Perspectives on body: embodiment and body image

"Body" is a basic concept of both the natural and human sciences. This extensive review of the literature explores the various philosophical approaches to the body, including empiricism, idealism, existentialism and phenomenology, as well as the relationship between body and mind. Embodiment and body image are the two main concepts of body addressed in this article. Merleau-Ponty's perspective on embodiment, an important new area of theory development, emphasizes that embodiment research must focus on life experiences, such as the study of body image. Using Schilder's framework of psychosocialology, this article provides a comprehensive understanding of the concept of body image and women's perspectives on the "body" in both Western culture and Eastern cultures. Body size and shape significantly influence the self-image of women. Body image is something that develops and changes throughout one's life span and is continually being constructed, destructed, and reconstructed. Personal body image has important psychological effects on the individual, especially women. This integrative review can make a significant contribution to knowledge in this area and, consequently, to related practice and research.     

Adolescence and body image

Concerns about body image range from a normal desire to look attractive to a pathological concern with thinness or physical perfection. Today, more than ever, adolescents in America are prone to body image distortions and dissatisfaction. The reasons for this are multi-determined and include the influence of the media and cultural expectations, as well as a discrepancy between an adolescent's own physical characteristics and the expectations of his or her social environment. Adolescents with severe body image distortions are vulnerable to developing serious psychiatric disorders that can have life-threatening consequences. Schools can help by providing guidance and information in a time of uncertainty.     

Poetry and homeopathy: an exploration

This paper explores a relationship between poetry and homeopathy. It proposes we expand and enlighten our knowledge of the patient and develop our consultation through our experience of poetry. Within each consultation is a poem. Heightened awareness of this and many other aspects can improve the sensibilities of the practitioner and enhance deeper healing of the patient. We are challenged to respond.     

Terminal illness and body image

Mark Wareing's case study of a patient with penile cancer (p34) offers an insight into issues of disturbed body image at the end of life. This paper explores some of the patient's experiences in terms of the confrontation and avoidance of difficulties after disfigurement. The effect of the nurse's own anxieties when reflecting on the patient's experiences is also discussed.     

Altered body image: managing social encounters

For terminally ill people who are still active within the community, altered body image can pose significant problems. Patients may have an obvious change in appearance or function, but be unsure how to present a positive image to others. Moreover, lay supporters are often equally unsure how to react to the changed appearance of the dying person. Changes in physical appearance and function associated with disease processes (and sometimes treatment) need to be integrated into the interaction that occurs between patients and lay carers. This is likely to be a difficult matter to facilitate, taxing the ingenuity of the palliative care nurse who hopes to assist the patient in this regard. This article uses a case study from the community-based palliative care setting to introduce steps that nurses and patients might consider as the patient sets out to manage such social encounters.     

Limb loss: Alterations in body image

An estimated 10% of persons older than 70 years have peripheral vascular disease. Peripheral vascular disease includes venous and arterial medical conditions. Peripheral arterial disease (PAD) is a major concern in assessment of patients for loss of limb. With the ever increasing numbers of senior citizens in the United States today, a major public health concern is the management of chronic health problems. Many persons who have progressive PAD as a result of circulatory changes eventually are forced to have a limb amputated. This amputation triggers the realization of the loss of the limb, which directly influences body image. Therefore, management of the effect of limb loss on body image becomes a major nursing consideration in health promotion/health maintenance endeavors by health care professionals.This article explores the concepts of limb loss and body image. The relationship between PAD and limb loss is established. The conceptual link between limb loss and body image alteration is described, with emphasis on the importance of nursing interventions to manage body image alterations. Pathophysiologic conditions leading to PAD and limb loss are reviewed. Nursing implications for management of body image alterations with limb loss are summarized.     

Rheumatoid cachexia: cytokine-driven hypermetabolism accompanying reduced body cell mass in chronic inflammation.

The cytokines IL-1 beta and TNF-alpha cause cachexia and hypermetabolism in animal models, but their role in human inflammation remains controversial. The relationship between in vitro cytokine production and metabolism was examined in 23 adults with RA and 23 healthy control subjects matched on age, sex, race, and weight. Body composition was measured by multicompartmental analysis of body cell mass, water, fat, and bone mass. Resting energy expenditure (REE) was measured by indirect calorimetry. Cytokine production by PBMC was measured by radioimmunoassay. Usual energy intake, physical activity, disability scores, medication use, and other confounders were also measured. Body cell mass was 13% lower (P < 0.00001), REE was 12% higher (P < 0.008), and physical activity was much lower (P < 0.001) in subjects with RA. Production of TNF-alpha was higher in RA than controls, both before and after stimulation with endotoxin (P < 0.05), while production of IL-1 beta was higher with endotoxin stimulation (P < 0.01). In multivariate analysis, cytokine production was directly associated with REE (P < 0.001) in patients but not in controls. While energy and protein intake were similar in the two groups and exceeded the Recommended Dietary Allowances, energy intake in subjects with RA was inversely associated with IL-1 beta production (P < 0.005). In this study we conclude that: loss of body cell mass is common in RA; cytokine production in RA is associated with altered energy metabolism and intake, despite a theoretically adequate diet; and TNF-alpha and IL-1 beta modulate energy metabolism and body composition in RA.     

The asthma experience: altered body image and non-compliance

• ? Asthma remains a frustrating and underestimated threat to health.
• ? Non-compliance with medication is a frequent problem, especially when asthma attacks arc difficult to predict, and amongst children and young adults.
• ? Non-compliance has been attributed to shortfalls in patient education. There may, however, be an attitudinal–altered image dimension to the problem.

     

Nursing exploration summer camp: improving the image of nursing

Improving the image of nursing and finding ways to encourage young people to enter the nursing field are two areas that need attention from nurse executives. That concept was turned into reality with Inova Nursing Exploration Summer Camp 2001, a camp for seventh and eighth graders who are exploring their interest in nursing careers. The camp was a unique partnership among a county public school system, a local university, and an integrated healthcare system. The program, developed by the system nurses in consultation with middle school educators, introduced students to the nursing profession via demonstrations, site visits at multiple hospitals, role-playing, discussions, and a trip to the local nursing school to experience life as a nursing student. The authors discuss the planning, implementation, and outcome of this unique summer camp.     

Skeletal muscle and whole body protein turnover in cardiac cachexia: influence of branched-chain amino acid administration

Muscle protein wasting commonly accompanies severe heart failure. The mechanism of this so-called cardiac cachexia has been investigated in eight patients with an average body weight decrement of 19%, whose results have been compared with those from 11 healthy control subjects. Exchanges of tyrosine and 3-methylhistidine across leg tissue were used as specific indicators of net protein balance and myofibrillar protein breakdown, respectively. Whole body protein turnover was measured using a stable isotope labelling technique with L-[1-13C]leucine as tracer. In patients with cardiac cachexia there were greater values, relative to those values in normal control subjects, of leg efflux of tyrosine (-8.1 +/- 0.6 nmol 100 ml leg tissue-1 min-1 vs. -4.2 +/- 0.3 nmol 100 ml-1 min-1 (P less than 0.01) and of 3-methylhistidine (-0.8 +/- 0.1 nmol 100 ml leg tissue-1 min-1 vs. -0.1 +/- 0.02 nmol 100 ml-1 min-1 (P less than 0.005), mean +/- SEM). The results suggest that in patients with cardiac cachexia the state of net negative protein balance across leg tissue is associated with an increased rate of myofibrillar protein breakdown. In cardiac cachexia, neither efflux of tyrosine (-8.4 +/- 0.7 nmol 100 ml leg tissue-1 min-1) nor of 3-methylhistidine (-1.0 +/- 0.2 nmol 100 ml leg tissue-1 min-1) were significantly altered by branched-chain amino acid (BCAA) infusion to plasma concentrations of 1300 +/- 14 mumol ml-1, i.e., four times normal plasma values (282 +/- 11 mumol ml-1).(ABSTRACT TRUNCATED AT 250 WORDS)     

Student perceptions of a community engagement experience: exploration of reflections on social responsibility and professional formation

Physical therapy educators are challenged to emphasize the importance of social responsibility as a vital curricular element of professional development. Through reflection, students are able to identify core values, beliefs, and attitudes as part of the professional development process. The purpose of this study was to explore student perceptions and values of a community engagement experience based upon frequency of participation. This qualitative research report investigated student perceptions of the community experience following participation. Data collection tools included an open-ended questionnaire and focus group interviews. Comparisons were made across data for participants who engaged in the activity one time versus multiple times. Data analysis revealed participation in the community engagement experience had a positive impact on most participants. One time only participants demonstrated increased self-awareness, contemplating change, and capacity to serve while more than one time participants described a deeper understanding of community, impact on others, and professional transformation. Student involvement in community engagement activities combined with structured reflection provided meaningful insight into participants' personal beliefs. The results suggest incorporation of community-based learning experiences into academic curriculum may be beneficial in the students' preliminary understanding of social responsibility.     

Sociology and nursing science: reflections on an interdisciplinary approach

The present text is not the result of a necessarily improved sociological theory. It acts rather like an exploratory questioning on the contribution of sociology to the formation and the practice of the nurses in the context of globalization. Our purpose is related more precisely to the "décloisonnement" of the disciplines and the contribution of the interdisciplinary studies. To do so, we put in perspective a new conceptual approach called the "socio-environmental approach for health" (Bouchard and his/her colleagues; 2002) which aloud to introduce and to question concepts like the governorship, globalization, the social capital, life quality and health care. This conceptual unit is not exhaustive nor even homogeneous. It only makes it possible to think of what is at stake in the development of nurses health care practice and shows the central contribution of an interdisciplinary approach.