Toward a more viable model of grieving and consequences for older persons

Most theories of grieving derive from Sigmund Freud and Erich Lindemann's understanding of mourning and include two assumptions: (a) Grieving is time limited; the process should be completed or resolved after a year or two; and (b) The main task of grieving is to achieve “decathexis.” One should detach oneself from emotional ties to the deceased so as to be able to form new relationships. This study presents evidence that these assumptions are flawed and that modern theories of grieving fall short of explaining the complicated reality of the mourning process. An alternative model is presented arguing that when a “high-grief” death occurs, a griever may be able to adapt and adjust to loss, but the grieving continues indefinitely. Implications of this model for older grievers are explored.     

Clinical trials programs

The National Cancer Institute (NCI) is the largest single sponsor of studies using anti-neoplastic agents with over 100 compounds currently in various stages of clinical testing. Most of the clinical trials are conducted by the NCI sponsored cooperative oncology groups and community oncology programs, cancer centers, and the pharmaceutical industry. These organizations conduct studies both independently as well as in a collaborative fashion.     

Unemployment causes ill health: the wrong track

It is not unemployment per se that causes ill health. It can be a very desirable state. There are no diseases specific to unemployment. Contrast this with employment. Unemployment shares with all other socio-environmental situations risk of exposure to common physical, social and psychological stressors that predispose to disease. Focus for action and research should be on reducing such stressors and not on provision of full employment. The former is likely to be possible and beneficial. The latter is likely to be impossible and carries a risk of making matters worse. As an immediate first step, that will reduce 'cratogenic' disease, people in authority should stop misleading the public into believing that unemployment is the cause of ill health.     

Genetic analysis of host responses in sepsis

During much of the past century, the microbe itself stood at the heart of microbial pathogenesis. Little thought was devoted to the host per se, though it was granted that differences in susceptibility to certain infections did exist between individuals, and between different ethnic groups. During the past 20 years, extraordinary strides in our grasp of mammalian genetics have made the host side of the equation far more approachable. A restricted collection of genes now presents itself as the likely repository for genetic differences that foretell susceptibility to infectious disease. The Toll-like receptors, of which 10 are presently known to exist in humans, offer an excellent example of this genetic reductionism, in that they embody the afferent component of the innate immune system, and strongly influence the containment of an infection from its earliest stages. The Toll-like receptors were identified as the culmination of a long and relentless inquiry into the yet-unsolved clinical problem of sepsis.