Cultural processes in psychotherapy for perinatal loss: Breaking the cultural taboo against perinatal grief.

Science.gov (United States)

Markin, Rayna D; Zilcha-Mano, Sigal

2018-03-01

This paper argues that there is a cultural taboo against the public recognition and expression of perinatal grief that hinders parents' ability to mourn and their psychological adjustment following a loss. It is proposed that this cultural taboo is recreated within the therapy relationship, as feelings of grief over a perinatal loss are minimized or avoided by the therapist and parent or patient. Importantly, it is suggested that if these cultural dynamics are recognized within the therapy relationship, then psychotherapy has the immense opportunity to break the taboo by validating the parent's loss as real and helping the parent to mourn within an empathic and affect-regulating relationship. Specifically, it is suggested that therapists break the cultural taboo against perinatal grief and help parents to mourn through: acknowledging and not pathologizing perinatal grief reactions, considering intrapsychic and cultural factors that impact a parent's response to loss, exploring cultural reenactments within the therapy relationship, empathizing with the parent's experience of loss and of having to grieve within a society that does not recognize perinatal loss, coregulating the parent's feelings of grief and loss, and helping patients to create personally meaningful mourning rituals. Lastly, the impact of within and between cultural differences and therapist attitudes on the therapy process is discussed. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Bereaved parents’ online grief communities

DEFF Research Database (Denmark)

Christensen, Dorthe Refslund; Hård af Segerstad, Ylva; Kasperowski, Dick

2017-01-01

This article presents results from case studies of online grief communities for bereaved parents in Denmark and Sweden (Christensen & Sandvik 2013, 2015a; Hård af Segerstad & Kasperowski, 2015), analyzing how development of practices and norms for grieving and mourning online are related...... to the conditions for participation in the online forums, and to dominant ideas of grief in society as such. Rooted in contemporary research on grief and mourning, we discuss practices of tabooization, de-tabooization or even re-tabooization in the different online forums and how norms and traditions are performed...

Financial Perils in Higher Education--Good Grief!

Science.gov (United States)

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,…

Grief: Helping Young Children Cope

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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.

Neuropsychological correlates of complicated grief in older spousally bereaved adults.

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O'Connor, Mary-Frances; Arizmendi, Brian J

2014-01-01

Across many research domains, evidence for complicated grief as a distinct psychopathology continues to grow. Previous research from neuropsychology has shown an increased attentional bias to emotionally relevant stimuli in those suffering from complicated grief. This study furthers our understanding of the characteristics that distinguish complicated grief. We expand on previous research by (a) testing older adults, (b) excluding those with comorbid major depressive disorder, (c) using participant-chosen grief-related stimuli, and (d) using a married, nonbereaved control group. We recruited 76 older adults in 3 groups: spousally bereaved with complicated grief, spousally bereaved with noncomplicated grief, and nonbereaved controls. Performance on the Wisconsin Card Sorting Task, Digit Span Backwards, and the emotional counting Stroop was examined. Results indicate longer reaction time across 3 blocks of grief-related words in the complicated grief group but no difference across 3 blocks of the neutral words. The 3 groups performed comparably on the other neurocognitive tasks, indicating no cognitive differences in working memory or set shifting between groups. Furthermore, these effects of complicated grief generalize to older adults and appear independent of major depression. Complicated grief has cognitive interference as a neuropsychological component highlighting it as distinct from noncomplicated grief.

The Grief Account: Dimensions of a Contemporary Bereavement Genre

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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…

Concept clarification of grief in mothers of children with an addiction.

Science.gov (United States)

Zucker, Donna M; Dion, Kimberly; McKeever, Roxanna P

2015-04-01

To report an analysis of the concept of grief in mothers of children with an addiction. The concept of grief in this context is poorly understood and often synonymously used with concepts depression, loss and chronic sorrow. In the US, the core concept grief has been recently revised by both NANDA and the DSM-V in efforts to better understand and characterize the concept. The plethora of literature on grief worldwide often characterizes grief as a response to a death. Concept analysis. Search terms 'parental grief' and 'substance abuse' yielded 30 articles. A second review using terms 'grief' and 'substance abuse' yielded 323 articles, in PsychInfo, CINAHL, PubMed databases from 1980-2013. Limits for articles in English and for the terms 'death' and 'child' yielded 13 usable articles. The hybrid model of concept analysis, using a theoretical phase, an empirical phase and a final phase when a clarified definition of grief emerged. Definitions in the literature and defining characteristics of grief outline bio-psycho-social aspects of the concept. For one mother grief was accompanied by recurring feelings of sadness across time, while for the other mother grief was seen as coping, after having passed through a variety of stages of grief. For both, grief was seen to fall on a continuum. Grief is a universal concept and has a trajectory. Case study data have been essential in clarifying understandings of grief as experienced by mothers of addicted children and will provide direction for meaningful and tailored interventions. © 2014 John Wiley & Sons Ltd.

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

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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.

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

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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.

The Grief Resolution Process in Divorce.

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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)

Attitudes of palliative care clinical staff toward prolonged grief disorder diagnosis and grief interventions.

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Davis, Esther L; Deane, Frank P; Barclay, Gregory D; Bourne, Joan; Connolly, Vivienne

2017-07-03

The provision of psychological support to caregivers is an important part of the role of the clinical staff working in palliative care. Staff knowledge and attitudes may determine their openness to referring caregivers to a psychological intervention. We recently developed a self-help intervention for grief and psychological distress among caregivers and were interested in exploring the extent to which staff knowledge and attitudes might affect future implementation. The aims of our study were to: (1) examine the acceptability of self-help psychological intervention for caregivers among palliative care clinical staff; (2) examine potential attitudinal barriers toward prolonged grief disorder (PGD) as a diagnosis and interventions for grief; and (3) bolster staff confidence in skills and knowledge in identifying and managing caregiver psychological distress. An anonymous survey was distributed among clinical staff at two inpatient units and two community health services that assessed the acceptability of self-help interventions for caregivers, attitudes about PGD diagnosis and grief intervention, and staff confidence in skills and knowledge in assessing caregiver psychological distress. Overall, clinical staff were positively oriented toward self-help for caregivers and intervention for grief. They were also basically confident in their skills and knowledge. While it was positive PGD attitudes that were associated with acceptability of self-help for caregivers, it was both positive and negative PGD attitudes that were associated more specifically with a willingness to refer caregivers to such an intervention. Our findings are useful in highlighting the issues to be considered in the implementation of a self-help intervention within the healthcare service. Clinical staff seemed positively oriented toward engaging with a psychological intervention for caregivers and likely to act as key allies in implementation.

A confirmatory factor analysis of the Harvard Trauma Questionnaire and the Inventory of Complicated Grief-Revised: Are we measuring complicated grief or posttraumatic stress?

DEFF Research Database (Denmark)

O'Connor, Maja; Lasgaard, Mathias Kamp; Shevlin, Mark

2010-01-01

  The Inventory of Complicated Grief Revised (ICG-R) assesses symptoms of complicated grief in bereaved individuals. The aim of this study was to assess the factorial structure of Complicated Grief (CG) and investigate the relationship between CG and Posttraumatic Stress Disorder through the asse......  The Inventory of Complicated Grief Revised (ICG-R) assesses symptoms of complicated grief in bereaved individuals. The aim of this study was to assess the factorial structure of Complicated Grief (CG) and investigate the relationship between CG and Posttraumatic Stress Disorder through...... and the three factors of PTSD, as defined by the DSM-IV (American Psychiatric Association, 1994), were allowed to correlate provided the best fit. The results therefore indicate high levels of conceptual overlap among the dimensions of CG and PTSD....

Integrating Buddhist Psychology into Grief Counseling

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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…

Tweeting Prayers and Communicating Grief over Michael Jackson Online

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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…

The impact of bereaved parents' perceived grief similarity on relationship satisfaction.

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Buyukcan-Tetik, Asuman; Finkenauer, Catrin; Schut, Henk; Stroebe, Margaret; Stroebe, Wolfgang

2017-06-01

The present research focused on bereaved parents' perceived grief similarity, and aimed to investigate the concurrent and longitudinal effects of the perceptions that the partner has less, equal, or more grief intensity than oneself on relationship satisfaction. Participants of our longitudinal study were 229 heterosexual bereaved Dutch couples who completed questionnaires 6, 13, and 20 months after the loss of their child. Average age of participants was 40.7 (SD = 9.5). Across 3 study waves, participants' perceived grief similarity and relationship satisfaction were assessed. To control for their effects, own grief level, child's gender, expectedness of loss, parent's age, parent's gender, and time were also included in the analyses. Consistent with the hypotheses, cross-sectional results revealed that bereaved parents who perceived dissimilar levels of grief (less or more grief) had lower relationship satisfaction than bereaved parents who perceived similar levels of grief. This effect remained significant controlling for the effects of possible confounding variables and actual similarity in grief between partners. We also found that perceived grief similarity at the first study wave was related to the highest level of relationship satisfaction at the second study wave. Moreover, results showed that perceived grief similarity was associated with a higher level in partner's relationship satisfaction. Results are discussed considering the comparison and similarity in grief across bereaved partners after child loss. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

The use of pathological grief outcomes in bereavement studies on African Americans.

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Granek, Leeat; Peleg-Sagy, Tal

2017-06-01

Pathological bereavement outcomes (i.e., complicated grief, traumatic grief, prolonged grief disorder) are a robust and growing research area in the psychological and medical sciences. Although grief is considered to be a universal phenomenon, it is well documented that grieving processes and outcomes are culturally and contextually bound. The objectives of this study were: (a) to examine representations of African Americans in the grief and mourning literature and to assess the extent to which this research utilizes pathological grief outcomes; and (b) to examine the characteristics of pathological grief constructs in the literature to assess their relevance for African American populations. We conducted comprehensive searches of three scientific databases including PsycNET, Medline, and CINAHL, which contain the majority of grief and mourning literature published between January 1998 and February 2014. We found 59 studies addressing grief and mourning in African Americans. Thirteen of these studies used pathological grief outcomes. Pathological grief outcomes that were constructed and validated on White populations were frequently used as outcome variables with African American participants. We discuss the implications for the grief and mourning field and argue that the failure to use culturally sensitive outcome measures in research studies is a form of epistemological violence that may have negative research and clinical implications for African Americans and other ethnic minorities.

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

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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.

Is rumination after bereavement linked with loss avoidance? Evidence from eye-tracking.

Directory of Open Access Journals (Sweden)

Maarten C Eisma

Full Text Available Rumination is a risk factor in adjustment to bereavement. It is associated with and predicts psychopathology after loss. Yet, the function of rumination in bereavement remains unclear. In the past, researchers often assumed rumination to be a maladaptive confrontation process. However, based on cognitive avoidance theories of worry in generalised anxiety disorder (GAD and rumination after post-traumatic stress disorder (PTSD, others have suggested that rumination may serve to avoid painful aspects of the loss, thereby contributing to complicated grief. To examine if rumination is linked with loss avoidance, an eye-tracking study was conducted with 54 bereaved individuals (27 high and 27 low ruminators. On 24 trials, participants looked for 10 seconds at a picture of the deceased and a picture of a stranger, randomly combined with negative, neutral or loss-related words. High ruminators were expected to show initial vigilance followed by subsequent disengagement for loss stimuli (i.e., picture deceased with a loss word in the first 1500 ms. Additionally, we expected high ruminators to avoid these loss stimuli and to show attentional preference for non-loss-related negative stimuli (i.e., picture stranger with a negative word on longer exposure durations (1500-10000 ms. Contrary to expectations, we found no evidence for an effect of rumination on vigilance and disengagement of loss stimuli in the first 1500 ms. However, in the 1500-10000 ms interval, high ruminators showed shorter gaze times for loss stimuli and longer gaze times for negative (and neutral non-loss-related stimuli, even when controlling for depression and complicated grief symptom levels. Effects of rumination on average fixation times mirrored these findings. This suggests that rumination and loss avoidance are closely associated. A potential clinical implication is that rumination and grief complications after bereavement may be reduced through the use of exposure and acceptance

Effectiveness of Psychotherapy-Based Interventions for Complicated Grief: A Systematic Review

Directory of Open Access Journals (Sweden)

Ozge Enez

2017-12-01

Full Text Available Grief is a normal, dynamic and multidimensional process, which relates to the individuality and uniqueness of reactions to loss. However, complicated grief is a syndrome where normal grief is unusually prolonged because of complications in the natural healing process. Approximately one third of grieving individuals develop complicated grief symptoms. The individuals suffering from complicated grief tend to report clinical complaints that refer to anxiety, depression, psychical symptoms and life-threatening behaviours. The aims of this study were: to identify which psychother-apy-based interventions were designed for the treatment of complicated grief; and to make an infer-ence about the effect of these interventions. [Psikiyatride Guncel Yaklasimlar - Current Approaches in Psychiatry 2017; 9(4.000: 441-463

The Child in Grief: Implications for Teaching.

Science.gov (United States)

Hare, Jan; And Others

The purpose of this paper is to increase teachers' understanding of children's conceptualizations of death to enable them to respond to the symptoms of grief in both early and middle childhood. John Bowlby's theoretical framework of childhood mourning is elaborated, and research on teachers' facilitation of children's grief is briefly noted. The…

Designing personal grief rituals: An analysis of symbolic objects and actions.

Science.gov (United States)

Sas, Corina; Coman, Alina

2016-10-01

Personal grief rituals are beneficial in dealing with complicated grief, but challenging to design, as they require symbolic objects and actions meeting clients' emotional needs. The authors reported interviews with 10 therapists with expertise in both grief therapy and grief rituals. Findings indicate three types of rituals supporting honoring, letting go, and self transformation, with the latter being particularly complex. Outcomes also point to a taxonomy of ritual objects for framing and remembering ritual experience, and for capturing and processing grief. Besides symbolic possessions, the authors identified other types of ritual objects including transformational and future-oriented ones. Symbolic actions include creative craft of ritual objects, respectful handling, disposal, and symbolic play. They conclude with theoretical implications of these findings, and a reflection on their value for tailored, creative co-design of grief rituals. In particular, several implications for designing grief rituals were identified that include accounting for the client's need, selecting (or creating) the most appropriate objects and actions from the identified types, integrating principles of both grief and art/drama therapy, exploring clients' affinity for the ancient elements as medium of disposal in letting go rituals, and the value of technology for recording and reflecting on ritual experience.

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

Science.gov (United States)

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…

Effectiveness of a grief intervention for caregivers of people with dementia

OpenAIRE

MacCourt, Penny; McLennan, Marianne; Somers, Sandie; Krawczyk, Marian

2017-01-01

In this article, we report on the structure and effectiveness of a grief management coaching intervention with caregivers of individuals with dementia. The intervention was informed by Marwit and Meuser’s Caregiver Grief Model and considered levels of grief, sense of empowerment, coping, and resilience using five methods of delivery. Results indicate that the intervention had significant positive effects on caregivers’ levels of grief and increased their levels of empowerment, coping, and res...

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

Science.gov (United States)

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.

Memorial video tribute and the enfranchised grief of a gay widower

OpenAIRE

Pentaris, Panagiotis

2014-01-01

Doka (2008) introduced the term ‘disenfranchised grief ’ to refer to the form of grief that lacks social recognition. This paper argues that disenfranchised grief can find recognition and support via online communities, and it introduces this as enfranchised grief. Media and communication technologies have been widely used to communicate death and dying, while a vast number of the population, globally, has access to the information. Numerous deaths of celebrities have been covered by the news...

Effectiveness of a Grief Intervention for Caregivers of People With Dementia.

Science.gov (United States)

MacCourt, Penny; McLennan, Marianne; Somers, Sandie; Krawczyk, Marian

2017-08-01

In this article, we report on the structure and effectiveness of a grief management coaching intervention with caregivers of individuals with dementia. The intervention was informed by Marwit and Meuser's Caregiver Grief Model and considered levels of grief, sense of empowerment, coping, and resilience using five methods of delivery. Results indicate that the intervention had significant positive effects on caregivers' levels of grief and increased their levels of empowerment, coping, and resilience. The intervention was found to be effective across caregivers' characteristics as well as across five delivery modalities. Through description of this intervention, as well as outcome, this research contributes to the body of knowledge about caregivers' disenfranchised grief and ways to effectively address it.

Psychometric Properties of the Grief Cognitions Questionnaire for Children (GCQ-C)

NARCIS (Netherlands)

M. Spuij (Mariken); P.J. Prinzie (Peter); P.A. Boelen (Paul A.)

2017-01-01

textabstractNegative thinking is seen as an important mediating factor in the development of prolonged grief disorder (PGD), a syndrome encompassing debilitating symptoms of grief. No measure of specific grief related cognitions is available yet. Based on an adult measure of negative thinking in

Psychometric Properties of the Grief Cognitions Questionnaire for Children (GCQ-C)

NARCIS (Netherlands)

Spuij, Mariken; Prinzie, Peter; Boelen, Paul A.

2017-01-01

Negative thinking is seen as an important mediating factor in the development of prolonged grief disorder (PGD), a syndrome encompassing debilitating symptoms of grief. No measure of specific grief related cognitions is available yet. Based on an adult measure of negative thinking in adults we

The grief process for patient, family, and physician.

Science.gov (United States)

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.

Craving love? Enduring grief activates brain's reward center.

Science.gov (United States)

O'Connor, Mary-Frances; Wellisch, David K; Stanton, Annette L; Eisenberger, Naomi I; Irwin, Michael R; Lieberman, Matthew D

2008-08-15

Complicated Grief (CG) occurs when an individual experiences prolonged, unabated grief. The neural mechanisms distinguishing CG from Noncomplicated Grief (NCG) are unclear, but hypothesized mechanisms include both pain-related activity (related to the social pain of loss) and reward-related activity (related to attachment behavior). Bereaved women (11 CG, 12 NCG) participated in an event-related functional magnetic resonance imaging scan, during grief elicitation with idiographic stimuli. Analyses revealed that whereas both CG and NCG participants showed pain-related neural activity in response to reminders of the deceased, only those with CG showed reward-related activity in the nucleus accumbens (NA). This NA cluster was positively correlated with self-reported yearning, but not with time since death, participant age, or positive/negative affect. This study supports the hypothesis that attachment activates reward pathways. For those with CG, reminders of the deceased still activate neural reward activity, which may interfere with adapting to the loss in the present.

Ecological grief as a mental health response to climate change-related loss

Science.gov (United States)

Cunsolo, Ashlee; Ellis, Neville R.

2018-04-01

Climate change is increasingly understood to impact mental health through multiple pathways of risk, including intense feelings of grief as people suffer climate-related losses to valued species, ecosystems and landscapes. Despite growing research interest, ecologically driven grief, or `ecological grief', remains an underdeveloped area of inquiry. We argue that grief is a natural and legitimate response to ecological loss, and one that may become more common as climate impacts worsen. Drawing upon our own research in Northern Canada and the Australian Wheatbelt, combined with a synthesis of the literature, we offer future research directions for the study of ecological grief.

Voluntarism and transparent deliberation

DEFF Research Database (Denmark)

Steglich-Petersen, Asbjørn

2006-01-01

It is widely assumed that doxastic deliberation is transparent to the factual question of the truth of the proposition being considered for belief, and that this sets doxastic deliberation apart from practical deliberation. This feature is frequently invoked in arguments against doxastic voluntar......It is widely assumed that doxastic deliberation is transparent to the factual question of the truth of the proposition being considered for belief, and that this sets doxastic deliberation apart from practical deliberation. This feature is frequently invoked in arguments against doxastic...

Alexithymia and Grief Reactions in Bereaved Japanese Women

Science.gov (United States)

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…

Public stigma of prolonged grief disorder : An experimental study

NARCIS (Netherlands)

Eisma, Maarten C.

Prolonged grief disorder (PGD), characterized by severe, persistent and disabling grief, is being considered for inclusion in the International Classification of Diseases’ 11 (ICD-11) and a related disorder, Persistent Complex Bereavement Disorder (PCBD), is included for further investigation in the

Prolonged grief disorder: Psychometric validation of criteria proposed for DSM-V and ICD-11.

Directory of Open Access Journals (Sweden)

Holly G Prigerson

2009-08-01

Full Text Available Bereavement is a universal experience, and its association with excess morbidity and mortality is well established. Nevertheless, grief becomes a serious health concern for a relative few. For such individuals, intense grief persists, is distressing and disabling, and may meet criteria as a distinct mental disorder. At present, grief is not recognized as a mental disorder in the DSM-IV or ICD-10. The goal of this study was to determine the psychometric validity of criteria for prolonged grief disorder (PGD to enhance the detection and potential treatment of bereaved individuals at heightened risk of persistent distress and dysfunction.A total of 291 bereaved respondents were interviewed three times, grouped as 0-6, 6-12, and 12-24 mo post-loss. Item response theory (IRT analyses derived the most informative, unbiased PGD symptoms. Combinatoric analyses identified the most sensitive and specific PGD algorithm that was then tested to evaluate its psychometric validity. Criteria require reactions to a significant loss that involve the experience of yearning (e.g., physical or emotional suffering as a result of the desired, but unfulfilled, reunion with the deceased and at least five of the following nine symptoms experienced at least daily or to a disabling degree: feeling emotionally numb, stunned, or that life is meaningless; experiencing mistrust; bitterness over the loss; difficulty accepting the loss; identity confusion; avoidance of the reality of the loss; or difficulty moving on with life. Symptoms must be present at sufficiently high levels at least six mo from the death and be associated with functional impairment.The criteria set for PGD appear able to identify bereaved persons at heightened risk for enduring distress and dysfunction. The results support the psychometric validity of the criteria for PGD that we propose for inclusion in DSM-V and ICD-11. Please see later in the article for Editors' Summary.

Parental Grief Following the Death of a Child from Cancer: The Ongoing Odyssey.

Science.gov (United States)

Snaman, Jennifer M; Kaye, Erica C; Torres, Carlos; Gibson, Deborah; Baker, Justin N

2016-09-01

The death of a child is a devastating event that results in profound grief and significant psychosocial and physical morbidities in parents. The parental grief journey is a complex phenomenon necessitating the utilization of newer models of bereavement with a focus on relationships and exploration of parents' perceived meanings of the experience. To further characterize the grief journey of parents whose child died from cancer in order to better identify parents who can benefit from additional bereavement support and design strategies to improve bereavement services for these parents. We conducted focus group sessions with 11 bereaved parents. The parents were given two prompts to describe their grief journey before and after their child's death, and their responses in a narrative form were audio-recorded. The responses were coded and studied independently by semantic content analysis. Collation and analysis of the coded responses to both prompts results in the emergence of four concepts from the parental narratives: (1) description of the grief trajectory and evolution of grief over time, (2) mechanisms of parental coping throughout the grief journey, (3) factors that exacerbate parental grief, and (4) sources of parental support throughout the grief journey. The narratives highlighted that parents whose child died of cancer experience a unique and evolving form of grief and they wish to continue their bond with the deceased child. We recommend that healthcare providers and institutions incorporate support systems into a comprehensive bereavement program for families of children who die from cancer. © 2016 Wiley Periodicals, Inc.

Understanding Grief and Loss

Science.gov (United States)

... the process of adapting to life after a loss. It is influenced by each person’s society, culture, and religion. Bereavement is the state of having experienced a loss. Common grief reactions Reactions to loss are called ...

Deliberate Self Harm Behavior

Directory of Open Access Journals (Sweden)

Fatma Gul Helvaci Celik

2017-06-01

Full Text Available The deliberate self-harm behaviour which defined as attempting to own body resulting in tisue damage without conscious desire of peolple to die, is a major public health problem worldwide. The causes of deliberate self- harm, risk factors, the relationship between mental disorders and treatment strategies are not fully known. Deliberate self- harm can be observed together with psychiatric disorders such as borderline personality disorder, histrionic personality disorder, eating disorders and mood disorders. Also, deliberate self-harm must be distinguished from suicidal behavior. Psychologi-cal trauma has been suggested as a risk factor for deliberate self- harm behavior. Trauma and traumatic events have long been associated with deliberate self- harm behavior. The aim of this review article is to investigate the etiology and epidemiology of deliberate self-harm behaviour and relationship between psychiatric disorders. [Psikiyatride Guncel Yaklasimlar - Current Approaches in Psychiatry 2017; 9(2.000: 209-226

Factors Underlying the Relationship Between Parent and Child Grief.

Science.gov (United States)

Cipriano, David J; Cipriano, Madeline R

2017-01-01

The death of a parent in a child's life is a significant risk factor for later mental and physical health problems. While much has been written about the surviving parent's functioning and its effects on their bereaved children, little work has been done to look into factors underlying this effect such as how the parent copes. The present study recruited 38 parent-child dyads from a community-based grief support center. Parent and child, independently, completed various measures of emotional functioning, including grief symptoms and coping such as social support and locus of control. The results indicated that parental coping did have an impact on children's grief symptoms. This represents a unique view of adaptation in bereaved children: Parental coping strategies can have an impact on the child, independent of the child's coping strategies. By focusing on parent coping, we have highlighted another possible pathway through which parental functioning affects children's grief.

Cultural perspectives of death, grief, and bereavement.

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Clements, Paul T; Vigil, Gloria J; Manno, Martin S; Henry, Gloria C; Wilks, Jonathan; Das Sarthak; Kellywood, Rosie; Foster, Wil

2003-07-01

The cultural makeup of the United States continues to change rapidly, and as minority groups continue to grow, these groups' beliefs and customs must be taken into account when examining death, grief, and bereavement. This article discusses the beliefs, customs, and rituals of Latino, African American, Navajo, Jewish, and Hindu groups to raise awareness of the differences health care professionals may encounter among their grieving clients. Discussion of this small sample of minority groups in the United States is not intended to cover all of the degrees of acculturation within each group. Cultural groups are not homogeneous, and individual variation must always be considered in situations of death, grief, and bereavement. However, because the customs, rituals, and beliefs of the groups to which they belong affect individuals' experiences of death, grief, and bereavement, health care professionals need to be open to learning about them to better understand and help.

Maintaining connections in children's grief narratives in popular film.

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Sedney, Mary Anne

2002-04-01

Children's grief narratives in popular films were examined for their portrayal of connection-maintaining strategies with the deceased. Comparisons were made between strategies found in actual parentally bereaved children and in child characters in films. Implications of these filmed grief narratives for models of grieving and for practice are discussed.

Rhetorical Dimensions of the Post-September Eleventh Grief Process

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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…

Maternal resolution of grief after preterm birth: implications for infant attachment security.

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Shah, Prachi E; Clements, Melissa; Poehlmann, Julie

2011-02-01

This study explored the association between mothers' unresolved grief regarding their infant's preterm birth and infant-mother attachment security. We hypothesized that mothers with unresolved grief would be more likely to have insecurely attached infants at 16 months and that this association would be partially mediated by maternal interaction quality. This longitudinal study focused on 74 preterm infants (age of infants. The present analysis included assessment of neonatal and socioeconomic risks at NICU discharge; maternal depression, Reaction to Preterm Birth Interview findings, and quality of parenting at a postterm age of 9 months; and infant-mother attachment at postterm age of 16 months. Associations among findings of grief resolution with the Reaction to Preterm Birth Interview, quality of parenting interactions, and attachment security were explored by using relative risk ratios and logistic and multivariate regression models. The relative risk of developing insecure attachment when mothers had unresolved grief was 1.59 (95% confidence interval: 1.03-2.44). Controlling for covariates (adjusted odds ratio: 2.94), maternal feelings of resolved grief regarding the preterm birth experience were associated with secure infant-mother attachment at 16 months. Maternal grief resolution and interaction quality were independent predictors of attachment security. Maternal grief resolution regarding the experience of preterm birth and the quality of maternal interactions have important implications for emerging attachment security for infants born prematurely.

Coping with Death and Grief: A Strategy for Army Leadership

National Research Council Canada - National Science Library

Smith, Albert

1999-01-01

.... The military as a whole is not psychologically prepared to deal with death and grief. Military leaders and soldiers have learned from society that it is not okay to openly express their grief, which has a profound impact on morale in the Army...

A COMPLICATED GRIEF INTERVENTION MODEL

African Journals Online (AJOL)

2010-07-29

Jul 29, 2010 ... of complicated grief as a contributing factor to impaired social functioning. This can ... includes a diagnosis of bereavement-related major depression if symptoms ..... networking, Social Sciences Citation Index, Social Sciences.

End of Life: Suicide Grief

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Healthy Lifestyle End of life A loved one's suicide can be emotionally devastating. Use healthy coping strategies — ... Clinic Staff When a loved one dies by suicide, overwhelming emotions can leave you reeling. Your grief ...

Grief Counselling In African Indigenous Churches: A Case Of The ...

African Journals Online (AJOL)

collective participation, social isolation of the bereaved and then culminates in reincorporation of the bereaved into the community. The aim of this article is to explicate the meaning and value of grief counselling in AICs with special reference to the Zion Apostolic Church in Venda. Keywords: Grief counselling, african ...

The impact of bereaved parents' perceived grief similarity on relationship satisfaction

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Buyukcan-Tetik, Asuman; Finkenauer, Catrin; Schut, Henk; Stroebe, Margaret; Stroebe, Wolfgang

2017-01-01

The present research focused on bereaved parents' perceived grief similarity, and aimed to investigate the concurrent and longitudinal effects of the perceptions that the partner has less, equal, or more grief intensity than oneself on relationship satisfaction. Participants of our longitudinal

The Impact of Bereaved Parents' Perceived Grief Similarity on Relationship Satisfaction

NARCIS (Netherlands)

Buyukcan-Tetik, Asuman; Finkenauer, Catrin; Schut, Henk; Stroebe, Margaret; Stroebe, Wolfgang

The present research focused on bereaved parents' perceived grief similarity, and aimed to investigate the concurrent and longitudinal effects of the perceptions that the partner has less, equal, or more grief intensity than oneself on relationship satisfaction. Participants of our longitudinal

Exploring oncology nurses' grief: A self-study

Directory of Open Access Journals (Sweden)

Lisa C Barbour

2016-01-01

Full Text Available 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.

Cognitive-Behavioral Grief Therapy: The ABC Model of Rational-Emotion Behavior Therapy

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Ruth Malkinson

2010-12-01

Full Text Available The article briefly reviews the changes that occurred in the field of grief and bereavement, viewing it as a process of searching for a "rational" meaning to life without the deceased in line with the concept of continuing bonds and thus replacing that of Fred’s concept of decathexis. Cognitive-behavioral therapy (CBT evidenced-based studies for PTSD and complicated grief and the Cognitive-behavioral therapy − Rational-emotion behavior therapy (CBT-REBT model for grief are reviewed. The focus of intervention based on CBT-REBT is to facilitate a healthy adaptation to loss following death. A distinction is made between rational (adaptive and irrational (maladaptive grief processes. Case example illustrating the application of the model specifically a dialogue with repetitive thoughts, are presented.

A COMPLICATED GRIEF INTERVENTION MODEL

African Journals Online (AJOL)

2010-07-29

Jul 29, 2010 ... work approach to therapy) in an attempt to develop a model for complicated grief intervention ..... way feels right for them, thus making them equal partners with .... This question points out the benefits of success and affords the.

A COMPLICATED GRIEF INTERVENTION MODEL

African Journals Online (AJOL)

2010-07-29

Jul 29, 2010 ... 2006). Grief thus refers to the physical, emotional, cognitive, spiritual and social experiences of the loss. ... (CGIM) will add to a better understanding of the client and that it will also ... MOTIVATION FOR THE STUDY. There are ...

Perinatal grief following a termination of pregnancy for foetal abnormality: the impact of coping strategies.

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Lafarge, Caroline; Mitchell, Kathryn; Fox, Pauline

2013-12-01

Pregnancy termination for foetal abnormality (TFA) can have significant psychological repercussions, but little is known about the coping strategies involved in dealing with TFA. This study examined the relationships between women's coping strategies and perinatal grief. A total of 166 women completed a survey online. Coping and perinatal grief were measured using the Brief COPE and Short Perinatal Grief Scales. Data were analysed through multiple regression analyses. Despite using mostly adaptive coping strategies, women's levels of grief were high and varied according to obstetric and termination variables. Grief was predicted by behavioural disengagement, venting, planning, religion, self-blame, being recently bereaved, being childless at the time of TFA, not having had children/being pregnant since TFA and uncertainty about the decision to terminate the pregnancy. Acceptance and positive reframing negatively predicted grief. Identifying women vulnerable to poor psychological adjustment and promoting coping strategies associated with lower levels of grief may be beneficial. This could be addressed through information provision and interventions such as Cognitive Behavioural Therapy or Acceptance and Commitment Therapy. © 2013 John Wiley & Sons, Ltd.

The ties that bind: a reflection on physician grief.

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Giddings, Gordon

2010-10-01

Physician grief remains a prevalent yet largely unacknowledged problem in the medical profession. Several techniques can be employed to improve coping in physicians that deal frequently with patients approaching the end of life that can be integrated into medical training programs and physician practices. The author recounts his own experience of physician grief having cared for a patient on his dying journey and using it as an opportunity for personal growth.

Cognitive-Behavioral Grief Therapy: The ABC Model of Rational-Emotion Behavior Therapy

OpenAIRE

Malkinson, Ruth

2010-01-01

The article briefly reviews the changes that occurred in the field of grief and bereavement, viewing it as a process of searching for a "rational" meaning to life without the deceased in line with the concept of continuing bonds and thus replacing that of Fred’s concept of decathexis. Cognitive-behavioral therapy (CBT) evidenced-based studies for PTSD and complicated grief and the Cognitive-behavioral therapy − Rational-emotion behavior therapy (CBT-REBT) model for grief are reviewed. The foc...

Resolving Child and Adolescent Traumatic Grief: Creative Techniques and Interventions

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Edgar-Bailey, Meredith; Kress, Victoria E.

2010-01-01

This article presents a review of creative interventions that can be helpful in facilitating the resolution of traumatic grief in children and adolescents. Traumatic grief is conceptualized as a condition in which a person loses a close loved one (e.g., a parent or a sibling) in a traumatic manner, and ensuing trauma-related symptoms disrupt the…

"So truly afflicting and distressing to me his sorrowing mother": expressions of maternal grief in eighteenth-century Philadelphia.

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McMahon, Lucia

2012-01-01

In 1781, Lowry Wister produced an eight-page account of her three-year son’s death from small pox. Lowry Wister’s narrative offers important insights into the emotional landscape of mothering, mourning, and religion in late eighteenth-century America. Religious and cultural prescriptions stressed restraint throughout the mourning process, and in particular admonished women to avoid excessive displays of grief. Lowry Wister’s emotional struggles as a “sorrowing mother” enable us to examine the relationship between individual experiences and prescribed expressions of grief and mourning. While eighteenth-century conventions stressed quiet resignation to God’s will, emerging cultural changes increasingly enabled – indeed, encouraged – women to give public voice to their private emotions. By the nineteenth century, sentimental views of childhood, along with a culture of mourning, inspired parents – especially mothers – to give full expression to intense feelings of loss and sorrow. Lowry Wister’s narrative reveals how women responded to and negotiated various religious, cultural and literary conventions that shaped their understandings of motherhood and mourning. Her narrative illustrates the various ways in which individual women challenged cultural norms and helped usher in new forms of emotional and literary expression. Comparisons of Wister’s narrative to other eighteenth-century women’s writings on grief and mourning further illuminate the interplay between cultural convention and individual expression.

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

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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.

Don't just do something, stand there! The value and art of deliberate clinical inertia.

Science.gov (United States)

Keijzers, Gerben; Cullen, Louise; Egerton-Warburton, Diana; Fatovich, Daniel M

2018-04-01

It can be difficult to avoid unnecessary investigations and treatments, which are a form of low-value care. Yet every intervention in medicine has potential harms, which may outweigh the potential benefits. Deliberate clinical inertia is the art of doing nothing as a positive response. This paper provides suggestions on how to incorporate deliberate clinical inertia into our daily clinical practice, and gives an overview of current initiatives such as 'Choosing Wisely' and the 'Right Care Alliance'. The decision to 'do nothing' can be complex due to competing factors, and barriers to implementation are highlighted. Several strategies to promote deliberate clinical inertia are outlined, with an emphasis on shared decision-making. Preventing medical harm must become one of the pillars of modern health care and the art of not intervening, that is, deliberate clinical inertia, can be a novel patient-centred quality indicator to promote harm reduction. © 2018 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

Grief: Lessons from the Past, Visions for the Future

Directory of Open Access Journals (Sweden)

Colin Murray Parkes

2010-09-01

Full Text Available Over the last millennium patterns of mortality have changed and have determined who grieves and how. At all times grief has been recognised as a threat to physical and mental health. More recently the scientific study of bereavement has enabled us to quantify such effects and to develop theoretical explanations for them. This paper reviews our evolving understanding of grief, focusing especially on the developments in research, theory and practice that have taken place during the twentieth century. Wars and similar conflicts are associated with repression of grief but methods of helping by facilitating its expression, which were introduced during the two World Wars are less needed and effective at other times. In recent years more attention has been paid to the social context in which grief arises and, particularly, to the nature of the attachments which precede and influence the reaction to bereavement and to other traumatic life events. At the same time a range of caring resources have become available and acceptable to bereaved people and the results of scientific evaluation of these give promise that we are moving towards an era in which more sensitive and appropriate care will be provided to the bereaved by both voluntary and professional caregivers.

Adult Children of Dysfunctional Families: Treatment from a Disenfranchised Grief Perspective.

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Zupanick, Corinne E.

1994-01-01

Generalizes concept of disenfranchised grief to understanding of recovery process for adult children of dysfunctional families. Describes recovery process of this population as parallel to grief process. Identifies two layers of unrecognized loss: loss of one's childhood and loss of one's fantasized and idealized parent. Suggests specific…

Grief: The Unrecognized Parental Response to Mental Illness in a Child.

Science.gov (United States)

MacGregor, Peggy

1994-01-01

Notes that parents whose son or daughter develops serious mental illness experience grief that is often neither recognized by society nor addressed by mental health professionals. Describes some common elements of parental bereavement, losses experienced with mental illness, consequences of ignoring grief, and appropriate interventions for mental…

Predicting Grief Reactions One Year Following a Mass University Shooting: Evaluating Dose-Response and Contextual Predictors.

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Smith, Andrew J; Layne, Christopher M; Coyle, Patrick; Kaplow, Julie B; Brymer, Melissa J; Pynoos, Robert S; Jones, Russell T

2017-12-01

This study identifies risk factors for grief following a mass school shooting. Participants (N = 1,013) completed online questionnaires 3-4 months (Time 1) and 1 year (Time 2) post-shootings. We tested models predicting Time 2 grief reactions, exploring direct and indirect predictive effects of exposure variables (physical and social proximity) through hypothesized peritraumatic mediators (peritraumatic perceived threat to self or others) while controlling for Time 1 grief and posttraumatic stress (PTS) reactions, pretrauma vulnerabilities. Findings demonstrate that closer social proximity predicted higher levels of Time 2 grief, directly and indirectly through increasing peritraumatic perceived threat to others' safety. Physical proximity and peritraumatic threat to self did not predict Time 2 grief reactions. Implications for grief screening instruments and theory building research through identifying risk factors and causal mechanisms are discussed.

Are shame and self-esteem risk factors in prolonged grief after death of a spouse?

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Dellmann, Thomas

2018-07-01

Although many single factors of prolonged grief have been identified in the literature, a comprehensive understanding of predictors is still lacking. This article argues that shame and low self-esteem, present risk factors in prolonged grief after spousal loss, based on a review of correlational studies. Using a practitioner-scientist approach, a developmental model of shame as a core factor in prolonged grief is proposed, outlining the progression from childhood relational trauma, to insecure attachment, shame, self-esteem contingent on spousal approval to eventual prolonged grief.

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

Science.gov (United States)

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.…

Back home: a qualitative study exploring re-entering cross-cultural missionary aid workers' loss and grief.

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Selby, Susan; Moulding, Nicole; Clark, Sheila; Jones, Alison; Braunack-Mayer, Annette; Beilby, Justin

2009-01-01

Over 200 Australian, American, and British Non-Government Organizations send aid workers overseas including missionaries. On re-entry, they may suffer psychological distress; however, there is little research about their psychosocial issues and management in the family practice setting. Research suggests loss and grief as a suitable paradigm for family practitioners dealing with psychosocial issues. The aim of this study was to explore loss and grief issues for adult Australian missionary cross-cultural aid workers during their re-entry adjustment. Mixed methods were used and this study reports the qualitative method: semi-structured interviews conducted with 15 participants. Results were analyzed using framework analysis. Themes of re-entry loss and grief were identified with sub-themes of multiple varied losses, mechanisms of loss, loss of control, common grief phenomena, disenfranchised grief, and reactivation of past grief. Theoretical and clinical implications are discussed. Findings of this study suggest that loss and grief is an appropriate paradigm for the management of these workers in the family practice setting. Further research is needed to enable appropriate care.

A Nationwide Random Sampling Survey of Potential Complicated Grief in Japan

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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…

A systematic writing program as a tool in the grief process: part 1.

Science.gov (United States)

Furnes, Bodil; Dysvik, Elin

2010-12-06

The basic aim of this paper is to suggest a flexible and individualized writing program as a tool for use during the grief process of bereaved adults. An open, qualitative approach following distinct steps was taken to gain a broad perspective on the grief and writing processes, as a platform for the writing program. Following several systematic methodological steps, we arrived at suggestions for the initiation of a writing program and its structure and substance, with appropriate guidelines. We believe that open and expressive writing, including free writing and focused writing, may have beneficial effects on a person experiencing grief. These writing forms may be undertaken and systematized through a writing program, with participation in a grief writing group and with diary writing, to achieve optimal results. A structured writing program might be helpful in promoting thought activities and as a tool to increase the coherence and understanding of individuals in the grief process. Our suggested program may also be a valuable guide to future program development and research.

Coping with Grief: Life After Loss

Science.gov (United States)

... are called grief. It’s a natural response to loss. Grieving doesn’t mean that you have to feel certain emotions. People can grieve in very different ways. Cultural beliefs and traditions can influence how someone expresses ...

After the death of a friend: young men's grief and masculine identities.

Science.gov (United States)

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

2013-05-01

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. Copyright © 2013 Elsevier Ltd. All rights reserved.

Grief Symptoms in Relatives who Experienced Organ Donation Request in the ICU.

Science.gov (United States)

Kentish-Barnes, Nancy; Chevret, Sylvie; Cheisson, Gaëlle; Joseph, Liliane; Martin-Lefèvre, Laurent; Si Larbi, Anne Gaelle; Viquesnel, Gérald; Marqué, Sophie; Donati, Stéphane; Charpentier, Julien; Pichon, Nicolas; Zuber, Benjamin; Lesieur, Olivier; Ouendo, Martial; Renault, Anne; Le Maguet, Pascale; Kandelman, Stanislas; Thuong, Marie; Floccard, Bernard; Mezher, Chaouki; Galon, Marion; Duranteau, Jacques; Azoulay, Elie

2018-03-19

In the case of organ donation, the family is highly involved in the decision process. To assess experience of organ donation process and grief symptoms in relatives of brain dead patients who discussed organ donation in the ICU. Multicentre cross-sectional study in 28 ICUs in France. Participating subjects were relatives of brain dead patients who were approached to discuss organ donation. Relatives were followed-up by phone at 3 time points: at 1 month to complete a questionnaire describing their experience of organ donation process; At 3 months to complete the Hospital Anxiety and Depression Scale and the Impact of Event Scale-Revised; At 9 months, to complete the IES-R and the Inventory of Complicated Grief. 202 relatives of 202 patients were included, of whom 158 consented and 44 refused organ donation. Interviews were conducted at 1, 3 and 9 months for 157, 137 and 117 relatives respectively. Experience was significantly more burdensome for relatives of non-donors. However there were no significant differences in grief symptoms measured at 3 and 9 months between the 2 groups. Understanding of brain death was associated with grief symptoms with higher prevalence of complicated grief symptoms in relatives who did not understand (75% vs 46.1%, p=0.026). Experience of the organ donation process varies between relatives of donor vs non-donor patients with relatives of non-donors experiencing lower quality communication, but the decision was not associated with subsequent grief symptoms. Importantly, understanding of brain death is a key element for relatives.

Accommodating Grief on Twitter: An Analysis of Expressions of Grief Among Gang Involved Youth on Twitter Using Qualitative Analysis and Natural Language Processing

Science.gov (United States)

Patton, Desmond Upton; MacBeth, Jamie; Schoenebeck, Sarita; Shear, Katherine; McKeown, Kathleen

2018-01-01

There is a dearth of research investigating youths’ experience of grief and mourning after the death of close friends or family. Even less research has explored the question of how youth use social media sites to engage in the grieving process. This study employs qualitative analysis and natural language processing to examine tweets that follow 2 deaths. First, we conducted a close textual read on a sample of tweets by Gakirah Barnes, a gang-involved teenaged girl in Chicago, and members of her Twitter network, over a 19-day period in 2014 during which 2 significant deaths occurred: that of Raason “Lil B” Shaw and Gakirah’s own death. We leverage the grief literature to understand the way Gakirah and her peers express thoughts, feelings, and behaviors at the time of these deaths. We also present and explain the rich and complex style of online communication among gang-involved youth, one that has been overlooked in prior research. Next, we overview the natural language processing output for expressions of loss and grief in our data set based on qualitative findings and present an error analysis on its output for grief. We conclude with a call for interdisciplinary research that analyzes online and offline behaviors to help understand physical and emotional violence and other problematic behaviors prevalent among marginalized communities. PMID:29636619

Creating philanthropic foundations to deal with grief: case studies of bereaved parents.

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Rossetto, Kelly R

2014-01-01

The current study involves the analysis of six bereaved parents' stories and argues that the development of philanthropic foundations helped these parents make meaning of their children's deaths and find purpose in the midst of their grief. Furthermore, philanthropy, as a way of making meaning and finding purpose, is a mutually beneficial process because it helps both the bereaved founders and the communities the organizations reach. Connections between these narratives and the bereavement literature help us better understand the individual/family grief process and meaning making, as well as how internal grief states intersect with communities.

Cultural manifestations of grief and bereavement: a clinical perspective.

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Hardy-Bougere, Marilyn

2008-01-01

The purpose of this article is to inform the reader that a commonality in grief and bereavement exists even though it is highly individualized. Health care providers and consumers of health care should realize and understand the potential for bias and miscommunication when there is delivery of care from non-similar cultures. Grief and bereavement are two of many issues existing in the health care delivery system which can result in substandard delivery of care as a result of cultural insensitivity and cultural incompetence.

Dealing with grief related to loss by death and chronic pain: An integrated theoretical framework. Part 1

Directory of Open Access Journals (Sweden)

Bodil Furnes

2010-05-01

Full Text Available Bodil Furnes, Elin DysvikUniversity of Stavanger, Faculty of Social Sciences, Department of Health Studies, Stavanger, NorwayObjective: Based on the present authors’ research and several approaches to grief related to loss by death and nonmalignant chronic pain, the paper suggests a new integrated theoretical framework for intervention in clinical settings.Methods: An open qualitative review of the literature on grief theories was performed searching for a new integrated approach in the phenomenological tradition. We then investigated the relationship between grief, loss and chronic nonmalignant pain, looking for main themes and connections and how these could be best understood in a more holistic manner.Results: Two main themes were formulated, “relearning the world” and “adaptation”. Between these themes a continuous movement emerged involving experience such as: “despair and hope”, “lack of understanding and insight”, “meaning disruption and increased meaning”, and “bodily discomfort and reintegrated body”. These were identified as paired subthemes.Conclusions: Grief as a distinctive experience means that health care must be aimed at each individual experience and situation. Grief experience and working with grief are considered in terms of relearning the world while walking backwards and living forwards, as described in our integrated model. We consider that this theoretical framework regarding grief should offer an integrated foundation for health care workers who are working with people experiencing grief caused by death or chronic pain.Keywords: health care, loss, grief

'What the hell is water?' How to use deliberate clinical inertia in common emergency department situations.

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Egerton-Warburton, Diana; Cullen, Louise; Keijzers, Gerben; Fatovich, Daniel M

2018-06-01

Appropriate deliberate clinical inertia refers to the art of doing nothing as a positive clinical response. It includes shared decision-making to improve patient care with the use of clinical judgement. We discuss common clinical scenarios where the use of deliberate clinical inertia can occur. The insertion of peripheral intravenous cannulae, investigating patients with suspected renal colic and the investigation of low risk chest pain are all opportunities for the thoughtful clinician to 'stand there' and use effective patient communication to avoid low value tests and procedures. Awareness is key to identifying these opportunities to practice deliberate clinical inertia, as many of the situations may be so much a part of our environment that they are hidden in plain view. © 2018 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

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

Science.gov (United States)

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.

Grief after patient death: direct care staff in nursing homes and homecare.

Science.gov (United States)

Boerner, Kathrin; Burack, Orah R; Jopp, Daniela S; Mock, Steven E

2015-02-01

Patient death is common in long-term care (LTC). Yet, little attention has been paid to how direct care staff members, who provide the bulk of daily LTC, experience patient death and to what extent they are prepared for this experience. To 1) determine how grief symptoms typically reported by bereaved family caregivers are experienced among direct care staff, 2) explore how prepared the staff members were for the death of their patients, and 3) identify characteristics associated with their grief. This was a cross-sectional study of direct care staff experiencing recent patient death. Participants were 140 certified nursing assistants and 80 homecare workers. Standardized assessments and structured questions addressed staff (e.g., preparedness for death), institutional (e.g., support availability), and patient/relational factors (e.g., relationship quality). Data analyses included bivariate group comparisons and hierarchical regression. Grief reactions of staff reflected many of the core grief symptoms reported by bereaved family caregivers in a large-scale caregiving study. Feelings of being "not at all prepared" for the death and struggling with "acceptance of death" were prevalent among the staff. Grief was more intense when staff-patient relationships were closer, care was provided for longer, and staff felt emotionally unprepared for the death. Grief symptoms like those experienced by family caregivers are common among direct care workers after patient death. Increasing preparedness for this experience via better training and support is likely to improve the occupational experience of direct care workers and ultimately allow them to provide better palliative care in nursing homes and homecare. Copyright © 2015 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

Dream Content in Complicated Grief: A Window into Loss-Related Cognitive Schemas Running Head: Dreams in Complicated Grief

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

2012-01-01

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 complicated grief (CG) differed from that of a normative sample, and to explore whether CG patients who dream of the deceased differ from CG patients who do not dream of the deceased on measures of daytime emotional distress. CG dreams were characterized by more family and familiar characters including the deceased (in women), and fewer social interactions and emotions compared to norms. Increased representations of familiar characters in CG dreams may reflect attempts to reorganize relational cognitive schemas to compensate for the loss. PMID:24524436

The year of magical thinking: Joan Didion and the dialectic of grief.

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Brennan, F; Dash, M

2008-06-01

Joan Didion is a prominent American writer. In late 2003, while her only child lay critically ill, her husband, John, died suddenly. Theirs was a marriage of great intimacy and love. Grief enveloped her. Eventually she began to write an account of the first 12 months of her bereavement and the vigil for her child: The year of magical thinking. Raw, insightful and challenging, it is a rich, generous and graceful document. Didion draws on the literature of grief, personal and professional. Here, those readings are examined and reflections are made on the singular, unique grief of the author in the context of current theories on bereavement.

Aims and harvest of moral case deliberation.

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Weidema, Froukje C; Molewijk, Bert A C; Kamsteeg, Frans; Widdershoven, Guy A M

2013-09-01

Deliberative ways of dealing with ethical issues in health care are expanding. Moral case deliberation is an example, providing group-wise, structured reflection on dilemmas from practice. Although moral case deliberation is well described in literature, aims and results of moral case deliberation sessions are unknown. This research shows (a) why managers introduce moral case deliberation and (b) what moral case deliberation participants experience as moral case deliberation results. A responsive evaluation was conducted, explicating moral case deliberation experiences by analysing aims (N = 78) and harvest (N = 255). A naturalistic data collection included interviews with managers and evaluation questionnaires of moral case deliberation participants (nurses). From the analysis, moral case deliberation appeals for cooperation, team bonding, critical attitude towards routines and nurses' empowerment. Differences are that managers aim to foster identity of the nursing profession, whereas nurses emphasize learning processes and understanding perspectives. We conclude that moral case deliberation influences team cooperation that cannot be controlled with traditional management tools, but requires time and dialogue. Exchanging aims and harvest between manager and team could result in co-creating (moral) practice in which improvements for daily cooperation result from bringing together perspectives of managers and team members.

Grief and Solidarity Reactions 1 Week After an On-Campus Shooting.

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Wayment, Heidi A; Silver, Roxane Cohen

2018-03-01

The impact of interpersonal violence extends beyond the victims and perpetrator(s). The purpose of this research was threefold: (a) to identify whether college students' very early reactions to an on-campus shooting were associated with well-known predictors of distress, (b) to examine whether grief and distress reactions were distinguishable in the early days following a shooting, and (c) to investigate whether a compassionate self-identity was uniquely associated with grief but not distress. Beginning just 3 days after an early morning shooting that killed one student and injured three others, university students ( N = 408) completed an online questionnaire. Grief, but not distress, was associated with a sense of solidarity with other students and a compassionate self-identity. General distress was associated with prior mental health difficulties and exposure to the shooting. Acute stress was positively associated with being female, having prior mental health difficulties, media exposure, perceived similarity to victims, less victim blame, social support, and social strain. Results suggest that grief reactions that arise in the early days following a collective loss may serve as important psychosocial resources in coping with interpersonal violence.

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

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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.

Factors associated with the grief after stillbirth: a comparative study between Brazilian and Canadian women

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Gisele Ferreira Paris

Full Text Available Abstract OBJECTIVE To verify the association between complicated grief and sociodemographic, reproductive, mental, marital satisfaction, and professional support characteristics in women after stillbirth. METHOD Cross-sectional study with 26 women who had stillbirth in 2013, living in the city of Maringá, Brazil, and eight women who attended the Centre d'Études et de Rechercheen Intervention Familiale at the University of Quebec en Outaouais, in Canada. The instrument was administered as an interview to a small number of mothers of infants up to three months (n=50, who did not participate in the validation study. RESULTS By applying the short version of the Perinatal Grief Scale, the prevalence of complicated grief in Brazilian women was found to be higher (35% in relation to Canadian women (12%.Characteristics of the Brazilian women associated with the grief period included the presence of previous pregnancy with live birth, absence of previous perinatal loss, postpartum depression, and lack of marital satisfaction. For the Canadians it was observed that 80% of the women presenting no grief made use of the professional support group. In both populations the occurrence of complicated grief presented a higher prevalence in women with duration of pregnancy higher than 28 weeks. CONCLUSION The women that must be further investigated during the grief period are those living in Brazil, making no use of a professional support group, presenting little to no marital satisfaction, having no religion, and of a low educational level.

Voluntarism and transparent deliberation

DEFF Research Database (Denmark)

Steglich-Petersen, Asbjørn

2006-01-01

voluntarism. I argue that transparency to factual questions occurs in practical deliberation in ways parallel to transparency in doxastic deliberation. I argue that this should make us reconsider the appeal to transparency in arguments against doxastic voluntarism, and the wider issue of distinguishing...... theoretical from practical rationality....

Dyadic coping mediates the relationship between parents' grief and dyadic adjustment following the loss of a child.

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Albuquerque, Sara; Narciso, Isabel; Pereira, Marco

2018-01-01

This study aimed to examine forms of dyadic coping (DC) as mediators of the association between parents' grief response and dyadic adjustment and to determine whether these indirect effects were moderated by the child's type of death, timing of death, and age. The study design was cross-sectional. The sample consisted of 197 bereaved parents. Participants completed the Prolonged Grief Disorder Scale, Revised Dyadic Adjustment Scale, and Dyadic Coping Inventory. Significant indirect effects of parents' grief response on dyadic adjustment were found through stress communication by oneself and by the partner, positive and negative DC by the partner, and joint DC. The timing of death moderated the association between grief response and dyadic adjustment and between joint DC and dyadic adjustment. Grief response was negatively associated with dyadic adjustment only when the death occurred after birth. Grief response was negatively associated with joint DC, which, in turn, was positively associated with dyadic adjustment, when the death occurred both before and after birth. However, the association was stronger in the latter. Specific forms of DC might be mechanisms through which grief response is associated with dyadic adjustment and should be promoted in clinical practice.

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

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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

Normal grief and its correlates in Lubumbashi, an urban city in the ...

African Journals Online (AJOL)

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 ...

Complicated grief and bereavement in young adults following close friend and sibling loss.

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

2013-12-01

This study examined the association between types of loss (i.e., sibling or close friend) and relationship quality (i.e., depth and conflict) with complicated grief, depression, somatic symptoms, and world assumptions in bereaved young adults. Participants were 107 young adults aged 17-29 years who were either bereaved or had never experienced a loss. Among bereaved participants, 66 lost a close friend and seven lost a sibling within the past 3 years (M = 1.63 years). Nineteen percent of the young adults met criteria for complicated grief and 31% had mild to severe depression. Participants with a deceased sibling reported greater depth in the relationship as compared to those who lost a friend. They were also more likely to have complicated grief (57% versus 15%) and report significantly higher levels of grief, depression, and somatic symptoms. Those who lost a sibling reported a lower sense of meaningfulness and benevolence of the world and self-worth as compared with those who lost a close friend or had not experienced a loss. Complicated grief and depression are common among bereaved young adults. Sibling loss is particularly distressing to young adults, due in part to the high level of relationship depth, and is associated with increased psychological and physical symptoms postloss. © 2013 Wiley Periodicals, Inc.

Providing grief resolution as an oncology nurse retention strategy: a literature review.

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Hildebrandt, Lori

2012-12-01

Oncology nurses play a pivotal role in optimizing care provided to patients at the end of life (EOL). Although oncology nurses commonly provide EOL care and witness deaths of patients that they have maintained long-standing relationships with, they are frequently excluded from grief resolution endeavors. With a worldwide shortage of oncology nurses, retention is paramount to ensuring that the care patients with cancer receive is not jeopardized. Various strategies were identified to resolve grief and increase nurse retention, including creating supportive work environments, debriefing with colleagues, providing EOL and grief education, and altering patient care assignments. Future research on emerging technologies and their effects on oncology nurse coping and retention strategies also was suggested.

Understanding Grief within a Cultural Context

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... the loved ones who are preparing for their loss. Culture and the meaning of death Every culture has ... and mourning practices of a person from another culture. Related Resources Coping With Grief Coping With Change After a Loss f t k e P Coping With Cancer ...

Traumatic grief in young people in Sub-Saharan Africa: a scoping review

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Taggart H

2015-07-01

Full Text Available Holly Taggart,1 Sheila Greatrex-White,2 1Mental Health Commission, CentreForum, Westminster, UK; 2School of Health Sciences, Queen's Medical Centre, University of Nottingham, Nottingham, UK Aim: To identify relevant and pertinent themes and interventions within the literature relating to childhood traumatic grief, in order to provide a sound background of evidence for further research and service development. Background: Childhood traumatic grief is caused when a significant person in a child's life dies under circumstances that they perceive to be traumatic. This can leave a child unable to return to the same level of physical and emotional functioning that he or she had prior to the death occurring. In Sub-Saharan Africa, there is an increased risk for childhood traumatic grief due to a high prevalence of orphanhood, environmental stressors, stigma, and abuse. This can have detrimental effects upon mental health. Methods: The review followed the York methodology: identifying the purpose and agreeing on the strategy beforehand; identifying relevant sources/studies; selecting the studies; charting the data; and collating, summarizing, and reporting results. Results and discussion: Interventions identified to prevent and/or manage traumatic grief included narrative exposure therapy, psychotherapy, mentoring, peer-group support, psychosocial support, a grief and loss therapy session, and memory boxes. Mental health remains neglected within service and policy development as well as in global health spending. The average amount expended on mental health services per person per year in low-income countries is less than $0.25. Only 36% of people in low income countries are covered by a mental health policy, compared with 92% in high income countries. Limitations: The sixth stage of the York methodology was omitted. Only papers written in English were included in the review. Conclusion: Childhood traumatic grief in young people is an important issue

Exploring the relationship between posttraumatic stress disorder and deliberate self-harm: the moderating roles of borderline and avoidant personality disorders.

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Gratz, Kim L; Tull, Matthew T

2012-08-30

Despite increasing evidence for an association between posttraumatic stress disorder (PTSD) and deliberate self-harm (DSH), few studies have examined the factors that moderate this association or the impact of co-occurring personality disorders among individuals with PTSD on DSH frequency. Given the high rates of co-occurrence between PTSD and two personality disorders of particular relevance to DSH, borderline personality disorder (BPD) and avoidant personality disorder (AVPD), this study examined the moderating role of these personality disorders in the association between PTSD and DSH frequency among a sample of substance use disorder patients (N=61). Patients completed structured clinical interviews assessing PTSD, BPD, and AVPD and a questionnaire assessing DSH. Results revealed more frequent DSH among patients with (vs. without) PTSD and provided evidence for the moderating role of AVPD in this association. Specifically, results revealed heightened levels of DSH only among PTSD patients with co-occurring AVPD. Findings are consistent with past research demonstrating that the presence of co-occurring AVPD among patients with other Axis I and II disorders is associated with worse outcomes, and highlight the importance of continuing to examine the moderating role of AVPD in the association between PTSD and a variety of health-risk behaviors. Copyright © 2012 Elsevier Ltd. All rights reserved.

Does knowing that a suicide was "rational" influence grief?

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Brazda, Geoffrey F; Range, Lillian M; Remley, Theodore P; White, Carolyn C

2018-03-15

Counseling professionals and graduate students (N = 117) recruited online read a randomly assigned one-paragraph vignette about either a non-rational or rational suicide involving an imaginary loved one. Then, they completed the Grief Experiences Questionnaire (GEQ) about how they would feel. The non-rational suicide group expected significantly more search for explanation than the rational suicide group, but were not significantly different on the other six GEQ subscales. All participants expected few distressing reactions to either vignette, suggesting a one-paragraph vignette may not be sufficient to induce the kind of grief many experience when a loved one dies by suicide.

Prevalence and predictors of parental grief and depression after the death of a child from cancer.

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McCarthy, Maria C; Clarke, Naomi E; Ting, Cheng Lin; Conroy, Rowena; Anderson, Vicki A; Heath, John A

2010-11-01

To investigate patterns of grief and depression in a sample of parents whose child had died of cancer, and to examine factors related to burden of illness and end-of-life care as potential predictors of parental grief and depression outcomes. Fifty-eight parents completed standardized self-report questionnaires measuring prolonged grief disorder (Inventory of Complicated Grief-Revised [ICG-R]) and depression (Beck Depression Inventory-Second Edition [BDI-II]) and participated in structured interviews designed to elicit their perceptions of their child's end-of-life care and burden of illness. The majority of participants were mothers (84%) and the mean length of time since child death was 4.5 (standard deviation [SD] = 2.4) years (range, 1.0-9.8 years). Rates of prolonged grief disorder (PGD) were similar to those reported in other bereaved populations (10.3%); however, 41% of parents met diagnostic criteria for grief-related separation distress. Twenty-two percent of parents reported clinically significant depressive symptoms. Time since death and parental perception of the oncologist's care predicted parental grief symptoms but not depressive symptoms. Perceptions of the child's quality of life during the last month, preparedness for the child's death, and economic hardship also predicted grief and depression outcomes. A minority of parents met criteria for PGD and depression, however, almost half the sample was experiencing significant separation distress associated with persistent longing and yearning for their child. Time since death is a significant predictor of parental psychological distress. This study also highlights the importance of end-of-life factors in parents' long-term adjustment and the need for optimal palliative care to ensure the best possible outcomes for parents.

Grief, Bereavement, and Coping with Loss (PDQ)

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... mental distress than those in the counseling group. Depression related to grief is sometimes treated with drugs. ... Institutes of Health FOLLOW US Facebook Twitter Instagram YouTube Google+ LinkedIn GovDelivery RSS CONTACT INFORMATION Contact Us ...

The Effect Specialization and Diversification Involvement on Learning of Sports Skills According To Deliberate Practice and Deliberate Play

Directory of Open Access Journals (Sweden)

Mahdi Fahimi

2016-12-01

Full Text Available Objective: The aim was effect deliberate practice and deliberate play on sports skills with emphasis on specialization and diversification in boys 10-12. Methods: The 120 male students randomly divided into four groups of volleyball, soccer, basketball deliberate practice and deliberate play. Pretest and posttest were AAHPERD volleyball, soccer, and Basketball sports skills. Duration of the project was 16 weeks and 3 sessions per week and 90 minutes each session began. Data obtained from questionnaires and personal details about sports experience and test were adjusted using parametric tests, such as T-dependent test and MANOVA with Tukey post hoc test, and software Statistical SPSS19. Results: The results of the study showed that compared four groups, deliberate plays to other deliberate practices have a better motor skill in volleyball, soccer and Basketball sports skills (P<0.05. Volleyball and soccer deliberate practice group had developed Soccer Dribble Test and Control dribble and Defensive movement basketball skills test. Basketball deliberate practice group had not developed the others soccer and volleyball skills. Conclusion: The results showed that diversification participation in some exercises during the early stages of growth, can facilitate the development of general cognitive and physiological skills and create a rich environment for children.

Grief Experiences and Expectance of Suicide

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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…

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

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Han, Doug Hyun; Lee, Jung Jae; Moon, Duk-Soo; Cha, Myoung-Jin; Kim, Min A; Min, Seonyeong; Yang, Ji Hoon; Lee, Eun Jeong; Yoo, Seo Koo; Chung, Un-Sun

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 (PKaiser-Meyer-Olkin Measure of Sampling Adequacy=0.911; Bartlett's Test of Sphericity, χ(2)=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.

Prolonged grief: where to after Diagnostic and Statistical Manual of Mental Disorders, 5th Edition?

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Bryant, Richard A

2014-01-01

Although there is much evidence for the construct of prolonged grief, there was much controversy over the proposal to introduce a prolonged grief diagnosis into Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5), and it was finally rejected as a diagnosis in DSM-5. This review outlines the evidence for and against the diagnosis, and highlights the implications of the DSM-5 decision. Convergent evidence indicates that prolonged grief characterized by persistently severe yearning for the deceased is a distinct construct from bereavement-related depression and anxiety, is associated with marked functional impairment, is responsive to targeted treatments for prolonged grief, and has been validated across different cultures, age groups, and types of bereavement. Although DSM-5 has rejected the construct as a formal diagnosis, evidence continues to emerge on related mechanisms, including maladaptive appraisals, memory and attentional processes, immunological and arousal responses, and neural circuitry. It is most likely that the International Classification of Diseases (ICD-11) will introduce a diagnosis to recognize prolonged grief, even though DSM-5 has decided against this option. It is probable that the DSM-5 decision may result in more prolonged grief patients being incorrectly diagnosed with depression after bereavement and possibly incorrectly treated. The DSM-5 decision is unlikely to impact on future research agendas.

Attachment styles, grief responses, and the moderating role of coping strategies in parents bereaved by the Sewol ferry accident

OpenAIRE

Huh, Hyu Jung; Kim, Kyung Hee; Lee, Hee-Kyung; Chae, Jeong-Ho

2018-01-01

ABSTRACT Background: Previous studies on the influence of different types of attachment on grief responses have yielded contradictory outcomes. Little research has been conducted to identify the psychological processes that moderate the relationship between attachment representations and patterns of grief in disaster-related grief. Objective: The present study examines the effects of different attachment types on the grief responses of parents bereaved by loss of a child in a ferry accident, ...

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

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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…

Effects of Mental Health Support on the Grief of Bereaved People Caused by Sewol Ferry Accident

OpenAIRE

Han, Hyesung; Noh, Jin-Won; Huh, Hyu jung; Huh, Seung; Joo, Ji-Young; Hong, Jin Hyuk; Chae, Jeong-Ho

2017-01-01

Few studies have assessed the overall effects of multi-centered, complicated mental health support on the grief process. This study investigated the broader influence of mental health support provided practically to the bereaved family on the severity of complicated grief. Ninety-three bereaved family members of the Sewol ferry accident were recruited. Severity of complicated grief, post-traumatic stress disorder (PTSD) and depressive disorder was assessed through self-reporting questionnaire...

Understanding bereavement, grief, and mourning: implications for donation and transplant professionals.

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Corr, Charles A; Coolican, Margaret B

2010-06-01

This article surveys recent literature on bereavement, grief, and mourning. It offers a review of the state of the art of current understandings of those topics to assist professionals who work in the field of organ and tissue donation and transplantation. The article's goal is to provide well-developed and up-to-date education and knowledge about bereavement, grief, and mourning to supplement the natural skills and experience of donation and transplant professionals in their work with bereaved persons.

Medical comorbidity in complicated grief: Results from the HEAL collaborative trial.

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Robbins-Welty, Gregg; Stahl, Sarah; Zhang, Jun; Anderson, Stewart; Schenker, Yael; Shear, M Katherine; Simon, Naomi M; Zisook, Sidney; Skritskaya, Natalia; Mauro, Christina; Lebowitz, Barry D; Reynolds, Charles F

2018-01-01

To describe medical comorbidity in persons with Complicated Grief (CG) and to test whether medical comorbidity in individuals with CG is associated with the severity and duration of CG, after adjusting for age, sex, race, and current depressive symptoms. In exploratory analyses, we compared data from participants in an NIMH-sponsored multisite clinical trial of CG ("HEAL": "Healing Emotions After Loss") to archival data from participants matched on age, gender, and race/ethnicity, stratified by the presence or absence of current major depression. We used the Cumulative Illness Rating Scale for Geriatrics (CIRS-G) as a measure of medical polymorbidity. We investigated the association between CG and medical comorbidity via multiple linear regression, adjusting for sociodemographic and clinical variables, including severity of depressive symptoms. Chronological age and severity of co-occurring symptoms of major depression correlated with cumulative medical polymorbidity in persons with Complicated Grief. The severity of CG and the time since loss did not correlate with global medical polymorbidity (CIRS-G score). Nor was there an interaction between severity of depressive symptoms and severity of CG symptoms in predicting global CIRS-G score. Cumulative medical comorbidity, as measured by CIRS-G scores, was greater in subjects with current major depression ("DEPRESSED") than in CG subjects, and both DEPRESSED and CG subjects had greater medical morbidity than CONTROLS. Medical comorbidity is prevalent in Complicated Grief, associated with increasing age and co-occurring depressive symptoms but apparently not with chronicity and severity of Complicated Grief per se. This observation suggests that treating depression in the context of CG may be important to managing medical conditions in individuals with Complicated Grief to attenuate or prevent the long-term medical sequelae of CG. Copyright © 2017 Elsevier Ltd. All rights reserved.

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

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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.

Hospice Counsellor Facing the Grief of the Terminally Ill Child and Its Family

Directory of Open Access Journals (Sweden)

Grzegorz Godawa

2012-09-01

Full Text Available The child’s illness, suffering and death provoke many emotions in the family. The ill child and its family both experience grief which is an emotional reaction to the danger of losing health or life. Support offered by home hospices for children aims at overcoming the destructive influence of illness. A hospice counsellor’s task is to improve the ill child and its family’s quality of life. He is helping the family overcome grief and prepare for the child’s death. The hospice team supports the family members who experience anticipatory and later, actual mourning. Preventing pathological effects of grief is a basic challenge for people who offer help.

Parents' experiences of pediatric palliative care and the impact on long-term parental grief.

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van der Geest, Ivana M M; Darlington, Anne-Sophie E; Streng, Isabelle C; Michiels, Erna M C; Pieters, Rob; van den Heuvel-Eibrink, Marry M

2014-06-01

Approximately 25% of children diagnosed with cancer eventually die. Losing a child puts parents at increased risk for developing psychological problems. To explore parents' perceptions of the interaction with health care professionals (communication, continuity of care, and parental involvement) and symptom management during the pediatric palliative phase, and to investigate the influence on long-term grief in parents who lost a child to cancer. A total of 89 parents of 57 children who died of cancer between 2000 and 2004 participated in this retrospective cross-sectional study by completing a set of questionnaires measuring grief (Inventory of Traumatic Grief), parents' perceptions of the interaction with health care professionals (communication, continuity of care, and parental involvement), and symptom management during the palliative phase. Care was assessed on a five point Likert scale (1=disagree and 5=agree). Parents highly rated communication (4.6±0.6), continuity of care (4.3±0.6), and parental involvement (4.6±0.7) during the palliative phase. Parents' most often reported physical and psychological symptoms of their child during the palliative phase were fatigue (75%), pain (74%), anxiety to be alone (52%), and anger (48%). Higher ratings of parents on communication (β=-9.08, P=0.03) and continuity of care (β=-11.74, P=0.01) were associated with lower levels of long-term parental grief. The severity of the child's dyspnea (β=2.96, P=0.05), anxiety to be alone (β=4.52, Pparental grief. Multivariate models combining the interaction with health care professionals and symptom management showed a significant influence of both aspects on long-term parental grief. Both interaction with health care professionals, especially communication and continuity of care, and symptom management in children dying of cancer are associated with long-term parental grief levels. Copyright © 2014 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights

Grief symptoms and difficult patient loss for oncologists in response to patient death.

Science.gov (United States)

Granek, Leeat; Ben-David, Merav; Shapira, Shahar; Bar-Sela, Gil; Ariad, Samuel

2017-07-01

The study aimed to explore oncologist's grief symptoms over patient death and to identify why and which losses are particularly challenging when patients die. The grounded theory method was used to collect and analyze the data. Twenty-two oncologists were interviewed between March 2013 and June 2014 from three adult oncology centers in the north, center, and south of Israel. Oncologists were at different stages of their careers and varied in their sub-specialties, gender, and personal and professional backgrounds. Grief begun when the patient died, in anticipation of the patient's death, many days after the death, or when the patient received a poor prognosis. The phenomenological experience of grief for oncologists included behavioral, cognitive, physical, and emotional symptoms in response to patient death. Behavioral symptoms included crying and difficulties sleeping. Cognitive symptoms included self-doubt and rumination about the patient and the care the patient had received before death. Physical symptoms included chest pain, fatigue, and general physical discomfort. Emotional symptoms included sadness, anxiety, helplessness, guilt, relief, irritability, and loss. Difficult patient loss was caused by patient-related factors, family-related factors, and disease-related factors. Patient deaths result in behavioral, cognitive, physical, and emotional symptoms of grief in oncologists. These symptoms become particularly intense in the context of patient, family, and disease-related factors. Educational and supportive interventions for managing grief related to patient death are needed in order to support oncologists in their emotionally and mentally taxing work. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Grief and Horses: Putting the Pieces Together

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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…

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

Science.gov (United States)

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.

Grief as a Social Emotion: Theoretical Perspectives

Science.gov (United States)

Jakoby, Nina R.

2012-01-01

The article explores a sociological perspective on grief as a social emotion. Focusing on the social bond with the deceased, the self-concept of the survivor or the power of feeling rules, general sociological theories of emotions (symbolic interactionism, structural theory, behavioral theory) have the potential to deepen the understanding of…

Grief and culture: a checklist

OpenAIRE

Walter, Tony

2010-01-01

All groups have a culture. This article is intended to help the bereavement practitioner better understand the support needs of clients from other cultures. It sets out and explains a simple checklist of questions designed to explore cultural practices and attitudes to grief and bereavement. The questions cover the obligations mourners feel towards the dead and towards society; who should be mourned; what should be done with the dead; what should be done with emotions; the inclusion or exclus...

Deliberation as Communication Instruction: A Study of a Climate Change Deliberation in an Introductory Biology Course

Science.gov (United States)

Drury, Sara A. Mehltretter

2015-01-01

The author argues that deliberation is an innovative method for teaching communication skills, particularly group communication, in the undergraduate science, technology, engineering, and math (STEM) curriculum. A case study using a deliberation activity on global climate change in an introductory biology course demonstrates how deliberative…

Persistent Complex Bereavement Disorder and Culture: Early and Prolonged Grief in Nepali Widows.

Science.gov (United States)

Kim, Jane; Tol, Wietse A; Shrestha, Abina; Kafle, Hari Maya; Rayamajhi, Rajin; Luitel, Nagendra P; Thapa, Lily; Surkan, Pamela J

2017-01-01

Persistent complex bereavement disorder (PCBD) in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), has not been well studied in socioculturally diverse populations. Thus, this qualitative study examined (a) how widows in Nepal understand grief, (b) whether a local construct of PCBD exists, and (c) its comparability with the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), terminology. Using an adapted Explanatory Model Interview Catalogue (EMIC) framework, semistructured interviews with 25 widows and 12 key informants, as well as three focus-group discussions (n = 20), were conducted between October 2014 and April 2015. Through an inductive grounded theory-based approach, we used the constant comparative method, iteratively coding transcripts to identify themes and patterns in the data. Also, we created two lists of grief responses, one of early reactions and another all reactions to grief, based on the frequency of mention. No single term for grief was reported. Widows reported a local construct of PCBD, which was broadly compatible with DSM-5 terminology but with important variation reflecting societal influence. Surviving torture during conflict, economic and family stressors, and discrimination were mentioned as important determinants that prolong and complicate grief. Suicidal ideation was common, with about 31% and 62% of widows reporting past-year and lifetime suicidality, respectively. Findings may not be generalizable to all Nepali widows; participants were recruited from a non-governmental organization, from Kathmandu and its neighboring districts, and were primarily of reproductive age. While PCBD symptoms proposed in DSM-5 were mentioned as relevant by study participants, some components may need adaptation for use in non-Western settings, such as Nepal.

Deliberate self-harming application of superglue in the nose: case report and literature review.

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Tikka, T; Al Abduwani, J; Costello, D

2015-01-01

Accidental and non-accidental applications of superglue in the ear, nose and oral cavity have been reported previously. Surgical removal of glue from the nose is the current practice. This paper reports the case of an 18-year-old female, who presented with complete bilateral nasal occlusion due to deliberate self-application of superglue in both nostrils to avoid nasogastric tube insertion. Removal of glue was accomplished with a combination of local anaesthetic cream and acetone-soaked cotton buds, which caused only minimal discomfort to the patient. All traces of glue disappeared within 10 days, without causing damage to the nasal mucosa, nasal blockage or pain. To the best of our knowledge, this is the first case report of deliberate self-application of superglue in the nose. A successful non-surgical management option for the removal of glue from the nose is introduced.

Effects of Mental Health Support on the Grief of Bereaved People Caused by Sewol Ferry Accident

NARCIS (Netherlands)

Han, Hyesung; Noh, Jin-Won; Huh, Hyu Jung; Huh, Seung; Joo, Ji-Young; Hong, Jin Hyuk; Chae, Jeong-Ho

Few studies have assessed the overall effects of multi-centered, complicated mental health support on the grief process. This study investigated the broader influence of mental health support provided practically to the bereaved family on the severity of complicated grief. Ninety-three bereaved

Death by request in Switzerland: posttraumatic stress disorder and complicated grief after witnessing assisted suicide.

Science.gov (United States)

Wagner, B; Müller, J; Maercker, A

2012-10-01

Despite continuing political, legal and moral debate on the subject, assisted suicide is permitted in only a few countries worldwide. However, few studies have examined the impact that witnessing assisted suicide has on the mental health of family members or close friends. A cross-sectional survey of 85 family members or close friends who were present at an assisted suicide was conducted in December 2007. Full or partial Post-Traumatic Distress Disorder (PTSD; Impact of Event Scale-Revised), depression and anxiety symptoms (Brief Symptom Inventory) and complicated grief (Inventory of Complicated Grief) were assessed at 14 to 24 months post-loss. Of the 85 participants, 13% met the criteria for full PTSD (cut-off≥35), 6.5% met the criteria for subthreshold PTSD (cut-off≥25), and 4.9% met the criteria for complicated grief. The prevalence of depression was 16%; the prevalence of anxiety was 6%. A higher prevalence of PTSD and depression was found in the present sample than has been reported for the Swiss population in general. However, the prevalence of complicated grief in the sample was comparable to that reported for the general Swiss population. Therefore, although there seemed to be no complications in the grief process, about 20% of respondents experienced full or subthreshold PTSD related to the loss of a close person through assisted suicide. Copyright © 2010 Elsevier Masson SAS. All rights reserved.

Deliberate honesty

NARCIS (Netherlands)

Bereby-Meyer, Y.; Shalvi, S.

2015-01-01

Studies on lying, especially on inhibiting honest responses and generating dishonest responses, suggest that honesty is the default behavior and dishonesty requires deliberate effort. Here, we argue that when lying serves self-interest, that is, when lying is tempting and lies are easy to craft,

Grief Interrupted: The Experience of Loss Among Incarcerated Women

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Harner, Holly M.; Hentz, Patricia M.; Evangelista, Maria Carmela

2011-01-01

Incarcerated women face a number of stressors apart from the actual incarceration. Nearly half of all women in prison experience the death of a loved one during their incarceration. Our purpose for this study was to explore the experience of grief and loss among incarcerated women using a phenomenological method. Our study approach followed van Manen's method of phenomenology and Munhall's description of existential lifeworlds. Our analysis revealed four existential lifeworlds: temporality: frozen in time; spatiality: no place, no space to grieve; corporeality: buried emotions; and relationality: never alone, yet feeling so lonely. The findings generated from this study can help mental health providers as well as correctional professionals develop policies and programs that facilitate the grief process of incarcerated women within the confines of imprisonment. PMID:20581074

Adolescents' Deliberate Self-Harm, Interpersonal Stress, and the Moderating Effects of Self-Regulation: A Two-Wave Longitudinal Analysis

Science.gov (United States)

Jutengren, Goran; Kerr, Margaret; Stattin, Hakan

2011-01-01

The predictive effects of peer victimization and harsh parenting on deliberate self-harm were examined. As derived from the experiential avoidance model, the study also tested whether these links were moderated by individual self-regulation approaches. Data were collected at two points in time from 880 junior high school students (mean age =…

Supporting in grief and burnout of the nursing team from pediatric units in Chilean hospitals.

Science.gov (United States)

Vega, Paula Vega; Rodriguez, Rina González; Galdamez, Natalie Santibáñez; Molina, Camila Ferrada; Orellana, Javiera Spicto; Villanueva, Antonia Sateler; Melo, Jose Bustos

2017-01-01

Objective To know the levels of Burnout Syndrome and perception of grief support in nursing teams of oncology and pediatric intensive care in public hospitals in Chile. Method A study of descriptive cross-sectional design. The Maslach Burnout Inventory and the Grief Support Health Care Scale were applied to university-level and technical nursing professionals between March and November 2015. An analysis to compare the means was performed with use of the Student's t-test, and the level of significance was set at 5%. Results The study included 153 professionals. Results show 4% of professionals have Burnout Syndrome (BS) and 89% are at risk of having it. Oncology professionals are at higher risk as they present higher levels of emotional exhaustion and lower levels of personal fulfillment. Half of professionals have a high level of perception of grief support, which is greater in the oncology team. Conclusion Professionals working in pediatric oncology units are at increased risk of Burnout Syndrome and grief support may be a mediating factor in this process.

Rates and risks for prolonged grief disorder in a sample of orphaned and widowed genocide survivors.

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

2010-07-06

The concept of Prolonged Grief Disorder (PGD) has been defined in recent years by Prigerson and co-workers, who have developed and empirically tested consensus and diagnostic criteria for PGD. Using these most recent criteria defining PGD, the aim of this study was to determine rates of and risks for PGD in survivors of the 1994 Rwandan genocide who had lost a parent and/or the husband before, during or after the 1994 events. The PG-13 was administered to 206 orphans or half orphans and to 194 widows. A regression analysis was carried out to examine risk factors of PGD. 8.0% (n = 32) of the sample met criteria for PGD with an average of 12 years post-loss. All but one person had faced multiple losses and the majority indicated that their grief-related loss was due to violent death (70%). Grief was predicted mainly by time since the loss, by the violent nature of the loss, the severity of symptoms of posttraumatic stress disorder (PTSD) and the importance given to religious/spiritual beliefs. By contrast, gender, age at the time of bereavement, bereavement status (widow versus orphan), the number of different types of losses reported and participation in the funeral ceremony did not impact the severity of prolonged grief reactions. A significant portion of the interviewed sample continues to experience grief over interpersonal losses and unresolved grief may endure over time if not addressed by clinical intervention. Severity of grief reactions may be associated with a set of distinct risk factors. Subjects who lose someone through violent death seem to be at special risk as they have to deal with the loss experience as such and the traumatic aspects of the loss. Symptoms of PTSD may hinder the completion of the mourning process. Religious beliefs may facilitate the mourning process and help to find meaning in the loss. These aspects need to be considered in the treatment of PGD.

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

Science.gov (United States)

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.

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

Science.gov (United States)

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…

Intuition, deliberation, and the evolution of cooperation.

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Bear, Adam; Rand, David G

2016-01-26

Humans often cooperate with strangers, despite the costs involved. A long tradition of theoretical modeling has sought ultimate evolutionary explanations for this seemingly altruistic behavior. More recently, an entirely separate body of experimental work has begun to investigate cooperation's proximate cognitive underpinnings using a dual-process framework: Is deliberative self-control necessary to reign in selfish impulses, or does self-interested deliberation restrain an intuitive desire to cooperate? Integrating these ultimate and proximate approaches, we introduce dual-process cognition into a formal game-theoretic model of the evolution of cooperation. Agents play prisoner's dilemma games, some of which are one-shot and others of which involve reciprocity. They can either respond by using a generalized intuition, which is not sensitive to whether the game is one-shot or reciprocal, or pay a (stochastically varying) cost to deliberate and tailor their strategy to the type of game they are facing. We find that, depending on the level of reciprocity and assortment, selection favors one of two strategies: intuitive defectors who never deliberate, or dual-process agents who intuitively cooperate but sometimes use deliberation to defect in one-shot games. Critically, selection never favors agents who use deliberation to override selfish impulses: Deliberation only serves to undermine cooperation with strangers. Thus, by introducing a formal theoretical framework for exploring cooperation through a dual-process lens, we provide a clear answer regarding the role of deliberation in cooperation based on evolutionary modeling, help to organize a growing body of sometimes-conflicting empirical results, and shed light on the nature of human cognition and social decision making.

Using Narrative Approach for Anticipatory Grief Among Family Caregivers at Home

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Toyama, Hiroko; Honda, Akiko

2016-01-01

Family caregivers of patients with terminal-stage cancer have numerous roles as caregivers, which can influence their anticipatory grief. The purpose of this study was to clarify how talking to family caregivers of patients with terminal illness using the narrative approach can influence such caregivers’ process of anticipatory grief. We conducted the narrative approach as an intervention with two family caregivers several times and qualitatively analyzed their narratives. The results indicated that these family caregivers had two primary roles—family member and caregiver—and that family caregivers felt trapped in their caregiver role. The narrative approach helped them transition into the role needed for coping with the loss. PMID:28462354

The American Indian Holocaust: Healing Historical Unresolved Grief.

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Brave Heart, Maria Yellow Horse; DeBruyn, Lemyra M.

1998-01-01

Argues for the existence of historical unresolved grief among American Indians. Outlines the historical legacy of war, genocide, and boarding schools resulting in intergenerational trauma and a host of associated social problems. Suggests healing strategies that integrate modern and traditional approaches to healing at the individual, family, and…

[THE FORMS OF DELIBERATION INVOLVED IN THE FIELD OF BIOETHICS: TECHNIQUE DELIBERATION AND ETHICS DELIBERATION].

Science.gov (United States)

Neves Pinto, Gerson

2015-12-01

In this article the author examines the formulation of the problem of new technologies with their ethical limits and legal. To do this, in a first it is d'assess the contribuitions of the two most important contemporary philosophers who have treated this subject: Jürgen Habermas and Ronald Dworkin, while trying to put them into dialog with the one who has been one of the founders of l'classic ethics: Aristotle. Then, it tries to answer the question of how could we understand this notion that Dworkin nome "moral dislocation" between the random and the choice or well, as the appointed Habermas, "l'extension of the contingency". Finally, we questioned how the Aristotelian distinction between the technical deliberation and deliberative ethical-moral can contribute to a better understanding of the questions on the decisions and choices that will make the moral agents (such as patients or the judges), as well as those relating to the type of deliberation technique chosen by the doctor or by the health professional.

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

Science.gov (United States)

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

Excluding parental grief: A critical discourse analysis of bereavement accommodation in Canadian labour standards.

Science.gov (United States)

Macdonald, Mary Ellen; Kennedy, Kimberly; Moll, Sandra; Pineda, Carolina; Mitchell, Lisa M; Stephenson, Peter H; Cadell, Susan

2015-01-01

Grief following child loss is profoundly destabilizing with serious long-term repercussions for bereaved parents. Employed parents may need time away from work to deal with this loss. The purpose of this study was to reflect upon the ways labour policies and practices respond to parental bereavement. Critical discourse analysis was used to examine labour policies and practices related to employment leave for bereaved parents in Canada. Results were compared to international labour standards. Universally, employment policies provide only for the practical issues of bereavement. Commonly, leave is three days, unpaid, and meant to enable ceremonial obligations. Policies do not acknowledge the long-term suffering caused by grief or the variable intensity of different kinds of loss. Managerial, moral, normative and neoliberal values embedded in these policies efface the intensely personal experience of grief, thereby leaving employees at risk for serious health and workplace safety issues. Bereavement leave currently understands grief as a generic, time-limited state with instrumental tasks and ceremonial obligations. In contrast, research characterizes responses to child loss as intense, highly personal experiences for which healing and recovery can take years. This disconnect is especially problematic when viewed through the lens of employee wellbeing, reintegration and workplace productivity.

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

NARCIS (Netherlands)

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

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

NARCIS (Netherlands)

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

Designing Deliberation Systems

DEFF Research Database (Denmark)

Rose, Jeremy; Sæbø, Øystein

2010-01-01

the potential to revitalize and transform citizen engagement in democracy.  Although the majority of web 2.0 systems enable these discourses to some extent, government institutions commission and manage specialized deliberation systems (information systems designed to support participative discourse) intended...... to promote citizen engagement.  The most common examples of these are political discussion forums.  Though usually considered trivial adaptations of well-known technologies, these types of deliberative systems are often unsuccessful, and present a distinct set of design and management challenges.......  In this article we analyze the issues involved in establishing political deliberation systems under four headings: stakeholder engagement, web platform design, service management, political process re-shaping and evaluation and improvement.  We review the existing literature and present a longitudinal case study...

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

Directory of Open Access Journals (Sweden)

Isaac Rahimian-Boogar

2015-10-01

Full Text Available 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.

Attachment style dimensions can affect prolonged grief risk in caregivers of terminally ill patients with cancer.

Science.gov (United States)

Lai, Carlo; Luciani, Massimiliano; Galli, Federico; Morelli, Emanuela; Cappelluti, Roberta; Penco, Italo; Aceto, Paola; Lombardo, Luigi

2015-12-01

The aim of the present study was to evaluate the predictive role of attachment dimensions on the risk of prolonged grief. Sixty caregivers of 51 terminally ill patients with cancer who had been admitted in a hospice were selected. Caregivers were interviewed using Attachment Scale Questionnaire, Hamilton Depression Rating Scale, Hamilton Anxiety Rating Scale, and Prolonged Grief Disorder 12 (PG-12). The consort caregivers showed higher PG-12 level compared to the sibling caregivers. Anxiety, depression, need for approval, and preoccupation with relationships levels were significantly correlated with PG-12 scores. Female gender, high levels of depression, and preoccupation with relationships significantly predicted higher levels of prolonged grief risk. © The Author(s) 2014.

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

Science.gov (United States)

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…

"Every time that month comes, I remember": using cognitive interviews to adapt grief measures for use with bereaved adolescents in South Africa.

Science.gov (United States)

Taylor, Tory M; Thurman, Tonya R; Nogela, Lineo

2016-07-01

To assess standard grief measures through cognitive interviews with bereaved adolescents in Free State, South Africa, and make recommendations designed to improve the measurement of grief in this and similar populations. Twenty-one parentally bereaved adolescents participated in semi-structured cognitive interviews about the Core Bereavement Items (CBI) questionnaire, Grief Cognitions Questionnaire for Children (GCQ-C), or Intrusive Griefs Thoughts Scale (IGTS). Interviewees offered valuable insights for improving grief measurement with this population (e.g., consensus that not thinking frequently about a deceased loved one was shameful, aversion to terms including "died"). Participants were better able to apply response options denoting specific frequencies (e.g., "once or twice a week") versus general ones (e.g., "a little bit of the time"). Questions intended to gauge grief commonly elicited responses reflecting the impact of loss on adolescents' basic survival instead of psychological wellbeing. The need for psychological support is high among orphans and vulnerable children. Tools for measuring psychological outcomes can provide evidence of programme effects and guide decision making about investment. Grief measures used with adolescents in South Africa should account for the issues raised by cognitive interviewees in the study, including question and response option complexity, linguistic preferences, and cultural norms.

End of Life: Dealing with Grief and Confronting Painful Emotions

Science.gov (United States)

... 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 ...

Procedures and Methods for Cross-community Online Deliberation

Directory of Open Access Journals (Sweden)

Cyril Velikanov

2010-09-01

Full Text Available In this paper we introduce our model of self-regulated mass online deliberation, and apply it to a context of cross-border deliberation involving translation of contributions between participating languages, and then to a context of cross-community online deliberation for dispute resolution, e.g. between opposing ethnic or religious communities. In such a cross-border or cross-community context, online deliberation should preferably progress as a sequence of segmented phases each followed by a combining phase. In a segmented phase, each community deliberates separately, and selects their best contributions for being presented to all other communities. Selection is made by using our proposed mechanism of mutual moderation and appraisal of contributions by participants themselves. In the subsequent combining phase, the selected contributions are translated (by volunteering or randomly selected participants among those who have specified appropriate language skills and presented to target segments for further appraisal and commenting. Our arguments in support of the proposed mutual moderation and appraisal procedures remain mostly speculative, as the whole subject of mass online self-regulatory deliberation still remains largely unexplored, and there exist no practical realisation of it .

Do anticipatory grief and preparedness affect distress in bereaved caregivers?

DEFF Research Database (Denmark)

Nielsen, Mette Kjærgaard

Objective Family caregivers of terminally ill patients are in a vulnerable position, and previous studies show that bereaved caregivers are at risk of psychological distress. Pre-loss grief symptoms seem to predict post-loss psychological distress, while preparedness for a looming loss tends...... to decrease distress. The aim of this nation-wide study was to investigate the association of both anticipatory grief symptoms and preparedness with psychological distress in bereaved family caregivers. Methods A list of all adult patients in Denmark receiving drug reimbursement for terminal illness...... was retrieved from the Danish Health and Medicines Authority on a weekly basis during 2012. All newly registered patients were requested by letter to pass on an enclosed baseline questionnaire to their closest relative. Responding caregivers bereaved within six months received a follow-up questionnaire six...

How do adults with mild learning disabilities experience bereavement and grief? A qualitative exploration.

OpenAIRE

McRitchie, Robyn

2012-01-01

Background: The vast majority of research into the experiences of people with learning disabilities (LD) in regard to bereavement and grief involves the collection of data from second-hand sources, or via quantitative measures. This qualitative study aimed to explore the lived experiences of bereavement and grief in a group of adults with mild LD. Methods: Semi-structured interviews were carried out with 13 adults (aged 20-72 years) with mild LD who had experienced bereaveme...

Homo Ignorans: Deliberately Choosing Not to Know.

Science.gov (United States)

Hertwig, Ralph; Engel, Christoph

2016-05-01

Western history of thought abounds with claims that knowledge is valued and sought. Yet people often choose not to know. We call the conscious choice not to seek or use knowledge (or information) deliberate ignorance. Using examples from a wide range of domains, we demonstrate that deliberate ignorance has important functions. We systematize types of deliberate ignorance, describe their functions, discuss their normative desirability, and consider how they can be modeled. To date, psychologists have paid relatively little attention to the study of ignorance, let alone the deliberate kind. Yet the desire not to know is no anomaly. It is a choice to seek rather than reduce uncertainty whose reasons require nuanced cognitive and economic theories and whose consequences-for the individual and for society-require analyses of both actor and environment. © The Author(s) 2016.

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

Science.gov (United States)

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.

When hope and grief intersect: rates and risks of prolonged grief disorder among bereaved individuals and relatives of disappeared persons in Colombia.

Science.gov (United States)

Heeke, Carina; Stammel, Nadine; Knaevelsrud, Christine

2015-03-01

Forced disappearance is a frequent phenomenon in violent conflicts and regimes, yet little is known about unresolved grief processes as a possible outcome of the disappearance of a loved one. This study investigates prolonged grief disorder (PGD) and its risk factors in a sample of persons who lost a significant other to disappearance as compared with a sample of bereaved individuals, both groups having experienced displacement due to the armed conflict in Colombia. In a cross-sectional study conducted in four Colombian provinces, 73 persons who lost a significant other to disappearance and 222 bereaved individuals completed measures of PGD (PG-13), depression (HSCL-25), and PTSD (PCL-C) via face-to-face interviews. Trauma- and loss-related variables, including the extent to which significant others of disappeared persons hoped that their loved one was still alive, were assessed. Results indicated that 23% of participants who lost a significant other to disappearance met criteria for PGD as compared to 31.5% in bereaved participants. No differences were found between the two groups in terms of symptom severity of PGD, depression, posttraumatic stress disorder, or traumatic exposure. Regression analysis indicated that, among relatives and friends of disappeared persons, the extent of hope predicted PGD above and beyond depression severity whereas among bereaved persons, PGD was predicted by time since the loss, the number of traumatic events and symptom severity of PTSD and depression. The instruments were not validated for use in Colombia; generalizability of findings is limited. Forced disappearance is related to prolonged grief reactions, particularly when those left behind maintain hope that the disappeared person is still alive. Copyright © 2014 Elsevier B.V. All rights reserved.

Problem-solving ability and repetition of deliberate self-harm: a multicentre study.

Science.gov (United States)

McAuliffe, Carmel; Corcoran, Paul; Keeley, Helen S; Arensman, Ella; Bille-Brahe, Unni; De Leo, Diego; Fekete, Sandor; Hawton, Keith; Hjelmeland, Heidi; Kelleher, Margaret; Kerkhof, Ad J F M; Lönnqvist, Jouko; Michel, Konrad; Salander-Renberg, Ellinor; Schmidtke, Armin; Van Heeringen, Kees; Wasserman, Danuta

2006-01-01

While recent studies have found problem-solving impairments in individuals who engage in deliberate self-harm (DSH), few studies have examined repeaters and non-repeaters separately. The aim of the present study was to investigate whether specific types of problem-solving are associated with repeated DSH. As part of the WHO/EURO Multicentre Study on Suicidal Behaviour, 836 medically treated DSH patients (59% repeaters) from 12 European regions were interviewed using the European Parasuicide Study Interview Schedule (EPSIS II) approximately 1 year after their index episode. The Utrecht Coping List (UCL) assessed habitual responses to problems. Factor analysis identified five dimensions--Active Handling, Passive-Avoidance, Problem Sharing, Palliative Reactions and Negative Expression. Passive-Avoidance--characterized by a pre-occupation with problems, feeling unable to do anything, worrying about the past and taking a gloomy view of the situation, a greater likelihood of giving in so as to avoid difficult situations, the tendency to resign oneself to the situation, and to try to avoid problems--was the problem-solving dimension most strongly associated with repetition, although this association was attenuated by self-esteem. The outcomes of the study indicate that treatments for DSH patients with repeated episodes should include problem-solving interventions. The observed passivity and avoidance of problems (coupled with low self-esteem) associated with repetition suggests that intensive therapeutic input and follow-up are required for those with repeated DSH.

Deliberate change without hierarchical influence?

DEFF Research Database (Denmark)

Nørskov, Sladjana; Kesting, Peter; Ulhøi, John Parm

2017-01-01

reveals that deliberate change is indeed achievable in a non-hierarchical collaborative OSS community context. However, it presupposes the presence and active involvement of informal change agents. The paper identifies and specifies four key drivers for change agents’ influence. Originality....../value The findings contribute to organisational analysis by providing a deeper understanding of the importance of leadership in making deliberate change possible in non-hierarchical settings. It points to the importance of “change-by-conviction”, essentially based on voluntary behaviour. This can open the door...

Grief in Two Guises: "Mourning and Melancholia" Revisited

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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…

Hacia una visión constructivista del Duelo Going to a constructivist model of grief

Directory of Open Access Journals (Sweden)

Martín Rodríguez Alvaro

2008-09-01

Full Text Available Recientemente NANDA ha revisado su diagnóstico 00136 Duelo (antes Duelo anticipado. La nueva definición de este diagnóstico aprobado en 1980, incluye sutiles cambios que identifican al fenómeno como un proceso normal que incluye respuestas emocionales, físicas, espirituales, intelectuales y sociales. Esto supone un paso hacia la adopción desde la disciplina enfermera de una visión constructivista del duelo, desbancando las corrientes tradicionales que impregnan nuestro trabajo diario. En este artículo, pretendemos acercar al lector a una concepción de la muerte y el duelo desde una postura constructivista, estableciendo comparaciones entre esta tendencia y teorías tradicionales.Recently NANDA has modified his diagnosis 00136 Grief (previously titled "Aticipatory Grieving". The new definition of this diagnosis - dates back of 1980 - includes aspects like emotional, physical, spiritual, intellectual and social answers to the grief; that identifies the grief as a normal response to loss. This supposes that nursing is going to a constructivist model (contemporary theory, not adopting traditional perspectives. In this article, we try to bring the reader over to a conception of the death, the grief and loss from a cognitive-constructivist model, doing a comparisons with traditional theories.

Identifying a combined construct of grief and explosive anger as a response to injustice amongst survivors of mass conflict: A latent class analysis of data from Timor-Leste.

Directory of Open Access Journals (Sweden)

Susan J Rees

Full Text Available Previous studies have identified high rates of explosive anger amongst post-conflict populations including Timor-Leste. We sought to test whether explosive anger was integrally associated with symptoms of grief amongst the Timorese, a society that has experienced extensive conflict-related losses. In 2010 and 2011 we recruited adults (n = 2964, 18-years and older, living in an urban and a rural village in Timor-Leste. We applied latent class analysis to identify subpopulations based on symptoms of explosive anger and grief. The best fitting model comprised three classes: grief (24%, grief-anger (25%, and a low symptom group (51%. There were more women and urban dwellers in the grief and grief-anger classes compared to the reference class. Persons in the grief and grief-anger classes experienced higher rates of witnessing murder and atrocities and traumatic losses, ongoing poverty, and preoccupations with injustice for the two historical periods of conflict (the Indonesian occupation and the later internal conflict. Compared to the reference class, only the grief-anger class reported greater exposure to extreme deprivations during the conflict, ongoing family conflict, and preoccupations with injustice for contemporary times; and compared to the grief class, greater exposure to traumatic losses, poverty, family conflict and preoccupations with injustice for both the internal conflict and contemporary times. A substantial number of adults in this post-conflict country experienced a combined constellation of grief and explosive anger associated with extensive traumatic losses, deprivations, and preoccupations with injustice. Importantly, grief-anger may be linked to family conflict in this post-conflict environment.

The role of grief symptoms and a sense of injustice in the pathways to post-traumatic stress symptoms in post-conflict Timor-Leste.

Science.gov (United States)

Tay, A K; Rees, S; Steel, Z; Liddell, B; Nickerson, A; Tam, N; Silove, D

2017-08-01

Grief symptoms and a sense of injustice may be interrelated responses amongst persons exposed to mass conflict and both reactions may contribute to post-traumatic stress disorder (PTSD) symptoms. As yet, however, there is a dearth of data examining these relationships. Our study examined the contributions of grief and a sense of injustice to a model of PTSD symptoms that included the established determinants of trauma events, ongoing adversity and severe psychological distress. The study involved a large population sample (n = 2964, response rate: 82.4%) surveyed in post-conflict Timor-Leste. The survey sites included an urban administrative area (suco) in Dili, the capital of Timor-Leste and a rural village located an hour's drive away. Culturally adapted measures were applied to assess conflict related traumatic events (TEs), ongoing adversity, persisting preoccupations with injustice, symptoms of grief, psychological distress (including depressive symptoms) and PTSD symptoms. We tested a series of structural equation models, the final comprehensive model, which included indices of grief symptoms and injustice, producing a good fit. Locating grief symptoms as the endpoint of the model produced a non-converging model. In the final model, strong associations were evident between grief and injustice (β = 0.34, s.e. = 0.02, p < 0.01) and grief and PTSD symptoms (β = 0.14, s.e. = 0.02, p < 0.01). The sense of injustice exerted a considerable effect on PTSD symptoms (β = 0.13, s.e. = 0.03, p < 0.01). In addition, multiple indirect paths were evident, most involving grief and a sense of injustice, attesting to the complex inter-relationship of these factors in contributing to PTSD symptoms. Our findings support an expanded model of PTSD symptoms relevant to post-conflict populations, in which grief symptoms and a sense of injustice play pivotal roles. The model supports the importance of a focus on loss, grief and a sense of injustice in conducting trauma

Optimism in prolonged grief and depression following loss: A three-wave longitudinal study.

Science.gov (United States)

Boelen, Paul A

2015-06-30

There is considerable evidence that optimism, the predisposition to have generalized favorable expectancies for the future, is associated with numerous desirable outcomes. Few studies have examined the association of optimism with emotional distress following the death of a loved one. Doing so is important, because optimism may be an important target for interventions for post-loss psychopathology. In the current study, we examined the degree to which optimism, assessed in the first year post-loss (Time 1, T1), was associated with symptom levels of prolonged grief and depression six months (Time 2, T2) and fifteen months (Time 3, T3) later, controlling for baseline symptoms and also taking into account positive automatic cognitions at T1. Findings showed that higher optimism at T1 was associated with lower concurrent prolonged grief and depression severity. Higher optimism at T1 was also inversely related with depression symptom severity at T2 and T3, but not prolonged grief severity at T2 and T3. Implications of these findings are discussed. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Traditional and Contemporary Lakota Death, Dying, Grief, and Bereavement Beliefs and Practices: A Qualitative Study

OpenAIRE

Stone, Joseph B.

1998-01-01

Bereavement beliefs and practices in the modern, American culture have been well documented. However, virtually no research has been conducted on traditional and contemporary death, dying, grief, and bereavement beliefs and practices among native tribes, such as the Lakota. The present study was conducted with the Lakota, and fulfilled two goals. iii First, the contemporary and traditional death, dying, grief, and bereavement beliefs and practices of the Lakota were documented and summariz...

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

NARCIS (Netherlands)

de Groot, M.; Neeleman, J.; van der Meer, K.; Burger, H.

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

Family Anticipatory Grief: An Integrative Literature Review.

Science.gov (United States)

Coelho, Alexandra; Barbosa, António

2017-09-01

Despite all the investment in research, uncertainty persists in anticipatory grief (AG) literature, concerning its nuclear characteristics and definition. This review aimed to synthesize recent research in order to develop further knowledge about the family experience of AG during a patient's end of life. An integrative review was performed using standard methods of analysis and synthesis. The electronic databases Medline, Web of Knowledge, and EBSCO and relevant journals were systematically searched since 1990 to October 2015. Twenty-nine articles were selected, the majority with samples composed of caregivers of terminally ill patients with cancer. From systematic comparison of data referring to family end-of-life experience emerged 10 themes, which correspond to AG nuclear characteristics: anticipation of death, emotional distress, intrapsychic and interpersonal protection, exclusive focus on the patient care, hope, ambivalence, personal losses, relational losses, end-of-life relational tasks, and transition. For the majority of family caregivers in occidental society, AG is a highly stressful and ambivalent experience due to anticipation of death and relational losses, while the patient is physically present and needed of care, so family must be functional and inhibit grief expressions. The present study contributes to a deeper conceptualization of this term and to a more sensitive clinical practice.

How adults with an intellectual disability experience bereavement and grief: a qualitative exploration.

Science.gov (United States)

McRitchie, Robyn; McKenzie, Karen; Quayle, Ethel; Harlin, Margaret; Neumann, Katja

2014-01-01

This qualitative study explored the lived experiences of bereavement of 13 adults with an intellectual disability and found that their experiences could be situated within the concept of disenfranchised grief. The latter mediated participants' meaning making of the grieving process illustrated in the themes of intra- and interpersonal bereavement experiences, core beliefs about life and death, level of inclusion, and maintaining a continuing relationship with the deceased. The results suggest that participants experience bereavement and grief in a manner similar to that of the general population and suggest the need for open communication, facilitation of informed choice, and a culture of inclusion.

Factorial structure of complicated grief: associations with loss-related traumatic events and psychosocial impacts of mass conflict amongst West Papuan refugees.

Science.gov (United States)

Tay, Alvin Kuowei; Rees, Susan; Chen, Jack; Kareth, Moses; Silove, Derrick

2016-03-01

Definitions of complicated grief vary across diagnostic systems, being represented as persistent complex bereavement (PCB) in DSM-5 and prolonged grief disorder (PGD) in the proposed revision of the ICD system. A past study in a high-income country has identified a six-factor structure for complicated grief, but there are no data testing this or any other model across cultures. The present study reports findings from a survey amongst West Papuan refugees (n = 230, response rate = 92 %) residing in Port Moresby, Papua New Guinea. We applied culturally adapted measures of conflict-related traumatic event (TEs) (drawing specifically on domains of conflict and loss), symptoms of complicated grief adapted and modified to the culture, and a multidimensional psychosocial index of the broader effects of conflict and displacement. Confirmatory factor analysis yielded a single higher order construct of complicated grief comprising six factors of yearning/preoccupation; shock/disbelief; anger/negative appraisal; behavioural change; estrangement from others/impairment; and a novel dimension of confusion/diminished identity. In contrast, our analysis failed to support DSM or ICD models of PCB or PGD. A Multiple Indicators Multiple Causes (MIMIC) model revealed that traumatic loss and the sense of injustice each were associated with the unitary construct of complicated grief and its subdomains of yearning/preoccupation; shock/disbelief; anger/negative appraisal (exclusive to injustice); and estrangement from others/social impairment (exclusive to TE domain of conflict and loss). Conflict and loss associated with feelings of injustice may be especially pathogenic in generating the anger/negative appraisal component of complicated grief amongst refugees.

Parental grief and relationships after the loss of a stillborn baby.

Science.gov (United States)

Avelin, Pernilla; Rådestad, Ingela; Säflund, Karin; Wredling, Regina; Erlandsson, Kerstin

2013-06-01

to describe the grief of mothers and fathers and its influence on their relationships after the loss of a stillborn baby. a postal questionnaire at three months, one year and two years after stillbirth. a study of mothers and fathers of babies stillborn during a one-year period in the Stockholm region of Sweden. 55 parents, 33 mothers and 22 fathers. mothers and fathers stated that they became closer after the loss, and that the feeling deepened over the course of the following year. The parents said that they began grieving immediately as a gradual process, both as individuals, and together as a couple. During this grieving process their expectations, expressions and personal and joint needs might have threatened their relationship as a couple, in that they individually felt alone at this time of withdrawal. While some mothers and fathers had similar grieving styles, the intensity and expression of grief varied, and the effects were profound and unique for each individual. experiences following a loss are complex, with each partner attempting to come to terms with the loss and the resultant effect on the relationship with their partner. anticipating and being able to acknowledge the different aspects of grief will enable professionals to implement more effective intervention in helping couples grieve both individually and together. Copyright © 2012 Elsevier Ltd. All rights reserved.

Establishing Political Deliberation Systems

DEFF Research Database (Denmark)

Rose, Jeremy; Sæbø, Øystein

2008-01-01

The extension and transformation of political participation is dependent on widespread deliberation supported by information and communication technologies.  The most commonly found examples of these eParticipation systems are political discussion forums.  Though much of the discussion...... of these technologies is conducted in the eGovernment and (particularly) the eDemocracy literature, political discussion forums present a distinct set of design and management challenges which relate directly to IS concerns. In this article we analyze problems in establishing political deliberation systems under five...... headings: stakeholder engagement, web platform design, web platform management, political process re-shaping and evaluation and improvement. We review the existing literature and present a longitudinal case study of a political discussion forum: the Norwegian DemokratiTorget (Democracy Square).  We define...

Perinatal grief in Latino parents.

Science.gov (United States)

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.

Men’s Grief, Meaning and Growth

DEFF Research Database (Denmark)

Spaten, Ole Michael; Byrialsen, Mia Nørremark; Langdridge, Darren

2012-01-01

There is a scarcity of research on men's experience of bereavement (Reiniche, 2006), particularly in relation to qualitative research that focuses on the meaning of such an experience. This paper seeks to address this scarcity by presenting the findings from a phenomenological study of the life-w...... phenomenological method of Van Manen (1990) was used to uncover three key themes, labelled grief and self-reflection, meaning of life and loss, and re-figuring the life-world. These themes are discussed in the light of broader existential concerns and the extant literature....

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

Science.gov (United States)

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. (PsycINFO Database Record (c) 2015 APA, all rights reserved).

Effects of Mental Health Support on the Grief of Bereaved People Caused by Sewol Ferry Accident.

Science.gov (United States)

Han, Hyesung; Noh, Jin Won; Huh, Hyu Jung; Huh, Seung; Joo, Ji Young; Hong, Jin Hyuk; Chae, Jeong Ho

2017-07-01

Few studies have assessed the overall effects of multi-centered, complicated mental health support on the grief process. This study investigated the broader influence of mental health support provided practically to the bereaved family on the severity of complicated grief. Ninety-three bereaved family members of the Sewol ferry accident were recruited. Severity of complicated grief, post-traumatic stress disorder (PTSD) and depressive disorder was assessed through self-reporting questionnaire, inventory of complicated grief (ICG), PTSD Check List-5 (PCL-5) and Patient Health Questionnaire-9 (PHQ-9). We also included demographic, socioeconomic, health-related variables, and Functional Social Support Questionnaire (FSSQ), which affect the ICG score. Participants were divided into 4 groups based on the experience of psychotherapy or psychiatry clinic service before the accident and mental health support after the disaster. In univariate analysis, these 4 groups showed a significant difference in the mean ICG score (P = 0.020). Participants who received mental health support only after the Sewol ferry accident (group 2) showed a lower mean ICG score than those who received neither psychotherapy or psychiatry clinic service before the disaster nor mental health support after the accident (group 4). There was no significant correlation between the ICG score and other variables except for subjective health status measured 1 month after the disaster (P = 0.005). There was no significant difference in PCL-5 (P = 0.140) and PHQ-9 scores (P = 0.603) among groups, respectively. In conclusion, mental health support significantly reduced the severity of grief only in those participants who had not received any psychotherapy or psychiatry clinic service before the accident. © 2017 The Korean Academy of Medical Sciences.

Evaluation and perceived results of moral case deliberation: A mixed methods study.

Science.gov (United States)

Janssens, Rien M J P A; van Zadelhoff, Ezra; van Loo, Ger; Widdershoven, Guy A M; Molewijk, Bert A C

2015-12-01

Moral case deliberation is increasingly becoming part of various Dutch healthcare organizations. Although some evaluation studies of moral case deliberation have been carried out, research into the results of moral case deliberation within aged care is scarce. How did participants evaluate moral case deliberation? What has moral case deliberation brought to them? What has moral case deliberation contributed to care practice? Should moral case deliberation be further implemented and, if so, how? Quantitative analysis of a questionnaire study among participants of moral case deliberation, both caregivers and team leaders. Qualitative analysis of written answers to open questions, interview study and focus group meetings among caregivers and team leaders. Caregivers and team leaders in a large organization for aged care in the Netherlands. A total of 61 moral case deliberation sessions, carried out on 16 care locations belonging to the organization, were evaluated and perceived results were assessed. Participants gave informed consent and anonymity was guaranteed. In the Netherlands, the law does not prescribe independent ethical review by an Institutional Review Board for this kind of research among healthcare professionals. Moral case deliberation was evaluated positively by the participants. Content and atmosphere of moral case deliberation received high scores, while organizational issues regarding the moral case deliberation sessions scored lower and merit further attention. Respondents indicated that moral case deliberation has the potential to contribute to care practice as relationships among team members improve, more openness is experienced and more understanding for different perspectives is fostered. If moral case deliberation is to be successfully implemented, top-down approaches should go hand in hand with bottom-up approaches. The relevance of moral case deliberation for care practice received wide acknowledgement from the respondents. It can contribute

Music Therapy with Bereaved Youth: Expressing Grief and Feeling Better

Science.gov (United States)

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…

The Emotional Experience of School Change: Resistance, Loss, and Grief.

Science.gov (United States)

Marshak, David

1996-01-01

Ignoring the emotional experience of school change may unintentionally sabotage rational planning. Reinventing schools means attending to educators' emotional experience, particularly their expectations, sense of loss, and resulting grief. School norms must be transformed so that teachers and administrators can have meaningful conversations about…

The epistemic-teleologic model of deliberate self-persuasion.

Science.gov (United States)

Maio, Gregory R; Thomas, Geoff

2007-02-01

Although past theory and research point to the importance of understanding deliberate self-persuasion (i.e., deliberate self-induced attitude change), there have been no empirical and theoretical efforts to model this process. This article proposes a new model to help understand the process, while comparing the process of deliberate self-persuasion with relevant theory and research. The core feature of this model is a distinction between epistemic processes, which involve attempting to form new valid attitudes, and teleologic processes, which involve self-induced attitude change but with minimal concerns for validity. The epistemic processes employ tactics of reinterpretation, reattribution, reintegration, retesting, changing comparators, and changing dimensions of comparison. The teleologic processes include suppression, preemption, distraction, and concentration. By mapping these processes, this model helps to generate many novel and testable hypotheses about the use of deliberate self-persuasion to cope with ambivalent attitudes.

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

Science.gov (United States)

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…

Bereaved parents' online grief communities: de-tabooing practices or grief-ghettos?

DEFF Research Database (Denmark)

Sandvik, Kjetil; Christensen, Dorthe Refslund; Hård af Segerstad, Ylva

, children are not supposed to die before their parents, old people are supposed to die. Losing a child cuts to the core of human existence. A 100 years ago, the most common death was a child. Today, it is an old person. So the percentage of parents who have suffered the death of a child is comparably small...... compared with people who have lost an old relative. Moreover, the traditional view for socially accepted grief and mourning (at least in protestant Nordic countries) is often that you should not to grieve for too long, not too intensely or not to publicly. A taboo can be said to be a rule against something......-tabooing practices going on. In everyday interaction in the physical world there is a taboo against performing parenthood once your child is dead. It is normal for a parent to talk about their children extensively, as long as it lives. What is to be considered normal, or accepted, is a matter of perspective...

Deliberating on intersectionality: women’s conferences in Recife

Directory of Open Access Journals (Sweden)

Maria-Hélène Sa Vilas Boas

2015-12-01

Full Text Available Under what conditions can deliberation include marginalized social groups? Several feminist authors criticize deliberative theory for reproducing power relations between social groups. They defend the explicit recognition of marginalized social groups within deliberative devices. This article aims to analyze the dynamics of deliberation when it gathers a traditionally underrepresented group, women. Based on the study of women’s conferences in Recife, it shows that the combination the politics of recognition and deliberation can lead both to the integration and marginalization of different actors within the group of women, depending on the resources they have available to voice their perspectives.

Dyadic coping mediates the relationship between parents’ grief and dyadic adjustment following the loss of a child

OpenAIRE

Albuquerque, Sara; Narciso, Isabel; Pereira, Marco

2018-01-01

Background and Objectives: This study aimed to examine forms of dyadic coping (DC) as mediators of the association between parents’ grief response and dyadic adjustment and to determine whether these indirect effects were moderated by the child’s type of death, timing of death, and age. Design: The study design was cross-sectional. Method: The sample consisted of 197 bereaved parents. Participants completed the Prolonged Grief Disorder Scale, Revised Dyadic Adjustment ...

Inviting Grief into Games

DEFF Research Database (Denmark)

Harrer, Sabine; Schoenau-Fog, Henrik

2015-01-01

facilitation process with Jocoi. It will trace key moments in moving from kick-off workshop to the final game. Finally, the ensuing discussion will highlight learnings for a broader understanding of introducing diversity into games. The question of appropriateness seems to be of particular importance for game......This paper investigates how designers might initiate a dialogue with underrepresented groups, infusing design with individuals’ personal stories and imaginations. It does so alongside the example of Jocoi, a game aiming at mediating the experience of loss and grief over a dead baby. Apart from...... being a taboo subject in general, there is no explanation for the absence of this fairly common experience in games. Drawing on the emotional worlds and tastes of individuals identifying as bereft parents, Jocoi involved a collaboration with an Austrian self-help group for affected parents. The stories...

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

Science.gov (United States)

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…

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

Science.gov (United States)

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…

Freedom of Expression, Deliberation, Autonomy and Respect

DEFF Research Database (Denmark)

Rostbøll, Christian F.

2011-01-01

This paper elaborates on the deliberative democracy argument for freedom of expression in terms of its relationship to different dimensions of autonomy. It engages the objection that Enlightenment theories pose a threat to cultures that reject autonomy and argues that autonomy-based democracy...... is not only compatible with but necessary for respect for cultural diversity. On the basis of an intersubjective epistemology, it argues that people cannot know how to live on mutually respectful terms without engaging in public deliberation and develop some degree of personal autonomy. While freedom...... of expression is indispensable for deliberation and autonomy, this does not mean that people have no obligations regarding how they speak to each other. The moral insights provided by deliberation depend on the participants in the process treating one another with respect. The argument is related to the Danish...

Acknowledging sexual bereavement: a path out of disenfranchised grief.

Science.gov (United States)

Radosh, Alice; Simkin, Linda

2016-11-01

Despite increasing awareness of the importance of sexuality for older adults, research and popular literature rarely acknowledge what we term "sexual bereavement" - mourning the loss of sexual intimacy when predeceased. The reluctance to acknowledge sexual bereavement may create "disenfranchised grief" leaving the bereaved unsupported in coping with this aspect of mourning. This preliminary study focuses on women in the United States and sought to determine whether they anticipate missing sex if predeceased, whether they would want to talk about this loss, and identified factors associated with communicating about sexual bereavement. Findings from our survey of 104 women, 55 years and older, most of whom were heterosexual, revealed that a large majority (72%) anticipates missing sex with their partner and 67% would want to initiate a discussion about this. An even higher percentage would want friends to initiate the topic. Yet, 57% of participants report it would not occur to them to initiate a discussion with a widowed friend about the friend's loss. Disenfranchised grief can have negative emotional and physical consequences. This paper suggests a role for friends and professionals in addressing this neglected issue. Copyright © 2016 Elsevier Inc. All rights reserved.

Non-Conscious vs. Deliberate Dynamic Decision-Making—A Pilot Experiment

OpenAIRE

Andreas Größler; Etiënne Rouwette; Jac Vennix

2016-01-01

The purpose of this paper is to explore the effects of non-conscious vs. deliberate ways of making decisions in a dynamic decision-making task. An experimental setting is used to study this question; three experimental groups are distinguished: immediate decision-making (only very limited time for deliberate cognitive processing), considerate decision-making (relatively long time for deliberate cognitive processing), and distracted decision-making (time for non-conscious cognitive processing ...

Non-conscious vs. deliberate dynamic decision-making—a pilot experiment

OpenAIRE

Grössler, A.; Rouwette, E.A.J.A.; Vennix, J.A.M.; Größler, A.

2016-01-01

The purpose of this paper is to explore the effects of non-conscious vs. deliberate ways of making decisions in a dynamic decision-making task. An experimental setting is used to study this question; three experimental groups are distinguished: immediate decision-making (only very limited time for deliberate cognitive processing), considerate decision-making (relatively long time for deliberate cognitive processing), and distracted decision-making (time for non-conscious cognitive processing ...

The effects of deliberate practice in undergraduate medical education

NARCIS (Netherlands)

Moulaert, Véronique; Verwijnen, Maarten GM; Rikers, Remy; Scherpbier, Albert JJA

2004-01-01

INTRODUCTION: Ericsson and colleagues introduced the term 'deliberate practice' to describe training activities that are especially designed to maximise improvement. They stressed that how much one practises is as important as how one practises. Essential aspects of deliberate practice are the

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

Science.gov (United States)

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.

"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

NARCIS (Netherlands)

Maciejewski, Paul K; Maercker, Andreas; Boelen, Paul A|info:eu-repo/dai/nl/174011954; 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

WORKSHOP: Discussion, debate, deliberation

NARCIS (Netherlands)

Jeliazkova, Margarita I.

2014-01-01

Discussing, deliberating and debating are a core part of any democratic process. To organise these processes well, a great deal of knowledge and skill is required. It is not simple to find a good balance between a number of elements: appropriate language and terminology; paying attention to solid

Helping parents live with the hole in their heart: The role of health care providers and institutions in the bereaved parents' grief journeys.

Science.gov (United States)

Snaman, Jennifer M; Kaye, Erica C; Torres, Carlos; Gibson, Deborah V; Baker, Justin N

2016-09-01

Bereaved parents experience significant psychosocial and health sequelae, suggesting that this population may benefit from the ongoing extension of support and resources throughout the grief journey. The interaction of hospital staff with patients and families at the end of a child's life and after death profoundly affects parental grief, offering a unique opportunity for the medical community to positively impact the bereavement experience. The current study was conducted to explore the role of the health care team and medical institutions in the grief journeys of parents whose child died a cancer-related death. Eleven bereaved parents participated in 2 focus groups. Responses to each of the 3 main prompts were coded and analyzed independently using semantic content analysis techniques. Four main concepts were identified within the parental narratives, including the importance of strong and ongoing relationships between providers and bereaved families, the importance of high-quality communication, the effect of negative experiences between providers and families on parental grief, and the importance of the institution's role in the grief journeys of bereaved parents. Bereaved parents consistently identified the critical role played by medical staff and medical institutions throughout the grief journey. Key components of bereavement support identified by parents should serve to guide the actions of providers as well as provide a template for the development of a comprehensive bereavement program within an institution. Cancer 2016. © 2016 American Cancer Society. Cancer 2016;122:2757-2765. © 2016 American Cancer Society. © 2016 American Cancer Society.

Depression or Grief? The Experience of Caregivers of People with Dementia.

Science.gov (United States)

Walker, Rebecca J.; Pomeroy, Elizabeth C.

1996-01-01

Study of caregivers of people with dementia suggests that the depression so frequently described in the literature may not be as severe or clinically significant as previously thought and may be described as anticipatory grief. Results may assist practitioners in planning and evaluating the effectiveness of clinical interventions. (RJM)

Immigrants Coping with Transnational Deaths and Bereavement: The Influence of Migratory Loss and Anticipatory Grief.

Science.gov (United States)

Nesteruk, Olena

2017-12-14

This study examines immigrants' experiences of bereavement and coping with the deaths of family members in a transnational context. Data were collected through in-depth personal interviews with middle-aged and older immigrants from different countries of origin, who have been living in the United States for a majority of their adult lives. Thematic analysis of participants' narratives showed that immigrants' geographic distance from family complicated caregiving circumstances and rituals surrounding burial, and impacted the grieving process. At the same time, this distance also served as an emotional barrier and provided protection from prolonged grief. Immigrants' U.S.-based family and work responsibilities served as buffers from prolonged grief. Over time, immigrants became Americanized in their attitudes toward coping with death and favored a fast return to productive activities. Finally, immigrants' experience of migratory loss and anticipatory grief early in immigration, along with their personal growth and resilience developed over time, impacted their bereavement experiences later in life. Considering the limitations and the exploratory nature of the present study, further research is needed to investigate the specifics of coping with loss and bereavement among immigrants. © 2017 Family Process Institute.

Curricular Deliberation about "Hamlet": An Exercise in the Practical.

Science.gov (United States)

Siegel, Judith Susan

This study attempts to clarify and exploit Joseph Schwab's recent and current work on "practical" and "eclectic" curriculums in a simulated deliberation about a concrete curricular question, How might "Hamlet" be taught to one group of high school juniors? By exemplifying curricular deliberation, it aims to clarify…

Online Structured Writing Therapy for Post-traumatic Stress Disorder and Complicated Grief

NARCIS (Netherlands)

Ruwaard, J.; Lange, A.; Lindefors, N.; Andersson, G.

2016-01-01

Post-traumatic stress disorder (PTSD) and complicated grief are related disorders for which well-described and effective cognitive-behavioural therapeutic procedures exist that are firmly rooted in theoretical work. As a result, several research groups have been able to successfully translate these

Somatic expressions of grief and psychosomatic illness in the works of William Shakespeare and his coevals.

Science.gov (United States)

Heaton, Kenneth W

2012-10-01

To find out if Shakespeare, famed for his insights into human nature, is exceptional in how much his characters express grief through somatic symptoms and signs, and by physical illness. The texts of all large-scale works currently attributed to Shakespeare (39 plays, 3 long narrative poems) were systematically searched for bodily changes and for evidence of grief as dominating the character's emotional state at the time. The findings were compared with those from a search of 46 works, similar in genre, by 15 prominent playwrights active at the same time as Shakespeare. In Shakespeare 31 different grief-associated symptoms or signs were found, in 140 instances. They are present in all but two of his plays and long poems and involve most systems of the body. With non-Shakespearean writers there were 26 kinds, 132 instances. Twenty-two changes are common to both groups, including fainting, death (sudden or after a decline), and wrinkled face, and symptoms such as malaise, fatigue, awareness of the heart-beat, and anorexia. Ten somatic expressions of grief were found only in Shakespeare, including hyperventilation, hair turning white and premature childbirth. Four were found only in his contemporaries but were trivial or unconvincing. Deaths and non-fatal illnesses are prevalent in Shakespeare. Grieving Shakespearean characters exhibit many somatic symptoms and signs and a wide range of psychosomatic illnesses. This panoply of psychosomatic phenomena may be an artistic artefact but it also confirms that Shakespeare's empathy with grieving humanity was unrivalled. Copyright © 2012 Elsevier Inc. All rights reserved.

Creating informed public opinion: citizen deliberation about nanotechnologies for human enhancements

International Nuclear Information System (INIS)

Cobb, Michael D.

2011-01-01

Many people believe that ordinary citizens should influence scientific and technological developments, but the American public is routinely uninformed about these issues. As a solution, some scholars advocate creating informed public opinions by encouraging citizens to deliberate about the issues. Although this idea is currently widely applauded in the science and technology literature, deliberative outcomes are infrequently measured and the practice of deliberation is routinely criticized in other disciplines. This research contributes to our understanding of the effectiveness of citizen deliberation as a method for increasing public engagement with science. I report data measuring results of deliberation in a national citizens’ technology forum (NCTF) about nanotechnologies for human enhancement. The NCTF was a month-long process involving six groups of 9–15 ordinary citizens who deliberated in different locations across the United States with the goal of reaching consensus about policy recommendations within their groups. I find that structured deliberation generated informed opinions, sometimes meaningful shifts in preferences, and increased trust and internal efficacy among the participants. Nevertheless, the NCTF has important shortcomings, and it is not obvious that consensus conferences should be preferred over other mechanisms for creating informed opinions. Future research is needed to corroborate the findings of this study and to systematically compare outcomes of structured citizen deliberation to other less resource intensive forms of engagement.

Evaluation and perceived results of moral case deliberation: A mixed methods study

NARCIS (Netherlands)

Janssens, R.; van Zadelhoff, E.; van Loo, G.; Widdershoven, G.A.; Molewijk, A.C.

2015-01-01

Background: Moral case deliberation is increasingly becoming part of various Dutch healthcare organizations. Although some evaluation studies of moral case deliberation have been carried out, research into the results of moral case deliberation within aged care is scarce. Research questions: How did

The existential realities of grief and bereavement

DEFF Research Database (Denmark)

Køster, Allan; Winther-Lindqvist, Ditte

Our poster outlines the basic analytical and methodological strategy of a pending 3-year investigation into the existential dimensions of grief. The project is divided into two main foci: 1) a retrospective investigation into how bereavement of a parent in childhood/adolescence shapes the various....... Methodologically our design stands out by including a strong focus on the embodied and prereflective dimension of personal existences and connecting this with narrative accounts. The theoretical basis for this approach has been presented in recent publications by the authors (Køster & Winther-Lindqvist 2017...... and Køster 2016, 2017) and will be explicated in the poster session....

Deliberate self harm in children.

Science.gov (United States)

Krishnakumar, P; Geeta, M G; Riyaz, A

2011-05-01

To study the nature of deliberate self-harm (DSH) in children and to identify the associated factors. Child Guidance Clinic attached to the Department of Pediatrics of a teaching hospital in South India. Children with history of deliberate self harm who were referred to the CGC for psychological evaluation during a 10 year period. Children and parents were interviewed together and separately and details regarding age, sex, family and school environment, stresses and nature of self harm were documented. Psychiatric diagnosis was made based on DSM IV diagnostic criteria. Among the 30 children included in the study, 21 were boys and 9 were girls. Majority of children were between the ages of 11 and 13 years, the youngest being 6 years old. 76%of children had history of acute stressful life events and 62%of them had chronic ongoing stress. 62%of children had stress in the family and 41%had stress at school. Stress in the family included death of a parent, conflicts with parents or siblings, mental illness in the family, parental alcoholism and parental disharmony. Stress at school included conflicts with classmates, punishment or negative comments by teachers and learning problems. Psychiatric disorders were present in 52%of children, the commonest being depressive disorder. The commonest mode of DSH was self poisoning, and rat poison (zinc phosphide) was the commonest substance used. Deliberate self harm occurs in young children and the risk factors are comparable to those in adolescents.

What’s There Not to ‘Like’? Sustainability Deliberations on Facebook

Directory of Open Access Journals (Sweden)

Roy Bendor

2012-10-01

Full Text Available Social media are considered ideal means to promote inclusive political participation by “reaching citizens where they are” in scalable and cost-effective ways. However, with all the excitement about the new virtual public sphere, little attention is given to the technical mediation itself – the affordances of e-deliberation platforms and the kind of interactions they support. In response, this paper aims to thicken the account of the interrelated political and technological contexts of e-deliberation. Using recent Facebook deliberations on sustainable transportation in Vancouver as our example, we argue that different rationales for public participation in policymaking animate different approaches to discourse, which, in turn, inform and are affected by different design and use strategies for e-deliberation platforms. Our argument suggests that the design affordances of e-deliberation represent opportunities to promote or curtail certain visions of a political culture of sustainability.

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

Science.gov (United States)

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…

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

Science.gov (United States)

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.

Grief Interrupted: The Experience of Loss Among Incarcerated Women

OpenAIRE

Harner, Holly M.; Hentz, Patricia M.; Evangelista, Maria Carmela

2010-01-01

Incarcerated women face a number of stressors apart from the actual incarceration. Nearly half of all women in prison experience the death of a loved one during their incarceration. Our purpose for this study was to explore the experience of grief and loss among incarcerated women using a phenomenological method. Our study approach followed van Manen's method of phenomenology and Munhall's description of existential lifeworlds. Our analysis revealed four existential lifeworlds: temporality: f...

Incidence Rates of Deliberate Self-Harm in Denmark 1994–2011

DEFF Research Database (Denmark)

Morthorst, Britt Reuter; Soegaard, Bodil; Nordentoft, Merete

2016-01-01

Background: The validity and reliability of suicide statistics have been questioned and few nationwide studies of deliberate selfharm have been presented. Aim: To calculate rates of deliberate self-harm in Denmark in order to investigate trends and assess the reliability of hospital records...... incidence of deliberate self-harm among young Danish women was observed, despite detection bias. An improved registration procedure of suicidal behavior is needed....

Ethical case deliberation and decision making.

Science.gov (United States)

Gracia, Diego

2003-01-01

During the last thirty years different methods have been proposed in order to manage and resolve ethical quandaries, specially in the clinical setting. Some of these methodologies are based on the principles of Decision-making theory. Others looked to other philosophical traditions, like Principlism, Hermeneutics, Narrativism, Casuistry, Pragmatism, etc. This paper defends the view that deliberation is the cornerstone of any adequate methodology. This is due to the fact that moral decisions must take into account not only principles and ideas, but also emotions, values and beliefs. Deliberation is the process in which everyone concerned by the decision is considered a valid moral agent, obliged to give reasons for their own points of view, and to listen to the reasons of others. The goal of this process is not the reaching of a consensus but the enrichment of one's own point of view with that of the others, increasing in this way the maturity of one's own decision, in order to make it more wise or prudent. In many cases the members of a group of deliberation will differ in the final solution of the case, but the confrontation of their reasons will modify the perception of the problem of everyone. This is the profit of the process. Our moral decisions cannot be completely rational, due to the fact that they are influenced by feelings, values, beliefs, etc., but they must be reasonable, that is, wise and prudent. Deliberation is the main procedure to reach this goal. It obliges us to take others into account, respecting their different beliefs and values and prompting them to give reasons for their own points of view. This method has been traditional in Western clinical medicine all over its history, and it should be also the main procedure for clinical ethics.

The shared circuits model (SCM): how control, mirroring, and simulation can enable imitation, deliberation, and mindreading.

Science.gov (United States)

Hurley, Susan

2008-02-01

Imitation, deliberation, and mindreading are characteristically human sociocognitive skills. Research on imitation and its role in social cognition is flourishing across various disciplines. Imitation is surveyed in this target article under headings of behavior, subpersonal mechanisms, and functions of imitation. A model is then advanced within which many of the developments surveyed can be located and explained. The shared circuits model (SCM) explains how imitation, deliberation, and mindreading can be enabled by subpersonal mechanisms of control, mirroring, and simulation. It is cast at a middle, functional level of description, that is, between the level of neural implementation and the level of conscious perceptions and intentional actions. The SCM connects shared informational dynamics for perception and action with shared informational dynamics for self and other, while also showing how the action/perception, self/other, and actual/possible distinctions can be overlaid on these shared informational dynamics. It avoids the common conception of perception and action as separate and peripheral to central cognition. Rather, it contributes to the situated cognition movement by showing how mechanisms for perceiving action can be built on those for active perception.;>;>The SCM is developed heuristically, in five layers that can be combined in various ways to frame specific ontogenetic or phylogenetic hypotheses. The starting point is dynamic online motor control, whereby an organism is closely attuned to its embedding environment through sensorimotor feedback. Onto this are layered functions of prediction and simulation of feedback, mirroring, simulation of mirroring, monitored inhibition of motor output, and monitored simulation of input. Finally, monitored simulation of input specifying possible actions plus inhibited mirroring of such possible actions can generate information about the possible as opposed to actual instrumental actions of others, and the

Family focused grief therapy: The therapy of choice in palliative care

Directory of Open Access Journals (Sweden)

Klikovac Tamara

2017-01-01

Full Text Available Palliative care refers to offering physical, psychosocial and spiritual care to patients who are suffering from life threatening diseases. It also includes providing psychological support for family members and other close relations during the period of illness (anticipatory grief and in the period of bereavement and mourning after the patient's death. The choice of therapy during the process of bereavement and mourning is Family Focused Grief Therapy (FFGT. FFGT is a brief, focused and time-limited psychotherapeutic model of intervention belonging to family psychotherapy which is specified for the families that face a life threatening disease of a family member. FFGT, with some modifications, can be applied in work with the families who are facing a terminal illness of younger family members - a child or an adolescent. FFGT typically comprises of 7 to 9 sessions lasting for 90 minutes, which are arranged flexibly across 9 to 18 months, depending on the needs of each family individually. It is important to emphasize that the frequency and number of sessions in each phase depend on the specific features and needs of each particular family. The intervention aim of FFGT is to prevent the complications of bereavement by enhancing the functioning of the family, through exploration of its cohesion, communications (of thoughts and feelings, and handling of conflict. The story of illness and the related grief is shared in the process. The creator of this model is Dr David Kissane, a psychiatrist and a family psychotherapist from Melbourne, Australia, who also worked at the Memorial Sloan Kettering Cancer Centre in New York. The main aims of this article are, on the one hand, to introduce this very useful model of the family therapy to the professional community in Serbia and, on the other, to introduce a conceptual and practical frame of palliative care.

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

Science.gov (United States)

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)

Sources of bias in clinical ethics case deliberation.

Science.gov (United States)

Magelssen, Morten; Pedersen, Reidar; Førde, Reidun

2014-10-01

A central task for clinical ethics consultants and committees (CEC) is providing analysis of, and advice on, prospective or retrospective clinical cases. However, several kinds of biases may threaten the integrity, relevance or quality of the CEC's deliberation. Bias should be identified and, if possible, reduced or counteracted. This paper provides a systematic classification of kinds of bias that may be present in a CEC's case deliberation. Six kinds of bias are discussed, with examples, as to their significance and risk factors. Possible remedies are suggested. The potential for bias is greater when the case deliberation is performed by an individual ethics consultant than when an entire clinical ethics committee is involved. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Prolonged grief and depression after unnatural loss : Latent class analyses and cognitive correlates

NARCIS (Netherlands)

Boelen, Paul A; Reijntjes, Albert; J Djelantik, A A A Manik; Smid, Geert E

2016-01-01

This study sought to identify (a) subgroups among people confronted with unnatural/violent loss characterized by different symptoms profiles of prolonged grief disorder (PGD) and depression, and (b) socio-demographic, loss-related, and cognitive variables associated with subgroup membership. We used

Bringing values and deliberation to science communication.

Science.gov (United States)

Dietz, Thomas

2013-08-20

Decisions always involve both facts and values, whereas most science communication focuses only on facts. If science communication is intended to inform decisions, it must be competent with regard to both facts and values. Public participation inevitably involves both facts and values. Research on public participation suggests that linking scientific analysis to public deliberation in an iterative process can help decision making deal effectively with both facts and values. Thus, linked analysis and deliberation can be an effective tool for science communication. However, challenges remain in conducting such process at the national and global scales, in enhancing trust, and in reconciling diverse values.

Post Rio Communication Styles for Deliberation

DEFF Research Database (Denmark)

Holm, Jesper; Almlund, Pernille

2015-01-01

The communicative turn in planning, multi-layered governance and governmentality are analytical concepts from various schools of thought to comprehend the emergence of new types of publicprivate politics when it comes to complex, wicked issues such as sustainability or the 3rd wave of public health......: health promotion. The paper explores a research approach to compare two different policy communication tracks in order to conceive various impacts on deliberation. The tracks are constructed along the narratives individual-collective & consensus-conflictual in the discursive framing of political...... communication. We build on an ANT inspired methodology and look into two simultaneously evolving political agendas during the last two decades - sustainability and health promotion - that have framed communication efforts, campaigns and politics in general. How is public participation and deliberation...

Maladaptive coping in adults who have experienced early parental loss and grief counseling

DEFF Research Database (Denmark)

Høeg, Beverley Lim; Appel, Charlotte W.; von Heymann-Horan, Annika B.

2017-01-01

bereaved adults who received grief counseling (N = 822 women, N = 190 men) with bereaved controls who had not (N = 233 women, N = 66 men). Bereaved adults reported significantly more substance use, behavioral disengagement, and emotional eating than non-bereaved adults. Counseling participants reported...

Long-term effects of the Family Bereavement Program on spousally bereaved parents: Grief, mental health problems, alcohol problems, and coping efficacy.

Science.gov (United States)

Sandler, Irwin; Tein, Jenn-Yun; Cham, Heining; Wolchik, Sharlene; Ayers, Tim

2016-08-01

This study reports on the findings from a 6-year follow-up of a randomized trial of the Family Bereavement Program (FBP) on the outcomes for spousally bereaved parents. Spousally bereaved parents (N = 131) participated in the trial in which they were randomly assigned to receive the FBP (N = 72) or literature control (N = 59). Parents were assessed at four time points: pretest, posttest, and 11-month and 6-year follow-up. They reported on mental health problems, grief, and parenting at all four time periods. At the 6-year follow-up, parents reported on additional measures of persistent complex bereavement disorder, alcohol abuse problems, and coping efficacy. Bereaved parents in the FBP as compared to those in the literature control had lower levels of symptoms of depression, general psychiatric distress, prolonged grief, and alcohol problems, and higher coping efficacy (for mothers) at the 6-year follow-up. Multiple characteristics of the parent (e.g., gender, age, and baseline mental health problems) and of the spousal death (e.g., cause of death) were tested as moderators of program effects on each outcome, but only 3 of 45 tests of moderation were significant. Latent growth modeling found that the effects of the FBP on depression, psychiatric distress, and grief occurred immediately following program participation and were maintained over 6 years. Mediation analysis found that improvement in positive parenting partially mediated program effects to reduce depression and psychiatric distress, but had an indirect effect to higher levels of grief at the 6-year follow-up. Mediation analysis also found that improved parenting at the 6-year follow-up was partially mediated by program effects to reduce depression and that program effects to increase coping efficacy at the 6-year follow-up was partially mediated through reduced depression and grief and improved parenting. FBP reduced mental health problems, prolonged grief, and alcohol abuse, and increased coping

Rural health professionals' perspectives on providing grief and loss support in cancer care.

Science.gov (United States)

Breen, L J; O'Connor, M

2013-11-01

Research demonstrates considerable inequalities in service delivery and health outcomes for people with cancer living outside large metropolitan cities. Semi-structured interviews with 11 professionals providing grief and loss support for people with cancer and their families in rural, regional, and remote areas Western Australia revealed the challenges they faced in delivering such support. The data are presented in four themes - Inequity of regional versus metropolitan services, Strain of the 'Jack of all trades' role, Constraints to accessing professional development, and Challenges in delivering post-bereavement services. These challenges are likely to be of growing concern given that populations are declining in rural areas as Australia becomes increasingly urban. The findings have implications in enhancing the loss and grief support services available in rural, regional, and remote Western Australia, including those grieving the death of a loved one through cancer. © 2013 John Wiley & Sons Ltd.

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

Science.gov (United States)

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…

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

Science.gov (United States)

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…

An Avalanche of Ignoring-A Qualitative Study of Health Care Avoidance in Women With Malignant Breast Cancer Wounds

DEFF Research Database (Denmark)

Lund-Nielsen, Betina; Midtgaard, Julie; Rørth, Mikael

2011-01-01

BACKGROUND:: A contributing factor to development of malignant wounds is patient-related delay caused by health care avoidance. OBJECTIVE:: The purpose of this study was to describe the experience of health care avoidance in women with advanced breast cancer who have developed malignant wounds....... METHODS:: A qualitative study was conducted based on semistructured interviews. Seventeen women with advanced breast cancer (median age, 69 years; range, 47-90 years) who had avoided medical treatment despite development of malignant wounds participated. Systematic text-condensation analysis was used....... RESULTS:: The women deliberately avoided health care for a median of 24 months (minimum, 3 months; maximum, 84 months). Despite being aware of the development of a malignant wound from a breast lump, the women avoided health care because of negative health care experiences and extremely burdening life...

Complicated grief in Aboriginal populations.

Science.gov (United States)

Spiwak, Rae; Sareen, Jitender; Elias, Brenda; Martens, Patricia; Munro, Garry; Bolton, James

2012-06-01

To date there have been no studies examining complicated grief (CG) in Aboriginal populations. Although this research gap exists, it can be hypothesized that Aboriginal populations may be at increased risk for CG, given a variety of factors, including increased rates of all-cause mortality and death by suicide. Aboriginal people also have a past history of multiple stressors resulting from the effects of colonization and forced assimilation, a significant example being residential school placement. This loss of culture and high rates of traumatic events may place Aboriginal individuals at increased risk for suicide, as well as CG resulting from traumatic loss and suicide bereavement. Studies are needed to examine CG in Aboriginal populations. These studies must include cooperation with Aboriginal communities to help identify risk factors for CG, understand the role of culture among these communities, and identify interventions to reduce poor health outcomes such as suicidal behavior.

Cultivating Mathematical Skills: From Drill-and-Practice to Deliberate Practice

Science.gov (United States)

Lehtinen, Erno; Hannula-Sormunen, Minna; McMullen, Jake; Gruber, Hans

2017-01-01

Contemporary theories of expertise development highlight the crucial role of deliberate practice in the development of high level performance. Deliberate practice is practice that intentionally aims at improving one's skills and competencies. It is not a mechanical or repetitive process of making performance more fluid. Instead, it involves a…

Sociopolitical drivers in the development of deliberate carbon storage

Science.gov (United States)

Stephens, Jennie C.

The idea of engineering the storage of carbon released from fossil fuel burning in reservoirs other than the atmosphere has developed in the past 20 years from an obscure idea to an increasingly recognized potential approach that could be an important contributor to stabilizing atmospheric carbon dioxide (CO2) concentrations. Despite the intense application of scientific and technological expertise to the development of options for deliberate carbon storage, nontechnical factors play an important role. This chapter identifies sociopolitical, nontechnical factors that have contributed to the development of ideas and technologies associated with deliberate carbon storage. Broadly, interest in deliberate storage has expanded in response to increasing societal attention to reducing CO2 emissions for climate change mitigation. Specific societal groups, or stakeholders, which have contributed to the recent focus on carbon storage include the fossil fuel industry that has been shifting to a strategy of confronting rather than denying the CO2-climate change connection, a scientific community motivated by an increased sense of urgency of the need to reduce atmospheric CO2 concentrations, the general public with little knowledge about or awareness of carbon storage, and environmental advocacy groups that have demonstrated some divergence in levels of support for deliberate carbon storage. Among the policy mechanisms that have provided incentives for deliberate carbon storage are national accounting of carbon sources and sinks and carbon taxes. Another driver with particular importance in the United States is the political preference of some politicians to support development of advanced technologies for climate change mitigation rather than supporting mandatory CO2 regulations.

Mourning Child Grief Support Group Curriculum: Early Childhood Edition, Kindergarten-Grade 2.

Science.gov (United States)

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

The Mourning Child Early Childhood grief support curriculum is intended for use with early elementary-aged children, specifically children in kindergarten through grade two, 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…

How Should We Deliberate? Between the Argumentative and the Representative Dimensions of Democratic Deliberation

Directory of Open Access Journals (Sweden)

Tutui Viorel

2012-01-01

Full Text Available Abstract: My paper focuses on an important subject of the contemporary theory of democracy: what is the relationship between the argumentative and the representative dimensions of deliberative democracy? Using James Fishkin’s account of deliberative democracy and its relations with other democratic models I will argue that there is a severe conflict between these two dimensions: the attempt to enhance the value of argumentation presupposes a decrease in the representative value and the attempt to enhance the representative value results in a decrease in the argumentative value. This conflict is generated by what I call ‘the paradox of democratic deliberation’: the legitimacy of political decisions demands for the ‘raw’ opinion of the citizens, while the epistemic rightness of political decisions demands for a ‘filtered’ public opinion. But we cannot have both. In the final part of this paper I will sustain a moderate conception regarding the role of deliberation in democracy which offers us a way around this paradox but only at the price of significantly reducing the importance of deliberation.

Posttraumatic growth following pregnancy termination for fetal abnormality: the predictive role of coping strategies and perinatal grief.

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Lafarge, Caroline; Mitchell, Kathryn; Fox, Pauline

2017-09-01

Research about termination for fetal abnormality (TFA) suggests that it is a traumatic event with potential negative psychological consequences. However, evidence also indicates that following traumatic events individuals may experience growth. Although TFA's negative psychological outcomes are well documented, little is known of the potential for growth following this event. Therefore, the study's objectives were to measure posttraumatic growth (PTG) post-TFA, examine the relationship between PTG, perinatal grief and coping, and determine the predictors of PTG. An online, retrospective survey was conducted with 161 women. Eligible participants were women over 18 who had undergone TFA. Participants were recruited from a support organisation. They completed the Brief COPE, Short Perinatal Grief Scale and Posttraumatic Growth Inventory. Data were analysed using regression analyses. Moderate levels of PTG were observed for "relating to others," "personal strengths" and "appreciation of life." "Positive reframing" was a significant predictor of PTG. Despite using mainly "adaptive" coping strategies, women's grief levels were high. "Adaptive" coping strategies such as, "positive reframing" are relevant to TFA. They may act as protective factors against distress and as foundations for growth, implicating that interventions such as Cognitive Behavioural Therapy, which aim to reframe women's experience, may be beneficial.

Factors Associated with Complicated Grief in Students Who Survived the Sewol Ferry Disaster in South Korea.

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Lee, So Hee; Nam, Hee Sun; Kim, Hak Beom; Kim, Eun Ji; Noh, Jin-Won; Chae, Jeong-Ho

2018-03-01

The Sewol ferry disaster caused shock and grief in South Korea. The aim of this study was to identify the factors associated with symptoms of complicated grief (CG) among the surviving students 20 months after that disaster. This study was conducted using a cross-sectional design and a sample of 57 students who survived the Sewol ferry disaster. Data were collected using the following instruments: Inventory of Complicated Grief (ICG), the Lifetime Incidence of Traumatic Events-Child, the Child Report of Post-Traumatic Symptoms (CROPS), KIDSCREEN-27, Family Adaptability and Cohesion Evaluation Scales-III, the Peri-traumatic Dissociation-Post-traumatic Negative Beliefs-Post-traumatic Social Support scale, and the Strengths and Difficulties Questionnaire. A generalized linear model using a log link and Poisson distribution was performed to identify factors associated with symptoms of CG. The mean score on the ICG was 15.57 (standard deviation: 12.72). Being born in 1999, a higher score on the CROPS and a lower score in autonomy and relationship with parents on the KIDSCREEN-27 were related to higher levels of CG. Twenty months after the Sewol ferry disaster, 24.5% of surviving students were suffering from CG. This study uncovered a vulnerable population of bereaved children at high risk for CG.

Mourning Child Grief Support Group Curriculum: Middle Childhood Edition, Grades 3-6.

Science.gov (United States)

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

The Mourning Child Early Childhood grief support curriculum is intended for use with late elementary and middle school-aged children, specifically children in grades three through six, 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,…

The utilisation of storytelling as a therapeutic intervention by educational psychologists to address behavioural challenges relating to grief of adolescent clients

OpenAIRE

2014-01-01

M.Ed. (Educational Psychology) Storytelling as a therapeutic intervention entails the narrating of events by externalising emotions, thoughts and responses to life-changing events such as loss and grief. This creates the opportunity for clients to engage with psychologists by projecting various beliefs and challenges, such as grief, through a range of therapeutic modalities. This study conducts an inquiry into the ways in which storytelling can be utilised by educational psychologists with...

Cautioning Health-Care Professionals : Bereaved Persons Are Misguided Through the Stages of Grief

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Stroebe, Margaret; Schut, Henk; Boerner, Kathrin

2017-01-01

Science and practice seem deeply stuck in the so-called stage theory of grief. Health-care professionals continue to "prescribe" stages. Basically, this perspective endorses the idea that bereaved people go through a set pattern of specific reactions over time following the death of a loved one. It

Ethical case deliberation on the ward. A comparison of four methods.

NARCIS (Netherlands)

Steinkamp, N.L.; Gordijn, B.

2003-01-01

The objective of this article is to analyse and compare four methods of ethical case deliberation. These include Clinical Pragmatism, The Nijmegen Method of ethical case deliberation, Hermeneutic dialogue, and Socratic dialogue. The origin of each method will be briefly sketched. Furthermore, the

Suicide Following Deliberate Self-Harm.

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Olfson, Mark; Wall, Melanie; Wang, Shuai; Crystal, Stephen; Gerhard, Tobias; Blanco, Carlos

2017-08-01

The authors sought to identify risk factors for repeat self-harm and completed suicide over the following year among adults with deliberate self-harm. A national cohort of Medicaid-financed adults clinically diagnosed with deliberate self-harm (N=61,297) was followed for up to 1 year. Repeat self-harm per 1,000 person-years and suicide rates per 100,000 person-years (based on cause of death information from the National Death Index) were determined. Hazard ratios of repeat self-harm and suicide were estimated by Cox proportional hazard models. During the 12 months after nonfatal self-harm, the rate of repeat self-harm was 263.2 per 1,000 person-years and the rate of completed suicide was 439.1 per 100,000 person-years, or 37.2 times higher than in a matched general population cohort. The hazard of suicide was higher after initial self-harm events involving violent as compared with nonviolent methods (hazard ratio=7.5, 95% CI=5.5-10.1), especially firearms (hazard ratio=15.86, 95% CI=10.7-23.4; computed with poisoning as reference), and to a lesser extent after events of patients who had recently received outpatient mental health care (hazard ratio=1.6, 95% CI=1.2-2.0). Compared with self-harm patients using nonviolent methods, those who used violent methods were at significantly increased risk of suicide during the first 30 days after the initial event (hazard ratio=17.5, 95% CI=11.2-27.3), but not during the following 335 days. Adults treated for deliberate self-harm frequently repeat self-harm in the following year. Patients who use a violent method for their initial self-harm, especially firearms, have an exceptionally high risk of suicide, particularly right after the initial event, which highlights the importance of careful assessment and close follow-up of this group.

A pilgrimage into the liminal: an experiential enquiry into the psychological and embodied space of grief and its representation in film

OpenAIRE

Lovey, Christina

2016-01-01

The lived experience of grief is a universal phenomenon that is both a psychological and embodied experience; it finds expression in varying art forms and is considered in multiple discourses, including psychoanalysis. This project identifies a range of responses to loss and grief and critically reflects on their value and efficacy. Through the use of a phenomenological research process, that results in the production of filmworks, the value of using film as a way of managing and processing...

Ethical case deliberation on the ward. A comparison of four methods.

Science.gov (United States)

Steinkamp, Norbert; Gordijn, Bert

2003-01-01

The objective of this article is to analyse and compare four methods of ethical case deliberation. These include Clinical Pragmatism, The Nijmegen Method of ethical case deliberation, Hermeneutic dialogue, and Socratic dialogue. The origin of each method will be briefly sketched. Furthermore, the methods as well as the related protocols will be presented. Each method will then be evaluated against the background of those situations in which it is being used. The article aims to show that there is not one ideal method of ethical case deliberation, which fits to all possible kinds of moral problems. Rather, as each of the methods highlights a limited number of morally relevant aspects, each method has its strengths and weaknesses as well. These strengths and weaknesses should be evaluated in relation to different types of situations, for instance moral problems in treatment decisions, moral uneasiness and residue, and the like. The suggestion arrived at on the basis of the findings of this paper is a reasonable methodological plurality. This means that a method can be chosen depending on the type of moral problem to be deliberated upon. At the same time it means, that by means of a method, deliberation should be facilitated.

Growing up with grief: revisiting the death of a parent over the life course.

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Blank, Nancee M; Werner-Lin, Allison

2011-01-01

In the era of managed care, evidence-based practice, and short term, solution focused interventions, clinicians in agency based settings generally do not have the luxury of long-term contact with bereaved children. Although a substantial, yet controversial, literature argues that children cannot fully resolve early loss until adulthood, limited attention is given to how children's understandings of early loss shift as their cognitive capacities mature. This article argues the emotional experience of grief shifts: 1) as children grapple with both normative life changes and the tasks of mourning, and 2) as their cognitive and emotional development allow them to understand and question aspects of their deceased parent's life and death in new ways. This article will present an overview of longitudinal and cross-sectional research on the long-term impact of childhood grief. We then suggest the ways bereaved children and adolescents revisit and reintegrate the loss of a parent as their emotional, moral, and cognitive capacities mature and as normative ego-centrism and magical thinking decline. To demonstrate these ideas, we draw on the case of a parentally bereaved boy and his family presenting across agency-based and private-practice work over the course of 14 years. This case suggests the need for coordinated care for children who are moving beyond the initial trauma of parental loss into various stages of grief and reintegration. While the loss of a parent is permanent and unchanging, the process is not: it is part of the child's ongoing experience. (Worden, 1996, p. 16).

Self-compassion, grief rumination, and psychopathology among relatives of missing persons : A mediation analysis

NARCIS (Netherlands)

Lenferink, Lonneke I.M.; Eisma, Maarten C.; de Keijser, Jos; Boelen, Paul A.

2017-01-01

Abstract Introduction Experiencing the disappearance of a loved one is a unique type of loss that may heighten the risk of developing prolonged grief (PG), depression, and posttraumatic stress (PTS) symptoms. Little is known about protective and risk factors for psychopathology among relatives of

The bereavement process of tissue donors' family members: responses of grief, posttraumatic stress, personal growth, and ongoing attachment.

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Hogan, Nancy; Schmidt, Lee; Coolican, Maggie

2014-09-01

Donated tissues can save lives of critically burned patients and those needing a heart valve replacement. Tissues enhance the lives of a million recipients annually through transplants of corneas, bones, tendons, and vein grafts. Unfortunately, the need for some tissues exceeds their availability. The goal of the quantitative component of this mixed methods study was to identify the grief, posttraumatic stress, personal growth, and ongoing attachment response of tissue donors' family members during a 2-year period. Simultaneous mixed methods design. The sample for this study consisted of 52 tissue donors' family members, mostly widows (83%). Data were collected for 2 years to test changes in grief, posttraumatic stress, panic behavior, personal growth, and ongoing attachment. The bereaved participants experienced significantly fewer grief reactions, less posttraumatic stress, and greater personal growth. There was no significant difference in the ongoing attachment to their deceased loved ones. The results of this study may reinforce the positive meaning that tissue donors' family members can find in tissue donation. Findings also demonstrate that the bereavement process corroborates contemporary bereavement and attachment theories. Health professionals are encouraged to seek donations with less worry that tissue donors' family members will experience adverse outcomes during bereavement.

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

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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…

Advanced Cancer Patients' Perceptions of Dignity: The Impact of Psychologically Distressing Symptoms and Preparatory Grief.

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Kostopoulou, Sotiria; Parpa, Efi; Tsilika, Eleni; Katsaragakis, Stylianos; Papazoglou, Irene; Zygogianni, Anna; Galanos, Antonis; Mystakidou, Kyriaki

2018-04-01

The present study assesses the relationship between patient dignity in advanced cancer and the following variables: psychological distress, preparatory grief, and sociodemographic and clinical characteristics. The sample consisted of 120 patients with advanced cancer. The self-administered questionnaires were as follows: the Preparatory Grief in Advanced Cancer Patients (PGAC), the Patient Dignity Inventory-Greek (PDI-Gr), the Greek Schedule for Attitudes toward Hastened Death (G-SAHD), and the Greek version of the Hospital Anxiety and Depression Scale (G-HADS). Moderate to strong statistically significant correlations were found between the 4 subscales of PDI-Gr (psychological distress, body image and role identity, self-esteem, and social support) with G-HADS, G-SAHD, and PGAC ( P dignity among patients with advanced cancer. Clinicians should assess and attend to dignity-distressing factors in the care of patients with advanced cancer.

Deliberate Evolution in Multi-Agent Systems

NARCIS (Netherlands)

Brazier, F.M.; Jonker, C.M.; Treur, J.; Wijngaards, N.J.E.; Gabbay, D.

2001-01-01

Evolution in societies of agents is a challenging phenomenon, both from a fundamental perspective and from an applied perspective. In the literature often genetic programming approaches are used and relatively simple agents are considered, which have no deliberate influence on the direction of the

Emotional response patterns of depression, grief, sadness and stress to differing life events: a quantitative analysis.

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Parker, Gordon; Paterson, Amelia; Hadzi-Pavlovic, Dusan

2015-04-01

In clarifying the clinical definition of an episode of major depression, DSM-5 equates bereavement with a number of other loss-related stressors (e.g. financial ruin, serious medical problems) and infers differences between such loss-related and non-loss-related responses. We undertook a study with the aim of examining the likelihood of varying life stressors leading to depression or to other emotional responses, and so allowing consideration as to whether bereavement might be equivalent to other loss-related stressful triggers. We studied a sample comprising sub-sets of those likely to have either experienced or never experienced a clinical depressive episode and report data for both the whole sample and the separate sub-sets. Participants were asked to report their exposure to 16 differing stressors and, given definitions of depression, grief, sadness and stress, to rate (in order of importance) their primary and secondary reactions if so experienced. Only one event (i.e. the individual being left by their partner) generated depression as the most likely response within the sample. A grief reaction was nominated as the most likely primary response to the death of a first-degree relative (52%) and was also a relatively common primary response to the death of a more distant relative or close family friend (36%). While one-fourth (24%) nominated grief as the primary response to being left by one's partner, it was rarely nominated as a primary response to all other events, including the DSM-5 'loss-related' exemplars of a financial crisis and of a medical illness (rates of 3% and 2%, respectively). As participants were given a definition of the emotional responses and candidate contexts, their responses may have been a reflection of the definitions provided. Additionally, a retrospective, self-report design was used which may have impacted on the veracity of responses. Findings position a grief response as showing relative specificity to bereavement events and that

The mourning before: can anticipatory grief theory inform family care in adult intensive care?

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Coombs, Maureen A

2010-12-01

Although anticipatory grief is a much-debated and critiqued bereavement concept, it does offer a way of understanding and exploring expected loss that may be helpful in certain situations. In end-of-life care in adult intensive care units, families often act as proxy decision makers for patients in the transition from curative treatment efforts to planned treatment withdrawal. Despite there being a developed evidence base to inform care of families at this time, few of the clinical studies that provided this evidence were underpinned by bereavement theory. Focusing on end-of-life intensive care practices, this paper integrates work on anticipatory grief and family interventions to present a family-centred framework of care. Through this it is argued that the complex needs of families must be more comprehensively understood by doctors and nurses and that interventions must be more systematically planned to improve quality end-of-life care for families in this setting.

Comparative study of personality disorder associated with deliberate self harm in two different age groups (15-24 years and 45-74 years).

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Nath, Saswati; Patra, Dipak Kumar; Biswas, Srilekha; Mallick, Asim Kumar; Bandyopadhyay, Gautam Kumar; Ghosh, Srijit

2008-07-01

To study the presence of personality disorder in cases of deliberate self harm (DSH) in young (15-24 years) and elderly (45-74 years) and compare. Deliberate self harm cases admitted in Medical and surgical departments and cases attending psychiatry department of R.G. Kar Medical College, Kolkata were studied. For diagnosis of personality disorder ICD 10 International Personality Disorder Examination (IPDE) questionnaire was used. Percentage of elderly patients having personality disorder (64%) was higher compared to young DSH patients (58.5%). In young group, most common disorder was emotionally unstable personality disorder (28.6%) and in elderly group most common was anankastic type of personality disorder (36%). Schizoid, dissocial, histrionic, and anxious-avoidant personality disorders were found in small percentages of cases. Among DSH patients, the most common personality disorder found in young age was Emotionally unstable (Impulsive and Borderline) personality disorder, but most common personality disorder found in elderly patients was Anankastic personality disorder.

It's not all about moral reasoning: Understanding the content of Moral Case Deliberation.

Science.gov (United States)

Svantesson, Mia; Silén, Marit; James, Inger

2018-03-01

Moral Case Deliberation is one form of clinical ethics support described as a facilitator-led collective moral reasoning by healthcare professionals on a concrete moral question connected to their practice. Evaluation research is needed, but, as human interaction is difficult to standardise, there is a need to capture the content beyond moral reasoning. This allows for a better understanding of Moral Case Deliberation, which may contribute to further development of valid outcome criteria and stimulate the normative discussion of what Moral Case Deliberation should contain. To explore and compare the content beyond moral reasoning in the dialogue in Moral Case Deliberation at Swedish workplaces. A mixed-methods approach was applied for analysing audio-recordings of 70 periodic Moral Case Deliberation meetings at 10 Swedish workplaces. Moral Case Deliberation facilitators and various healthcare professions participated, with registered nurses comprising the majority. Ethical considerations: No objection to the study was made by an Ethical Review Board. After oral and written information was provided, consent to be recorded was assumed by virtue of participation. Other than 'moral reasoning' (median (md): 45% of the spoken time), the Moral Case Deliberations consisted of 'reflections on the psychosocial work environment' to a varying extent (md: 29%). Additional content comprised 'assumptions about the patient's psychosocial situation' (md: 6%), 'facts about the patient's situation' (md: 5%), 'concrete problem-solving' (md: 6%) and 'process' (md: 3%). The findings suggest that a restorative function of staff's wellbeing in Moral Case Deliberation is needed, as this might contribute to good patient care. This supports outcome criteria of improved emotional support, which may include relief of moral distress. However, facilitators need a strategy for how to proceed from the participants' own emotional needs and to develop the use of their emotional knowing to focus on

The role of deliberate practice in the acquisition of clinical skills

Directory of Open Access Journals (Sweden)

Duvivier Robbert J

2011-12-01

Full Text Available Abstract Background The role of deliberate practice in medical students' development from novice to expert was examined for preclinical skill training. Methods Students in years 1-3 completed 34 Likert type items, adapted from a questionnaire about the use of deliberate practice in cognitive learning. Exploratory factor analysis and reliability analysis were used to validate the questionnaire. Analysis of variance examined differences between years and regression analysis the relationship between deliberate practice and skill test results. Results 875 students participated (90%. Factor analysis yielded four factors: planning, concentration/dedication, repetition/revision, study style/self reflection. Student scores on 'Planning' increased over time, score on sub-scale 'repetition/revision' decreased. Student results on the clinical skill test correlated positively with scores on subscales 'planning' and 'concentration/dedication' in years 1 and 3, and with scores on subscale 'repetition/revision' in year 1. Conclusions The positive effects on test results suggest that the role of deliberate practice in medical education merits further study. The cross-sectional design is a limitation, the large representative sample a strength of the study. The vanishing effect of repetition/revision may be attributable to inadequate feedback. Deliberate practice advocates sustained practice to address weaknesses, identified by (self-assessment and stimulated by feedback. Further studies should use a longitudinal prospective design and extend the scope to expertise development during residency and beyond.

The grief experience of same-sex couples within an Irish context: tacit acknowledgement.

Science.gov (United States)

Glackin, Michelle; Higgins, Agnes

2008-06-01

This study sought to explore the grief experience of same sex couples. To date, the majority of research in this area has focused on the bereavement experience of individuals whose partner has died from an AIDS/HIV-related illness. The research design used was descriptive exploratory. A multi-pronged sampling strategy was employed to generate participants. Seven people underwent in-depth interviews once the study had received ethical approval. Data were analysed by coding, comparing, and merging codes into higher order themes. Five themes subsequently emerged that captured the essence of the bereavement experience, namely:'tacit acknowledgement'; 'sculpting the distress'; 'multiple losses'; 'seeking support'; and 'journeying anew.' While not all bereaved gay or lesbian partners experience 'disenfranchized grief', particularly if their relationship with the deceased was not hidden, it is clear from the findings of this study that many of the participants did (Doka, 1989;Wallbank, 1998). Health care professionals need to consider their approach to people who identify themselves as gay or lesbian, if they are to provide support structures (formal and informal) to meet their unique needs.

The MM-CGI Cerebral Palsy: modification and pretesting of an instrument to measure anticipatory grief in parents whose child has cerebral palsy.

Science.gov (United States)

Al-Gamal, Ekhlas; Long, Tony

2014-07-01

To establish the potential of a modified version of the MM-CGI Childhood Cancer to assess anticipatory grief in parents of children with cerebral palsy, to amend the existing scale for use with the specific patient group, to test the psychometric properties of the modified version (MM-CGI Cerebral Palsy) and to review the clinical potential of the new scale. Parents of children with cerebral palsy may experience reactions similar to parents of children with other enduring or life-limiting conditions, and anticipatory grief may be one such psychological reaction. While the burden of caring is sometimes balanced by positive perceptions of the child, which enhance coping ability, for many parents the outcome is damage to their physical and mental health and impaired family functioning. A cross-sectional, descriptive, correlational design. The MM-CGI Cerebral Palsy was administered in structured interviews with 204 parents. Standardised measures of caregivers' depression, stress and perceived social support were also administered. Mothers and fathers were recruited from healthcare centres and schools for special education. Cronbach's alpha was used to assess internal consistency, and Pearson's product-moment correlation was used to assess construct validity. The subscales were each found to measure a single dimension of anticipatory grief, and significant correlations were established with existing instruments. The instrument demonstrated excellent internal consistency reliability and good construct validity. The MM-CGI Cerebral Palsy could be useful for diagnosing anticipatory grief among parents of children with cerebral palsy. This preliminary work moves the programme on to testing in intervention studies. In the absence of an existing measure for the assessment of anticipatory grief, specifically in parents of children with cerebral palsy, the MM-CGI Cerebral Palsy could prove to be an effective assessment tool for clinicians and researchers. © 2013 John Wiley

Evaluating Referral, Screening, and Assessment Procedures for Middle School Trauma/Grief-Focused Treatment Groups

Science.gov (United States)

Grassetti, Stevie N.; Williamson, Ariel A.; Herres, Joanna; Kobak, Roger; Layne, Christopher M.; Kaplow, Julie B.; Pynoos, Robert S.

2018-01-01

There is a need to delineate best practices for referring, assessing, and retaining students suspected of posttraumatic stress (PTS) and maladaptive grief (MG) in school-based treatment. Evidence-based risk-screening procedures should accurately include students who are appropriate for group treatment and exclude students who do not require…

Freedom of Expression, Deliberation, Autonomy, and Respect

DEFF Research Database (Denmark)

Rostbøll, Christian Fogh

for freedom of expression in terms of its relationship to different dimensions of autonomy. In response to the objection that Enlightenment theories pose a threat to cultures that reject autonomy, it is argued that autonomy-based democracy is not only compatible with but necessary for respect for cultural......The strongest versions of the democracy argument for freedom of expression rely on the deliberative conception of democracy. Deliberative democracy entails both an ideal of political autonomy and of autonomous preference formation. This paper elaborates the deliberative democracy argument...... diversity. On the basis of an intersubjective epistemology, I argue that citizens cannot know how to live on mutually respectful terms without engaging in public deliberation. Moreover, to be successful deliberation must foster some degree of personal autonomy, at least the ability to distinguish what...

In the public interest: assessing expert and stakeholder influence in public deliberation about biobanks.

Science.gov (United States)

MacLean, Samantha; Burgess, Michael M

2010-07-01

Providing technical and experiential information without overwhelming participants' perspectives presents a major challenge to public involvement in policy decisions. This article reports the design and analysis of a case study on incorporating expert and stakeholder knowledge without including them as deliberators, while supporting deliberative participants' ability to introduce and critically assess different perspectives. Analysis of audio-recorded deliberations illustrates how expert and stakeholder knowledge was cited, criticized and incorporated into deliberations. In conclusion, separating experts and stakeholders from deliberations may be an important prima facie principle when the goal is to enhance citizen representation on technical issues and related policy.

Developing a Blended Course on Dying, Loss, and Grief

Science.gov (United States)

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

Using deliberation to address controversial issues: Developing Holocaust education curriculum.

Directory of Open Access Journals (Sweden)

THOMAS MISCO

2007-10-01

Full Text Available This paper explores how a cross-cultural project responded to the need for new Holocaust educational materials for the Republic of Latvia through the method of curriculum deliberation. Analysis of interview, observational, and document data drawn from seven curriculum writers and numerous project members suggest that curriculum deliberation helped awaken a controversial and silenced history while attending to a wide range of needs and concerns for a variety of stakeholders. The findings highlight structural features that empowered the curriculum writers as they engaged in protracted rumination, reflected upon competing norms, and considered the nuances of the curriculum problem in relation to implementation. Understanding the process, challenges, and promises of cross-cultural curriculum deliberation holds significance for educators, curricularists, and educational researchers wishing to advance teaching and learning within silenced histories and controversial issues.

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

Science.gov (United States)

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.…

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

Science.gov (United States)

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…

Aristotle on Deliberation:Its Place in Ethics, Politics and Rhetoric

OpenAIRE

Kock, Christian Erik J

2014-01-01

Aristotle differs from most later philosophers in distinguishing clearly between epistemic reasoning, which aims for truth, and practical reasoning, which does not. How can he posit this distinction and yet not dismiss practical reasoning as flattery and manipulation, as Plato did? The answer lies in the concepts of deliberation (boulē, bouleusis) and deliberate choice (proairesis). They link Aristotle's rhetoric, ethics, and politics together and help provide definitions of all three: Ethics...

Grief rumination mediates the association between self-compassion and psychopathology in relatives of missing persons

NARCIS (Netherlands)

Lenferink, Lonneke; Eisma, Maarten; de Keijser, Jos; Boelen, P.A.

2017-01-01

Background The disappearance of a loved one is a unique type of loss, also termed “ambiguous loss”, which may heighten the risk for developing prolonged grief (PG), depression, and posttraumatic stress (PTS) symptoms. Little is known about protective and risk factors for psychopathology among

How deliberation makes better citizens

DEFF Research Database (Denmark)

Hansen, Kasper Møller; Normann Andersen, Vibeke

2007-01-01

This article presents results from a Danish national Deliberative Poll on the single European currency. A representative sample of 364 Danish citizens assembled to deliberate on Denmark's participation in the single currency. As a quasi-experiment, the Deliberative Poll is an example of deliberat...... emphasizes the need for further elaboration of the theory of deliberative democracy so that it better reflects these features of ‘real-life' politics....

Neural basis of moral verdict and moral deliberation

Science.gov (United States)

Borg, Jana Schaich; Sinnott-Armstrong, Walter; Calhoun, Vince D.; Kiehl, Kent A.

2011-01-01

How people judge something to be morally right or wrong is a fundamental question of both the sciences and the humanities. Here we aim to identify the neural processes that underlie the specific conclusion that something is morally wrong. To do this, we introduce a novel distinction between “moral deliberation,” or the weighing of moral considerations, and the formation of a “moral verdict,” or the commitment to one moral conclusion. We predict and identify hemodynamic activity in the bilateral anterior insula and basal ganglia that correlates with committing to the moral verdict “this is morally wrong” as opposed to “this is morally not wrong,” a finding that is consistent with research from economic decision-making. Using comparisons of deliberation-locked vs. verdict-locked analyses, we also demonstrate that hemodynamic activity in high-level cortical regions previously implicated in morality—including the ventromedial prefrontal cortex, posterior cingulate, and temporoparietal junction—correlates primarily with moral deliberation as opposed to moral verdicts. These findings provide new insights into what types of processes comprise the enterprise of moral judgment, and in doing so point to a framework for resolving why some clinical patients, including psychopaths, may have intact moral judgment but impaired moral behavior. PMID:21590588

Feelings of loss and grief in parents of children diagnosed with autism spectrum disorder (ASD).

Science.gov (United States)

Fernańdez-Alcántara, Manuel; García-Caro, M Paz; Pérez-Marfil, M Nieves; Hueso-Montoro, Cesar; Laynez-Rubio, Carolina; Cruz-Quintana, Francisco

2016-08-01

Various authors have reported feelings of loss and grief in parents of children with autism spectrum disorder. However, no previous studies have investigated the structure of these feelings. To analyze in depth the feelings of loss in parents of children diagnosed with autism spectrum disorder. A qualitative study was conducted based on grounded theory. Twenty parents participated through purposive sampling. Semi-structured interviews were conducted, asking about different emotional aspects of the upbringing of a child with autism spectrum disorder. Atlas.ti 6.2 program was used for open, axial, and selective coding. The core category that explained the feelings of these parents was unexpected child loss, associated with shock, negation, fear, guilt, anger, and/or sadness. Two processes were identified, one associated with the resolution of grief and the other with obstacles to overcoming it. Feelings of loss play an important role in explaining the complex emotions experienced by these parents. Different intervention strategies are proposed. Copyright © 2016 Elsevier Ltd. All rights reserved.

A longitudinal study of the grief of mothers and fathers of children with intellectual disability.

Science.gov (United States)

Bruce, E J; Schultz, C L; Smyrnios, K X

1996-03-01

As a follow-up to a single-point-in-time study which suggested support for the proposition that grieving is an ongoing feature of parenting children with intellectual disability, the present investigation reports findings based on annual interviews conducted over a three-year period. Longitudinal outcomes on measures used to define grief largely confirmed the original findings. Of particular interest were (a) indications of the presence of grief over time (b) the finding that the 49 mothers and 49 fathers report similar intensity of continued wishing for what might have been, and (c) the conclusion that the responses of the mothers on the Impact of Event Scale and to current levels of distress when thinking about time of diagnoses are significantly more intense than those of the fathers. Attention is drawn to patterns emerging from gender-related differences. Resulted are discussed within the framework of four mandates for research and practice, with particular reference to psycho-educational support through groupwork.

A Cognitive Attachment Model of prolonged grief: integrating attachments, memory, and identity.

Science.gov (United States)

Maccallum, Fiona; Bryant, Richard A

2013-08-01

Prolonged grief (PG), otherwise known as complicated grief, has attracted much attention in recent years as a potentially debilitating condition that affects approximately 10% of bereaved people. We propose a model of PG that integrates processes of attachment, self-identity, and autobiographical memory. The paper commences with a discussion of the PG construct and reviews current evidence regarding the distinctiveness of PG from other bereavement related-outcomes. We then review the evidence regarding the dysfunctional attachments, appraisals, and coping styles that people with PG display. Recent evidence pertaining to the patterns of autobiographical memory in PG is described in the context of the self-memory system. This system provides a unifying framework to understand the roles of personal memories, identity, attachments, and coping responses in PG. The proposed model places emphasis on how one's sense of identity influences yearning, memories of the deceased, appraisals, and coping strategies, to maintain a focus on the loss. The model is discussed in relation to existing models of PG. The potential for shaping treatment strategies to shift perceptions of the self is then outlined. Finally, we outline future directions to test propositions stemming from the model and enhance our understanding of the mechanisms underlying PG. Copyright © 2013 Elsevier Ltd. All rights reserved.

From grief, guilt pain and stigma to hope and pride - a systematic review and meta-analysis of mixed-method research of the psychosocial impact of stillbirth.

Science.gov (United States)

Burden, Christy; Bradley, Stephanie; Storey, Claire; Ellis, Alison; Heazell, Alexander E P; Downe, Soo; Cacciatore, Joanne; Siassakos, Dimitrios

2016-01-19

Despite improvements in maternity healthcare services over the last few decades, more than 2.7 million babies worldwide are stillborn each year. The global health agenda is silent about stillbirth, perhaps, in part, because its wider impact has not been systematically analysed or understood before now across the world. Our study aimed to systematically review, evaluate and summarise the current evidence regarding the psychosocial impact of stillbirth to parents and their families, with the aim of improving guidance in bereavement care worldwide. Systematic review and meta-summary (quantitative aggregation of qualitative findings) of quantitative, qualitative, and mixed-methods studies. All languages and countries were included. Two thousand, six hundred and nineteen abstracts were identified; 144 studies were included. Frequency effect sizes (FES %) were calculated for each theme, as a measure of their prevalence in the literature. Themes ranged from negative psychological symptoms post bereavement (77 · 1) and in subsequent pregnancies (27 · 1), to disenfranchised grief (31 · 2), and incongruent grief (28 · 5), There was also impact on siblings (23 · 6) and on the wider family (2 · 8). They included mixed-feelings about decisions made when the baby died (12 · 5), avoidance of memories (13 · 2), anxiety over other children (7 · 6), chronic pain and fatigue (6 · 9), and a different approach to the use of healthcare services (6 · 9). Some themes were particularly prominent in studies of fathers; grief suppression (avoidance)(18 · 1), employment difficulties, financial debt (5 · 6), and increased substance use (4 · 2). Others found in studies specific to mothers included altered body image (3 · 5) and impact on quality of life (2 · 1). Counter-intuitively, Some themes had mixed connotations. These included parental pride in the baby (5 · 6), motivation for engagement in healthcare

Psychosocial therapy and causes of death after deliberate self-harm

DEFF Research Database (Denmark)

Birkbak, J; Stuart, E A; Lind, B D

2016-01-01

BACKGROUND: Psychosocial therapy after deliberate self-harm might be associated with reduced risk of specific causes of death. METHOD: In this matched cohort study, we included patients, who after an episode of deliberate self-harm received psychosocial therapy at a Suicide Prevention Clinic...... in Denmark between 1992 and 2010. We used propensity score matching in a 1:3 ratio to select a comparison group from 59 046 individuals who received standard care. National Danish registers supplied data on specific causes of death over a 20-year follow-up period. RESULTS: At the end of follow-up, 391 (6.......5-448.4) for mental or behavioural disorders as a cause of death, 111.1 (95% CI 79.2-210.5) for alcohol-related causes and 96.8 (95% CI 69.1-161.8) for other diseases and medical conditions. CONCLUSIONS: Our findings indicate that psychosocial therapy after deliberate self-harm might reduce long-term risk of death...

Sustainability and deliberate transition of socio-technical systems

DEFF Research Database (Denmark)

Hansen, Ole Erik; Søndergård, Bent; Stærdahl, Jens

or developing socio-technical systems in order to integrate the concept of sustainability as a driver for the deliberate and purposeful shaping and transition. The article discusses the requirements to effective governance networks and governing of governance networks. Research within innovation systems......The article suggests that deliberate planning for sustainability demands a focus on the transition of socio-technical systems in order to establish robust and more sustainable patterns of production and consumption. This implies the necessity of a new perspective for environmental planning......, transition management and technology systems combined with planning and experimental activities provides both a theoretical and empirical body of knowledge of such governance processes. The article discusses how this perspective can be used in relation to the process of developing bio-fuel systems...

"While you still think, I already type": experienced social power reduces deliberation during e-mail communication.

Science.gov (United States)

Scholl, Annika; Sassenberg, Kai

2014-11-01

E-mail allows individuals to deliberate on their communication before sending it off. For instance, communication partners can easily take their time to ponder how best to frame a request before they actually send a message. Individuals at times strategically exploit this opportunity to deliberate in order to tailor messages to their communication partner, such as when communicating with a relatively more powerful person. As social power reduces concerns about impression management, we predicted that individuals deliberate more while composing e-mail messages under low (vs. high) power. This assumption was tested with well-established power priming. As such, we expected that experienced power in one context would diminish deliberation times during a subsequent e-mail communication. An experiment manipulating the experience of (low vs. high) power and measuring deliberation times during e-mail composition supported this hypothesis. The findings thus indicate how social power alters deliberation times. More importantly, the results show that individuals not only strategically deliberate during e-mail communication in line with their current situation, but also in line with their social standing in a previous situation (here, their experience of power).

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

Science.gov (United States)

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…

Grief and mourning in schizophrenia.

Science.gov (United States)

Wittmann, Daniela; Keshavan, Matcheri

2007-01-01

Depression and suicidality after first episode of psychosis are well-documented responses in patients with schizophrenia (Addington, Williams, Young, & Addington, 2004). The understanding of depression and suicidality has been increasingly refined through careful study. Researchers have identified a number of factors that may cause depression such as insight into the illness, feelings of loss and inferiority about the illness as a damaging life event, hopelessness about having a viable future with the illness and mourning for losses engendered by the illness. The authors argue that grief and mourning are not just an occasional reaction to the diagnosis of schizophrenia, but are a necessary part of coming to terms with having the illness. They offer three case examples, each of which illuminates a distinct way in which psychosis and mourning may be related--psychosis as a loss of former identity, psychosis as offering meaning and transformation, and psychosis as a way of coping with the inability to mourn. In their view, recovery depends on mourning illness-related losses, developing personal meaning for the illness, and moving forward with "usable insight" and new identity (Lewis, 2004) that reflects a new understanding of one's strengths and limitations with the illness.

Cognitive-behavioural therapy for deliberate self-harm

NARCIS (Netherlands)

Slee, Nadja

2008-01-01

This thesis describes the outcomes of a randomized controlled trial of a Cognitive Behavioural Therapy (CBT) intervention for patients who engage in Deliberate Self-Harm (DSH). The CBT intervention was designed to supplement usual care following an episode of DSH. The study involved 90 people (95%

Research opportunities in simulation-based medical education using deliberate practice.

Science.gov (United States)

McGaghie, William C

2008-11-01

There are many opportunities for the academic emergency medicine (EM) community to engage in simulation-based educational research using deliberate practice (DP). This article begins by defining and giving examples of two key concepts: deliberate practice and mastery learning. The article proceeds to report six lessons learned from a research legacy in simulation-based medical education (SBME). It concludes by listing and amplifying 10 DP research opportunities in academic EM. A coda states that the research agenda is rich and ambitious and should focus on the goal of educating superb, expert clinicians.

Conscious thought beats deliberation without attention in diagnostic decision-making: at least when you are an expert.

Science.gov (United States)

Mamede, Sílvia; Schmidt, Henk G; Rikers, Remy M J P; Custers, Eugene J F M; Splinter, Ted A W; van Saase, Jan L C M

2010-11-01

Contrary to what common sense makes us believe, deliberation without attention has recently been suggested to produce better decisions in complex situations than deliberation with attention. Based on differences between cognitive processes of experts and novices, we hypothesized that experts make in fact better decisions after consciously thinking about complex problems whereas novices may benefit from deliberation-without-attention. These hypotheses were confirmed in a study among doctors and medical students. They diagnosed complex and routine problems under three conditions, an immediate-decision condition and two delayed conditions: conscious thought and deliberation-without-attention. Doctors did better with conscious deliberation when problems were complex, whereas reasoning mode did not matter in simple problems. In contrast, deliberation-without-attention improved novices' decisions, but only in simple problems. Experts benefit from consciously thinking about complex problems; for novices thinking does not help in those cases.

Deliberate practice and performance in music, games, sports, education, and professions: a meta-analysis.

Science.gov (United States)

Macnamara, Brooke N; Hambrick, David Z; Oswald, Frederick L

2014-08-01

More than 20 years ago, researchers proposed that individual differences in performance in such domains as music, sports, and games largely reflect individual differences in amount of deliberate practice, which was defined as engagement in structured activities created specifically to improve performance in a domain. This view is a frequent topic of popular-science writing-but is it supported by empirical evidence? To answer this question, we conducted a meta-analysis covering all major domains in which deliberate practice has been investigated. We found that deliberate practice explained 26% of the variance in performance for games, 21% for music, 18% for sports, 4% for education, and less than 1% for professions. We conclude that deliberate practice is important, but not as important as has been argued. © The Author(s) 2014.

Deliberate practice predicts performance over time in adolescent chess players and drop-outs: a linear mixed models analysis.

Science.gov (United States)

de Bruin, Anique B H; Smits, Niels; Rikers, Remy M J P; Schmidt, Henk G

2008-11-01

In this study, the longitudinal relation between deliberate practice and performance in chess was examined using a linear mixed models analysis. The practice activities and performance ratings of young elite chess players, who were either in, or had dropped out of the Dutch national chess training, were analysed since they had started playing chess seriously. The results revealed that deliberate practice (i.e. serious chess study alone and serious chess play) strongly contributed to chess performance. The influence of deliberate practice was not only observable in current performance, but also over chess players' careers. Moreover, although the drop-outs' chess ratings developed more slowly over time, both the persistent and drop-out chess players benefited to the same extent from investments in deliberate practice. Finally, the effect of gender on chess performance proved to be much smaller than the effect of deliberate practice. This study provides longitudinal support for the monotonic benefits assumption of deliberate practice, by showing that over chess players' careers, deliberate practice has a significant effect on performance, and to the same extent for chess players of different ultimate performance levels. The results of this study are not in line with critique raised against the deliberate practice theory that the factors deliberate practice and talent could be confounded.

How Adults With an Intellectual Disability Experience Bereavement and Grief: A Qualitative Exploration

OpenAIRE

McRitchie, Robyn; McKenzie, Karen; Quayle, Ethel; Harlin, Margaret; Neumann, Katja

2014-01-01

This qualitative study explored the lived experiences of bereavement of 13 adults with an intellectual disability and found that their experiences could be situated within the concept of disenfranchised grief. The latter mediated participants' meaning making of the grieving process illustrated in the themes of intra- and interpersonal bereavement experiences, core beliefs about life and death, level of inclusion, and maintaining a continuing relationship with the deceased. The results suggest...

Deliberate and Crisis Action Planning and Execution Segments Increment 2A (DCAPES Inc 2A)

Science.gov (United States)

2016-03-01

2016 Major Automated Information System Annual Report Deliberate and Crisis Action Planning and Execution Segments Increment 2A (DCAPES Inc 2A...Program Name Deliberate and Crisis Action Planning and Execution Segments Increment 2A (DCAPES Inc 2A) DoD Component Air Force Responsible Office Program...APB) dated March 9, 2015 DCAPES Inc 2A 2016 MAR UNCLASSIFIED 4 Program Description Deliberate and Crisis Action Planning and Execution Segments

Deliberate and Crisis Action Planning and Execution Segments Increment 2B (DCAPES Inc 2B)

Science.gov (United States)

2016-03-01

2016 Major Automated Information System Annual Report Deliberate and Crisis Action Planning and Execution Segments Increment 2B (DCAPES Inc 2B...Information Program Name Deliberate and Crisis Action Planning and Execution Segments Increment 2B (DCAPES Inc 2B) DoD Component Air Force Responsible Office...been established. DCAPES Inc 2B 2016 MAR UNCLASSIFIED 4 Program Description Deliberate and Crisis Action Planning and Execution Segments (DCAPES) is

FEASIBILITY AND EFFECTIVENESS OF DYADIC PROLONGED EXPOSURE INTERVENTION FOR PREVENTING POSTTRAUMATIC GRIEF IN YOUNG CHILDREN: A CASE REPORT OF TWO SIBLINGS.

Science.gov (United States)

Rachamim, Lilach

2017-09-01

This article highlights the feasibility of a dyadic prolonged exposure (DPE) intervention (L. Rachamim, I. Mirochnik, L. Helpman, N. Nacasch, & E. Yadin, ) in a 3-year-old preschooler and in a 6-year-old kindergartener immediately following the traumatic death of their younger sibling. It presents a detailed case description of the DPE treatment addressing traumatic grief and includes transcribed treatment dialogue. At the time of treatment termination, both children and caregivers resumed normal functioning. The results suggest that DPE intervention may ameliorate posttraumatic grief symptoms in young children. Controlled studies of preventive interventions for this population are clearly warranted. © 2017 Michigan Association for Infant Mental Health.

Non-Conscious vs. Deliberate Dynamic Decision-Making—A Pilot Experiment

Directory of Open Access Journals (Sweden)

Andreas Größler

2016-02-01

Full Text Available The purpose of this paper is to explore the effects of non-conscious vs. deliberate ways of making decisions in a dynamic decision-making task. An experimental setting is used to study this question; three experimental groups are distinguished: immediate decision-making (only very limited time for deliberate cognitive processing, considerate decision-making (relatively long time for deliberate cognitive processing, and distracted decision-making (time for non-conscious cognitive processing only. As experimental stimulus, a simulator based on the Kaibab Plateau model was employed. With a sample size of more than 100 experimental participants, group differences are not significant for most data examined. Implications comprise the formulation of a framework to guide further research. The value of this paper lies in the fact that it connects to a recent discussion in psychology and transfers it to a domain in the core interest of the system community: decision-making in situations with dynamic complexity. Furthermore, it offers a range of improvement points for potential follow-up studies.

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

Science.gov (United States)

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.

The influence of deliberate practice on musical achievement: A meta-analysis

Directory of Open Access Journals (Sweden)

Friedrich ePlatz

2014-06-01

Full Text Available Deliberate practice (DP is a task-specific structured training activity that plays a key role in understanding skill acquisition and explaining individual differences in expert performance. Relevant activities that qualify as DP have to be identified in every domain. For example, for training in classical music, solitary practice is a typical training activity during skill acquisition. To date, no meta-analysis on the quantifiable effect size of deliberate practice on attained performance in music has been conducted. Yet the identification of a quantifiable effect size could be relevant for the current discussion on the role of various factors on individual difference in musical achievement. Furthermore, a research synthesis might enable new computational approaches to musical development. Here we present the first meta-analysis on the role of deliberate practice in the domain of musical performance. A final sample size of 13 studies (total N = 788 was carefully extracted to satisfy the following criteria: reported durations of task-specific accumulated practice as predictor variables and objectively assessed musical achievement as the target variable. We identified an aggregated effect size of rc = .61; 95% CI [.54, .67] for the relationship between task-relevant practice (which by definition includes DP and musical achievement. Our results corroborate the central role of long-term (deliberate practice for explaining expert performance in music.

The prevalence of self-reported deliberate self harm in Irish adolescents.

LENUS (Irish Health Repository)

Morey, Carolyn

2008-01-01

BACKGROUND: Deliberate self harm is major public health problem, in particular among young people. Although several studies have addressed the prevalence of deliberate self harm among young people in the community, little is known about the extent to which deliberate self harm comes to the attention of medical services, the self harm methods used and the underlying motives. The aim of this study was to determine the prevalence of deliberate self harm in adolescents and the methods, motives and help seeking behaviour associated with this behaviour. METHODS: A cross-sectional survey using an anonymous self-report questionnaire was administered in 39 schools in the Southern area of the Health Service Executive, Ireland. Of the 4,583 adolescents aged 15-17 years who were invited to participate in the survey, 3,881 adolescents took part (response: 85%). RESULTS: A lifetime history of DSH was reported by 9.1% (n = 333) of the adolescents. DSH was more common among females (13.9%) than males (4.3%). Self cutting (66.0%) and overdose (35.2%) were the most common DSH methods. A minority of participants accessed medical services after engaging in DSH (15.3%). CONCLUSION: DSH is a significant problem in Irish adolescents and the vast majority do not come to the attention of health services. Innovative solutions for prevention and intervention are required to tackle DSH in adolescents.

The influence of deliberate practice on musical achievement: a meta-analysis.

Science.gov (United States)

Platz, Friedrich; Kopiez, Reinhard; Lehmann, Andreas C; Wolf, Anna

2014-01-01

Deliberate practice (DP) is a task-specific structured training activity that plays a key role in understanding skill acquisition and explaining individual differences in expert performance. Relevant activities that qualify as DP have to be identified in every domain. For example, for training in classical music, solitary practice is a typical training activity during skill acquisition. To date, no meta-analysis on the quantifiable effect size of deliberate practice on attained performance in music has been conducted. Yet the identification of a quantifiable effect size could be relevant for the current discussion on the role of various factors on individual difference in musical achievement. Furthermore, a research synthesis might enable new computational approaches to musical development. Here we present the first meta-analysis on the role of deliberate practice in the domain of musical performance. A final sample size of 13 studies (total N = 788) was carefully extracted to satisfy the following criteria: reported durations of task-specific accumulated practice as predictor variables and objectively assessed musical achievement as the target variable. We identified an aggregated effect size of r c = 0.61; 95% CI [0.54, 0.67] for the relationship between task-relevant practice (which by definition includes DP) and musical achievement. Our results corroborate the central role of long-term (deliberate) practice for explaining expert performance in music.

Informal and Deliberate Learning with New Technologies

Science.gov (United States)

Trinder, Ruth

2017-01-01

Due to the ready availability of new technologies, opportunities for the incidental as well as deliberate practice of English have multiplied and far exceed what can be done in more formal environments. Yet, despite the sizeable literature on the classroom-based use of specific digital resources, few studies have investigated how students evaluate…

A Qualitative Study on the Grief of People Who Lose Their Only Child: From the Perspective of Familism Culture

Directory of Open Access Journals (Sweden)

Yudi Zhang

2018-05-01

Full Text Available Shidu is the Chinese transliteration for ‘losing an only child,’ which indicates the death of the only child in the family. Shidu is a unique social phenomenon resulting from the One-Child Policy implemented in China for several decades. Shiduers are parents who have lost their only child. The grief research scholar Neimeyer (2012 argued that grief research should consider the role of different cultures in the grieving process. Familism culture is a collectivist culture that has a profound effect on Chinese society and is likely to produce a significant effect on the grieving process of shiduers; however, this effect has not yet received systematic attention in research. To explore the effect of familism culture on the grief of shiduers, we conducted semi-structured personal interviews in Beijing, China, with seven shiduers. The study results show that the effect of familism culture on the grief of shiduers includes three levels: cognition, emotion, and behavior. These levels are reflected in a variety of relationships, including relationships with ancestors, the deceased child, the spouse, relatives, Tong Ming Ren (the Chinese transliteration of ‘people who share the same fate’, and the country. The first four types of relationships are reflections of ‘direct familism culture,’ and the latter two types of relationships are reflections of ‘extended familism culture’. The relationships with the deceased child, relatives, and Tong Ming Ren are mainly supportive; the relationship with ancestors is mainly stressful; the relationship with the spouse has a dual nature; and the relationship with the country is contradictory. Over time, shiduers have abandoned the concept of familism culture and have moved toward reducing stress and increasing supportiveness. Psychological professionals, social workers, and government staff may refer to the results of this study to help shiduers obtain support and reduce stress from the described

John porter lecture: waves of protest--direct action, deliberation, and diffusion.

Science.gov (United States)

Wood, Lesley

2015-02-01

The book Direct Action, Deliberation and Diffusion: Collective Action After the WTO Protests in Seattle argues that the process of diffusion is dependent on social processes in the receiving context. The most important in social movements is an egalitarian and reflexive deliberation among diverse actors. The book traces the direct action tactics associated with the Seattle protests against the World Trade Organization in 1999 and how these spread to activists in Toronto and New York City. It shows how the structure of the political field, racial and class inequalities, identity boundaries, and organizational and conversational dynamics limited deliberation among activists, and thus limited the diffusion of the Seattle tactics. By constraining the spread of the Seattle tactics, this slowed the global justice movement's wave of protest. In this paper, I explore the application of and implications of this model of protest tactic diffusion to the recent Idle No More mobilizations. © 2015 Canadian Sociological Association/La Société canadienne de sociologie.

[Moral case deliberation: time for ethical reflection in the daily practice of mental health care].

Science.gov (United States)

Vellinga, A; van Melle-Baaijens, E A H

2016-01-01

Nowadays, reflecting on ethics, which we choose to call moral case deliberation, is occurring more and more frequently in psychiatric institutions. We have personal experience of organising and supervising moral case deliberation in a large psychiatric institute and we can confirm the positive effects of moral case deliberation which have been reported in the literature. To describe a structured method for moral case deliberation which enables care-givers in health care and/or addiction care to reflect on moral dilemmas. We refer to the main findings in relevant literature and describe how we developed a structured method for implementing moral case deliberation. Our studies of the literature indicate that systematic reflection about ethical dilemmas can improve the quality of care and make care-givers more satisfied with their work. This is why we have developed our own method which is applicable particularly to psychiatric and/or addition care and which can be used systematically in discussions of moral dilemmas. Our method for discussing ethical issues works well in clinical practice, particularly when it is embedded in a multidisciplinary context. Of course, to ensure the continuity of the system, deliberation about moral and ethical issues needs to be financially safeguarded and embedded in the organisation. Discussion of moral issues improves the quality of care and increases care-givers' satisfaction with their work.

Grief elaboration in families with handicapped member.

Science.gov (United States)

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.

Place and Situated Deliberation in Participatory Planning – A Research Proposal

DEFF Research Database (Denmark)

Korn, Matthias

2011-01-01

for everyone and everywhere through a mobile augmented reality application that visualizes future, planned buildings on capable mobile phones. I conclude with the central questions and problems for future research that focuses on place and situated deliberation.......Within the domain of participatory urban planning, this position paper argues for a focus on the notion of place in the design of mobile and/or ubiquitous systems that are used in deliberation processes with central spatial references. I discuss (1) leveraging properties of place as a resource...

Doctor coach: a deliberate practice approach to teaching and learning clinical skills.

Science.gov (United States)

Gifford, Kimberly A; Fall, Leslie H

2014-02-01

The rapidly evolving medical education landscape requires restructuring the approach to teaching and learning across the continuum of medical education. The deliberate practice strategies used to coach learners in disciplines beyond medicine can also be used to train medical learners. However, these deliberate practice strategies are not explicitly taught in most medical schools or residencies. The authors designed the Doctor Coach framework and competencies in 2007-2008 to serve as the foundation for new faculty development and resident-as-teacher programs. In addition to teaching deliberate practice strategies, the programs model a deliberate practice approach that promotes the continuous integration of newly developed coaching competencies by participants into their daily teaching practice. Early evaluation demonstrated the feasibility and efficacy of implementing the Doctor Coach framework across the continuum of medical education. Additionally, the Doctor Coach framework has been disseminated through national workshops, which have resulted in additional institutions applying the framework and competencies to develop their own coaching programs. Design of a multisource evaluation tool based on the coaching competencies will enable more rigorous study of the Doctor Coach framework and training programs and provide a richer feedback mechanism for participants. The framework will also facilitate the faculty development needed to implement the milestones and entrustable professional activities in medical education.

Deliberative Democracy, Critical Thinking, and the Deliberating Individual: empirical challenges to the reasonability of the citizen

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Juho Ritola

2015-01-01

Full Text Available In this essay, I first discuss the conditions set by theorists of democratic deliberation on proper deliberation. These conditions call for reasoned decisions from mutually acceptable premises. Next, I present the ideal of critical thinking that should guide the citizen in this deliberation. I then examine the empirical literature on human reasoning. Some research results in the empirical literature paint a bleak picture of human rationality: we fall victim to heuristics and biases, persevere in our beliefs in the face of contrary evidence, and justify our moral judgments by post hoc-reasoning. In addition, the deliberating groups have problems of their own. The groups may, for example, amplify errors or fall victim to information cascades.  Though these epistemically detrimental processes can be overcome, they do present a challenge to our rationality. The essay concludes by arguing that the empirical evidence in fact supports an internalistic approach to group deliberation, a claim challenged by Solomon (2006.

Vaginismus and dyspareunia: automatic vs. deliberate disgust responsivity.

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Borg, Charmaine; de Jong, Peter J; Schultz, Willibrord Weijmar

2010-06-01

The difficulty of penetration experienced in vaginismus and dyspareunia may at least partly be due to a disgust-induced defensive response. To examine if sex stimuli specifically elicit: (i) automatic disgust-related memory associations; (ii) physiological disgust responsivity; and/or (iii) deliberate expression of disgust/threat. Two single target Implicit Association Task (st-IAT) and electromyography (EMG) were conducted on three groups: vaginismus (N = 24), dyspareunia (N = 24), and control (N = 31) group. st-IAT, to index their initial disgust-related associations and facial EMG for the m. levator labii and m. corrugator supercilii regions. Both clinical groups showed enhanced automatic sex-disgust associations. As a unique physiological expression of disgust, the levator activity was specifically enhanced for the vaginismus group, when exposed to a women-friendly SEX video clip. Also at the deliberate level, specifically the vaginismus group showed enhanced subjective disgust toward SEX pictures and the SEX clip, along with higher threat responses. Supporting the view that disgust is involved in vaginismus and dyspareunia, for both, clinical groups' sex stimuli automatically elicited associations with disgust. Particularly for the vaginismus group, these initial disgust associations persisted during subsequent validation processes and were also evident at the level of facial expression and self-report data. Findings are consistent with the notion that uncontrollable activated associations are involved in eliciting defensive reactions at the prospect of penetration seen in both conditions. Whereas deliberate attitudes, usually linked with the desire for having intercourse, possibly generate the distinction (e.g., severity) between these two conditions.

Governance networks as a frame for inter-demoi participation and deliberation

DEFF Research Database (Denmark)

Sørensen, Eva

2012-01-01

By focusing exclusively on the contributions of political participation and deliberation to the enhancement of democratic regulation within a unitary democratic unit-that is, a demos-traditional liberal theories of democracy overlook the democratic value of political participation and deliberation...... between demoi. The need to find ways to increase the democratic quality of inter-demoi interaction is growing rapidly due to the emergence of a pluricentric political system in which cross-demoi decision-making is more the rule than the exception. There is an urgent call for new theories of democracy able...

Production-phase greenhouse gas emissions arising from deliberate withdrawal and destruction of fresh fruit and vegetables under the EU's Common Agricultural Policy.

Science.gov (United States)

Porter, Stephen D; Reay, David S; Bomberg, Elizabeth; Higgins, Peter

2018-08-01

Since 1962 the Common Agriculture Policy (CAP) of the European Union (EU) has enabled payment of subsidy to some food producers for withdrawal of specific commodities - including fresh fruit and vegetables (FFV) - where market prices have fallen below a pre-set level. These deliberate withdrawals have led to large amounts of usable food (~60% of withdrawals) being destroyed on farms across the EU. Such wasted food incurs a significant climate change cost through its production-phase greenhouse gas (GHG) emissions. Here, we assess the magnitude of this FFV withdrawal and destruction, its spatial and temporal trends, and its associated GHG emissions between 1989 and 2015. We find the total mass of avoidable FFV losses occurring as a result of these EU CAP market interventions for this 26-year period to be 23.6Mt. The production-phase GHG emissions associated with the withdrawn FFV that was subsequently destroyed amount to 5.1Mt CO 2 e over this period. We also find that, with each successive Common Market Organisation (CMO) reform there has been a marked reduction (~95% between 1989 and 2015) in the quantity of such deliberate withdrawals. Surprisingly, however, whilst the absolute quantity of FFV withdrawn and destroyed has fallen, the proportion of withdrawals that is destroyed remained roughly static at an average of about 60%. Finally, to inform debate on action needed to address FFV specifically, and food loss and waste more generally, we highlight potential scenarios and mechanisms to reduce withdrawals, avoid FFV destruction and improve alternative use of withdrawn food in the future. Copyright © 2018 Elsevier B.V. All rights reserved.

Duelo, amor y subjetividad en adolescentes. Grief, love and subjectivity in teenagers.

OpenAIRE

Gallo Acosta, Jairo; Muhete, Magnolia

2012-01-01

 Grief, love and subjectivity in teenagers.ResumenEl articulo presenta resultados de un proyecto hace parte de la línea de investigación Psicoanálisis y Campo social. Es una propuesta desde la teoría psicoanalítica, en donde se aborda el tema del duelo amoroso en adolescentes, tema relevante para identificar las representaciones de los adolescentes en este proceso, y donde la elaboración de un duelo puede ser un aspecto importante para sus vidas, por eso la importancia de analizar el duelo y ...

Grief Tourism on Destination Image Formation: Afyonkarahisar and Başkomutan National Historical Park

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Burhan KILIÇ

2011-06-01

Full Text Available The diversification of supply sources owned causes differences between destinations and special interest which is shaped for demand leads to become tourism widespread. In Turkey, there are many destinations where different features exist together. By means of alternative tourism types, various destinations and tourism types emerge. When all the events happened during the Independence War are considered in terms of national heritage, Afyonkarahisar is an important centre among grief tourism destinations. In research related to image components of Afyonkarahisar, confectionery, food products, and thermal tourism are the values of this destination that come to mind first. When the city is considered in terms of tourism, by highlighting the thermal tourism, the slogan “The Capital of Thermal Tourism” has been used. However it is hard to say that thermal tourism has a success taking the research into consideration. Therefore either other tourism values will be used to support the slogan available or with the work of a new image, a new image destination image will be created. The aim of this study is to eliminate the current negativity of Afyonkarahisar province’s destination image, strengthen the image and examine the availability of grief tourism which is one of the heritage tourism types so as to increase its market share

The control of deliberate waiting strategies in a stop-signal task

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R.P. Sylwan

2004-06-01

Full Text Available To inhibit an ongoing flow of thoughts or actions has been largely considered to be a crucial executive function, and the stop-signal paradigm makes inhibitory control measurable. Stop-signal tasks usually combine two concurrent tasks, i.e., manual responses to a primary task (go-task are occasionally countermanded by a stimulus which signals participants to inhibit their response in that trial (stop-task. Participants are always instructed not to wait for the stop-signal, since waiting strategies cause the response times to be unstable, invalidating the data. The aim of the present study was to experimentally control the strategies of waiting deliberately for the stop-signal in a stop-task by means of an algorithm that measured the variation in the reaction times to go-stimuli on-line, and displayed a warning legend urging participants to be faster when their reaction times were more than two standard deviations of the mean. Thirty-four university students performed a stop-task with go- and stop-stimuli, both of which were delivered in the visual modality and were lateralized within the visual field. The participants were divided into two groups (group A, without the algorithm, vs group B, with the algorithm. Group B exhibited lower variability of reaction times to go-stimuli, whereas no significant between-group differences were found in any of the measures of inhibitory control, showing that the algorithm succeeded in controlling the deliberate waiting strategies. Differences between deliberate and unintentional waiting strategies, and anxiety as a probable factor responsible for individual differences in deliberate waiting behavior, are discussed.

Public deliberation in municipal planning

DEFF Research Database (Denmark)

Bohøj, Morten; Borchorst, Nikolaj Gandrup; Bødker, Susanne

2011-01-01

This paper reports on an exploratory participatory design process aimed at supporting citizen deliberation in municipal planning. It presents the main outcomes of this process in terms of selected prototypes and an approach to the use setting. We support and discuss different ways for citizens...... to act and reflect on proposed plans: in-situ, while physically close to the planning object, and ex-situ, when citizens are remote from this. The support of in-situ and ex-situ participation allows citizens to engage in continuous reflection-in and on-action as a collaborative activity with other...

Seeking Deliberation on the Unborn in International Law

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SA de Freitas

2011-08-01

Full Text Available International human rights instruments and jurisprudence radiate an understanding of international law as also serving to protect fundamental rights and the interests of the individual. The idea that human rights provide a credible framework for constructing common norms among nations and across cultures is both powerful and attractive. If the protection of being human serves as the common denominator in human rights discussion, and if human rights are deeply inclusive, despite being culturally and historically diverse, then a failure to deliberate on the legal status and protection of the unborn may be seen as a failure to extend respect where it is due. Such deliberation is required, irrespective of the fact that jurisprudential debate on the unborn and on abortion is complex and controversial. The protection of human life, well-being, and dignity are essential aims of the United Nations Charter and the international system created to implement it. Although there have been collective efforts resulting in substantial development in international human rights law, the international community has not approached the legal status and protection of the unborn as a matter of urgency – this, while much has been accomplished regarding women, children, animals and cloning. This article therefore argues for the development of a deliberative framework so as to further the recognition (not necessarily in an absolute sense of the unborn in international law, bearing in mind that opposition to abortion does not of itself constitute an attack on a woman's right to respect for privacy in her life. The article also sets out what such deliberation on the legal status and protection of the unborn entails, against the background of a procedurally-rational approach.

Engaging Youth and Pre-Service Teachers in Immigration Deliberations

Science.gov (United States)

Daniel, Shannon M.

2015-01-01

In this report of innovative teacher practice, the author describes an arts-based event which brought together adolescent refugee and immigrant students and pre-service teachers to deliberate about immigration policies and attitudes in the United States.

Assessing the associations among trait and state levels of deliberate and spontaneous mind wandering.

Science.gov (United States)

Seli, Paul; Risko, Evan F; Smilek, Daniel

2016-04-01

Recent research has demonstrated that mind wandering can be subdivided into spontaneous and deliberate types, and this distinction has been found to hold at both the trait and state levels. However, to date, no attempts have been made to link trait-level spontaneous and deliberate mind wandering with state-level assessments of these two subtypes of mind wandering. Here we evaluated whether trait-level deliberate and spontaneous mind wandering map onto state levels of these subtypes of mind wandering. Results showed correspondence between trait-level reports of spontaneous and deliberate mind wandering and their state-level counterparts, indicating that people's reports on the intentionality of their mind wandering in the laboratory correspond to their reports of the intentionality of mind wandering in everyday life. Thus, the trait- and state-level scales of mind wandering were found to validate each other: Whereas the state-level measures provided some construct validity for the trait-level measures, the trait-level measures indicated that the state-level measures may be generalizable to everyday situations. Copyright © 2016 Elsevier Inc. All rights reserved.

Comparing group deliberation to other forms of preference aggregation in valuing ecosystem services

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Mackenzie B. Murphy

2017-12-01

Full Text Available Deliberative methods for valuing ecosystem services are hypothesized to yield group preferences that differ systematically from those that would be obtained through calculative aggregation of the preferences of participating individuals. We tested this hypothesis by comparing the group consensus results of structured deliberations against a variety of aggregation methods applied to individual participant preferences that were elicited both before and after the deliberations. Participants were also asked about their perceptions of the deliberative process, which we used to assess their ability to detect preference changes and identify the causes of any changes. For five of the seven groups tested, the group consensus results could not have been predicted from individual predeliberation preferences using any of the aggregation rules. However, individual postdeliberation preferences could be used to reconstruct the group preferences using consensual and rank-based aggregation rules. These results imply that the preferences of participants changed over the course of the deliberation and that the group preferences reflected a broad consensus on overall rankings rather than simply the pairwise preferences of the majority. Changes in individual preferences seem to have gone largely unnoticed by participants, as most stated that they did not believe their preferences had substantially changed. Most participants were satisfied with the outcome of the deliberation, and their degree of satisfaction was correlated with the feeling that their opinion was heard and that they had an influence on the outcome. Based on our results, group deliberation shows promise as a means of generating ecosystem service valuations that reflect a consensus opinion rather than simply a collection of personal preferences.

Teaching ethics in the clinic. The theory and practice of moral case deliberation.

Science.gov (United States)

Molewijk, A C; Abma, T; Stolper, M; Widdershoven, G

2008-02-01

A traditional approach to teaching medical ethics aims to provide knowledge about ethics. This is in line with an epistemological view on ethics in which moral expertise is assumed to be located in theoretical knowledge and not in the moral experience of healthcare professionals. The aim of this paper is to present an alternative, contextual approach to teaching ethics, which is grounded in a pragmatic-hermeneutical and dialogical ethics. This approach is called moral case deliberation. Within moral case deliberation, healthcare professionals bring in their actual moral questions during a structured dialogue. The ethicist facilitates the learning process by using various conversation methods in order to find answers to the case and to develop moral competencies. The case deliberations are not unique events, but are a structural part of the professional training on the work floor within healthcare institutions. This article presents the underlying theory on (teaching) ethics and illustrates this approach with an example of a moral case deliberation project in a Dutch psychiatric hospital. The project was evaluated using the method of responsive evaluation. This method provided us with rich information about the implementation process and effects the research process itself also lent support to the process of implementation.

Simulation-Based Mastery Learning with Deliberate Practice Improves Clinical Performance in Spinal Anesthesia

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Ankeet D. Udani

2014-01-01

Full Text Available Introduction. Properly performing a subarachnoid block (SAB is a competency expected of anesthesiology residents. We aimed to determine if adding simulation-based deliberate practice to a base curriculum improved performance of a SAB. Methods. 21 anesthesia residents were enrolled. After baseline assessment of SAB on a task-trainer, all residents participated in a base curriculum. Residents were then randomized so that half received additional deliberate practice including repetition and expert-guided, real-time feedback. All residents were then retested for technique. SABs on all residents’ next three patients were evaluated in the operating room (OR. Results. Before completing the base curriculum, the control group completed 81% of a 16-item performance checklist on the task-trainer and this increased to 91% after finishing the base curriculum (P<0.02. The intervention group also increased the percentage of checklist tasks properly completed from 73% to 98%, which was a greater increase than observed in the control group (P<0.03. The OR time required to perform SAB was not different between groups. Conclusions. The base curriculum significantly improved resident SAB performance. Deliberate practice training added a significant, independent, incremental benefit. The clinical impact of the deliberate practice intervention in the OR on patient care is unclear.

Simulation-based mastery learning with deliberate practice improves clinical performance in spinal anesthesia.

Science.gov (United States)

Udani, Ankeet D; Macario, Alex; Nandagopal, Kiruthiga; Tanaka, Maria A; Tanaka, Pedro P

2014-01-01

Introduction. Properly performing a subarachnoid block (SAB) is a competency expected of anesthesiology residents. We aimed to determine if adding simulation-based deliberate practice to a base curriculum improved performance of a SAB. Methods. 21 anesthesia residents were enrolled. After baseline assessment of SAB on a task-trainer, all residents participated in a base curriculum. Residents were then randomized so that half received additional deliberate practice including repetition and expert-guided, real-time feedback. All residents were then retested for technique. SABs on all residents' next three patients were evaluated in the operating room (OR). Results. Before completing the base curriculum, the control group completed 81% of a 16-item performance checklist on the task-trainer and this increased to 91% after finishing the base curriculum (P < 0.02). The intervention group also increased the percentage of checklist tasks properly completed from 73% to 98%, which was a greater increase than observed in the control group (P < 0.03). The OR time required to perform SAB was not different between groups. Conclusions. The base curriculum significantly improved resident SAB performance. Deliberate practice training added a significant, independent, incremental benefit. The clinical impact of the deliberate practice intervention in the OR on patient care is unclear.

Dewey's Theory of Moral (and Political) Deliberation Unfiltered

Science.gov (United States)

Ralston, Shane J.

2010-01-01

In this paper, I argue that many recent interpretations of John Dewey's vision of democracy distort that vision by filtering it through the prism of contemporary deliberative democratic theories. An earlier attempt to defend Dewey's theory of moral deliberation is instructive for understanding the nature and function of this filter. In James…

Tax Salience, Voting, and Deliberation

DEFF Research Database (Denmark)

Sausgruber, Rupert; Tyran, Jean-Robert

Tax incentives can be more or less salient, i.e. noticeable or cognitively easy to process. Our hypothesis is that taxes on consumers are more salient to consumers than equivalent taxes on sellers because consumers underestimate the extent of tax shifting in the market. We show that tax salience...... biases consumers' voting on tax regimes, and that experience is an effective de-biasing mechanism in the experimental laboratory. Pre-vote deliberation makes initially held opinions more extreme rather than correct and does not eliminate the bias in the typical committee. Yet, if voters can discuss...... their experience with the tax regimes they are less likely to be biased....

Online Public Deliberation in China

DEFF Research Database (Denmark)

Medaglia, Rony; Yang, Yang

2017-01-01

Internet discussion platforms in China provide a hugely interesting and relevant source for understanding dynamics of online discussions in a unique context. Adopting the theoretical lens of public deliberation, this paper investigates the evolution of patterns of similar-minded and different......-minded interactions over time on a Chinese online discussion forum. We analyse the content and reply networks of 18,000+ messages on four highly debated topics on the Bulletin Board System (BBS) platform Tianya. Findings provide nuanced evidence to the phenomenon of increased network homophily over time, mitigated...... investigation on independent variables for understanding dynamics of online discussions, and for studies comparing cases across different contexts....

Use of Facebook in the maternal grief process: An exploratory qualitative study.

Science.gov (United States)

Perluxo, Diana; Francisco, Rita

2018-02-01

This study seeks to explore the potential implications of Facebook use in the process of maternal grief. The participants were 11 women who had lost their children due to accidents or prolonged illness. Semistructured interviews were conducted and subjected to thematic analysis. The participants stated that they used Facebook to receive support, to identify with other mothers, to remember the child who died, to access the child's information, to honor him/her, and to express their feelings. The use of Facebook can play a very important role in the initial phase of grieving due to the functions of this social network.

Clinical correlates of complicated grief among individuals with acute coronary syndromes

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Pini S

2015-10-01

Full Text Available Stefano Pini,1 Camilla Gesi,1 Marianna Abelli,1 Alessandra Cardini,1 Lisa Lari,1 Francesca Felice,2 Rossella Di Stefano,2 Gianfranco Mazzotta,3 Francesco Bovenzi,4 Daniele Bertoli,5 Lucia Borelli,4 Paola Michi,1 Claudia Oligeri,3 Alberto Balbarini,2 Vijaya Manicavasagar6 1Department of Clinical and Experimental Medicine, Psychiatry Sector, University of Pisa, Pisa, 2Department of Surgical, Medical, Molecular and Critical Area Pathology, University of Pisa, Pisa, 3Unit of Cardiology, Ospedale Sant’Andrea, La Spezia, 4Cardio-Respiratory Department, Ospedale Campo di Marte, Lucca, 5Unit of Cardiology, Ospedale San Bartolomeo, Sarzana (SP, Italy; 6Black Dog Institute, University of New South Wales, Sydney, NSW, Australia Objective: The study aimed at exploring bereavement and complicated grief (CG symptoms among subjects without a history of coronary heart disease (CHD at the time of a first acute coronary syndrome (ACS and to evaluate the relationship of CG symptoms and ACS. Method: Overall, 149 subjects with ACS (namely, acute myocardial infarct with or without ST-segment elevation or unstable angina, with no previous history of CHD, admitted to three cardiac intensive care units were included and evaluated by the Structured Clinical Interview for Complicated Grief (SCI-CG, Hamilton Depression Rating Scale, Hamilton Anxiety Rating Scale, and the 36-item Short-Form Health Survey (MOS-SF-36. Results: Of the total sample of 149 subjects with ACS, 118 (79.2% met criteria for DSM-5 persistent complex bereavement disorder. Among these, subjects who lost a partner, child, or sibling were older (P=0.008, less likely to be working (P=0.032, and more likely to be suffering from hypertension (P=0.021, returned higher scores on the SCI-CG (P=0.001 and developed the index ACS more frequently between 12 and 48 months after the death than those who lost a parent or another relative (P≤0.0001. The occurrence of ACS 12–48 months (P=0.019 after the loss was

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

Science.gov (United States)

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,…

Longitudinal relationships between gratitude, deliberate rumination, and posttraumatic growth in adolescents following the Wenchuan earthquake in China.

Science.gov (United States)

Zhou, Xiao; Wu, Xinchun

2015-10-01

To examine the longitudinal relationship between gratitude, deliberate rumination and posttraumatic growth (PTG) in the adolescent survivors after the Wenchuan earthquake, 217 adolescent survivors were randomly selected from several primary and secondary schools in the county of Wenchuan, and were assessed by questionnaires at three and a half years (T1), four and a half years (T2), five and a half years (T3) after the Wenchuan earthquake, respectively. The results found that there was a one-way predictive relationship of gratitude onto PTG from T1 to T3, and gratitude predicted deliberate rumination from T1 to T2 but not T2 to T3. Deliberate rumination only had a significant positive effect on PTG from T2 to T3, and PTG only predicted deliberate rumination from T1 to T2. These results indicated that gratitude could be a stable predictive factor for the development of PTG, and gratitude could also affect PTG by deliberate rumination. In addition, the predictive effect between deliberate rumination and PTG is unstable with time change. © 2015 Scandinavian Psychological Associations and John Wiley & Sons Ltd.

ADAPTAÇÃO TRANSCULTURAL E EVIDÊNCIAS DE VALIDAÇÃO DA PERINATAL GRIEF SCALE

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Gisele Ferreira Paris

2017-01-01

Full Text Available Objetivo : realizar la adaptación transcultural y validación de pruebas de la Perinatal Grief Scale para el portugués Brasil y Canadá francés. Metodo : estudio metodológico, con aplicación de Escala de Duelo Perinatal desde el conjunto de procedimientos de adaptación transcultural. La populación fue compuesta por todas las mujeres que tuvieron óbito fetal en el año de 2013 vecinas en el municipio de Maringá-Brasil y participantes del Centre d’Études et de Recherche en Intervention Familiale en la Université du Québec en Outaouais - Canadá. Resultados : la escala en las versiones en portugués y francés demostró para ser confiable en las dos poblaciones. Coeficiente alfa de Cronbach de la escala aplicada en Brasil fue de 0,93 y aplicada en Canadá fue 0.94. Versión portuguesa, cuatro elementos no correlacionan con la escala total. Conclusión : la Perinatal Grief Scale puede utilizarse para identificar el estado de duelo en mujeres que tenían la muerte fetal, en su versión de cada país.

Making Stories and Taking Stories: Methodological Reflections on Researching Grief and Marital Tension following the Death of a Child.

Science.gov (United States)

Riches, Gordon; Dawson, Pam

1996-01-01

Explores some of the methodological issues which arose during an investigation into experiences of bereaved parents. Notes the values of ethnographic approaches in researching intimate and painful experiences and argues that parents' stories about their children's lives are central to processes of identity reconstruction during grief. (RJM)

Intuitive and Deliberate Judgments Are Based on Common Principles

Science.gov (United States)

Kruglanski, Arie W.; Gigerenzer, Gerd

2011-01-01

A popular distinction in cognitive and social psychology has been between "intuitive" and "deliberate" judgments. This juxtaposition has aligned in dual-process theories of reasoning associative, unconscious, effortless, heuristic, and suboptimal processes (assumed to foster intuitive judgments) versus rule-based, conscious, effortful, analytic,…

The role of emotions in moral case deliberation: theory, practice, and methodology.

Science.gov (United States)

Molewijk, Bert; Kleinlugtenbelt, Dick; Widdershoven, Guy

2011-09-01

In clinical moral decision making, emotions often play an important role. However, many clinical ethicists are ignorant, suspicious or even critical of the role of emotions in making moral decisions and in reflecting on them. This raises practical and theoretical questions about the understanding and use of emotions in clinical ethics support services. This paper presents an Aristotelian view on emotions and describes its application in the practice of moral case deliberation. According to Aristotle, emotions are an original and integral part of (virtue) ethics. Emotions are an inherent part of our moral reasoning and being, and therefore they should be an inherent part of any moral deliberation. Based on Aristotle's view, we examine five specific aspects of emotions: the description of emotions, the attitude towards emotions, the thoughts present in emotions, the reliability of emotions, and the reasonable principle that guides an emotion. We then discuss three ways of dealing with emotions in the process of moral case deliberation. Finally, we present an Aristotelian conversation method, and present practical experiences using this method. © 2011 Blackwell Publishing Ltd.

From Protest to Political Parties: Online Deliberation in New Parties in Spain

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Rosa Borge Bravo

2016-12-01

Full Text Available The new parties that emerged following the 15-M movement and against the austerity measures in Spain want to build parties open to the participation and deliberation for all the citizenry. To what extent are these ideals being fulfilled? The aim of this article is to describe and assess some of the main online deliberative processes of the two most important parties, Podemos and Barcelona En Comú, following commonly accepted criteria in the literature for measuring online deliberation. Specifically, we have examined the two most-voted proposals from the online platform Plaza Podemos and the online development of the electoral programme of Barcelona En Comú. Thus, we have conducted a content analysis of 713 (Plaza Podemos and 563 (Barcelona En Comú posts. Both platforms meet the structural and technical criteria for fostering deliberation, but the external impact is high only in the case of Barcelona En Comú. The deliberative quality of the communication is good but not the criteria of reflexivity, inclusion and plurality.

Aristotle’s contribution to the deliberation from a bioethical perspective

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Mario Orlando Parra-Pineda

2017-10-01

Full Text Available Deliberation is a basic rational human activity recognized since ancient times due to its role in decision making during daily life activities and in specialized areas of knowledge such as medicine, politics and ethics. The objective of this reflection paper is to study the contribution of Aristotle to the deliberative process through his work the Nicomachean Ethics, where the following aspects of deliberation were identified for analysis: origin, definition, characteristics, and types and conditions for its development. Bioethics defend these aspects, since it finds in Aristotelian phronesis the fundamental axis to guide its actions in search of human self-realization and the analysis and decision making of the clinical bioethical problems. Twenty-four centuries have passed until the importance of this process and the need to educate about it was finally rediscovered.

In search of online deliberation : Towards a new method for examining the quality of online discussions

NARCIS (Netherlands)

Graham, Todd; Witschge, Tamara

2003-01-01

Many advocates of deliberative democracy see in the Internet a new opportunity for the development of public spaces, public spheres, and places where deliberation can take place. An important element of the notion of the public sphere in general and of deliberation specifically, is the quality of

Alignment of the Kübler-Ross grief cycle phases with the process of adaptation to type 1 diabetes mellitus.

Science.gov (United States)

Isla Pera, Pilar; Moncho Vasallo, Joaquín; Guasch Andreu, Oscar; Torras Rabasa, Alberto

2008-02-01

To understand the process of adaptation to type 1 diabetes mellitus (DM1) and analyze its alignment with the grief cycle phases described by Kübler-Ross. We performed an ethnographic study through in-depth interviews with 20 patients, 10 relatives and 12 health professionals (6 physicians and 6 nurses). For the analysis, the Miles and Huberman qualitative data analysis model was used. Patients diagnosed with DM1 and their families face a loss of lifestyle and of the objects, real or imaginary, of their previous life. Patients and relatives experience emotional reactions that in some cases can be similar to the grief cycle phases described by Kübler-Ross for terminal diseases (denial, anger, bargaining, depression and acceptance). However, there are some differences depending on personal and psycho-social factors. Health professionals tend to relate low adherence to denial of the disease, but some patients feel threatened by the demands of treatment and control and their effects on their quality of life, and consciously choose not to follow recommendations. It is more realistic to talk about disease adaptation than acceptance, since the loss processes are ongoing and patients must reconstruct their identity according to their situation. The grief cycle also affects the family and may differ from that of the patient in its duration, intensity and assessment of problems. Adaptation is a complex process in which many variables intervene. There are observable differences among the mechanisms used by each specific individual. Healthcare professionals, and specifically nurses, should consider the multiple psycho-social dimensions of chronic disease. Copyright © 2008 Sociedad Española de Endocrinología y Nutrición. Published by Elsevier Espana. All rights reserved.

Examining the scope and patterns of deliberate self-injurious cutting content in popular social media.

Science.gov (United States)

Miguel, Elizabeth M; Chou, Tommy; Golik, Alejandra; Cornacchio, Danielle; Sanchez, Amanda L; DeSerisy, Mariah; Comer, Jonathan S

2017-09-01

Social networking services (SNS) have rapidly become a central platform for adolescents' social interactions and media consumption patterns. The present study examined a representative sample of publicly accessible content related to deliberate self-injurious cutting across three SNS platforms: Twitter, Tumblr, and Instagram. Data collection simulated searches for publicly available deliberate self-injury content on Twitter, Tumblr, and Instagram. Over a six-month period at randomly generated time points, data were obtained by searching "#cutting" on each SNS platform and collecting the first 10 posts generated. Independent evaluators coded posts for presence of the following: (a) graphic content, (b) negative self-evaluations, (c) references to mental health terms, (d) discouragement of deliberate self-injury, and (e) recovery-oriented resources. Differences across platforms were examined. Data collection yielded a sample of 1,155 public posts (770 of which were related to mental health). Roughly 60% of sampled posts depicted graphic content, almost half included negative self-evaluations, only 9.5% discouraged self-injury, and Instagram posts displayed the greatest proportion of graphic content and negative self-evaluations, whereas Twitter exhibited the smallest proportion of each. Findings characterize the graphic nature of online SNS deliberate self-injury content and the relative absence of SNS-posted resources for populations seeking out deliberate self-injurious cutting content. Mental health professionals must recognize the rapidly changing landscape of adolescent media consumption, influences, and social interaction as they may pertain to self-harm patterns. © 2017 Wiley Periodicals, Inc.

Deliberate Learning and Vocabulary Acquisition in a Second Language

Science.gov (United States)

Elgort, Irina

2011-01-01

This study investigates outcomes of deliberate learning on vocabulary acquisition in a second language (L2). Acquisition of 48 pseudowords was measured using the lexical decision task with visually presented stimuli. The experiments drew on form priming, masked repetition priming, and automatic semantic priming procedures. Data analyses revealed a…

Deliberation at the hub of medical education: beyond virtue ethics and codes of practice.

Science.gov (United States)

Barilan, Y M; Brusa, M

2013-02-01

Although both codes of practice and virtue ethics are integral to the ethos and history of "medical professionalism", the two trends appear mutually incompatible. Hence, in the first part of the paper we explore and explicate this apparent conflict and seek a direction for medical education. The theoretical and empirical literature indicates that moral deliberation may transcend the incompatibilities between the formal and the virtuous, may enhance moral and other aspects of personal sensitivity, may help design and improve other parts of the curricula, and may foster self-awareness and clarification of the professional role. Not only are these goals essential for good and conscientious doctoring, but they may also reduce physicians' "burn-out". We argue that medical education should focus on the ubiquitous practice of deliberation in contemporary medicine, and especially the practice of moral deliberation.

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

Science.gov (United States)

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…

Dewey's Ethical Justification for Public Deliberation Democracy

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Shook, John

2013-01-01

Interpretations of John Dewey's political theory grasp his respect for public deliberation, but typically overlook his ethical justification for democracy. Dewey gave two primary reasons why democracy is superior to other forms of government. First, a public educated in the tools of social intelligence can be more effective at managing their…

Reorienting Deliberation: Identity Politics in Multicultural Societies

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Rebecca Mason

2010-03-01

Full Text Available Many political theorists argue that cross-cultural communication within multicultural democracies is not best served by a commitment to identity politics. In response, I argue that identity politics only interfere with democratic participation according to an erroneous interpretation of the relationship between identity and reasoning. I argue that recognizing the importance of identity to the intelligibility of reasons offered in the context of civic deliberation is the first step towards the kind of dialogue that democratic participation requires.

Mourning and Grief on Facebook: An Examination of Motivations for Interacting With the Deceased.

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Willis, Erin; Ferrucci, Patrick

2017-12-01

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.

Helping nurses cope with grief and compassion fatigue: an educational intervention.

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Houck, Dereen

2014-08-01

Oncology nurses may experience intense physical and emotional exhaustion, identified in the literature as symptoms of cumulative grief and compassion fatigue, with significant consequences for both nurses and organizations. The first step in preventing these consequences is recognition. Organizations should provide nurses with resources including education, counseling, and opportunities to grieve. Nurses need to learn the importance of work-life balance, self-care strategies, and communication skills. Using recommendations from the literature, an educational intervention was designed with the purpose of providing nurses with knowledge, skills, and resources to practice effective self-care and recognize when assistance is needed. The program's objective was to help nurses develop the coping skills and inner resources necessary to maintain their emotional and physical health.

Suicide attempts by deliberate self-poisoning in children and adolescents

Czech Academy of Sciences Publication Activity Database

Zakharov, S.; Navrátil, Tomáš; Pelclová, D.

2013-01-01

Roč. 210, č. 1 (2013), s. 302-307 ISSN 0165-1781 Institutional support: RVO:61388955 Keywords : Deliberate suicidal self-poisoning * Suicide attempts in children and adolescents * Czech Toxicological Information Centre Subject RIV: CF - Physical ; Theoretical Chemistry Impact factor: 2.682, year: 2013

Enacting Ethics: Bottom-up Involvement in Implementing Moral Case Deliberation

NARCIS (Netherlands)

Weidema, F.C.; Molewijk, A.C.; Widdershoven, G.A.M.; Abma, T.A.

2012-01-01

In moral case deliberation (MCD), healthcare professionals meet to reflect upon their moral questions supported by a structured conversation method and non-directive conversation facilitator. An increasing number of Dutch healthcare institutions work with MCD to (1) deal with moral questions, (2)

Pragmatism, metaphysics, and bioethics: beyond a theory of moral deliberation.

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Pamental, Matthew

2013-12-01

Pragmatism has been understood by bioethicists as yet another rival in the "methods wars," as yet another theory of moral deliberation. This has led to criticism of pragmatic bioethics as both theoretically and practically inadequate. Pragmatists' responses to these objections have focused mainly on misunderstandings of pragmatism's epistemology. These responses are insufficient. Pragmatism's commitment to radical empiricism gives it theoretical resources unappreciated by critics and defenders alike. Radical empiricism, unlike its more traditional ancestors, undercuts the gaps between theory and practice, and subjective and objective accounts of experience, and in so doing provides the metaphysical and epistemological basis for a thoroughgoing empirical naturalism in ethics. Pragmatism's strength as an approach to moral problems thus emerges as a result of a much wider array of resources than contemporary interpreters have acknowledged, which makes it a richer, deeper framework for understanding moral deliberation in general and bioethical decision making in particular.

FCJ-160 Politics is Serious Business: Jacques Rancière, Griefing, and the Re-Partitioning of the (NonSensical

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Steve Holmes

2013-12-01

Full Text Available This article contextualises certain elements of ‘griefing’ as a form of political action in virtual world by drawing on the political philosophy of Jacques Rancière. A small but growing number of scholars are starting to view griefing as an avant-garde, anarchist, or hacktivist political activity. I suggest that Rancière offers a more specific articulation of what constitutes political action and activism for griefing collectives because his understanding of politics is entirely grounded in relationship to the types of communities and individual political equality. The article focuses specifically on the Patriotic Nigras activities in the Great Habbo Raid of 2006 in an attempt to understand how a Rancièreian framework can provide some analytical tools for articulating politics in virtual worlds. I conclude that the PN do not ultimately realise a Rancièreian framework. They challenge not partitions of the sensible, but partitions of the nonsensical specific to the different operation of politics and community formation in virtual worlds.

Deliberation before determination: the definition and evaluation of good decision making.

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Elwyn, Glyn; Miron-Shatz, Talya

2010-06-01

In this article, we examine definitions of suggested approaches to measure the concept of good decisions, highlight the ways in which they converge, and explain why we have concerns about their emphasis on post-hoc estimations and post-decisional outcomes, their prescriptive concept of knowledge, and their lack of distinction between the process of deliberation, and the act of decision determination. There has been a steady trend to involve patients in decision making tasks in clinical practice, part of a shift away from paternalism towards the concept of informed choice. An increased understanding of the uncertainties that exist in medicine, arising from a weak evidence base and, in addition, the stochastic nature of outcomes at the individual level, have contributed to shifting the responsibility for decision making from physicians to patients. This led to increasing use of decision support and communication methods, with the ultimate aim of improving decision making by patients. Interest has therefore developed in attempting to define good decision making and in the development of measurement approaches. We pose and reflect whether decisions can be judged good or not, and, if so, how this goodness might be evaluated. We hypothesize that decisions cannot be measured by reference to their outcomes and offer an alternative means of assessment, which emphasizes the deliberation process rather than the decision's end results. We propose decision making comprises a pre-decisional process and an act of decision determination and consider how this model of decision making serves to develop a new approach to evaluating what constitutes a good decision making process. We proceed to offer an alternative, which parses decisions into the pre-decisional deliberation process, the act of determination and post-decisional outcomes. Evaluating the deliberation process, we propose, should comprise of a subjective sufficiency of knowledge, as well as emotional processing and

Coping with losses, grief, and mourning in prostate cancer.

Science.gov (United States)

Wittmann, Daniela

2015-01-01

Prostate cancer is a highly prevalent disease with a high likelihood of survival. If treated, survivors live with significant and lasting treatment-related side effects. Surgical treatment is associated with urinary incontinence and erectile dysfunction, and radiation leads to urinary and bowel irritability as well as erectile dysfunction. Patients who undergo hormonal treatment cope with sexual dysfunction, bone density loss, hot flashes, mood symptoms, and cardiac and metabolic disorders. Functional losses have a significant impact on patients and their partners' quality of life and are associated with distress and psychosocial morbidity. Psychosocial treatment is largely unavailable in usual care, but has been shown to reduce distress, to increase positive reappraisal of the illness, and to contribute to the recovery of sexual intimacy. Treatment for grief and mourning, typical reactions to loss, has not been introduced into psychosocial interventions but is increasingly recognized as a path toward a 'new normal' after prostate cancer treatment. © 2015 S. Karger AG, Basel.

Detecting the Evolution of Deliberate Fertility Control before the Demographic Transition in Germany

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Aliaksandr Amialchuk

2012-10-01

Full Text Available BACKGROUND Pervious literature has established the existence of deliberate non-parity-specific fertility control in pre-transitional populations. However, less focus has been given to the timing of its onset. In addition, previous studies focused on the changes in fertility in response to the local prices of grains, which may be endogenous. OBJECTIVE This paper studies the emergence and evolution of deliberate fertility control by investigating the link between child mortality and economic stress on the one hand and non-parity-specific birth control on the other, in historic German villages between 1700 and 1900. METHODS Birth histories from fourteen German villages (1700-1900 and rye price series are used in a micro-level event history analysis. The fertility response of second and higher-order births to the mortality of children over age two and exogenous fluctuations in rye price are used as measures of the extent of deliberate non-parity-specific birth control. RESULTS Over the course of the demographic transition, the effect of the death of children generally increases after controlling for the effect of the death of children less than two years old. The negative fertility response to high rye prices before and in the year immediately following the price change occurred only after 1800. CONCLUSIONS The replacement and insurance effects associated with child mortality generally increased before the demographic transition. The emergence of the negative effect of high rye prices on fertility after 1800 further supports the presence and evolution of deliberate non-parity-specific fertility control before the demographic transition.

Client participation in moral case deliberation: a precarious relational balance

NARCIS (Netherlands)

Weidema, F.C.; Abma, T.A.; Widdershoven, G.A.M.; Molewijk, A.C.

2011-01-01

Moral case deliberation (MCD) is a form of clinical ethics support in which the ethicist as facilitator aims at supporting professionals with a structured moral inquiry into their moral issues from practice. Cases often affect clients, however, their inclusion in MCD is not common. Client

Cognitive and Contextual Correlates of Spontaneous and Deliberate Mind-Wandering

Science.gov (United States)

Robison, Matthew K.; Unsworth, Nash

2018-01-01

Individuals with greater cognitive abilities generally show reduced rates of mind-wandering when completing relatively demanding tasks (Randall, Oswald, & Beier, 2014). However, it is yet unclear whether elevated rates of mind-wandering among low-ability individuals are manifestations of deliberate, intentional episodes of mind-wandering…

Public Deliberation on Government-managed Social Media

DEFF Research Database (Denmark)

Medaglia, Rony; Zhu, Demi

2017-01-01

– characterised by exposure to different opinions, mutual understanding, and reasonableness – or hinder them, resulting in increased homophily and polarisation. Using the theoretical lens of public deliberation, this study investigates attitudinal and cognitive aspects of user conversations on government......-managed social media accounts. Drawing on a survey of 417 users of the Chinese social media platform Weibo, our findings show that interactions on social media are mostly non-dialogical and non-creative in nature, and characterised by homophily and polarisation, even though users perceive their interactions...

Speed or deliberation: a comparison of post-disaster recovery in Japan, Turkey, and Chile.

Science.gov (United States)

Platt, Stephen; So, Emily

2017-10-01

This paper compares recovery in the wake of three recent earthquakes: the Great East Japan Earthquake in March 2011; the Van earthquake in Turkey in October 2011; and the Maule earthquake in Chile in February 2010. The authors visited all three locations approximately 12-18 months after the incidents and interviewed earthquake specialists, disaster managers, urban planners, and local authorities. A key challenge to post-disaster recovery planning is balancing speed and deliberation. While affected communities must rebuild as quickly as possible, they must also seek to maximise the opportunities for improvement that disasters provide. The three case studies bring this dilemma into stark relief, as recovery was respectively slow, fast, and just right in the aftermath of the events: the Government of Japan adopted a deliberate approach to recovery and reconstruction; speed was of the essence in Turkey; and an effective balance between speed and deliberation was achieved in Chile. © 2017 The Author(s). Disasters © Overseas Development Institute, 2017.

Deliberate practice is necessary but not sufficient to explain individual differences in piano sight-reading skill: the role of working memory capacity.

Science.gov (United States)

Meinz, Elizabeth J; Hambrick, David Z

2010-07-01

Deliberate practice-that is, engagement in activities specifically designed to improve performance in a domain-is strongly predictive of performance in domains such as music and sports. It has even been suggested that deliberate practice is sufficient to account for expert performance. Less clear is whether basic abilities, such as working memory capacity (WMC), add to the prediction of expert performance, above and beyond deliberate practice. In evaluating participants having a wide range of piano-playing skill (novice to expert), we found that deliberate practice accounted for nearly half of the total variance in piano sight-reading performance. However, there was an incremental positive effect of WMC, and there was no evidence that deliberate practice reduced this effect. Evidence indicates that WMC is highly general, stable, and heritable, and thus our results call into question the view that expert performance is solely a reflection of deliberate practice.

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

Science.gov (United States)

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…

Teaching in Grief: Critical Reflections, Redefining Justice, and a Reorientation to Teaching

Directory of Open Access Journals (Sweden)

Heather Cherie Moore

2016-11-01

Full Text Available Since the creation of the #BlackLivesMatter movement, many scholars from historically underrepresented communities have revisited discourse on social movements. Many supporters of the #BlackLivesMatter movement are outsiders participating in solidarity with organizers across the globe.  But what happens when questions of police brutality and injustice adversely impact your family and your career? Using the self-narrative method and grief framework, the author describes her teaching transformation in a pilot Multicultural Education course immediately following the death of her cousin in police custody. The author describes how the terms injustice, action, and pedagogy changed over time and took on new meanings during an extended grieving period.

Short-term and long-term effects of psychosocial therapy for people after deliberate self-harm

DEFF Research Database (Denmark)

Erlangsen, Annette; Lind, Bertel Dam; Stuart, Elizabeth A

2015-01-01

BACKGROUND: Although deliberate self-harm is a strong predictor of suicide, evidence for effective interventions is missing. The aim of this study was to examine whether psychosocial therapy after self-harm was linked to lower risks of repeated self-harm, suicide, and general mortality. METHODS......: In this matched cohort study all people who, after deliberate self-harm, received a psychosocial therapy intervention at suicide prevention clinics in Denmark during 1992-2010 were compared with people who did not receive the psychosocial therapy intervention after deliberate self-harm. We applied propensity...... score matching with a 1:3 ratio and 31 matching factors, and calculated odds ratios for 1, 5, 10, and 20 years of follow-up. The primary endpoints were repeated self-harm, death by suicide, and death by any cause. FINDINGS: 5678 recipients of psychosocial therapy (followed up for 42·828 person...

Non-conscious vs. deliberate dynamic decision-making—a pilot experiment

NARCIS (Netherlands)

Grössler, A.; Rouwette, E.A.J.A.; Vennix, J.A.M.; Größler, A.

2016-01-01

The purpose of this paper is to explore the effects of non-conscious vs. deliberate ways of making decisions in a dynamic decision-making task. An experimental setting is used to study this question; three experimental groups are distinguished: immediate decision-making (only very limited time for

A Deliberate Practice Instructional Approach for Upper Division Physics Courses

Science.gov (United States)

Jones, David

2015-05-01

In upper division physics courses, an overarching educational goal is to have students think about and use the material much as a practicing physicist in the field does. Specifically, this would include knowledge (such as concepts, formalism, and instruments), approaches, and metacognitive skills that physicists use in solving ``typical'' (research context) problems to both understand and predict physical observations and accompanying models. Using an interactive instructional approach known as deliberate practice (described earlier in this session) we will discuss our work on how to provide students with the necessary practice and feedback to achieve these skills in a core DAMOP course of modern optics. We present the results of a direct and explicit comparison between this approach and traditional lecture-based instruction revealing evidence that a significant improvement of the students' mastery of these skills occurs when deliberate practice is employed. Our work was supported by the University of British Columbia through the CWSEI.

Deliberate self-harm before psychiatric admission and risk of suicide

DEFF Research Database (Denmark)

Madsen, Trine; Agerbo, Esben; Mortensen, Preben Bo

2013-01-01

Psychiatric illness and deliberate self-harm (DSH) are major risk factors of suicide. In largely 15 % of psychiatric admissions in Denmark, the patient had an episode of DSH within the last year before admission. This study examined the survival and predictors of suicide in a suicidal high...

Deliberate Self-Harm in Adolescence: A Challenge for Schools

Science.gov (United States)

Best, Ron

2006-01-01

Acts of deliberate self-harm (DSH) by adolescents are thought to be on the increase. Many of those who self-harm are of school age and it is to be expected that schools (and their teachers) will be aware of the problem and will respond appropriately as part of their pastoral-care provision. However, a recent survey of research in pastoral care and…

Evolutionizing Grief: Viewing Photographs of the Deceased Predicts the Misattribution of Ambiguous Stimuli by the Bereaved

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Claire White

2013-07-01

Full Text Available We propose a cognitive-evolutionary model of grief where the function of grief is to reunite a person with an absent partner where this is possible, and where it is not, to disengage and reorientate the individual from the lost agent. The present study investigates the potential factors that affect reunion-promoting symptoms by focusing on the misattribution of external stimuli to the deceased by the bereaved - which we term ‘false recognitions’. We propose three factors that relate to false recognitions: First, we propose that strong attachment to the deceased predisposes one to false recognitions; second, we predict that viewing photographs of the deceased (that were taken when the individual was alive perpetuates false recognitions; and third, we propose that time elapsing since the death diminishes the frequency of false recognitions. In a survey of 164 recently bereaved (<25 months pet owners in the U.S. and U.K., predictions concerning the association of the predictor and outcome variables were confirmed. The strongest predictor was the frequency of viewing photographic images of the deceased, a pattern consonant with our premise that, being evolutionarily novel, realistic photographs are treated as reliable cues that the agent remains a viable relationship partner. This research demonstrates the potential of evolutionary theory to inform mainstream bereavement research.

Adapting the coping in deliberation (CODE) framework: a multi-method approach in the context of familial ovarian cancer risk management.

Science.gov (United States)

Witt, Jana; Elwyn, Glyn; Wood, Fiona; Rogers, Mark T; Menon, Usha; Brain, Kate

2014-11-01

To test whether the coping in deliberation (CODE) framework can be adapted to a specific preference-sensitive medical decision: risk-reducing bilateral salpingo-oophorectomy (RRSO) in women at increased risk of ovarian cancer. We performed a systematic literature search to identify issues important to women during deliberations about RRSO. Three focus groups with patients (most were pre-menopausal and untested for genetic mutations) and 11 interviews with health professionals were conducted to determine which issues mattered in the UK context. Data were used to adapt the generic CODE framework. The literature search yielded 49 relevant studies, which highlighted various issues and coping options important during deliberations, including mutation status, risks of surgery, family obligations, physician recommendation, peer support and reliable information sources. Consultations with UK stakeholders confirmed most of these factors as pertinent influences on deliberations. Questions in the generic framework were adapted to reflect the issues and coping options identified. The generic CODE framework was readily adapted to a specific preference-sensitive medical decision, showing that deliberations and coping are linked during deliberations about RRSO. Adapted versions of the CODE framework may be used to develop tailored decision support methods and materials in order to improve patient-centred care. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Cooperation, Fast and Slow: Meta-Analytic Evidence for a Theory of Social Heuristics and Self-Interested Deliberation.

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Rand, David G

2016-09-01

Does cooperating require the inhibition of selfish urges? Or does "rational" self-interest constrain cooperative impulses? I investigated the role of intuition and deliberation in cooperation by meta-analyzing 67 studies in which cognitive-processing manipulations were applied to economic cooperation games (total N = 17,647; no indication of publication bias using Egger's test, Begg's test, or p-curve). My meta-analysis was guided by the social heuristics hypothesis, which proposes that intuition favors behavior that typically maximizes payoffs, whereas deliberation favors behavior that maximizes one's payoff in the current situation. Therefore, this theory predicts that deliberation will undermine pure cooperation (i.e., cooperation in settings where there are few future consequences for one's actions, such that cooperating is not in one's self-interest) but not strategic cooperation (i.e., cooperation in settings where cooperating can maximize one's payoff). As predicted, the meta-analysis revealed 17.3% more pure cooperation when intuition was promoted over deliberation, but no significant difference in strategic cooperation between more intuitive and more deliberative conditions. © The Author(s) 2016.

Peer sexual harassment and deliberate self-injury: longitudinal cross-lag investigations in Canada and Sweden.

Science.gov (United States)

Marshall, Sheila K; Faaborg-Andersen, Pernille; Tilton-Weaver, Lauree C; Stattin, Håkan

2013-12-01

Although the receipt of peer sexual harassment in schools has been linked to deliberate self-injury, the direction of association over time has not been tested. Two longitudinal studies examined whether receipt of peer sexual harassment within schools predicts engagement in deliberate self-injury or vice versa. Differences between boys and girls were also tested. Surveys were conducted in two countries, Canada and Sweden. Measures of sexual harassment and deliberate self-injury were administered yearly in classrooms. Two waves of data were collected in the Canadian study (N = 161, 59.6% girls, mean age = 13.82 years); three waves of data were collected in Sweden (N = 513, 47% girls, mean age = 13.23 years). In the Canadian study, deliberate self-injury predicted subsequent peer sexual harassment; the converse relationship was not significant. No significant gender differences were found. Across the three waves of the Swedish study, peer sexual harassment predicted self-injury from T1 to T2, and self-injury predicted peer sexual harassment from T2 to T3. However, self-injury did not mediate peer sexual harassment at T1 and T3. Tests of gender differences revealed self-injury predicted sexual harassment from T2 to T3 among Swedish girls but not boys. Adolescents who deliberately self-injure may be vulnerable to sexual harassment by peers at school. Cultural norms may have a role in whether this process applies primarily to girls or to both genders. Sexual harassment by peers may also increase self-injury, but this is not subsequently linked to increases in receipt of sexual harassment. Copyright © 2013 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Motive Matters! An exploration of the notion ‘deliberate breach of contract’ and its consequences for the application of remedies

OpenAIRE

Kogelenberg, Martijn

2012-01-01

textabstractThis thesis explores the notion of deliberate breach of contract and its potential remedial consequences. In the major jurisdictions in Europe and in the United States the notion of deliberate breach of contract is generally not coherently and officially defined and acknowledged as an independent legal phenomenon. The ultimate added value of this thesis intends to be a first coherent comparative research on deliberate breach of contract and its potential consequences for the core ...

OA57 The digitalisation of dying, loss and grief on social media channels.

Science.gov (United States)

Taubert, Mark; Norris, James

2015-04-01

The internet and birth of social media channels have changed the way in which we deal with death, loss and grief forever. Our photo albums are now saved digitally and shared on Facebook. Our private thoughts are now relayed on Twitter. Each year we spend more of our lives online, this workshop will address what happens as we approach death and when we switch off. After building a relationship digitally they recently presented together at the Macmillan Primary Care Conference on the subject 'Can we Palliate Social media'. The outcome of the workshop can be viewed below: 'Can we Palliate Social Media' workshop (about) - http://deadsocial.org/blog/222-macmillan-primary-care-conference BMJ review/results of workshop - http://blogs.bmj.com/spcare/2014/12/04/palliating-social-media-a-seminar-workshop-at-the-macmillan-professionals-conference-in-london/ We will highlight how the digital landscape has changed to help evoke thought and discussion around the subject of digitising death. They will explore the ethical and moral questions regarding end of life within the digital context. The role of the HCP will be examined in relation to social media and patient practice. All attendees will be provided with a number of simple tasks to carryout online. This will again provide a better understanding around the conversations that are occurring online and the digitisation of death. An interactive 40 min workshop will be directed by us. This will conclude with a 20-minute discussion. Leaflets containing relevant tasks for HCPs to carryout online can be carried out after the workshop. Understanding of the main social and digital channels that we (in the UK) use today. Understanding of how online channels have changed how we communicate and behave. The different ways grieving, remembering and mourning occurs online How death, grief and loss is different online Examination of how social media is breaking down the notion of death Reflect on how could/should HCPs and EOL professionals

Organizing moral case deliberation experiences in two Dutch nursing homes

NARCIS (Netherlands)

van der Dam, S.; Abma, T.A.; Molewijk, A.C.; Kardol, M.J.M.; Schols, J.M.G.A.

2011-01-01

Moral case deliberation (MCD) is a specific form of clinical ethics, aiming to stimulate ethical reflection in daily practice in order to improve the quality of care. This article focuses on the implementation of MCD in nursing homes and the questions how and where to organize MCD. The purpose of

Del dolor al duelo: límites al anhelo frente a la desaparición forzada. // From the bereavement to the grief: limits to the yearning faced with the frorced dissapearance.

Directory of Open Access Journals (Sweden)

Victoria Eugenia Diaz.

2008-12-01

Full Text Available This article develops the research question about the logic of the grief process when a subject lost is caused by forced disappearance of a loved one. Even though the study of the sources allows to state that the common response to this event is a suspended bereavement, research results allow to propose that there are collective -justice and ritual and individual –grief act- mechanisms which can contribute for a subject to overcome the obstacles and to begin grief resolution. In order to come to this conclusion, the concepts of grief work, reality test, bereavement, and act are discussed to be able to state that the grief for the disappearance does not depend on the reunion with the lost object, nor on the find of a corpse, but on a change of the subject/object relationship where this latter is psychically assumed as radically lost. // El artículo desarrolla la pregunta de investigación en torno a la lógica del proceso de duelo cuando la pérdida de un sujeto es causada por la desaparición forzada de un ser amado. Si bien el estudio de las fuentes permite afirmar que la respuesta común a este evento es la de un dolor suspendido, los resultados de la investigación permiten proponer que existen mecanismo colectivos —la justicia y el ritual— y particulares —el acto de duelo— que pueden contribuir a que un sujeto movilice los obstáculos e inicie la elaboración de su duelo. Se discuten, para llegar a esta conclusión, las nociones de trabajo de duelo, de prueba de realidad, de dolor y de acto, para llegar a afirmar que el duelo por la desaparición no depende del reencuentro con el objeto perdido, ni siquiera bajo la forma de hallazgo del cadáver, sino de un cambio en la relación del sujeto con el objeto donde se instaure psíquicamente este último como radicalmente perdido.

The significance of internet communication in public deliberation:

OpenAIRE

Rasmussen, Terje

2009-01-01

The article addresses recent structural changes in the public sphere related to media as platforms for debate and deliberation. New media platforms for communication lead to changes in the communication structure itself. This can easily be seen in the differentiation processes of the public sphere that is now taking place: The differentiation of topics, styles and actors is an astonishing phenomenon, is constantly a topic of debate in itself, often labelled as both decay and democratisation. ...

The Quality of Deliberation in Two Committees of the European Parliament: The Neglected Influence of the Situational Context and the Policymaking Stage

Directory of Open Access Journals (Sweden)

Léa Roger

2013-10-01

Full Text Available In our paper we try to answer two empirical research questions. First, we assess the deliberative quality of discussions in two committees of the EU Parliament. In order to do so, we use a slightly revised version of the DQI. Second, we identify and empirically measure those variables that systematically influence the quality of deliberation in interviews with debate actors. We argue that the quality of deliberation in EU committees is influenced by two normative values: deliberation (common good orientation and responsiveness (particular interest orientation, with the guiding value determined by the particular situation. Using a multidimensional concept of deliberation, we empirically test the impact of situational variables on specific aspects of deliberative quality. In addition, we take into account the temporal dimension of deliberation.

Deliberating about race as a variable in biomedical research | van ...

African Journals Online (AJOL)

Race as a variable in research ethics is investigated: to what extent is it morally appropriate to regard the race of research subjects as pivotal for research outcomes? The challenges it poses to deliberation in research ethics committees are considered, and it is concluded that race sometimes must be considered, subject to ...

From the shadows into the light: How pretrial publicity and deliberation affect mock jurors' decisions, impressions, and memory.

Science.gov (United States)

Ruva, Christine L; Guenther, Christina C

2015-06-01

This 2-part study explored how exposure to negative pretrial publicity (Neg-PTP) influences the jury process, as well as possible mechanisms responsible for its biasing effects on decisions. Study Part A explored how PTP and jury deliberations affect juror/jury verdicts, memory, and impressions of the defendant and attorneys. One week before viewing a criminal trial mock-jurors (N = 320 university students) were exposed to Neg-PTP or unrelated crime stories (No-PTP). Two days later deliberating jurors came to a group decision, whereas nondeliberating jurors completed an unrelated task before making an individual decision. Neg-PTP jurors were more likely to vote guilty, make memory errors, and rate the defendant lower in credibility. Deliberation reduced Neg-PTP jurors' memory accuracy and No-PTP jurors' guilty verdicts (leniency bias). Jurors' memory and ratings of the defendant and prosecuting attorney significantly mediated the effect of PTP on guilt ratings. Study Part B content analyzed 30 mock-jury deliberations and explored how PTP influenced deliberations and ultimately jury decisions. Neg-PTP juries were more likely than No-PTP juries to discuss ambiguous trial evidence in a proprosecution manner and less likely to discuss judicial instructions and lack of evidence. All Neg-PTP juries mentioned PTP, after instructed otherwise, and rarely corrected jury members who mentioned PTP. Discussion of ambiguous trial evidence in a proprosecution manner and lack of evidence significantly mediated the effect of PTP on jury-level guilt ratings. Together the findings suggest that judicial admonishments and deliberations may not be sufficient to reduce PTP bias, because of memory errors, biased impressions, and predecisional distortion. (c) 2015 APA, all rights reserved).

Personal Characteristics of Teachers, Situational Variables and Deliberations in Planning Instruction.

Science.gov (United States)

Kremer, Lya

This study reveals possible relationships among teachers' personality traits, situational variables, and deliberation characteristics in planning instruction. Dogmatism and locus of control perceptions were the personality traits studied, and the situations compared student teachers with elementary and secondary school teachers. Both groups were…

Public Deliberation as a Teaching Andragogy: Implications for Adult Student Learning from a Doctoral Higher Education Policy Course

Science.gov (United States)

Johnson, Matthew; Partlo, Margaret; Hullender, Tammy; Akanwa, Emmanuel; Burke, Heather; Todd, Jerry; Alwood, Christine

2014-01-01

Public deliberation provides an inclusive and robust mechanism for making shared decisions in community and political settings; however, its application to teaching and learning remains underutilized (McMillan & Harriger, 2007). This manuscript reports on a case study of the use of public deliberation as a teaching andragogy in a graduate…

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

Science.gov (United States)

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…

Exploring the Association of Deliberate Self-Harm With Emotional Relief Using a Novel Implicit Association Test

Science.gov (United States)

Gratz, Kim L.; Chapman, Alexander L.; Dixon-Gordon, Katherine L.; Tull, Matthew T.

2017-01-01

Despite the growing consensus that negative reinforcement in the form of emotional relief plays a key role in the maintenance of deliberate self-harm (DSH), most of the research in this area has relied exclusively on self-report measures of the perceived motives for and emotional consequences of DSH. Thus, the primary aim of this study was to extend extant research on the role of emotional relief in DSH by examining the strength of the association of DSH with emotional relief using a novel version of the Implicit Association Test (IAT). The strength of the DSH-relief association among both participants with (vs. without) DSH and self-harming participants with (vs. without) BPD, as well as its associations with relevant clinical constructs (including DSH characteristics, self-reported motives for DSH, BPD pathology, and emotion dysregulation and avoidance) were examined in a community sample of young adults (113 with recent recurrent DSH; 135 without DSH). As hypothesized, results revealed stronger associations between DSH and relief among participants with versus without DSH, as well as among DSH participants with versus without BPD. Moreover, the strength of the DSH-relief association was positively associated with DSH frequency and versatility (both lifetime and at 6-month follow-up), BPD pathology, emotion dysregulation, experiential avoidance, and self-reported emotion relief motives for DSH. Findings provide support for theories emphasizing the role of emotional relief in DSH (particularly among individuals with BPD), as well as the construct validity, predictive utility, and incremental validity (relative to self-reported emotion relief motives) of this IAT. PMID:26147069

ICU versus Non-ICU Hospital Death: Family Member Complicated Grief, Posttraumatic Stress, and Depressive Symptoms.

Science.gov (United States)

Probst, Danielle R; Gustin, Jillian L; Goodman, Lauren F; Lorenz, Amanda; Wells-Di Gregorio, Sharla M

2016-04-01

Family members of patients who die in an ICU are at increased risk of psychological sequelae compared to those who experience a death in hospice. This study explored differences in rates and levels of complicated grief (CG), posttraumatic stress disorder (PTSD), and depression between family members of patients who died in an ICU versus a non-ICU hospital setting. Differences in family members' most distressing experiences at the patient's end of life were also explored. The study was an observational cohort. Subjects were next of kin of 121 patients who died at a large, Midwestern academic hospital; 77 died in the ICU. Family members completed measures of CG, PTSD, depression, and end-of-life experiences. Participants were primarily Caucasian (93%, N = 111), female (81%, N = 98), spouses (60%, N = 73) of the decedent, and were an average of nine months post-bereavement. Forty percent of family members met the Inventory of Complicated Grief CG cut-off, 31% met the Impact of Events Scale-Revised PTSD cut-off, and 51% met the Center for Epidemiologic Studies Depression Scale depression cut-off. There were no significant differences in rates or levels of CG, PTSD, or depressive symptoms reported by family members between hospital settings. Several distressing experiences were ranked highly by both groups, but each setting presented unique distressing experiences for family members. Psychological distress of family members did not differ by hospital setting, but the most distressing experiences encountered at end of life in each setting highlight potentially unique interventions to reduce distress post-bereavement for family members.

To Think or Not to Think:The Effect of Cognitive Deliberation on the Influence of Injunctive Versus Descriptive Social Norms

NARCIS (Netherlands)

Melnyk, V.; Herpen, van E.; Fischer, A.R.H.; Trijp, van H.C.M.

2011-01-01

Consumers can process information containing social norms at different cognitive deliberation levels. This paper investigates the effect of cognitive deliberation for both descriptive and injunctive norms. The experimental study examines the consequences for attitudes and behavioral intentions of

Managers' views on and experiences with moral case deliberation in nursing teams

NARCIS (Netherlands)

Weidema, F.C.; Molewijk, A.C.; Kamsteeg, F.; Widdershoven, G.A.M.

2015-01-01

Aims: Providing management insights regarding moral case deliberation (MCD) from the experiential perspective of nursing managers. Background: MCD concerns systematic group-wise reflection on ethical issues. Attention to implementing MCD in health care is increasing, and managers' experiences

A biopsychosocial approach to sexual recovery after prostate cancer surgery: the role of grief and mourning.

Science.gov (United States)

Wittmann, Daniela; Foley, Sallie; Balon, Richard

2011-01-01

Erectile dysfunction is a common side-effect of prostate cancer surgery that causes men suffering and hinders their sexual recovery. There are studies that describe men's and partners' distress and couples' difficulties engaging in sexual recovery. A few studies show a short-term benefit of brief psycho-social interventions such as psychoeducation and counseling. However, there is no conceptual framework to guide psychosocial treatments. We propose a model of intervention in sexual recovery that incorporates grief and mourning as a gateway to new and satisfying sexuality after prostate cancer treatment.

[The influence of unreconciled grief in the family on the functioning and development of a child].

Science.gov (United States)

Janusz, Bernadetta; Drozdzowicz, Lucyna

2013-01-01

The aim of the work is to present the influence of unreconciled grief in a family for functioning and growth of a child. The paper is based on some examples of clinical work from the field of family therapy, where developmental problems of children followed their carer's inability to cope with death and bereavement. Presented cases from family therapy serve as examples of possible therapeutic interventions in such situations. They show examples of developmental disturbances and psychopathology of the child who stays in relationship with deeply bereaved intimates.

Deliberations of working group 3: stakeholders and the public: who are they?

International Nuclear Information System (INIS)

Webster, S.

2000-01-01

The working-group deliberations opened with a general discussion centred primarily around the issues introduced in the two papers presented that morning in plenary session: 'Who Are Stakeholders in Environmental Risk Decisions?' and 'Participation of Stakeholders in Waste Management Decisions: The German Experience'. In general, the interventions by the group were open and frank and adequately covered the key issues of the subject. This was followed by a presentation on the views and experience of the current siting debate in Sweden from the perspective of the regulatory bodies and a brief summary by the Chairman of the definition of the public in EU legislation and International Conventions. The majority of the working-group members contributed actively to the debate, and the discussions were conducted in an informal and open-minded manner. Hereinafter are the main observations made during the working group deliberations. (author)

Air Force Leadership Study: The Need for Deliberate Development

Science.gov (United States)

2012-02-01

Abraham Maslow , once the basic needs of survival and security are met, people concern themselves with higher needs like affection, be- longing, the...maintaining the data needed , and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of...Study: The Need for Deliberate Development 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d. PROJECT NUMBER 5e

The Cognitive-Miser Response Model: Testing for Intuitive and Deliberate Reasoning

Science.gov (United States)

Bockenholt, Ulf

2012-01-01

In a number of psychological studies, answers to reasoning vignettes have been shown to result from both intuitive and deliberate response processes. This paper utilizes a psychometric model to separate these two response tendencies. An experimental application shows that the proposed model facilitates the analysis of dual-process item responses…

Motive Matters! An exploration of the notion ‘deliberate breach of contract’ and its consequences for the application of remedies

NARCIS (Netherlands)

M. van Kogelenberg (Martijn)

2012-01-01

textabstractThis thesis explores the notion of deliberate breach of contract and its potential remedial consequences. In the major jurisdictions in Europe and in the United States the notion of deliberate breach of contract is generally not coherently and officially defined and acknowledged as an

Prevalence and characteristics of moral case deliberation in Dutch health care

NARCIS (Netherlands)

Dauwerse, L.; Stolper, M.M.; Widdershoven, G.; Molewijk, A.C.

2014-01-01

The attention for Moral case deliberation (MCD) has increased over the past years. Previous research on MCD is often written from the perspective of MCD experts or MCD participants and we lack a more distant view to the role of MCD in Dutch health care institutions in general. The purpose of this

Outcomes of moral case deliberation--the development of an evaluation instrument for clinical ethics support (the Euro-MCD).

Science.gov (United States)

Svantesson, Mia; Karlsson, Jan; Boitte, Pierre; Schildman, Jan; Dauwerse, Linda; Widdershoven, Guy; Pedersen, Reidar; Huisman, Martijn; Molewijk, Bert

2014-04-08

Clinical ethics support, in particular Moral Case Deliberation, aims to support health care providers to manage ethically difficult situations. However, there is a lack of evaluation instruments regarding outcomes of clinical ethics support in general and regarding Moral Case Deliberation (MCD) in particular. There also is a lack of clarity and consensuses regarding which MCD outcomes are beneficial. In addition, MCD outcomes might be context-sensitive. Against this background, there is a need for a standardised but flexible outcome evaluation instrument. The aim of this study was to develop a multi-contextual evaluation instrument measuring health care providers' experiences and perceived importance of outcomes of Moral Case Deliberation. A multi-item instrument for assessing outcomes of Moral Case Deliberation (MCD) was constructed through an iterative process, founded on a literature review and modified through a multistep review by ethicists and health care providers. The instrument measures perceived importance of outcomes before and after MCD, as well as experienced outcomes during MCD and in daily work. A purposeful sample of 86 European participants contributed to a Delphi panel and content validity testing. The Delphi panel (n = 13), consisting of ethicists and ethics researchers, participated in three Delphi-rounds. Health care providers (n = 73) participated in the content validity testing through 'think-aloud' interviews and a method using Content Validity Index. The development process resulted in the European Moral Case Deliberation Outcomes Instrument (Euro-MCD), which consists of two sections, one to be completed before a participant's first MCD and the other after completing multiple MCDs. The instrument contains a few open-ended questions and 26 specific items with a corresponding rating/response scale representing various MCD outcomes. The items were categorised into the following six domains: Enhanced emotional support, Enhanced

Outcomes of Moral Case Deliberation - the development of an evaluation instrument for clinical ethics support (the Euro-MCD)

Science.gov (United States)

2014-01-01

Background Clinical ethics support, in particular Moral Case Deliberation, aims to support health care providers to manage ethically difficult situations. However, there is a lack of evaluation instruments regarding outcomes of clinical ethics support in general and regarding Moral Case Deliberation (MCD) in particular. There also is a lack of clarity and consensuses regarding which MCD outcomes are beneficial. In addition, MCD outcomes might be context-sensitive. Against this background, there is a need for a standardised but flexible outcome evaluation instrument. The aim of this study was to develop a multi-contextual evaluation instrument measuring health care providers’ experiences and perceived importance of outcomes of Moral Case Deliberation. Methods A multi-item instrument for assessing outcomes of Moral Case Deliberation (MCD) was constructed through an iterative process, founded on a literature review and modified through a multistep review by ethicists and health care providers. The instrument measures perceived importance of outcomes before and after MCD, as well as experienced outcomes during MCD and in daily work. A purposeful sample of 86 European participants contributed to a Delphi panel and content validity testing. The Delphi panel (n = 13), consisting of ethicists and ethics researchers, participated in three Delphi-rounds. Health care providers (n = 73) participated in the content validity testing through ‘think-aloud’ interviews and a method using Content Validity Index. Results The development process resulted in the European Moral Case Deliberation Outcomes Instrument (Euro-MCD), which consists of two sections, one to be completed before a participant’s first MCD and the other after completing multiple MCDs. The instrument contains a few open-ended questions and 26 specific items with a corresponding rating/response scale representing various MCD outcomes. The items were categorised into the following six domains: Enhanced

Automatic and deliberate affective associations with sexual stimuli in women with lifelong vaginismus before and after therapist-aided exposure treatment.

Science.gov (United States)

Melles, Reinhilde J; ter Kuile, Moniek M; Dewitte, Marieke; van Lankveld, Jacques J D M; Brauer, Marieke; de Jong, Peter J

2014-03-01

The intense fear response to vaginal penetration in women with lifelong vaginismus, who have never been able to experience coitus, may reflect negative automatic and deliberate appraisals of vaginal penetration stimuli which might be modified by exposure treatment. The aim of this study is to examine whether (i) sexual stimuli elicit relatively strong automatic and deliberate threat associations in women with vaginismus, as well as relatively negative automatic and deliberate global affective associations, compared with symptom-free women; and (ii) these automatic and more deliberate attitudes can be modified by therapist-aided exposure treatment. A single target Implicit Association Test (st-IAT) was used to index automatic threat associations, and an Affective Simon Task (AST) to index global automatic affective associations. Participants were women with lifelong vaginismus (N = 68) and women without sexual problems (N = 70). The vaginismus group was randomly allocated to treatment (n = 34) and a waiting list control condition (n = 34). Indices of automatic threat were obtained by the st-IAT and automatic global affective associations by the AST, visual analogue scales (VAS) were used to assess deliberate appraisals of the sexual pictures (fear and global positive affect). More deliberate fear and less global positive affective associations with sexual stimuli were found in women with vaginismus. Following therapist-aided exposure treatment, the strength of fear was strongly reduced, whereas global positive affective associations were strengthened. Automatic associations did not differ between women with and without vaginismus and did not change following treatment. Relatively stronger negative (threat or global affect) associations with sexual stimuli in vaginismus appeared restricted to the deliberate level. Therapist-aided exposure treatment was effective in reducing subjective fear of sexual penetration stimuli and led to more global positive affective

From core belief challenge to posttraumatic growth in para sport athletes: moderated mediation by needs satisfaction and deliberate rumination.

Science.gov (United States)

Hammer, Chris; Podlog, Leslie; Wadey, Ross; Galli, Nick; Forber-Pratt, Anjali J; Newton, Maria

2018-04-25

To examine how deliberate rumination and psychological need satisfaction interact to facilitate posttraumatic growth for para sport athletes with acquired disability. Utilizing a sample of 70 para sport athletes, the hypothesized mediating role of deliberate rumination was examined via a simple mediation model. The interaction between needs satisfaction and deliberate rumination and their effect on posttraumatic growth was examined utilizing a moderated mediation procedure. Disruption to one's core beliefs was significantly associated with posttraumatic growth. This relationship, was in part, explained by the deliberate rumination engaged in soon after the trauma. Needs satisfaction, while a significant predictor of posttraumatic growth, did not moderate the indirect effect. Although deliberate rumination at both timeframes and needs satisfaction were independently associated with posttraumatic growth, they did not interact in the hypothesized manner to influence posttraumatic growth. There remains a need to better understand how the experience of posttraumatic growth is achieved amongst individuals with acquired disability, and the role that para sport may play in this process. Implications for rehabilitation The disruption to one's core beliefs caused by acquiring a physical disability is not only a natural experience but also a necessary antecedent to posttraumatic growth. As such, rehabilitation practitioners ought to normalize these types of challenges when working with individuals with acquired disability. Practitioners may help to facilitate growth outcomes by encouraging individuals to deliberately ruminate about their acquired disability. That is, practitioners can help those with acquired disability to seek meaning and understanding about their disability or the precipitating event. For those who struggle to deliberately ruminate in the immediate disability aftermath, practitioners may encourage para sport participation to potentially prompt constructive

Meaningful Communication Before Death, but Not Present at the Time of Death Itself, Is Associated With Better Outcomes on Measures of Depression and Complicated Grief Among Bereaved Family Members of Cancer Patients.

Science.gov (United States)

Otani, Hiroyuki; Yoshida, Saran; Morita, Tatsuya; Aoyama, Maho; Kizawa, Yoshiyuki; Shima, Yasuo; Tsuneto, Satoru; Miyashita, Mitsunori

2017-09-01

Few studies have explored the clinical significance of the family's presence or absence at the moment of a patient's death and meaningful communication (saying "goodbye") in terms of post-bereavement outcomes. To explore the potential association between the family's depression/complicated grief and their presence at the moment of a patient's death and the patient's communication with the family. A nationwide questionnaire survey was conducted on 965 family members of cancer patients who had died at palliative care units. More than 90% of family members wished to have been present at the moment of death (agree: 40%, n = 217; strongly agree: 51%, n = 280); 79% (n = 393) thereof were present. Families' presence at death was not significantly associated with the occurrence of depression and complicated grief, but the dying patient's ability to say "goodbye" to the family beforehand was (depression: adjusted odds rate, 0.42; 95% CI, 0.26-0.69 adjusted P = 0.001; complicated grief: adjusted odds rate, 0.53; 95% CI, 0.29-0.94 adjusted P = 0.009). Many families wished to be present at the moment of the patient's death; however, meaningful communication (saying "goodbye") between the patient and family members, and not their presence or absence itself, was associated with better outcomes on measures of depression or complicated grief. Health care professionals could consider promoting both mutual communication (relating to preparation for death) between family members and patients before imminent death, as well as the family's presence at the moment of death. Copyright © 2017 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

Deliberate release of genetically modified plants into the environment in Slovenia

Directory of Open Access Journals (Sweden)

Zlata LUTHAR

2015-11-01

Full Text Available Deliberate release of genetically modified higher plants (GMHPs into the environment in Slovenia is regulated by the Law on the Management of Genetically Modified Organisms (ZRGSO Ur. l. RS 23/2005 and 21/2010, III chapter. For each deliberate release of GMPs into the environment a license issued by the Ministry of Environment and Spatial Planning (MESP must be acquired. The application or notification should contain a very accurate and complex description of the GMP, of the field where it will be released and of wider surroundings or environment. The application consists of Annex 2 with accessories: 1. Part A (technical data for the authorization of deliberate GMP release into the environment; 2. Part B (environmental risk assessment; 3. Application summary in Slovenian and English language for the release of GMP into environment, which is transmitted to Brussels by MESP; 4. Extract from the Land Cadastre of the field to which the GMP will be released. The release procedure runs (till here under the above mentioned Law, which has been in place for several years and which clearly defines that it is possible to release GMP in Slovenia. In the case of GM rice in 2011, the law applied till the site selection of the experiment. Here, the law was not sufficiently taken into account. It was prevailed by the regulation of Farmland and Forest Fund of the Republic of Slovenia and municipal decision, which was stronger than the national law and prevented the cultivation of GM rice in an area that is legally suitable for release of GMO into the environment. Rice is not grown in Slovenia and does not have wild ancestors or close relatives with whom it might mate. Nearest area of cultivation is in neighboring Italy, which is from potentially selected location in Slovenia more than 70 km away.

Problem solving ability and repetition of deliberate self-harm: a multicentre study.

NARCIS (Netherlands)

McAuliffe, C.; Corcoran, P.; Keeley, H.S.; Arensman, E.; Bille Brahe, U.; de Leio, D.; Fekete, S.; Hawton, K.; Hjelmeland, H.; Kelleher, M.; Kerkhof, A.J.F.M.; Lonnqvist, J.; Michel, K.; Salander Renberg, E.; Schmidtke, A.; van Heeringen, K.; Wasserman, D.

2006-01-01

Background. While recent studies have found problem-solving impairments in individuals who engage in deliberate self-harm (DSH), few studies have examined repeaters and non-repeaters separately. The aim of the present study was to investigate whether specific types of problem-solving are associated

Adolescent Deliberate Self-Harm: Linkages to Emotion Regulation and Family Emotional Climate

Science.gov (United States)

Sim, Leslie; Adrian, Molly; Zeman, Janice; Cassano, Michael; Friedrich, William N.

2009-01-01

Parents' responses to their children's emotional expressivity have been shown to significantly influence children's subsequent psychosocial functioning. This study hypothesized that adolescents' deliberate self-harm (DSH) may be an outcome associated with poor emotion regulation as well as an invalidating family environment. The mediational role…

Sophistic Ethics in the Technical Writing Classroom: Teaching "Nomos," Deliberation, and Action.

Science.gov (United States)

Scott, J. Blake

1995-01-01

Claims that teaching ethics is particularly important to technical writing. Outlines a classical, sophistic approach to ethics based on the theories and pedagogies of Protagoras, Gorgias, and Isocrates, which emphasizes the Greek concept of "nomos," internal and external deliberation, and responsible action. Discusses problems and…

Schizophrenia and Deliberate Self-Harm: A Systematic Review of Risk Factors

Science.gov (United States)

Haw, Camilla; Hawton, Keith; Sutton, Lesley; Sinclair, Julia; Deeks, Jonathan

2005-01-01

Deliberate self-harm (DSH) is a strong predictor of suicide in schizophrenia. The aim of this review was to identify risk factors for DSH in schizophrenia. This systematic review of the international literature examined cohort and case-control studies of patients with schizophrenia or related diagnoses that reported DSH as an outcome. Studies were…

Mental Models and Deliberate Manipulation of Data

DEFF Research Database (Denmark)

Koester, Thomas; Jakobsen, Jeanette; Brøsted, Jesper Ejdorf

2015-01-01

Human factors risk analysis and usability tests in telemedicine contexts primarily seek to investigate how to reduce the likelihood of slips, lapses and mistakes. However, to ensure trustworthiness in e-health data, one must also be aware of more intentional patient actions which could potentially...... compromise patient safety and/or the integrity of the system. The pilot study in this paper set out to explore mental models and deliberate manipulation of data in a Danish telemedicine setting of home monitoring among pregnant women. Results show, that patients construct mental models of the telemedicine...... system, and that the patient can utilize such mental models in attempts to manipulate their data input to get a desired output from the telemedicine system....

Deliberation and Scale in Mekong Region Water Governance

Science.gov (United States)

Dore, John; Lebel, Louis

2010-07-01

Understanding the politics of deliberation, scales, and levels is crucial to understanding the social complexity of water-related governance. Deliberative processes might complement and inform more conventional representational and bureaucratic approaches to planning and decision-making. However, they are also subject to scale and level politics, which can confound institutionalized decision-making. Scale and level contests arise in dialogues and related arenas because different actors privilege particular temporal or spatial scales and levels in their analysis, arguments, and responses. Scale contests might include whether to privilege administrative, hydrological, ecosystem, or economic boundaries. Level contests might include whether to privilege the subdistrict or the province, the tributary watershed or the international river basin, a river or a biogeographic region, and the local or the regional economy. In the Mekong Region there is a recurrent demand for water resources development projects and major policies proposed by governments and investors to be scrutinized in public. Deliberative forms of engagement are potentially very helpful because they encourage supporters and critics to articulate assumptions and reasoning about the different opportunities and risks associated with alternative options, and in doing so, they often traverse and enable higher-quality conversations within and across scales and within and between levels. Six case studies from the Mekong Region are examined. We find evidence that scale and level politics affects the context, process, content, and outcomes of deliberative engagement in a region where public deliberation is still far from being a norm, particularly where there are sensitive and far-reaching choices to be made about water use and energy production.

Bioethics education in clinical settings: theory and practice of the dilemma method of moral case deliberation.

Science.gov (United States)

Stolper, Margreet; Molewijk, Bert; Widdershoven, Guy

2016-07-22

Moral Case Deliberation is a specific form of bioethics education fostering professionals' moral competence in order to deal with their moral questions. So far, few studies focus in detail on Moral Case Deliberation methodologies and their didactic principles. The dilemma method is a structured and frequently used method in Moral Case Deliberation that stimulates methodological reflection and reasoning through a systematic dialogue on an ethical issue experienced in practice. In this paper we present a case-study of a Moral Case Deliberation with the dilemma method in a health care institution for people with an intellectual disability, describing the theoretical background and the practical application of the dilemma method. The dilemma method focuses on moral experiences of participants concerning a concrete dilemma in practice. By an in-depth description of each of the steps of the deliberation process, we elucidate the educational value and didactics of this specific method. The didactics and methodical steps of the dilemma method both supported and structured the dialogical reflection process of the participants. The process shows that the participants learned to recognize the moral dimension of the issue at stake and were able to distinguish various perspectives and reasons in a systematic manner. The facilitator played an important role in the learning process of the participants, by assisting them in focusing on and exploring moral aspects of the case. The reflection and learning process, experienced by the participants, shows competency-based characteristics. The role of the facilitator is that of a Socratic teacher with specific knowledge and skills, fostering reflection, inquiry and dialogue. The specific didactics of the dilemma method is well suited for teaching bioethics in clinical settings. The dilemma method follows an inductive learning approach through a dialogical moral inquiry in which participants develop not only knowledge but also skills

Death on the digital landscape: a preliminary investigation into the grief process and motivations behind participation in the online memoriam.

Science.gov (United States)

Egnoto, Michael J; Sirianni, Joseph M; Ortega, Christopher R; Stefanone, Michael

2014-01-01

Increasingly, individuals are bonding and maintaining relationships online. These digital representations of ourselves allow us to connect with others in ways previously not possible. One behavior that is growing in online presentations of self is grieving after the death of an individual in our social network. This work investigates the outcomes of online grieving from a transcorporeal communication model perspective, and draws conclusions on the outcomes of online grief behaviors.

A trial essay about studies of Grief Toward to recovery support for mothers who abuse their children

OpenAIRE

遠藤, 野ゆり

2016-01-01

This paper is a short essay about studies of Grief which are written by Sigmund Freud, Melanie Klein, John Bowlby, and Keigo Okonogi. The final aim is to describe parents’, mainly mother’s mechanism of recovery process from their abusing of children. This paper is one piece of this aim. The lag of support for abusing mother seems to be caused by the complexity and difficulty of their mechanism. They often have been abused in their childhood and can’t remember it. The process of recovery is pa...

Beyond Reactive Planning: Self Adaptive Software and Self Modeling Software in Predictive Deliberation Management

National Research Council Canada - National Science Library

Lenahan, Jack; Nash, Michael P; Charles, Phil

2008-01-01

.... We present the following hypothesis: predictive deliberation management using self-adapting and self-modeling software will be required to provide mission planning adjustments after the start of a mission...

Loss and grief process and Occupational Therapy assistance in scalping situations

Directory of Open Access Journals (Sweden)

Andreza Mourão Lopes

2013-08-01

Full Text Available In this research, we aimed to understand the loss and grief process and the occupational therapy assistance to a hospitalized child undergoing a scalping situation. It is a case study of qualitative approach. This survey was carried out with the participation of an 8-year-old female scalping victim. Results revealed that the scalping caused many changes such as loss of hair and parts of the facial skin. The child was hospitalized, staying away from occupational activities such as studying, playing, among others. We observed the expression of feelings such as fear, shame, anxiety and sadness generated by hair loss. Thus, we believe that this research is of high relevance because it allowed contact with a theme so characteristic of northern Brazil, as well as with the perception and clarification about the importance of occupational therapy assistance in providing space for expression and reframing of the doings, giving the opportunity to this child to resume her significant occupational activities.

European public deliberation on brain machine interface technology: five convergence seminars.

Science.gov (United States)

Jebari, Karim; Hansson, Sven-Ove

2013-09-01

We present a novel procedure to engage the public in ethical deliberations on the potential impacts of brain machine interface technology. We call this procedure a convergence seminar, a form of scenario-based group discussion that is founded on the idea of hypothetical retrospection. The theoretical background of this procedure and the results of five seminars are presented.

Truth in politics : rhetorical approaches to democratic deliberation in Africa and beyond

NARCIS (Netherlands)

Salazar, P.J.; Osha, S.; Binsbergen, van W.M.J.

2004-01-01

Democracy is about competing "truths". This is why "rhetoric"- the study of public deliberation and the training in public debate and argumentation - is part of democracy in development. This volume acclimatizes "rhetoric" to the philosophical scene in South Africa, and more in general in Africa as

Symptoms of post-traumatic stress disorder, severe psychological distress, explosive anger and grief amongst partners of survivors of high levels of trauma in post-conflict Timor-Leste.

Science.gov (United States)

Silove, D M; Tay, A K; Steel, Z; Tam, N; Soares, Z; Soares, C; Dos Reis, N; Alves, A; Rees, S

2017-01-01

Little is known about the mental health of partners of survivors of high levels of trauma in post-conflict countries. We studied 677 spouse dyads (n = 1354) drawn from a community survey (response 82.4%) in post-conflict Timor-Leste. We used culturally adapted measures of post-traumatic stress disorder (PTSD), psychological distress, explosive anger and grief. Latent class analysis identified three classes of couples: class 1, comprising women with higher trauma events (TEs), men with intermediate TEs (19%); class 2, including men with higher TEs, women with lower TEs (23%); and class 3, comprising couples in which men and women had lower TE exposure (58%) (the reference group). Men and women partners of survivors of higher TE exposure (classes 1 and 2) had increased symptoms of explosive anger and grief compared with the reference class (class 3). Women partners of survivors of higher TE exposure (class 2) had a 20-fold increased rate of PTSD symptoms compared with the reference class, a pattern that was not evident for men living with women exposed to higher levels of trauma (class 1). Men and women living with survivors of higher levels of trauma showed an increase in symptoms of grief and explosive anger. The manifold higher rate of PTSD symptoms amongst women living with men exposed to high levels of trauma requires replication. It is important to assess the mental health of partners when treating survivors of high levels of trauma in post-conflict settings.

Cognitive Functions of the Cerebellum Explain How Ericsson's Deliberate Practice Produces Giftedness

Science.gov (United States)

Vandervert, Larry R.

2007-01-01

A critical issue for Ericsson et al.'s proposal is the development of a fully adequate description of neurophysiological substrates for deliberate practice. Ericsson et al. do provide two substantial subsections on biological substrates--namely, their subsections, "Acquisition of superior power, control, and speed of motor activities" and…

Design and usability of heuristic-based deliberation tools for women facing amniocentesis.

Science.gov (United States)

Durand, Marie-Anne; Wegwarth, Odette; Boivin, Jacky; Elwyn, Glyn

2012-03-01

Evidence suggests that in decision contexts characterized by uncertainty and time constraints (e.g. health-care decisions), fast and frugal decision-making strategies (heuristics) may perform better than complex rules of reasoning. To examine whether it is possible to design deliberation components in decision support interventions using simple models (fast and frugal heuristics). The 'Take The Best' heuristic (i.e. selection of a 'most important reason') and 'The Tallying' integration algorithm (i.e. unitary weighing of pros and cons) were used to develop two deliberation components embedded in a Web-based decision support intervention for women facing amniocentesis testing. Ten researchers (recruited from 15), nine health-care providers (recruited from 28) and ten pregnant women (recruited from 14) who had recently been offered amniocentesis testing appraised evolving versions of 'your most important reason' (Take The Best) and 'weighing it up' (Tallying). Most researchers found the tools useful in facilitating decision making although emphasized the need for simple instructions and clear layouts. Health-care providers however expressed concerns regarding the usability and clarity of the tools. By contrast, 7 out of 10 pregnant women found the tools useful in weighing up the pros and cons of each option, helpful in structuring and clarifying their thoughts and visualizing their decision efforts. Several pregnant women felt that 'weighing it up' and 'your most important reason' were not appropriate when facing such a difficult and emotional decision. Theoretical approaches based on fast and frugal heuristics can be used to develop deliberation tools that provide helpful support to patients facing real-world decisions about amniocentesis. © 2011 Blackwell Publishing Ltd.

TRUTH OR DARE: ONLINE DELIBERATION. A CASE STUDY OF TWO INTERNET BASED DELIBERATIVE PLATFORMS

Directory of Open Access Journals (Sweden)

Luana Maria BIDAȘCĂ

2011-06-01

Full Text Available In this article, I attempt to discuss how the internet can be used to stimulate an effective communication between citizens and decision-makers. In particular, I will aim to see if it can facilitate a greater degree of deliberation among citizens, if it can make democracy more inclusive and if it can make decision makers more responsible. I will first look at the definition and characteristics of deliberative democracy. Then after looking at what has been written so far about the effect of online discussions on democracy, I shall analyze the role the internet played in two case studies: web based participatory budgeting (PB and domnuleprimar.ro (DearMrMayor.ro. Both of these platforms were designed to create a closer bond between decisionmakers and citizens and will thus prove relevant to the discussion. Finally, I conclude that while the two case studies seem to favor increased inclusiveness, it only partially increases accountability and does not register any significant progress with regard to deliberation. Still, I argue that reasons for optimism exist even with regard to the deliberative aspect. Since the debate regarding the value of online deliberation is far from over, more research is needed in order to perhaps design a framework which will allow us to exploit the democratic value of the internet to its full potential.

Clinical Diagnostic and Sociocultural Dimensions of Deliberate Self-Harm in Mumbai, India

Science.gov (United States)

Parkar, Shubhangi R.; Dawani, Varsha; Weiss, Mitchell G.

2006-01-01

Patients' accounts complement psychiatric assessment of deliberate self-harm (DSH). In this study we examined psychiatric disorders, and sociocultural and cross-cultural features of DSH. SCID diagnostic interviews and a locally adapted EMIC interview were used to study 196 patients after DSH at a general hospital in Mumbai, India. Major depression…

Research Evidence and School Board Deliberations: Lessons from Three Wisconsin School Districts

Science.gov (United States)

Asen, Robert; Gurke, Deb; Conners, Pamela; Solomon, Ryan; Gumm, Elsa

2013-01-01

This article analyzes the use of research evidence in school-board deliberations in three school districts in Wisconsin. In these settings, the circulation, meaning, and function of research depended importantly on the interests and backgrounds of advocates, the composition of audiences, and the values and contexts of decision-making. Board…

A meta-analysis of fear-avoidance and pain intensity: The paradox of chronic pain.

Science.gov (United States)

Kroska, Emily B

2016-10-01

The fear-avoidance model of chronic pain has established avoidance as a predictor of negative outcomes in chronic pain patients. Avoidance, or deliberate attempts to suppress or prevent unwanted experiences (e.g., pain), has been studied extensively, with multiple reviews implicating this behavior as a predictor of disability, physical disuse, and depression. Despite hundreds of studies examining the associations between different components of this model (i.e., catastrophizing, fear, avoidance, depression), the association between fear-avoidance and pain intensity has remained unclear. The present study seeks to clarify this association across samples. The present analyses synthesize the literature (articles from PsycInfo, PubMed, and ProQuest) to determine if fear-avoidance and pain intensity are consistently correlated across studies, samples, and measures. Eligible studies measured pain intensity and fear-avoidance cross-sectionally in chronic pain patients. The search resulted in 118 studies eligible for inclusion. A random-effects model was used to estimate the weighted mean effect size. Comprehensive Meta-Analysis software was used for all analyses. Moderation analyses elucidate the variables that affect the strength of this association. Meta-regression and meta-ANOVA analyses were conducted to examine moderating variables. Moderator variables include demographic characteristics, pain characteristics, study characteristics, and national cultural characteristics (using Hofstede's cultural dimensions). Publication bias was examined using the funnel plot and the p-curve. Results indicate a small-to-moderate positive association between fear-avoidance and pain intensity. The results were stable across characteristics of the sample, including mean age, gender distribution, marital status, and duration of pain. Moderation analyses indicate that the measures utilized and cultural differences affect the strength of this association. Weaker effect sizes were observed

One angry woman: Anger expression increases influence for men, but decreases influence for women, during group deliberation.

Science.gov (United States)

Salerno, Jessica M; Peter-Hagene, Liana C

2015-12-01

We investigated whether expressing anger increases social influence for men, but diminishes social influence for women, during group deliberation. In a deception paradigm, participants believed they were engaged in a computer-mediated mock jury deliberation about a murder case. In actuality, the interaction was scripted. The script included 5 other mock jurors who provided verdicts and comments in support of the verdicts; 4 agreed with the participant and 1 was a "holdout" dissenter. Holdouts expressed their opinions with no emotion, anger, or fear and had either male or female names. Holdouts exerted no influence on participants' opinions when they expressed no emotion or fear. Participants' confidence in their own verdict dropped significantly, however, after male holdouts expressed anger. Yet, anger expression undermined female holdouts: Participants became significantly more confident in their original verdicts after female holdouts expressed anger-even though they were expressing the exact same opinion and emotion as the male holdouts. Mediation analyses revealed that participants drew different inferences from male versus female anger, which created a gender gap in influence during group deliberation. The current study has implications for group decisions in general, and jury deliberations in particular, by suggesting that expressing anger might lead men to gain influence, but women to lose influence over others (even when making identical arguments). These diverging consequences might result in women potentially having less influence on societally important decisions than men, such as jury verdicts. (c) 2015 APA, all rights reserved).

Emotions and clinical ethics support. A moral inquiry into emotions in moral case deliberation.

Science.gov (United States)

Molewijk, Bert; Kleinlugtenbelt, Dick; Pugh, Scott M; Widdershoven, Guy

2011-12-01

Emotions play an important part in moral life. Within clinical ethics support (CES), one should take into account the crucial role of emotions in moral cases in clinical practice. In this paper, we present an Aristotelian approach to emotions. We argue that CES can help participants deal with emotions by fostering a joint process of investigation of the role of emotions in a case. This investigation goes beyond empathy with and moral judgment of the emotions of the case presenter. In a moral case deliberation, the participants are invited to place themselves in the position of the case presenter and to investigate their own emotions in the situation. It is about critically assessing the facts in the case that cause the emotion and the related (moral) thoughts that accompany the emotion. It is also about finding the right emotion in a given situation and finding the right balance in dealing with that emotion. These steps in the moral inquiry give rise to group learning. It is a process of becoming open towards the perspectives of others, leading to new insights into what is an appropriate emotion in the specific situation. We show how this approach works in moral case deliberation. A physician presents a situation in which he is faced with a pregnant woman who is about to deliver multiple extremely premature infants at the threshold of viability. The moral deliberation of the case and the emotions therein leads to the participants' conclusion that "compassion" is a more adequate emotion than "sadness". The emotion "sadness" is pointed towards the tragedy that is happening to the woman. The emotion "compassion" is pointed towards the woman; it combines consideration and professional responsibility. Through the shift towards compassion, participants experienced more creativity and freedom to deal with the sad situation and to support the woman. The paper ends with an analysis and reflection on the deliberation process. In the conclusion we argue for more attention to

Developing Emotionally Intelligent Leadership: The Need for Deliberate Practice and Collaboration across Disciplines

Science.gov (United States)

Allen, Scott J.; Shankman, Marcy Levy; Haber-Curran, Paige

2016-01-01

This chapter continues the discussion of what leadership education is and highlights the importance of emotionally intelligent leadership. The authors assert the need for deliberate practice and better collaboration between student affairs, academic affairs, and academic departments to develop emotionally intelligent leaders.

Deliberate ingestion of foreign bodies by institutionalised psychiatric hospital patients and prison inmates.

LENUS (Irish Health Repository)

O'Sullivan, S T

2012-02-03

Deliberate and recurrent foreign body ingestion is a common problem among institutionalised patients. We review our experience with 36 cases of deliberate foreign body ingestion by prisoners or psychiatric patients, thirty of whom were institutionalised at the time of ingestion. Symptoms were frequently severe in the prison inmate group but, in contrast, psychiatric patients presented with few, if any, symptoms. A majority of objects pass spontaneously or remain in situ without complication. Twenty-four patients were discharged following initial evaluation and without specific treatment. Eight of these were reviewed electively and discharged within one week. Twelve patients were admitted for observation, seven of whom were discharged within 48 hrs. Upper gastrointestinal endoscopy was performed in four patients and an intragastric foreign body identified in two cases. Laparotomy was performed in two cases for unresolving mechanical intestinal obstruction. Management should be conservative when possible, with surgery indicated only for complications.

Talent identification and deliberate programming in skeleton: ice novice to Winter Olympian in 14 months.

Science.gov (United States)

Bullock, Nicola; Gulbin, Jason P; Martin, David T; Ross, Angus; Holland, Terry; Marino, Frank

2009-02-15

The aims of this study were to talent transfer, rapidly develop, and qualify an Australian female athlete in the skeleton event at the 2006 Torino Winter Olympic Games and quantify the volume of skeleton-specific training and competition that would enable this to be achieved. Initially, 26 athletes were recruited through a talent identification programme based on their 30-m sprint time. After attending a selection camp, 10 athletes were invited to undertake an intensified skeleton training programme. Four of these athletes were then selected to compete for Australia on the World Cup circuit. All completed runs and simulated push starts were documented over a 14-month period. The athlete who eventually represented Australia at the Torino Winter Olympic Games did so following approximately 300 start simulations and about 220 training/competition runs over a period of 14 months. Using a deliberate programming model, these findings provide a guide to the minimum exposure required for a novice skeleton athlete to reach Olympic representative standard following intensified sport-specific training. The findings of this study are discussed in the context of the deliberate practice theory and offer the term "deliberate programming" as an alternative way of incorporating all aspects of expert development.

Burnout After Patient Death: Challenges for Direct Care Workers.

Science.gov (United States)

Boerner, Kathrin; Gleason, Hayley; Jopp, Daniela S

2017-09-01

Direct care workers in long-term care can develop close relationships with their patients and subsequently experience significant grief after patient death. Consequences of this experience for employment outcomes have received little attention. To investigate staff, institutional, patient, and grief factors as predictors of burnout dimensions among direct care workers who had experienced recent patient death; determine which specific aspects of these factors are of particular importance; and establish grief as an independent predictor of burnout dimensions. Participants were 140 certified nursing assistants and 80 homecare workers who recently experienced patient death. Data collection involved comprehensive semistructured in-person interviews. Standardized assessments and structured questions addressed staff, patient, and institutional characteristics, grief symptoms and grief avoidance, as well as burnout dimensions (depersonalization, emotional exhaustion, and personal accomplishment). Hierarchical regressions revealed that grief factors accounted for unique variance in depersonalization, over and above staff, patient, and institutional factors. Supervisor support and caregiving benefits were consistently associated with higher levels on burnout dimensions. In contrast, coworker support was associated with a higher likelihood of depersonalization and emotional exhaustion. Findings suggest that grief over patient death plays an overlooked role in direct care worker burnout. High supervisor support and caregiving benefits may have protective effects with respect to burnout, whereas high coworker support may constitute a reflection of burnout. Copyright © 2017 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

Participatory Sustainability Approach to Value Capture-Based Urban Rail Financing in India through Deliberated Stakeholder Engagement

Directory of Open Access Journals (Sweden)

Satya Sai Kumar Jillella

2015-06-01

Full Text Available Increasingly, cities around the world are seeking innovative financial mechanisms to build rail transit projects. Land value capture (VC is a financing mechanism to fund urban rail transit. Often VC mechanisms are viewed only as a financing tool applied in relation to increased land values from the administration and legislation perspectives, without actively involving the community in the process. The lack of such participation has resulted in the under collection of the true value established. The transit beneficiary community and city tax payers are especially important stakeholders in this process as their willingness to participate is really critical to the overall VC success and transport outcome. This paper introduces a participatory sustainability approach to enable a more deliberated stakeholder engagement intervention across the VC life cycle. A four-step “Participatory Strategic Value Capture (PSVC” framework is proposed offering step-by-step guidance toward facilitating a meaningful stakeholder dialogue, deliberation, and collaboration around the stated engagement interests. The PSVC framework, applied to the proposed Bangalore sub-urban rail project in India, has demonstrated the importance of stakeholder engagement using deliberated participatory approaches from a win-win perspective.

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

Science.gov (United States)

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…

A Decision Support Framework For Science-Based, Multi-Stakeholder Deliberation: A Coral Reef Example

Science.gov (United States)

We present a decision support framework for science-based assessment and multi-stakeholder deliberation. The framework consists of two parts: a DPSIR (Drivers-Pressures-States-Impacts-Responses) analysis to identify the important causal relationships among anthropogenic environ...

Deliberate Science, Continuum Magazine: Clean Energy Innovation at NREL, Winter 2012 (Book)

Energy Technology Data Exchange (ETDEWEB)

2012-02-01

This quarterly magazine is dedicated to stepping beyond the technical journals to reveal NREL's vital work in a real-world context for our stakeholders. Continuum provides insights into the latest and most impactful clean energy innovations, while spotlighting those talented researchers and unique facilities that make it all happen. This edition focuses on deliberate science.

Training healthcare professionals as moral case deliberation facilitators : evaluation of a Dutch training programme

NARCIS (Netherlands)

Plantinga, Mirjam; Molewijk, Bert; de Bree, Menno; Moraal, Marloes; Verkerk, Marian; Widdershoven, Guy A. M.

2012-01-01

Until recently, moral case deliberation (MCD) sessions have mostly been facilitated by external experts, mainly professional ethicists. We have developed a train the facilitator programme for healthcare professionals aimed at providing them with the competences needed for being an MCD facilitator.

Training healthcare professionals as moral case deliberation facilitators: evaluation of a Dutch training programme

NARCIS (Netherlands)

Plantinga, M.; Molewijk, A.C.; de Bree, M.; Moraal, M.; Verkerk, M.; Widdershoven, G.A.

2012-01-01

Until recently, moral case deliberation (MCD) sessions have mostly been facilitated by external experts, mainly professional ethicists. We have developed a train the facilitator programme for healthcare professionals aimed at providing them with the competences needed for being an MCD facilitator.

Hominin skeletal part abundances and claims of deliberate disposal of corpses in the Middle Pleistocene.

Science.gov (United States)

Egeland, Charles P; Domínguez-Rodrigo, Manuel; Pickering, Travis Rayne; Menter, Colin G; Heaton, Jason L

2018-05-01

Humans are set apart from other organisms by the realization of their own mortality. Thus, determining the prehistoric emergence of this capacity is of significant interest to understanding the uniqueness of the human animal. Tracing that capacity chronologically is possible through archaeological investigations that focus on physical markers that reflect "mortality salience." Among these markers is the deliberate and culturally mediated disposal of corpses. Some Neandertal bone assemblages are among the earliest reasonable claims for the deliberate disposal of hominins, but even these are vigorously debated. More dramatic assertions center on the Middle Pleistocene sites of Sima de los Huesos (SH, Spain) and the Dinaledi Chamber (DC, South Africa), where the remains of multiple hominin individuals were found in deep caves, and under reported taphonomic circumstances that seem to discount the possibility that nonhominin actors and processes contributed to their formation. These claims, with significant implications for charting the evolution of the "human condition," deserve scrutiny. We test these assertions through machine-learning analyses of hominin skeletal part representation in the SH and DC assemblages. Our results indicate that nonanthropogenic agents and abiotic processes cannot yet be ruled out as significant contributors to the ultimate condition of both collections. This finding does not falsify hypotheses of deliberate disposal for the SH and DC corpses, but does indicate that the data also support partially or completely nonanthropogenic formational histories.

Technology of radioactive waste management avoiding environmental disposal

International Nuclear Information System (INIS)

1964-01-01

This report considers present radioactive waste management methods and practices. In addition, present research and development activity designed to minimize discharges to the environment are noted. During its deliberations the Panel was able to define certain avenues of research and development which should be explored to enable the almost complete containment of wastes. The experience and practices at establishments, where, for geographical, geological or other reasons, discharges of radioactive material to the environment are extremely small, served as the starting point for the Panel's deliberations. Details of the experience and practice, together with the results obtained at these establishments, are summarized in Part I and described in more detail in Part II of this report. 48 refs, 89 figs, 11 tabs

Applying What Works: A Case for Deliberate Psychological Education in Undergraduate Business Ethics

Science.gov (United States)

Schmidt, Christopher Drees; Davidson, Kathleen M.; Adkins, Christopher

2013-01-01

The teaching of business ethics continues to be a topic of great concern as both businesses and business schools seek to develop effective approaches for fostering ethical behavior. Responses to this objective have been varied, and consistent empirical evidence for a particular approach has not emerged. One approach, deliberate psychological…

Ethnic density and deliberate self harm; a small area study in south east London

NARCIS (Netherlands)

Neeleman, J; Wilson-Jones, C; Wessely, S

Study objective-Relative risks are frequently used to convey how strongly outcomes like mental illness and suicidal behaviour are associated with personal characteristics Like ethnic background. This study examined whether RRs for deliberate self harm (DSH) in ethnic groups vary between small areas

Competencies in nursing students for organized forms of clinical moral deliberation and decision-making

NARCIS (Netherlands)

dr. Bart Cusveller; Jeanette den Uil-Westerlaken

2014-01-01

Bachelor-prepared nurses are expected to be competent in moral deliberation and decision-making (MDD) in clinical practice. It is unclear, however, how this competence develops in nursing students. This study explores the development of nursing students’ competence for participating in organized

Decision making and coping in healthcare: the Coping in Deliberation (CODE) framework.

Science.gov (United States)

Witt, Jana; Elwyn, Glyn; Wood, Fiona; Brain, Kate

2012-08-01

To develop a framework of decision making and coping in healthcare that describes the twin processes of appraisal and coping faced by patients making preference-sensitive healthcare decisions. We briefly review the literature for decision making theories and coping theories applicable to preference-sensitive decisions in healthcare settings. We describe first decision making, then coping and finally attempt to integrate these processes by building on current theory. Deliberation in healthcare may be described as a six step process, comprised of the presentation of a health threat, choice, options, preference construction, the decision itself and consolidation post-decision. Coping can be depicted in three stages, beginning with a threat, followed by primary and secondary appraisal and ultimately resulting in a coping effort. Drawing together concepts from prominent decision making theories and coping theories, we propose a multidimensional, interactive framework which integrates both processes and describes coping in deliberation. The proposed framework offers an insight into the complexity of decision making in preference-sensitive healthcare contexts from a patient perspective and may act as theoretical basis for decision support. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Deliberate Self-Harm within an International Community Sample of Young People: Comparative Findings from the Child & Adolescent Self-Harm in Europe (CASE) Study

Science.gov (United States)

Madge, Nicola; Hewitt, Anthea; Hawton, Keith; de Wilde, Erik Jan; Corcoran, Paul; Fekete, Sandor; van Heeringen, Kees; De Leo, Diego; Ystgaard, Mette

2008-01-01

Background: Deliberate self-harm among young people is an important focus of policy and practice internationally. Nonetheless, there is little reliable comparative international information on its extent or characteristics. We have conducted a seven-country comparative community study of deliberate self-harm among young people. Method: Over 30,000…

Psychometric properties of the Dutch version of the Attitude Towards Deliberate Self-Harm Questionnaire

NARCIS (Netherlands)

Kool, N.; van Meijel, B.; van der Bijl, J.; Koekkoek, B.; Kerkhof, A.

2015-01-01

The attitude of nurses and treatment staff is crucial in the treatment of patients who self-harm. However, many patients experience that attitude as negative. The aim of this study was to investigate the psychometric properties of the Dutch version of the Attitude Towards Deliberate Self-Harm

Learning by doing. Training health care professionals to become facilitator of moral case deliberation

NARCIS (Netherlands)

Stolper, M.M.; Molewijk, A.C.; Widdershoven, G.

2015-01-01

Moral case deliberation (MCD) is a dialogue among health care professionals about moral issues in practice. A trained facilitator moderates the dialogue, using a conversation method. Often, the facilitator is an ethicist. However, because of the growing interest in MCD and the need to connect MCD to

Informed decision making about predictive DNA tests: arguments for more public visibility of personal deliberations about the good life.

Science.gov (United States)

Boenink, Marianne; van der Burg, Simone

2010-05-01

Since its advent, predictive DNA testing has been perceived as a technology that may have considerable impact on the quality of people's life. The decision whether or not to use this technology is up to the individual client. However, to enable well considered decision making both the negative as well as the positive freedom of the individual should be supported. In this paper, we argue that current professional and public discourse on predictive DNA-testing is lacking when it comes to supporting positive freedom, because it is usually framed in terms of risk and risk management. We show how this 'risk discourse' steers thinking on the good life in a particular way. We go on to argue that empirical research into the actual deliberation and decision making processes of individuals and families may be used to enrich the environment of personal deliberation in three ways: (1) it points at a richer set of values that deliberators can take into account, (2) it acknowledges the shared nature of genes, and (3) it shows how one might frame decisions in a non-binary way. We argue that the public sharing and discussing of stories about personal deliberations offers valuable input for others who face similar choices: it fosters their positive freedom to shape their view of the good life in relation to DNA-diagnostics. We conclude by offering some suggestions as to how to realize such public sharing of personal stories.

Predictors of avoiding medical care and reasons for avoidance behavior.

Science.gov (United States)

Kannan, Viji Diane; Veazie, Peter J

2014-04-01

Delayed medical care has negative health and economic consequences; interventions have focused on appraising symptoms, with limited success in reducing delay. To identify predictors of care avoidance and reasons for avoiding care. Using the Health Information National Trends Survey (2007), we conducted logistic regressions to identify predictors of avoiding medical visits deemed necessary by the respondents; and, we then conducted similar analyses on reasons given for avoidance behavior. Independent variables included geographic, demographic, socioeconomic, personal health, health behavior, health care system, and cognitive characteristics. Approximately one third of adults avoided doctor visits they had deemed necessary. Although unadjusted associations existed, avoiding needed care was not independently associated with geographic, demographic, and socioeconomic characteristics. Avoidance behavior is characterized by low health self-efficacy, less experience with both quality care and getting help with uncertainty about health, having your feelings attended to by your provider, no usual source of care, negative affect, smoking daily, and fatalistic attitude toward cancer. Reasons elicited for avoidance include preference for self-care or alternative care, dislike or distrust of doctors, fear or dislike of medical treatments, time, and money; respondents also endorsed discomfort with body examinations, fear of having a serious illness, and thoughts of dying. Distinct predictors distinguish each of these reasons. Interventions to reduce patient delay could be improved by addressing the health-related behavioral, belief, experiential, and emotional traits associated with delay. Attention should also be directed toward the interpersonal communications between patients and providers.

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

Science.gov (United States)

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.

Decision making uncertainty, imperfection, deliberation and scalability

CERN Document Server

Kárný, Miroslav; Wolpert, David

2015-01-01

This volume focuses on uncovering the fundamental forces underlying dynamic decision making among multiple interacting, imperfect and selfish decision makers. The chapters are written by leading experts from different disciplines, all considering the many sources of imperfection in decision making, and always with an eye to decreasing the myriad discrepancies between theory and real world human decision making. Topics addressed include uncertainty, deliberation cost and the complexity arising from the inherent large computational scale of decision making in these systems. In particular, analyses and experiments are presented which concern: • task allocation to maximize “the wisdom of the crowd”; • design of a society of “edutainment” robots who account for one anothers’ emotional states; • recognizing and counteracting seemingly non-rational human decision making; • coping with extreme scale when learning causality in networks; • efficiently incorporating expert knowledge in personalized...

Immigration, Suicidal Ideation and Deliberate Self-Injury in the Boston Youth Survey 2006

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Borges, Guilherme; Azrael, Deborah; Almeida, Joanna; Johnson, Renee M.; Molnar, Beth E.; Hemenway, David; Miller, Matthew

2011-01-01

The prevalence and immigration-related correlates of deliberate self-injury (DSI) and suicidal ideation (SI) were estimated in a sample of Boston public high school students in 2006. Compared with U.S.-born youth, immigrant youth were not at increased risk for DSI or SI, even if they had experienced discrimination due to their ancestry. By…

The Socialization of Children’s Memory: Linking Maternal Conversational Style to the Development of Children’s Autobiographical and Deliberate Memory Skills

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Langley, Hillary A.; Coffman, Jennifer L.; Ornstein, Peter A.

2017-01-01

Data from a large-scale, longitudinal research study with an ethnically and socioeconomically diverse sample were utilized to explore linkages between maternal elaborative conversational style and the development of children’s autobiographical and deliberate memory. Assessments were made when the children were 3, 5, and 6 years of age, and the results reveal concurrent and longitudinal linkages between maternal conversational style in a mother-child reminiscing task and children’s autobiographical memory performance. Maternal conversational style while reminiscing was also significantly related to children’s strategic behaviors and recall in two deliberate memory tasks, both concurrently and longitudinally. Results from this examination replicate and extend what is known about the linkages between maternal conversational style, children’s abilities to talk about previous experiences, and children’s deliberate memory skills as they transition from the preschool to early elementary school years. PMID:29270083

Keep your bias to yourself: How deliberating with differently biased others affects mock-jurors' guilt decisions, perceptions of the defendant, memories, and evidence interpretation.

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Ruva, Christine L; Guenther, Christina C

2017-10-01

This experiment explored how mock-jurors' (N = 648) guilt decisions, perceptions of the defendant, memories, and evidence interpretation varied as a function of jury type and pretrial publicity (PTP); utilizing a 2 (jury type: pure-PTP vs. mixed-PTP) × 3 (PTP: defendant, victim, and irrelevant) factorial design. Mock-juries (N = 126) were composed of jurors exposed to the same type of PTP (pure-PTP; e.g., defendant-PTP) or different types of PTP (mixed-PTP; e.g., half exposed to defendant-PTP and half to irrelevant-PTP). Before deliberations jurors exposed to defendant-PTP were most likely to vote guilty; while those exposed to victim-PTP were least likely. After deliberations, jury type and PTP affected jurors' guilt decisions. Specifically, jurors deliberating on pure-PTP juries had verdict distributions that closely resembled the predeliberation distributions. The verdict distributions of jurors on mixed-PTP juries suggested that jurors were influenced by those they deliberated with. Jurors not exposed to PTP appeared to incorporate bias from PTP-exposed jurors. Only PTP had significant effects on postdeliberation measures of memory and evidence interpretation. Mediation analyses revealed that evidence interpretation and defendant credibility assessments mediated the effect of PTP on guilt ratings. Taken together these findings suggest that during deliberations PTP bias can spread to jurors not previously exposed to PTP. In addition, juries composed of jurors exposed to different PTP slants, as opposed to a single PTP slant, can result in less biased decisions. Finally, deliberating with others who do not share similar biases may have little, if any, impact on biased evidence interpretation or memory errors. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Peer conflict avoidance: associations with loneliness, social anxiety, and social avoidance.

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Johnson, H D; LaVoie, J C; Spenceri, M C; Mahoney-Wernli, M A

2001-02-01

Failure to resolve peer conflict is associated with children's reports of loneliness, social anxiety, and social avoidance. Although these relationships are well established, researchers have not examined the association between the avoidance of peer conflict and various adjustment characteristics. The current study examined the association between avoidance of conflict and measures of loneliness, social anxiety, and social avoidance for 59 pupils in Grade 4 (31 boys and 28 girls) and 47 in Grade 8 (22 boys and 25 girls). Volunteers indicated that conflict avoidance based on autonomy, e.g., independence issues, and interpersonal issues, e.g., closeness and cohesion, was associated with scores on loneliness for boys and girls, respectively. Conflict avoidance for emotional and physical well-being and fear of punishment was associated with increased reports of loneliness and social anxiety for children in Grade 4.

High-dose amrinone is required to accelerate rewarming from deliberate mild intraoperative hypothermia for neurosurgical procedures.

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Inoue, Satoki; Kawaguchi, Masahiko; Sakamoto, Takanori; Kitaguchi, Katsuyasu; Furuya, Hitoshi; Sakaki, Toshisuke

2002-07-01

Since the time available to provide the cooling and rewarming is limited during deliberate mild hypothermia, the technique to accelerate the cooling and rewarming rate of core temperature has been studied. Amrinone has been reported to accelerate the cooling rate but not the rewarming rate of core temperature during deliberate mild hypothermia. The failure of amrinone effect on the rewarming rate might be due to an insufficient dose of amrinone during hypothermic conditions. The authors therefore tested whether higher doses of amrinone can accelerate the rewarming rate of core temperature during deliberate mild hypothermia for neurosurgery. After institutional approval and informed consent, 30 patients were randomly assigned to one of three groups. Patients in the control group (n = 10) did not receive amrinone; patients in the AMR 15 group (n = 10) received 15 microg x kg(-1) x min(-1) amrinone with a 1.0-mg/kg loading dose of amrinone at the beginning of cooling; and patients in the ReAMR group (n = 10) received 5 microg x kg(-1) x min(-1) amrinone with 1.0-mg/kg loading and reloading doses of amrinone at the beginning of cooling and rewarming, respectively. Administration of amrinone was started just after the induction of cooling and continued until the end of anesthesia. Anesthesia was maintained with nitrous oxide in oxygen, propofol, and fentanyl. After induction of anesthesia, patients were cooled, and tympanic membrane temperature was maintained at 34.5 degrees C. After completion of the main surgical procedures, patients were actively rewarmed and extubated in the operating room. The cooling and rewarming rates of core temperature were both significantly faster in both amrinone groups than in the control group. During the cooling and rewarming periods, forearm minus fingertip temperature gradient was significantly smaller in both amrinone groups than in the control group. During the rewarming period, heart rate and mean arterial pressure in the AMR 15

MENSTRUAL PHASE OF WOMEN AND DEATH DUE TO DELIBERATE SELF HARM: AN AUTOPSY STUDY

OpenAIRE

Sujith Sreenivas

2015-01-01

The study was conducted by determining the phase of menstruation of women, who committed suicide by subjecting the uterus for gross and histopathological examination. An understanding whether there was an increased incidence of deliberate self - harm during any particular phase of menstruation was made by this study. AIMS: Determination of me...

Deliberate total parathyroidectomy: a potentially novel therapy for tumor-induced hypophosphatemic osteomalacia.

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Bhadada, Sanjay K; Palnitkar, Saroj; Qiu, Shijing; Parikh, Nayana; Talpos, Gary B; Rao, Sudhaker D

2013-11-01

Tumor-induced osteomalacia (TIO) is an acquired hypophosphatemic metabolic bone disorder that can be cured by removing or ablating the offending tumor. However, when the tumor cannot be localized, lifelong therapy with oral phosphate and calcitriol or cinacalcet with close monitoring is required. A 56-year-old man was diagnosed with TIO in 1990. Initial therapy consisted of oral phosphate and calcitriol with symptomatic and biochemical improvement and healing of osteomalacia. Eight years later, hypercalcemic hyperparathyroidism developed, requiring subtotal parathyroidectomy with a transient increase in serum phosphate and normalization of serum calcium and PTH. Recurrent hypercalcemic hyperparathyroidism developed after 10 years of medical therapy. A deliberate total parathyroidectomy produced a prompt rise in serum phosphate into the normal range > 3.0 mg/dL and remained normal during the next 4 years of follow-up, despite continued very high serum fibroblast growth factor-23 levels throughout the 23-year follow-up. We report an unusual case of a TIO patient with long-term follow-up who developed recurrent hypercalcemic hyperparathyroidism on long-term oral phosphate therapy. Deliberate total parathyroidectomy normalized serum phosphate despite persistently elevated fibroblast growth factor-23 levels. Total parathyroidectomy offers a potentially novel therapy in some patients with TIO in whom medical therapy is not feasible or the tumor is unresectable.

Ecrire et souffrir : L’inspiration partagée de Constance Fenimore Woolson et de Henry James Literature and Grief: Constance Fenimore Woolson and Henry James, A Common Inspiration

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Jeannine Hayat

2007-01-01

Full Text Available Miss Grief is a story by Constance Fenimore Woolson, an American novelist who often wrote about the difficulty a woman had in becoming an artist — a writer or a painter — in the nineteenth century. This tale is a very strange text, a kind of anticipation of a meeting to come, in Italy, in 1880, between Woolson and Henry James, and a friendship which lasted until the former’s death in 1894. For thirteen years, both writers would share a common inspiration. Death itself could not break the links between the two authors, who were connected even when settled in different European countries. William James, who was a member of the American Society for Psychical Research, probably helped his brother Henry to communicate — or so it appears — in some way with Woolson, even after her fatal accident, or possible suicide, in Venice. Henry James probably had in mind Miss Grief, a story by his dead friend, before writing some of his books. Indeed, Woolson had been the first to develop the image of “the figure in the carpet,” which was later transformed by Henry James. Woolson was also the first to devise a plot which Henry James would later use as a canvas for his novel The Wings of the Dove. What is an author and what is authorship? It seems impossible to separate what is Woolson’s and what is Henry James’s in four works of fiction that are in fact to be read together : Miss Grief, The Figure in the Carpet, The Beast in the Jungle, The Wings of the Dove.

Investigating the "self" in deliberate self-harm.

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Adams, Joanna; Rodham, Karen; Gavin, Jeff

2005-12-01

In this study, the authors explored how a group of young people aged 16 to 26 years (who identified themselves as having engaged in deliberate self-harm) made sense of the self by conducting two online focus groups and four e-mail interviews. They analyzed data using interpretive phenomenological analysis. The concept of validation was the primary means of making sense of the self and concerned the desire to be considered legitimate and of worth. This desire was clearly evident across three realms of conflict: (a) the intrinsic or extrinsic self, which marked the distinction between objective fact and subjective opinion; (b) the accepted or denied self; and (c) the notion of normality. It is possible that having one's denied self validated online might lead to an exacerbation of an individual's self-harming behavior. Further work is needed to explore the effects of online discussion forums on such taboo forms of behavior.

Emotion and self-regulation in deliberate personal change: A case study analysis

OpenAIRE

Lopes, Paulo Nuno; Coyle, Adrian; Gallie, Jack

2014-01-01

Two young adults’ experiences of deliberate personal change in the realms of study habits and social interaction were examined using a qualitative, interview-based case study approach. Both talked about an aspect of their behavior that they had changed and one that they would like to change. Thematic analysis was used to interpret their stories and reach an integrative and contextualized understanding of their individual developmental trajectories. Our analysis explored the use of motivated r...

The Basic Act for Suicide Prevention: Effects on Longitudinal Trend in Deliberate Self-Harm with Reference to National Suicide Data for 1996–2014

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Miharu Nakanishi

2017-01-01

Full Text Available A suicide prevention strategy was launched in Japan in 2006 to address the high suicide rate, which had increased considerably since 1998. The national strategy from 2007 involved the enhancement of psychiatric treatment services at emergency medical facilities and supportive observation by individuals close to patients. The national suicide rate has decreased gradually since 2008; however, national information regarding the number of patients who had engaged in deliberate self-harm was absent. Therefore, the present study examined the longitudinal trend in hospital admissions due to deliberate self-harm in Japan. Data from the National Patient Survey between 1996 and 2014—a nationally representative cross-sectional survey of inpatient care every 3 years—were used. Data for 13,014 patients were included in the estimation of the number of hospital admissions due to deliberate self-harm. The results show that the estimated number of admissions due to deliberate self-harm increased from 2078 in September 1996 to 3189 in September 2008, when the national number of suicide cases peaked, and decreased to 1783 in 2014. Approximately half of the patients were admitted to hospital because of self-harm via means other than drug poisoning, which had a high mortality rate (5.6%. The proportion of patients receiving public assistance was higher in those who had engaged in deliberate self-harm (8.5% relative to that observed in the general population. Overall, the trend in deliberate self-harm was synchronous with the number of suicide cases over time. As economic poverty has been associated with suicidal ideation and behavior and some recipients of public assistance tend to abuse psychotropic medication, the public assistance program should provide mental health support for recipients of social benefit schemes.

You can’t teach speed: sprinters falsify the deliberate practice model of expertise

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Michael P. Lombardo

2014-06-01

Full Text Available Many scientists agree that expertise requires both innate talent and proper training. Nevertheless, the highly influential deliberate practice model (DPM of expertise holds that talent does not exist or makes a negligible contribution to performance. It predicts that initial performance will be unrelated to achieving expertise and that 10 years of deliberate practice is necessary. We tested these predictions in the domain of sprinting. In Studies 1 and 2 we reviewed biographies of 15 Olympic champions and the 20 fastest American men in U.S. history. In all documented cases, sprinters were exceptional prior to initiating training, and most reached world class status rapidly (Study 1 median = 3 years; Study 2 = 7.5. In Study 3 we surveyed U.S. national collegiate championships qualifiers in sprinters (n = 20 and throwers (n = 44. Sprinters recalled being faster as youths than did throwers, whereas throwers recalled greater strength and throwing ability. Sprinters’ best performances in their first season of high school, generally the onset of formal training, were consistently faster than 95–99% of their peers. Collectively, these results falsify the DPM for sprinting. Because speed is foundational for many sports, they challenge the DPM generally.

Tragedy in moral case deliberation.

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Spronk, Benita; Stolper, Margreet; Widdershoven, Guy

2017-09-01

In healthcare practice, care providers are confronted with tragic situations, in which they are expected to make choices and decisions that can have far-reaching consequences. This article investigates the role of moral case deliberation (MCD) in dealing with tragic situations. It focuses on experiences of care givers involved in the treatment of a pregnant woman with a brain tumour, and their evaluation of a series of MCD meetings in which the dilemmas around care were discussed. The study was qualitative, focusing on the views and experiences of the participants. A case study design is used by conducting semi-structured interviews (N = 10) with health care professionals who both played a role in the treatment of the patient and attended the MCD. The results show that MCD helps people to deal with tragic situations. An important element of MCD in this respect is making explicit the dilemma and the damage, demonstrating that there is no simple solution. MCD prompts participants to formulate and share personal experiences with one another and thus helps to create a shared perception of the situation as tragic. The article concludes that MCD contributes to the sharing of tragic experiences, and fosters mutual interaction during a tragedy. Its value could be increased through explicit reflection on the aspect of contingency that characterises tragedy.

A collision avoidance model for two-pedestrian groups: Considering random avoidance patterns

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Zhou, Zhuping; Cai, Yifei; Ke, Ruimin; Yang, Jiwei

2017-06-01

Grouping is a common phenomenon in pedestrian crowds and group modeling is still an open challenging problem. When grouping pedestrians avoid each other, different patterns can be observed. Pedestrians can keep close with group members and avoid other groups in cluster. Also, they can avoid other groups separately. Considering this randomness in avoidance patterns, we propose a collision avoidance model for two-pedestrian groups. In our model, the avoidance model is proposed based on velocity obstacle method at first. Then grouping model is established using Distance constrained line (DCL), by transforming DCL into the framework of velocity obstacle, the avoidance model and grouping model are successfully put into one unified calculation structure. Within this structure, an algorithm is developed to solve the problem when solutions of the two models conflict with each other. Two groups of bidirectional pedestrian experiments are designed to verify the model. The accuracy of avoidance behavior and grouping behavior is validated in the microscopic level, while the lane formation phenomenon and fundamental diagrams is validated in the macroscopic level. The experiments results show our model is convincing and has a good expansibility to describe three or more pedestrian groups.

Young People and Caregivers' Perceptions of an Intervention Program for Children Who Deliberately Light Fires

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Lambie, Ian; Seymour, Fred; Popaduk, Tanya

2012-01-01

A significant number of children and adolescents engage in deliberate fire setting, beyond the scope of curiosity and experimentation. Interventions developed to respond to the needs of such fire setters generally involve educational and/or psychosocial approaches. Research evaluating the effectiveness of these interventions is dominated by…

From consultation to deliberation? Tracing deliberative norms in EIA frameworks in Swedish roads planning

International Nuclear Information System (INIS)

Isaksson, Karolina; Richardson, Tim; Olsson, Krister

2009-01-01

This paper presents the results of an analysis of deliberative norms in the framework for Environmental Impact Assessment (EIA) in roads planning in Sweden. The more specific question is how this framework has responded to the shift towards more deliberative approaches to planning and decision making, advocated in planning theory and policy literature over the last decade. The analysis, which compares the current framework and guidance with an earlier iteration, identifies a shift towards deliberation; deliberative norms are present, and even dominate recent guidance. However, an instrumental norm permeates both the former and the current guidance, suggesting that even as a language of consultation is replaced by one of deliberation, the intention remains to secure and legitimise a smooth development pathway. Evidence from interviews with professionals working in the Swedish EIA system highlights the difficulties of navigating these uncertainties in practice. By opening up critical analysis of deliberative norms as they shape the conditions for practice, this study contributes to the continuous development of planning practice, by supporting a more normatively reflexive approach to framework-design.

OA12 When grief and work collide.

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Rosenberg, Kathryn

2015-04-01

There is a significant price to pay for organisations that fail to take seriously the challenges involved in supporting grieving employees in the workplace, including loss of productivity, sickness absence, and low morale. The purpose of this study was to look at how social service organisations implement their bereavement policies and support bereaved staff. The study aimed to raise awareness of current issues and practices in the implementation of bereavement policies and the management and support of grieving employees on their return to work. A generic qualitative method was used and recruitment of six participants from social service organisations within New Zealand was undertaken. Non-probability purposive sampling was used. Data collection was via email interviews. While New Zealand employees are legally entitled to three days paid bereavement leave, how flexible and supportive employers were willing to be beyond that varied. Participants felt out of their depth in dealing with grieving employees and lack of training around grief and loss meant a heavy reliance on external sources of support. The study also exposed a possible lack of understanding in relation to cultural mourning rituals. This study uncovered several areas of concern relating to organisational attitudes towards grieving employees and their ability to adequately support bereaved staff on their return to work. It poses the question for future research as to whether organisations can afford not to care and serves as a springboard for examining the detrimental consequences of neglecting the realities of loss. © 2015, Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Comparative study of personality disorder associated with deliberate self harm in two different age groups (15?24 years and 45?74 years)

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Nath, Saswati; Patra, Dipak Kumar; Biswas, Srilekha; Mallick, Asim Kumar; Bandyopadhyay, Gautam Kumar; Ghosh, Srijit

2008-01-01

Aims: To study the presence of personality disorder in cases of deliberate self harm (DSH) in young (15?24 years) and elderly (45?74 years) and compare. Materials and Methods: Deliberate self harm cases admitted in Medical and surgical departments and cases attending psychiatry department of R.G. Kar Medical College, Kolkata were studied. For diagnosis of personality disorder ICD 10 International Personality Disorder Examination (IPDE) questionnaire was used. Results: Percentage of elderly pa...

Emergency planning and preparedness for the deliberate release of toxic industrial chemicals.

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Russell, David; Simpson, John

2010-03-01

Society in developed and developing countries is hugely dependent upon chemicals for health, wealth, and economic prosperity, with the chemical industry contributing significantly to the global economy. Many chemicals are synthesized, stored, and transported in vast quantities and classified as high production volume chemicals; some are recognized as being toxic industrial chemicals (TICs). Chemical accidents involving chemical installations and transportation are well recognized. Such chemical accidents occur with relative frequency and may result in large numbers of casualties with acute and chronic health effects as well as fatalities. The large-scale production of TICs, the potential for widespread exposure and significant public health impact, together with their relative ease of acquisition, makes deliberate release an area of potential concern. The large numbers of chemicals, together with the large number of potential release scenarios means that the number of possible forms of chemical incident are almost infinite. Therefore, prior to undertaking emergency planning and preparedness, it is necessary to prioritize risk and subsequently mitigate. This is a multi-faceted process, including implementation of industrial protection layers, substitution of hazardous chemicals, and relocation away from communities. Residual risk provides the basis for subsequent planning. Risk-prioritized emergency planning is a tool for identifying gaps, enhancing communication and collaboration, and for policy development. It also serves to enhance preparedness, a necessary prelude to preventing or mitigating the public health risk to deliberate release. Planning is an iterative and on-going process that requires multi-disciplinary agency input, culminating in the formation of a chemical incident plan complimentary to major incident planning. Preparedness is closely related and reflects a state of readiness. It is comprised of several components, including training and exercising

Deliberate practice theory: relevance, effort, and inherent enjoyment of music practice.

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Hyllegard, Randy; Bories, Tamara L

2008-10-01

This study examined three assumptions of the theory of deliberate practice for practice playing music on an electronic keyboard. 40 undergraduate students, divided into two separate groups, practiced one of two music sequences and rated the relevance of practice for improving performance on the sequences, the amount of effort needed to learn the sequences, and the inherent enjoyment of practice sessions. Findings for each assumption were consistent with those suggested by theory but also showed that perceptions are affected by the amount of practice completed and performance of the skill.

An examination of emergency department nurses' attitudes towards deliberate self-harm in an Irish teaching hospital.

LENUS (Irish Health Repository)

McCarthy, Linda

2010-01-01

The purpose of this study was to examine emergency department (ED) nurses\\' attitudes towards individuals presenting with deliberate self-harm (DSH), including the relationship between attitudes and factors such as age, academic achievements, length of experience, and self-harm education.

The use of moral deliberation in empirical research in bioethics

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Elma Zoboli

2016-10-01

Full Text Available The article presents an integrated empirical ethics research project that used the moral deliberation, according to the theoretical and philosophical conception, and methodical proposal of Diego Gracia, as a theoretical and methodological framework. The application showed the potential to realize the dynamics of the studied object in real life, making it possible, from the situation presented in the vignettes, for participants to include what they considered for dealing with the conflict of values. It also made the integration of philosophical and empirical approaches in bioethics research possible. The analytical category of prudence allowed the results to be assessed in a critical and comprehensive way.

Stress potentiates decision biases: A stress induced deliberation-to-intuition (SIDI model

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Rongjun Yu

2016-06-01

Full Text Available Humans often make decisions in stressful situations, for example when the stakes are high and the potential consequences severe, or when the clock is ticking and the task demand is overwhelming. In response, a whole train of biological responses to stress has evolved to allow organisms to make a fight-or-flight response. When under stress, fast and effortless heuristics may dominate over slow and demanding deliberation in making decisions under uncertainty. Here, I review evidence from behavioral studies and neuroimaging research on decision making under stress and propose that stress elicits a switch from an analytic reasoning system to intuitive processes, and predict that this switch is associated with diminished activity in the prefrontal executive control regions and exaggerated activity in subcortical reactive emotion brain areas. Previous studies have shown that when stressed, individuals tend to make more habitual responses than goal-directed choices, be less likely to adjust their initial judgment, and rely more on gut feelings in social situations. It is possible that stress influences the arbitration between the emotion responses in subcortical regions and deliberative processes in the prefrontal cortex, so that final decisions are based on unexamined innate responses. Future research may further test this ‘stress induced deliberation-to-intuition’ (SIDI model and examine its underlying neural mechanisms.

Coping Flexibility and Complicated Grief: A Comparison of American and Chinese Samples

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Burton, Charles L.; Yan, Oscar H.; Pat-Horenczyk, Ruth; Chan, Ide S. F.; Ho, Samuel; Bonanno, George A.

2011-01-01

Background The ability to process a death, and the ability to remain optimistic and look beyond the loss, are both thought to be effective means of coping with loss and other aversive events. Recently, these seemingly contrary dimensions have been integrated into the idea of coping flexibility. Method In this study we assessed the ability of married and bereaved individuals in the US and Hong Kong to use both coping approaches as operationalized by the trauma-focused and forward-focused coping scales of a previously validated questionnaire. We also calculated a single flexibility score. Results Bereaved participants reported greater trauma-focused coping ability than did married participants. However, bereaved participants meeting criteria for complicated grief (CG) reported less forward-focused coping than both asymptomatic bereaved and married participants. The CG group also showed less overall coping flexibility than the asymptomatic bereaved and married groups. Country was not a factor. Conclusions Findings suggest that deficits in coping flexibility are indicative of pathology in bereaved individuals, and that this relationship extends across cultures. Limitations of the study and directions for future research are discussed. PMID:21898713

Democracy and the Internet: Access, Engagement and Deliberation

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Roman Gerodimos

2005-12-01

Full Text Available The internet has the capacity to facilitate the creation of new forms of civic engagement, but the realisation of these opportunities requires institutional and cultural reinforcement. The democratic character of e-citizenship and the equal distribution of online resources to the public require the fulfilment of four conditions: access, engagement (incorporating education, motivation and trust, meaningful deliberation and a link between civic input and public policy output. Furthermore, the gap between the main features of cyberspace and the inherent prerequisites of democracy, such as a finite space and a set of rules, create tensions that need to be negotiated politically. Although the empirical evidence available includes some encouraging signs regarding the future use of the internet for civic engagement, the existing limitations and obstacles mean that the new media will complement, rather than replace, the old media as a democratic public sphere.

The Use of Expressives in Online Political Talk : Impeding or Facilitating the Normative Goals of Deliberation?

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Graham, T.S.; Tambouris, E; Macintosh, A; Glassey, O

2010-01-01

Net-based public sphere researchers have questioned whether the internet presents the public sphere with a new opportunity for the development of public spaces where free, equal and open deliberation among citizens can flourish. However, much of the research has operationalized a formal notion of

Higher threat avoidance costs reduce avoidance behaviour which in turn promotes fear extinction in humans.

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Rattel, Julina A; Miedl, Stephan F; Blechert, Jens; Wilhelm, Frank H

2017-09-01

Theoretical models specifying the underlying mechanisms of the development and maintenance of anxiety and related disorders state that fear responses acquired through classical Pavlovian conditioning are maintained by repeated avoidance behaviour; thus, it is assumed that avoidance prevents fear extinction. The present study investigated behavioural avoidance decisions as a function of avoidance costs in a naturalistic fear conditioning paradigm. Ecologically valid avoidance costs - manipulated between participant groups - were represented via time-delays during a detour in a gamified computer task. After differential acquisitions of shock-expectancy to a predictive conditioned stimulus (CS+), participants underwent extinction where they could either take a risky shortcut, while anticipating shock signaled by the CS+, or choose a costly avoidance option (lengthy detour); thus, they were faced with an approach-avoidance conflict. Groups with higher avoidance costs (longer detours) showed lower proportions of avoiders. Avoiders gave heightened shock-expectancy ratings post-extinction, demonstrating 'protecting from extinction', i.e. failure to extinguish. Moreover, there was an indirect effect of avoidance costs on protection from extinction through avoidance behaviour. No moderating role of trait-anxiety was found. Theoretical implications of avoidance behaviour are discussed, considering the involvement of instrumental learning in the maintenance of fear responses. Copyright © 2016 Elsevier Ltd. All rights reserved.

A Transient Dopamine Signal Represents Avoidance Value and Causally Influences the Demand to Avoid

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Pultorak, Katherine J.; Schelp, Scott A.; Isaacs, Dominic P.; Krzystyniak, Gregory

2018-01-01

Abstract While an extensive literature supports the notion that mesocorticolimbic dopamine plays a role in negative reinforcement, recent evidence suggests that dopamine exclusively encodes the value of positive reinforcement. In the present study, we employed a behavioral economics approach to investigate whether dopamine plays a role in the valuation of negative reinforcement. Using rats as subjects, we first applied fast-scan cyclic voltammetry (FSCV) to determine that dopamine concentration decreases with the number of lever presses required to avoid electrical footshock (i.e., the economic price of avoidance). Analysis of the rate of decay of avoidance demand curves, which depict an inverse relationship between avoidance and increasing price, allows for inference of the worth an animal places on avoidance outcomes. Rapidly decaying demand curves indicate increased price sensitivity, or low worth placed on avoidance outcomes, while slow rates of decay indicate reduced price sensitivity, or greater worth placed on avoidance outcomes. We therefore used optogenetics to assess how inducing dopamine release causally modifies the demand to avoid electrical footshock in an economic setting. Increasing release at an avoidance predictive cue made animals more sensitive to price, consistent with a negative reward prediction error (i.e., the animal perceives they received a worse outcome than expected). Increasing release at avoidance made animals less sensitive to price, consistent with a positive reward prediction error (i.e., the animal perceives they received a better outcome than expected). These data demonstrate that transient dopamine release events represent the value of avoidance outcomes and can predictably modify the demand to avoid. PMID:29766047

Parental Choices and Ethical Dilemmas Involving Disabilities: Special Education and the Problem of Deliberately Chosen Disabilities

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Kauffman, James M.; Hallahan, Daniel P.

2009-01-01

Ethical issues regarding children with disabilities have long involved their treatment after they are born. These issues remain important, but children may be deliberately created with or without characteristics that are usually thought of as disabilities. Preimplantation genetic diagnosis (PGD) and related technologies that involve human…

Motives and Suicide Intent Underlying Hospital Treated Deliberate Self-Harm and Their Association with Repetition

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McAuliffe, Carmel; Arensman, Ella; Keeley, Helen S.; Corcoran, Paul; Fitzgerald, Anthony P.

2007-01-01

The association between motives for deliberate self-harm (DSH), level of suicide intent, and history of DSH is poorly understood. As part of the WHO/EURO Multicentre Study on Suicidal Behavior, the Suicide Intent Scale, and the Motives for Parasuicide Questionnaire were administered to 146 patients presenting with DSH in the Cork region in…

A Crowd Avoidance Method Using Circular Avoidance Path for Robust Person Following

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Kohei Morishita

2017-01-01

Full Text Available A life-support service robot must avoid both static and dynamic obstacles for working in a real environment. Here, a static obstacle means an obstacle that does not move, and a dynamic obstacle is the one that moves. Assuming the robot is following a target person, we discuss how the robot avoids a crowd through which the target person passes and arrives at the target position. The purpose of this paper is to propose a crowd avoidance method that makes a robot to be able to avoid both static and dynamic obstacles. The method uses the surface points of the obstacles to form an avoidance region, and the robot moves along the edge of the region. We conducted experiments assuming various situations such that the robot was blocked, there was a wide gap in the crowd, or a person in the crowd yielded for the robot to pass through. As an experimental result, it was confirmed the robot could avoid the crowd even when the obstacles were aligned in an “inverted wedge” shape.

Airborne Collision Detection and Avoidance for Small UAS Sense and Avoid Systems

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Sahawneh, Laith Rasmi

The increasing demand to integrate unmanned aircraft systems (UAS) into the national airspace is motivated by the rapid growth of the UAS industry, especially small UAS weighing less than 55 pounds. Their use however has been limited by the Federal Aviation Administration regulations due to collision risk they pose, safety and regulatory concerns. Therefore, before civil aviation authorities can approve routine UAS flight operations, UAS must be equipped with sense-and-avoid technology comparable to the see-and-avoid requirements for manned aircraft. The sense-and-avoid problem includes several important aspects including regulatory and system-level requirements, design specifications and performance standards, intruder detecting and tracking, collision risk assessment, and finally path planning and collision avoidance. In this dissertation, our primary focus is on developing an collision detection, risk assessment and avoidance framework that is computationally affordable and suitable to run on-board small UAS. To begin with, we address the minimum sensing range for the sense-and-avoid (SAA) system. We present an approximate close form analytical solution to compute the minimum sensing range to safely avoid an imminent collision. The approach is then demonstrated using a radar sensor prototype that achieves the required minimum sensing range. In the area of collision risk assessment and collision prediction, we present two approaches to estimate the collision risk of an encounter scenario. The first is a deterministic approach similar to those been developed for Traffic Alert and Collision Avoidance (TCAS) in manned aviation. We extend the approach to account for uncertainties of state estimates by deriving an analytic expression to propagate the error variance using Taylor series approximation. To address unanticipated intruders maneuvers, we propose an innovative probabilistic approach to quantify likely intruder trajectories and estimate the probability of

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African Journals Online (AJOL)

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2017-07-01

Jul 1, 2017 ... ToP, child death or where a child has been given up for adoption at ... A mother may decide to avoid a birth through abortion, she may give a child up for ... families. That is, perinatal loss related grief responses of parents may ...

Comparative-Effectiveness of Simulation-Based Deliberate Practice Versus Self-Guided Practice on Resident Anesthesiologists' Acquisition of Ultrasound-Guided Regional Anesthesia Skills.

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Udani, Ankeet Deepak; Harrison, T Kyle; Mariano, Edward R; Derby, Ryan; Kan, Jack; Ganaway, Toni; Shum, Cynthia; Gaba, David M; Tanaka, Pedro; Kou, Alex; Howard, Steven K

2016-01-01

Simulation-based education strategies to teach regional anesthesia have been described, but their efficacy largely has been assumed. We designed this study to determine whether residents trained using the simulation-based strategy of deliberate practice show greater improvement of ultrasound-guided regional anesthesia (UGRA) skills than residents trained using self-guided practice in simulation. Anesthesiology residents new to UGRA were randomized to participate in either simulation-based deliberate practice (intervention) or self-guided practice (control). Participants were recorded and assessed while performing simulated peripheral nerve blocks at baseline, immediately after the experimental condition, and 3 months after enrollment. Subject performance was scored from video by 2 blinded reviewers using a composite tool. The amount of time each participant spent in deliberate or self-guided practice was recorded. Twenty-eight participants completed the study. Both groups showed within-group improvement from baseline scores immediately after the curriculum and 3 months following study enrollment. There was no difference between groups in changed composite scores immediately after the curriculum (P = 0.461) and 3 months following study enrollment (P = 0.927) from baseline. The average time in minutes that subjects spent in simulation practice was 6.8 minutes for the control group compared with 48.5 minutes for the intervention group (P < 0.001). In this comparative effectiveness study, there was no difference in acquisition and retention of skills in UGRA for novice residents taught by either simulation-based deliberate practice or self-guided practice. Both methods increased skill from baseline; however, self-guided practice required less time and faculty resources.

Mental health risks in the local workforce engaged in disaster relief and reconstruction.

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Wang, Xiao L; Chan, Cecilia L W; Shi, Zhan B; Wang, Bin

2013-02-01

To build a sustainable workforce for long-term disaster relief and reconstruction, more effort must be made to promote local relief workers' mental health. We conducted 25 semistructured interviews with local relief officials 10 months after the 2008 earthquake in China to investigate the stress and coping experiences in their personal lives as survivors. We conducted thematic analysis of interview transcripts. Traumatic bereavement and grief, housing and financial difficulties, and work-family conflict were the three main sources of stress in the respondents' personal lives. The coping themes were finding meaning and purpose in life through relief work, colleagues' support and understanding, suppression or avoidance of grief, appreciation for life, hardiness, optimism, letting nature take its course, and making up for loss. We suggest that relief work has a double-edged-sword effect on workers' coping abilities. We discuss the implications of this effect for work-life balance measures and trauma and grief counseling services.

Oxytocin promotes intuitive rather than deliberated cooperation with the in-group.

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Ten Velden, Femke S; Daughters, Katie; De Dreu, Carsten K W

2017-06-01

A contribution to a special issue on Hormones and Human Competition. In intergroup settings, individuals prefer cooperating with their in-group, and sometimes derogate and punish out-groups. Here we replicate earlier work showing that such in-group bounded cooperation is conditioned by oxytocin and extend it by showing that oxytocin-motivated in-group cooperation is intuitive rather than deliberated. Healthy males (N=65) and females (N=129) self-administered intranasal placebo or 24IU oxytocin in a double-blind placebo-controlled between-subjects design, were assigned to a three-person in-group (that faced a 3-person out-group), and given an endowment from which they could contribute to a within-group pool (benefitting the in-group), and/or to a between-group pool (benefitting the in-group and punishing the out-group). Prior to decision-making, participants performed a Stroop Interference task that was either cognitively taxing, or not. Cognitively taxed individuals kept less to themselves and contributed more to the within-group pool. Furthermore, participants receiving placebo contributed more to the within-group pool when they were cognitively taxed rather than not; those receiving oxytocin contributed to the within-group pool regardless of cognitive taxation. Neither taxation nor treatment influenced contributions to the between-group pool, and no significant sex differences were observed. It follows that in intergroup settings (i) oxytocin increases in-group bounded cooperation, (ii) oxytocin neither reduces nor increases out-group directed spite, and (iii) oxytocin-induced in-group cooperation is independent of cognitive taxation and, therefore, likely to be intuitive rather than consciously deliberated. Copyright © 2016 Elsevier Inc. All rights reserved.

Pregnancy continuation and organizational religious activity following prenatal diagnosis of a lethal fetal defect are associated with improved psychological outcome.

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Cope, Heidi; Garrett, Melanie E; Gregory, Simon; Ashley-Koch, Allison

2015-08-01

The aim of the article is to examine the psychological impact, specifically symptoms of grief, post-traumatic stress and depression, in women and men who either terminated or continued a pregnancy following prenatal diagnosis of a lethal fetal defect. This project investigated a diagnostically homogeneous group composed of 158 women and 109 men who lost a pregnancy to anencephaly, a lethal neural tube defect. Participants completed the Perinatal Grief Scale, Impact of Event Scale - Revised and Beck Depression Inventory-II, which measure symptoms of grief, post-traumatic stress and depression, respectively. Demographics, religiosity and pregnancy choices were also collected. Gender-specific analysis of variance was performed for instrument total scores and subscales. Women who terminated reported significantly more despair (p = 0.02), avoidance (p = 0.008) and depression (p = 0.04) than women who continued the pregnancy. Organizational religious activity was associated with a reduction in grief (Perinatal Grief Scale subscales) in both women (p = 0.02, p = 0.04 and p = 0.03) and men (p = 0.047). There appears to be a psychological benefit to women to continue the pregnancy following a lethal fetal diagnosis. Following a lethal fetal diagnosis, the risks and benefits, including psychological effects, of termination and continuation of pregnancy should be discussed in detail with an effort to be as nondirective as possible. © 2015 John Wiley & Sons, Ltd.

Disrupted avoidance learning in functional neurological disorder: Implications for harm avoidance theories

Directory of Open Access Journals (Sweden)

Laurel S. Morris

Full Text Available Background: Functional neurological disorder (FND is an elusive disorder characterized by unexplained neurological symptoms alongside aberrant cognitive processing and negative affect, often associated with amygdala reactivity. Methods: We examined the effect of negative conditioning on cognitive function and amygdala reactivity in 25 FND patients and 20 healthy volunteers (HV. Participants were first conditioned to stimuli paired with negative affective or neutral (CS+/CS− information. During functional MRI, subjects then performed an instrumental associative learning task to avoid monetary losses in the context of the previously conditioned stimuli. We expected that FND patients would be better at learning to avoid losses when faced with negatively conditioned stimuli (increased harm avoidance. Multi-echo resting state fMRI was also collected from the same subjects and a robust denoising method was employed, important for removing motion and physiological artifacts. Results: FND subjects were more sensitive to the negative CS+ compared to HV, demonstrated by a reinforcement learning model. Contrary to expectation, FND patients were generally more impaired at learning to avoid losses under both contexts (CS+/CS−, persisting to choose the option that resulted in a negative outcome demonstrated by both behavioural and computational analyses. FND patients showed enhanced amygdala but reduced dorsolateral prefrontal cortex responses when they received negative feedback. Patients also had increased resting state functional connectivity between these two regions. Conclusions: FND patients had impaired instrumental avoidance learning, findings that parallel previous observations of impaired action-outcome binding. FND patients further show enhanced behavioural and neural sensitivity to negative information. However, this did not translate to improved avoidance learning. Put together, our findings do not support the theory of harm avoidance in FND

Deliberate utilization of interaction torques brakes elbow extension in a fast throwing motion.

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Hore, Jon; Debicki, Derek B; Gribble, Paul L; Watts, Sherry

2011-05-01

We tested the hypothesis that in fast arm movements the CNS deliberately utilizes interaction torques to decelerate (brake) joint rotations. Twelve subjects performed fast 2-D overarm throws in which large elbow extension velocities occurred. Joint motions were computed from recordings made with search coils; joint torques were calculated using inverse dynamics. After ball release, a large follow-through shoulder extension acceleration occurred that was initiated by shoulder extensor muscle torque. This shoulder acceleration produced a flexor interaction torque at the elbow that initiated elbow deceleration (braking). An instantaneous mechanical interaction of passive torques then occurred between elbow and shoulder, i.e., elbow extension deceleration produced a large shoulder extensor interaction torque that contributed to the shoulder extension acceleration which, simultaneously, produced a large elbow flexor interaction torque that contributed to elbow extension deceleration, and so on. Late elbow flexor muscle torque also contributed to elbow deceleration. The interaction of passive torques between shoulder and elbow was braked by shoulder flexor muscle torque. In this mechanism, shoulder musculature contributed to braking elbow extension in two ways: shoulder extensors initiated the mechanical interaction of passive torques between shoulder and elbow and shoulder flexors dissipated kinetic energy from elbow braking. It is concluded that, in fast 2-D throws, the CNS deliberately utilizes powerful interaction torques between shoulder and elbow to brake motion at the elbow.

Emotional reactions of medical doctors and students following the ...

African Journals Online (AJOL)

2009-09-03

Sep 3, 2009 ... throughout the interviews and that all information would be treated with confidentiality. ... change.7 Saunders and Valente found that when doctors had not been able, ... earlier loss, and perhaps adopting a coping strategy of avoiding all grief ..... Perceptions of clients by professional helpers. Psychological ...

Effect of counseling quality on anxiety, grief, and coping after second-trimester abortion for pregnancy complications.

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Kerns, Jennifer L; Mengesha, Biftu; McNamara, Blair C; Cassidy, Arianna; Pearlson, Geffan; Kuppermann, Miriam

2018-06-01

We sought to explore the relationship between counseling quality, measured by shared decision making and decision satisfaction, and psychological outcomes (anxiety, grief, and posttraumatic stress) after second-trimester abortion for pregnancy complications. We conducted a cross-sectional study of women who underwent second-trimester abortion for complications. We recruited participants from Facebook and online support groups and surveyed them about counseling experiences and psychosocial issues. We used multivariate linear regression to evaluate relationships between counseling quality and psychological outcomes. We analyzed data from 145 respondents. Shared decision making and decision satisfaction scores were positively and strongly correlated in bivariate analysis (r=0.7, pCounseling quality may be especially important in this setting given the sensitive nature of decisions regarding pregnancy termination for complications. These results highlight the importance of patient-centered counseling for women seeking pregnancy termination. Copyright © 2018. Published by Elsevier Inc.

Stimulus conflict triggers behavioral avoidance.

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Dignath, David; Eder, Andreas B

2015-12-01

According to a recent extension of the conflict-monitoring theory, conflict between two competing response tendencies is registered as an aversive event and triggers a motivation to avoid the source of conflict. In the present study, we tested this assumption. Over five experiments, we examined whether conflict is associated with an avoidance motivation and whether stimulus conflict or response conflict triggers an avoidance tendency. Participants first performed a color Stroop task. In a subsequent motivation test, participants responded to Stroop stimuli with approach- and avoidance-related lever movements. These results showed that Stroop-conflict stimuli increased the frequency of avoidance responses in a free-choice motivation test, and also increased the speed of avoidance relative to approach responses in a forced-choice test. High and low proportions of response conflict in the Stroop task had no effect on avoidance in the motivation test. Avoidance of conflict was, however, obtained even with new conflict stimuli that had not been presented before in a Stroop task, and when the Stroop task was replaced with an unrelated filler task. Taken together, these results suggest that stimulus conflict is sufficient to trigger avoidance.

On Mourning and Recovery: Integrating Stages of Grief and Change Toward a Neuroscience-Based Model of Attachment Adaptation in Addiction Treatment.

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Chambers, R Andrew; Wallingford, Sue C

2017-01-01

Interpersonal attachment and drug addiction share many attributes across their behavioral and neurobiological domains. Understanding the overlapping brain circuitry of attachment formation and addiction illuminates a deeper understanding of the pathogenesis of trauma-related mental illnesses and comorbid substance use disorders, and the extent to which ending an addiction is complicated by being a sort of mourning process. Attention to the process of addiction recovery-as a form of grieving-in which Kubler-Ross's stages of grief and Prochaska's stages of change are ultimately describing complementary viewpoints on a general process of neural network and attachment remodeling, could lead to more effective and integrative psychotherapy and medication strategies.

Deliberate practice predicts performance throughout time in adolescent chess players and dropouts: A linear mixed models analysis.

NARCIS (Netherlands)

de Bruin, A.B.H.; Smits, N.; Rikers, R.M.J.P.; Schmidt, H.G.

2008-01-01

In this study, the longitudinal relation between deliberate practice and performance in chess was examined using a linear mixed models analysis. The practice activities and performance ratings of young elite chess players, who were either in, or had dropped out of the Dutch national chess training,

Managing deliberate self-harm in young people: An evaluation of a training program developed for school welfare staff using a longitudinal research design

Directory of Open Access Journals (Sweden)

McGorry Patrick D

2008-09-01

Full Text Available Abstract Background Although deliberate self-harm is prevalent among young people, many who engage in deliberate self-harm receive sub-optimal care. Although schools are a well placed setting to support young people who engage in self-harm there are no specific training packages designed to assist school welfare staff to support these young people. The current study aimed to design, deliver and evaluate a training course specifically for school staff. Methods The study employed a longitudinal design. Two hundred and thirteen people participated in the training and evaluation. A questionnaire was administered at baseline, immediately after the training and at 6-month follow-up in order to determine if the training led to improvements in confidence when working with young people who self-harm, perceived skill, knowledge of, and attitudes towards people who self harm. Results Prior to the course, the majority of participants demonstrated relatively high levels of confidence, perceived skill and knowledge of self-harm and endorsed relatively positive attitudes towards people who engage in self-harm. Despite this, significant improvements were observed in terms of increased confidence, increased perceptions of skill along with increased knowledge of deliberate self-harm. These improvements were sustained over the follow-up period. Conclusion The results demonstrated that the provision of specifically designed training can help school welfare staff to feel better equipped to support young people who are engaging in deliberate self-harm.

Abstract 20854: A Tale of Self-Fulfilling Prophecies in Out-of-Hospital Cardiac Arrest: Emergency Medical Technicians Deliberately Perform Substandard CPR When Anticipating Poor Prognosis

DEFF Research Database (Denmark)

Bødtker, Henrik; Klausen, Troels M; Lauridsen, Kasper G

2017-01-01

) if they believe resuscitation to be futile. Furthermore, to investigate if different patient and resuscitation attempt characteristics result in EMTs deliberately performing substandard CPR.Methods: This was a cross-sectional questionnaire survey study conducted in 2016 through 2017 including EMTs from a Danish...... and compressions). Overall, 22% and 51% would perform substandard CPR if the patient were 80 or 90 years old respectively, 46% if the patient was living in a nursing home and up to 31% due to comorbidity such as cancer. EMTs (51%) would deliberately perform substandard CPR in case of on-going bystander CPR >20...... minutes. EMTs (72%) felt competent to terminate resuscitation, but only 9% knew international termination guidelines.Conclusion: EMTs delay start of resuscitation if they anticipate resuscitation to be futile. Furthermore, they deliberately perform substandard CPR based on controversial patient...

Outcomes of moral case deliberation - the development of an evaluation instrument for clinical ethics support (the Euro-MCD)

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Svantesson, M.; Karlsson, J.; Boitte, P.; Schildman, J.; Dauwerse, L.; Widdershoven, G.; Pedersen, R.; Huisman, M.; Molewijk, A.C.

2014-01-01

Background: Clinical ethics support, in particular Moral Case Deliberation, aims to support health care providers to manage ethically difficult situations. However, there is a lack of evaluation instruments regarding outcomes of clinical ethics support in general and regarding Moral Case

Risk factors and correlates of deliberate self-harm behavior: a systematic review.

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Fliege, Herbert; Lee, Jeong-Ran; Grimm, Anne; Klapp, Burghard F

2009-06-01

Deliberate self-harm behavior--without suicidal intent--is a serious health problem and may be studied as a clinical phenomenon in its own right. Empirical studies of sociodemographic and psychological correlates and risk factors are systematically reviewed. We searched Medline, PsycINFO, PSYNDEX (German psychological literature), and reference lists. We targeted self-induced bodily harm without conscious suicidal intent. Studies on suicidal behavior or self-poisoning were only included if they also assessed nonsuicidal self-harm. Fifty-nine original studies met the criteria. Deliberate self-harm may occur at all ages, yet adolescents and young adults are at a higher risk. Evidence on gender is complex. Only 5 studies realize a prospective design (6 months to 10 years) and test predictors. The majority use cross-sectional and retrospective methods. No longitudinal study (separately) examines new incidence. Evidence of correlates encompasses distal/proximal, person/environment, and state/trait factors. Many studies report associations between current self-harm behavior and a history of childhood sexual abuse. Adolescent and adult self-harmers experience more frequent and more negative emotions, such as anxiety, depression, and aggressiveness, than persons who do not self-harm. Two studies yield specific interactions between childhood trauma and current traits and states such as low emotional expressivity, low self-esteem, and dissociation with respect to a vulnerability to self-harm. Evidence of distal, biographical stressors is fairly strong. Proximal stressors have rarely been investigated; protective factors, hardly at all. Despite many findings of correlates, the data do not yet justify terming them risk factors. Longitudinal studies are needed.

Effect of alcohol dose on deliberate self-harm in men and women.

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Berman, Mitchell E; Fanning, Jennifer R; Guillot, Casey R; Marsic, Angelika; Bullock, Joshua; Nadorff, Michael R; McCloskey, Michael S

2017-09-01

Nonexperimental survey and field research support the notion that alcohol use may be associated with deliberate self-harm (DSH) across the spectrum of lethality, from nonsuicidal self-injury (NSSI) through suicide. Nonexperimental studies, however, provide limited information about potential causal relationships between alcohol consumption and DSH. Two previous experiments showed that a relatively high-dose of alcohol increases the likelihood of engaging in DSH in men, with DSH defined by the self-administration of a "painful" shock (the self-aggression paradigm [SAP]; Berman & Walley, 2003; McCloskey & Berman, 2003). In this study, we examined whether (a) lower doses of alcohol also elicit DSH, (b) this effect occurs for women as well as men, and (c) individual differences in past nonsuicidal self-injury (NSSI) moderate alcohol's effects on DSH. Nonalcohol dependent men and women (N = 210) were assigned either to .00%, .05%, .075%, or .100% blood alcohol concentration (BAC) drink conditions and completed a self-rating scale of NSSI (the Deliberate Self-Harm Inventory [DSHI]; Gratz, 2001). As in previous SAP studies, DSH was operationalized by shock setting behavior during a competitive reaction time (RT) game. Overall, a greater proportion of participants in the .075% and .100% (but not .050%) alcohol conditions self-selected a "painful" shock to administer compared to participants in the placebo condition. NSSI predicted self-administration of painful shocks, but did not moderate the alcohol effect. Results provide experimental evidence to support the notion that interventions for self-harm should include processes to monitor and limit alcohol intake. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Deliberate acquisition of competence in physiological breech birth: A grounded theory study.

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Walker, Shawn; Scamell, Mandie; Parker, Pam

2018-06-01

Research suggests that the skill and experience of the attendant significantly affect the outcomes of vaginal breech births, yet practitioner experience levels are minimal within many contemporary maternity care systems. Due to minimal experience and cultural resistance, few practitioners offer vaginal breech birth, and many practice guidelines and training programmes recommend delivery techniques requiring supine maternal position. Fewer practitioners have skills to support physiological breech birth, involving active maternal movement and choice of birthing position, including upright postures such as kneeling, standing, squatting, or on a birth stool. How professionals learn complex skills contrary to those taught in their local practice settings is unclear. How do professionals develop competence and expertise in physiological breech birth? Nine midwives and five obstetricians with experience facilitating upright physiological breech births participated in semi-structured interviews. Data were analysed iteratively using constructivist grounded theory methods to develop an empirical theory of physiological breech skill acquisition. Among the participants in this research, the deliberate acquisition of competence in physiological breech birth included stages of affinity with physiological birth, critical awareness, intention, identity and responsibility. Expert practitioners operating across local and national boundaries guided less experienced practitioners. The results depict a specialist learning model which could be formalised in sympathetic training programmes, and evaluated. It may also be relevant to developing competence in other specialist/expert roles and innovative practices. Deliberate development of local communities of practice may support professionals to acquire elusive breech skills in a sustainable way. Copyright © 2017 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

Adolescents\\' experience of a parental traumatic brain injury | Harris ...

African Journals Online (AJOL)

The phenomenon of parental traumatic brain injury was characterised by denial, anger, grief, guilt, anxiety, over-protectiveness, social isolation, and change in many areas of the participants' lives. The adolescents coped using both approaches and avoidance styles of coping. Religion was a theme in the lives of all four ...

Myopic Regret Avoidance: Feedback Avoidance and Learning in Repeated Decision Making

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Reb, Jochen; Connolly, Terry

2009-01-01

Decision makers can become trapped by "myopic regret avoidance" in which rejecting feedback to avoid short-term "outcome regret" (regret associated with counterfactual outcome comparisons) leads to reduced learning and greater long-term regret over continuing poor decisions. In a series of laboratory experiments involving repeated choices among…

Deliberate Practice in Medicine: The Motivation to Engage in Work-Related Learning and Its Contribution to Expertise

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van de Wiel, Margje W. J.; Van den Bossche, Piet

2013-01-01

This study examined physicians' motivation to engage in work-related learning and its contribution to expertise development beyond work experience. Based on deliberate practice theory, semi-structured interviews were conducted with 17 residents and 28 experienced physicians in internal medicine, focusing on the activities they engaged in during…

Short-term and long-term effects of psychosocial therapy for people after deliberate self-harm: a register-based, nationwide multicentre study using propensity score matching

DEFF Research Database (Denmark)

Lind, Bertel; Erlangsen, Anette; Stuart, Elisabeth

2014-01-01

Background Although deliberate self-harm is a strong predictor of suicide, evidence for effective interventions is missing. The aim of this study was to examine whether psychosocial therapy after self-harm was linked to lower risks of repeated self-harm, suicide, and general mortality. Methods...... In this matched cohort study all people who, after deliberate self-harm, received a psychosocial therapy intervention at suicide prevention clinics in Denmark during 1992—2010 were compared with people who did not receive the psychosocial therapy intervention after deliberate self-harm. We applied propensity...... score matching with a 1:3 ratio and 31 matching factors, and calculated odds ratios for 1, 5, 10, and 20 years of follow-up. The primary endpoints were repeated self-harm, death by suicide, and death by any cause. Findings 5678 recipients of psychosocial therapy (followed up for 42·828 person...

Deliberate and emergent strategies for implementing person-centred care: a qualitative interview study with researchers, professionals and patients.

Science.gov (United States)

Naldemirci, Öncel; Wolf, Axel; Elam, Mark; Lydahl, Doris; Moore, Lucy; Britten, Nicky

2017-08-04

The introduction of innovative models of healthcare does not necessarily mean that they become embedded in everyday clinical practice. This study has two aims: first, to analyse deliberate and emergent strategies adopted by healthcare professionals to overcome barriers to normalization of a specific framework of person-centred care (PCC); and secondly, to explore how the recipients of PCC understand these strategies. This paper is based on a qualitative study of the implementation of PCC in a Swedish context. It draws on semi-structured interviews with 18 researchers and 17 practitioners who adopted a model of PCC on four different wards and 20 patients who were cared for in one of these wards. Data from these interviews were first coded inductively and emerging themes are analysed in relation to normalization process theory (NPT). In addition to deliberate strategies, we identify emergent strategies to normalize PCC by (i) creating and sustaining coherence in small but continuously communicating groups (ii) interpreting PCC flexibly when it meets specific local situations and (iii) enforcing teamwork between professional groups. These strategies resulted in patients perceiving PCC as bringing about (i) a sense of ease (ii) appreciation of inter-professional congruity (ii) non-hierarchical communication. NPT is useful to identify and analyse deliberate and emergent strategies relating to mechanisms of normalization. Emergent strategies should be interpreted not as trivial solutions to problems in implementation, but as a possible repertoire of tools, practices and skills developed in situ. As professionals and patients may have different understandings of implementation, it is also crucial to include patients' perceptions to evaluate outcomes.

Afrontar el proceso de duelo To deal with grief

Directory of Open Access Journals (Sweden)

Mª Trinidad Pérez Vallejo

2008-06-01

Full Text Available Ana, con su testimonio y con su vida nos enseña como afrontar los procesos de duelo. La muerte de su esposo se produce en febrero de 2005, este suceso fue probablemente la experiencia más difícil e importante que ha pasado durante sus 74 años de vida. Ana cuidó a su esposo durante la enfermedad con celo, dedicación y sobre todo con mucho amor. Ahora nos cuenta su experiencia para que pueda servir a aliviar a todas aquellas personas que se hallan en una situación semejante, a la vez, que rinde homenaje a su esposo que con su vida llena de salud y vitalidad le enseñó a morir. Ana tiene una vida plena dedicada a ayudar a los más necesitados, y canaliza esa ayuda con la gente de su barrio visitando a los enfermos, a los que se encuentran solos y los que tienen condiciones económicas más adversas.Anne, in her testimony and life, teaches us how to deal with grief. The death of her husband, on February, 2005, was probably the most difficult and important occurance in the 74 years of her life. Anne had cared for her husband with zeal, dedication and most importantly, love. Anne shares her experience with us so that it may help to alleviate those of us who find ourselves in a similar situation, and at the same time, pays homage to her husband who, when he was filled whit health and vitality, taught to die. Now Anne has a full life dedicated to helping the most needy as she channels this help through the people of her neighbourhood, visiting the ill, the lonely and those in the most adverse economic circumstances.

Cigarette tax avoidance and evasion.

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Stehr, Mark

2005-03-01

Variation in state cigarette taxes provides incentives for tax avoidance through smuggling, legal border crossing to low tax jurisdictions, or Internet purchasing. When taxes rise, tax paid sales of cigarettes will decline both because consumption will decrease and because tax avoidance will increase. The key innovation of this paper is to compare cigarette sales data to cigarette consumption data from the Behavioral Risk Factor Surveillance System (BRFSS). I show that after subtracting percent changes in consumption, residual percent changes in sales are associated with state cigarette tax changes implying the existence of tax avoidance. I estimate that the tax avoidance response to tax changes is at least twice the consumption response and that tax avoidance accounted for up to 9.6% of sales between 1985 and 2001. Because of the increase in tax avoidance, tax paid sales data understate the level of smoking and overstate the drop in smoking. I also find that the level of legal border crossing was very low relative to other forms of tax avoidance. If states have strong preferences for smoking control, they must pair high cigarette taxes with effective policies to curb smuggling and other forms of tax avoidance or employ alternative policies such as counter-advertising and smoking restrictions.

A pilot study on the effectiveness of anticipatory grief therapy for elderly facing the end of life.

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Cheng, Joanna Oi-Yue; Lo, Raymond; Chan, Faye; Woo, Jean

2010-01-01

This pilot study evaluates the benefits of anticipatory grief therapy (AGT) for day hospice patients and long-term care (LTC) residents with cancer and non-malignant chronic diseases. Twenty-six elderly people (69.2 percent female; average age 81.8 years) participated in experiential, expressive activities and discussions during AGT. The McGill Quality of Life Questionnaire-Hong Kong version and the 15-item Geriatrics Depression Scale (Chinese version) were administered immediately before and after AGT, and at a four-week follow-up. Focus groups were held to collect qualitative feedback. Significant post-AGT improvements were found in physical (Z = -2.12, p art, perceived benefits of AGT, and comments and suggestions for improving AGT in the future. We conclude that AGT delivered in both day hospice and LTC settings could be acceptable, feasible, and useful for elderly people facing the end of life.

Ubiquitous media in everyday practices of grief and commemoration on children’s graves and online memorial sites

DEFF Research Database (Denmark)

Sandvik, Kjetil; Christensen, Dorthe Refslund

is not allocated to a specific period of time (a time of mourning) but that grieving and the social technologies like media, materiality and ritualization related to it are embedded in everyday life practices and have to be conceived of as processes rather than events that (suddenly) occur and then are over......’s graves in urban cemeteries. It is, however, also similarly apparent in the formation of network and peer-to-peer associations and, not the least, in the establishment of online networks and sites of grief and commemoration on social media. Facebook, Twitter and YouTube are media alive with discussions...... as such (Featherstone 1992, Elias 1998) and in relation to death practices (Gibson 2008). In recent years, media research has contributed to the field of death studies. Mediatization studies have focused on how various societal practices are influenced by media logics (Livingstone 2009, Lundby 2009) including religious...

Approach/avoidance in dreams.

Science.gov (United States)

Malcolm-Smith, Susan; Koopowitz, Sheri; Pantelis, Eleni; Solms, Mark

2012-03-01

The influential threat simulation theory (TST) asserts that dreaming yields adaptive advantage by providing a virtual environment in which threat-avoidance may be safely rehearsed. We have previously found the incidence of biologically threatening dreams to be around 20%, with successful threat avoidance occurring in approximately one-fifth of such dreams. TST asserts that threat avoidance is over-represented relative to other possible dream contents. To begin assessing this issue, we contrasted the incidence of 'avoidance' dreams with that of their opposite: 'approach' dreams. Because TST states that the threat-avoidance function is only fully activated in ecologically valid (biologically threatening) contexts, we also performed this contrast for populations living in both high- and low-threat environments. We find that 'approach' dreams are significantly more prevalent across both contexts. We suggest these results are more consistent with the view that dreaming is generated by reward-seeking systems than by fear-conditioning systems, although reward-seeking is clearly not the only factor determining the content of dreams. Copyright © 2011 Elsevier Inc. All rights reserved.

Collaborative deliberation: a model for patient care.

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Elwyn, Glyn; Lloyd, Amy; May, Carl; van der Weijden, Trudy; Stiggelbout, Anne; Edwards, Adrian; Frosch, Dominick L; Rapley, Tim; Barr, Paul; Walsh, Thom; Grande, Stuart W; Montori, Victor; Epstein, Ronald

2014-11-01

Existing theoretical work in decision making and behavior change has focused on how individuals arrive at decisions or form intentions. Less attention has been given to theorizing the requirements that might be necessary for individuals to work collaboratively to address difficult decisions, consider new alternatives, or change behaviors. The goal of this work was to develop, as a forerunner to a middle range theory, a conceptual model that considers the process of supporting patients to consider alternative health care options, in collaboration with clinicians, and others. Theory building among researchers with experience and expertise in clinician-patient communication, using an iterative cycle of discussions. We developed a model composed of five inter-related propositions that serve as a foundation for clinical communication processes that honor the ethical principles of respecting individual agency, autonomy, and an empathic approach to practice. We named the model 'collaborative deliberation.' The propositions describe: (1) constructive interpersonal engagement, (2) recognition of alternative actions, (3) comparative learning, (4) preference construction and elicitation, and (5) preference integration. We believe the model underpins multiple suggested approaches to clinical practice that take the form of patient centered care, motivational interviewing, goal setting, action planning, and shared decision making. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Investigation of Groundwater Flow Variations near a Recharge Pond with Repeat Deliberate Tracer Experiments

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Jordan F Clark

2014-06-01

Full Text Available Determining hydraulic connections and travel times between recharge facilities and production wells has become increasingly important for permitting and operating managed aquifer recharge (MAR sites, a water supply strategy that transfers surface water into aquifers for storage and later extraction. This knowledge is critical for examining water quality changes and assessing the potential for future contamination. Deliberate tracer experiments are the best method for determining travel times and identifying preferential flow paths between recharge sites over the time scales of weeks to a few years. This paper compares the results of two deliberate tracer experiments at Kraemer Basin, Orange County, CA, USA. Results from the first experiment, which was conducted in October 1998, showed that a region of highly transmissive sedimentary material extends down gradient from the basin for more than 3 km [1]. Mean groundwater velocities were determined to be approximately 2 km/year in this region based on the arrival time of the tracer center of mass. A second experiment was initiated in January 2008 to determine if travel times from this basin to monitoring and production wells changed during the past decade in response to new recharge conditions. Results indicate that flow near Kraemer Basin was stable, and travel times to most wells determined during both experiments agree within the experimental uncertainty.

Healthcare avoidance: a critical review.

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Byrne, Sharon K

2008-01-01

The purpose of this study is to provide a critical review and synthesis of theoretical and research literature documenting the impact of avoidance on healthcare behaviors, identify the factors that influence healthcare avoidance and delay in the adult population, and propose a direction for future research. The Theory of Reasoned Action, Theory of Planned Behavior, Theory of Care-Seeking Behavior, the Transtheoretical Model, and the Behavioral Model of Health Services Use/Utilization are utilized to elaborate on the context within which individual intention to engage in healthcare behaviors occurs. Research literature on the concept of healthcare avoidance obtained by using computerized searches of CINAHL, MEDLINE, PSYCH INFO, and HAPI databases, from 1995 to 2007, were reviewed. Studies were organized by professional disciplines. Healthcare avoidance is a common and highly variable experience. Multiple administrative, demographic, personal, and provider factors are related to healthcare avoidance, for example, distrust of providers and/or the science community, health beliefs, insurance status, or socioeconomic/income level. Although the concept is recognized by multiple disciplines, limited research studies address its impact on healthcare decision making. More systematic research is needed to determine correlates of healthcare avoidance. Such studies will help investigators identify patients at risk for avoidant behaviors and provide the basis for health-promoting interventions. Methodological challenges include identification of characteristics of individuals and environments that hinder healthcare behaviors, as well as, the complexity of measuring healthcare avoidance. Studies need to systematically explore the influence of avoidance behaviors on specific healthcare populations at risk.

Hierarchy, Dominance, and Deliberation: Egalitarian Values Require Mental Effort.

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Van Berkel, Laura; Crandall, Christian S; Eidelman, Scott; Blanchar, John C

2015-09-01

Hierarchy and dominance are ubiquitous. Because social hierarchy is early learned and highly rehearsed, the value of hierarchy enjoys relative ease over competing egalitarian values. In six studies, we interfere with deliberate thinking and measure endorsement of hierarchy and egalitarianism. In Study 1, bar patrons' blood alcohol content was correlated with hierarchy preference. In Study 2, cognitive load increased the authority/hierarchy moral foundation. In Study 3, low-effort thought instructions increased hierarchy endorsement and reduced equality endorsement. In Study 4, ego depletion increased hierarchy endorsement and caused a trend toward reduced equality endorsement. In Study 5, low-effort thought instructions increased endorsement of hierarchical attitudes among those with a sense of low personal power. In Study 6, participants' thinking quickly allocated more resources to high-status groups. Across five operationalizations of impaired deliberative thought, hierarchy endorsement increased and egalitarianism receded. These data suggest hierarchy may persist in part because it has a psychological advantage. © 2015 by the Society for Personality and Social Psychology, Inc.

Decision-making in adolescent females who deliberately self-harm

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Rigler Tristan

2016-01-01

Full Text Available Self-harming behaviour most commonly begins in adolescence and is more frequent among adolescent females. We explored the hypothesis that adolescent females who deliberately selfharm were more likely to perform worse on a decision-making task. Previous research in adolescents who self-harm reported impaired decision-making. However, research put little emphasis on older adolescents and the emotional learning. In our research, we presented the Iowa Gambling Task to 35 adolescent females who self-harmed and were treated at a psychiatric clinic, and to 35 healthy female controls. Our results show that in comparison to the control group the adolescents who self-harm took more risky decisions and were less concerned about the outcome. In addition, the clinical group also focused more on immediate gains and showed a reduced ability to learn from poor decisions in the past. Further research is suggested to explore the potential neurological correlates of decision-making and selfharming behaviour.

The temporal relationship between change in symptoms of prolonged grief and posttraumatic stress following old age spousal bereavement

DEFF Research Database (Denmark)

O Connor, Maja; Nickerson, Angela; Aderka, Idan M.

2015-01-01

Background: High levels of both prolonged grief symptoms (PGS) and posttraumatic stress symptoms (PTSS) are relatively common following bereavement, and the two types of bereavement complications share some of the same features. Little research has studied which of the two precedes the other...... following the death of a loved one. The purpose of this study was to examine the temporal relationship between change in high levels of PGS and PTSS during the first four years following old age spousal loss. Methods: Participants were 237 Danes (40% male; mean age = 73 years, SD = 4.4; range 65-81) who....... Results: Lower-level mediation analyses wereas performed. Results indicated that PGS mediated 83% of the relationship between time and PTSS, while PTSS only mediated 17% of the relationship between time and PGS. These results suggest that changes in PGS mediated changes in PTSS following spousal...