Caregiver Discourse: Perceptions of Illness-Related Dialogue

Interacting with terminally-ill patients is significantly stressful for caregiving families. To date, few studies have examined how caregivers perceive their communication with dying family members. As such, the present investigation was undertaken. A sample of 10 family caregivers was utilized for the study; informants had to be the spouse or child of the patient, having provided the majority of care during the illness period. Semi-structured interviews were employed by the investigator to collect data on the communicative experiences of these caregivers; they were asked to describe their thoughts and interactional experiences with specific reference to the following: (1) the inevitability of the patient’s death, (2) the patient’s preferred courses of action, (3) levels of family interaction, (4) patient denial, (5) previous patterns of discourse, and (6) bereavement. All interviews were audio-recorded, transcribed verbatim, and analyzed using a two-tier system incorporating aspects of content analysis methodology. Results indicate that caregivers experience difficulty communicating with their patients and with other family members. Suggestions for developing effective, appropriate, and sensitive communication training programs for terminally-ill patients and their caregiving families are provided. [Single or multiple copies of this article are available from The Haworth Document Delivery Service: 1-800-342-9678, 9:00?a.m. - 5:00?p.m. (EST)]     

Equine-assisted therapy and its impact on cortisol levels of children and horses: a pilot study and meta-analysis

Childhood trauma, abuse or neglect impacts the function and structure of the brain of affected children. Attunement with other beings as well as an enriched environment can contribute to normal brain development. The enriched environment of a barn and attunement with an animal may contribute to reductions in stress for traumatised children. A pilot study, using a multiple base line, single case design included four children with post-traumatic stress syndrome (aged eight to ten years) and four therapy riding horses. This study hypothesised that cortisol would correlate between each child–horse pair, using a 12-day intervention that included six consecutive days of riding and grooming. A meta-analysis was completed of correlation levels of four child–horse pairs The weighted mean cross-correlation, controlling for autocorrelation, was 0.23, Z?=?3.03, approximate 95% confidence interval 0.23?±?(1.96?×?0.076) or 0.08 to 0.38. The data suggest a need for further research.     

Chapter 6. The New Story: On the Possibility of Liberating Oneself From the Drug Self

This chapter explores the meaning(s) of “treatment effect” within the psychodynamic tradition. The conventional wisdom is that a successful treatment presupposes a transformation of unconscious “material” to a conscious level. The “treatment effect” is reinterpreted as being better understood as changing an old (and detrimental) story into a new tale—an alternative narrative about the self. New possibilities following this conceptual change are introduced with the aid of some concrete examples.     

Antagonistic Effect In Vivo of Zinc on Inhibition of δ -Aminolevulinic Acid Dehydratase by Lead

δ-aminolevulinic acid dehydratase (ALAD) is an enzyme involved in the biosynthesis of heme, in which it catalyzes the condensation of two molecules of δ-aminolevulinic acid to one molecule of porphobilinogen. It is a sulfhydryl enzyme, which means, among other tilings, that its activity is inhibited by many heavy metals. In the present investigation rabbits were given either zinc or lead or both. Zinc had a strong activating effect on ALAD in vivo, and the inhibitory effect of lead was almost completely eliminated. A close positive correlation was found between ALAD in the red blood cells and zinc in the plasma, but there was no correlation between ALAD and zinc in the red blood cells. These observations are of particular interest in the light of recent findings, suggesting that zinc is an essential metal for ALAD.     

“Living with the Dirty Secret”: Problems of Disclosure for Methadone Maintenance Clients

Abstract

This article focuses on the management of stigma by methadone maintenance patients. It explores (1) the consequences of this persistent stigma, which necessitates the need for secrecy, (2) the adaptations made in order to successfully “pass as normal,” and (3) the contexts in which methadone-maintained individuals decide to disclose their stigmatized status. The data reported and analyzed were gathered between 1980 and 1989 during a series of studies funded by the National Institute on Drug Abuse. The three studies—“Women on Methadone,” “Getting Off Methadone,” and “Alameda County Methadone Study”—utilized qualitative, in-depth interviews and ethnographic sampling techniques, primarily chain referral sampling. After ten years of interviewing women and men in various stages of their methadone maintenance careers, recurring themes emerged, one of which was that being a methadone patient is a marginal identity; not quite junkie, not quite conventional. Clients' efforts to manage this stigmatized identity were often shrouded in anguish and secrecy. Methadone patients were in a kind of identity limbo; a holding pattern between two extremely different social worlds. They were trying to effect an identity transformation; however, in many circumstances they were still associated with and defined by their “dirty secret.”     

Strategies of Intervention with Families of Pediatric Leukemia Patients

As part of a longitudinal research study, families of children with leukemia were provided with a psychosocial intervention program over a two-year period. This paper describes the approaches used at specific times during the illness: diagnosis and initial treatment, early outpatient treatment, later outpatient treatment, remission, relapse, and death. the goals of the intervention strategies were to facilitate: an understanding of the realities of the illness; management of emotional distress; and utilization of resources to care for the child, attend to other responsibilities, and support and communicate with one another.     

Mutability of Muscle Fiber Types

No abstract available for this article.