effect size, although it did not reach statistical significance. The anxiety sensitivity social concerns subscale was significantly associated with a wish to die. These findings add to a growing literature implicating anxiety sensitivity in reporting a wish to die.

  4. Complicated Grief Treatment for older adults: The critical role of a supportive person.

    PubMed

    Nam, Ilsung

    2016-10-30

    In the wake of the increased interest in treatment for complicated grief (CG) symptoms, research has reported the promising effect of CG treatment (CGT) on CG symptoms. This study compared CGT with supportive counseling (SC) in terms of improvement in CG symptoms. A randomized trial design was used to compare the effectiveness of CGT with that of SC in treating CG symptoms, depressive symptoms, and social impairments. The primary outcome was the Inventory of Complicated Grief. Relative to SC, CGT resulted in improved CG symptoms and depressive symptoms. Among those receiving CGT, participants with a supportive person in their sessions showed more beneficial results in CG and depressive symptoms than those without a supportive person did. This suggests that CGT is superior to SC in reducing CG symptoms and depressive symptoms, and in improving work and social functions during bereavement. Moreover, having a supportive person plays a critical role in the effectiveness of CGT sessions.

  5. Complicated grief and manic comorbidity in the aftermath of the loss of a son.

    PubMed

    Carmassi, Claudia; Shear, M Katherine; Socci, Chiara; Corsi, Martina; Dell'osso, Liliana; First, Michael B

    2013-09-01

    Based on the recommendations of the sub-workgroup on trauma and dissociative disorders, the American Psychiatric Association (APA) removed the "bereavement exclusion" from the criteria for major depression in DSM-5. In addition, proposed DSM-5 research criteria for persistent complex bereavement disorder (PCBD) were included in the new manual in a section for conditions and criteria needing further research. We describe a case that warranted such a diagnosis. The patient was a 52- year-old woman who was admitted to the inpatient unit of our clinic on the birthday of her son who had died 18 months earlier. She was diagnosed with a manic episode with psychotic symptoms according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) criteria and was treated accordingly. Three months after discharge, she made a suicide attempt and was admitted and re-assessed. During this admission, she completed the Inventory of Complicated Grief (ICG), the Mood-Spectrum Rating Scale (MOODS-SR), and the Trauma and Loss Spectrum questionnaire (TALS-SR). She endorsed symptoms of intense yearning for her son, feelings of shock and disbelief, anger and bitterness related to his death, estrangement from others, auditory, tactile and visual hallucinations of the deceased, and intense emotional reactivity to memories of her son. These symptoms were sufficiently prolonged and severe to meet criteria for complicated grief. While complicated grief appeared to be the primary diagnosis for this patient, when she was diagnosed using only DSMIV-TR criteria, her treatment failed to address herprimary problem. This case draws attention to the occurrence of manic-like symptoms as well as depression-like manifestations following bereavement and highlights the importance of including the syndrome of complicated grief in the diagnostic nomenclature.

  6. The Grief and Meaning Reconstruction Inventory (GMRI): Initial Validation of a New Measure.

    PubMed

    Gillies, James M; Neimeyer, Robert A; Milman, Evgenia

    2015-01-01

    Although increasing numbers of grief theorists, researchers, and therapists have begun to focus on the quest for meaning in lives disrupted by loss, no convenient and psychometrically validated measure of meanings made specifically in bereavement has been available to guide their efforts. To construct such a measure, the authors began with a systematic content analysis of sense-making, benefit finding, and identity reconstruction themes gleaned from the narrative responses of a sample of 162 adults who were diverse in their age, ethnicity, relationship to the decedent, cause of death, and severity of their grief response. These were then formulated into a set of 65 candidate items in a Likert scale format representing the level of the respondent's endorsement of the item in the past week. Subsequent administration to a second sample of 300 bereaved respondents permitted factor analysis of this pilot version of the Grief and Meaning Reconstruction Inventory (GMRI), and reduced the items to 29, which loaded on 5 distinct factors, labeled Continuing Bonds, Personal Growth, Sense of Peace, Emptiness and Meaninglessness, and Valuing Life. Both the overall GMRI and its constituent factors showed good internal consistency and strong convergent validity in the form of negative correlations with established measures of bereavement-related negative emotions, symptoms of complicated grief, and more general psychological distress and mental health symptomatology, and positive correlations with grief related personal growth. The authors close by noting several specific research and clinical applications of the measure, which could play a useful role in testing and refining contemporary models of meaning made in the wake of loss.

  7. African American homicide bereavement: aspects of social support that predict complicated grief, PTSD, and depression.

    PubMed

    Burke, Laurie A; Neimeyer, Robert A; McDevitt-Murphy, Meghan E

    2010-01-01

    Psychological adaptation following homicide loss is challenged not only by the violent nature of the death itself but also by the bereaved's relationships with would-be supporters. Recruiting a sample of 54 African-American homicidally bereaved individuals, we examined perceived and actual support, the size of the support network, family versus non-family support, and number of negative relationships to gauge the role of social support in bereavement outcomes such as complicated grief, PTSD, and depression. Results of quantitative assessments revealed that size of available network, quantity of negative relationships, and levels of grief-specific support were correlated with bereavement outcome. Clinical implications and suggestions for future research on the role of social support in adaptation of African Americans to traumatic loss are discussed.

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

    PubMed

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

    2015-01-01

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

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

    ERIC Educational Resources Information Center

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

    2013-01-01

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

  10. Complicated grief and depression in young adults: personality and relationship quality.

    PubMed

    Mash, Holly B Herberman; Fullerton, Carol S; Shear, M Katherine; Ursano, Robert J

    2014-07-01

    Young adults experience problematic responses to loss more often than is commonly recognized. Few empirical studies have examined the contribution of intrapersonal and interpersonal characteristics to grief and depression in bereaved young adults. This study investigated the association of dependency and quality of the relationship with the deceased (i.e., depth and conflict) with complicated grief (CG) and depression. Participants were 157 young adults aged 17 to 29 years who experienced loss of a family member or close friend within the past 3 years (mean = 1.74 years). Participants completed the Inventory of Complicated Grief, Beck Depression Inventory, Depth and Conflict subscales of the Quality of Relationships Inventory, and the Dependency subscale of the Depressive Experiences Questionnaire. Relationships among dependency and interpersonal depth and conflict and CG and depression were examined through analyses of covariance. Sixteen percent of participants met criteria for CG and 34% had mild to severe depression. Dependency and depth were independently related to CG and dependency was related to depression, but the pattern of associations was somewhat different for each outcome. Greater depth was associated with CG, at both high and low levels of dependency. High levels of dependency were related to more depressive symptoms. Interpretation of the findings is limited by the relatively small sample size and cross-sectional design. CG and depression are related but distinct responses to loss. Although dependency is associated with both CG and depression after loss, relationships between the bereaved and deceased that are characterized by high levels of depth are particularly related to the development of CG symptoms.

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

    ERIC Educational Resources Information Center

    Kristensen, Pal; Weisaeth, Lars; Heir, Trond

    2010-01-01

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

  12. The Structured Clinical Interview for Complicated Grief: Reliability, Validity, and Exploratory Factor Analysis

    PubMed Central

    Bui, Eric; Mauro, Christine; Robinaugh, Donald J.; Skritskaya, Natalia A.; Wang, Yuanjia; Gribbin, Colleen; Ghesquiere, Angela; Horenstein, Arielle; Duan, Naihua; Reynolds, Charles; Zisook, Sidney; Simon, Naomi M.; Shear, M. Katherine

    2015-01-01

    Background Complicated grief (CG) has been recently included in the DSM-5, under the term “Persistent Complex Bereavement Disorder”, as a condition requiring further study. To our knowledge, no psychometric data on any structured clinical interview of CG is available to date. In this manuscript, we introduce the Structured Clinical Interview for CG (SCI-CG) a 31-item “SCID-like” clinician-administered instrument to assess the presence of CG symptoms. Methods Participants were 281 treatment-seeking adults with CG (77.9% (n=219) women, mean age = 52.4, SD = 17.8) who were assessed with the SCI-CG and measures of depression, posttraumatic stress, anxiety, functional impairment. Results The SCI-CG exhibited satisfactory internal consistency (α = .78), good test-retest reliability (Inter-class correlation [ICC] 0.68, 95% CI [0.60, 0.75]), and excellent inter-rater reliability (ICC=0.95, 95% CI [0.89, 0.98]). Exploratory factor analyses revealed that a five-factor structure, explaining 50.3% of the total variance, was the best fit for the data. Conclusions The clinician-rated SCI-CG demonstrates good internal consistency, reliability, and convergent validity in treatment-seeking individuals with CG and therefore can be a useful tool to assess CG. Although diagnostic criteria for CG have yet to be adequately validated, the SCI-CG may facilitate this process. The SCI-CG can now be used as a validated instrument in research and clinical practice. PMID:26061724

  13. Complicated Grief

    MedlinePlus

    ... Your key personal information, especially any additional major stress or change you've experienced since your loved one died, such as serious illness, significant family disruptions or financial problems. Medical information, including other physical or mental ...

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

    ERIC Educational Resources Information Center

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

    2010-01-01

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

  15. Examination of Proposed Criteria for Complicated Grief in People Confronted with Violent or Non-Violent Loss

    ERIC Educational Resources Information Center

    Boelen, Paul A.; van den Bout, Jan

    2007-01-01

    In the late 1990s, a panel of experts proposed criteria for complicated grief (CG) and found these to have satisfactory operating characteristics. The present study aimed to replicate that finding in 4 groups of mourners divided by cause of loss and time from loss. Data were available from 1,052 bereaved individuals. All had completed the revised…

  16. Initial Validation of a Comprehensive Assessment Instrument for Bereavement-Related Grief Symptoms and Risk of Complications: The Indicator of Bereavement Adaptation—Cruse Scotland (IBACS)

    PubMed Central

    Schut, Henk; Stroebe, Margaret S.; Wilson, Stewart; Birrell, John

    2016-01-01

    Objective This study assessed the validity of the Indicator of Bereavement Adaptation Cruse Scotland (IBACS). Designed for use in clinical and non-clinical settings, the IBACS measures severity of grief symptoms and risk of developing complications. Method N = 196 (44 male, 152 female) help-seeking, bereaved Scottish adults participated at two timepoints: T1 (baseline) and T2 (after 18 months). Four validated assessment instruments were administered: CORE-R, ICG-R, IES-R, SCL-90-R. Discriminative ability was assessed using ROC curve analysis. Concurrent validity was tested through correlation analysis at T1. Predictive validity was assessed using correlation analyses and ROC curve analysis. Optimal IBACS cutoff values were obtained by calculating a maximal Youden index J in ROC curve analysis. Clinical implications were compared across instruments. Results ROC curve analysis results (AUC = .84, p < .01, 95% CI between .77 and .90) indicated the IBACS is a good diagnostic instrument for assessing complicated grief. Positive correlations (p < .01, 2-tailed) with all four instruments at T1 demonstrated the IBACS' concurrent validity, strongest with complicated grief measures (r = .82). Predictive validity was shown to be fair in T2 ROC curve analysis results (n = 67, AUC = .78, 95% CI between .65 and .92; p < .01). Predictive validity was also supported by stable positive correlations between IBACS and other instruments at T2. Clinical indications were found not to differ across instruments. Conclusions The IBACS offers effective grief symptom and risk assessment for use by non-clinicians. Indications are sufficient to support intake assessment for a stepped model of bereavement intervention. PMID:27741246

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

    PubMed Central

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

    2015-01-01

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

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

    PubMed

    Wakefield, Jerome C

    2012-06-01

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

  19. The effectiveness of family-based cognitive-behavior grief therapy to prevent complicated grief in relatives of suicide victims: the mediating role of suicide ideation.

    PubMed

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

    2010-10-01

    Grief interventions are more effective for high risk individuals. The presence of suicide ideation following suicide bereavement was examined to determine whether it indicates a high risk status. Using data from a randomized controlled trial (n = 122) on the effectiveness of cognitive-behavior therapy, the effect of suicide ideation on the effectiveness of grief therapy on the bereavement outcome at 13 months post loss was examined. Results show that suicide ideators more often have a history of mental disorder and suicidal behavior than non-ideators, and suicide ideation indicates a high risk for adverse bereavement outcome. Grief therapy likely reduces the risk of maladaptive grief reactions among suicide ideators. Therefore, suicide ideators may benefit from grief therapy following a loss through suicide.

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

    ERIC Educational Resources Information Center

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

    2013-01-01

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

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

    PubMed Central

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

    2015-01-01

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

  2. The Process of Change in Complicated Grief Group Therapy for Bereaved Dementia Caregivers: an Evaluation Using the Meaning of Loss Codebook.

    PubMed

    Supiano, Katherine P; Haynes, Lara Burns; Pond, Vicki

    2017-01-04

    Caring for a person with dementia is challenging and has adverse health and mental health effects that, for 9-25% of caregivers persist into bereavement in the form of complicated grief (CG). For those bereaved dementia caregivers unable to satisfactorily process grief, specialized Complicated Grief Group Therapy (CGGT) can restore a healthy grief process. We investigated the progression of therapeutic change in CGGT participants (N = 16 in three treatment groups), using an adapted version of Meaning of Loss Codebook (MLC; Gillies et al., 2014, 2015) that captured both negatively and positively valenced meaning of death themes in CGGT participants. We evaluated MLC coded video segments of group therapy sessions focusing on inflection points in grief transitions including retelling of the death story, voiced interpretation of imaginal conversations with the deceased care recipient and self-statements of change. Participants demonstrated positive gains in 16 thematic areas, most notably in moving on with life, in summoning pleasant memories, and in ascribing bad memories to disease rather than the decedent. Our hypothesis that meaning of loss themes would transition from negatively to positively valenced interpretations of the death over the course of treatment was supported, and will contribute to refinement of CGGT treatment.

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

    ERIC Educational Resources Information Center

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

    2010-01-01

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

  4. Prevalence and psychological correlates of complicated grief among bereaved adults 2.5-3.5 years after September 11th attacks.

    PubMed

    Neria, Yuval; Gross, Raz; Litz, Brett; Maguen, Shira; Insel, Beverly; Seirmarco, Gretchen; Rosenfeld, Helena; Suh, Eun Jung; Kishon, Ronit; Cook, Joan; Marshall, Randall D

    2007-06-01

    A Web-based survey of adults who experienced loss during the September 11, 2001, terrorist attacks was conducted to examine the prevalence and correlates of complicated grief (CG) 2.5-3.5 years after the attacks. Forty-three percent of a study group of 704 bereaved adults across the United States screened positive for CG. In multivariate analyses, CG was associated with female gender, loss of a child, death of deceased at the World Trade Center, and live exposure to coverage of the attacks on television. Posttraumatic stress disorder, major depression, anxiety, suicidal ideation, and increase in post-9/11 smoking were common among participants with CG. A majority of the participants with CG reported receiving grief counseling and psychiatric medication after 9/11. Clinical and policy implications are discussed.

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

    ERIC Educational Resources Information Center

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

    2013-01-01

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

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

    PubMed

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

    2013-09-01

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

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

    PubMed Central

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

    2013-01-01

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

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

    PubMed

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

    2013-09-01

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

  9. Grief in the context of HIV: recommendations for practice.

    PubMed

    Mallinson, R Kevin

    2013-01-01

    Grief is a universal human response to loss. While the symptoms of grief are distressing and uncomfortable, they usually diminish over time without therapy. For persons grieving an HIV-related death, however, a variety of unique factors may interfere with the healthy resolution of symptoms. When the grief process becomes complicated, a person may experience serious alterations in physical health and/or disruptions in daily functioning. To assess grief, nurses need to apply interpersonal skills and therapeutic communication techniques in a compassionate manner; currently, no one screening instrument is optimal for evaluating grief in the clinical setting. The person experiencing grief or complicated grief may be referred for support services or counseling, pharmacologic interventions, or cognitive behavioral therapy. This report summarizes evidence from the literature and clinical practice to support recommendations for the practice of nurses caring for persons with HIV-associated grief; recommended strategies are illustrated through an exemplar case study.

  10. Grief counseling.

    PubMed Central

    Borins, M.

    1995-01-01

    Patients grieve the loss of loved ones, jobs, marriages, or even functioning. They seek comfort, understanding, respect, and especially hope. The "work of grief" progresses through stages. Mixed with the sadness can be feelings of anger, fear, and guilt. Psychotherapy can relieve self-destructive anger and guilt, advance the recovery phase, and stimulate psychological strength and personality growth. PMID:7647626

  11. Acute versus chronic grief: the case of pregnancy loss.

    PubMed

    Lasker, J N; Toedter, L J

    1991-10-01

    Conceptual and measurement problems in identifying those at risk of chronic grief are reviewed, and results are presented of a longitudinal study of people who have experienced pregnancy loss. Coping resources, particularly prior mental health and social support, were the best predictors of low scores on subscales of the Perinatal Grief Scale that indicate chronic grief reactions. Results also offer some evidence of delayed grief responses, especially among men and those who experienced early losses.

  12. The Continuing Process of Parental Grief

    ERIC Educational Resources Information Center

    Arnold, Joan; Gemma, Penelope Buschman

    2008-01-01

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

  13. Understanding Grief and Loss

    MedlinePlus

    ... worker, psychologist, or spiritual counselor. Grief in different cultures Although each person's grief is unique, the experience is shaped by his or her society and culture. Each culture has its own set of beliefs ...

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

    ERIC Educational Resources Information Center

    Robinson, Tristan; Marwit, Samuel J.

    2006-01-01

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

  15. “Prolonged grief disorder” and “persistent complex bereavement disorder”, but not “complicated grief”, are one and the same diagnostic entity: an analysis of data from the Yale Bereavement Study

    PubMed Central

    Maciejewski, Paul K.; Maercker, Andreas; Boelen, Paul A.; Prigerson, Holly G.

    2016-01-01

    There exists a general consensus that prolonged grief disorder (PGD), or some variant of PGD, represents a distinct mental disorder worthy of diagnosis and treatment. Nevertheless, confusion remains over whether different names and proposed symptom criteria for this disorder identify the same or different diagnostic entities. This study aimed to determine whether PGD, complicated grief (CG), and persistent complex bereavement disorder (PCBD) as described by the DSM‐5 are substantively or merely semantically different diagnostic entities. Data were derived from the Yale Bereavement Study, a longitudinal community‐based study of bereaved individuals funded by the US National Institute of Mental Health, designed explicitly to evaluate diagnostic criteria for disordered grief. The results suggested that the difference between PGD and PCBD is only semantic. The level of agreement between the original PGD test, a new version of the PGD test proposed for ICD‐11 and the PCBD test was high (pairwise kappa coefficients = 0.80‐0.84). Their estimates of rate of disorder in this community sample were similarly low (∼10%). Their levels of diagnostic specificity were comparably high (95.0‐98.3%). Their predictive validity was comparable. In contrast, the test for CG had only moderate agreement with those for PGD and PCBD; its estimate of rate of disorder was three‐fold higher (∼30%); its diagnostic specificity was poorer, and it had no predictive validity. We conclude that PGD, PCBD and proposed ICD‐11, but not CG, symptom‐diagnostic tests identify a single diagnostic entity. Ultimately, brief symptom‐diagnostic tests, such as the one proposed here for ICD‐11, may have the greatest clinical utility. PMID:27717273

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

    PubMed

    Moayedoddin, Babak; Markowitz, John C

    2015-01-01

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

  17. Understanding Grief & Loss.

    ERIC Educational Resources Information Center

    Parker, Judith

    1995-01-01

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

  18. Death and Grief

    MedlinePlus

    ... response to a death or loss. Grief can affect our body, mind, emotions, and spirit. People might notice or show grief in several ways: Physical reactions: These might be things like changes in appetite or sleep, an upset stomach, tight chest, crying, tense muscles, ...

  19. The narrative dynamics of grief after homicide.

    PubMed

    Rynearson, Edward K

    2012-01-01

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

  20. Death and Grief

    MedlinePlus

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

  1. How to Deal with Grief

    MedlinePlus

    ... life. Grief is a typical reaction to death, divorce, job loss, a move away from family and ... to return to work. While these feelings and behaviors are normal during grief, they will pass. How ...

  2. Diagnostic and clinical considerations in prolonged grief disorder

    PubMed Central

    Maercker, Andreas; Lalor, John

    2012-01-01

    This review focuses on the similarities and differences between prolonged grief disorder (PGD) and post-traumatic stress disorder (PTSD). It highlights how a PTSD-related understanding aids the investigation and clinical management of PGD. Grief has long been understood as a natural response to bereavement, as serious psychological and physiological stress has been regarded as a potential outcome of extreme or traumatic stress. PTSD was first included in DSM-III in 1980. In the mid-1980s, the first systematic investigation began into whether there is an extreme or pathological form of mourning. Meanwhile, there is much research literature on complicated, traumatic, or prolonged grief This literature is reviewed in this article, with the following questions: Is it possible to distinguish normal from non-normal grief? Which clinical presentation does PGD have—and how does this compare with PTSD? Finally, diagnostic, preventive, and therapeutic approaches and existing tools are presented. PMID:22754289

  3. Communication During Grief.

    ERIC Educational Resources Information Center

    Larson, Charles U.

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

  4. The Calculus of Grief

    ERIC Educational Resources Information Center

    Williams, Lee Burdette

    2010-01-01

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

  5. The grief map

    NASA Astrophysics Data System (ADS)

    Monteiro, L. H. A.

    2014-12-01

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

  6. [Abnormal grief reaction].

    PubMed

    Meyer, J E

    1977-01-01

    Pathological grief reactions following the death of a child are reported on the basis of five case studies. In contrast to acute grief reactions these pathological syndromes are of long standing. One parent had not truly accepted the death of the child. The denial of reality is sometimes a defence against aggression towards the deceased, because of his having left one behind. The mourning process comes to no end but remains in its initial phase. At the same time the life of the mourner stands still, as in the house and the family everything is left unchanged. Family interactions alter, particularly between the parents. For the genesis of these grief syndromes the following is of relevance: The death occurs at a time, when another child cannot replace the one who died. Mature independence had not been reached by either parent or child. Death destroyed expectations that this child would succeed in that which the parent had been unable to achieve. The parent had not seen the child after death--a gap in the continuity of experiencing which made acceptance of the irreversibility of the loss even more difficult.

  7. African Americans in bereavement: grief as a function of ethnicity.

    PubMed

    Laurie, Anna; Neimeyer, Robert A

    2008-01-01

    Few empirical studies have explored the grieving process among different ethnic groups within the United States, and very little is known about how African Americans and Caucasians may differ in their experience of loss. The purpose of this study was to examine the African-American experience of grief, with particular emphasis on issues of identity change, interpersonal dimensions of the loss, and continuing attachments with the deceased. Participants were 1,581 bereaved college students (940 Caucasians and 641 African Americans) attending classes at a large southern university. Each participant completed the Inventory of Complicated Grief-Revised, the Continuing Bonds Scale, and questions regarding the circumstances surrounding his or her loss. Results revealed that African Americans experienced more frequent bereavement by homicide, maintenance of a stronger continuing bond with the deceased, greater grief for the loss of extended kin beyond the immediate family, and a sense of support in their grief, despite their tendency to talk less with others about the loss or seek professional support for it. Overall, African Americans reported higher levels of complicated grief symptoms than Caucasians, especially when they spent less time speaking to others about their loss experience. Implications of these findings for bereavement support services for African Americans were briefly noted.

  8. Grief: Helping Young Children Cope

    ERIC Educational Resources Information Center

    Wood, Frances B.

    2008-01-01

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

  9. Building metaphors and extending models of grief.

    PubMed

    VandeCreek, L

    1985-01-01

    Persons in grief turn to metaphors as they seek to understand and express their experience. Metaphors illustrated in this article include "grief is a whirlwind," "grief is the Great Depression all over again" and "grief is gray, cloudy and rainy weather." Hospice personnel can enhance their bereavement efforts by identifying and cultivating the expression of personal metaphors from patients and families. Two metaphors have gained wide cultural acceptance and lie behind contemporary scientific explorations of grief. These are "grief is recovery from illness" (Bowlby and Parkes) and "death is the last stage of growth and grief is the adjustment reaction to this growth" (Kubler-Ross). These models have developed linear perspectives of grief but have neglected to study the fluctuating intensity of symptoms. Adopting Worden's four-part typology of grief, the author illustrates how the pie graph can be used to display this important aspect of the grief experience, thus enhancing these models.

  10. Grief after second-trimester termination for fetal anomaly: a qualitative study

    PubMed Central

    Maguire, Marguerite; Light, Alexis; Kuppermann, Miriam; Dalton, Vanessa K.; Steinauer, Jody E.; Kerns, Jennifer L.

    2015-01-01

    Objectives We aimed to qualitatively evaluate factors that contribute to and alleviate grief associated with termination of a pregnancy for a fetal anomaly and how that grief changes over time. Study design We conducted a longitudinal qualitative study of decision satisfaction, grief and coping among women undergoing termination (dilation and evacuation or induction termination) for fetal anomalies and other complications. We conducted three postprocedure interviews at 1–3 weeks, 3 months and 1 year. We used a generative thematic approach to analyze themes related to grief using NVivo software program. Results Of the 19 women in the overall study, 13 women’s interviews were eligible for analysis of the grief experience. Eleven women completed all three interviews, and two completed only the first interview. Themes that contributed to grief include self-blame for the diagnosis, guilt around the termination decision, social isolation related to discomfort with abortion and grief triggered by reminders of pregnancy. Social support and time are mechanisms that serve to alleviate grief. Conclusions Pregnancy termination in this context is experienced as a significant loss similar to other types of pregnancy loss and is also associated with real and perceived stigma. Women choosing termination for fetal anomalies may benefit from tailored counseling that includes dispelling misconceptions about cause of the anomaly. In addition, efforts to decrease abortion stigma and increase social support may improve women’s experiences and lessen their grief response. Implications The nature and course of grief after second-trimester termination for fetal anomaly are, as of yet, poorly understood. With improved understanding of how women grieve over time, clinicians can better recognize the significance of their patients’ suffering and offer tools to direct their grief toward positive coping. PMID:25499590

  11. [Parents' grief at the loss of a premature infant and approaches to their care].

    PubMed

    Liu, Hsiu-Mei

    2007-10-01

    The more than 3,000 deaths of premature infants due to low weight in Taiwan cause deep personal grief in their parents, for whom there is no pain greater than losing a child. This loss, nearly always sudden and unexpected, is an issue often ignored by clinic nursing staff. The purpose of this paper was to consider various grief counseling theories in order to help nurses attend to the grief counseling needs of parents who lose a premature infant. Better understanding of parents' grief responses by nursing staffs will help nurses to accept and address such. Grief processes identified include: shock and numbness, searching and yearning, disorientation and reorganization. Grief responses include: feel, physiology and sense organs, cognition and behavior. The four tasks essential to grief recovery include: to accept the reality of the loss, to work through the pain of grief, to adjust to an environment in which the deceased is missing, and to emotionally relocate the deceased and move on with life. Coaching through grief counseling theory puts forward and looks after concrete measures, and provides three suggestions for the parents who lose a premature infant. These can be used as reference by clinical staffs, help promote nursing staff understanding of this topic, help improve care for grieving parents and improve care quality.

  12. AN INTERNET TOOL TO NORMALIZE GRIEF*

    PubMed Central

    DOMINICK, SALLY A.; IRVINE, A. BLAIR; BEAUCHAMP, NATASHA; SEELEY, JOHN R.; NOLEN-HOEKSEMA, SUSAN; DOKA, KENNETH J.; BONANNO, GEORGE A.

    2009-01-01

    This research evaluated the efficacy of a psycho-educational Internet self-help tool to educate and support recently (1–6 months) bereaved individuals. The goal of the website was to help users normalize their grief to enhance their adaptive adjustment. A randomized controlled trial evaluated the gains in social cognitive theory constructs and state anxiety. Compared to the control group (N = 34), treatment participants (N = 33) reported significant multivariate gains (eta-square = .191). Significant program effects were obtained on all three outcome measures: attitude (eta-square = .177), self-efficacy (eta-square = .106), and state anxiety (eta-square = .083). These findings suggest the potential efficacy of an Internet-based grief support tool to enhance adaptive adjustment of the bereaved. PMID:20039532

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

    ERIC Educational Resources Information Center

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

    2014-01-01

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

  14. Anticipatory Grief: A Mere Concept?

    PubMed

    Moon, Paul J

    2016-06-01

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

  15. Tlaxcalan constructions of acute grief.

    PubMed

    Fabrega, H; Nutini, H

    1994-12-01

    In rural Tlaxcala, Mexico, the sudden and unexpected death of infants and young children was a relatively common occurrence during the time when this study was conducted. Not surprisingly, the deaths constituted major social tragedies and operated as psychological traumas to the family, especially the parents. Acute grief reactions inevitably resulted and these were suffused with bodily and psychological disturbances of different types, some of which were handled in the society as illness. The article grows out of a longitudinal study about these tragedies to families of the region. Attention is given to the grief reactions of parents, with special emphasis placed on psychological and behavioral manifestations. Of particular interest is the way local, cultural symbols pertaining to the cause of the deaths, which involved the malevolent attack of blood-sucking witches, were configured in the verbalizations and behavioral reactions that comprised the grief reactions. Details of the way symbols entered into the construction of meaningful accounts of the tragedies during the ordeal of the grief reactions are discussed and analyzed. Although the manifestations of grief could be said to have clinical, psychiatric implications, it is the way these manifestations served to explain the tragedies, in the process regulating and restoring social relations, that is given principal attention. A description of one mother's grief reaction is provided as a case illustration.

  16. Themes of grief.

    PubMed

    Carter, S L

    1989-01-01

    A thematic analysis of 30 narrative accounts of bereavement revealed nine themes that included five core themes in bereavement--being stopped, hurting, missing, holding, and seeking; three meta-themes about bereavement--change, expectations, and inexpressibility; and a contextual theme--personal history. The themes were compared with three theoretical perspectives on bereavement by Freud, Kübler-Ross, and one defined as existential-phenomenological. Features of bereavement that are dissimilar or unaddressed by the theoretical perspectives were: (a) the quality of grief's changing character, including "waves" and intense pain which may be triggered years after the death; (b) holding, an individual process of preserving the fact and meaning of the loved one's existence; (c) expectations, both social and personal, as to how the bereaved should be overlaying the experience; and (d) the critical importance of personal history in affecting the quality and meaning of individual bereavement.

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

    PubMed Central

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

    2015-01-01

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

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

    MedlinePlus

    ... a loved one include rituals, beliefs, and roles. Cultures have different ways of coping with death. Grief ... personal experiences of grief are similar in different cultures. The ways in which people of all cultures ...

  19. Perinatal grief and mourning.

    PubMed

    Menke, J A; McClead, R E

    1990-01-01

    The grief and mourning that parents experience following a perinatal loss is as devastating as the loss of an older loved one. The pattern of mourning can be anticipated and interventions can be implemented. With proper help, the parents can pass through this catastrophic time in their lives with a minimum of scars. If the physician stops, reaches out, listens, and supports the parents, he or she can have a dramatic effect on the lives of these parents. In the same manner in which we started this paper, we close with a quotation from another parent who suffered a loss: Daughters may die, But why? For even daughters can't live with half a heart. Three days isn't much a life. But long enough to remember thin blue lips, uneven gasps in incubators, Racking breaths that cause a pain to those who watched. Long enough to remember I never held her Or felt her softness Or counted her toes. I didn't even know the color of her eyes. Dead paled hands not quite covered by the gown she Was to go home in. Moist earth smell. One small casket. And the tears. You see, I hold in my hand but souvenirs of an occasion. A sheet of paper filled with statistics, A certificate with smudged footprints, A tiny bracelet engraved "Girl, Smith." You say that you are sorry That you know how I feel. But you can't know because I don't feel. Not yet.

  20. Reading Guidance: Death and Grief.

    ERIC Educational Resources Information Center

    Smith, Alice Gullen

    1989-01-01

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

  1. Children and Grief. ERIC Digest.

    ERIC Educational Resources Information Center

    McEntire, Nancy

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

  2. Helping Teens Work Through Grief.

    ERIC Educational Resources Information Center

    Perschy, Mary Kelly

    Teens who have experienced the death of a parent, grandparent, friend, or relative often find it difficult to grieve openly. When adults whom teens trust are aware of the cycle of grief, they can provide a safe atmosphere to allow teens to experience the turmoil of the intense and conflicting emotions in order to move toward healing. This guide is…

  3. Grief as pathology: The evolution of grief theory in psychology from Freud to the present.

    PubMed

    Granek, Leeat

    2010-02-01

    The emergence of grief as a topic worthy of psychological study is an early 20th century invention. Freud published his influential essay on mourning and melancholia in 1917. Since he proposed the concept of "grief work," contemporary psychologists have examined his theory empirically and have claimed that grief is a pathology that should be included within the psychological domain. How, and why, has grief theory evolved within the discipline of psychology in this way? In what ways do these changes in the understanding of grief coincide with other historical developments within the discipline? In this article, I trace the development of grief, originally conceived by Freud within a psychoanalytic and nonpathological framework, to the current conceptualization of grief within the disease model. I show how grief theory has evolved within the discipline of psychology to become (a) an object worthy of scientific study within the discipline, and subsequently, (b) a pathology to be privatized, specialized, and treated by mental health professionals.

  4. Mindfulness-based Intervention for Perinatal Grief after Stillbirth in Rural India

    PubMed Central

    Roberts, Lisa R.; Montgomery, Susanne B.

    2015-01-01

    We explored the concept of using a Mindfulness-based intervention to reduce perinatal grief among Indian women. Data were collected using mixed methods to explore concept acceptability, receptivity, modality, and feasibility of the intervention. The intervention was piloted and evaluated with measures of perinatal grief, psychosocial wellbeing, religious coping, perceived social provision of support, and mindfulness. The intervention was well received and effective in teaching skills to help women deal with high levels of grief and subsequent mental health challenges. To overcome attendance barriers modification is necessary. Partnership with a local nursing school is critical to enhance sustainability of the intervention. PMID:25898268

  5. Pathological Grief: Causes, Recognition, and Treatment

    PubMed Central

    Gort, George

    1984-01-01

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

  6. Pathological grief: two Victorian case studies.

    PubMed

    Ramchandani, D

    1996-01-01

    Despite 75 years of investigation, the concept of pathological grief remains tenuous and controversial. The author turns to the stories of two nineteenth century women, one real and the other fictitious to examine the syndrome of grief gone away. He concludes that pathological grief may be best viewed on a continuum of psychopathology, the expression of which depends upon the interaction between the personality of the patient, the nature of the lost relationship, and the circumstances of its loss.

  7. Innovative moments in grief therapy: the meaning reconstruction approach and the processes of self-narrative transformation.

    PubMed

    Alves, Daniela; Fernández-Navarro, Pablo; Baptista, João; Ribeiro, Eugénia; Sousa, Inês; Gonçalves, Miguel M

    2014-01-01

    Several studies have proposed that self-narrative transformation occurs through the elaboration of "Innovative Moments" (IMs), which are alternative experiences to the problematic self-narrative. This study aimed to analyze the emergence of IMs among 6 complicated grief women undergoing grief therapy according to the meaning reconstruction approach and to examine associations of IMs to the severity of grief symptomatology, assessed by the "Inventory of Complicated Grief." Eighty-three sessions were analyzed using the "Innovative Moments Coding System" (IMCS). A generalized linear model analysis (GLM) showed a significant association between the emergence of IMs and the interaction between time and symptomatic improvement, indicating a higher rate of IM production over time in cases with better clinical outcomes. These results reinforce IMs' relevance in studying narrative change among cases with distinct clinical progressions.

  8. The Spectrum of Grief: Identification and Management

    PubMed Central

    Barnes, Daphne

    1989-01-01

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

  9. Autonomy and social norms in a three factor grief model predicting perinatal grief in India.

    PubMed

    Roberts, Lisa R; Lee, Jerry W

    2014-01-01

    Perinatal grief following stillbirth is a significant social and mental health burden. We examined associations among the following latent variables: autonomy, social norms, self-despair, strained coping, and acute grief-among poor, rural women in India who experienced stillbirth. A structural equation model was built and tested using quantitative data from 347 women of reproductive age in Chhattisgarh. Maternal acceptance of traditional social norms worsens self-despair and strained coping, and increases the autonomy granted to women. Greater autonomy increases acute grief. Greater despair and acute grief increase strained coping. Social and cultural factors were found to predict perinatal grief in India.

  10. Dream Work in Grief Therapy

    PubMed Central

    Noronha, Konrad Joseph

    2014-01-01

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

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

    PubMed

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

    2015-01-01

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

  12. Grief Counseling: A Review of the Literature

    ERIC Educational Resources Information Center

    Daneker, Darlene; Cashwell, Craig

    2005-01-01

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

  13. The Grief Resolution Process in Divorce.

    ERIC Educational Resources Information Center

    Crosby, John F.; And Others

    1983-01-01

    Compares grief in divorce to the Kubler-Ross model of grief resolution in bereavement in 17 persons who wrote essays about their divorce. The results suggested a conceptual model based on three chronological stages with linear progression through the stages, characterized by circularity within each stage. (JAC)

  14. Integrating Buddhist Psychology into Grief Counseling

    ERIC Educational Resources Information Center

    Wada, Kaori; Park, Jeeseon

    2009-01-01

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

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

    ERIC Educational Resources Information Center

    Dennis, Michael Robert

    2008-01-01

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

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

    ERIC Educational Resources Information Center

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

    2006-01-01

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

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

    ERIC Educational Resources Information Center

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

    2011-01-01

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

  18. Perinatal grief in Latino parents.

    PubMed

    Whitaker, Claudia; Kavanaugh, Karen; Klima, Carrie

    2010-01-01

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

  19. Perinatal Grief in Latino Parents

    PubMed Central

    Whitaker, Claudia; Kavanaugh, Karen; Klima, Carrie

    2013-01-01

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

  20. Mourning and Grief on Facebook.

    PubMed

    Willis, Erin; Ferrucci, Patrick

    2017-01-01

    Facebook not only changed the way we communicate but also the way we mourn and express grief. The social networking site allows users to interact with deceased users' walls after death. This study utilized textual analysis to categorize Facebook posts ( N = 122) on 30 deceased users' walls according to uses and gratifications theory. Most posts were found to be motivated by entertainment, followed by integration and social interaction. Facebook users posted memories, condolences, and interacted with friends and family members in the deceased user's network. Implications and potential future research are discussed.

  1. Social and Cultural Factors Associated with Perinatal Grief in Chhattisgarh, India

    PubMed Central

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

    2017-01-01

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

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

    PubMed

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

    2012-06-01

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

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

    PubMed Central

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

    2009-01-01

    Objectives This paper reports on results from a randomized experimental trial of the effects of the Family Bereavement Program (FBP) on multiple measures of grief experienced by parentally-bereaved children and adolescents over a six year period of time. Method Participants were 244 youth (ages 8–16, mean age = 11.4 years) from 156 families that had experienced the death of a parent. The sample consisted of 53% boys; ethnicity was 67% non-Hispanic white and 33% ethnic minority. Families were randomly assigned to the FBP (N=135) or a literature control condition (N=109). Two grief measures, the Texas Revised Inventory of Grief (TRIG) and the Intrusive Grief Thoughts Scale (IGTS) were administered at four times over six years, pre-test, post-test, eleven-month and six-year follow-ups. A third measure, an adaptation of the Inventory of Traumatic Grief (ITG) was administered only at the six-year follow-up. Results The FBP showed a greater reduction as compared to controls in their level of problematic grief (IGTS) at post-test and six-year follow-up and in the percent at clinical levels of problematic grief at the post-test. The FBP also reduced scores on a dimension of the ITG, Social Detachment/Insecurity, at six-year follow-up for three subgroups; those who experienced lower levels of grief at program entry, older youth, and boys. Conclusion These are the first findings from a randomized trial with long-term follow-up of the effects of a program to reduce problematic levels of grief of parentally-bereaved youth. PMID:20350025

  4. Identity, grief and self-awareness after traumatic brain injury.

    PubMed

    Carroll, Emma; Coetzer, Rudi

    2011-06-01

    The objective of this study was to investigate perceived identity change in adults with traumatic brain injury (TBI) and explore associations between identity change, grief, depression, self-esteem and self-awareness. The participants were 29 adults with TBI who were being followed up by a community brain injury rehabilitation service. Participants were longer post-injury than those more commonly studied. Time since injury ranged from 2.25 to 40 years (mean = 11.17 years, SD = 11.4 years). Participants completed a battery of questionnaires. Significant others and clinicians completed a parallel version of one of these measures. Questionnaires included the Head Injury Semantic Differential Scale (HISDS-III), Brain Injury Grief Inventory (BIGI), Hospital Anxiety and Depression Scale - Depression, Rosenberg Self-Esteem Scale (RSES) and the Awareness Questionnaire (Self/Significant other/Clinician versions). The main findings were that participants reported significant changes in self-concept with current self being viewed negatively in comparison to pre-injury self. Perceived identity change was positively associated with depression and grief and negatively associated with self-esteem and awareness. Awareness was negatively associated with self-esteem and positively associated with depression. These findings were consistent with previous research, revealing changes in identity following TBI. Further research is needed to increase our understanding of the psychological factors involved in emotional adjustment after TBI and to inform brain injury rehabilitation interventions, including psychotherapy approaches.

  5. Convergent Validity of Three Methods for Measuring Postoperative Complications

    PubMed Central

    Fritz, Bradley A.; Escallier, Krisztina E.; Abdallah, Arbi Ben; Oberhaus, Jordan; Becker, Jennifer; Geczi, Kristin; McKinnon, Sherry; Helsten, Dan L.; Sharma, Anshuman; Wildes, Troy S.; Avidan, Michael S.

    2016-01-01

    Background Anesthesiologists need tools to accurately track postoperative outcomes. The accuracy of patient report in identifying a wide variety of postoperative complications after diverse surgical procedures has not previously been investigated. Methods In this cohort study, 1,578 adult surgical patients completed a survey at least 30 days after their procedure asking if they had experienced any of 18 complications while in the hospital after surgery. Patient responses were compared to the results of an automated electronic chart review and (for a random subset of 750 patients) to a manual chart review. Results from automated chart review were also compared to those from manual chart review. Forty-two randomly selected patients were contacted by telephone to explore reasons for discrepancies between patient report and manual chart review. Results Comparisons between patient report, automated chart review, and manual chart review demonstrated poor-to-moderate positive agreement (range, 0 to 58%) and excellent negative agreement (range, 82 to 100%). Discordance between patient report and manual chart review was frequently explicable by patients reporting events that happened outside the time period of interest. Conclusions Patient report can provide information about subjective experiences or events that happen after hospital discharge, but often yields different results from chart review for specific in-hospital complications. Effective in-hospital communication with patients and thoughtful survey design may increase the quality of patient-reported complication data. PMID:27028469

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

    PubMed Central

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

    2016-01-01

    Introduction Grief is a universal experience faced at one time or another by most people during their lives. Response to grief and bereavement losses can lead to psychiatric disorders such as mood disorders, post traumatic responses, insomnia loss of appetite, anxiety, and depression. The aim of our study is to value in our community the physical and psychological complications of a normal grief. Methods We conducted a cross-sectional study from March 2012 to September 2012 in Lubumbashi, Democratic Republic of Congo. Two questionnaires, the Hamilton Anxiety Scale and the Beck Depression Inventory scale were used as screening tool. A snow ball sampling method was performed and the questionnaires were administered only to those who consented to participate in the study. Results A total of 78 subjects were included in the study of which 87.2% were aged between 14-50 years old. The majority of the subjects were female 65.4%, and about a quarter (28%) was unemployed. The main correlates of the grief reported in the present study were being treated as witchcraft or accused to be responsible of a death (68%), being rejected by family and not being allowed to inherit (32%). Being homeless was reported in 26%. The main psychological symptoms reported were psychological distress after 1 year (65%) and related physical health problems after the death (72%). Depression and mild anxiety were the most reported disorders, with respectively 92.3% and 74.4% of the subjects. Conclusion Grief in Lubumbashi is associated with a large number of psychological, social and health problems. Health problems such as gastric is, high blood pressure were often reported. Being accused of witchcraft remains the main social impact. Depression and anxiety were the most psychological problem associated with grief. PMID:27583088

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

    ERIC Educational Resources Information Center

    Shaw, Kenneth A.; Britton, Thomas C.

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

  8. Brief Information on Childhood Traumatic Grief for School Personnel

    ERIC Educational Resources Information Center

    National Child Traumatic Stress Network, 2008

    2008-01-01

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

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

    ERIC Educational Resources Information Center

    Brown, Tiffany B.; Kimball, Thomas G.

    2012-01-01

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

  10. Tweeting Prayers and Communicating Grief over Michael Jackson Online

    ERIC Educational Resources Information Center

    Sanderson, Jimmy; Cheong, Pauline Hope

    2010-01-01

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

  11. The grief involved in change.

    PubMed

    Linney, B J

    1999-01-01

    In this era of rapid change, people need to be helped through the grieving process at work. "By acknowledging and articulating what is involved, you facilitate people's movement through it ... successful people in growing organizations need to learn to move through the process as quickly and efficiently as possible and help others do the same." Morris Shectman, in Working Without a Net says, "Contrary to the old paradigm--which held that others don't have a right to know about your personal life--the new paradigm says that it's a necessity that they know." If people are to move through the grief that is caused by undesired change, they will have to tell some of their personal feelings. "Each stage of the process--shock and denial, anger, bargaining, depression, and acceptance--is functional ... when people go through the process in a healthy manner, they'll recycle through it in a diluted fashion." Leaders in the organization can help people start the process or move through it if they get stuck at a particular stage.

  12. The grief account: dimensions of a contemporary bereavement genre.

    PubMed

    Dennis, Michael Robert

    2008-01-01

    The genre of the grief account is identified to include published narratives of surviving grief. Thematic analysis of Andrew Holleran's (2006) Grief: A Novel, Lolly Winston's (2004) Good Grief: A Novel, Joan Didion's (2005) The Year of Magical Thinking, and J. Canfield and M. V. Hansen's (2003) Chicken Soup for the Grieving Soul: Stories About Life, Death and Overcoming the Loss of a Loved One is informed by recent scholarship regarding eulogies and illness and dying narratives. Six dimensions (restorative, evaluative, interpretive, affirmative, affective, transformative) of contemporary grief accounts are recognized as sources of inspiration for the practice and experience of bereavement.

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

    ERIC Educational Resources Information Center

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

    2006-01-01

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

  14. [Grief and crises in Norse literature].

    PubMed

    Høyersten, J G

    1993-03-30

    The significance of literature for psychiatry and vice versa is commented on, as an introduction to a study of Norse literature. This was written down mainly in Iceland in the 13th Century on the basis of oral traditions, some of which date back to the 9th century. From a psychological point of view, the Icelandic Sagas, the Royal Sagas of Snorri Sturluson and the earliest hero-poems of the Edda are of particular interest. This literature includes detailed descriptions of grief and crisis reactions, the management and rituals of grief, and the associated rituals. These patterns have a striking similarity to modern principles of crisis intervention.

  15. Perinatal loss and parental grief: the challenge of ambiguity and disenfranchised grief.

    PubMed

    Lang, Ariella; Fleiszer, Andrea R; Duhamel, Fabie; Sword, Wendy; Gilbert, Kathleen R; Corsini-Munt, Serena

    2011-01-01

    Following perinatal loss, a type of ambiguous loss, bereaved couples struggle with and experience distress due to various forms of ambiguity. Moreover, the juxtaposition of their grief with society's minimization often disenfranchises them from traditional grieving processes. The purpose of this study was to explore sources of ambiguity and disenfranchised grief related to perinatal loss. Audio-taped interviews with 13 bereaved couples at 2, 6, and 13 months following the death of their fetus or infant were analyzed. Several categories of ambiguity and disenfranchised grief emerged, pertaining to: (a) the viability of the pregnancy; (b) the physical process of pregnancy loss; (c) making arrangements for the remains; and (d) sharing the news. This study uncovers the many sources of ambiguity and disenfranchised grief that bereaved couples face in interactions with family, friends, society, and healthcare professionals. These insights may inform healthcare professionals in their attempts to ease distress related to perinatal loss.

  16. Nursing 433: Uncomplicated Grief and Bereavement.

    ERIC Educational Resources Information Center

    Kane, James J.

    A description is provided of "Uncomplicated Grief and Bereavement," a course designed to provide the graduate nursing student with the assessment, diagnosis, planning, intervention, and evaluation skills required to facilitate a normal bereavement outcome among persons experiencing the loss of a significant other. The course description first…

  17. Living with Grief: Children, Adolescents, and Loss.

    ERIC Educational Resources Information Center

    Doka, Kenneth J., Ed.

    Noting that the best way to help and prepare children to cope with death and trauma is through education and understanding of the day-to-day ramifications that loss and grief have on them, this book is designed to help adults involved with children and adolescents to provide that education and understanding. Chapters in the first section of the…

  18. Treating Childhood Traumatic Grief: A Pilot Study.

    ERIC Educational Resources Information Center

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

    2004-01-01

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

  19. Grief Experiences and Expectance of Suicide

    ERIC Educational Resources Information Center

    Wojtkowiak, Joanna; Wild, Verena; Egger, Jos

    2012-01-01

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

  20. Grief and Horses: Putting the Pieces Together

    ERIC Educational Resources Information Center

    Symington, Ashley

    2012-01-01

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

  1. Birth mother grief and the challenge of adoption reunion contact.

    PubMed

    March, Karen

    2014-07-01

    A large body of work exists on the grief expressed by birth mothers over the loss of their children to adoption. Less is known about the grief emotions that surface when these women are contacted by adopted adults who seek contact relationships. The themes of mourning, grief, and bereavement that emerged in the qualitative interview data of 33 reunited birth mothers indicate more attention be given to these social psychological processes. Suggestions for future research possibilities and implications for clinical practice are explored.

  2. The grief process: a preparation for death.

    PubMed

    Curry, L C; Stone, J G

    1991-01-01

    Despite the multitude of losses we experience in our lifetime, death is likely to be the most paramount. Acceptance of losses and death takes time and energy as an individual passes through various phases of a process known as the grief process. Elisabeth Kübler-Ross (1969) has defined five stages in the grief process that individuals pass through in moving toward acceptance of losses. A case study has been presented to share one family's journey through these five stages. If a strict disease-oriented viewpoint is adopted, then the case was a failure: the patient died. From an emotional and spiritual viewpoint, however, this individual and his family achieved success, as they had time to complete their journey to acceptance.

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

    PubMed

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

    2014-06-30

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

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

    ERIC Educational Resources Information Center

    Klass, Dennis

    1988-01-01

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

  5. Grief and Loss Education: Recommendations for Curricular Inclusion

    ERIC Educational Resources Information Center

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

    2013-01-01

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

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

    ERIC Educational Resources Information Center

    Theriault, Brian

    2012-01-01

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

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

    ERIC Educational Resources Information Center

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

    2016-01-01

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

  8. Alexithymia and Grief Reactions in Bereaved Japanese Women

    ERIC Educational Resources Information Center

    Nakao, Mutsuhiro; Kashiwagi, Masayo; Yano, Eiji

    2005-01-01

    To examine the relationship between grief reactions and alexithymia, 54 Japanese women (33 outpatients attending a psychosomatic clinic and 21 normal healthy participants) completed the Texas Inventory of Grief (TIG), the 20-item Toronto Alexithymia Scale (TAS-20), and the Profile of Mood States (POMS). Each woman had experienced the death of a…

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

    ERIC Educational Resources Information Center

    Schwartzman, Roy; Tibbles, David

    2005-01-01

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

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

    ERIC Educational Resources Information Center

    Frost, Mardi

    2014-01-01

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

  11. Personal Fear of Death and Grief in Bereaved Mothers

    ERIC Educational Resources Information Center

    Barr, Peter; Cacciatore, Joanne

    2008-01-01

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

  12. Attachment, Loss of Spouse, and Grief in Elderly Adults.

    ERIC Educational Resources Information Center

    Sable, Pat

    1991-01-01

    Administered Texas Inventory of Grief to and conducted interviews with 81 widows between the ages of 26 and 82. Compared to younger women, older women showed more intense grief at time of interview and reported more feelings of anxiety and depression. Findings showed that older women did not tolerate or adapt to bereavement more successfully than…

  13. Grief and Loss: Towards an Existential Phenomenology of Child Spirituality

    ERIC Educational Resources Information Center

    Walters, David A.

    2008-01-01

    Western cultures have taken on a death-denying and grief-avoiding dimension, suggesting that children in particular are to be protected from the harshness of loss and death. As a result, many children grow up without having consciously experienced the pain of major loss and grief. It is argued that having been spared from suffering, from the pain…

  14. Families and the Grief Process. ARCH Factsheet Number 21.

    ERIC Educational Resources Information Center

    Braza, Kathleen

    This fact sheet points out that knowledge of the process of grief (defined as one's own personal experience of loss) and ways of helping individuals and families cope with their loss experiences can be an invaluable asset to crisis nurseries and respite care programs and their service providers. The fact sheet lists the emotions of grief, and…

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

    ERIC Educational Resources Information Center

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

    2008-01-01

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

  16. The Role of Hardiness in the Resolution of Grief.

    ERIC Educational Resources Information Center

    Campbell, Jane; And Others

    1991-01-01

    Investigated relation of personality factor of hardiness to resolution of grief. In anonymous sample of 70 widows, hardiness was significant predictor of grief resolution in addition to general mental health, time since death, and widow's age. Whether death was expected did not relate to course of resolution. (Author/NB)

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

    ERIC Educational Resources Information Center

    DeGroot, Jocelyn M.; Carmack, Heather J.

    2013-01-01

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

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

    ERIC Educational Resources Information Center

    Parker, Judith A.

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

  19. [A nurse's experience applying grief counseling to a bereaved family].

    PubMed

    Hsiao, Wen-Ling

    2010-04-01

    This case report describes a nurse's experience applying William Worden's Grief Counseling on a young woman whose mother had passed away after a brief period in a coma. The report describes how the nurse facilitated this case and assisted the woman though the grief process, during which the woman completed the four tasks of mourning. Seven behavioral process records were analyzed base on Worden's grief responses. Emotional reactions included shock, denial, guilt and fear. Insomnia was the sole physical reaction indicated. Cognitive reactions included disbelief with regard to the death and preoccupation with her mother. Social withdrawal, avoidance of mentioning her mother, calling out, sighing and crying comprised the main behavioral reactions. The author applied the concepts and principles of grief counseling by accompanying and supporting this case though the grief process, and helping the patient complete the four tasks of mourning, which are: (1) to experience the pain of grief, (2) to accept the reality of the death, (3) to adjust to life after the death, and (4) to move on with life. It is hoped that this case report will help nursing staffs be more sensitive and receptive to family grieving and be better equipped to provide proper grief care.

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

    PubMed Central

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

    2015-01-01

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

  1. Design of a scale for measuring post-surgical complications in third molar surgery.

    PubMed

    Aravena, P C; Astudillo, P; Manterola, C

    2014-08-01

    The aim of this study was to design a scale for measuring the extent and severity of post-surgical complications in third molar surgery. A multi-stage study using a quantitative methodology and qualitative interview strategy was employed. The degree of importance of signs and symptoms in the evaluation of post-surgical complications was initially observed using a self-report questionnaire administered to maxillofacial surgeons and surgical residents at the International Conference of Oral and Maxillofacial Surgeons in 2011. Then, using exploratory factor analysis, the items and components of the scale were established, with internal consistency determined using Cronbach's alpha. Finally, a group of experts performed a face validity analysis and provided conceptual definitions for the items and components. Thirty-six signs and symptoms were evaluated by 100 respondents, with the most relevant being 'suppuration' and 'abscess'. Factor analysis of the results identified three factors, defined as 'secondary complication', 'soft tissue infection', and 'osseous involvement' (Cronbach's alpha>0.7). Finally, a preliminary scale was designed comprised of these three components and 10 items. In this way, a preliminary scale for measuring post-surgical complications was designed to standardize the semiological concepts of post-surgical assessment. This scale will be assessed in a future investigation.

  2. The grief process for patient, family, and physician.

    PubMed

    Bruce, Christine A

    2002-09-01

    In the grieving process, patient, family, and health professionals have the same needs-rest, relaxation, nourishment, a sense of security, trust, hope in the future, and humor among them. Grief, defined as a shared, universal, and natural neuropsychobiologic expression in response to loss, is distinct from mourning, a practice that varies in expression across diverse cultures. To aid in an understanding of grief and its effects, the author looks at the models for grief proposed by Kubler-Ross, Bowlby, Parkes, Worden, and Wolfelt. Addressing patients' concerns requires physicians be empathic, attentive, and respective and have willingness to take time, be present, and listen.

  3. Planting hope in loss and grief: self-care applications of horticultural therapy for grief caregivers in Taiwan.

    PubMed

    Lin, Yeh-Jen; Lin, Chi Yun; Li, Yu-Chan

    2014-01-01

    In 2008, the Taiwan Association for Care and Counseling for Loss organized a workshop about Horticultural Therapy, conducted as a participatory action research (PAR). Nineteen grief caregivers participated. Specific goals were designed according to a survey of participant expectations and focus-group discussions. The workshop content included lectures and interactive activities. Results demonstrated that most participants displayed an increased awareness of personal loss and meaning in grief, indicating that horticulture and nature appreciation might relieve individual grief and stress. The report introduces the rationale, evolution, execution, and results of the program development.

  4. Early Family Deaths May Create 'Grief Gap' for Blacks

    MedlinePlus

    ... medlineplus.gov/news/fullstory_163190.html Early Family Deaths May Create 'Grief Gap' for Blacks Compared to ... 000 racially diverse Americans, the researchers found that death strikes black families significantly earlier than whites on ...

  5. End of Life: Dealing with Grief and Confronting Painful Emotions

    MedlinePlus

    ... who aren't prepared for the avalanche of emotions that sweep over them when the final moment ... know how challenging and devastating the raw, intense emotions of grief can be, because it's happened to ...

  6. Grief: Coping with the Reminders After a Loss

    MedlinePlus

    ... professional help, however, you can re-establish a sense of control and direction in your life — and return to the path toward healing. References Shear MK. Grief and bereavement in adults: Clinical ...

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

    SciTech Connect

    Ren Zhiguo; Liao Jiarui; Cai Lilong

    2010-04-01

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

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

    PubMed

    Ren, Zhiguo; Liao, Jiarui; Cai, Lilong

    2010-04-01

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

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

    PubMed Central

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

    2015-01-01

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

  10. Grief elaboration in families with handicapped member.

    PubMed

    Calandra, C; Finocchiaro, G; Raciti, L; Alberti, A

    1992-01-01

    Families with handicapped member seem to follow the same five stages (rejection and isolation, anger, dealing with the problem, depression, acceptance) of Kubler-Ross grief elaboration theory while dealing with the narcissistic wound of a handicapped child. Some of these families show a block in one of the stages. The effort of psychotherapy is to remove the block and let them reach the last stage. In this paper families under systemic psychotherapeutic treatment are analyzed, who had in common the birth of a child with low or modest invalidating signs and psychotic or autistic features. The families structure did not show the characteristics of a psychotic family. Nevertheless either one or both parents ignored the evidence of their child disease and they built a "disease-incongrous" wait around the child, trying to push away the painful reality. The authors explain the importance of this approach for the improvement of the autistic traits.

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

    PubMed

    Kurotori, Isaku; Kato, Satoshi

    2015-01-01

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

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

    ERIC Educational Resources Information Center

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

    2009-01-01

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

  13. The effects of gestational age and gender on grief after pregnancy loss.

    PubMed

    Goldbach, K R; Dunn, D S; Toedter, L J; Lasker, J N

    1991-07-01

    The roles of gestational age and gender in grief reactions following loss of pregnancy were explored. Parents with losses later in pregnancy reported more intense grief than did those whose losses were earlier. Women expressed higher levels of grief than did men six to eight weeks after the loss; however, this difference had decreased by one and two years after the loss.

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

    ERIC Educational Resources Information Center

    Dennis, Michael Robert

    2012-01-01

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

  15. The Experience of Grief after Bereavement: A Phenomenological Study with Implications for Mental Health Counseling.

    ERIC Educational Resources Information Center

    Muller, Elizabeth D.; Thompson, Charles L.

    2003-01-01

    Phenomenological methods were used to explore the experience of grief after bereavement. Nine bereaved adults volunteered to participate in interviews in which they discussed their experience of grief after the death of a loved one. An analysis of the interviews revealed the following themes in the experience of grief after bereavement: Coping,…

  16. Continuing Bonds and Reconstructing Meaning: Mitigating Complications in Bereavement

    ERIC Educational Resources Information Center

    Neimeyer, Robert A.; Baldwin, Scott A.; Gillies, James

    2006-01-01

    Drawing on attachment theory and constructivist conceptualizations of bereavement, the authors assessed the relation between continuing bonds coping and meaning reconstruction following the death of a loved one and complicated grief symptomatology. Five hundred six young adults in the first two years of bereavement from a variety of losses…

  17. Descriptions of Social Support in Treatment Narratives of Complicated Grievers

    ERIC Educational Resources Information Center

    Wilsey, Stephanie A.; Shear, M. Katherine

    2007-01-01

    The authors performed a qualitative analysis of revisiting exercise narratives provided by 22 bereaved individuals undergoing complicated grief (CG) treatment. Revisiting entails telling the story of the death. Most participants described social interactions in the narratives, viewing others as helpful (n = 7), unhelpful (n = 7), or both (n = 6).…

  18. Exploring Oncology Nurses’ Grief: A Self-study

    PubMed Central

    Barbour, Lisa C.

    2016-01-01

    Oncology nursing, like many other nursing fields, often provides nurses with the opportunity to get to know their patients and their families well. This familiarity allows oncology nurses to show a level of compassion and empathy that is often helpful to the patient and their family during their struggle with cancer. However, this familiarity can also lead to a profound sense of grief if the patient loses that struggle. This self-study provided me the opportunity to systematically explore my own experience with grief as an oncology nurse, helping me to identify specific stressors and also sources of stress release. PMID:27981166

  19. Mindfulness-based Intervention for Perinatal Grief Education and Reduction among Poor Women in Chhattisgarh, India: a Pilot Study

    PubMed Central

    Roberts, Lisa; Montgomery, Susanne

    2017-01-01

    Introduction Stillbirth is a significant public health problem in low-to-middle-income countries and results in perinatal grief, often with negative psychosocial impact. In low-resource settings, such as Chhattisgarh, India, where needs are high, it is imperative to utilize low-cost, effective interventions. Mindfulness-based stress reduction (MBSR) is an empirically sound intervention that has been utilized for a broad range of physical and mental health problems, and is adaptable to specific populations. The main objective of this pilot study was to explore the feasibility and effectiveness of a shortened, culturally adapted mindfulness-based intervention to address complex grief after stillbirth. Methods We used an observational, pre-post-6-week post study design. The study instrument was made up of descriptive demographic questions and validated scales and was administered as a structured interview due to low literacy rates. We used a community participatory approach to culturally adapt the five-week mindfulness-based intervention and delivered it through two trained local nurses. Quantitative and qualitative data analyses explored study outcomes as well as acceptability and feasibility of the intervention. Results 29 women with a history of stillbirth enrolled, completed the pretest and began the intervention; 26 completed the five-week intervention and post-test (89.7%), and 23 completed the six-week follow-up assessment (88.5%). Pretest results included elevated psychological symptoms and high levels of perinatal grief, including the active grief, difficulty coping, and despair subscales. General linear modeling repeated measures was used to explore posttest and six-week follow up changes from baseline, controlling for significantly correlated demographic variables. These longitudinal results included significant reduction in psychological symptoms; four of the five facets of mindfulness changed in the desired direction, two significantly; as well as

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

    ERIC Educational Resources Information Center

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

    2012-01-01

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

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

    ERIC Educational Resources Information Center

    Bohannon, Judy Rollins

    1991-01-01

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

  2. Play and Healing: Therapeutic Recreation's Role in Coping with Grief.

    ERIC Educational Resources Information Center

    Sorensen, Beth; King, Kathryn

    1999-01-01

    Camp Releaf, a weekend camp in North Carolina, uses therapeutic recreation to help children in grades K-8 develop positive coping skills for dealing with the recent death of a family member. The camp's therapeutic activities are described. Sidebars outline the nature of grief in different age groups and suggestions for working with grieving…

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

    ERIC Educational Resources Information Center

    Cohen, Judith A.; Mannarino, Anthony P.

    2011-01-01

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

  4. Grief and Needs of Adults with Acquired Visual Impairments

    ERIC Educational Resources Information Center

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

    2010-01-01

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

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

    ERIC Educational Resources Information Center

    Moore, Rebecca

    2011-01-01

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

  6. Effectiveness of Grief Therapy: A Meta-Analysis.

    ERIC Educational Resources Information Center

    Allumbaugh, Denise Litterer; Hoyt, William T.

    1999-01-01

    Describes analyses based on 35 studies on effectiveness of Grief Therapy. Clients with no-treatment control groups showed little improvement, possibly because of the relatively long delay between loss and treatment. Client selection procedures appear to contribute strongly to variability in effect size (ESs). The majority of studies involving…

  7. Scrapbooking as an Intervention for Grief Recovery with Children

    ERIC Educational Resources Information Center

    Williams, Kristie; Lent, Jonathan

    2008-01-01

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

  8. The Grief Group: A University and Hospice Collaboration

    ERIC Educational Resources Information Center

    O'Neill, Daniel; Fry, Michele

    2013-01-01

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

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

    ERIC Educational Resources Information Center

    Green, Viviane

    2013-01-01

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

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

    ERIC Educational Resources Information Center

    McFerran, Katrina

    2011-01-01

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

  11. Grief in Separated, Divorced, and Widowed Women: Similarities and Differences.

    ERIC Educational Resources Information Center

    Petiet, Carole Anne

    To systematically test previous assumptions about grief in widows and divorcing women, 410 separated, divorced, or widowed women, between the ages of 23 and 76, with at least one child, completed the Multiple Affect Adjective Checklist, the Revised UCLA Loneliness Scale, the Coopersmith Self-Esteem Inventory--Form C, the Attachment Index, and the…

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

    ERIC Educational Resources Information Center

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

    2011-01-01

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

  13. Enhancement of Death Acceptance by a Grief Counseling Course.

    ERIC Educational Resources Information Center

    Irwin, Harvey J.; Melbin-Helberg, Elizabeth B.

    1992-01-01

    Investigated impact of grief counseling course in terms of two-component formulation of death acceptance. Compared to controls, participants showed significant and sustained increase in cognitive confrontation of death and in assimilation of attitudes at emotional level. Identified predictors of extent of effect included individual's initial death…

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

    ERIC Educational Resources Information Center

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

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

  15. Race as a Factor in Teachers' Responses to Children's Grief.

    ERIC Educational Resources Information Center

    Atkinson, Trudie L.

    1982-01-01

    Investigated how teachers respond to children in death-related situations. When Black and non-Black teachers were compared, no differences were evident in attitudes toward death or belief in an afterlife. However, significant differences appeared in the responses they chose to children's grief. (Author)

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

    ERIC Educational Resources Information Center

    Bellali, Thalia; Papadatou, Danai

    2006-01-01

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

  17. In memoriam: the disenfranchised grief of chaplains and the recovery of memory.

    PubMed

    Helsel, Philip Browning

    2008-01-01

    The article explores the disenfranchised grief of the chaplain from the perspective of the author's own experience in hospice chaplaincy. Borrowing from the works of Kenneth J. Doka on disenfranchised grief, Robert C. Dykstra on crisis ministry, and James Dittes on grief work in ministry, this article focuses on the grief work of chaplains. In doing so, it analyzes the theological perspective of remembrance, explaining how personal remembrances connect the chaplain with his or her own repressed grief in a way that communal events can not accomplish because of the chaplain's responsibility for the grief of the community in these settings. From the perspective of the Christian faith in its sacramental connections with the Lord's Supper, the spiritual practice of honoring the deceased and praying for their guidance is posed as a possible model of healing remembrance.

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

    PubMed

    Salloum, Alison; Overstreet, Stacy

    2012-03-01

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

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

    PubMed

    Dennis, Michael Robert

    2012-01-01

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

  20. Disciplinary Wounds: Has Grief Become the Identified Patient for a Field Gone Awry?

    PubMed Central

    GRANEK, LEEAT

    2014-01-01

    In the last few decades, grief and loss research in the psychological domain has focused almost exclusively on its dysfunctional nature. I examine what is underneath these questions about pathology and suggest that our discipline is suffering from an attachment wound where we have dissociated from our historical roots when it comes to the study of grief and loss. I argue that we need to ask new questions about grief and loss and present two examples of my collaborative work to illustrate innovative ways of thinking about and researching grief. PMID:24976797

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

    PubMed

    Varga, Mary Alice; Paulus, Trena M

    2014-01-01

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

  2. Politics, religions, and grief: the cases of American spiritualism and the Deuteronomic reform in Israel.

    PubMed

    Klass, Dennis; Goss, Robert

    2002-11-01

    The article is a contribution to the task of developing a cross-cultural model of grief. It shows that grief narratives can be complexly interwoven with the religious and political narratives of the culture. Two political reforms in which religious narratives figured prominently are given as case examples: 19th-century Spiritualism in North America and the Deuteronomic reform in 7th-century BCE Israel. Similarities and differences between the two are discussed. The article concludes that an adequate cross-cultural model of grief must be capable of explaining how a particular grief narrative relates to the politics and religious narratives in which it is set.

  3. Loss and grief in the workplace: the challenge of leadership.

    PubMed

    Tehan, Mary; Thompson, Neil

    There is no part of human existence that loss and grief do not reach, and the workplace is no exception to this. This article is therefore concerned with some of the implications of loss and grief in work settings in general and for workplace leaders in particular. By way of example, it explores in particular the needs of bereaved caregivers returning to work and the potential for stigma to emerge in relation to employment and bereavement. Central to the article is an argument in favor of the need for change within the workplace, specifically within the structures and systems that support bereaved caregivers returning to work. This article critically reflects on the leadership management challenge of supporting bereaved caregivers returning to, or seeking, work and addressing the problem of stigma in relation to employment and bereavement. Some structural and policy changes are highlighted to assist employers and bereaved caregivers faced with this situation.

  4. Resident work hours: the five stages of grief.

    PubMed

    Barone, James E; Ivy, Michael E

    2004-05-01

    The authors describe their reactions, as surgical educators, to the mandate of the Accreditation Council for Graduate Medical Education to reduce resident work hours. They explain these reactions in terms of Dr. Elizabeth Kübler-Ross's five stages of grief: denial, anger, bargaining, depression, and finally acceptance ("which should not be mistaken for a happy stage"). The authors describe each stage of grief and use it to make specific comments on the difficulties that the mandate imposes. They then reveal that their views about the work-hours regulations differ: Dr. Ivy now sees them as an opportunity to grow and improve, and likens the resistance to the new restrictions to that of Europeans to the printing press. But Dr. Barone ("the older of the coauthors and a known curmudgeon") is not so sure, and shares many of the concerns described earlier in the five stages of grief, even though he has outwardly accepted the work-hours rules and insists on full compliance by his residents and faculty. In particular, he is saddened that some residents feel they have the absolute right to go home regardless of the situation on the surgery service, and this feeling is validated by the work-hours rules.

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

    ERIC Educational Resources Information Center

    Briggs, Cynthia A.; Pehrsson, Dale-Elizabeth

    2008-01-01

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

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

    ERIC Educational Resources Information Center

    Sprang, M. Virginia; And Others

    1993-01-01

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

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

    ERIC Educational Resources Information Center

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

    2006-01-01

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

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

    ERIC Educational Resources Information Center

    Waldrop, Deborah P.

    2007-01-01

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

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

    ERIC Educational Resources Information Center

    Salloum, Alison; Overstreet, Stacy

    2008-01-01

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

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

    ERIC Educational Resources Information Center

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

    2010-01-01

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

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

    ERIC Educational Resources Information Center

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

    2013-01-01

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

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

    ERIC Educational Resources Information Center

    Allred, Keith W.

    2015-01-01

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

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

    ERIC Educational Resources Information Center

    Seibert, Phyllis M.; Pastorello, Thomas

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

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

    ERIC Educational Resources Information Center

    Stinson, Kandi M.; And Others

    1992-01-01

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

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

    ERIC Educational Resources Information Center

    Celik, Seher Balci

    2013-01-01

    The purpose of this study is to reveal whether university students' level of resilience differ by gender and attitude toward grief, and to identify to what extent resilience predicts attitude toward grief. 259 students studying at Ondokuz Mayis University participated in the study. The average age of the participants was 20.27 plus or minus 1.19.…

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

    ERIC Educational Resources Information Center

    Powers, Harry L.

    1987-01-01

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

  17. Improving the understanding and treatment of complex grief: an important issue for psychotraumatology

    PubMed Central

    Boelen, Paul A.

    2016-01-01

    In the Netherlands, every year 500,000 people are confronted with the death of a close relative. Many of these people experience little emotional distress. In some, bereavement precipitates severe grief, distress, and dysphoria. A small yet significant minority of bereaved individuals develops persistent and debilitating symptoms of persistent complex bereavement disorder (PCBD) (also termed prolonged grief disorder), posttraumatic stress disorder, and depression. Knowledge about early identification of, and preventive care for complex grief has increased. Moreover, in recent years there has been an increase in treatment options for people for whom loss leads to persistent psychological problems. That said, preventive and curative treatments are effective for some, but not all bereaved individuals experiencing distress and dysfunction following loss. This necessitates further research on the development, course, and treatment of various stages of complex grief, including PCBD. Highlights of the article “Complex grief” is an informal term referring to debilitating, non-normative grief. It will likely be named Prolonged Grief Disorder in the forthcoming ICD-11. It is named Persistent Complex Bereavement Disorder in DSM-5. Research on the development, course, and treatment of complex grief is needed. This research should address different stages and manifestations of complex grief. PMID:27667723

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

    ERIC Educational Resources Information Center

    Wilson, John; Gabriel, Lynne; James, Hazel

    2014-01-01

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

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

    ERIC Educational Resources Information Center

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

    2004-01-01

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

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

    PubMed

    Carmack, Heather J; DeGroot, Jocelyn M

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

  1. Coping with grief responses among African American family members of homicide victims.

    PubMed

    Sharpe, Tanya L; Osteen, Philip; Frey, Jodi Jacobson; Michalopoulos, Lynn Murphy

    2014-01-01

    Research relevant to coping with grief for African American family members of homicide victims is limited. This retrospective study was conducted to determine the effects of gender, length of time since death, the traumatic impact of experiencing the homicide of a loved one, and the use of coping strategies to current grief reactions of African American family members of homicide victims (N = 44). Multiple regression analysis results suggest that gender and level of traumatic stress, related to posttraumatic stress symptomatology, predict current symptoms of grief. Women reported higher levels of current grief symptoms than men. Family members of homicide victims who reported higher levels of posttraumatic stress symptomology reported higher levels of current grief. Implications for research and recommendations for practitioners are discussed.

  2. Underutilization of Mental Health Services Among Bereaved Caregivers With Prolonged Grief Disorder

    PubMed Central

    Lichtenthal, Wendy G.; Nilsson, Matthew; Kissane, David W.; Breitbart, William; Kacel, Elizabeth; Jones, Eric C.; Prigerson, Holly G.

    2013-01-01

    Objective This study examined grief and mental health service use among 86 bereaved caregivers of advanced cancer patients. Methods Caregivers were assessed before (median=3.1 months) and after (median=6.6 months) patients’ deaths for prolonged grief disorder, axis I psychiatric disorders, mental health service use, suicidality, and health-related quality of life. Results Sixteen percent of the bereaved sample met criteria for prolonged grief disorder, which was significantly associated with suicidality and poorer health-related quality of life, but not with mental health service use. The majority of bereaved caregivers with prolonged grief disorder did not access mental health services. In multivariable analyses, having discussed psychological concerns with a health care professional when the patient was ill was the only significant predictor of mental health service use during bereavement. Conclusions Because bereaved caregivers with prolonged grief disorder underutilize mental health services, connecting them with services while the patient is still alive may be beneficial. PMID:21969652

  3. Counselling Adolescents Through Loss, Grief and Trauma Malone Pamela Counselling Adolescents Through Loss, Grief and Trauma 168pp £24.99 Routledge 9780415857055 0415857058 [Formula: see text].

    PubMed

    2016-10-07

    Adolescents experience loss, grief and trauma more often than many adults recognise. Their responses are different from those of children and adults, and they can struggle to share their experiences or express emotions.

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

    PubMed Central

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

    2010-01-01

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

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

    PubMed

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

    2012-10-01

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

  6. Utility of a grief services program for medical examiners' offices.

    PubMed

    Berry, Ryan S; Aurelius, Michelle B; Barickman, Nancy; Lathrop, Sarah L

    2013-03-01

    Medical examiner/coroner's (ME/C) offices investigate sudden, violent, and unexpected deaths, leaving those close to the deceased suffering traumatic loss with little in terms of support and counseling. We investigated a grief services program (GSP) at the New Mexico Office of the Medical Investigator (OMI) to better understand the needs of bereaved individuals, identify the services provided, and propose our findings as a model for others. A total of 1085 contacts occurred over 1 year, with the majority occurring at OMI (60.5%), followed by telephone (23.1%). Support was primarily provided to those suffering a loss due to homicide (28.8%) and suicide (26.1%). The roles grief counselors play in the setting of a GSP and ME/C office are multiple. Given the frequent utilization of OMI's GSP and diverse reasons for visits, it is apparent there is a need for GSPs at ME/C offices, particularly given the traumatic nature of deaths investigated by ME/Cs.

  7. Coping With Loss: Mapping Digital Rituals for the Expression of Grief.

    PubMed

    Gamba, Fiorenza

    2016-11-29

    Although death has been frequently discussed in health communication, there has been a lack of research on coping with loss. Nevertheless, there are many websites and social network sites that offer suggestions to people as to how to cope with loss, including sites for support, sharing of experiences, and expressing grief. This article provides a theoretical understanding of grief by considering it as an emotional experience in terms of how it is expressed, its consequences, and the confrontation between the offline and online grief experience.

  8. Predictors of husbands' and wives' grief reactions following infant death: the role of marital intimacy.

    PubMed

    Lang, A; Gottlieb, L N; Amsel, R

    1996-01-01

    This follow-up study examined how bereaved couples' grief reactions change over time and how the quality of the marriage can predict these reactions for men and women. A group of 31 bereaved couples who 2 to 4 years earlier had lost an infant ( greater than 20 weeks gestation and less than 1 year of age) were revisited in their home 24 months after the initial home visit. With the exception of somatization, couples' grief reactions were less intense at follow-up than at the initial visit. Overall, husbands experienced less guilt, meaninglessness, yearning, and morbid fear than wives. Both husbands and wives who reported lower levels of marital intimacy soon after the loss experienced more intense grief at follow-up. Finally, couples continued to be vulnerable to a resurgence of grief even years later.

  9. Grief Reporting: A Print Media Content Analysis of the Gander, Newfoundland Air Disaster

    DTIC Science & Technology

    1988-03-11

    SUBJXCTTERMS Media; newspaper reporting; Gander, Newfoundland1s. NUMBEROF PAGES disasters; grief reporting; thanatology ; media-military 125...Purpose of Study 2 Statement of the Problem 3 Chapter II Conceptual Framework Crisis and Grief Reporting 11 Thanatology 15 Hypothesis to be Tested 21...reporters, they all set their jobs aside and we talked as people. I really appreciated that.ŕ 6 Thanatology Thanatology , "the secular study of death and

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

    PubMed Central

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

    2014-01-01

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

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

    PubMed

    Loomis, Beth

    2009-06-01

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

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

    NASA Astrophysics Data System (ADS)

    Cicchetti, Richard Jude

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

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

    ERIC Educational Resources Information Center

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

    2015-01-01

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

  14. Opportunities for mourning when grief is disenfranchised: descendants of Nazi perpetrators in dialogue with Holocaust survivors.

    PubMed

    Livingston, Kathy

    2010-01-01

    This article explores the concepts of unmourned and disenfranchised grief as a way to understand the experiences of adult children of Nazi perpetrators, who grew up with cultural norms of grieving alone or in silence. The scholarly literature on descendants of Nazis reflects a group unlikely to warrant empathy or support from others because of the stigma surrounding their family's possible involvement in the Holocaust atrocities. This article uses, as a case study approach, the testimony given by Monika Hertwig, the adult daughter of a high ranking Nazi, who appears in the documentary film, Inheritance. From the perspective of disenfranchised grief, defined as grief that is not socially recognized or supported, the article links Monika's testimony with existing research from in-depth interviews with other descendants of Nazis to suggest that, as a group, they lacked permission to grieve their deceased parents, acknowledgment of their grief, and opportunities to mourn. Based on the theory that the effects of grief can be transgenerational, the disenfranchisement experienced by the "children of the Third Reich" does not have to pass to subsequent generations if opportunities for mourning are made possible and some resolution of grief occurs. Studies have shown that ongoing dialogue groups between Holocaust survivors and descendants of Nazis provide opportunities for mourning to both groups.

  15. Tangled up in grief: Bob Dylan's songs of separation.

    PubMed

    Smith, Keverne

    This article argues that much can be learned about the ways in which individuals grieve through a careful analysis of the presentation of loss in creative fiction, especially in terms of unconscious and uncensored responses presented indirectly through figurative language and structural patterns. It takes Bob Dylan's collection of songs about the anguish caused by lost love, Blood on the Tracks, as an example. An examination of the songs included in, and some rejected for, the album reveals developing responses to grief resulting from relationship breakdown, including the search for the absent one and for reconciliation; the intrusion of deep pain into everyday situations; the problem of infidelity and guilt; the attempt to reach a more detached perspective; the consequences of the pain becoming unbearable; and the attempt at a kind of closure. Taken together, the songs reveal how complex and contradictory responses to the agony of loss can be.

  16. Grief consolation in eulogy rhetoric: an integrative framework.

    PubMed

    Kunkel, Adrianne Dennis; Dennis, Michael Robert

    2003-01-01

    In an ever more deadly and uncertain world, rhetoric honoring the deceased is still examined as though that was its primary, if not only, function. Some critics of eulogia also identify the consolation of survivors but rarely define it precisely or analyze its rhetorical execution. This article introduces a framework for the critical analysis and production of eulogia that draws from comforting mechanisms recognized in the interpersonal communication, social psychology, and grief therapy literatures. Self-disclosure, problem-focused coping, positive reappraisal, and the affirmation and continuation of relationships with the deceased are shown to inform criticism of five contemporary eulogies. Challenges inherent in the invention and appreciation of eulogy rhetoric are thus illuminated and addressed.

  17. Elevated rates of prolonged grief disorder in African Americans.

    PubMed

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

    2008-01-01

    The prevalence of Prolonged Grief Disorder (PGD) in non-Whites is currently unknown. This study was performed to explore the prevalence of PGD in African Americans (AAs). Multivariable analysis of two studies of recently bereaved individuals found AAs to have significantly higher rates of PGD than Whites (21% [14 of 66] vs. 12% [55 of 471], respectively; p = 0.03). Experiencing a loved one's death as sudden or unexpected was also significantly associated with PGD over and above the effects of race/ethnicity. AAs may be at increased risk for the development of PGD. The development of effective interventions to treat PGD highlights the need to identify high-risk individuals and refer them to therapy and suggests the potential need for such therapies to adopt culturally sensitive approaches to care.

  18. Pregnancy Complications

    MedlinePlus

    ... To receive Pregnancy email updates Enter email Submit Pregnancy complications Complications of pregnancy are health problems that ... pregnancy. Expand all | Collapse all Health problems before pregnancy Before pregnancy, make sure to talk to your ...

  19. Adenosine-induced torsade de pointes complicating a fractional flow reserve measurement in a right coronary artery intermediate stenosis.

    PubMed

    Piccolo, Raffaele; Niglio, Tullio; Di Gioia, Giuseppe; D'Anna, Carolina; De Rosa, Roberta; Strisciuglio, Teresa; Trimarco, Bruno; Piscione, Federico; Galasso, Gennaro

    2013-01-01

    We present the case of a 57 year-old patient that presented to our Institution with a positive treadmill stress test. Coronary angiography revealed an intermediate stenosis of the right coronary artery evaluated with a fractional flow reserve (FFR), complicated by torsade de pointes. Despite this being a very rare arrhythmic complication during FFR, its prompt recognition and treatment are of utmost importance.

  20. Perspectives of US Direct Care Workers on the Grief Process of Persons with Intellectual and Developmental Disabilities: Implications for Practice

    ERIC Educational Resources Information Center

    Gray, Jennifer A.; Abendroth, Maryann

    2016-01-01

    Background: The study explored the grief process of persons with intellectual and developmental disabilities (PWIDDs) as perceived by direct care workers (DCWs) and how such workers can guide and support PWIDDs experiencing grief. Materials and Methods: A thematic analysis approach was used to examine data from nine focus groups with 60 DCWs from…

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

    ERIC Educational Resources Information Center

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

    2007-01-01

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

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

    ERIC Educational Resources Information Center

    Hedman, A. S.

    2012-01-01

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

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

    ERIC Educational Resources Information Center

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

    2014-01-01

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

  4. Tibetan Buddhism and the resolution of grief: the Bardo-thodol for the dying and the grieving.

    PubMed

    Goss, R E; Klass, D

    1997-01-01

    This article is a contribution to the cross-cultural study of grief. The Bardo-thodol (sometimes translated the Tibetan Book of the Dead) and the ritual associated with it provides a way to understand how Buddhism in Tibetan culture manages the issues associated with what is called grief in Western psychology. The resolution of grief in the survivors is intertwined with the journey to rebirth of the deceased. The present article describes (a) the progression of the deceased, (b) the rituals by which survivors separate from the physical incarnation of the deceased, (c) how, by channeling the feelings of grief to support the progress of the deceased, grief is brought to a positive resolution, and (d) the continuing bond survivors maintain with the dead even though the dead has moved on to the next life.

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

    PubMed

    Schaal, Susanne; Elbert, Thomas; Neuner, Frank

    2009-01-01

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

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

    PubMed Central

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

    2015-01-01

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

  7. Empathy and silence in pastoral care for traumatic grief and loss.

    PubMed

    Capretto, Peter

    2015-02-01

    This paper evaluates silence as a therapeutic practice in pastoral care for traumatic grief and loss. Informed by the history of attachment and mourning theory, its research considers the basic effect that empathy has upon the therapeutic relationship around psychic difference. The study appraises the potential resources and detriments that empathic language may have for the grief process. Offering clinical examples in hospice chaplaincy, it refutes the idea that silence is formulaic tool to be used. It instead offers silence as the acceptance of the limits of empathic language and the affirmation of psychological difference and theological wholeness.

  8. Before Kubler-Ross: lessons about grief from the book of Job.

    PubMed

    Lyon, D S

    2000-07-01

    Medicine is as old as the human species, and medical literature is among the earliest writing. Current research is of great help in identifying new interventions, but a great deal of the art of medicine is showcased in ancient works. The 20th century saw a plethora of books, articles, and monographs on the subjects of grief, death and dying, and suffering, but none of these has provided greater insight than the biblical book of Job. Excerpts from Job illustrate both the nature of grief and appropriate intervention when it is confronted.

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

    NASA Astrophysics Data System (ADS)

    Bakioğlu, Burcu S.

    2012-12-01

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

  10. Grief and older people: the making or breaking of emotional bonds following partner loss in later life.

    PubMed

    Costello, J; Kendrick, K

    2000-12-01

    The aim of this ethnographic study was to explore retrospectively the grief experiences of 12 older people whose partners had recently died in hospital, following a period of terminal illness. The rationale was based upon developing an understanding of the grief experiences of newly bereaved older people. In doing so, it is important to consider that grief is not only shaped by culture and social context but also by the nature of the relationship between the mourner and the deceased. For most of this century, the dominant conceptualization relating to grief and the social experience of bereavement has been based on the psychoanalytical school of thought. This process is said to involve the mourner passing through a number of stages or phases and forms the basis of the 'grief work hypothesis'. Using in-depth ethnographic interviews, the mourner's reactions to and perceptions of the loss were explored. Tape-recorded interview data were analysed using the inductive process of both content analysis and discourse evaluation. The findings from this study shed light on an area of conjugal bereavement that has received little attention in the past and challenges traditional models of grief. The indications are that in the first year of bereavement, the bereaved retain and modify the emotional relationship with their deceased partners, through a range of symbolic behaviours. The discussion raises issues concerning the need to consider the extent to which contemporary conceptualizations of grief explain the reactions of older people whose grief experiences are shaped by their social situation. The study also highlights important issues concerning the need to understand the complexity of grief experiences and bereavement support for older people which has a number of implications for nurses in both hospital and community settings.

  11. Representations of African Americans in the Grief and Mourning Literature from 1998 to 2014: A Systematic Review.

    PubMed

    Granek, Leeat; Peleg-Sagy, Tal

    2015-01-01

    The authors examined representations of African Americans in the grief literature to assess (a) frequencies; (b) content; and (c) use of universalist or a contextualized framework. They conducted searches in 3 databases that target the grief literature published in the last 15 years. Fifty-nine articles met the criteria. There are a small number of studies published on African Americans and these tend to focus on homicide. Many studies had incomplete methods. Comparison studies were common and pathological grief outcomes that were validated on White populations were used as outcome variables with African American participants.

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

    PubMed Central

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

    2015-01-01

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

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

    ERIC Educational Resources Information Center

    Penzo, Jeanine A.; Harvey, Pat

    2008-01-01

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

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

    ERIC Educational Resources Information Center

    Granek, Leeat

    2013-01-01

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

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

    ERIC Educational Resources Information Center

    Camp, Delpha; Bolton, Christopher

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

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

    ERIC Educational Resources Information Center

    Schneider, Katherine Standish

    2005-01-01

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

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

    ERIC Educational Resources Information Center

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

    2009-01-01

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

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

    ERIC Educational Resources Information Center

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

    2006-01-01

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

  19. Similarities and differences in couples' grief reactions following a miscarriage: results from a longitudinal study.

    PubMed

    Beutel, M; Willner, H; Deckardt, R; Von Rad, M; Weiner, H

    1996-03-01

    Recent studies have documented grief and depressive reactions in women after a miscarriage. However, the men's reactions to their partner's experience have been neglected. In a controlled follow-up study, 56 couples were studied shortly after the miscarriage, and 6 (N = 47) and 12 months later (N = 45). The participants completed standardized questionnaires for depression, physical complaints, anxiety, and grief. Contrary to commonly held beliefs, men do grieve, but less intensely and enduringly than their partners. The manner in which they experience their grief is similar to that of the women, except that the men cry less and feel less need to talk about it. Unlike the women they do not react with an increased depressive reaction (compared to age- and sex-matched community control groups). Giving up their personal expectations, hopes for, and fantasies about the unborn child is a major source of grieving for both. Some men feel burdened by their wives' grief or depressive reactions. Conflicting reactions may affect the couples' interactions and promote depressive reactions in the women.

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

    ERIC Educational Resources Information Center

    Brabant, Sarah

    1990-01-01

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

  1. Do Incarcerated Offenders Experience the Five Stages of Grief as Do Terminally Ill Patients?

    ERIC Educational Resources Information Center

    Pledger, Carolyn Brastow

    1985-01-01

    Examines Kubler-Ross' five stages of grief (denial, anger, bargaining, depression, acceptance) as they are experienced not by terminally ill persons, but by 20 criminal offenders and their families during incarceration. Concludes that shock of arrest and incarceration stimulates reactions similar to those of persons coping with terminal diagnosis.…

  2. Grief, Anger, Social Action: Experiences of the Windsor Chapter, Mothers against Drunk Driving (MADD).

    ERIC Educational Resources Information Center

    Kroeker, B. J.; And Others

    1994-01-01

    The experiences of the Windsor, Ontario, Canada, chapter of Mothers Against Drunk Driving (MADD), in its development and progress through the grief-anger-social action continuum, are described. This article also portrays a model for problem resolution which emphasizes incorporating the respective strengths and efficiencies of self-help groups and…

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

    ERIC Educational Resources Information Center

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

    2005-01-01

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

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

    ERIC Educational Resources Information Center

    Sveen, Carl-Aksel; Walby, Fredrik A.

    2008-01-01

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

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

    ERIC Educational Resources Information Center

    Holley, Caitlin K.; Mast, Benjamin T.

    2009-01-01

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

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

    ERIC Educational Resources Information Center

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

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

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

    ERIC Educational Resources Information Center

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

    2012-01-01

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

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

    ERIC Educational Resources Information Center

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

    2012-01-01

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

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

    ERIC Educational Resources Information Center

    Charkow, Wendy B.

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

  10. Complications in percutaneous nephrolithotomy.

    PubMed

    Kyriazis, Iason; Panagopoulos, Vasilios; Kallidonis, Panagiotis; Özsoy, Mehmet; Vasilas, Marinos; Liatsikos, Evangelos

    2015-08-01

    Percutaneous nephrolithotomy (PCNL) is generally considered a safe technique offering the highest stone-free rates after the first treatment as compared to the other minimal invasive lithotripsy techniques. Still, serious complications although rare should be expected following this percutaneous procedure. In this work, the most common and important complications associated with PCNL are being reviewed focusing on the perioperative risk factors, current management, and preventing measures that need to be taken to reduce their incidence. In addition, complication reporting is being criticized given the absence of a universal consensus on PCNL complications description. Complications such as perioperative bleeding, urine leak from nephrocutaneous fistula, pelvicalyceal system injury, and pain are individually graded as complications by various authors and are responsible for a significant variation in the reported overall PCNL complication rate, rendering comparison of morbidity between studies almost impossible. Due to the latter, a universally accepted grading system specialized for the assessment of PCNL-related complications and standardized for each variation of PCNL technique is deemed necessary.

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

    PubMed Central

    2014-01-01

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

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

    PubMed

    Doran, Gerry; Downing Hansen, Nancy

    2006-04-01

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

  13. Disenfranchised grief following African American Homicide loss: an inductive case study.

    PubMed

    Piazza-Bonin, Elizabeth; Neimeyer, Robert A; Burke, Laurie A; McDevitt-Murphy, Meghan E; Young, Amanda

    2015-01-01

    Disenfranchised grief is experienced when a mourner's grief response is socially invalidated, unacknowledged, or discouraged. When the circumstances of death or the emotional reactions of the griever violate social norms, empathic failures can occur within the bereaved individual's support systems. This study used conventional content analysis, an intensive and inductive qualitative research method, to analyze the experience of one African American woman who lost her only son to homicide, a particularly distressing and marginalized form of loss. Results elucidate both the empathic failings and resiliencies within the social systems of this griever and emerged from the perspectives offered by the bereaved mother and her primary supporter. Clinical implications and suggestions for future research are discussed.

  14. Let me hear of your mercy in the mourning: forgiveness, grief, and continuing bonds.

    PubMed

    Gassin, Elizabeth A; Lengel, Gregory J

    2014-01-01

    Clarity about the utility of continuing bonds (CB) continues to be evasive in the research. In 2 different correlational studies, the authors explored the relationship between CB and 2 other variables: 1 representing mental health (forgiveness of the deceased) and the other representing psychological distress (prolonged grief). Although researchers have addressed the latter relationship in the literature, assessing the relationship between CB and forgiveness has not been undertaken. Results suggest that forgiveness in general, and affective aspects of forgiveness in particular, predict psychological forms of CB. Results related to grief depended on how CB was assessed. These findings provide evidence of the relative health of certain types of relationship with deceased persons and also suggest that forgiveness interventions may be a way of promoting such healthy bonds.

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

    PubMed

    Gilrane-McGarry, Ursula; O Grady, Tom

    2012-04-01

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

  16. Dealing with stress, burnout, and grief in the practice of oncology.

    PubMed

    Lyckholm, L

    2001-12-01

    There is a substantial amount of published work describing how to help patients and families deal with stress, grief, and loss, but there is much less advice available for clinicians dealing with similar issues. Working as an oncologist is inherently difficult, and racked by emotional and psychological traumas. However, it can also be tremendously rewarding. In this review, I discuss the extent of stress and burnout in the practice of oncology, its causes and manifestations, and strategies for overcoming it.

  17. Erotic complications.

    PubMed

    Slochower, J

    1999-12-01

    The author argues that erotic transference-countertransference dynamics present particular complexities when they develop between gender constellations other than male analyst and female patient. She addresses the dynamics of a complicated erotic transference in concert with an aversive countertransference response as it evolved between a female analyst and female patient. The intense erotic transference that developed defied classification as either maternallerotic or oedipallerotic, and instead included both features in a rapidly shifting process that was difficult to address analytically. The analyst's confused, often aversive, response to her patient's erotic wishes ultimately revealed a subtle re-enactment involving split-off and erotised experiences of emotional penetration and scrutiny. When these issues were addressed, the erotic transference dissolved, and the analyst's experience of her patient shifted rather dramatically. It is suggested that complex erotic transference sometimes contains within it evidence of previously repressed object experiences that were not primarily sexual in nature.

  18. Neurologic complications of vaccinations.

    PubMed

    Miravalle, Augusto A; Schreiner, Teri

    2014-01-01

    This chapter reviews the most common neurologic disorders associated with common vaccines, evaluates the data linking the disorder with the vaccine, and discusses the potential mechanism of disease. A literature search was conducted in PubMed using a combination of the following terms: vaccines, vaccination, immunization, and neurologic complications. Data were also gathered from publications of the American Academy of Pediatrics Committee on Infectious Diseases, the World Health Organization, the US Centers for Disease Control and Prevention, and the Vaccine Adverse Event Reporting System. Neurologic complications of vaccination are rare. Many associations have been asserted without objective data to support a causal relationship. Rarely, patients with a neurologic complication will have a poor outcome. However, most patients recover fully from the neurologic complication. Vaccinations have altered the landscape of infectious disease. However, perception of risk associated with vaccinations has limited the success of disease eradication measures. Neurologic complications can be severe, and can provoke fear in potential vaccines. Evaluating whether there is causal link between neurologic disorders and vaccinations, not just temporal association, is critical to addressing public misperception of risk of vaccination. Among the vaccines available today, the cost-benefit analysis of vaccinations and complications strongly argues in favor of vaccination.

  19. Metabolomics in diabetic complications.

    PubMed

    Filla, Laura A; Edwards, James L

    2016-04-01

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

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

    PubMed

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

    2013-09-01

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

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

    PubMed Central

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

    2015-01-01

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

  2. Hypoglycemia: The neglected complication

    PubMed Central

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

    2013-01-01

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

  3. [Mechanical complication of central venous catheterization].

    PubMed

    Koja, Hiroki; Tokumine, Joho; Sugahara, Kazuhiro

    2007-01-01

    Central venous catheterization is a procedure with a high success rate. However, life-threatening complications are occasionally caused by mechanical injury during the catheterization process. Therefore, surgeons should have sufficient knowledge of the potential complications and the effective use of preventative measures when performing catheterization. We herein review and discuss the mechanical complications previously reported to have occurred in association with central venous catheterization. Comprehensive knowledge about various complication-inducing factors, the ability to make a quick and accurate diagnosis of such complications, and sufficient skill to prevent worsening of these complications can thus help patients from suffering lethal complications due to central venous catheterization.

  4. A Greek perspective on concepts of death and expression of grief, with implications for practice.

    PubMed

    Mystakidou, Kyriaki; Tsilika, Eleni; Parpa, Efi; Katsouda, Emmanuela; Vlahos, Lambros

    2003-12-01

    Death has been conceptualised in different ways by different cultures and civilizations. It is increasingly entering into the public consciousness and society is now more ready to discuss and lessen the fear of dying and grief than it has been in the past few decades. In Greece, by Classical times there was an increase in burial rituals and commemorative practices compared to earlier periods. When Christianity was introduced into Greece it attempted to change the way the dead were mourned, preaching immortality of the soul and resurrection of the dead. Nevertheless, the way people grieve and bury their dead in Greece has not changed greatly since before the introduction of Christianity, except for the difficulty experienced in witnessing burial procedures observed in the large cities. Burial and bereavement traditions were introduced to help Greeks cope with death and bereavement. In Greece today beliefs about grief and death are based both on the ancient and the Christian Orthodox traditions. Healthcare professionals need to develop cultural competence to improve nursing and future health care. If care is culturally informed and tailored its quality is improved.

  5. Cognitive behavioral variables mediate the associations of neuroticism and attachment insecurity with Prolonged Grief Disorder severity.

    PubMed

    Boelen, Paul A; Klugkist, Irene

    2011-05-01

    Prolonged Grief Disorder (PGD) is a debilitating syndrome of grief. A recent cognitive behavioral model asserts that three processes are critical to this condition: (1) insufficient integration of the loss with autobiographical knowledge about the self and the lost person; (2) negative cognitions; and (3) anxious and depressive avoidance behaviors. These processes are assumed to contribute to PGD symptoms and to mediate the influence of personality-related vulnerabilities on the development and maintenance of these symptoms. The present study examined the mediational role of these three processes in the linkage between neuroticism, attachment anxiety, and attachment avoidance on the one hand and PGD symptom severity on the other hand. Self-reported data from 348 bereaved people were used. The results showed that the three personality variables were significantly associated with PGD symptom severity. Moreover, the results provided support for the mediating effects of indices of insufficient integration, negative cognitions, as well as avoidance behaviors - even after controlling for the shared variance between mediators. Theoretical and clinical implications are discussed.

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

    PubMed

    Courtney, Jeanne

    2008-01-01

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

  7. Unresolved grief in women and men in Sweden three years after undergoing unsuccessful in vitro fertilization treatment

    PubMed Central

    Volgsten, Helena; Skoog Svanberg, Agneta; Olsson, Pia

    2010-01-01

    Objective. To explore the experience of undergoing unsuccessful in vitro fertilization (IVF) treatment and of remaining childless 3 years after IVF in both women and men. Design. Qualitative-approach study. Sample. Ten women and nine men who had attended a public fertility clinic in Sweden. Methods. Individual qualitative semi-structured interviews were conducted with qualitative content analysis guiding the analysis. Results. Three years after the end of IVF treatment, most men and women were still processing and had not adapted to childlessness, indicating that the grieving process was unresolved. Unsuccessful IVF was experienced by women in terms of grief, whereas men took upon themselves a supportive role and did not express grief. A need for professional support and counseling in how to handle grief was described. An unstructured end after IVF treatment left unanswered questions. Conclusions. The grieving process after unsuccessful IVF treatment was hampered among both men and women. The provision of additional individual support during IVF is recommended as men and women experienced childlessness differently. Support and counseling concerning grief reactions following IVF failure, and a structured final consultation after IVF may facilitate the grieving process after undergoing unsuccessful IVF treatment. PMID:20846062

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

    ERIC Educational Resources Information Center

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

    2008-01-01

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

  9. Grief Reactions and Depression in Caregivers of Individuals with Alzheimer's Disease: Results from a Pilot Study in an Urban Setting

    ERIC Educational Resources Information Center

    Sanders, Sara; Adams, Kathryn Betts

    2005-01-01

    The relationship between grief and depression in caregivers of individuals with Alzheimer's disease has not been clearly defined through empirical research. This pilot study examined the relationship between these two variables and determined the strength of their relationship. A racially diverse sample of caregivers was drawn from an urban…

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

    ERIC Educational Resources Information Center

    Kelley, Melissa M.; Chan, Keith T.

    2012-01-01

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

  11. Assessing the role of attachment to God, meaning, and religious coping as mediators in the grief experience.

    PubMed

    Kelley, Melissa M; Chan, Keith T

    2012-03-01

    Research has examined the relationship of styles of attachment to others and meaning with grief and the stress-related growth process. Less has been written on styles of attachment to God and patterns of religious coping and how these constructs may impact adjustment in persons dealing with loss. This study examines the roles of attachment to God, meaning, and religious coping as mediators in the grief experience for a sample of 93 individuals who experienced a significant death in the prior year. Results suggest that a more secure style of attachment to God was directly and indirectly associated with lower depression and grief and increased stress-related growth for this sample. Meaning, defined as a sense of purpose and coherence, also emerged as an important construct in this process. Overall goodness-of fit statistics were examined for competing models using structural equation modeling. Secure attachment to God, meaning, and positive religious coping were found to have significant direct and indirect effects on grief and stress-related growth. For some individuals, attachment to God may be an important construct in the experience of meaning following a significant death and may have tremendous potential in its direct and indirect effects on overall outcomes.

  12. Master's Students' Self-Assessment of Competency in Grief Education and Training in CACREP-Accredited Counseling Programs

    ERIC Educational Resources Information Center

    Wood, Jane E.

    2016-01-01

    Counseling can promote positive outcomes for grieving clients by addressing personal loss and helping the client process their grief. However, a lack of understanding on the part of counselors of how people grieve may result in negative client outcomes such as psychological stress, poor health, or an increased risk of depression. Education and…

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

    ERIC Educational Resources Information Center

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

    2016-01-01

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

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

    ERIC Educational Resources Information Center

    Zinner, Ellen S.; And Others

    1991-01-01

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

  15. Pleuropulmonary complications of pancreatitis

    PubMed Central

    Kaye, Michael D.

    1968-01-01

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

  16. Persistent grief in the aftermath of mass violence: the predictive roles of posttraumatic stress symptoms, self-efficacy, and disrupted worldview.

    PubMed

    Smith, Andrew J; Abeyta, Andrew A; Hughes, Michael; Jones, Russell T

    2015-03-01

    This study tested a conceptual model merging anxiety buffer disruption and social-cognitive theories to predict persistent grief severity among students who lost a close friend, significant other, and/or professor/teacher in tragic university campus shootings. A regression-based path model tested posttraumatic stress (PTS) symptom severity 3 to 4 months postshooting (Time 1) as a predictor of grief severity 1 year postshootings (Time 2), both directly and indirectly through cognitive processes (self-efficacy and disrupted worldview). Results revealed a model that predicted 61% of the variance in Time 2 grief severity. Hypotheses were supported, demonstrating that Time 1 PTS severity indirectly, positively predicted Time 2 grief severity through undermining self-efficacy and more severely disrupting worldview. Findings and theoretical interpretation yield important insights for future research and clinical application.

  17. The immunological and psychological effects of bereavement: does grief counseling really make a difference? A pilot study.

    PubMed

    Beem, E E; Hooijkaas, H; Cleiren, M H; Schut, H A; Garssen, B; Croon, M A; Jabaaij, L; Goodkin, K; Wind, H; de Vries, M J

    1999-01-18

    This study evaluates psychological and immunological functioning after bereavement and the influence of group counseling. Eighteen widows (bereaved within 3 months of enrolment) and a reference group of 10 married control subjects were asked to fill in self-report scales and to donate a blood sample (T1). After T1, half of the widows (the experimental group) were randomly assigned to grief counseling (13 sessions over 4 months), while the other subjects (the control group) received no treatment. Seven months after bereavement (T2) or, in the case of the experimental group, immediately after the intervention, a follow-up was conducted in the widowed subsample using the same measures. Blood samples were analyzed to determine the total number of white blood cells, number of lymphocyte subsets, natural killer cell activity (NKCA) and lymphocyte proliferative response to phytohemagglutinin (PHA), anti-CD3 and pokeweed mitogen (PWM). At T1, we found significant differences between widows and non-widows regarding both psychological and immunological measures. Widows felt more anxious, depressed, hostile and agoraphobic. At T1, widows had a lower number of the CD19+CD5+ B cell subpopulation. The cell function tests for T and B cells showed higher responses in widows (lymphocyte proliferation response to PHA, anti-CD3 and PWM). No significant difference in NKCA was found between widows and non-widows. At T2, there appeared to be no significant difference between widows and non-widows on the psychological measures. With respect to the immunological measures, widows and non-widows showed no significant differences for the total number of white blood cells, number of lymphocyte subsets and NKCA. Consistent with our findings at T1, the lymphocyte proliferation response to PHA, anti-CD3 and PWM at T2 appeared to be higher in widows than in non-widows. Comparing the experimental group (widows) and the control group (widows) with respect to psychological measures at T1, widows in

  18. Prolonged grief following the recent death of a daughter among mothers who experienced distal losses during the Khmer Rouge era: Validity of the prolonged grief construct in Cambodia.

    PubMed

    Field, Nigel P; Strasser, Judith; Taing, Sopheap; Horiuchi, Shoko; Chhim, Sotheara; Packman, Wendy

    2014-09-30

    This study addressed the validity of the prolonged grief (PG) construct in a Cambodian context. Eighty mothers who lost a young adult daughter stemming from a crowd stampede incident during the annual water festival were interviewed at the six-month post-loss point along with a control group of similarly aged women who were not recently bereaved. Both groups were assessed for PG, PTSD, anxiety, and depression symptoms and well as for the number of distal losses experienced during the Khmer Rouge (KR) regime - knowing that all the women were old enough to have lived through the KR regime. Support for the discriminant validity of PG was shown in a factor analysis in which its core symptoms were distinguished from anxiety, depression, and PTSD symptoms. Also, support was found for its incremental validity as shown in the unique sensitivity of PG in distinguishing the two groups when controlling for the other symptoms. Lastly, a positive relationship was found between the number of distal deaths experienced during the KR regime and PG symptom severity among the group of recently bereaved mothers, providing support for the predictive validity of PG. Implications as well as study limitations are discussed.

  19. Complications of multiple myeloma.

    PubMed

    Bladé, Joan; Rosiñol, Laura

    2007-12-01

    Multiple myeloma, also known as myeloma or plasma cell myeloma, is a progressive hematologic disease. Complications of multiple myeloma include renal insufficiency, hematologic complications (anemia, bone marrow failure, bleeding disorders), infections, bone complications (pathologic fractures, spinal cord compression, hyercalcemia), and neurologic complications (spinal cord and nerve root compression, intracranial plasmacytomas, leptomeningeal involvement, among others). This article reviews these various complications connected to multiple myeloma, examining their various causes and possible treatment.

  20. 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.

  1. Central line complications

    PubMed Central

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

    2015-01-01

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

  2. Confronting Grief.

    ERIC Educational Resources Information Center

    Bensley, Loren B.; Bertsch, Donald P.

    1987-01-01

    Since no school district is immune to death, the concepts of death and dying, stress management, and suicide should be worked into the curriculum beginning in the fourth grade. Advice is given concerning planning for potential tragedy, responding to a student's or staff member's death, and establishing memorials. Two figures cite teenage suicide…

  3. Effectiveness of a trauma/grief-focused group intervention: a qualitative study with war-exposed Bosnian adolescents.

    PubMed

    Cox, Jonathan; Davies, D Rob; Burlingame, Gary M; Campbell, J Eric; Layne, Christopher M; Katzenbach, R Jason

    2007-07-01

    The effectiveness and impacts of a school-based, trauma/grief-focused group treatment program for war-exposed youth in Bosnia and Herzegovina were investigated using semistructured focus groups, conducted separately for students and their school counselor group leaders. Overall, students' and leaders' evaluations of the groups were generally positive. General themes of outcomes and impacts perceived by students and group leaders include: acquisition of coping skills and attitudes, willingness to advocate for peers, improved interpersonal relationships, negative impacts, general positive impacts, impacts in the schools, impacts on the group and logistics of the program, and broader impacts on the perception of mental health in the community. The broad positive impacts of this program suggest that trauma/grief-focused group treatment intervention programs targeting trauma-exposed youth may be effective on multiple levels with war-exposed youth and their communities.

  4. Intestinal Complications of IBD

    MedlinePlus

    ... that only affects the colon). LOCAL COMPLICATIONS OF CROHN’S DISEASE INTESTINAL OBSTRUCTION The most common complication of Crohn’s disease, obstruction may arise from swelling and the formation ...

  5. Complications of Sinusitis

    MedlinePlus

    ... A Complications of Sinusitis Epistaxis (Nosebleeds) Allergic Rhinitis (Hay Fever) Headaches and Sinus Disease Disorders of Smell & Taste ... A Complications of Sinusitis Epistaxis (Nosebleeds) Allergic Rhinitis (Hay Fever) Headaches and Sinus Disease Disorders of Smell & Taste ...

  6. Skin Complications of IBD

    MedlinePlus

    ... Home > Resources > Skin Complications of IBD Go Back Skin Complications of IBD Email Print + Share After arthritis, ... about 5% of people with inflammatory bowel disease. SKIN DISORDERS COMMONLY SEEN IN IBD ERHTHEMA NODOSUM The ...

  7. Eye Complications in IBD

    MedlinePlus

    ... Home > Resources > Eye Complications in IBD Go Back Eye Complications in IBD Email Print + Share Approximately 10% ... doctor’s attention sooner rather than later. TYPES OF EYE DISORDERS UVEITIS One of the most common eye ...

  8. Extraintestinal Complications: Kidney Disorders

    MedlinePlus

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

  9. Pregnancy Complications: Anemia

    MedlinePlus

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

  10. Pregnancy Complications: Liver Disorders

    MedlinePlus

    ... X Home > Complications & Loss > Pregnancy complications > Liver disorders Liver disorders Now playing: E-mail to a friend ... have blood on them (razors, toothbrushes). Acute fatty liver of pregnancy What is acute fatty liver of ...

  11. Complications of endoscopic ultrasonography.

    PubMed

    Fabbri, C; Luigiano, C; Cennamo, V; Ferrara, F; Pellicano, R; Polifemo, A M; Tarantino, I; Barresi, L; Morace, C; Consolo, P; D'Imperio, N

    2011-06-01

    Since its development in the 1980s, endoscopic ultrasonography (EUS) has undergone a great deal of technological modifications. EUS has become an important tool in the evaluation of patients with various clinical disorders and is increasingly being utilized in many centers. EUS has been evolving over the years; EUS-guided fine needle aspiration (FNA) for cytological and/or histological diagnosis has become standard practice and a wide array of interventional and therapeutic procedures are performed under EUS guidance for diseases which otherwise would have needed surgery, with its associated morbidities. EUS shares the risks and complications of other endoscopic procedures. This article addresses the specific adverse effects and risks associated with EUS, EUS-FNA and interventional EUS, namely perforation, bleeding, pancreatitis and infection. Measures to help minimizing these risks will also be discussed.

  12. Complications of Strabismus Surgery

    PubMed Central

    Olitsky, Scott E.; Coats, David K.

    2015-01-01

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

  13. Complications of mandibular fractures.

    PubMed

    Zweig, Barry E

    2009-03-01

    Before any definitive treatment of mandibular fractures, the patient needs to be evaluated for more potentially life-threatening injuries. Complications can and do occur with treatment of mandibular fractures and can occur during any of the phases of treatment. The development of an accurate diagnosis and appropriate treatment plan is vital in achieving optimal success and decreasing complications. Knowledge of the anatomy and the principles of bone healing is also an important factor in preventing complications. To limit long-term untoward effects, complications should be recognized early and the appropriate treatment should be started before a minor complication becomes a complex one that is more difficult to manage.

  14. Complications of prostate biopsy.

    PubMed

    Anastasiadis, Anastasios; Zapała, Lukasz; Cordeiro, Ernesto; Antoniewicz, Artur; Dimitriadis, Georgios; De Reijke, Theo

    2013-07-01

    Biopsy of the prostate is a common procedure with minor complications that are usually self-limited. However, if one considers that millions of men undergo biopsy worldwide, one realizes that although complication rate is low, the number of patients suffering from biopsy complications should not be underestimated and can be a clinically relevant problem for healthcare professionals. In this review, the authors present diagnosis and management of postbiopsy of prostate complications. Bleeding is the most common complication observed after prostate biopsy, but the use of aspirin or nonsteroidal anti-inflammatory drugs is not an absolute contraindication to prostate biopsy. Emerging resistance to ciprofloxacin is the most probable cause of the increasing risk of infectious complications after prostate biopsy. Even though extremely rare, fatal complications are possible and were described in case reports.

  15. Narrative reconstruction therapy for prolonged grief disorder—rationale and case study

    PubMed Central

    Peri, Tuvia; Hasson-Ohayon, Ilanit; Garber, Sharon; Tuval-Mashiach, Rivka; Boelen, Paul A.

    2016-01-01

    Background Prolonged grief disorder (PGD) is a potentially disabling condition affecting approximately 10% of bereaved people. It has been suggested that the impaired integration of the loss memory, as expressed in recurrent memories of the loss and disorganization of memory, is involved in the development of PGD. Narrative reconstruction (NR), originally designed for the treatment of posttraumatic stress disorder (PTSD) in an integrative therapy module, and consisting of exposure to the loss memory, detailed written reconstruction of the loss memory narrative and an elaboration of the personal significance of that memory for the bereaved, has been shown to be effective in the treatment of intrusion symptoms. Objective In light of findings that cognitive behavior therapy (CBT), including cognitive restructuring and exposure, is effective in the treatment of PGD, we suggest the implementation of a somewhat novel therapy module, NR, for the treatment of intrusive phenomena in bereaved patients. Method The rationale for the implementation of NR for PGD and a case study of the treatment of a woman suffering from PGD after the death of her father are presented. Therapy took place in a university outpatient training clinic. Results Evaluations conducted before and after treatment and at a 3-month follow-up demonstrated the effectiveness of NR in reducing symptoms of PGD and depression. The analysis of spontaneous narratives recorded before and after treatment showed an increased organization of the narratives. Conclusions This case report demonstrates an adaptation of NR for the treatment of PGD. The results provide preliminary support for the effectiveness of NR for PGD. The significance of the study and its limitations are discussed. Highlights of the article Prolonged grief disorder (PGD) affects approximately ten percent of bereaved people. Narrative Reconstruction (NR), an integrative therapy module originally used for PTSD patients, was adapted for PGD. NR consists

  16. Surgical Complications of Gynecologic Surgery

    PubMed Central

    Weekes, Leroy R.; Gandhi, Shobhana Anil; Gandhi, Anil Krishnakumar

    1977-01-01

    Complications of gynecological surgery are considerable and when reviewed in detail are almost frightening. There is no substitute for experience and intimate knowledge of the intricate pelvic structures in health and disease. Anyone who is active in the field is sooner or later going to experience some difficulty whether it be due to his miscalculation or to innate conditions in the patient which are beyond his/her control. It is the responsibility of the pelvic surgeon to recognize the complication and apply proper corrective measures. The patient should not be given false hopes of sure success nor should she be deprived of whatever hope for success does exist. PMID:572875

  17. Complications of Rhinitis.

    PubMed

    Keswani, Anjeni; Peters, Anju T

    2016-05-01

    Chronic rhinitis involves inflammation of the upper airways. An association with comorbid conditions, such as rhinosinusitis, asthma, and chronic obstructive pulmonary disease, has been commonly observed in epidemiologic studies. The underlying pathogenesis of these disorders may be similar. Complications of rhinitis include sleep disturbances, learning impairment, and decreased quality of life. It is vital to recognize the complications of rhinitis so that treatment strategies can address rhinitis as well as its comorbidities and complications in a coordinated manner.

  18. The postanesthetic period. Complications.

    PubMed

    Malamed, S F

    1987-01-01

    Postanesthetic complications can occur even in the best of circumstances. Proper preparation of the staff, aggressive monitoring of the recovering patient, and early recognition and management of the complications are essential if the outcome is to be successful. In reviewing postanesthetic complications, two factors are present in the overwhelming majority of situations--hypoxia and hypercarbia--often the direct result of inadequate monitoring during the postanesthetic period. The anesthetic procedure is not over once the anesthetic agents are discontinued. The skillful anesthetist is aware of the possibilities of postoperative complications and prevents problems by employing enhanced monitoring techniques during the recovery phase.

  19. Postpancreatectomy Complications and Management.

    PubMed

    Malleo, Giuseppe; Vollmer, Charles M

    2016-12-01

    Although mortality rates after pancreatectomy have decreased, the incidence of postoperative morbidity remains high. The major procedure-related complications are pancreatic fistula, delayed gastric emptying, and postpancreatectomy hemorrhage. The International Study Group of Pancreatic Surgery defined leading complications in a standardized fashion, allowing unbiased comparison of operative results and management strategies. Risk factors for postoperative complications have been investigated and quantitative scoring systems established to estimate patient-specific risks. Management of postpancreatectomy complications has shifted from an operative to a conservative approach. Nevertheless, postoperative morbidities may have a profound impact on patient recovery and length of hospital stay and are associated with increased hospital costs.

  20. [Complications of body piercing].

    PubMed

    Friedrich, L; Madrid, C; Odman-Jaques, M; Yersin, B; Carnon, P N

    2014-03-19

    The trend of body piercing has grown in popularity in the past decade within the general population and especially among young adults. Complications of body piercing include local inflammation and infections, but severe complications are also possible and largely underestimated. People are usually not aware of the risks before making a piercing, and their medical history, medication and comorbidities are largely neglected by the people who realise the piercing. This article presents a review of the complications that a primary care physician may observe, for a patient who wishes to make a piercing, or presents complications due to the implementation of such a device.

  1. Neurologic Complications and Treatment.

    PubMed

    Welch, Kevin C

    2015-10-01

    Risk is inherent with all surgical procedures. Most endoscopic sinus surgery (ESS) is uncomplicated. Among the many complications inherent with ESS are the neurologic complications, which include cerebrospinal fluid rhinorrhea, traumatic soft tissue and vascular injuries, infection, and seizures. Despite intense review of a patient's preoperative scans, use of stereotactic image guidance, and an expert understanding of anatomy, neurologic complications occur. An understanding of these complications and how to manage them can help to reduce long-term patient injury as well as help prevent recurrence.

  2. Music Therapy Helping to Work Through Grief and Finding a Personal Identity.

    PubMed

    Smeijsters; van Den Hurk J

    1999-01-01

    This article describes a qualitative single-case study of the treatment of a woman having problems with grief and finding a personal identity. In this case the treatment has been supported by research techniques like categorizing, developing themes, writing memos, member checking, peer debriefing, and triangulation. During treatment, diagnostic themes were generated such as: problems of identity, low self-esteem, a lack of assertiveness, and problems expressing feelings and problems in relationships. These themes became important along with feelings of depression which she experienced since the death of her beloved husband. The study describes how the client was able to express, in an unconscious way, a part of her personality, which she had been suppressing since childhood, through playing the piano and vocalizing during the music therapy process. The music therapist used several techniques of improvisation to support the client's cautious steps into a new musical and a new personal world. Tables of music therapy improvisations show how the client became musically expressive, how she found a personal melody and how she developed a closer relationship with the music therapist through musical interaction. Guidelines for similar cases and generated hypotheses about the contribution of music are enclosed as results of research.

  3. The AAP Resilience in the Face of Grief and Loss Curriculum.

    PubMed

    Serwint, Janet R; Bostwick, Susan; Burke, Ann E; Church, Annamaria; Gogo, Albina; Hofkosh, Dena; King, Marta; Linebarger, Jennifer; McCabe, Megan E; Moon, Margaret; Osta, Amanda; Rana, Deborah T; Sahler, O J; Smith, Keely; Rivera, Florence; Baldwin, Constance

    2016-11-01

    A career in pediatrics can bring great joy and satisfaction. It can also be challenging and lead some providers to manifest burnout and depression. A curriculum designed to help pediatric health providers acquire resilience and adaptive skills may be a key element in transforming times of anxiety and grief into rewarding professional experiences. The need for this curriculum was identified by the American Academy of Pediatrics Section on Medical Students, Residents and Fellowship Trainees. A working group of educators developed this curriculum to address the professional attitudes, knowledge, and skills essential to thrive despite the many stressors inevitable in clinical care. Fourteen modules incorporating adult learning theory were developed. The first 2 sections of the curriculum address the knowledge and skills to approach disclosure of life-altering diagnoses, and the second 2 sections focus on the provider's responses to difficult patient care experiences and their needs to develop strategies to maintain their own well-being. This curriculum addresses the intellectual and emotional characteristics patient care medical professionals need to provide high-quality, compassionate care while also addressing active and intentional ways to maintain personal wellness and resilience.

  4. The Unique Impact of Late-Life Bereavement and Prolonged Grief on Diurnal Cortisol

    PubMed Central

    2014-01-01

    Objectives. This study expands on previous research by examining the effects of prolonged grief disorder (PGD) symptoms and bereavement on diurnal cortisol patterns above and beyond depressive symptomatology. Methods. Drawing on information from 56 depressed older adults, 3 groups were compared: (1) a depressed nonbereaved group, (2) a depressed bereaved without elevated PGD symptoms group, and (3) a depressed bereaved with elevated PGD symptoms group. Multilevel modeling was used to examine differences in diurnal cortisol profiles between these 3 groups, controlling for demographic factors and depressive symptoms. Results. Results revealed that those who were bereaved had more dysregulated cortisol patterns, but PGD symptomatology seemed to have little effect. Subsidiary analysis with just the bereaved participants suggests that those who were recently widowed may have had greater cortisol dysregulation compared with other bereaved individuals in the sample. Discussion. These findings suggest that the circumstance of being bereaved may be associated with more dysregulated cortisol, regardless of PGD symptomatology. This pattern of results might reflect greater disturbance in daily routines among bereaved individuals and acute stress in the case of those experiencing the recent loss of a spouse, which leads to disruption in circadian rhythms and the diurnal cycle of cortisol. PMID:23740094

  5. The Journey through Grief: Insights from a Qualitative Study of Electronic Health Record Implementation

    PubMed Central

    McAlearney, Ann Scheck; Hefner, Jennifer L; Sieck, Cynthia J; Huerta, Timothy R

    2015-01-01

    Objective To improve understanding of facilitators of EHR system implementation, paying particular attention to opportunities to maximize physician adoption and effective deployment. Data Sources/Study Setting Primary data collected from 47 physician and 35 administrative key informants from six U.S. health care organizations identified because of purported success with EHR implementation. Study Design We conducted interviews and focus groups in an extensive qualitative study. Data Collection/Extraction Methods Verbatim transcripts were analyzed both deductively and inductively using the constant comparative method. Principal Findings Conceptualizing EHR adoption as loss through the lens of Kübler-Ross's five stages of grief model may help individuals and organizations more effectively orient to the challenge of change. Coupled with Kotter's eight-step change management framework, we offer a structure to facilitate organizations' movement through the EHR implementation journey. Combining insights from these frameworks, we identify 10 EHR strategies that can help address EHR implementation barriers. Conclusions Loss is one part of change often overlooked. Addressing it directly and compassionately can potentially facilitate the EHR implementation journey. We offer a summarized list of deployment strategies that are sensitive to these issues to support physician transition to new technologies that will bring value to clinical practice. PMID:25219627

  6. Care arrangement, grief, and psychological problems among children orphaned by AIDS in China

    PubMed Central

    Zhao, Guoxiang; Li, Xiaoming; Fang, Xiaoyi; Zhao, Junfeng; Yang, Hongmei; Stanton, Bonita

    2007-01-01

    The China Ministry of Health has estimated that there are at least 100,000 AIDS orphans in China. The UNICEF China Office estimates that between 150,000 and 250,000 additional children will be orphaned by AIDS over the next five years. However, limited data are available regarding the socio-demographic characteristics, care arrangement, barriers to appropriate grief resolution and psychological problems among AIDS orphans in China. In this article, we review secondary data and reports from scientific literature, government, non-governmental organizations, and public media regarding children orphaned by AIDS in China to address their living situation, bereavement process, and psychological problems. Our review suggests that AIDS orphans in China are living in a stressful environment with many orphans struggling with psychological problems and unmet basic needs such as food, shelter, education, and medical care. Based on our review, we suggest that future studies should address the psychosocial needs of AIDS orphans in China and develop health promotion programs to mitigate the negative impact of parental death on the physical and psychosocial well-being of these orphans. PMID:18058390

  7. A space for mothers: grief as identity construction on memorial websites created by SIDS parents.

    PubMed

    Finlay, Christopher J; Krueger, Guenther

    2011-01-01

    In this article we conduct a textual analysis of memorial websites created by mothers who have experienced a loss due to sudden infant death syndrome (SIDS). Using an online Internet ethnographic approach, we reviewed a series of 20 sites in an attempt to analyze the motivations of the site creators as manifested in their online projects. We spent time on the sites, moving through all facets of them, following links, and experiencing them the way a visitor would encounter them. In this virtual exploration we uncovered personal narratives, community building, religious imagery, and numerous examples of social networking. We also analyzed guest books in order to understand who visits these sites and their reasons for doing so. We conclude that development of these sites are a process that helps some mothers in their grief and gives them a focus and activity that is helpful and perhaps healing. More importantly perhaps is the potential for community building and networking that this type of activity allows. As an extension of a real-world memorial such as a gravesite, a virtual mourning space provides more in the way of these types of communications. Our work suggests that memorial websites constructed by SIDS parents help in meaning and identity reconstruction after loss.

  8. Is post-mortem harm possible? Understanding death harm and grief.

    PubMed

    Tomasini, Floris

    2009-10-01

    The purpose of this article is not to affirm or deny particular philosophical positions, but to explore the limits of intelligibility about what post-mortem harm means, especially in the light of improper post-mortem procedures at Bristol and Alder Hey hospitals in the late 1990s. The parental claims of post-mortem harm to dead children at Alder Hey Hospital are reviewed from five different philosophical perspectives, eventually settling on a crucial difference of perspective about how we understand harm to the dead. On the one hand there is the broadly 'analytical' tradition(1) of thinking that predicates the notion of harm on the basis of an existing subject. Since the dead are non-existent persons, it makes little sense to view the dead as being harmed. On the other hand, there is a phenomenological perspective, where the dead, in respect to the experience of grief, are existentially absent. This forms the basis that it is possible to harm grieving parent's experiences of how their dead are treated. The article ends with a short examination of what harming the dead implies for traditional bioethical concerns, namely, obtaining informed consent from significant others when planning medical research on the newly dead.

  9. Peritraumatic Distress and Dissociation in Prolonged Grief and Posttraumatic Stress Following Violent and Unexpected Deaths.

    PubMed

    Boelen, Paul A

    2015-01-01

    This study examined associations between the violence of a loss and the suddenness of a loss and symptom levels of prolonged grief disorder (PGD) and posttraumatic stress disorder (PTSD) after the death of a loved one. A further aim was to investigate whether peritraumatic distress (i.e., fear, helplessness, and horror) and peritraumatic dissociation mediate the emotional impact of violent losses and unexpected losses. We obtained self-reported data from 265 individuals bereaved in the previous 3 years by losses due to violent causes (17%) or illness (83%). Outcomes showed that participants who experienced violent losses (due to homicide, suicide, or accident) reported more PGD symptoms and PTSD symptoms compared to those confronted with illness loss. In this latter group, greater perceived unexpectedness was positively associated with PGD severity and PTSD severity. Multiple mediation analyses showed that the impact of violent loss and unexpectedness of the loss on PGD severity and PTSD severity was fully mediated by peritraumatic distress and dissociation; peritraumatic helplessness and peritraumatic dissociation (but not peritraumatic fear and horror) emerged as unique mediators. Findings suggest that both violent and unexpected losses exacerbate postloss psychopathology, which is at least partially because of such losses yielding more intense acute helplessness and dissociative responses.

  10. Complications of open reduction and internal fixation of ankle fractures.

    PubMed

    Leyes, Manuel; Torres, Raúl; Guillén, Pedro

    2003-03-01

    This article discusses the complications after open reduction and internal fixation of ankle fractures. Complications are classified as perioperative (malreduction, inadequate fixation, and intra-articular penetration of hardware), early postoperative (wound edge dehiscence, necrosis, infection and compartment syndrome), and late (stiffness, distal tibiofibular synostosis, degenerative osteoarthritis, and hardware related complications). Emphasis is placed on preventive measures to avoid such complications.

  11. A "Needling" Complication.

    PubMed

    Banerji, John S; Govier, Fred E

    2016-11-01

    Intracavernosal injection therapy with vasoactive agents for treatment of erectile dysfunction has been around for more than 3 decades since its advent in the early 1980s. Common complications include ecchymosis and hematoma at the site of injection, priapism, and fibrosis. We describe a rare but potentially dangerous complication of breakage of needle during administering of injections, and discuss its successful retrieval.

  12. COMPLICATIONS IN HIP ARTHROSCOPY

    PubMed Central

    Contreras, Marcos Emílio Kuschnaroff; Hoffmann, Rafael Barreiros; de Araújo, Lúcio Cappelli Toledo; Dani, William Sotau; José Berral, Francisco

    2015-01-01

    Objectives: To determine the prevalence of complications in a series of consecutive cases of hip arthroscopy; to assess the progression of the sample through a learning curve; and to recognize the causes of complications in arthroscopic hip operations. Method: 150 consecutive cases that underwent hip arthroscopy between May 2004 and December 2008 were evaluated. The complications encountered were classified in three ways: organic system affected, severity and groups of 50 consecutive cases. The data were analyzed by means of descriptive statistics and Fisher's exact test. Results: We observed 15 complications in this study (10%): ten were neurological, two were osteoarticular, one was vascular-ischemic and two were cutaneous. In the classification of severity, three were classified as major, 12 as intermediate and none as minor. The incidence of complications over the course of the learning curve did not present any statistically significant difference (p = 0.16). Conclusions: Hip arthroscopy is a surgical procedure that involves low morbidity, but which presents complications in some cases. These complications are frequently neurological and transitory, and mainly occur because of joint traction. The complication rate did not decrease with progression of our sample. PMID:27022521

  13. Pregnancy Complications: Shoulder Dystocia

    MedlinePlus

    ... severe cases, which are rare, this can cause brain damage and even death. Complications for the mother include: Heavy bleeding after ... severe cases, which are rare, this can cause brain damage and even death. Complications for the mother include: Heavy bleeding after ...

  14. Post dengue neurological complication.

    PubMed

    Hasliza, A H; Tohid, H; Loh, K Y; Santhi, P

    2015-01-01

    Dengue infection is highly endemic in many tropical countries including Malaysia. However, neurological complications arising from dengue infection is not common; Gullain-Barre syndrome (GBS) is one of these infrequent complications. In this paper, we have reported a case in which a 39-year-old woman presented with a neurological complication of dengue infection without typical symptoms and signs of dengue fever. She had a history of acute gastroenteritis (AGE) followed by an upper respiratory tract infection (URTI) weeks prior to her presentation rendering GBS secondary to the post viral URTI and AGE as the most likely diagnosis. Presence of thrombocytopenia was the only clue for dengue in this case.

  15. Complications following hepatectomy.

    PubMed

    Russell, Maria C

    2015-01-01

    As the number of liver resections in the United States has increased, operations are more commonly performed on older patients with multiple comorbidities. The advent of effective chemotherapy and techniques such as portal vein embolization, have compounded the number of increasingly complex resections taking up to 75% of healthy livers. Four potentially devastating complications of liver resection include postoperative hemorrhage, venous thromboembolism, bile leak, and post-hepatectomy liver failure. The risk factors and management of these complications are herein explored, stressing the importance of identifying preoperative factors that can decrease the risk for these potentially fatal complications.

  16. The Impact of Diabetes-Related Complications on Preference-Based Measures of Health-Related Quality of Life in Adults with Type I Diabetes

    PubMed Central

    Peasgood, Tessa; Brennan, Alan; Mansell, Peter; Elliott, Jackie; Basarir, Hasan; Kruger, Jen

    2016-01-01

    Introduction. This study estimates health-related quality of life (HRQoL) or utility decrements associated with type 1 diabetes mellitus (T1DM) using data from a UK research program on the Dose Adjustment For Normal Eating (DAFNE) education program. Methods. A wide range of data was collected from 2341 individuals who undertook a DAFNE course in 2009–2012, at baseline and for 2 subsequent years. We use fixed- and random-effects linear models to generate utility estimates for T1DM using different instruments: EQ-5D, SF-6D, and EQ-VAS. We show models with and without controls for HbA1c and depression, which may be endogenous (if, for example, there is reverse causality in operation). Results. We find strong evidence of an unobserved individual effect, suggesting the superiority of the fixed-effects model. Depression shows the greatest decrement across all the models in the preferred fixed-effects model. The fixed-effects EQ-5D model also finds a significant decrement from retinopathy, body mass index, and HbA1c (%). Estimating a decrement using the fixed-effects model is not possible for some conditions where there are few new cases. In the random-effects model, diabetic foot disease shows substantial utility decrements, yet these are not significant in the fixed-effects models. Conclusion. Utility decrements have been calculated for a wide variety of health states in T1DM that can be used in economic analyses. However, despite the large data set, the low incidence of several complications leads to uncertainty in calculating the utility weights. Depression and diabetic foot disease result in a substantial loss in HRQoL for patients with T1DM. HbA1c (%) appears to have an independent negative impact on HRQoL, although concerns remain regarding the potential endogeneity of this variable. PMID:27553209

  17. Neurological Complications of AIDS

    MedlinePlus

    ... the neurological complications of AIDS. Some disorders require aggressive therapy while others are treated symptomatically. Medicines range ... certain bacterial infections, and penicillin to treat neurosyphilis. Aggressive antiretroviral therapy is used to treat AIDS dementia ...

  18. Complications of Mumps

    MedlinePlus

    ... Serology Publications and Resources Multimedia MMWR Articles Outbreak Articles Related Links World Health Organization Medline Plus Complications of Mumps Language: English Español (Spanish) Recommend on Facebook Tweet Share Compartir ...

  19. Infection and Other Complications

    MedlinePlus

    ... is Lymphedema? What Causes Lymphedema What is the Lymphatic System? Signs and Symptoms Stage 0 Stage 1 Stage ... is Lymphedema? What Causes Lymphedema What is the Lymphatic System? Signs and Symptoms Infection and Other Complications NLN ...

  20. Atrial Fibrillation: Complications

    MedlinePlus

    ... this page please turn JavaScript on. Feature: Atrial Fibrillation Atrial Fibrillation: Complications Past Issues / Winter 2015 Table of Contents ... two major complications—stroke and heart failure. Atrial Fibrillation and Stroke Click to enlarge image This illustration ...

  1. Complications of Circumcision

    PubMed Central

    Krill, Aaron J.; Palmer, Lane S.; Palmer, Jeffrey S.

    2011-01-01

    In the United States, circumcision is a commonly performed procedure. It is a relatively safe procedure with a low overall complication rate. Most complications are minor and can be managed easily. Though uncommon, complications of circumcision do represent a significant percentage of cases seen by pediatric urologists. Often they require surgical correction that results in a significant cost to the health care system. Severe complications are quite rare, but death has been reported as a result in some cases. A thorough and complete preoperative evaluation, focusing on bleeding history and birth history, is imperative. Proper selection of patients based on age and anatomic considerations as well as proper sterile surgical technique are critical to prevent future circumcision-related adverse events. PMID:22235177

  2. Chickenpox (Varicella) Complications

    MedlinePlus

    ... Search The CDC Cancel Submit Search The CDC Chickenpox (Varicella) Note: Javascript is disabled or is not ... message, please visit this page: About CDC.gov . Chickenpox Home About Chickenpox Signs & Symptoms Complications Transmission Prevention & ...

  3. Neurological Complications of AIDS

    MedlinePlus

    ... Patient & Caregiver Education » Fact Sheets Neurological Complications of AIDS Fact Sheet Table of Contents (click to jump ... Where can I get more information? What is AIDS? AIDS (acquired immune deficiency syndrome) is a condition ...

  4. Early complications. Respiratory failure.

    PubMed

    Zwischenberger, J B; Alpard, S K; Bidani, A

    1999-08-01

    Pulmonary complications following thoracic surgery are common and associated with significant morbidity and mortality. Respiratory failure after pneumonectomy occurs in approximately 5% to 15% of cases and significantly increases patient mortality. Strategies for ventilator support are based on the nature of the underlying complication and the pathophysiology of respiratory failure. This article describes the cause and pathophysiology of respiratory failure and pulmonary embolus postpneumonectomy. Diagnosis, management, and innovative therapies are also reviewed.

  5. Complications of auricular correction

    PubMed Central

    Staindl, Otto; Siedek, Vanessa

    2008-01-01

    The risk of complications of auricular correction is underestimated. There is around a 5% risk of early complications (haematoma, infection, fistulae caused by stitches and granulomae, allergic reactions, pressure ulcers, feelings of pain and asymmetry in side comparison) and a 20% risk of late complications (recurrences, telehone ear, excessive edge formation, auricle fitting too closely, narrowing of the auditory canal, keloids and complete collapse of the ear). Deformities are evaluated less critically by patients than by the surgeons, providing they do not concern how the ear is positioned. The causes of complications and deformities are, in the vast majority of cases, incorrect diagnosis and wrong choice of operating procedure. The choice of operating procedure must be adapted to suit the individual ear morphology. Bandaging technique and inspections and, if necessary, early revision are of great importance for the occurence and progress of early complications, in addition to operation techniques. In cases of late complications such as keloids and auricles that are too closely fitting, unfixed full-thickness skin flaps have proved to be the most successful. Large deformities can often only be corrected to a limited degree of satisfaction. PMID:22073079

  6. Complications in Hip Arthroscopy

    PubMed Central

    Nakano, Naoki; Khanduja, Vikas

    2016-01-01

    Summary Background Recent developments in hip arthroscopic techniques and technology have made it possible in many cases to avoid open surgical dislocation for treating a variety of pathology in the hip. Although early reports suggest favourable results’ using hip arthroscopy and it has been shown to be a relatively safe procedure, complications do exist and can sometimes lead to significant morbidity. Methods This is a review article. The aim of this manuscript is to present the most frequent and/or serious complications that could occur at or following hip arthroscopy and some guidelines to avoid these complications. Conclusion Most complications of hip arthroscopy are minor or transient but serious complications can occur as well. A lot of complication e.g. acetabular labral puncture go unreported. Appropriate education and training, precise and meticulous surgical technique with correct instrumentation, the right indication in the right patient and adherence to advice from mentors and experienced colleagues are all essential factors for a successful outcome. Level of evidence: V. PMID:28066747

  7. [Type 2 diabetes complications].

    PubMed

    Schlienger, Jean-Louis

    2013-05-01

    People with type 2 diabetes are at increased risk of many complications, which are mainly due to complex and interconnected mechanisms such as hyperglycemia, insulino-resistance, low-grade inflammation and accelerated atherogenesis. Cardi-cerebrovascular disease are frequently associated to type 2 diabetes and may become life threatening, particularly coronaropathy, stroke and heart failure. Their clinical picture are sometimes atypical and silencious for a long time. Type 2 diabetes must be considered as an independent cardiovascular risk factor. Nephropathy is frequent in type 2 diabetes but has a mixed origin. Now it is the highest cause of end-stage renal disease. Better metabolic and blood pressure control and an improved management of microalbuminuria are able to slowdown the course of the disease. Retinopathy which is paradoxically slightly progressive must however be screened and treated in these rather old patients which are globally at high ophthalmologic risk. Diabetic foot is a severe complication secondary to microangiopathy, microangiopathy and neuropathy. It may be considered as a super-complication of several complications. Its screening must be done on a routine basis. Some cancer may be considered as an emerging complication of type 2 diabetes as well as cognitive decline, sleep apnea syndrome, mood disorders and bone metabolism impairments. Most of the type 2 diabetes complications may be prevented by a strategy combining a systematic screening and multi-interventional therapies.

  8. A Theoretical Study of the Hidden Wounds of War: Disenfranchised Grief and the Impact on Nursing Practice

    PubMed Central

    Aloi, Janice A.

    2011-01-01

    Combat veterans face enormous challenges upon the return to civilian life, one of which is the ability to integrate incidences of death and killing into a healthy postdeployment life. This paper presents the lived experience of grief and loss resulting from the trauma of war. Social constructionist theory, due to its emphasis on meaning-making, serves as the theoretical framework. The effects of inhibited mourning due to the inability to mourn in combat and lack of nurturing upon returning home are described. Personal excerpts derived from interviews of warfare from veterans that experienced death and killing are presented. It is suggested that combat veterans experience a unique form of grief and therefore require a style of grieving that differs from those that have not served on the battlefield. Regardless of the point of care, nurses are positioned to help with the challenges of readjustment. A better understanding of combat veterans as a disenfranchised group would enable nurses to intervene in ways that contribute to the readjustment process. PMID:22007331

  9. Treating maladaptive grief and posttraumatic stress symptoms in orphaned children in Tanzania: group-based trauma-focused cognitive-behavioral therapy.

    PubMed

    O'Donnell, Karen; Dorsey, Shannon; Gong, Wenfeng; Ostermann, Jan; Whetten, Rachel; Cohen, Judith A; Itemba, Dafrosa; Manongi, Rachel; Whetten, Kathryn

    2014-12-01

    This study was designed to test the feasibility and child clinical outcomes for group-based trauma-focused cognitive behavior therapy (TF-CBT) for orphaned children in Tanzania. There were 64 children with at least mild symptoms of grief and/or traumatic stress and their guardians who participated in this open trial. The TF-CBT for Child Traumatic Grief protocol was adapted for use with a group, resulting in 12 weekly sessions for children and guardians separately with conjoint activities and 3 individual visits with child and guardian. Using a task-sharing approach, the intervention was delivered by lay counselors with no prior mental health experience. Primary child outcomes assessed were symptoms of grief and posttraumatic stress (PTS); secondary outcomes included symptoms of depression and overall behavioral adjustment. All assessments were conducted pretreatment, posttreatment, and 3 and 12 months after the end of treatment. Results showed improved scores on all outcomes posttreatment, sustained at 3 and 12 months. Effect sizes (Cohen's d) for baseline to posttreatment were 1.36 for child reported grief symptoms, 1.87 for child-reported PTS, and 1.15 for guardian report of child PTS.

  10. Keeping the Music Alive: Using the "Grief and Hope Box" with Adult Offenders with Co-Occurring Mental Health and Substance Use Issues

    ERIC Educational Resources Information Center

    Gee, Robert; Springer, Paul; Bitar, George; Drew, Faith; Graff, Chad

    2005-01-01

    Individuals with co-occurring mental health and substance use disorder (COD) present unique challenges for counselors. When individuals are incarcerated, they suffer unique forms of losses, including the loss and grief of their family members. In addition, they often struggle with stigma and cultural stereotypes that are oppressive and…

  11. Therapeutic Intervention in the Treatment of Substance Abuser's Unresolved Grief Reactions in an Inpatient Hospital Setting: A Study of Two Group Approaches.

    ERIC Educational Resources Information Center

    Forrest, Alan; Geoffroy, Kevin

    This study examined the differential effects of a higher level inpatient therapy group as compared with a structured didactic group on adult substance abusers' unresolved grief reactions in an inpatient hospital setting. It was hypothesized that, compared to control group subjects, subjects participating in the two treatment groups would…

  12. Treating Unresolved Grief and Posttraumatic Stress Symptoms in Orphaned Children in Tanzania: Group-based Trauma-focused Cognitive Behavioral Therapy

    PubMed Central

    O’Donnell, Karen; Dorsey, Shannon; Gong, Wenfeng; Ostermann, Jan; Whetten, Rachel; Cohen, Judith A.; Itemba, Dafrosa; Manongi, Rachel; Whetten, Kathryn

    2015-01-01

    The study was designed to test the feasibility and child clinical outcomes for a group-based application of Trauma-focused Cognitive Behavior Therapy (TF-CBT) for orphaned children with unresolved grief in Moshi, Tanzania. Sixty-four orphaned children with at least mild symptoms of unresolved grief and/or traumatic stress and their guardians participated in the open trial. The evidence-based TF-CBT protocol was adapted for group delivery, resulting in 12 weekly sessions for child and guardians separately with conjoint activities and three individual visits. Using a task-sharing approach, the intervention was delivered by lay counselors with no prior mental health experience. Primary outcomes assessed were symptoms of unresolved grief and posttraumatic stress (PTS); secondary outcomes included symptoms of depression and overall behavioral adjustment. All assessments were conducted pre-treatment, post-treatment, and 3- and 12-months after the end of treatment. Results showed improved scores on all outcomes post-treatment, sustained at 3 and 12 months. Effect sizes (Cohen’s d) for baseline to post-treatment were 1.36 for child reported grief symptoms; 1.87 for child-reported PTS, and 1.15 for caregiver report of child PTS. PMID:25418514

  13. Grief and Bereavement Issues and the Loss of a Companion Animal: People Living with a Companion Animal, Owners of Livestock, and Animal Support Workers

    ERIC Educational Resources Information Center

    Chur-Hansen, Anna

    2010-01-01

    Companion animals play various roles in people's lives and these roles can impact on loss, grief, bereavement and mourning when the animal has been lost, whether that is through death, when missing, or when relinquished. This paper considers not only companion animal owners, but also those who own farm animals and those who work in animal service…

  14. The Central Role of Meaning in Adjustment to the Loss of a Child to Cancer: Implications for the Development of Meaning-Centered Grief Therapy

    PubMed Central

    Lichtenthal, Wendy G.; Breitbart, William

    2015-01-01

    Purpose of review This review describes research on meaning and meaning-making in parents who lost a child to cancer, suggesting the need for a meaning-centered therapeutic approach to improve their sense of meaning, purpose, and identity and to help with management of prolonged grief symptoms. Recent findings Several studies have demonstrated that parents bereaved by cancer experience unique meaning related challenges associated with the caregiving and illness experience, including struggles with making sense of their loss, benefit-finding, their sense of identity and purpose, disconnection from sources of meaning, and sustaining a sense of meaning in their child’s life. Meaning-Centered Grief Therapy, adapted from Meaning-Centered Psychotherapy, directly addresses these issues, highlighting the choices parents have in how they face their pain, how they honor their child and his/her living legacy, the story they create, and how they live their lives. Summary Given the important role that meaning plays in adjustment to the loss of a child to cancer, a meaning-focused approach such as Meaning-Centered Grief Therapy, may help improve parents’ sense of meaning and grief symptoms. It seems particularly appropriate for parents who lost a child to cancer because it does not pathologize their struggles and directly targets issues they frequently face. PMID:25588204

  15. Gastrointestinal complications of diabetes mellitus

    PubMed Central

    Krishnan, Babu; Babu, Shithu; Walker, Jessica; Walker, Adrian B; Pappachan, Joseph M

    2013-01-01

    Diabetes mellitus affects virtually every organ system in the body and the degree of organ involvement depends on the duration and severity of the disease, and other co-morbidities. Gastrointestinal (GI) involvement can present with esophageal dysmotility, gastro-esophageal reflux disease (GERD), gastroparesis, enteropathy, non alcoholic fatty liver disease (NAFLD) and glycogenic hepatopathy. Severity of GERD is inversely related to glycemic control and management is with prokinetics and proton pump inhibitors. Diabetic gastroparesis manifests as early satiety, bloating, vomiting, abdominal pain and erratic glycemic control. Gastric emptying scintigraphy is considered the gold standard test for diagnosis. Management includes dietary modifications, maintaining euglycemia, prokinetics, endoscopic and surgical treatments. Diabetic enteropathy is also common and management involves glycemic control and symptomatic measures. NAFLD is considered a hepatic manifestation of metabolic syndrome and treatment is mainly lifestyle measures, with diabetes and dyslipidemia management when coexistent. Glycogenic hepatopathy is a manifestation of poorly controlled type 1 diabetes and is managed by prompt insulin treatment. Though GI complications of diabetes are relatively common, awareness about its manifestations and treatment options are low among physicians. Optimal management of GI complications is important for appropriate metabolic control of diabetes and improvement in quality of life of the patient. This review is an update on the GI complications of diabetes, their pathophysiology, diagnostic evaluation and management. PMID:23772273

  16. Painless thyroiditis complicated by acromegaly.

    PubMed

    Saito, Takatoshi; Tojo, Katsuyoshi; Tajima, Naoko

    2010-01-01

    The serum thyroid stimulating hormone (TSH) level is decreased in acromegalic patients. Although this phenomenon is thought to be caused by the enhanced secretion of somatostatin which suppresses TSH production, it has not yet been proven. We describe a 60-year-old woman with acromegaly who showed a low concentration of TSH. We diagnosed her as painless thyroiditis based on an increased level of thyroglobulin, depressed radioactive iodine uptake (RAIU), normal vascularity and mild swelling of the thyroid, and normal T3, T4, free T3 and free T4 levels. To our knowledge, this is the second reported case of acromegaly complicated by painless thyroiditis. The differential diagnosis between central hypothyroidism and painless thyroiditis is so important. Since it is difficult to diagnose precisely based on only the data of a low level of TSH and normal levels of thyroid hormones, we consider that measurement of thyroglobulin and RAIU is necessary when the complication of painless thyroiditis is suspected.

  17. [Complications of tubal sterilization].

    PubMed

    Schreiner, W E

    1986-05-01

    In Europe and the US, tubal sterilization by laparoscopy has become the most widely used technique for female sterilization. The overall rate of intra- and postoperative complications differs between 0.145% and 0.85% in the numerous studies which have been done. This means 1 severe complication in 120-700 laparoscopic sterilizations. The lethality of tubal sterilization by laparoscopy lies between 3-10 deaths/100,000 interventions. The so-called "post-tubal ligation syndrome" is a rare complication. The overall pregnancy rate after tubal sterilization is 3-10/1000 women. The rate of ectopic pregnancy is very high and varies between 13.6% and 90%. Only 5% of the sterilized women show dissatisfaction. Several factors are relevant with regard to psychological sequelae and must be considered before tubal sterilization can be performed. 1 of the most important is the individual comprehensive counselling of the female or the couple prior to the sterilization.

  18. Osteoarticular complications of brucellosis.

    PubMed Central

    Colmenero, J D; Reguera, J M; Fernández-Nebro, A; Cabrera-Franquelo, F

    1991-01-01

    Two hundred and sixty three patients with a diagnosis of brucellosis between January 1984 and December 1987 were studied prospectively. Sixty five patients (25%) developed osteoarticular complications. These patients had a more prolonged course than those with no complications. Spondylitis in 38 (58%) and sacroiliitis in 29 (45%) were the most prevalent. There were no significant laboratory, serological, or bacteriological differences between patients with and without osteoarticular complications. At diagnosis 47 patients (72%) showed radiographic abnormalities, commonly in axial sites but rarely in peripheral sites. Radionuclide bone scan was positive with no radiographic abnormalities in 17 (26%) of cases. Fifty seven patients received medical treatment alone, 51 (89%) being cured with a single course of treatment. Treatment failed or there was a relapse in six patients (11%), of whom five had spondylitis. Eight of the 65 patients (12%), all of whom had spondylitis and paravertebral or epidural abscesses, also required surgical treatment. Images PMID:1994863

  19. [Orbital complications of sinusitis].

    PubMed

    Šuchaň, M; Horňák, M; Kaliarik, L; Krempaská, S; Koštialová, T; Kovaľ, J

    2014-12-01

    Orbital complications categorised by Chandler are emergency. They need early diagnosis and agresive treatment. Stage and origin of orbital complications are identified by rhinoendoscopy, ophtalmologic examination and CT of orbite and paranasal sinuses. Periorbital cellulitis and early stage of orbital cellulitis can be treated conservatively with i. v. antibiotics. Monitoring of laboratory parameters and ophtalmologic symptoms is mandatory. Lack of improvement or worsening of symptoms within 24-48 hours and advanced stages of orbital complications are indicated for surgery. The purpose of the study is to evaluate epidemiology, clinical features and management of sinogenic orbital complications. Retrospective data of 8 patients with suspicion of orbital complication admited to hospital from 2008 to 2013 were evaluated. Patients were analyzed in terms of gender, age, CT findings, microbiology, clinical features, stage and treatment. Male and female were afected in rate 1,66:1. Most of patients were young adult in 3rd. and 4th. decade of life (62,5 %). Acute and chronic sinusitis were cause of orbital complication in the same rate. The most common origin of orbital complication was ethmoiditis (62,5 %), than maxillary (25 %) and frontal (12,5 %) sinusitis. Polysinusitis with affection of ethmoidal, maxillary and frontal sinuses (75 %) was usual CT finding. Staphylococcus epidermidis and Staphylococcus aureus were etiological agens in half of cases. Periorbital oedema (100 %), proptosis, chemosis (50 %), diplopia and glaucoma (12,5 %) were observed. Based on examinations, diagnosis of periorbital oedema/preseptal cellulitis was made in 3 (37,5 %), orbital cellulitis in 3 (37,5 %) and subperiosteal abscess in 2 cases (25 %). All patients underwent combined therapy - i. v. antibiotics and surgery within 24 hours. Eradication of disease from ostiomeatal complex (OMC), drainage of affected sinuses and drainage of subperiosteal abscess were done via fuctional endonasal

  20. [Septic complications of gonorrhea].

    PubMed

    Ebner, H; Gebhart, W

    1976-09-01

    Septic gonococcal complications consist in intermittent fever, arthralgia and skin lesions. In recent years predominantly females suffering from this disease were observed. This diagnosis is made by the demonstration of gonococcal infection combined with the above mentioned clinical symptoms. A further confirmation is possible by blood culture and the demonstration of gonococci in skin lesions or joint fluid.

  1. Cardiovascular Complications of Pregnancy

    PubMed Central

    Gongora, Maria Carolina; Wenger, Nanette K.

    2015-01-01

    Pregnancy causes significant metabolic and hemodynamic changes in a woman’s physiology to allow for fetal growth. The inability to adapt to these changes might result in the development of hypertensive disorders of pregnancy (hypertension, preeclampsia or eclampsia), gestational diabetes and preterm birth. Contrary to previous beliefs these complications are not limited to the pregnancy period and may leave permanent vascular and metabolic damage. There is in addition, a direct association between these disorders and increased risk of future cardiovascular disease (CVD, including hypertension, ischemic heart disease, heart failure and stroke) and diabetes mellitus. Despite abundant evidence of this association, women who present with these complications of pregnancy do not receive adequate postpartum follow up and counseling regarding their increased risk of future CVD. The postpartum period in these women represents a unique opportunity to intervene with lifestyle modifications designed to reduce the development of premature cardiovascular complications. In some cases it allows early diagnosis and treatment of chronic hypertension or diabetes mellitus. The awareness of this relationship is growing in the medical community, especially among obstetricians and primary care physicians, who play a pivotal role in detecting these complications and assuring appropriate follow up. PMID:26473833

  2. Cardiovascular Complications of Pregnancy.

    PubMed

    Gongora, Maria Carolina; Wenger, Nanette K

    2015-10-09

    Pregnancy causes significant metabolic and hemodynamic changes in a woman's physiology to allow for fetal growth. The inability to adapt to these changes might result in the development of hypertensive disorders of pregnancy (hypertension, preeclampsia or eclampsia), gestational diabetes and preterm birth. Contrary to previous beliefs these complications are not limited to the pregnancy period and may leave permanent vascular and metabolic damage. There is in addition, a direct association between these disorders and increased risk of future cardiovascular disease (CVD, including hypertension, ischemic heart disease, heart failure and stroke) and diabetes mellitus. Despite abundant evidence of this association, women who present with these complications of pregnancy do not receive adequate postpartum follow up and counseling regarding their increased risk of future CVD. The postpartum period in these women represents a unique opportunity to intervene with lifestyle modifications designed to reduce the development of premature cardiovascular complications. In some cases it allows early diagnosis and treatment of chronic hypertension or diabetes mellitus. The awareness of this relationship is growing in the medical community, especially among obstetricians and primary care physicians, who play a pivotal role in detecting these complications and assuring appropriate follow up.

  3. Complicating Visual Culture

    ERIC Educational Resources Information Center

    Daiello, Vicki; Hathaway, Kevin; Rhoades, Mindi; Walker, Sydney

    2006-01-01

    Arguing for complicating the study of visual culture, as advocated by James Elkins, this article explicates and explores Lacanian psychoanalytic theory and pedagogy in view of its implications for art education practice. Subjectivity, a concept of import for addressing student identity and the visual, steers the discussion informed by pedagogical…

  4. Pulmonary complications of hepatic diseases

    PubMed Central

    Surani, Salim R; Mendez, Yamely; Anjum, Humayun; Varon, Joseph

    2016-01-01

    Severe chronic liver disease (CLD) may result from portal hypertension, hepatocellular failure or the combination of both. Some of these patients may develop pulmonary complications independent from any pulmonary pathology that they may have. Among them the hepatopulmonary syndrome (HPS), portopulmonary hypertension (PPH) and hepatic hydrothorax (HH) are described in detail in this literature review. HPS is encountered in approximately 15% to 30% of the patients and its presence is associated with increase in mortality and also requires liver transplantation in many cases. PPH has been reported among 4%-8% of the patient with CLD who have undergone liver transplantation. The HH is another entity, which has the prevalence rate of 5% to 6% and is associated in the absence of cardiopulmonary disease. These clinical syndromes occur in similar pathophysiologic environments. Most treatment modalities work as temporizing measures. The ultimate treatment of choice is liver transplant. This clinical review provides basic concepts; pathophysiology and clinical presentation that will allow the clinician to better understand these potentially life-threatening complications. This article will review up-to-date information on the pathophysiology, clinical features and the treatment of the pulmonary complications among liver disease patients. PMID:27468192

  5. Complications of percutaneous vertebroplasty

    PubMed Central

    Saracen, Agnieszka; Kotwica, Zbigniew

    2016-01-01

    Abstract Percutaneous vertebroplasty (PVP) is a minimally invasive procedure widely used for the treatment of pain due to vertebral fractures of different origins—osteoporotic, traumatic, or neoplastic. PVP is minimally invasive, but the complications are not rare; however, they are in most cases not significant clinically. The most frequent is cement leakage, which can occur onto veins, paravertebral soft tissue, into the intervertebral disk, or to the spinal canal, affecting foraminal area or epidural space. We analyzed results of treatment and complications of vertebroplasty performed with the use of polimethylomethylacrylate cement (PMMA) on 1100 vertebrae, with a special regard to the severity of complication and eventual clinical manifestation. One thousand one hundred PVP were analyzed, performed in 616 patients. There were 468 (76%) women and 148 men (24%), 24 to 94-year old, mean age 68 years. From 1100 procedures, 794 treated osteporotic and 137 fractures due to malignant disease, 69 PVP were made in traumatic fractures. One hundred patients had painful vertebral hemangiomas. Seven hundred twenty-six (66%) lesions were in thoracic, and 374 (34%) in lumbar area. Results of treatment were assessed using 10 cm Visual Analogue Scale (VAS) 12 hours after surgery, 7 days, 30 days, and then each 6 months, up to 3 years. Before surgery all patients had significant pain 7 to 10 in VAS scale, mean 8.9 cm. Twelve  hours after surgery 602 (97.7%) reported significant relief of pain, with mean VAS of 2,3 cm. Local complications occurred in 50% of osteoporotic, 34% of neoplastic, 16% of traumatic fractures, and 2% of vertebral hemangiomas. The most common was PMMA leakage into surrounding tissues—20%; paravertebral vein embolism—13%; intradiscal leakage—8%; and PMMA leakage into the spinal canal—0.8%. Results of treatment did not differ between patients with and without any complications. From 104 patients who had chest X-ray or CT study performed

  6. Endodontic management of patients with systemic complications

    PubMed Central

    Rajeswari, Kalaiselvam; Kandaswamy, Deivanayagam; Karthick, Soundararajan

    2016-01-01

    Successful endodontic practice requires complete knowledge about the various medical conditions and appropriateness in planning treatment as per the need with effective safety measures. This review focuses on a number of systemic complications encountered in endodontic practice and directions to be followed for avoiding potential complications. A detailed PubMed search was carried out using specific keywords, and 25 articles were referred for finalizing the content. PMID:27829742

  7. Thrombophilia and Pregnancy Complications.

    PubMed

    Simcox, Louise E; Ormesher, Laura; Tower, Clare; Greer, Ian A

    2015-11-30

    There is a paucity of strong evidence associated with adverse pregnancy outcomes and thrombophilia in pregnancy. These problems include both early (recurrent miscarriage) and late placental vascular-mediated problems (fetal loss, pre-eclampsia, placental abruption and intra-uterine growth restriction). Due to poor quality case-control and cohort study designs, there is often an increase in the relative risk of these complications associated with thrombophilia, particularly recurrent early pregnancy loss, late fetal loss and pre-eclampsia, but the absolute risk remains very small. It appears that low-molecular weight heparin has other benefits on the placental vascular system besides its anticoagulant properties. Its use is in the context of antiphospholipid syndrome and recurrent pregnancy loss and also in women with implantation failure to improve live birth rates. There is currently no role for low-molecular weight heparin to prevent late placental-mediated complications in patients with inherited thrombophilia and this may be due to small patient numbers in the studies involved in summarising the evidence. There is potential for low-molecular weight heparin to improve pregnancy outcomes in women with prior severe vascular complications of pregnancy such as early-onset intra-uterine growth restriction and pre-eclampsia but further high quality randomised controlled trials are required to answer this question.

  8. [Respiratory complications after transfusion].

    PubMed

    Bernasinski, M; Mertes, P-M; Carlier, M; Dupont, H; Girard, M; Gette, S; Just, B; Malinovsky, J-M

    2014-05-01

    Respiratory complications of blood transfusion have several possible causes. Transfusion-Associated Circulatory Overload (TACO) is often the first mentioned. Transfusion-Related Acute Lung Injury (TRALI), better defined since the consensus conference of Toronto in 2004, is rarely mentioned. French incidence is low. Non-hemolytic febrile reactions, allergies, infections and pulmonary embolism are also reported. The objective of this work was to determine the statistical importance of the different respiratory complications of blood transfusion. This work was conducted retrospectively on transfusion accidents in six health centers in Champagne-Ardenne, reported to Hemovigilance between 2000 and 2009 and having respiratory symptoms. The analysis of data was conducted by an expert committee. Eighty-three cases of respiratory complications are found (316,864 blood products). We have counted 26 TACO, 12 TRALI (only 6 cases were identified in the original investigation of Hemovigilance), 18 non-hemolytic febrile reactions, 16 cases of allergies, 5 transfusions transmitted bacterial infections and 2 pulmonary embolisms. Six new TRALI were diagnosed previously labeled TACO for 2 of them, allergy and infection in 2 other cases and diagnosis considered unknown for the last 2. Our study found an incidence of TRALI 2 times higher than that reported previously. Interpretation of the data by a multidisciplinary committee amended 20% of diagnoses. This study shows the imperfections of our system for reporting accidents of blood transfusion when a single observer analyses the medical records.

  9. Neurologic complications of immunizations.

    PubMed

    Rutledge, S L; Snead, O C

    1986-12-01

    Although there does appear to be at least a temporal relationship between pertussis immunization and serious acute neurologic illness, data to suggest that children with stable preexisting neurologic disease or positive family history of neurologic disease are at increased risk for complications of pertussis immunizations are inconclusive. Furthermore, there are no firm statistical data concerning the incidence of pertussis vaccine-related encephalopathy. Rather, the literature on pertussis vaccine complications is replete with anecdotal reports and retrospective studies with a number of questionable conclusions drawn from this inadequate data base. Unfortunately, these conclusions have been sensationalized and exploited with litigious fervor to the point that the practice of pertussis immunization is being questioned in the United States. A number of points should be reiterated: pertussis is a dangerous and deadly disease, as seen in the epidemic in Great Britain; pertussis immunization is effective in protecting against the disease; and there is no conclusive proof that the incidence of complications from pertussis vaccination of children with seizure disorders or other preexisting stable neurologic abnormalities is higher, because appropriate studies have not been done to define such a risk. We would do well to keep these facts in mind in order to avoid a disaster similar to the pertussis epidemic in Great Britain. Pertussis vaccination should be given to all children except those with allergic hypersensitivity, a progressive neurologic disorder, or an adverse reaction to a previous pertussis dose.

  10. Keratomycosis complicating pterygium excision.

    PubMed

    Merle, Harold; Guyomarch, Jérôme; Joyaux, Jean-Christophe; Dueymes, Maryvonne; Donnio, Angélique; Desbois, Nicole

    2011-01-01

    The authors describe a case of keratomycosis that appeared after the exeresis of a pterygium. A 48-year-old patient had been referred with a red right eye associated with an abscess of the cornea along the ablation zone of the pterygium. The surgery had been performed a month beforehand. The abscess was 6 mm high and 4 mm wide. The authors instigated a treatment that included amphotericin B (0.25%) after noticing a clinical aspect evoking a fungal keratitis and finding several septate filaments on direct examination. On day 10, a Fusarium dimerum was isolated on Sabouraud agar. After 15 days of treatment, the result was favorable and the size of the ulceration as well as the size of the abscess had progressively decreased. The antifungal treatment was definitively stopped at 14 weeks. Infectious-related complications of the pterygium surgery are rare and are essentially caused by bacterial agents. Secondary infections by fungus are rare. There have been two previous cases reported: one that appeared 15 years after radiotherapy and another that appeared at 3 weeks post surgery, consecutive to the use of mitomycin C. To the authors' knowledge, this is the first case of a keratomycosis due to F. dimerum reported that complicated the exeresis of a pterygium without the use of an adjuvant antihealing treatment. Pterygium surgery is a common procedure; nevertheless, ophthalmologists need to be aware of the existence of potential infectious complications.

  11. Pregnancy complicated with agranulocytosis

    PubMed Central

    Wang, Hai; Sun, Jiang-Li; Zhang, Zheng-Liang; Pei, Hong-Hong

    2016-01-01

    Abstract Rationale: Pregnancy is a complicated physiological process. Physiological leukocytosis often takes place and it is primarily related to the increased circulation of neutrophils, especially during the last trimester of pregnancy. Noncongenital agranulocytosis during pregnancy is rare and reported only occasionally, while in most of the cases, the agranulocytosis has already occurred prior to pregnancy or induced by identified factors such as antibiotics, antithyroid agents, or cytotoxic agents. Gestation-induced agranulocytosis has not been reported, so we present a case of gestation-induced agranulocytosis in this article. Patients concern: In this case, we present a Chinese woman (aged 25) in her 38th week of the first gestation who had the complication of agranulocytosis. No abnormality was detected in regular examinations before pregnancy and in the first trimester. Since the last trimester of pregnancy, the patient began to suffer from agranulocytosis and intermittent fever, the maximum being temperature 38.8°C. At admission, the neutrophil granulocytes were 0.17 × 109 L−1 and the bone marrow biopsy showed that agranulocytosis was detected, but the levels of red blood cell and megalokaryocyte were normal. In addition, antinuclear antibodies were detected at a dilution of 1:40, but anti-dsDNA, antiphospholipid antibody, and neutrophil granulocyte antibody were negative. Diagnoses: The patient was empirically treated as having pneumonia. Interventions: We tried to use granulocyte colony-stimulating factor, γ-globulin, glucocorticoids, antibiotics, and antifungi agents to treat the patient, but her symptoms were not alleviated until the patient had a cesarean section. Outcomes: After 24 hours of cesarean section, the temperature and neutrophil granulocyte returned to normal. After a year of follow-up, we found that the patient and the baby were healthy. Lessons: Agranulocytosis during pregnancy seems to be associated with immunosuppression

  12. Cryptococcal meningitis complicating sarcoidosis

    PubMed Central

    Leonhard, Sonja E.; Fritz, Daan; van de Beek, Diederik; Brouwer, Matthijs C.

    2016-01-01

    Abstract Background: Cryptococcal meningitis is an uncommon but severe complication of sarcoidosis. Methods: We present 2 patients with cryptococcal meningitis complicating sarcoidosis and compared findings with 38 cases reported in the literature. Results: When analyzing our patients and 38 cases reported in the literature, we found that median age of sarcoidosis patients with cryptococcal meningitis was 39 years (range 30–48); 27 of 33 reported cases (82%) had a history of sarcoidosis. Only 16 of 40 patients (40%) received immunomodulating therapy at the time of diagnosis of cryptococcal meningitis. The diagnosis of cryptococcal meningitis was delayed in 17 of 40 patients (43%), mainly because of the initial suspicion of neurosarcoidosis. Cerebrospinal fluid (CSF) examination showed mildly elevated white blood cell count (range 23–129/mm3). Twenty-nine of 32 cases (91%) had a positive CSF culture for Cryptococcus neoformans and 25 of 27 cases (93%) had a positive CSF C neoformans antigen test. CD4 counts were low in all patients in whom counts were performed (84–228/mL). Twelve patients had an unfavorable outcome (32%), of which 7 died (19%) and 24 patients (65%) had a favorable outcome. The rate of unfavorable outcome in patients with a delayed diagnosis was 7 of 17 (41%) compared to 5 of 28 (21%) in patients in whom diagnosis was not delayed. Conclusion: Cryptococcal meningitis is a rare but life-threatening complication of sarcoidosis. Patients were often initially misdiagnosed as neurosarcoidosis, which resulted in considerable treatment delay and worse outcome. CSF cryptococcal antigen tests are advised in patients with sarcoidosis and meningitis. PMID:27583871

  13. [Complications of hemorrhoids].

    PubMed

    Slauf, P; Antoš, F; Marx, J

    2014-04-01

    The most common and serious complications of haemorrhoids include perianal thrombosis and incarcerated prolapsed internal haemorrhoids with subsequent thrombosis. They are characterised by severe pain in the perianal region possibly with bleeding. In a short history of the perianal thrombosis, acute surgical incision or excision is indicated, which can result in rapid relief of the painful symptoms. In incarcerated prolapsed internal haemorrhoids, emergency haemorrhoidectomy may also be indicated. Segmental haemorrhoidectomy in the most affected quadrants followed by further elective surgery for haemorrhoids in the next stage is preferred.

  14. Unexpected complication of colonoscopy.

    PubMed

    Nadarajah, Ramesh; Pee, Leon

    2017-01-16

    The authors present a rare case of a 71-year-old man presenting with large bowel obstruction after attempted colonoscopy. The procedure was impossible to complete due to a tight sigmoid stricture and the patient presented with an acute abdomen the following day. He was managed conservatively and discharged before returning for an elective laparoscopic sigmoid colectomy. The potential differentials of an acute abdomen post-colonoscopy are discussed and the literature reviewed on this rare complication. Finally, the authors review whether there is pressure on endoscopists to 'complete' colonoscopies (by achieving caecal intubation) based on regulatory indices in quality, and how this might have to be disregarded in unfavourable circumstances.

  15. Complications of decorative tattoo.

    PubMed

    Shinohara, Michi M

    2016-01-01

    Decorative tattoo is a popular practice that is generally safe when performed in the professional setting but can be associated with a variety of inflammatory, infectious, and neoplastic complications, risks that may be increased with current trends in home tattooing. Modern tattoo inks contain azo dyes and are often of unknown composition and not currently regulated for content or purity. Biopsy of most (if not all) tattoo reactions presenting to the dermatologist is recommended, given recent clusters of nontuberculous mycobacterial infections occurring within tattoo, as well as associations between tattoo reactions and systemic diseases such as sarcoidosis.

  16. Complications of Macular Peeling

    PubMed Central

    Asencio-Duran, Mónica; Manzano-Muñoz, Beatriz; Vallejo-García, José Luis; García-Martínez, Jesús

    2015-01-01

    Macular peeling refers to the surgical technique for the removal of preretinal tissue or the internal limiting membrane (ILM) in the macula for several retinal disorders, ranging from epiretinal membranes (primary or secondary to diabetic retinopathy, retinal detachment…) to full-thickness macular holes, macular edema, foveal retinoschisis, and others. The technique has evolved in the last two decades, and the different instrumentations and adjuncts have progressively advanced turning into a safer, easier, and more useful tool for the vitreoretinal surgeon. Here, we describe the main milestones of macular peeling, drawing attention to its associated complications. PMID:26425351

  17. Complications of Distal Biceps Tendon Repair

    PubMed Central

    Amin, Nirav H.; Volpi, Alex; Lynch, T. Sean; Patel, Ronak M.; Cerynik, Douglas L.; Schickendantz, Mark S.; Jones, Morgan H.

    2016-01-01

    Background: Anatomic reinsertion of the distal biceps is critical for restoring flexion and supination strength. Single- and double-incision surgical techniques have been reported, analyzing complications and outcomes measures. Which technique results in superior clinical outcomes and the lowest associated complications remains unclear. Hypothesis: We hypothesized that rerupture rates would be similar between the 2 techniques, while nerve complications would be higher for the single-incision technique and heterotopic ossification would be more frequent with the double-incision technique. Study Design: Systematic review and meta-analysis; Level of evidence, 4. Methods: A systematic review was conducted using the PubMed, MEDLINE, Cumulative Index to Nursing and Allied Health Literature (CINAHL), SPORTSDiscus, and the Cochrane Central Register of Controlled Trials databases to identify articles reporting distal biceps ruptures up to August 2013. We included English-language articles on adult patients with a minimum of 3 cases reporting single- and double-incision techniques. Frequencies of each complication as a percentage of total cases were calculated. Fisher exact tests were used to test the association between frequencies for each repair method, with P < .05 considered statistically significant. Odds ratios with 95% CIs were also computed. Results: A total of 87 articles met the inclusion criteria. Lateral antebrachial cutaneous nerve neurapraxia was the most common complication in the single-incision group, occurring in 77 of 785 cases (9.8%). Heterotopic ossification was the most common complication in the double-incision group, occurring in 36 of 498 cases (7.2%). Conclusion: The overall frequency of reported complications is higher for single-incision distal biceps repair than for double-incision repair. The frequencies of rerupture and nerve complications are both higher for single-incision repairs while the frequency of heterotopic ossification is higher for

  18. Complications associated with orthognathic surgery

    PubMed Central

    2017-01-01

    While most patients undergo orthognathic surgery for aesthetic purposes, aesthetic improvements are most often followed by postoperative functional complications. Therefore, patients must carefully decide whether their purpose of undergoing orthognathic surgery lies on the aesthetic side or the functional side. There is a wide variety of complications associated with orthognathic surgery. There should be a clear distinction between malpractice and complications. Complications can be resolved without any serious problems if the cause is detected early and adequate treatment provided. Oral and maxillofacial surgeons must have a full understanding of the types, causes, and treatment of complications, and should deliver this information to patients who develop these complications. PMID:28280704

  19. Complications and discomfort of bronchoscopy: a systematic review

    PubMed Central

    Leiten, Elise Orvedal; Martinsen, Einar Marius Hjellestad; Bakke, Per Sigvald; Eagan, Tomas Mikal Lind; Grønseth, Rune

    2016-01-01

    Objective To identify bronchoscopy-related complications and discomfort, meaningful complication rates, and predictors. Method We conducted a systematic literature search in PubMed on 8 February 2016, using a search strategy including the PICO model, on complications and discomfort related to bronchoscopy and related sampling techniques. Results The search yielded 1,707 hits, of which 45 publications were eligible for full review. Rates of mortality and severe complications were low. Other complications, for instance, hypoxaemia, bleeding, pneumothorax, and fever, were usually not related to patient characteristics or aspects of the procedure, and complication rates showed considerable ranges. Measures of patient discomfort differed considerably, and results were difficult to compare between different study populations. Conclusion More research on safety aspects of bronchoscopy is needed to conclude on complication rates and patient- and procedure-related predictors of complications and discomfort. PMID:27839531

  20. “Dulling the edges”: Young Men’s use of alcohol to deal with grief following the death of a male friend

    PubMed Central

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

    2015-01-01

    Background The death of a male friend can be challenging for men because expressions of grief can be governed and restrained by dominant ideals of masculinity. It is common for young men to engage in health risk practices, such as alcohol overuse, to deal with feelings of sadness. Objective This qualitative study investigated the ways that young men use alcohol in the process of grieving the accidental death of a male friend. Methods Participants included 35 men 19–25 years old, and 22 men, ages 26–35 who participated in individual semi-structured interviews between 2010–2012. Results Methodology informed by grounded theory and narrative analysis was used to analyse and interpret the transcribed interviews, focusing on the ways that men used alcohol in the grief process. Through data analysis we inductively derived three themes: 1) Using Alcohol to Dull the Pain and 2) Using Alcohol to Purge Sadness, and 3) Troubled Drinking. Conclusions This study provides evidence to show that men’s binge drinking following tragic loss is a means to express emotion and connect with others. Health interventions for young men who have lost a male peer need to be sensitive to gendered norms that inform grief practices and work with them to discern pathways toward recovery that promote long term wellness. PMID:26202615

  1. Parent Spirituality, Grief, and Mental Health at 1 and 3 Months After Their Infant's/Child's Death in an Intensive Care Unit

    PubMed Central

    Hawthorne, Dawn M.; Youngblut, JoAnne M.; Brooten, Dorothy

    2016-01-01

    Problem The death of an infant/child is one of the most devastating experiences for parents and immediately throws them into crisis. Research on the use of spiritual/religious coping strategies is limited, especially with Black and Hispanic parents after a neonatal (NICU) or pediatric intensive care unit (PICU) death. Purpose The purpose of this longitudinal study was to test the relationships between spiritual/religious coping strategies and grief, mental health (depression and post-traumatic stress disorder) and personal growth for mothers and fathers at 1 (T1) and 3 (T2) months after the infant's/child's death in the NICU/ PICU, with and without control for race/ethnicity and religion. Results Bereaved parents' greater use of spiritual activities was associated with lower symptoms of grief, mental health (depression and post-traumatic stress), but not post-traumatic stress in fathers. Use of religious activities was significantly related to greater personal growth for mothers, but not fathers. Conclusion Spiritual strategies and activities helped parents cope with their grief and helped bereaved mothers maintain their mental health and experience personal growth. PMID:26320884

  2. Long term complications of diabetes

    MedlinePlus

    ... medlineplus.gov/ency/patientinstructions/000327.htm Long-term complications of diabetes To use the sharing features on this page, ... other tests. All these may help you keep complications of diabetes away. You will need to check your blood ...

  3. Complicated bile duct stones

    PubMed Central

    Roy, Ashwin; Martin, Derrick

    2013-01-01

    Common bile duct stones (CBDSs) are solid deposits that can either form within the gallbladder or migrate to the common bile duct (CBD), or form de novo in the biliary tree. In the USA around 15% of the population have gallstones and of these, 3% present with symptoms annually. Because of this, there have been major advancements in the management of gallstones and related conditions. Management is based on the patient's risk profile; young and healthy patients are likely to be recommended for surgery and elderly patients with comorbidities are usually recommended for endoscopic procedures. Imaging of gallstones has advanced in the last 30 years with endoscopic retrograde cholangiopancreatography evolving from a diagnostic to a therapeutic procedure in removing CBDSs. We present a complicated case of a patient with a CBDS and periampullary diverticulum and discuss the techniques used to diagnose and remove the stone from the biliary system. PMID:23946532

  4. Neurological complications in chronic kidney disease

    PubMed Central

    Arnold, Ria; Issar, Tushar; Krishnan, Arun V

    2016-01-01

    Patients with chronic kidney disease (CKD) are frequently afflicted with neurological complications. These complications can potentially affect both the central and peripheral nervous systems. Common neurological complications in CKD include stroke, cognitive dysfunction, encephalopathy, peripheral and autonomic neuropathies. These conditions have significant impact not only on patient morbidity but also on mortality risk through a variety of mechanisms. Understanding the pathophysiological mechanisms of these conditions can provide insights into effective management strategies for neurological complications. This review describes clinical management of neurological complications in CKD with reference to the contributing physiological and pathological derangements. Stroke, cognitive dysfunction and dementia share several pathological mechanisms that may contribute to vascular impairment and neurodegeneration. Cognitive dysfunction and dementia may be differentiated from encephalopathy which has similar contributing factors but presents in an acute and rapidly progressive manner and may be accompanied by tremor and asterixis. Recent evidence suggests that dietary potassium restriction may be a useful preventative measure for peripheral neuropathy. Management of painful neuropathic symptoms can be achieved by pharmacological means with careful dosing and side effect considerations for reduced renal function. Patients with autonomic neuropathy may respond to sildenafil for impotence. Neurological complications often become clinically apparent at end-stage disease, however early detection and management of these conditions in mild CKD may reduce their impact at later stages. PMID:27867500

  5. Postoperative complications of spine surgery.

    PubMed

    Swann, Matthew C; Hoes, Kathryn S; Aoun, Salah G; McDonagh, David L

    2016-03-01

    A variety of surgical approaches are available for the treatment of spine diseases. Complications can arise intraoperatively, in the immediate postoperative period, or in a delayed fashion. These complications may lead to severe or even permanent morbidity if left unrecognized and untreated [1-4]. Here we review a range of complications in the early postoperative period from more benign complications such as postoperative nausea and vomiting (PONV) to more feared complications leading to permanent loss of neurological function or death [5]. Perioperative pain management is covered in a separate review (Chapter 8).

  6. Ocular complications of diabetes mellitus

    PubMed Central

    Sayin, Nihat; Kara, Necip; Pekel, Gökhan

    2015-01-01

    Diabetes mellitus (DM) is a important health problem that induces ernestful complications and it causes significant morbidity owing to specific microvascular complications such as, retinopathy, nephropathy and neuropathy, and macrovascular complications such as, ischaemic heart disease, and peripheral vasculopathy. It can affect children, young people and adults and is becoming more common. Ocular complications associated with DM are progressive and rapidly becoming the world’s most significant cause of morbidity and are preventable with early detection and timely treatment. This review provides an overview of five main ocular complications associated with DM, diabetic retinopathy and papillopathy, cataract, glaucoma, and ocular surface diseases. PMID:25685281

  7. Impact of dose calculation models on radiotherapy outcomes and quality adjusted life years for lung cancer treatment: do we need to measure radiotherapy outcomes to tune the radiobiological parameters of a normal tissue complication probability model?

    PubMed Central

    Docquière, Nicolas; Bondiau, Pierre-Yves; Balosso, Jacques

    2016-01-01

    Background The equivalent uniform dose (EUD) radiobiological model can be applied for lung cancer treatment plans to estimate the tumor control probability (TCP) and the normal tissue complication probability (NTCP) using different dose calculation models. Then, based on the different calculated doses, the quality adjusted life years (QALY) score can be assessed versus the uncomplicated tumor control probability (UTCP) concept in order to predict the overall outcome of the different treatment plans. Methods Nine lung cancer cases were included in this study. For the each patient, two treatments plans were generated. The doses were calculated respectively from pencil beam model, as pencil beam convolution (PBC) turning on 1D density correction with Modified Batho’s (MB) method, and point kernel model as anisotropic analytical algorithm (AAA) using exactly the same prescribed dose, normalized to 100% at isocentre point inside the target and beam arrangements. The radiotherapy outcomes and QALY were compared. The bootstrap method was used to improve the 95% confidence intervals (95% CI) estimation. Wilcoxon paired test was used to calculate P value. Results Compared to AAA considered as more realistic, the PBCMB overestimated the TCP while underestimating NTCP, P<0.05. Thus the UTCP and the QALY score were also overestimated. Conclusions To correlate measured QALY’s obtained from the follow-up of the patients with calculated QALY from DVH metrics, the more accurate dose calculation models should be first integrated in clinical use. Second, clinically measured outcomes are necessary to tune the parameters of the NTCP model used to link the treatment outcome with the QALY. Only after these two steps, the comparison and the ranking of different radiotherapy plans would be possible, avoiding over/under estimation of QALY and any other clinic-biological estimates. PMID:28149761

  8. Emergency Surgery for Acute Complicated Diverticulitis

    PubMed Central

    Köckerling, Ferdinand

    2015-01-01

    Background The optimal treatment of acute complicated diverticulitis is a matter of debate and has undergone significant changes. Currently, the main focus of surgical treatment concepts is on controlling the emergency situation triggered by acute complicated sigmoid diverticulitis through interventional and minimally invasive measures. Methods This article presents the current data and recommendations on differentiated treatment of acute complicated sigmoid diverticulitis, which are also summarized in a decision tree. Results In general, resection of the diverticular sigmoid is needed to treat acute complicated sigmoid diverticulitis, because without resection the recurrence rate is too high at 40%. Since the morbidity and mortality rates associated with emergency resection are extremely high, resulting in the creation of a stoma, efforts are made to control the acute situation through interventional and laparoscopic measures. Therefore, pericolic and pelvic abscesses (Hinchey stages I, II) are eliminated through percutaneous or laparoscopic drainage. Likewise, laparoscopic lavage and drainage are performed for purulent and feculent peritonitis (Hinchey stages III, IV). After elimination of the acute septic situation, interval elective sigmoid resection is conducted. If emergency resection cannot be avoided, it is performed, while taking account of the patient's overall condition, with primary anastomosis and a protective stoma or as discontinuity resection using Hartmann's procedure. Conclusion Thanks to the progress made in interventional and laparoscopic treatment, differentiated concepts are now used to treat acute complicated sigmoid diverticulitis. PMID:26989380

  9. Clearinghouse: Diagnostic Categories and Obstetric Complication Histories in Disturbed Children

    ERIC Educational Resources Information Center

    McNeil, Thomas F.; Wiegerink, Ronald

    1971-01-01

    No significant differences in the obstetric complication measures were found among the various diagnostic groupings of 61 psychologically or behaviorally disturbed children, nor between any complication measures and any of the three disturbed behavior patterns identified (psychotic withdrawal, acting-out aggression, organic signs). (KW)

  10. Dermatological complications of obesity.

    PubMed

    García Hidalgo, Linda

    2002-01-01

    Obesity is a health problem of considerable magnitude in the Western world. Dermatological changes have been reported in patients with obesity, including: acanthosis nigricans and skin tags (due to insulin resistance); hyperandrogenism; striae due to over extension; stasis pigmentation due to peripheral vascular disease; lymphedema; pathologies associated with augmented folds; morphologic changes in the foot anatomy due to excess load; and complications that may arise from hospitalization. Acanthosis nigricans plaques can be managed by improved control of hyperinsulinemia; the vitamin D3 analog calcipitriol has also been shown to be effective. Skin tags can be removed by snipping with curved scissors, by cryotherapy or by electrodesiccation. Hyperandrogenism, a result of increased production of endogenous androgens due to increased volumes of adipose tissue (which synthesizes testosterone) and hyperinsulinemia (which increases the production of ovarian androgens) needs to be carefully assessed to ensure disorders such as virilizing tumors and congenital adrenal hyperplasia are treated appropriately. Treatment of hyperandrogenism should be centred on controlling insulin levels; weight loss, oral contraceptive and antiandrogenic therapies are also possible treatment options. The etiology of striae distensae, also known as stretch marks, is yet to be defined and treatment options are unsatisfactory at present; striae rubra and alba have been treated with a pulsed dye laser with marginal success. The relationship between obesity and varicose veins is controversial; symptoms are best prevented by the use of elastic stockings. Itching and inflammation associated with stasis pigmentation, the result of red blood cells escaping into the tissues, can be treated with corticosteroids. Lymphedema is associated with dilatation of tissue channels, reduced tissue oxygenation and provides a culture medium for bacterial growth. Lymphedema treatment is directed towards reducing the

  11. [Acral necrosis as a complication of urosepsis].

    PubMed

    Blarer, J; Pfister, D; Jandali, A R; Gutzeit, A; John, H; Horstmann, M

    2014-06-01

    Sepsis is the third most common cause of death in Germany. Every fourth patient with sepsis has urosepsis. Even if substantial therapeutic progress has been made, sepsis remains a severe condition with high morbidity and mortality that requires rapid interdisciplinary measures. Besides life-threatening complications, acral necrosis as presented here can occur as a result of disseminated intravascular coagulation and severe microcirculatory disorders.

  12. Hematologic Complications of Pregnancy

    PubMed Central

    Townsley, Danielle M.

    2013-01-01

    Pregnancy induces a number of physiologic changes that affect the hematologic indices, either directly or indirectly. Recognizing and treating hematologic disorders that occur during pregnancy is difficult owing to the paucity of evidence available to guide consultants. This paper specifically reviews the diagnosis and management of benign hematologic disorders occurring during pregnancy. Anemia secondary to iron deficiency is the most frequent hematologic complication and is easily treated with oral iron formulations,; however care must be taken not to miss other causes of anemia, such as sickle cell disease. Thrombocytopenia is also a common reason for consulting the hematologist and distinguishing gestational thrombocytopenia from immune thrombocytopenia (ITP), preeclampsia, HELLP syndrome, or thrombotic thrombocytopenic purpura (TTP) is essential since the treatment differs widely. Occasionally the management of mother and infant involves the expeditious recognition of neonatal alloimmune thrombocytopenia (NAIT), a condition that is responsible for severe life-threatening bleeding of the newborn. Additionally, inherited and acquired bleeding disorders affect pregnant women disproportionately and often require careful monitoring of coagulation parameters in order to prevent bleeding in the puerperium. Finally, venous thromboembolism (VTE) during pregnancy is still largely responsible for mortality during pregnancy and the diagnosis, treatment options and guidelines for prevention of VTE during pregnancy are explored. PMID:23953339

  13. Complications of radiation therapy

    SciTech Connect

    Dalinka, M.K.; Mazzeo, V.P. Jr.

    1985-01-01

    The skeletal effects of radiation are dependent upon many variables, but the pathologic features are consistent. Radiation may cause immediate or delayed cell death, cellular injury with recovery, arrest of cellular division, or abnormal repair with neoplasia. Radiation necrosis and radiation-induced neoplasm still occur despite the use of supervoltage therapy. Complications of radiotherapy are well known and have led to more judicious use of this therapeutic modality. With few exceptions, benign bone tumors are no longer treated with irradiation. Radiation necrosis may be difficult to differentiate from sarcoma arising in irradiated bone. They both occur within the field of irradiation. Radiation necrosis often has a long latent period which is, of course, the rule in radiation-induced neoplasia. A soft tissue mass favors the diagnosis of neoplasia, while its absence suggests radiation necrosis. Lack of pain favors necrosis. Calcification may occur in radiation necrosis and does not indicate neoplasia. A lack of progression on serial roentgenograms also favors radiation necrosis. 76 references.

  14. Complications of donor apheresis.

    PubMed

    Winters, Jeffrey L

    2006-07-01

    A decreasing blood donor pool in the presence of increasing blood transfusion demands has resulted in the need to maximally utilize each blood donor. This has led to a trend in the increasing use of automated blood collections. While apheresis donation shares many reactions and injuries with whole blood donation, because of the differences, unique complications also exist. Overall, evidence in the literature suggests that the frequency of reactions to apheresis donation is less than that seen in whole blood donation, though the risk of reactions requiring hospitalization is substantially greater. The most common apheresis-specific reaction is hypocalcemia due to citrate anticoagulation, which, while usually mild, has the potential for severely injuring the donor. Other reactions to apheresis donation are uncommon (e.g., hypotension) or rare (e.g., air embolism). More worrisome, and in need of additional study, are the long-term effects of apheresis donation. Recent evidence suggests that repeated apheresis platelet donations may adversely effect thrombopoiesis as well as bone mineralization. Granulocyte donation has also been implicated in unexpected long-term consequences.

  15. COMPLICATIONS OF TATTOOING

    PubMed Central

    Lubeck, Glenn; Epstein, Ervin

    1952-01-01

    Pathologic consequence of tattooing is relatively rare, but in light of the great number of persons in military service, where tattooing seems to be popular, consideration of the complications seems worth while. Four unusual cases of patients with cutaneous lesions in tattoos are reported. One patient had Boeck's sarcoid, in which the cutaneous eruption was limited solely to the tattooed areas on the body and involved all the various colors of the tattoo. The cutaneous eruption was only a single manifestation of generalized sarcoidosis. Another patient had secondary syphilis with the cutaneous lesions involving multi-colored tattoos, including the red areas. These tattoos were applied in Hawaii, and presumably the red dye was not the usual cinnabar (mercuric sulfide). As a general rule, the cutaneous lesions of secondary syphilis do not involve the red areas because of the treponomicidal action of mercuric sulfide. In the third case the characteristic eruption of discoid lupus erythematosus was present. It began over the red areas of a tattoo on the patient's forearm. It has been stated that mercuric sulfide is a photo-sensitizing agent, and it is believed that this explains the localization of the eruption in this case. The fourth patient had eruption, caused by mercury sensitivity, in an area of tattoo. The eruption was noted soon after the tattooing was done, and it persisted for seven years. PMID:14905289

  16. Neurovascular complications of cocaine.

    PubMed

    Daras, M; Tuchman, A J; Koppel, B S; Samkoff, L M; Weitzner, I; Marc, J

    1994-08-01

    Use of cocaine in the USA, has reached epidemic proportions since 1983, when "crack" was introduced, its higher potency compared with cocaine HCl has been associated with a tremendous increase in the incidence of strokes. This study reports our experience with 55 cases of neurovascular events (25 ischemic and 30 hemorrhagic) related to cocaine use in 54 patients. Only 15 patients had other risk factors for stroke. Twenty six patients smoked "crack", 10 snorted cocaine and 12 injected it intravenously. Strokes occurred within 3 h of cocaine use in 15 patients with infarcts and 17 with hemorrhages. Ten infarcts occurred after an overnight binge. Of the hemorrhage group 9 were subarachnoid, 16 intracerebral (8 basal ganglia, 7 hemispheric and one brain stem) and 5 intraventricular. Computerized tomography (CT) showed an aneurysm of the anterior communicating artery, as well as one of the vein of Galen. Four aneurysms and 3 AVMs were identified on angiography. CT revealed 15 infarcts; it was normal in 7 patients with pure motor hemiparesis and in 3 with findings consistent with anterior spinal artery infarction. Several mechanisms may be responsible for the cerebrovascular complications. A sudden rise in systemic arterial pressure may cause hemorrhages, frequently in association with an underlying aneurysm or AVM. Vasospasm, arteritis, myocardial infarction with cardiac arrhythmias and increased platelet aggregation may provoke infarcts.

  17. Nutritional Predictors of Complications Following Radical Cystectomy

    PubMed Central

    Johnson, David C.; Riggs, Stephen B.; Nielsen, Matthew E.; Matthews, Jonathan E.; Woods, Michael E.; Wallen, Eric M.; Pruthi, Raj S.; Smith, Angela B.

    2016-01-01

    Purpose To determine the impact of preoperative nutritional status on the development of surgical complications following cystectomy using the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP). Methods We performed a retrospective review of the NSQIP 2005–2012 Participant Use Data Files. ACS-NSQIP collects data on 135 variables, including pre- and intraoperative data and 30-day post-operative complications and mortality on all major surgical procedures at participating institutions. Preoperative albumin (<3.5 or >3.5 g/dl), weight loss 6 months before surgery (>10%), and BMI were identified as nutritional variables within the database. The overall complication rate was calculated and predictors of complications were identified using multivariable logistic regression models. Results 1,213 patients underwent cystectomy for bladder cancer between 2005–2012. The overall 30-day complication rate was 55.1% (n=668). While 14.7% (n=102) had a preoperative albumin <3.5 g/dL, 3.4% had >10% weight loss in the 6 months prior to surgery, and the mean BMI was 28 kg/m2. After controlling for age, sex, medical comorbidities, medical resident involvement, operation year, operative time and prior operation, only albumin <3.5g/dl was a significant predictor of experiencing a postoperative complication (p=0.03). This remained significant when albumin was evaluated as a continuous variable (p=0.02) Conclusions Poor nutritional status measured by serum albumin is predictive of an increased rate of surgical complications following radical cystectomy. This finding supports the importance of preoperative nutritional status in this population and highlights the need for the development of effective nutritional interventions in the preoperative setting. PMID:25240535

  18. [Hyponatremia - carbamazepine medication complications].

    PubMed

    Dedinská, I; Maňka, V; Ságová, I; Klimentová, A; Makovický, P; Polko, J; Sadloňová, J; Mokáň, M

    2012-01-01

    Hyponatremia can be defined like the low sodium concentration, lower that 135 mmol/l. It becomes really serious when the concentration is lower than 120 mmol/l. The most frequent causes of hyponatremia are: the extrarenal loss (GIT, skin, bleeding, sequestration), the renal loss (diuretics, nephritis with the salt loss, osmotical diuresis, the Addison disease), hypothyroidism, the lack of glucocorticoids, emotional stress, pain, pseudohyponatremia (incorrect taking, dyslipoproteinemia). There is fatigue, exhaustion, headache and vertigoes dominating in the clinical record file. By the deficit increasing a patient becomes delirious, comatose even with the shock development. It is necessary to separate sufficient supply of sodium from much more often reason, which is loss of sodium which can be caused by: excessive sweating, vomitting with the metabolical alkalosis development, diarrhoea with the metabolical acidosis development, renal losses (a phase of renal failure). Treatment of hyponatremia: intensive treatment starts at the level of plasmatic concentration of sodium under 120 mmol/l or when neurological symptoms of brain oedema are present. In the therapy it is necessary to avoid fast infusions of hypertonic saline solutions (3-5% NaCl solutions) because of the danger of the development of serious CNS complications (intracranial bleeding, etc.). It is recommended to adjust the plasmatic concentration of sodium up to 120 mmol/l during the first four hours and a subsequent correction should not be higher than 2 mmol per an hour. Treatment of the basic illness is very important. We present 2 case histories: a 74-year old female patient and a 69-year old female patient both with the hyponatremia caused by taking of carbamazepine. We want to inform and warn about not only a well known side effect during long-term treatment but about hyponatremia that arose within 48 hours after the start of taking medicine as well.

  19. The politics of grief and continuing bonds with the dead: the cases of Maoist China and Wahhabi Islam.

    PubMed

    Klass, Dennis; Goss, Robert

    2003-11-01

    The article is a contribution to a cross-cultural theory of grief. It examines the relationship between individual/family continuing bonds with the dead and cultural narratives that legitimize political power. The dead are collective representations (Dirkheim) that mediate the larger culture to individuals and to smaller communities and that reinforce social solidarity and identity. The political question is which collective--family, community, church, party, nation--owns the dead and controls the rituals by which bonds with the dead are maintained or relinquished? The article discusses one historical condition: times of rapid change in power arrangements. Bonds with the dead have a power in individual, family, or tribal life that can threaten the narrative that legitimizes the new political power holders. Ancestor rituals that support identity as a family or tribal member are surpressed and replaced by allegiance to collective representations of the new political order. Two historical examples are given: China under Chairman Mao and the Wahhabi reform in Arabic Islam.

  20. "The story God is weaving us into": narrativizing grief, faith, and infant loss in US evangelical women's blog communities

    NASA Astrophysics Data System (ADS)

    Whitehead, Deborah

    2015-04-01

    This case study explores how US evangelical Christian "mommy blog" communities constitute spaces for the collective memorialization of infant loss. Personal religious blogs feature a rich combination of esthetics, narrative structure, description of religious practices and beliefs, reader interaction, and linked networks. Using a textual approach, I illustrate distinctive features in how pregnancy and infant loss and grief are experienced, shared and memorialized in US women's evangelical blogging communities. I argue that the blog format allows for a (re)narrativization of the devastating experience of infant loss as grieving mothers situate their traumatic personal experiences within the context of an ongoing religious narrative in which blog readers also come to participate. As the blogger tells the story of her own loss to a listening public, it becomes a larger shared story, so that it is not just the child's story but also the author's story, their family's story, and "our story" inclusive of the blog community of readers, "the story God is weaving us into," post by post, day by day. Personal religious blogs and their reading publics, therefore, can provide a medium for the ongoing creation of meaning, faith and community in the context of infant loss.

  1. Neurosurgical complications after intranasal ethmoidectomy.

    PubMed

    Toselli, R M; dePapp, A; Harbaugh, R E; Saunders, R L

    1991-05-01

    Intranasal ethmoidectomy is a common otolaryngological procedure. Despite the potential for serious intracranial complications, there is a paucity of reports describing the neurosurgical complications of the procedure. Two patients with intracranial complications of intranasal ethmoidectomy, and the relevant medical literature, are reviewed. The anatomy of the ethmoid air cells and their relation to the intracranial cavity are described. The importance of definitive, emergent repair with attention to the potential for vascular injury is discussed.

  2. Neurosurgical complications after intranasal ethmoidectomy.

    PubMed Central

    Toselli, R M; dePapp, A; Harbaugh, R E; Saunders, R L

    1991-01-01

    Intranasal ethmoidectomy is a common otolaryngological procedure. Despite the potential for serious intracranial complications, there is a paucity of reports describing the neurosurgical complications of the procedure. Two patients with intracranial complications of intranasal ethmoidectomy, and the relevant medical literature, are reviewed. The anatomy of the ethmoid air cells and their relation to the intracranial cavity are described. The importance of definitive, emergent repair with attention to the potential for vascular injury is discussed. PMID:1865214

  3. [Epidural emphysema complicating bronchial asthma].

    PubMed

    Rouetbi, N; Ben Saad, A; Joobeur, S; Skhiri, N; Cheikh Mhamed, S; Mribah, H; El Kamel, A

    2012-12-01

    Epidural emphysema is an exceptional complication of bronchial asthma, revealed by an incidental finding in chest tomography. We report a case of a 21-year-old man admitted with asthma attack complicated by subcutaneous and mediastinal emphysema. Chest tomography confirmed the mediastinal emphysema and also revealed the epidural emphysema within the vertebral canal. Neurological examination was negative. The patient showed complete recovery 10days after the onset of symptoms. The epidural emphysema is a rare complication during asthma attacks. The benignity of this complication should not require a systematic chest tomography.

  4. Complications of endoscopic intranasal ethmoidectomy.

    PubMed

    Stankiewicz, J A

    1987-11-01

    A consecutive series of 90 patients undergoing endoscopic intranasal ethmoidectomy was reviewed. There were 26 complications (29%) in 19 patients in this group. Eight complications (8%) including CSF leak, temporary blindness, and hemorrhage were considered major with the latter occurring most commonly. Synechiae were the most commonly occurring minor complications. Endoscopic nasal sinus surgery performed by inexperienced operators carries with it the same risks and complications as traditional intranasal sinus surgery. Any surgeon who does not routinely perform traditional intranasal ethmoidectomy should accrue endoscopic experience through appropriate didactic training and multiple cadaver dissections (akin to otologic training).

  5. Hemodialysis Tunneled Catheter Noninfectious Complications

    PubMed Central

    Miller, Lisa M.; MacRae, Jennifer M.; Kiaii, Mercedeh; Clark, Edward; Dipchand, Christine; Kappel, Joanne; Lok, Charmaine; Luscombe, Rick; Moist, Louise; Oliver, Matthew; Pike, Pamela; Hiremath, Swapnil

    2016-01-01

    Noninfectious hemodialysis catheter complications include catheter dysfunction, catheter-related thrombus, and central vein stenosis. The definitions, causes, and treatment strategies for catheter dysfunction are reviewed below. Catheter-related thrombus is a less common but serious complication of catheters, requiring catheter removal and systemic anticoagulation. In addition, the risk factors, clinical manifestation, and treatment options for central vein stenosis are outlined. PMID:28270922

  6. [Renal complications due to desensitization].

    PubMed

    Drouet, M; Sabbah, A; Bonneau, J C; Le Sellin, J

    1986-04-01

    Two observations with induction of renal complications during immunotherapy are reported. For the first patient proteinuria and infections complications happened immediately after a rush immunotherapy with Yellow Jacket Venom Extract. For the second patient an "half-rush" immunotherapy with light doses of phleole extract (cumulative dose: 7 PNU) induced an immediate reaction with rhinitis, conjunctivitis and after 24 hours a macroscopic hematuria.

  7. [Complications caused by intravenous therapy].

    PubMed

    Quirós Luque, José María; Gago Fornells, Manuel

    2005-11-01

    Nursing professionals must know everything related to complications caused by intravenous therapy including the ways to prevent and solve these complications. We need not forget that nurses are the ones mainly responsible for the insertion, manipulation, removal and care of catheters.

  8. Complications of Laparoscopic Gynecologic Surgery

    PubMed Central

    Fuentes, Mariña Naveiro; Naveiro Rilo, José Cesáreo; Paredes, Aida González; Aguilar Romero, María Teresa; Parra, Jorge Fernández

    2014-01-01

    Background and Objectives: To analyze the frequency of complications during laparoscopic gynecologic surgery and identify associated risk factors. Methods: A descriptive observational study was performed between January 2000 and December 2012 and included all gynecologic laparoscopies performed at our center. Variables were recorded for patient characteristics, indication for surgery, length of hospital stay (in days), major and minor complications, and conversions to laparotomy. To identify risk factors and variables associated with complications, crude and adjusted odds ratios were calculated with unconditional logistic regression. Results: Of all 2888 laparoscopies included, most were procedures of moderate difficulty (adnexal surgery) (54.2%). The overall frequency of major complications was 1.93%, and that of minor complications was 4.29%. The level of technical difficulty and existence of prior abdominal surgery were associated with a higher risk of major complications and conversions to laparotomy. Conclusion: Laparoscopic gynecologic surgery is associated with a low frequency of complications but is a procedure that is not without risk. Greater technical difficulty and prior surgery were factors associated with a higher frequency of complications. PMID:25392659

  9. Neurological Complications of Bariatric Surgery.

    PubMed

    Goodman, Jerry Clay

    2015-12-01

    Obesity has attained pandemic proportions, and bariatric surgery is increasingly being employed resulting in turn to more neurological complications which must be recognized and managed. Neurological complications may result from mechanical or inflammatory mechanisms but primarily result from micro-nutritional deficiencies. Vitamin B12, thiamine, and copper constitute the most frequent deficiencies. Neurological complications may occur at reasonably predictable times after bariatric surgery and are associated with the type of surgery used. During the early post-operative period, compressive or stretch peripheral nerve injury, rhabdomyolysis, Wernicke's encephalopathy, and inflammatory polyradiculoneuropathy may occur. Late complications ensue after months to years and include combined system degeneration (vitamin B12 deficiency) and hypocupric myelopathy. Bariatric surgery patients require careful nutritional follow-up with routine monitoring of micronutrients at 6 weeks and 3, 6, and 12 months post-operatively and then annually after surgery and multivitamin supplementation for life. Sustained vigilance for common and rare neurological complications is essential.

  10. The Normalcy of Parental Bereavement: Re-Thinking Complicated Mourning.

    ERIC Educational Resources Information Center

    Kagan, Henya Klein

    The death of a child is a traumatic event for parents. Parental bereavement is a normal reactive process to an abnormal event. The duration of grief is life-long with varying intensity. It requires readjustment to a new reality. This process of readjustment is considered from both the bereaved parent's and from the outside observer's perspectives.…

  11. Complications of baclofen overdosage.

    PubMed

    Ghose, K; Holmes, K M; Matthewson, K

    1980-12-01

    A 39-year-old female patient who had been receiving 30 mg of baclofen daily for 5 months was admitted to the hospital about 12 hr after overdose of this drug (450 mg). On admission, she was comatose, flaccid, and in respiratory failure. Later she developed muscle twitchings and had several epileptic fits. She was treated symptomatically and became conscious within 36 hr. However, approximately 65 hr after the overdose she developed sinus tachycardia which was successfully treated with oral propranolol. Plasma concentrations, as measured on days 2 and 3, were within the therapeutic range but the elimination half-life was prolonged.

  12. Neurological complications of bariatric surgery

    PubMed Central

    Algahtani, Hussein A.; Khan, Abid S.; Khan, Muhammad A.; Aldarmahi, Ahmed A.; Lodhi, Yousif

    2016-01-01

    Objective: To review and analyze the neurological complications from bariatric surgery in Kingdom of Saudi Arabia. Methods: This cross sectional study was carried out in King Abdulaziz Medical City, Jeddah, Kingdom of Saudi Arabia from January 2009 to December 2015. Important personal and clinical data were collected from the charts of the patients who underwent bariatric surgery. Data on follow up visit and remote complication if present, was also collected. All patients with neurological complications were reviewed in detail. The significant difference was calculated by using T-test and p-value<0.05 was considered significant. Results: A total of 451 patients underwent bariatric surgery, 15 cases had neurological complications (3%). Axonal polyneuropathy was the most frequent neurological complication, but cases of Wernicke syndrome, vitamin B12 deficiency, Guillain-Barre syndrome and copper deficiency were also identified. Fourteen patients (93.3%) had full recovery from the neurological signs and symptoms; one patient died. Conclusions: Bariatric surgery is not free of potential neurological complications. Complications may affect both central and peripheral nervous system and death is a possibility. Multidisciplinary care including consultation of different teams is highly recommended. PMID:27356656

  13. Grief and Grief Processing for Preschool Children.

    ERIC Educational Resources Information Center

    Duncan, Uyntha

    Educators contribute to children's anxiety and pain when they fail to provide children with information about loss and death and ways of coping with loss and death. Children who are denied factual information about experiences of loss and death develop fantasies and misconceptions regarding the experiences and suffer more anxiety and pain than…

  14. Airway complications after lung transplantation.

    PubMed

    Machuzak, Michael; Santacruz, Jose F; Gildea, Thomas; Murthy, Sudish C

    2015-01-01

    Airway complications after lung transplantation present a formidable challenge to the lung transplant team, ranging from mere unusual images to fatal events. The exact incidence of complications is wide-ranging depending on the type of event, and there is still evolution of a universal characterization of the airway findings. Management is also wide-ranging. Simple observation or simple balloon bronchoplasty is sufficient in many cases, but vigilance following more severe necrosis is required for late development of both anastomotic and nonanastomotic airway strictures. Furthermore, the impact of coexisting infection, rejection, and medical disease associated with high-level immunosuppression further complicates care.

  15. Neurological complications of cardiac surgery.

    PubMed

    McDonagh, David L; Berger, Miles; Mathew, Joseph P; Graffagnino, Carmelo; Milano, Carmelo A; Newman, Mark F

    2014-05-01

    As increasing numbers of elderly people undergo cardiac surgery, neurologists are frequently called upon to assess patients with neurological complications from the procedure. Some complications mandate acute intervention, whereas others need longer term observation and management. A large amount of published literature exists about these complications and guidance on best practice is constantly changing. Similarly, despite technological advances in surgical intervention and modifications in surgical technique to make cardiac procedures safer, these advances often create new avenues for neurological injury. Accordingly, rapid and precise neurological assessment and therapeutic intervention rests on a solid understanding of the evidence base and procedural variables.

  16. Complications of equine oral surgery.

    PubMed

    Dixon, Padraic M; Hawkes, Claire; Townsend, Neil

    2008-12-01

    The vast majority of equine oral procedures are dental-related and, unless great care is taken, almost all such procedures have the potential to cause marked short- or long-term damage to other oral structures. This review of the more common complications of oral surgery begins at the rostral oral cavity with procedures of the incisors, and then moves caudally to deal with complications related to procedures of wolf teeth and cheek teeth, including salivary duct disruption and dental sinusitis. Finally, complications associated with maxillary and mandibular fractures are discussed.

  17. Gastrointestinal Complications After Bariatric Surgery

    PubMed Central

    Ma, Irene T.

    2015-01-01

    Bariatric surgery is increasingly being performed in the medically complicated obese population as convincing data continue to mount, documenting the success of surgery not only in achieving meaningful weight loss but also in correcting obesity-related illnesses. Several surgical procedures with varying degrees of success and complications are currently being performed. This article discusses the short- and long-term gastrointestinal complications for the 4 most common bariatric surgical procedures: laparoscopic adjustable gastric banding, vertical sleeve gastrectomy, Roux-en-Y gastric bypass, and biliopancreatic diversion with duodenal switch. PMID:27118949

  18. Management and complications of stomas.

    PubMed

    Bafford, Andrea C; Irani, Jennifer L

    2013-02-01

    Stomas are created for a wide range of indications such as temporary protection of a high-risk anastomosis, diversion of sepsis, or permanent relief of obstructed defecation or incontinence. Yet this seemingly benign procedure is associated with an overall complication rate of up to 70%. Therefore, surgeons caring for patients with gastrointestinal diseases must be proficient not only with stoma creation but also with managing postoperative stoma-related complications. This article reviews the common complications associated with ostomy creation and strategies for their management.

  19. Liver Transplant: Complications/Medications

    MedlinePlus

    ... can develop a complication requiring return to the operating room for repair or other procedures to open up the new connections. Rejection: Your immune system helps fight infections. It does this by recognizing ...

  20. Prevention of complications in dermatosurgery.

    PubMed

    Situm, Mirna; Buljan, Marija; Cavka, Vlatka; Di Biagio, Nevena Skroza; Sebetić, Klaudija; Poduje, Sanja

    2008-01-01

    Dermatosurgery has become ever more popular and important in recent years, mostly due to the increasing prevalence of skin malignancies. It also encompasses a wide variety of methods to remove or modify skin tissue for numerous cosmetic reasons. Nowadays, many dermatologists provide complete dermatologic care for their patients, including surgery. Therefore, it is important to be aware of the possible complications and to be able to manage them properly. Complications in cutaneous surgery are not very often, but they can be serious and worrisome including bleeding, infections, allergic reactions, syncope, wound dehiscence, necrosis, and others. In this article special attention is given to bleeding, which is the most common complication in this field. The best way to reduce the number of possible complications is to recognize patients at risk. Thus, complete history and physical examination are required before performing any dermatosurgical operation.

  1. Ocular complications of boxing

    PubMed Central

    Bianco, M; Vaiano, A; Colella, F; Coccimiglio, F; Moscetti, M; Palmieri, V; Focosi, F; Zeppilli, P; Vinger, P

    2005-01-01

    Objectives: To investigate the prevalence of ocular injuries in a large population of boxers over a period of 16 years, in particular, the most severe lesions that may be vision threatening. Methods: Clinical records of the medical archive of the Italian Boxing Federation were analysed. A total of 1032 boxers were examined from February 1982 to October 1998. A complete ophthalmological history was available for 956, who formed the study population (a total of 10 697 examinations). The following data were collected: age when started boxing; duration of competitive boxing career (from the date of the first bout); weight category; a thorough ocular history. The following investigations were carried out: measurement of visual acuity and visual fields, anterior segment inspection, applanation tonometry, gonioscopy, and examination of ocular fundus. Eighty age matched healthy subjects, who had never boxed, formed the control group. Results: Of the 956 boxers examined, 428 were amateur (44.8%) and 528 professional (55.2%). The median age at first examination was 23.1 (4.3) years (range 15–36). The prevalence of conjunctival, corneal, lenticular, vitreal, ocular papilla, and retinal alterations in the study population was 40.9% compared with 3.1% in the control group (p⩽0.0001). The prevalence of serious ocular findings (angle, lens, macula, and peripheral retina alterations) was 5.6% in boxers and 3.1% in controls (NS). Conclusions: Boxing does not result in a higher prevalence of severe ocular lesions than in the general population. However, the prevalence of milder lesions (in particular with regard to the conjunctiva and cornea) is noteworthy, justifying the need for adequate ophthalmological surveillance. PMID:15665199

  2. A resolution supporting the goals and ideals of "Children's Grief Awareness Day".

    THOMAS, 112th Congress

    Sen. Casey, Robert P., Jr. [D-PA

    2012-11-13

    11/13/2012 Referred to the Committee on Health, Education, Labor, and Pensions. (text of measure as introduced: CR S6747) (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

  3. [Postoperative complications in plastic surgery].

    PubMed

    Vogt, P M

    2009-09-01

    Plastic surgery covers a broad spectrum of diseases and conditions in the areas of reconstructive surgery, hand, burn and aesthetic surgery. Besides acquired defects or malformations an increasing number of patients are being treated for surgical or multimodal complications. In a considerable number of patients plastic and reconstructive surgery remains the only therapeutic alternative after other therapy has failed. Therefore complication management in plastic surgery is of utmost importance for a successful outcome. In addition patient expectations in the results of plastic surgery as a discipline of invention and problem solving are steadily increasing. This challenge is reflected in clinical patient management by intensive research in tissue engineering and regenerative medicine. Patients in plastic surgery are recruited from all age groups of either gender, involving traumatic and oncologic as well as congenital and aesthetic disorders. The demographics of aging, multimorbidity and obesity pose new challenges to plastic surgery. Although age over 70 years is not an independent risk factor per se for complications in plastic surgery, e.g. for complex free flap transfer, medical problems are present at a higher rate, which is to be expected in this age group. Risk factors such as alcoholism and coronary heart diseases seem to be independent predictors of perioperative complications. Therefore older patients can also benefit from plastic surgery and recurrent operations by the corresponding risk and complication management. Complication management necessitates careful patient selection, estimation of operative risks and patient-adapted selection of procedures. In addition to expertise in plastic surgery a thorough knowledge of non-surgical and surgical back-up procedures for technical incidents as well as vascular circulatory and wound healing disorders is required to deal successfully with complications in plastic surgery. This article presents these specific

  4. The management of complicated glaucoma

    PubMed Central

    Clement, C I; Goldberg, Ivan

    2011-01-01

    Complicated glaucomas present considerable diagnostic and management challenges. Response to treatment can be unpredictable or reduced compared with other glaucomas. However, target intraocular pressure and preservation of vision may be achieved with selected medical, laser and surgical treatment. The evidence for such treatment is expanding and consequently affords clinicians a better understanding of established and novel techniques. Herein we review the mechanisms involved in the development of complicated glaucoma and the current evidence supporting its management. PMID:21150026

  5. [Multiple complications after renal transplantation].

    PubMed

    Manrique, J; Rossich, E; Hernández Sierra, A

    2004-01-01

    This is the case of a 32-year-old male patient, diagnosed with end stage renal disease secondary to a focal and segmental glomerulonephritis. After four years of haemodialysis, he received a renal graft from a cadaveric donor. During the following sixteen years, he developped many different complications. In the early post-transplant period, he developed a severe acute tubular necrosis and two episodes of acute rejection took place, both of them with later recovery. Among the outstanding infectious complications were a virus herpes zoster dorsal infection and a Pseudomonas aeruginosa nosocomial pneumonia. Twelve months later, a series of severe digestive complications took place: cholecystitis that required cholecystectomy, pancreatic pseudocyst which required laparotomy because of an abdominal complication, two separate episodes of upper digestive bleeding that finally required gastric surgery, and an hemorrhagic subphrenic abscess that required a second laparotomy. Currently he has developed a calcified chronic pancreatitis. Moreover, metabolic complications must be mentioned carbohydrate intolerance, cataracts and an avascular bone necrosis, all of them closely related to the immunosuppressive therapy. In spite of these multiple complications, he mantains a good renal function and his quality of life is acceptable.

  6. The genetics of diabetic complications.

    PubMed

    Ahlqvist, Emma; van Zuydam, Natalie R; Groop, Leif C; McCarthy, Mark I

    2015-05-01

    The rising global prevalence of diabetes mellitus is accompanied by an increasing burden of morbidity and mortality that is attributable to the complications of chronic hyperglycaemia. These complications include blindness, renal failure and cardiovascular disease. Current therapeutic options for chronic hyperglycaemia reduce, but do not eradicate, the risk of these complications. Success in defining new preventative and therapeutic strategies hinges on an improved understanding of the molecular processes involved in the development of these complications. This Review explores the role of human genetics in delivering such insights, and describes progress in characterizing the sequence variants that influence individual predisposition to diabetic kidney disease, retinopathy, neuropathy and accelerated cardiovascular disease. Numerous risk variants for microvascular complications of diabetes have been reported, but very few have shown robust replication. Furthermore, only limited evidence exists of a difference in the repertoire of risk variants influencing macrovascular disease between those with and those without diabetes. Here, we outline the challenges associated with the genetic analysis of diabetic complications and highlight ongoing efforts to deliver biological insights that can drive translational benefits.

  7. Living bereavement: an exploration of healthcare workers' responses to loss and grief in an NHS continuing care ward for older people.

    PubMed

    Holman, Cheryl

    2008-12-01

    This article reports on research rooted in a work based education project and the theme of loss was chosen by the participating care staff who felt it was central to their work with dependent older people. They coined the phrase 'living bereavement' meaning the complex responses and grief reactions of those experiencing and bearing witness to the multiple losses endured in continuing care environments. Aim.  The research was to identify the emotional demand of living bereavement and to explore and develop care staff's capacity to work with it. Methods.  Qualitative methods including participant observation and Reflective Work Groups were used to generate and analyse data over a three year period. A psychoanalytic dimension was added to the research through participation in a supervision group facilitated by a psychotherapist. Findings.  In the article the key message from the findings, that there is an intense emotional demand in care work related to loss and grief in continuing care environments, is explained. The trajectory of living bereavement is discussed and illustrated with examples. Implications for practice.  Some emotional aspects of the care work were glossed over or ignored which affected the way care was delivered. This may have been because the feelings were disturbing or painful to deal with. It is important to support staff working with difficult feelings so that emotional aspects of their work can be acknowledged and thought about.

  8. A narrative approach to explore grief experiences and treatment adherence in people with chronic pain after participation in a pain-management program: a 6-year follow-up study

    PubMed Central

    Dysvik, Elin; Natvig, Gerd Karin; Furnes, Bodil

    2013-01-01

    Objective The aim of this study was to explore grief caused by chronic pain and treatment adherence, and how these experiences are integrated into ongoing life stories. Methods A 6-year follow-up using a qualitative mixed-methods design based on written narratives and image narratives was performed. Five women suffering from chronic pain comprised the purposive sample. They had completed an 8-week group pain-management program with two follow-ups, and thereafter continued as a self-help group. A narrative approach was used to analyze the written and image narratives guided by three analytic steps. Results Findings showed that experiences of grief over time were commonly associated with chronic pain. The participants’ past experiences reflected their grief at having to abandon jobs and social networks, and revealed loneliness and despair. The present life situation seemed to reflect adaptation, and hope for the future had been established. Overall, forward progression means an ongoing struggle towards a reintegrated body and a meaningful life. Conclusion Through such narratives, health-care workers can identify treatment adherence related to grief and pain, and learn how people might regain their lives beyond using traditional interviews. PMID:23990710

  9. Pulmonary complications following orthotopic liver transplant.

    PubMed

    Durán, F G; Piqueras, B; Romero, M; Carneros, J A; de Diego, A; Salcedo, M; Santos, L; Ferreiroa, J; Cos, E; Clemente, G

    1998-01-01

    Pulmonary complications after orthotopic liver transplant (OLT) are frequent, involving high morbidity and mortality. We have determined the pulmonary complication incidence in 187 patients submitted to OLT at the General University Hospital "Gregorio Marañón" in the last 4 years, analyzing the type of infection, evolution, diagnostic and therapeutic measures and their influence on OLT mortality. A total of 120 patients had pulmonary complications, the most frequent being pleural effusion (61.94%), pneumonia (43.36%), and pneumothorax (11.5%). Serious pulmonary hypertension was diagnosed by invasive methods in two patients at the time of surgery (unidentified before OLT); both died at early post postoperative times. Pleural effusion was noted in 70 patients, 31.42% of them requiring thoracic tube drainage, complications developing in 22.72%. Thirteen patients were diagnosed of pneumothorax, the most frequent etiologies being percutaneous liver biopsy, thoracic tube drainage for pleural effusion, and postoperative complications in 41.6, 33.3, and 23.3%, respectively. Pneumonia was diagnosed in the 1st month after OLT in 45 patients. Tests to diagnose and identify the etiological agent were made in 71.1% of diagnosed pneumonia patients, identification being obtained in 62.5%. Telescope catheter culture identified the agent in 48%, fiber optic bronchoscopy in 50%, and lung or pleural biopsy in 100%. Respiratory insufficiency was noted in 64 patients (34.22% of transplanted patients). Factors involved in their development were pneumonia (42.18%), graft dysfunction (39.06%, pleural effusion (34.37%), sepsis (28.18%), and poor nutritional status (7.81%). Fifty patients (41.66%) died, pulmonary pathology being the determinant factor in 28.8%. Patient mortality with respiratory insufficiency was greater, especially in those with three factors involved the development of respiratory insufficiency.

  10. Survival and complications in thalassemia.

    PubMed

    Borgna-Pignatti, C; Cappellini, M D; De Stefano, P; Del Vecchio, G C; Forni, G L; Gamberini, M R; Ghilardi, R; Origa, R; Piga, A; Romeo, M A; Zhao, H; Cnaan, A

    2005-01-01

    The life expectancy of patients with thalassemia major has significantly increased in recent years, as reported by several groups in different countries. However, complications are still frequent and affect the patients' quality of life. In a recent study from the United Kingdom, it was found that 50% of the patients had died before age 35. At that age, 65% of the patients from an Italian long-term study were still alive. Heart disease is responsible for more than half of the deaths. The prevalence of complications in Italian patients born after 1970 includes heart failure in 7%, hypogonadism in 55%, hypothyroidism in 11%, and diabetes in 6%. Similar data were reported in patients from the United States. In the Italian study, lower ferritin levels were associated with a lower probability of experiencing heart failure and with prolonged survival. Osteoporosis and osteopenia are common and affect virtually all patients. Hepatitis C virus antibodies are present in 85% of multitransfused Italian patients, 23% of patients in the United Kingdom, 35% in the United States, 34% in France, and 21% in India. Hepatocellular carcinoma can complicate the course of hepatitis. A survey of Italian centers has identified 23 such cases in patients with a thalassemia syndrome. In conclusion, rates of survival and complication-free survival continue to improve, due to better treatment strategies. New complications are appearing in long-term survivors. Iron overload of the heart remains the main cause of morbidity and mortality.

  11. [On the question of functional postvagotomy complications].

    PubMed

    Khalimov, E V; Kapustin, B B

    2004-01-01

    The intraoperative measures preventing functional complications after vagotomy were determined in performing organ-saving operations on 63 patients with complications of ulcer disease of the duodenum. Truncal vagotomy must be supplemented with draining operation. The draining operations should be carried out with the dissection of the cicatricial-ulcerous infiltration. The gastroduodenal anastomosis in draining operation should be formed by a one-row suture. When performing selective proximal vagotomy and its variants it is necessary to avoid iatrogenic damage of the Laterge nerve and its terminal part--"crow's feet". Mobilization of the abdominal part of the esophagus during different variants of selective proximal vagotomy must be fulfilled along the length not more than 5 cm proximal to the gastro-esophageal passage and to be associated with a correcting operation on the esophagocardial part.

  12. Factors associated with immediate abortion complications.

    PubMed Central

    Ferris, L E; McMain-Klein, M; Colodny, N; Fellows, G F; Lamont, J

    1996-01-01

    OBJECTIVE: To identify factors associated with increased risk of immediate complications from induced abortion. DESIGN: Retrospective analysis of a provincial database. SETTING: All Ontario general hospitals in which abortions are performed and all free-standing abortion clinics in Ontario. POPULATION: Women in Ontario aged 15 to 44 years who underwent an induced abortion in the province (without concurrent sterilization) between Jan. 1, 1992, and Dec. 31, 1993. OUTCOME MEASURES: Recording of complications at the time of the procedure, gestational age, type of procedure, place of abortion (hospital or clinic), and patient's age, parity and history of previous abortion (spontaneous or induced). RESULTS: During the study period 83 469 abortions were performed that met our inclusion criteria. Immediate complications were reported in 571 cases (0.7%). Multivariate logistic regression analysis revealed that, after other variables were controlled for, the patient's age, parity and history of previous abortions (spontaneous or induced) were not significant risk factors for immediate complications; however, gestational age, method of abortion and place of abortion were significant risk factors (p < 0.001). The odds ratio (OR) for having a complication from abortion was 1.3 (95% confidence interval [CI] 1.02 to 1.63) between 9 and 12 weeks, compared with having one after abortion at 9 weeks or earlier, and increased to 3.3 (95% CI 2.23 to 5.00) after abortion between 17 and 20 weeks. Compared with surgical dilatation and curettage (D&C), instillation of saline and instillation of prostaglandins were more likely to be associated with immediate complications (OR 24.0, 95% CI 13.22 to 43.70, and OR 11.7, 95% CI 6.43 to 21.18, respectively), whereas both suction D&C and insertion of a laminaria tent were less likely to be associated with immediate complications (OR 0.4, 95% CI 0.26 to 0.67, and OR 0.3, 95% CI 0.19 to 0.52, respectively). Compared with women who had an abortion

  13. Complications

    MedlinePlus

    ... Disease (Nephropathy) Gastroparesis Mental Health Step On Up Treatment & Care Blood Glucose Testing Medication Doctors, Nurses & More ... us get closer to curing diabetes and better treatments for those living with diabetes. Other Ways to ...

  14. Neurological complications of underwater diving.

    PubMed

    Rosińska, Justyna; Łukasik, Maria; Kozubski, Wojciech

    2015-01-01

    The diver's nervous system is extremely sensitive to high ambient pressure, which is the sum of atmospheric and hydrostatic pressure. Neurological complications associated with diving are a difficult diagnostic and therapeutic challenge. They occur in both commercial and recreational diving and are connected with increasing interest in the sport of diving. Hence it is very important to know the possible complications associated with this kind of sport. Complications of the nervous system may result from decompression sickness, pulmonary barotrauma associated with cerebral arterial air embolism (AGE), otic and sinus barotrauma, high pressure neurological syndrome (HPNS) and undesirable effect of gases used for breathing. The purpose of this review is to discuss the range of neurological symptoms that can occur during diving accidents and also the role of patent foramen ovale (PFO) and internal carotid artery (ICA) dissection in pathogenesis of stroke in divers.

  15. [Surgery in complicated colorectal cancer].

    PubMed

    Kreisler, Esther; Biondo, Sebastiano; Martí-Ragué, Joan

    2006-07-01

    Colorectal cancer continues to have a serious social impact. A large proportion of patients are diagnosed at an advanced stage of the disease. Approximately one-third of patients with colorectal cancer will undergo emergency surgery for a complicated tumor, with a high risk of mortality and poorer long-term prognosis. The most frequent complications are obstruction and perforation, while massive hemorrhage is rare. The curative potential of surgery, whether urgent or elective, depends on how radical the resection is, among other factors. In the literature on the management of urgent colorectal disease, there are few references to the oncological criteria for resection. Uncertainly about the optimal treatment has led to wide variability in the treatment of this entity. The present article aims to provide a critical appraisal of the controversies surrounding the role of surgery and its impact on complicated colorectal cancer.

  16. Neurologic Complications in Infective Endocarditis

    PubMed Central

    Morris, Nicholas A.; Matiello, Marcelo; Samuels, Martin A.

    2014-01-01

    Neurologic complications of infective endocarditis (IE) are common and frequently life threatening. Neurologic events are not always obvious. The prediction and management of neurologic complications of IE are not easily approached algorithmically, and the impact they have on timing and ability to surgically repair or replace the affected valve often requires a painstaking evaluation and joint effort across multiple medical disciplines in order to achieve the best possible outcome. Although specific recommendations are always tailored to the individual patient, there are some guiding principles that can be used to help direct the decision-making process. Herein, we review the pathophysiology, epidemiology, manifestations, and diagnosis of neurological complications of IE and further consider the impact they have on clinical decision making. PMID:25360207

  17. Neurological complications of childhood leukaemia.

    PubMed Central

    Campbell, R H; Marshall, W C; Chessells, J M

    1977-01-01

    We have reviewed the neurological complications not directly attributable to leukaemic infiltration in a group of 438 children with leukaemia or lymphoma. 61 children had one or more complications due chiefly to bleeding, infection, or drug toxicity. Early death from intracranial haemorrhage occurred in 1% of children with lymphoblastic leukaemia and 7% of children with myeloblastic leukaemia. Measles and chicken pox were the most serious infective complications; one child remains severely retarded after presumed measles encephalitis, one child with chicken pox died, and a second remains disabled. 2 additional cases of measles encephalitis and one of progressive multifocal leucoencephalopathy are described. Drugs which caused neurotoxicity included vincristine, cytosine arabinoside, L-asparaginase, and phenothiazines, but most problems were caused by methotrexate. Methotrexate toxicity was more prevalent and more serious in children who had had previous central nervous system leukaemia. We conclude that viral infections and methotrexate pose the greatest neurological hazards to children with leukaemia. PMID:596922

  18. Complications of third molar surgery.

    PubMed

    Bouloux, Gary F; Steed, Martin B; Perciaccante, Vincent J

    2007-02-01

    This article addresses the incidence of specific complications and, where possible, offers a preventive or management strategy. Injuries of the inferior alveolar and lingual nerves are significant issues that are discussed separately in this text. Surgical removal of third molars is often associated with postoperative pain, swelling, and trismus. Factors thought to influence the incidence of complications after third molar removal include age, gender, medical history, oral contraceptives, presence of pericoronitis, poor oral hygiene, smoking, type of impaction, relationship of third molar to the inferior alveolar nerve, surgical time, surgical technique, surgeon experience, use of perioperative antibiotics, use of topical antiseptics, use of intra-socket medications, and anesthetic technique. Complications that are discussed further include alveolar osteitis, postoperative infection, hemorrhage, oro-antral communication, damage to adjacent teeth, displaced teeth, and fractures.

  19. Complications of injectable fillers, part 2: vascular complications.

    PubMed

    DeLorenzi, Claudio

    2014-05-01

    Accidental intra-arterial filler injection may cause significant tissue injury and necrosis. Hyaluronic acid (HA) fillers, currently the most popular, are the focus of this article, which highlights complications and their symptoms, risk factors, and possible treatment strategies. Although ischemic events do happen and are therefore important to discuss, they seem to be exceptionally rare and represent a small percentage of complications in individual clinical practices. However, the true incidence of this complication is unknown because of underreporting by clinicians. Typical clinical findings include skin blanching, livedo reticularis, slow capillary refill, and dusky blue-red discoloration, followed a few days later by blister formation and finally tissue slough. Mainstays of treatment (apart from avoidance by meticulous technique) are prompt recognition, immediate treatment with hyaluronidase, topical nitropaste under occlusion, oral acetylsalicylic acid (aspirin), warm compresses, and vigorous massage. Secondary lines of treatment may involve intra-arterial hyaluronidase, hyperbaric oxygen therapy, and ancillary vasodilating agents such as prostaglandin E1. Emergency preparedness (a "filler crash cart") is emphasized, since early intervention is likely to significantly reduce morbidity. A clinical summary chart is provided, organized by complication presentation.

  20. [Intestinal complications from vascular prostheses].

    PubMed

    Fernández, C; Calvete, J; García, J; Buch, E; Castells, P; Lledó, S

    1993-01-01

    Secondary FAE is a rare complication, usually located at the duodenum. The typical clinical presentation is like a digestive hemorrhage or a sepsis. We report two cases of FAE with atypical manifestations. The first case presented a lower digestive hemorrhage produced by the fistulization to the sigma. The second case appeared like an intestinal obliteration caused by the full emigration of a prosthesis to the jejunum. We wish to remark the importance of the clinical suspicion of a FAE (Key of diagnosis), and the sparing relevance of the complementary examinations and the urgency of a surgical treatment in order to avoid the high rate of morbi-mortality associated with this complication.

  1. Managing complications in cirrhotic patients

    PubMed Central

    Angeli, Paolo; Cordoba, Juan; Farges, Oliver; Valla, Dominique

    2015-01-01

    Liver cirrhosis is a serious and potentially life-threatening condition. This life-threatening condition usually arises from complications of cirrhosis. While variceal bleeding is the most acute and probably best studied, several other complications of liver cirrhosis are more insidious in their onset but nevertheless more important for the long-term management and outcome of these patients. This review summarizes the topics discussed during the UEG-EASL Hepatology postgraduate course of the United European Gastroenterology Week 2013 and discusses emergency surgical conditions in cirrhotic patients, the management of hepatic encephalopathy, ascites and hepatorenal syndrome, coagulation disorders, and liver cancer. PMID:25653862

  2. Sigmoid Volvulus Complicating Postpartum Period

    PubMed Central

    Blake, Erin; Gonzalez, Eduardo; Pieracci, Frederic

    2017-01-01

    Background. Sigmoid volvulus is a rare complication of pregnancy and the puerperium. Case. A 19-year-old patient, gravida 1 para 0 at 41 0/7 weeks of gestation, admitted for late-term induction of labor underwent an uncomplicated primary low transverse cesarean delivery for arrest of descent. Her postoperative period was complicated by sudden onset of abdominal pain and the ultimate diagnosis of sigmoid volvulus. Conclusion. Prompt surgical evaluation of an acute abdomen in the postpartum period is essential; delayed diagnosis and treatment can lead to significant maternal morbidity and mortality. PMID:28251004

  3. Intracranial complications of transnasal ethmoidectomy.

    PubMed

    Freije, J E; Donegan, J O

    1991-06-01

    The transnasal approach to the ethmoid and sphenoid sinuses is a well-established technique for treating nasal polyposis and chronic sinusitis. The literature supports the effectiveness and safety of this procedure when performed by experienced surgeons. Although various authors allude to catastrophic complications of intranasal ethmoidectomy, there are few case reports of complications involving significant morbidity or mortality. The potential for serious intracranial trauma is present during ethmoid surgery, especially during an intranasal approach due to limited exposure and difficulty in identifying surgical landmarks, but with renewed interest in this approach utilizing endoscopic instrumentation, the risks may be reduced.

  4. Venous complications of pancreatitis: a review.

    PubMed

    Aswani, Yashant; Hira, Priya

    2015-01-31

    Pancreatitis is notorious to cause vascular complications. While arterial complications include pseudoaneurysm formation with a propensity to bleed, venous complications can be quite myriad. Venous involvement in pancreatitis often presents with thrombosis. From time to time case reports and series of unusual venous complications associated with pancreatitis have, however, been described. In this article, we review multitudinous venous complications in the setting of pancreatitis and propose a system to classify pancreatitis associated venous complications.

  5. The Complicate Observations and Multi-Parameter Land Information Constructions on Allied Telemetry Experiment (COMPLICATE)

    PubMed Central

    Tian, Xin; Li, Zengyuan; Chen, Erxue; Liu, Qinhuo; Yan, Guangjian; Wang, Jindi; Niu, Zheng; Zhao, Shaojie; Li, Xin; Pang, Yong; Su, Zhongbo; van der Tol, Christiaan; Liu, Qingwang; Wu, Chaoyang; Xiao, Qing; Yang, Le; Mu, Xihan; Bo, Yanchen; Qu, Yonghua; Zhou, Hongmin; Gao, Shuai; Chai, Linna; Huang, Huaguo; Fan, Wenjie; Li, Shihua; Bai, Junhua; Jiang, Lingmei; Zhou, Ji

    2015-01-01

    The Complicate Observations and Multi-Parameter Land Information Constructions on Allied Telemetry Experiment (COMPLICATE) comprises a network of remote sensing experiments designed to enhance the dynamic analysis and modeling of remotely sensed information for complex land surfaces. Two types of experimental campaigns were established under the framework of COMPLICATE. The first was designed for continuous and elaborate experiments. The experimental strategy helps enhance our understanding of the radiative and scattering mechanisms of soil and vegetation and modeling of remotely sensed information for complex land surfaces. To validate the methodologies and models for dynamic analyses of remote sensing for complex land surfaces, the second campaign consisted of simultaneous satellite-borne, airborne, and ground-based experiments. During field campaigns, several continuous and intensive observations were obtained. Measurements were undertaken to answer key scientific issues, as follows: 1) Determine the characteristics of spatial heterogeneity and the radiative and scattering mechanisms of remote sensing on complex land surfaces. 2) Determine the mechanisms of spatial and temporal scale extensions for remote sensing on complex land surfaces. 3) Determine synergist inversion mechanisms for soil and vegetation parameters using multi-mode remote sensing on complex land surfaces. Here, we introduce the background, the objectives, the experimental designs, the observations and measurements, and the overall advances of COMPLICATE. As a result of the implementation of COMLICATE and for the next several years, we expect to contribute to quantitative remote sensing science and Earth observation techniques. PMID:26332035

  6. The Complicate Observations and Multi-Parameter Land Information Constructions on Allied Telemetry Experiment (COMPLICATE).

    PubMed

    Tian, Xin; Li, Zengyuan; Chen, Erxue; Liu, Qinhuo; Yan, Guangjian; Wang, Jindi; Niu, Zheng; Zhao, Shaojie; Li, Xin; Pang, Yong; Su, Zhongbo; van der Tol, Christiaan; Liu, Qingwang; Wu, Chaoyang; Xiao, Qing; Yang, Le; Mu, Xihan; Bo, Yanchen; Qu, Yonghua; Zhou, Hongmin; Gao, Shuai; Chai, Linna; Huang, Huaguo; Fan, Wenjie; Li, Shihua; Bai, Junhua; Jiang, Lingmei; Zhou, Ji

    2015-01-01

    The Complicate Observations and Multi-Parameter Land Information Constructions on Allied Telemetry Experiment (COMPLICATE) comprises a network of remote sensing experiments designed to enhance the dynamic analysis and modeling of remotely sensed information for complex land surfaces. Two types of experimental campaigns were established under the framework of COMPLICATE. The first was designed for continuous and elaborate experiments. The experimental strategy helps enhance our understanding of the radiative and scattering mechanisms of soil and vegetation and modeling of remotely sensed information for complex land surfaces. To validate the methodologies and models for dynamic analyses of remote sensing for complex land surfaces, the second campaign consisted of simultaneous satellite-borne, airborne, and ground-based experiments. During field campaigns, several continuous and intensive observations were obtained. Measurements were undertaken to answer key scientific issues, as follows: 1) Determine the characteristics of spatial heterogeneity and the radiative and scattering mechanisms of remote sensing on complex land surfaces. 2) Determine the mechanisms of spatial and temporal scale extensions for remote sensing on complex land surfaces. 3) Determine synergist inversion mechanisms for soil and vegetation parameters using multi-mode remote sensing on complex land surfaces. Here, we introduce the background, the objectives, the experimental designs, the observations and measurements, and the overall advances of COMPLICATE. As a result of the implementation of COMLICATE and for the next several years, we expect to contribute to quantitative remote sensing science and Earth observation techniques.

  7. Teaching Energy Geography? It's Complicated

    ERIC Educational Resources Information Center

    Huber, Matt

    2016-01-01

    The premise of this essay is that energy geographies are complicated, and this in itself presents some pedagogical difficulties. As someone who wants students to critically examine and confront the complexity of energy systems, it can be frustrating when students react to demonstrate frustration, apathy, or even confusion. In what follows, I will…

  8. Third-trimester pregnancy complications.

    PubMed

    Newfield, Emily

    2012-03-01

    Complications arising in the third trimester often challenge the clinician to balance the concern for maternal well-being with the consequences of infant prematurity. The most serious and challenging antepartum issues relate to preterm labor and birth, hypertensive disorders, and bleeding events. This article guides the practitioner through decision-making and management of these problems.

  9. Inflammatory duodenal necrosis complicating gastroschisis

    PubMed Central

    Fouad, Dina; Lee, Geraint J.; Upadhyaya, Manasvi; Drake, David

    2016-01-01

    Babies with gastroschisis have an increased risk of necrotizing enterocolitis (NEC) that can lead to short bowel syndrome, a long-term parenteral nutrition requirement, and its associated complications. To our knowledge, this is the first case report of recurrent duodenal ischemia and necrosis associated with gastroschisis in the absence of NEC totalis. PMID:27695214

  10. Not to Complicate Matters, but ...

    ERIC Educational Resources Information Center

    Jacoby, Russell

    2008-01-01

    The writer discusses the current academic enthrallment with complicating seemingly every aspect of every event or phenomenon, arguing that the fashion elevates confusion from a transitional stage into an end goal. Rather than scholarly clarification, says Jacoby, people celebrate the fact that everything can be "problematized," rejoicing in…

  11. Anaesthetic complications in plastic surgery.

    PubMed

    Nath, Soumya Sankar; Roy, Debashis; Ansari, Farrukh; Pawar, Sundeep T

    2013-05-01

    Anaesthesia related complications in plastic surgeries are fortunately rare, but potentially catastrophic. Maintaining patient safety in the operating room is a major concern of anaesthesiologists, surgeons, hospitals and surgical facilities. Circumventing preventable complications is essential and pressure to avoid these complications in cosmetic surgery is increasing. Key aspects of patient safety in the operating room are outlined, including patient positioning, airway management and issues related to some specific conditions, essential for minimizing post-operative morbidity. Risks associated with extremes of age in the plastic surgery population, may be minimised by a better understanding of the physiologic changes as well as the pre-operative and post-operative considerations in caring for this special group of patients. An understanding of the anaesthesiologist's concerns during paediatric plastic surgical procedures can facilitate the coordination of efforts between the multiple services involved in the care of these children. Finally, the reader will have a better understanding of the perioperative care of unique populations including the morbidly obese and the elderly. Attention to detail in these aspects of patient safety can help avoid unnecessary complication and significantly improve the patients' experience and surgical outcome.

  12. Anaesthetic complications in plastic surgery

    PubMed Central

    Nath, Soumya Sankar; Roy, Debashis; Ansari, Farrukh; Pawar, Sundeep T.

    2013-01-01

    Anaesthesia related complications in plastic surgeries are fortunately rare, but potentially catastrophic. Maintaining patient safety in the operating room is a major concern of anaesthesiologists, surgeons, hospitals and surgical facilities. Circumventing preventable complications is essential and pressure to avoid these complications in cosmetic surgery is increasing. Key aspects of patient safety in the operating room are outlined, including patient positioning, airway management and issues related to some specific conditions, essential for minimizing post-operative morbidity. Risks associated with extremes of age in the plastic surgery population, may be minimised by a better understanding of the physiologic changes as well as the pre-operative and post-operative considerations in caring for this special group of patients. An understanding of the anaesthesiologist's concerns during paediatric plastic surgical procedures can facilitate the coordination of efforts between the multiple services involved in the care of these children. Finally, the reader will have a better understanding of the perioperative care of unique populations including the morbidly obese and the elderly. Attention to detail in these aspects of patient safety can help avoid unnecessary complication and significantly improve the patients’ experience and surgical outcome. PMID:24501480

  13. A Rare Complication of Septorhinoplasty

    PubMed Central

    2014-01-01

    Summary: Septoplasty and septorhinoplasty are common procedures. A 28-year-old woman underwent the procedure and presented postoperatively with headache and vomiting and had developed a large pneumocephalus. We describe the case in detail and analyze the possible causes and ways to prevent such a complication. PMID:25587507

  14. Total Psoas Area Predicts Complications following Radical Cystectomy

    PubMed Central

    Lyon, Timothy D.; Farber, Nicholas J.; Chen, Leo C.; Fuller, Thomas W.; Davies, Benjamin J.; Gingrich, Jeffrey R.; Hrebinko, Ronald L.; Maranchie, Jodi K.; Taylor, Jennifer M.; Tarin, Tatum V.

    2015-01-01

    Purpose. To determine whether total psoas area (TPA), a simple estimate of muscle mass, is associated with complications after radical cystectomy. Materials and Methods. Patients who underwent radical cystectomy at our institution from 2011 to 2012 were retrospectively identified. Total psoas area was measured on preoperative CT scans and normalized for patient height. Multivariable logistic regression was used to determine whether TPA was a predictor of 90-day postoperative complications. Overall survival was compared between TPA quartiles. Results. 135 patients were identified for analysis. Median follow-up was 24 months (IQR: 6–37 months). Overall 90-day complication rate was 56% (75/135). TPA was significantly lower for patients who experienced any complication (7.8 cm2/m2 versus 8.8 cm2/m2, P = 0.023) and an infectious complication (7.0 cm2/m2 versus 8.7 cm2/m2, P = 0.032) than those who did not. On multivariable analysis, TPA (adjusted OR 0.70 (95% CI 0.56–0.89), P = 0.003) and Charlson comorbidity index (adjusted OR 1.34 (95% CI 1.01–1.79), P = 0.045) were independently associated with 90-day complications. TPA was not a predictor of overall survival. Conclusions. Low TPA is associated with infectious complications and is an independent predictor of experiencing a postoperative complication following radical cystectomy. PMID:26798336

  15. Risks and complications in rhinoplasty

    PubMed Central

    Rettinger, Gerhard

    2008-01-01

    Rhinoplasty is regarded to be associated with many risks as the expectations of patient and physician are not always corresponding. Besides of postoperative deformities many other risks and complications have to be considered. Reduction-rhinoplasty e.g. can cause breathing disturbances which are reported in 70% of all revision-rhinoplasty-patients. One has to be aware however that scars and loss of mucosal-sensation can also give the feeling of a “blocked nose”. The main risks of autogenous transplants are dislocation and resorption, while alloplasts can cause infection and extrusion. In this respect silicone implants can have a complication rate between 5-20%. Less complications are reported with other materials like Gore-Tex. Complications of skin and soft tissues can be atrophy, fibrosis, numbness, cysts originating from displaced mucosa or subcutaneous granulomas caused by ointment material. Postoperative swelling depends mainly on the osteotomy technique. Percutaneous osteotomies cause less trauma, but may result in visible scars. Infections are rare but sometimes life-threatening (toxic-shock-syndrome). The risk is higher, when sinus surgery and rhinoplasty are combined. Osteotomies can also cause injuries of the orbital region. Necrosis of eye-lids by infections and blindness by central artery occlusion are known. There are reports on various other risks like rhinoliquorrhea, brain damage, fistulas between sinus-cavernosus and carotid artery, aneurysms and thrombosis of the cavernous sinus. Discoloration of incisors are possible by damage of vessels and nerves. Rhinoplasty can also become a court-case in dissatisfied patients, a situation that may be called a “typical complication of rhinoplasty”. It can be avoided by proper patient selection and consideration of psychological disturbances. Postoperative deformities are considered as main risks of rhinoplasty, causing revision surgery in 5% to 15% of the cases. The analysis of postoperative

  16. Laryngeal complications by orotracheal intubation: Literature review

    PubMed Central

    Mota, Luiz Alberto Alves; de Cavalho, Glauber Barbosa; Brito, Valeska Almeida

    2012-01-01

    Sumamry Introduction: The injuries caused for the orotracheal intubation are common in our way and widely told by literature. Generally the pipe rank of or consequence of its permanence in the aerial ways of the patient is caused by accidents in. It has diverse types of larynx injuries, caused for multiple mechanisms. Objective: To verify, in literature, the main causes of laryngeal complications after- orotracheal intubation and its mechanisms of injury. Revision of Literature: The searched databases had been LILACS, BIREME and SCIELO. Were updated, books and theses had been used, delimiting itself the period enters 1953 the 2009. The keywords used for the search of articles had been: complications, injuries, larynx, intubation, endotracheal, orotracheal, granulomas, stenosis. 59 references had been selected. The used criteria of inclusion for the choice of articles had been the ones that had shown to the diverse types of injuries caused for the orotracheal intubation and its pathophysiology. Final Considerations: This revision of literature was motivated by the comment in the practical clinic of a great number of laryngeal sequels in patients submitted to the orotracheal intubation. Of that is ahead important the knowledge, for the professionals of the area of health, the types of complications and its causes, with intention to prevent them, adopting measured of prevention of these injuries. PMID:25991942

  17. Medical Complications of Tattoos: A Comprehensive Review.

    PubMed

    Islam, Parvez S; Chang, Christopher; Selmi, Carlo; Generali, Elena; Huntley, Arthur; Teuber, Suzanne S; Gershwin, M Eric

    2016-04-01

    Tattoos are defined as the introduction of exogenous pigments into the dermis in order to produce a permanent design. This process may occur unintentional or may be deliberately administered for cosmetic or medical reasons. Tattoos have been around for over 5000 years and over time have evolved to represent a common cosmetic practice worldwide. Currently, adverse reactions are relatively rare and generally unpredictable and predominantly include immune-mediated reactions and skin infections. Along with better healthcare standards and more stringent public health mandates such as the provision of disposable needles, major infectious complications related to hepatitis and human retroviral infections have decreased significantly. When they do occur, skin infections are most frequently associated with Staphylococcus aureus or Streptococcus pyogenes. The aim of this study is to review the types and rates of medical complications of permanent tattoos. PubMed search and search dates were open ended. Acute local inflammation is the most common complication, but infections, allergic contact dermatitis, and other inflammatory or immune responses that are not well-characterized may occur. As many patients with immune reactions to tattoos do not react on skin or patch testing, it is postulated that the antigens contained in dyes or pigments are such small molecules that they need to be haptenized in order to become immunogenic. Red ink is associated more frequently with long-term reactions, including granulomatous and pseudolymphomatous phenomena or morphea-like lesions and vasculitis. Exacerbation of preexisting psoriasis, atopic dermatitis, and pyoderma gangrenosum may occur after tattooing. There is no well-defined association between cancer and tattoos. The treatment of tattoo-related complications may include local destructive measures (cryotherapy, electro-surgery, dermabrasion, chemical destruction, ablative laser destruction), surgical excision, and thermolysis of the

  18. [Rehabilitation methods for children with complicated cataract].

    PubMed

    Ivanov, G; Cuşnir, V; Septichina, Natalia; Cuşnir, Vitalie

    2010-01-01

    The work deals with the results of surgical treatment of 155 patients, who had uveal cataract, by method of facoemulsification with artificial crystalline lens transplanting. The age of the sick varied from 3 to 15 as a result of a complex treatment, involving determination of ethnic factor in the development of uveal cataract, before- and after-operation conservative medical treatment, surgical treatment of abscuration ambliopia 78.1% children and the keenness of sight 0.4 and 68.7% got binocularious sight. The study lot of posttraumatic cataract affected children included 189 patients, from them 68 with stationary cataract, 87 with intumescent cataract and 34 with postoperatorial aphakia. Age from 2 to 15 years. 76.3% cases of evolution without postoperatorial complications, in 13.7% intraoperatorial were observed different complications. The work presents the results of surgical treatment 196 of children, who had innate cataract, by the method of facoasoriation with soft intra-eyepiece lens transplanting from 133 patients who had two-sided cataract, 63 had monolateral cataract. All children underwent laser simulation and videocomputer auto-training in post-operation period. As a result of the treatment, 66.8% patients got the amelioration of sight with 0.4, and 58% got binocular sight. The children's age varied between 6 months and 15 years. This article presents a review of the treatment results of 213 children with posttraumatic, congenital and complicated cataracts. The rehabilitation of the patients with the lens pathology includes a complex of measures of early diagnosis, surgery, optimal correction, medical treatment before and after surgery, the prophilaxis and treatment of complications. This approach permits to increase the visual acuity in 83.8% and to restore the binocular vision in 71.4% patients.

  19. Iatrogenic complications in the neonatal intensive care unit.

    PubMed

    Sekar, K C

    2010-10-01

    With the introduction of novel technologies and approaches in neonatal care and the lack of appropriately designed and well-executed randomized clinical trials to investigate the impact of these interventions, iatrogenic complications have been increasingly seen in the neonatal intensive care unit. In addition, increased awareness and the introduction of more appropriate quality control measures have resulted in higher levels of suspicion about and increased recognition of complications associated with delivery of care. The incidence of complications also rises with the increased length of hospital stay and level of immaturity. Approximately half of the iatrogenic complications are related to medication errors. The other complications are due to nosocomial infections, insertion of invasive catheters, prolonged mechanical ventilation, administration of parenteral nutrition solution, skin damage and environmental complications. Adopting newer technologies and preventive measures might decrease these complications and improve outcomes. Quality improvement projects targeting areas for improvement are expected to build team spirit and further improve the outcomes. In addition, participation in national reporting systems will enhance education and provide an opportunity to compare outcomes with peer institutions.

  20. Postoperative surgical complications of lymphadenohysterocolpectomy

    PubMed Central

    Marin, F; Pleşca, M; Bordea, CI; Voinea, SC; Burlănescu, I; Ichim, E; Jianu, CG; Nicolăescu, RR; Teodosie, MP; Maher, K; Blidaru, A

    2014-01-01

    Rationale The current standard surgical treatment for the cervix and uterine cancer is the radical hysterectomy (lymphadenohysterocolpectomy). This has the risk of intraoperative accidents and postoperative associated morbidity. Objective The purpose of this article is the evaluation and quantification of the associated complications in comparison to the postoperative morbidity which resulted after different types of radical hysterectomy. Methods and results Patients were divided according to the type of surgery performed as follows: for cervical cancer – group A- 37 classic radical hysterectomies Class III Piver - Rutledge -Smith ( PRS ), group B -208 modified radical hysterectomies Class II PRS and for uterine cancer- group C -79 extended hysterectomies with pelvic lymphadenectomy from which 17 patients with paraaortic lymphnode biopsy . All patients performed preoperative radiotherapy and 88 of them associated radiosensitization. Discussion Early complications were intra-abdominal bleeding ( 2.7% Class III PRS vs 0.48% Class II PRS), supra-aponeurotic hematoma ( 5.4% III vs 2.4% II) , dynamic ileus (2.7% III vs 0.96% II) and uro - genital fistulas (5.4% III vs 0.96% II).The late complications were the bladder dysfunction (21.6% III vs 16.35% II) , lower limb lymphedema (13.5% III vs 11.5% II), urethral strictures (10.8% III vs 4.8% II) , incisional hernias ( 8.1% III vs 7.2% II), persistent pelvic pain (18.91% III vs 7.7% II), bowel obstruction (5.4% III vs 1.4% II) and deterioration of sexual function (83.3% III vs 53.8% II). PRS class II radical hysterectomy is associated with fewer complications than PRS class III radical hysterectomy , except for the complications of lymphadenectomy . A new method that might reduce these complications is a selective lymphadenectomy represented by sentinel node biopsy . In conclusion PRS class II radical hysterectomy associated with neoadjuvant radiotherapy is a therapeutic option for the incipient stages of cervical cancer

  1. Risks and Complications of Coronary Angiography: A Comprehensive Review

    PubMed Central

    Tavakol, Morteza; Ashraf, Salman; Brener, Sorin J.

    2012-01-01

    Coronary angiography and heart catheterization are invaluable tests for the detection and quantification of coronary artery disease, identification of valvular and other structural abnormalities, and measurement of hemodynamic parameters. The risks and complications associated with these procedures relate to the patient’s concomitant conditions and to the skill and judgment of the operator. In this review, we examine in detail the major complications associated with invasive cardiac procedures and provide the reader with a comprehensive bibliography for advanced reading. PMID:22980117

  2. Complications of Guillain-Barré syndrome.

    PubMed

    Wang, Ying; Zhang, Hong-Liang; Wu, Xiujuan; Zhu, Jie

    2016-01-01

    Guillain-Barré syndrome (GBS) is an immune-mediated disorder in the peripheral nervous system with a wide spectrum of complications. A good understanding of the complications of GBS assists clinicians to recognize and manage the complications properly thereby reducing the mortality and morbidity of GBS patients. Herein, we systemically review the literature on complications of GBS, including short-term complications and long-term complications. We summarize the frequency, severity, clinical manifestations, managements and possible mechanisms of different kinds of complications, and point out the flaws of current studies as well as demonstrate the further investigations needed.

  3. Complications in endoscopic intranasal ethmoidectomy: an update.

    PubMed

    Stankiewicz, J A

    1989-07-01

    A previous publication by this author discussing complications of endoscopic intranasal ethmoidectomy indicated an overall complication rate of 29% in 90 patients (17% in 150 ethmoidectomies). Compared to published complications rates for traditional intranasal ethmoidectomy (2.7% to 3.7%), 17% is alarming and of concern. The complication results in 300 ethmoidectomies performed on 180 patients are presented. The overall complication rate was 9.3%. Only two further complications have occurred since the first reported series: a cerebrospinal fluid leak and one case of subcutaneous emphysema. Methods and techniques that have led to the reduction of complications are briefly discussed. Endoscopic ethmoidectomy is a valid, safe procedure in experienced hands.

  4. Retinal complications after bungee jumping.

    PubMed

    Filipe, J A; Pinto, A M; Rosas, V; Castro-Correia, J

    Bungee jumping is becoming a popular sport in the Western world with some cases of ophthalmic complications being reported in recent literature. The authors reported a case of a 23-year-old healthy female who presented retinal complications following a bungee jumping. Her fundi showed superficial retinal hemorrhages in the right eye and a sub-internal limiting membrane hemorrhage affecting the left eye. A general examination, including a full neurological examination, was normal and laboratorial investigations were all within normal values. More studies are necessary to identify risk factors and the true incidence of related ocular lesions, but until then, we think this sport activity should be desencouraged, especially to those that are not psychological and physically fit.

  5. Evaluating Complications of Chronic Sinusitis

    PubMed Central

    Hong, Phillip; Pereyra, Charles A.; Breslin, Adam; Melville, Laura

    2017-01-01

    Chronic sinusitis is a relatively common diagnosis throughout the US. In patients with an otherwise unremarkable medical history the treatment is typically supportive, requiring only clinical evaluation. We present the case of a 25-year-old male with a history of chronic sinusitis that was brought to our emergency department with new-onset seizure. Three days before he had presented to his usual care facility with two days of headache and fever and was discharged stating headache, subjective fever, and neck stiffness. After further investigation he was diagnosed with a mixed anaerobic epidural abscess. The evaluation and management of chronic sinusitis are based on the presence of symptoms concerning for complication. Prompt investigation of complicated sinusitis is essential in preventing debilitating and fatal sequelae. Our case study underscores the importance of early diagnosis and appropriate management. PMID:28163938

  6. Bacterial infections complicating tongue piercing.

    PubMed

    Yu, Catherine Hy; Minnema, Brian J; Gold, Wayne L

    2010-01-01

    Tongue piercing has become an increasingly popular form of body art. However, this procedure can occasionally be complicated by serious bacterial infections. The present article reports a case of prosthetic valve endocarditis caused by a Gemella species in a patient with a pierced tongue, and reviews 18 additional cases of local and systemic bacterial infections associated with tongue piercing. Infections localized to the oral cavity and head and neck region included molar abscess, glossal abscess, glossitis, submandibular lymphadenitis, submandibular sialadenitis, Ludwig's angina and cephalic tetanus. Infections distal to the piercing site included eight cases of infective endocarditis, one case of chorioamnionitis and one case of cerebellar abscess. Oropharyngeal flora were isolated from all cases. While bacterial infections following tongue piercing are rare, there are reports of potentially life-threatening infections associated with the procedure. Both piercers and their clients should be aware of these potential complications, and standardized infection prevention and control practices should be adopted by piercers to reduce the risk.

  7. Medical complications associated with earthquakes.

    PubMed

    Bartels, Susan A; VanRooyen, Michael J

    2012-02-25

    Major earthquakes are some of the most devastating natural disasters. The epidemiology of earthquake-related injuries and mortality is unique for these disasters. Because earthquakes frequently affect populous urban areas with poor structural standards, they often result in high death rates and mass casualties with many traumatic injuries. These injuries are highly mechanical and often multisystem, requiring intensive curative medical and surgical care at a time when the local and regional medical response capacities have been at least partly disrupted. Many patients surviving blunt and penetrating trauma and crush injuries have subsequent complications that lead to additional morbidity and mortality. Here, we review and summarise earthquake-induced injuries and medical complications affecting major organ systems.

  8. [Infectious complications of biological therapy].

    PubMed

    Holub, M; Rozsypal, H; Chalupa, P

    2011-02-01

    Biological treatment represents a significant progress in the therapy of many serious diseases. Together with the growing knowledge of pathophysiology and subsequent development of new therapeutic agents, this progress will definitely lead to further expansion of biologics. Since biologics interfere with many mechanisms of host defence, which may sometimes be compromised by them, increased risk of infectious complications must be taken into account. Patients treated with biologics are prone to classical virulent infections (e.g. listeriosis, legionellosis and tuberculosis) and opportunistic infections such as progressive multifocal leukoencephalopathy. Furthermore, suppression of the immune response that is caused by biologics may lead to reactivation of latent infections such as tuberculosis or viral hepatitis B. Therefore, the knowledge of basic mechanisms by which biologics modify the immune response is important for a rapid clinical diagnosis of possible aetiology of infectious complications.

  9. [Prevention of complications of IUDs].

    PubMed

    Henrion, R

    1980-11-01

    Complications resulting from IUD use are essentially of 4 types: 1) uterine perforation, either at the time of insertion or by translocation of the device. Perforations can be avoided by exercising the utmost attention at time of insertion, and by choosing the proper time of insertion, usually postmentruation. It is also imperative that the IUD be right for the uterine cavity size; 2) pelvic infection, the most serious of IUD complications, since it can, however rarely, cause death; it is absolutely necessary to observe the strictest asepsy during IUD insertion; 3) menorrhagia, which, when severe, can cause anemia. Women with heavy menstrual flow should not wear an IUD; and, 4) ectopic pregnancy, which usually ends in spontaneous abortion, but which can cause infection.

  10. Gastrointestinal complications postthoracotomy and postvagotomy.

    PubMed

    Kokoska, E R; Naunheim, K S

    1998-08-01

    Postthoracotomy gastrointestinal complications, although relatively uncommon, can be associated with significant morbidity and mortality. It is necessary to identify patients who are at high risk for gastrointestinal complications during the preoperative evaluation. Appropriate stress ulcer prophylaxis should be provided to high-risk patients, and enteral feeds should be initiated as early in the postoperative course as possible. Postoperative hypotension and massive blood transfusions can be avoided with early reexploration in the case of postoperative hemorrhage. Finally, unexplained abdominal pain must not be ignored; a high index of suspicion should be maintained, with early and liberal use of diagnostic tools such as standard radiography, CT, endoscopy, and angiography. Consultation should be requested from a surgeon experienced in abdominal catastrophes. Early laparotomy with aggressive operative management can be lifesaving therapy but must be not applied in a cavalier fashion, as many of these disorders can and should be managed conservatively.

  11. Permanent makeup: indications and complications.

    PubMed

    De Cuyper, Christa

    2008-01-01

    Cosmetic tattoos, simulating makeup, have become very popular in the last decades; the technique of micropigmentation consists of implantation of pigment into the skin using a tattoo pen. The procedure can also be used to camouflage vitiligo, to mask scars, and as an adjunct to reconstructive surgery. Risks and complications include infections, allergic reactions, scarring, fanning, fading, and dissatisfaction about color and shape. Lasers offer the best cosmetic result for removal of unwanted tattoos.

  12. Oral complications in cancer patients

    SciTech Connect

    Carl, W.

    1983-02-01

    Ionizing radiation used in treating the head and neck area produces oral side effects such as mucositis, salivary changes, trismus and radiation caries. Sequelae of cancer chemotherapy often include oral stomatitis, myelosuppression and immunosuppression. Infections of dental origin in compromised patients are potentially lethal. Specific programs to eliminate dental pathology before radiation and chemotherapy, and to maintain oral hygiene during and after therapy, will minimize these complications.

  13. Abdominal Complications after Severe Burns

    DTIC Science & Technology

    2009-05-01

    abdominal compartment syndrome, schemic bowel, biliary disease, peptic ulcer disease and astritis requiring laparotomy, small bowel obstruction, rimary fungal...complications in- luded trauma exploratory laparotomy, abdominal com- artment syndrome, ischemic bowel, biliary disease, peptic lcer disease and gastritis, large...70%); 13 for other compli- ations, such as biliary or perineal conditions (26%); and 4 or feeding access (8%). For the civilians, 2 had trauma

  14. Hemorrhagic complications in dermatologic surgery

    PubMed Central

    Bunick, Christopher G.; Aasi, Sumaira Z.

    2014-01-01

    The ability to recognize, manage, and, most importantly, prevent hemorrhagic complications is critical to performing dermatologic procedures that have safe and high quality outcomes. This article reviews the preoperative, intraoperative, and postoperative factors and patient dynamics that are central to preventing such an adverse outcome. Specifically, the role that anticoagulants and antiplatelet agents, hypertension, and other medical conditions play in the development of postoperative hemorrhage are discussed. In addition, this article provides practical guidelines on managing bleeding during and after surgery. PMID:22515669

  15. Prevalence Estimates of Complicated Syphilis.

    PubMed

    Dombrowski, Julia C; Pedersen, Rolf; Marra, Christina M; Kerani, Roxanne P; Golden, Matthew R

    2015-12-01

    We reviewed 68 cases of possible neurosyphilis among 573 syphilis cases in King County, WA, from 3rd January 2012 to 30th September 2013; 7.9% (95% confidence interval, 5.8%-10.5%) had vision or hearing changes, and 3.5% (95% confidence interval, 2.2%-5.4%) had both symptoms and objective confirmation of complicated syphilis with either abnormal cerebrospinal fluid or an abnormal ophthalmologic examination.

  16. Mitochondrial Hormesis and Diabetic Complications

    PubMed Central

    2015-01-01

    The concept that excess superoxide production from mitochondria is the driving, initial cellular response underlying diabetes complications has been held for the past decade. However, results of antioxidant-based trials have been largely negative. In the present review, the data supporting mitochondrial superoxide as a driving force for diabetic kidney, nerve, heart, and retinal complications are reexamined, and a new concept for diabetes complications—mitochondrial hormesis—is presented. In this view, production of mitochondrial superoxide can be an indicator of healthy mitochondria and physiologic oxidative phosphorylation. Recent data suggest that in response to excess glucose exposure or nutrient stress, there is a reduction of mitochondrial superoxide, oxidative phosphorylation, and mitochondrial ATP generation in several target tissues of diabetes complications. Persistent reduction of mitochondrial oxidative phosphorylation complex activity is associated with the release of oxidants from nonmitochondrial sources and release of proinflammatory and profibrotic cytokines, and a manifestation of organ dysfunction. Restoration of mitochondrial function and superoxide production via activation of AMPK has now been associated with improvement in markers of renal, cardiovascular, and neuronal dysfunction with diabetes. With this Perspective, approaches that stimulate AMPK and PGC1α via exercise, caloric restriction, and medications result in stimulation of mitochondrial oxidative phosphorylation activity, restore physiologic mitochondrial superoxide production, and promote organ healing. PMID:25713188

  17. Renal complications of Fabry disease in children.

    PubMed

    Najafian, Behzad; Mauer, Michael; Hopkin, Robert J; Svarstad, Einar

    2013-05-01

    Fabry disease is an X-linked α-galactosidase A deficiency, resulting in accumulation of glycosphingolipids, especially globotriaosylceramide, in cells in different organs in the body. Renal failure is a serious complication of this disease. Fabry nephropathy lesions are present and progress in childhood while the disease commonly remains silent by routine clinical measures. Early and timely diagnosis of Fabry nephropathy is crucial since late initiation of enzyme replacement therapy may not halt progressive renal dysfunction. This may be challenging due to difficulties in diagnosis of Fabry disease in children and absence of a sensitive non-invasive biomarker of early Fabry nephropathy. Accurate measurement of glomerular filtration rate and regular assessment for proteinuria and microalbuminuria are useful, though not sensitive enough to detect early lesions in the kidney. Recent studies support the value of renal biopsy in providing histological information relevant to kidney function and prognosis, and renal biopsy could potentially be used to guide treatment decisions in young Fabry patients. This review aims to provide an update of the current understanding, challenges, and needs to better approach renal complications of Fabry disease in children.

  18. Complications of groin hernia repair: their prevention and management.

    PubMed

    Gaines, R D

    1978-03-01

    An estimated overall complication rate of approximately ten percent is found in the half million patients who annually undergo groin hernia repair in the United States. Certain features in the operative technique are emphasized which should prevent many of these complications.Intraoperative complications during the groin hernia repair are primarily hemorrhage and injury to the vas deferens, the three nerves in the area, the vascular supply of the testis, and the abdominal and pelvic viscera. Miscellaneous intraoperative complications relate to problems associated with the repair of massive hernias, missed hernia, and the loss of strangulated bowel into the abdominal cavity.Early postoperative complications may be either systemic or local with cardiac and respiratory conditions comprising the former group. The early local complications are primarily wound problems of infection, hematoma formation, and scrotal swelling involving the skin and testis. High ligation in excision of the sac in all hernias, repair of the defect in the plane of its occurrence, and suture of fascia to fascia in the same plane without tension are the basic tenets of inguinal hernia repair which should result in a low incidence of recurrence.The most effective prophylactic measures necessary for the prevention of complications considered are a thorough knowledge of inguinofemoral anatomy, mature surgical judgment, and meticulous surgical technique.

  19. Dealing with Your Grief

    MedlinePlus

    ... Search Our mission Fighting premature birth About us Annual report Our work Community impact Global programs Research Need ... Cause Our mission Fighting premature birth About us Annual report Our work Community impact Global programs Research Need ...

  20. Crisis, grief and loss.

    PubMed

    Evans, J V

    1993-09-01

    At one time or another, many of us experience a life-threatening crisis that proves to be a turning point in our lives. I had such a crisis while working as a medic on the oil-rig Vinland, offshore of Nova Scotia, in 1984.

  1. Children and grief

    MedlinePlus

    It helps to understand how children think before talking to them about death. This is because you must speak to them on the subject at their own level. Infants and toddlers will be aware that people are sad. But they ...

  2. Economic Components of Grief

    ERIC Educational Resources Information Center

    Corden, Anne; Hirst, Michael

    2013-01-01

    This article investigates the nature, context, and impact of economic stressors associated with loss, drawing on a mixed-methods study of changes in financial circumstances and economic roles following death of a life partner. Findings show how economic changes, and the practicalities of dealing with such transitions, shaped individual responses…

  3. Childhood Traumatic Grief

    MedlinePlus

    ... Awareness Human Trafficking Awareness Month Holiday Stress Homeless Youth Awareness Month Bullying Prevention Domestic Violence Awareness Month Suicide Prevention Month/World Suicide Day Sept. 11th National ...

  4. Children and Grief

    MedlinePlus

    ... For all questions please contact the AACAP Communications & Marketing Coordinator, ext. 154. If you need immediate assistance, please dial 911. Copyright © 2015 by the American Academy of Child and Adolescent Psychiatry. ... {1} ##LOC[OK]## ##LOC[Cancel]## { ...

  5. [Surgical treatment of intestinal complications of pelvic radiotherapy].

    PubMed

    Bannura, G

    1995-08-01

    One hundred forty patients treated for intestinal complications of pelvic irradiation are presented. The most common clinical expression was radiation rectitis, complicated with rectovaginal fistulas in 58% of cases. These patients were subjected to Parks procedure for fistula repair with satisfactory results. Half the operated patients remained with an ostomy as a definitive sequel and overall perioperative mortality in these patients was 10%. Radiation enteritis has a high operative mortality due to delays in diagnosis and to severe septic complications. It must be suspected in irradiated patients presenting with chronic diarrhea and weight loss. Urological complications and involvement of several intestinal segments are bad prognostic factors. Resections and anastomoses with undamaged segments are the safest surgical procedures. Improvements of radiation techniques and the use of a reabsorbable mesh to seal the pelvis during radiation therapy are adequate preventive measures.

  6. Ocular complications of orbital venography.

    PubMed

    Safer, J N; Guibor, P

    1975-03-01

    Three ocular complications directly related to orbital venography are described, one resulting in permanent loss of vision,. The patient had lymphangioma of the orbit which evidently had bled secondary to increased venous pressure and injection of contrast bolus. Both of the 2 patients with transient visual disturbances had diabetic retinopathy. The common factor is felt to be an imparied vascular bed which cannot meet the stress of increased venous pressure and contrast medium injection. Conditions which predispose to ocular-orbital stasis and/or hemorrhage are discussed.

  7. Ocular complications of bungee jumping

    PubMed Central

    Hassan, H Mohammed J; Mariatos, Georgios; Papanikolaou, Theocharis; Ranganath, Akshatha; Hassan, Hala

    2012-01-01

    Aim In this paper, we will try to highlight the importance of various investigations and their crucial role in identifying whether the defect is structural or functional. Case history A 24-year-old woman presented with ocular complications after bungee jumping. Subsequently, although all ophthalmic signs resolved, she complained of decreased vision in her left eye. Conclusion Initial ophthalmic injury was detected by optical coherence tomography scan showing a neurosensory detachment of the fovea. This was not initially detected on slit-lamp examination or fluorescein angiography. On later examination, although the optical coherence tomography scan showed no structural damage, electrodiagnostic tests showed a functional defect at the fovea. PMID:23055687

  8. [Neurological complications in cancer patients].

    PubMed

    Hundsberger, Thomas; Roth, Patrick; Roelcke, Ulrich

    2014-08-20

    Neurological symptoms in cancer patients have a great impact on quality of life and need an interdisciplinary approach. They lead to significant impairment in activities of daily living (gait disorders, dizziness), a loss of patients independency (vegetative disturbances, wheel-chair dependency) and interfere with social activities (ban of driving in case of epilepsy). In this article we describe three main and serious neurological problems in the context of oncological patients. These are chemotherapy-induced polyneuropathy, malignant spinal cord compression and epileptic seizures. Our aim is to increase the awareness of neurological complications in cancer patients to improve patients care.

  9. Strabismus complications from local anesthetics.

    PubMed

    Guyton, David L

    2008-01-01

    Strabismus developing after retrobulbar or peribulbar anesthesia for both anterior and posterior segment eye surgery may be due to myotoxicity to an extraocular muscle from the local anesthetic agent. Initial paresis often causes diplopia immediately after surgery, but later progressive segmental fibrosis occurs, and/or hypertrophy of the muscle, producing diplopia in the opposite direction from the direction of the initial diplopia. The inferior rectus muscle is most commonly affected. Usually a large recession on an adjustable suture of the involved muscle(s) yields good alignment. Using topical anesthesia or sub-Tenon's anesthesia can avoid this complication.

  10. Neurological complications of coeliac disease

    PubMed Central

    Pengiran, T; Wills, A; Holmes, G

    2002-01-01

    A variety of neurological disorders have been reported in association with coeliac disease including epilepsy, ataxia, neuropathy, and myelopathy. The nature of this association is unclear and whether a specific neurological complication occurs in coeliac disease remains unproved. Malabsorption may lead to vitamin and trace element deficiencies. Therefore, patients who develop neurological dysfunction should be carefully screened for these. However, malabsorption does not satisfactorily explain the pathophysiology and clinical course of many of the associated neurological disorders. Other mechanisms proposed include altered autoimmunity, heredity, and gluten toxicity. This review attempts to summarise the literature and suggests directions for future research. PMID:12151653

  11. Diabetes Complications in Childhood Diabetes—New Biomarkers and Technologies

    PubMed Central

    Bjornstad, Petter; Maahs, David M.

    2015-01-01

    A major challenge in preventing vascular complications in diabetes is the inability to identify high-risk patients at an early stage, emphasizing the importance of discovering new risk factors, technologies and therapeutic targets to reduce the development and progression of complications. Promising biomarkers which may improve risk stratification and serve as therapeutic targets, include: uric acid, insulin sensitivity, copeptin, SGLT-2 and Klotho/FGF-23. Non-invasive measures of macrovasuclar disease in youth, include: 1) pulse wave velocity to examine arterial stiffness; 2) carotid intima-media thickness to evaluate arterial thickness; 3) cardiac MRI to investigate cardiac function and structure. Novel microvascular measures include: GFR by iohexol clearance using filter paper to directly measure GFR, retinal vascular geometry to predict early retinal changes and corneal confocal microscopy to improve detection of early nerve loss to better predict diabetic neuropathy. Herein we will review technologies, novel biomarkers, and therapeutic targets in relation to vascular complications of diabetes. PMID:26425403

  12. Clinical Implications of Glucose Variability: Chronic Complications of Diabetes.

    PubMed

    Jung, Hye Seung

    2015-06-01

    Glucose variability has been identified as a potential risk factor for diabetic complications; oxidative stress is widely regarded as the mechanism by which glycemic variability induces diabetic complications. However, there remains no generally accepted gold standard for assessing glucose variability. Representative indices for measuring intraday variability include calculation of the standard deviation along with the mean amplitude of glycemic excursions (MAGE). MAGE is used to measure major intraday excursions and is easily measured using continuous glucose monitoring systems. Despite a lack of randomized controlled trials, recent clinical data suggest that long-term glycemic variability, as determined by variability in hemoglobin A1c, may contribute to the development of microvascular complications. Intraday glycemic variability is also suggested to accelerate coronary artery disease in high-risk patients.

  13. Infectious complications of regional anesthesia.

    PubMed

    Horlocker, Terese T; Wedel, Denise J

    2008-09-01

    Although individual cases have been reported in the literature, serious infections of the central nervous system (CNS) such as arachnoiditis, meningitis, and abscess following spinal or epidural anesthesia are rare. However, recent epidemiologic series from Europe suggest that the frequency of infectious complications associated with neuraxial techniques may be increasing. Importantly, while meningitis and epidural abscess are both complications of neuraxial block, the risk factors and causative organisms are disparate. For example, staphylococcus is the organism most commonly associated epidural abscess; often these infections occurred in patients with impaired immunity. Conversely, meningitis follows dural puncture, and is typically caused by alpha-hemolytic streptococci, with the source of the organism the nasopharynx of the proceduralist. In order to reduce the risk of serious infection following neuraxial blockade, the clinician must be knowledgeable in the pathogenesis of CNS infections, patient selection, and use of meticulous aseptic technique. Finally, since delay in the diagnosis may result in morbidity and even death, it is crucial to be aware of the presenting signs and symptoms of meningitis and epidural abscess.

  14. Infectious Complications After Liver Transplantation

    PubMed Central

    Hernandez, Maria Del Pilar; Martin, Paul

    2015-01-01

    Orthotopic liver transplantation (OLT) is the standard of care for patients with decompensated cirrhosis and for patients with hepatocellular carcinoma. More than 6000 liver transplants are performed annually in the United States. High patient and graft survival rates have been achieved in great part due to the availability of potent immunosuppressive agents. Systemic immunosuppression has rendered the liver recipient susceptible to de novo infections as well as reactivation of preexisting latent infections. Infections occurring during the first month post-OLT are usually nosocomial, donor-derived, or the result of a perioperative complication. The development of opportunistic infections (OIs) such as Aspergillus and the reactivation of latent infections such as Mycobacterium tuberculosis are more frequent 1 to 6 months posttransplant, when the net state of immunosuppression is the highest. Immunosuppressive therapy is tapered 6 to 12 months post-OLT; therefore, infections occurring during that time period and afterward generally resemble those of the general population. Screening strategies applied to determine the risk of an infection after transplantation and the use of prophylactic antimicrobial therapy have reduced the incidence of OIs after OLT. This article will review the various causes of infection post-OLT and the therapies used to manage complications. PMID:27134589

  15. Measuring $\

    SciTech Connect

    Mitchell, Jessica Sarah

    2011-01-01

    The MINOS Experiment consists of two steel-scintillator calorimeters, sampling the long baseline NuMI muon neutrino beam. It was designed to make a precise measurement of the ‘atmospheric’ neutrino mixing parameters, Δm2 atm. and sin2 (2 atm.). The Near Detector measures the initial spectrum of the neutrino beam 1km from the production target, and the Far Detector, at a distance of 735 km, measures the impact of oscillations in the neutrino energy spectrum. Work performed to validate the quality of the data collected by the Near Detector is presented as part of this thesis. This thesis primarily details the results of a vμ disappearance analysis, and presents a new sophisticated fitting software framework, which employs a maximum likelihood method to extract the best fit oscillation parameters. The software is entirely decoupled from the extrapolation procedure between the detectors, and is capable of fitting multiple event samples (defined by the selections applied) in parallel, and any combination of energy dependent and independent sources of systematic error. Two techniques to improve the sensitivity of the oscillation measurement were also developed. The inclusion of information on the energy resolution of the neutrino events results in a significant improvement in the allowed region for the oscillation parameters. The degree to which sin2 (2θ )= 1.0 could be disfavoured with the exposure of the current dataset if the true mixing angle was non-maximal, was also investigated, with an improved neutrino energy reconstruction for very low energy events. The best fit oscillation parameters, obtained by the fitting software and incorporating resolution information were: | Δm2| = 2.32+0.12 -0.08×10-3 eV2 and sin2 (2θ ) > 0.90(90% C.L.). The analysis provides the current world best measurement of the atmospheric neutrino mass

  16. Post-operative pulmonary complications after thoracotomy

    PubMed Central

    Sengupta, Saikat

    2015-01-01

    Pulmonary complications are a major cause of morbidity and mortality in the post-operative period after thoracotomy. The type of complications and the severity of complications depend on the type of thoracic surgery that has been performed as well as on the patient's pre-operative medical status. Risk stratification can help in predicting the possibility of the post-operative complications. Certain airway complications are more prone to develop with thoracic surgery. Vocal cord injuries, bronchopleural fistulae, pulmonary emboli and post-thoracic surgery non-cardiogenic pulmonary oedema are some of the unique complications that occur in this subset of patients. The major pulmonary complications such as atelectasis, bronchospasm and pneumonia can lead to respiratory failure. This review was compiled after a search for search terms within ‘post-operative pulmonary complications after thoracic surgery and thoracotomy’ on search engines including PubMed and standard text references on the subject from 2000 to 2015. PMID:26556921

  17. Traumatic abdominal hernia complicated by necrotizing fasciitis.

    PubMed

    Martínez-Pérez, Aleix; Garrigós-Ortega, Gonzalo; Gómez-Abril, Segundo Ángel; Martí-Martínez, Eva; Torres-Sánchez, Teresa

    2014-11-01

    Necrotizing fasciitis is a critical illness involving skin and soft tissues, which may develop after blunt abdominal trauma causing abdominal wall hernia and representing a great challenge for physicians. A 52-year-old man was brought to the emergency department after a road accident, presenting blunt abdominal trauma with a large non-reducible mass in the lower-right abdomen. A first, CT showed abdominal hernia without signs of complication. Three hours after ICU admission, he developed hemodynamic instability. Therefore, a new CT scan was requested, showing signs of hernia complication. He was moved to the operating room where a complete transversal section of an ileal loop was identified. Five hours after surgery, he presented a new episode of hemodynamic instability with signs of skin and soft tissue infection. Due to the high clinical suspicion of necrotizing fasciitis development, wide debridement was performed. Following traumatic abdominal wall hernia (TAWH), patients can present unsuspected injuries in abdominal organs. Helical CT can be falsely negative in the early moments, leading to misdiagnosis. Necrotizing fasciitis is a potentially fatal infection and, consequently, resuscitation measures, wide-spectrum antibiotics, and early surgical debridement are required. This type of fasciitis can develop after blunt abdominal trauma following wall hernia without skin disruption.

  18. Complications in Musculoskeletal Intervention: Important Considerations

    PubMed Central

    Wang, David T.; Dubois, Melissa; Tutton, Sean M.

    2015-01-01

    Musculoskeletal (MSK) intervention has proliferated in recent years among various subspecialties in medicine. Despite advancements in image guidance and percutaneous technique, the risk of complication has not been fully eliminated. Overall, complications in MSK interventions are rare, with bleeding and infection the most common encountered. Other complications are even rarer. This article reviews various complications unique to musculoskeletal interventions, assists the reader in understanding where pitfalls lie, and highlights ways to avoid them. PMID:26038623

  19. Treatment of complications of parotid gland surgery

    PubMed Central

    Marchese-Ragona, R; De Filippis, C; Marioni, G; Staffieri, A

    2005-01-01

    Summary Although several reports in the literature have documented the surgical technique, and the oncological outcome achieved with parotidectomy, only a few articles have described the complications of parotid gland surgery and their management. Several complications have been reported in parotid surgery. We re-classified the complications of parotidectomy in intra-operative and post-operative (early and late). The commonest complications after parotidectomy are temporary or permanent facial palsy and Frey’s syndrome. PMID:16450773

  20. Complications of Recanalization of Chronic Total Occlusion

    PubMed Central

    Kalyanasundaram, Arun; Lombardi, William L.

    2015-01-01

    Percutaneous Coronary Intervention (PCI) of Chronic Total Occlusions (CTO) is an accepted revascularization procedure. These complex procedures carry with them certain risks and potential complications. Complications of PCI such as contrast induced renal dysfunction, radiation, etc, assume more relevance given the length and complexity of these procedures. Further, certain complications such as donor vessel injury, foreign body entrapment are unique to CTO PCI. A thorough understanding of the potential complications is important in mitigating risk during these complex procedures.