Longing for existential recognition: A qualitative study of everyday concerns for people with somatoform disorders

Objective

Patients with somatoform disorders could be vulnerable to stressors and have difficulties coping with stress. The aim was to explore what the patients experience as stressful and how they resolve stress in everyday life.

Methods

A cross-sectional retrospective design using 24 semi-structured individual life history interviews. Data-analysis was based on grounded theory.

Results

A major concern in patients was a longing for existential recognition. This influenced the patients' self-confidence, stress appraisals, symptom perceptions, and coping attitudes. Generally, patients had difficulties with self-confidence and self-recognition of bodily sensations, feelings, vulnerability, and needs, which negatively framed their attempts to obtain recognition in social interactions. Experiences of recognition appeared in three different modalities: 1) “existential misrecognition” covered the experience of being met with distrust and disrespect, 2) “uncertain existential recognition” covered experiences of unclear communication and a perception of not being totally recognized, and 3) “successful existential recognition” covered experiences of total respect and understanding. “Misrecognition” and “uncertain recognition” related to decreased self-confidence, avoidant coping behaviours, increased stress, and symptom appraisal; whereas “successful recognition” related to higher self-confidence, active coping behaviours, decreased stress, and symptom appraisal.

Conclusion

Different modalities of existential recognition influenced self-identity and social identity affecting patients' daily stress and symptom appraisals, self-confidence, self-recognition, and coping attitudes. Clinically it seems crucial to improve the patients' ability to communicate concerns, feelings, and needs in social interactions. Better communicative skills and more active coping could reduce the harm the patients experienced by not being recognized and increase the healing potential of successful recognition.     

Influence of the crown-to-implant length ratio on the clinical performance of implants supporting single crown restorations: a cross-sectional retrospective 5-year investigation

Purpose: The aim of this study was to investigate the influence of the crown‐to‐implant length ratio (c/i ratio) on the implant survival, changes of the marginal bone level (MBL) and the occurrence of biological and technical complications. Material and methods: This cross‐sectional retrospective study included all patients with implants in the posterior segments supporting single crown restorations with a minimum follow‐up of 5 years. All patients were questioned and examined clinically and radiographically. The technical and biological c/i ratio and the MBL were measured on digitized periapical radiographs. The following outcome parameters in relation to the c/i ratio and the co‐factors were statistically analyzed: implant survival rate, MBL, occurrence of technical and biological complications. For statistical analysis, regression, correlation and survival analyses were applied (P<0.05). Results: Seventy patients (mean age of 50.7 years [range 19.8–76.6 years]) with a total of 100 implants (24 Straumann type, 76 Brånemark type) were included in this study. The mean follow‐up period was 6.2 years (range 4.73–11.7 years). Six implants failed during the follow‐up period, yielding a cumulative survival rate of 95.8% at 5 years in function. The mean technical c/i ratio was 1.04 (±0.26, range 0.59–2.01). The mean biological c/i ratio was 1.48 (±0.42, range 0.82–3.24). No statistically significant influence of the technical and biological c/i ratio was found on the implant survival, MBL and occurrence of technical and biological complications. When adjusted for the biological c/i ratio, smoking was the only co‐factor significantly associated with implant failure and biological complications. Conclusion: In the present study, the c/i ratio did not influence the clinical performance of implants supporting single crown restorations in the posterior segments of the jaw within the range tested. To cite this article:
Schneider D, Witt L, Hämmerle CHF. Influence of the crown‐to‐implant length ratio on the clinical performance of implants supporting single crown restorations: a cross‐sectional retrospective 5‐year investigation.
Clin. Oral Impl. Res. 23 , 2012; 169–174.
doi: 10.1111/j.1600‐0501.2011.02230.x     

Dental hygienists as adult learners and educators to improve access to care

To cite this article:
Int J Dent Hygiene 10 , 2012; 36–45
DOI: 10.1111/j.1601‐5037.2011.00510.x
Rogo EJ. Dental hygienists as adult learners and educators to improve access to care. Abstract: Objective: The purpose of the qualitative study was to understand dental hygienists as adult learners and educators in their quest to improve access to care. The intent of this article is to share the results from open and focused coding procedures and the participants’ rich stories from which the analysis was constructed. Methods: A grounded theory approach to data collection and analysis was used. Data were collected from eight practitioners in three US states who met the inclusion criteria, using semi‐structured interviews. Traditional grounded theory procedures with a constructivist emphasis on lived experiences of the participants and situational analysis were used to analyse the data. Results: The process of learning was experienced in three categories: Awareness, Adaptation and Relationships. Awareness was the process of learning participants experienced as developing consciousness of self, status quo, power and injustice of systems. Adaptation was constructed from experiences of specializing and creating to adjust to the new environments and prepare future practitioners. Relationships were developed to feel connected and collaborate to build support and gain respect to improve access to care. Dental hygienists as educators revealed one category: Improvement. Improvement was the process of educating others to enhance awareness, oral health and the dental hygiene profession. Conclusions: Dental hygienists were adult learners by using their experiences in the context of their struggle to improve health inequities. A strong educator role was necessary to make improvements in the oral health delivery system.     

Department of Veterans Affairs Geriatric Research, Education and Clinical Centers: translating aging research into clinical geriatrics

Department of Veterans Affairs (VA) Geriatric Research, Education and Clinical Centers (GRECCs) originated in 1975 in response to the rapidly aging veteran population. Since its inception, the GRECC program has made major contributions to the advancement of aging research, geriatric training, and clinical care within and outside the VA. GRECCs were created to conduct translational research to enhance the clinical care of future aging generations. GRECC training programs also provide leadership in educating healthcare providers about the special needs of older persons. GRECC programs are also instrumental in establishing robust clinical geriatric and aging research programs at their affiliated university schools of medicine. This report identifies how the GRECC program has successfully adapted to changes that have occurred in VA since 1994, when the program's influence on U.S. geriatrics was last reported, focusing on its effect on advancing clinical geriatrics in the last 10?years. This evidence supports the conclusion that, after more than 30?years, the GRECC program remains a vibrant "jewel in the crown of the VA" and is poised to make contributions to aging research and clinical geriatrics well into the future.     

Cyber.rules – What you really need to know about the Internet

Over the next three issues three linked articles will take you through guidance about how to write for publication. In 2009 and 2010 Taylor &; Francis funded two workshops on this topic for members of the British Association for Sexual and Relationship Therapy. Using some of the exercises and feedback from these workshops the article will consider: common anxieties that therapists have about writing and how to address these; some of the main forms of writing that counsellors and therapists can consider; key aspects of structure and content; and how to go through the process of submission, review and revision. It is hoped that the articles will go some way towards demystifying the process and increasing your confidence in writing and submitting publications.