Furnes, Bodil; Dysvik, Elin
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.
Bruce, Christine A
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.
Bonanno, George A.; Papa, Anthony; Lalande, Kathleen; Zhang, Nanping; Noll, Jennie G.
In this study, the authors measured grief processing and deliberate grief avoidance and examined their relationship to adjustment at 4 and 18 months of bereavement for 2 types of losses (spouse, child) in 2 cultures (People's Republic of China, United States). Three hypotheses were compared: the traditional grief work assumption, a conditional…
Crosby, John F.; And Others
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)
Persons in grief turn to metaphors as they seek to understand and express their experience. Metaphors illustrated in this article include "grief is a whirlwind," "grief is the Great Depression all over again" and "grief is gray, cloudy and rainy weather." Hospice personnel can enhance their bereavement efforts by identifying and cultivating the expression of personal metaphors from patients and families. Two metaphors have gained wide cultural acceptance and lie behind contemporary scientific explorations of grief. These are "grief is recovery from illness" (Bowlby and Parkes) and "death is the last stage of growth and grief is the adjustment reaction to this growth" (Kubler-Ross). These models have developed linear perspectives of grief but have neglected to study the fluctuating intensity of symptoms. Adopting Worden's four-part typology of grief, the author illustrates how the pie graph can be used to display this important aspect of the grief experience, thus enhancing these models.
Patton, Desmond Upton; MacBeth, Jamie; Schoenebeck, Sarita; Shear, Katherine; McKeown, Kathleen
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
Nickrand, Heather L; Brock, Cara M
Although loss of loved ones is a universal experience, individuals who experience this loss grieve in different ways. Complicated grief involves the development of trauma symptoms, such as flashbacks, anxiety, and fear associated with daily activities after a death that disrupts the healthy grieving process. Daily activities such as eating, meal planning, grocery shopping, managing finances, and household maintenance can become painful and isolating for those experiencing complicated grief. Cognitive behavioral therapy is used to address irrational beliefs, feelings of depression or anger, and avoidance or numbing behaviors with a goal of leading the individual to adapting to a life, which no longer includes the lost loved one. As part of the bereavement counseling program in a hospice, a need was identified in individuals who had lost loved ones and were having difficulty with adjusting to meal planning, grocery shopping, and cooking for one. To address this need for grief counseling centered on meal planning, grocery shopping, meal preparations, and eating meals alone, "Culinary Grief Therapy: Cooking for One Series" was developed with a local Culinary Arts Program. Partnering with a local community college culinary arts program, the Cooking for One Series provides an interactive venue for cognitive behavioral therapy centered on meal planning and meal times. Along with demonstrations and hands-on experiences, participants are engaged in bereavement counseling with hospice staff. Initial reactions to Culinary Grief Therapy have been positive. Many attendees have participated in multiple workshops, and the number of participants grows for each offering. Culinary Grief Therapy is a novel approach to the needs of those experiencing the loss of a loved one and may reduce or prevent complicated grief associated with meal planning, grocery shopping, and cooking for one.
Schwartzman, Roy; Tibbles, David
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…
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,…
Wood, Frances B.
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.
Markin, Rayna D; Zilcha-Mano, Sigal
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).
... Staying Safe Videos for Educators Search English Español Death and Grief KidsHealth / For Teens / Death and Grief What's in this article? What Is ... the reaction we have in response to a death or loss. Grief can affect our body, mind, ...
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
Smid, Geert E; Kleber, Rolf J; de la Rie, Simone M; Bos, Jannetta B A; Gersons, Berthold P R; Boelen, Paul A
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 of) posttraumatic stress disorder (PTSD) and/or major depressive disorder (MDD) following confrontation with a traumatic loss. Trauma survivors, who are frequently from different cultural backgrounds, have often experienced multiple losses and ambiguous loss (missing family members or friends). Current evidence-based treatments for PTSD do not focus on traumatic grief. To develop a treatment for traumatic grief combining treatment interventions for PTSD and PCBD that may accommodate cultural aspects of grief. To provide a rationale for treatment, we propose a cognitive stress model of traumatic grief. Based on this model and on existing evidence-based treatments for PTSD and complicated grief, we developed Brief Eclectic Psychotherapy for Traumatic Grief (BEP-TG) for the treatment of patients with traumatic grief. The treatment is presented along with a case vignette. Processes contributing to traumatic grief include inadequately integrating the memory of the traumatic loss, negative appraisal of the traumatic loss, sensitivity to matching triggers and new stressors, and attempting to avoid distress. BEP-TG targets these processes. The BEP-TG protocol consists of five parts with proven effectiveness in the treatment of PCBD, PTSD, and MDD: information and motivation, grief-focused exposure, memorabilia and writing assignments, finding meaning and activation, and a farewell ritual. Tailored to fit the needs of trauma survivors, BEP-TG can be used to address traumatic grief symptoms related to multiple losses and ambiguous loss, as well as cultural aspects of bereavement through its different components.
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.
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
Moayedoddin, Babak; Markowitz, John C
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.
Davis, Esther L; Deane, Frank P; Barclay, Gregory D; Bourne, Joan; Connolly, Vivienne
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.
Dennis, Michael Robert
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…
Andreza Mourão Lopes
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.
Full Text Available Following the death of a loved one, a small group of grievers develop an abnormal grieving style, termed complicated or prolonged grief. In the effort to establish complicated grief as a disorder in DSM and ICD, several attempts have been made over the past two decades to establish symptom criteria for this form of grieving. Complicated grief is different from depression and PTSD yet often comorbid with other psychological disorders. Meta-analyses of grief interventions show small to medium effect sizes, with only few studies yielding large effect sizes. In this article, an integrative cognitive behavioral treatment manual for complicated grief disorder (CG-CBT of 25 individual sessions is described. Three treatment phases, each entailing several treatment strategies, allow patients to stabilize, explore, and confront the most painful aspects of the loss, and finally to integrate and transform their grief. Core aspects are cognitive restructuring and confrontation. Special attention is given to practical exercises. This article includes the case report of a woman whose daughter committed suicide.
Zupanick, Corinne E.
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…
... 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 ...
Roberts, Lisa R; Lee, Jerry W
Perinatal grief following stillbirth is a significant social and mental health burden. We examined associations among the following latent variables: autonomy, social norms, self-despair, strained coping, and acute grief-among poor, rural women in India who experienced stillbirth. A structural equation model was built and tested using quantitative data from 347 women of reproductive age in Chhattisgarh. Maternal acceptance of traditional social norms worsens self-despair and strained coping, and increases the autonomy granted to women. Greater autonomy increases acute grief. Greater despair and acute grief increase strained coping. Social and cultural factors were found to predict perinatal grief in India.
Winther-Lindqvist, Ditte Alexandra; Køster, Allan; Brinkmann, Svend
The authors involved in the creation of this text are collaborators on a research project called The Culture of Grief that explores the current conditions and implications of grief. The present text represents an attempt to reach a level of understanding of grief that is not easily obtained through...... conventional methods. The group of authors participated as members of the audience in an avant-garde theatrical performance about grief, created by a group called CoreAct, and we as researchers decided to study the development of the play and its performance, and to report our impressions in fragments...
Dennis, Michael Robert
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.
Shear, M Katherine
Complicated grief is a recently recognized condition that occurs in about 7% of bereaved people. People with this condition are caught up in rumination about the circumstances of the death, worry about its consequences, or excessive avoidance of reminders of the loss. Unable to comprehend the finality and consequences of the loss, they resort to excessive avoidance of reminders of the loss as they are tossed helplessly on waves of intense emotion. People with complicated grief need help, and clinicians need to know how to recognize the symptoms and how to provide help. This paper provides a framework to help clinicans understand bereavement, grief, and mourning. Evidence-based diagnostic criteria are provided to help clinicians recognize complicated grief, and differentiate it from depression as well as anxiety disorder. We provide an overview of risk factors and basic assumptions and principles that can guide treatment.
Granek, Leeat; Peleg-Sagy, Tal
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.
Sandvik, Kjetil; Christensen, Dorthe Refslund; Hård af Segerstad, Ylva
their loss as well as their ability to establish and continue their role as parents. However, with new practices on children’s graves, the growing use of memory tattoos and especially the use of online media as platform for various communities for bereaved parents, this seem to be changing and strengthen...... both the interpersonal communication and social interactions about and with the deceased child. This study presents results from case studies of both open and closed online grief communities for bereaved parents in Denmark and Sweden (Refslund Christensen & Sandvik 2013, Hård af Segerstad & Kasperowski...... media, casting online communities for bereaved parents as grief-ghettos? Studying bereaved parents’ grief work in dynamic communities online enhances our understanding of contemporary and contributes to a nuancing of theoretical understanding of parental grief. References Christensen, D. R., & Sandvik...
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.
Sas, Corina; Coman, Alina
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.
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
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.
Rossetto, Kelly R
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.
Mendhekar, D N; Lohia, D
The concept of "absence of grief" in children has been embedded in psychoanalytic literature since its beginning. The clinical phenomenon of grief in a toddler is rarely described or analysed in the psychiatric literature. Early theorists felt that grieving does not occur until adolescence due to a younger child's psychological structure, including poor object-relations development. However, data on grief reaction in preschool children has mostly been under-reported or neglected, especially since most of the studies on childhood grief have been conducted on school-age children. We present a two-and-a-half-year-old girl, whose emotional and behavioural reactions to the loss of her grandfather became a focus of clinical attention. This report shows that even toddlers can mourn for their loved ones, although the expression and process of grief differ from that of older children and may occasionally draw clinical attention. Suggestions on how to investigate this phenomenon more closely and how to avoid it in socio-cultural contexts are proposed.
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...
González, Débora; Carvalho, María; Cantillo, Jordi; Aixalá, Marc; Farré, Magí
The death of a loved one is ultimately a universal experience. However, conventional interventions employed for people suffering with uncomplicated grief have gathered little empirical support. The present study aimed to explore the potential effects of ayahuasca on grief. We compared 30 people who had taken ayahuasca with 30 people who had attended peer-support groups, measuring level of grief and experiential avoidance. We also examined themes in participant responses to an open-ended question regarding their experiences with ayahuasca. The ayahuasca group presented a lower level of grief in the Present Feelings Scale of Texas Revised Inventory of Grief, showing benefits in some psychological and interpersonal dimensions. Qualitative responses described experiences of emotional release, biographical memories, and experiences of contact with the deceased. Additionally, some benefits were identified regarding the ayahuasca experiences. These results provide preliminary data about the potential of ayahuasca as a therapeutic tool in treatments for grief.
Christensen, Dorthe Refslund; Hård af Segerstad, Ylva; Kasperowski, Dick
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...
Hogan, Nancy; Schmidt, Lee; Coolican, Maggie
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.
Perluxo, Diana; Francisco, Rita
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.
O'Connor, Mary-Frances; Arizmendi, Brian J
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.
Dennis, Michael Robert
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…
Haley, Melinda; Hammond, Helen; Ingalls, Lawrence; Marín, Merranda Romaro
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…
Zucker, Donna M; Dion, Kimberly; McKeever, Roxanna P
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.
Lin, Yeh-Jen; Lin, Chi Yun; Li, Yu-Chan
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.
Herberman Mash, Holly B; Fullerton, Carol S; Ursano, Robert J
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.
Bellali, Thalia; Papadatou, Danai
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…
Huh, Hyu Jung; Kim, Kyung Hee; Lee, Hee-Kyung; Chae, Jeong-Ho
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, ...
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 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...
Isla Pera, Pilar; Moncho Vasallo, Joaquín; Guasch Andreu, Oscar; Torras Rabasa, Alberto
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.
O'Connor, Maja; Lasgaard, Mathias Kamp; Shevlin, Mark
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....
Wada, Kaori; Park, Jeeseon
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…
Sanderson, Jimmy; Cheong, Pauline Hope
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…
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 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).
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
Creighton, Genevieve; Oliffe, John L; Butterwick, Shauna; Saewyc, Elizabeth
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.
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…
MacCourt, Penny; McLennan, Marianne; Somers, Sandie; Krawczyk, Marian
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...
Creighton, Genevieve; Oliffe, John L.; Butterwick, Shauna; Saewyc, Elizabeth
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
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...
Kurotori, Isaku; Kato, Satoshi
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.
MacCourt, Penny; McLennan, Marianne; Somers, Sandie; Krawczyk, Marian
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.
M. Spuij (Mariken); P.J. Prinzie (Peter); P.A. Boelen (Paul A.)
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
Spuij, Mariken; Prinzie, Peter; Boelen, Paul A.
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
Bryant, Richard A
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.
O'Connor, Mary-Frances; Wellisch, David K; Stanton, Annette L; Eisenberger, Naomi I; Irwin, Michael R; Lieberman, Matthew D
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.
Cunsolo, Ashlee; Ellis, Neville R.
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.
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…
Harner, Holly M.; Hentz, Patricia M.; Evangelista, Maria Carmela
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
Toyama, Hiroko; Honda, Akiko
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
Nakao, Mutsuhiro; Kashiwagi, Masayo; Yano, Eiji
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…
Schaal, Susanne; Jacob, Nadja; Dusingizemungu, Jean-Pierre; Elbert, Thomas
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.
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
Snaman, Jennifer M; Kaye, Erica C; Torres, Carlos; Gibson, Deborah; Baker, Justin N
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.
Blank, Nancee M; Werner-Lin, Allison
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).
Cipriano, David J; Cipriano, Madeline R
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.
Vega, Paula Vega; Rodriguez, Rina González; Galdamez, Natalie Santibáñez; Molina, Camila Ferrada; Orellana, Javiera Spicto; Villanueva, Antonia Sateler; Melo, Jose Bustos
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.
Avelin, Pernilla; Rådestad, Ingela; Säflund, Karin; Wredling, Regina; Erlandsson, Kerstin
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.
Clements, Paul T; Vigil, Gloria J; Manno, Martin S; Henry, Gloria C; Wilks, Jonathan; Das Sarthak; Kellywood, Rosie; Foster, Wil
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.
Sedney, Mary Anne
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.
Wagner, B; Müller, J; Maercker, A
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.
McRitchie, Robyn; McKenzie, Karen; Quayle, Ethel; Harlin, Margaret; Neumann, Katja
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.
Shah, Prachi E; Clements, Melissa; Poehlmann, Julie
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.
.... 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...
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.
Huh, Hyu Jung; Kim, Kyung Hee; Lee, Hee-Kyung; Chae, Jeong-Ho
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, along with the moderating role of coping strategies. Methods : Bereaved parents ( n = 81) completed self-report questionnaires evaluating attachment, coping strategies, complicated grief, and shame/guilt. We performed correlational analyses to examine the associations among variables. We also conducted hierarchical regression analyses and simple slope analyses to examine the moderation effects of coping strategies. Results : Anxious attachment was associated with severe shame/guilt, and avoidant attachment correlated with complicated grief. Anxious attachment was positively associated with all types of coping strategies, and avoidant attachment was negatively related to problem- and emotion-focused coping. The use of problem-focused coping strategies was a significant moderator of the relationship between the avoidant attachment dimension and shame/guilt. Avoidant attachment had a significant effect on shame/guilt in groups with a high level of problem-focused coping. In contrast, none of the coping strategies significantly moderated the relationship between anxious attachment and grief response. Conclusions : The results suggest that people with highly avoidant attachment might be overwhelmed by shame and guilt when they try to use problem-focused coping strategies. This finding suggests that grief interventions should be organized with consideration of individual differences in attachment representations.
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 ...
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 ...
Smith, Andrew J; Abeyta, Andrew A; Hughes, Michael; Jones, Russell T
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).
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
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
Lisa C Barbour
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.
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.
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 ...
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.
Lafarge, Caroline; Mitchell, Kathryn; Fox, Pauline
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.
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.
Edgar-Bailey, Meredith; Kress, Victoria E.
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…
Roberts, Lisa R; Montgomery, Susanne; Lee, Jerry W; Anderson, Barbara A
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.
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...
Colin Murray Parkes
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.
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…
Smith, Andrew J; Layne, Christopher M; Coyle, Patrick; Kaplow, Julie B; Brymer, Melissa J; Pynoos, Robert S; Jones, Russell T
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.
Heeke, Carina; Stammel, Nadine; Knaevelsrud, Christine
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.
Harrer, Sabine; Schoenau-Fog, Henrik
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...
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.
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.…
Selby, Susan; Moulding, Nicole; Clark, Sheila; Jones, Alison; Braunack-Mayer, Annette; Beilby, Justin
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.
Mizuno, Yasunao; Kishimoto, Junji; Asukai, Nozomu
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…
Much theorizing in psychology and related disciplines begins with a given model of the mind that is then applied in research projects to study concrete phenomena. Sometimes psychological research can be theory-driven in quite an explicit way, approaching the logic of the hypothetico-deductive method. Others reject this and prefer to work inductively, and, in the extreme case of positivism, perhaps try to avoid theorizing altogether. In this article I shall suggest another way to think of the relationship between psychological theories and psychological phenomena. My suggestion is not simply to replace the hypothetico-deductive model with an inductive one, but to argue that the most direct route to theories of the human mind that grasp its complexity is to begin with the Kantian question of transcendental philosophy: X exists - how is X possible? In the context of this article, I apply this questioning to the phenomenon of grief: Grief exists - what general psychological theory of the mind do we need in order to account for its possibility? I attempt to extract three general psychological points from the existence of grief, viz. (1) the deep relationality of the self, (2) the limitations of evolutionary accounts, and (3) the normativity of psychological phenomena. I shall argue that these are general psychological lessons to be learned from grief, although they could also be arrived at by considering several other significant psychological phenomena.
... 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 ...
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.
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.
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 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.
Boerner, Kathrin; Burack, Orah R; Jopp, Daniela S; Mock, Steven E
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.
Germain, Anne; Shear, Katherine M.; Walsh, Colleen; Buysse, Daniel J.; Monk, Timothy H.; Reynolds, Charles F.; Frank, Ellen; Silowash, Russell
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
Brennan, F; Dash, M
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.
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.
Wayment, Heidi A; Silver, Roxane Cohen
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.
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.
Albuquerque, Sara; Narciso, Isabel; Pereira, Marco
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.
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 ...
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.
... 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 ...
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
Brazda, Geoffrey F; Range, Lillian M; Remley, Theodore P; White, Carolyn C
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.
McCarthy, Maria C; Clarke, Naomi E; Ting, Cheng Lin; Conroy, Rowena; Anderson, Vicki A; Heath, John A
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.
... 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 ...
Wojtkowiak, Joanna; Wild, Verena; Egger, Jos
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…
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
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.
Jacobsen, Juliet C.; Zhang, Baohui; Block, Susan D.; Maciejewski, Paul K.; Prigerson, Holly G.
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…
Corr, Charles A; Coolican, Margaret B
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.
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
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.
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.
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.
Gallo Acosta, Jairo; Muhete, Magnolia
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 ...
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
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
Granek, Leeat; Ben-David, Merav; Shapira, Shahar; Bar-Sela, Gil; Ariad, Samuel
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.
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…
Lyon, D S
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.
Jakoby, Nina R.
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…
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...
Wittmann, Daniela; Keshavan, Matcheri
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.
McRitchie, Robyn; McKenzie, Karen; Quayle, Ethel; Harlin, Margaret; Neumann, Katja
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...
Kim, Jane; Tol, Wietse A; Shrestha, Abina; Kafle, Hari Maya; Rayamajhi, Rajin; Luitel, Nagendra P; Thapa, Lily; Surkan, Pamela J
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.
Granek, Leeat; Peleg-Sagy, Tal
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.
Brave Heart, Maria Yellow Horse; DeBruyn, Lemyra M.
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…
Fernańdez-Alcántara, Manuel; García-Caro, M Paz; Pérez-Marfil, M Nieves; Hueso-Montoro, Cesar; Laynez-Rubio, Carolina; Cruz-Quintana, Francisco
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.
Kaplow, Julie B.; Layne, Christopher M.; Saltzman, William R.; Cozza, Stephen J.; Pynoos, Robert S.
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
Macdonald, Mary Ellen; Kennedy, Kimberly; Moll, Sandra; Pineda, Carolina; Mitchell, Lisa M; Stephenson, Peter H; Cadell, Susan
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.
Smid, Geert E.; Kleber, Rolf J.; de la Rie, Simone M.; Bos, Jannetta B. A.; Gersons, Berthold P. R.; Boelen, Paul A.
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
Smid, Geert E; Kleber, Rolf J; de la Rie, Simone M; Bos, Jannetta B A; Gersons, Berthold P R; Boelen, Paul A
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
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.
Lai, Carlo; Luciani, Massimiliano; Galli, Federico; Morelli, Emanuela; Cappelluti, Roberta; Penco, Italo; Aceto, Paola; Lombardo, Luigi
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.
Riches, Gordon; Dawson, Pam
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)
Taylor, Tory M; Thurman, Tonya R; Nogela, Lineo
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.
... 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 ...
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...
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...
Kelley, Melissa M.; Chan, Keith T.
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,…
Kaplow, Julie B; Layne, Christopher M; Saltzman, William R; Cozza, Stephen J; Pynoos, Robert S
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.
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
Maccallum, Fiona; Bryant, Richard A
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.
Full Text Available Background: Attentional bias refers to a preference for (e.g., vigilance or a shifting away (e.g., avoidance of one’s focus with respect to specific stimuli. Accumulating evidence suggests that an attentional bias toward death/threat-related stimuli exists in bereaved individuals experiencing prolonged grief (PG. Measuring for different processing may reflect different cognitive characteristics. Therefore, this study sought to compare information-processing biases in Chinese individuals with high versus low levels of PG symptomatology at supraliminal and subliminal levels, respectively.Method: A 2 (grief level × 2 (consciousness level × 2 (word type three-factor mixed design with supraliminal and subliminal tasks was utilized in the current study. Based on their Prolonged Grief Questionnaire-13 (PG-13 scores, 38 participants were included in the low-PG group, and 34 individuals were included in the high-PG group. All the participants completed a dot-probe task in which they were primed with death-related and life-related words paired with neutral stimuli.Results: High-PG individuals were slower in reacting to the death-related information in both supraliminal and subliminal tasks. After controlling for other symptoms in the backward deletion regression, PG-13 scores significantly predicted the avoidance tendency to death-related words in the supraliminal task, while anxiety was the best predictor of turning one’s vision away from death-related stimuli in the subliminal trials.Conclusion: The results suggested that high PG is associated with a tendency to avoid death-related words. Future research is needed to explore interventions that address the avoidance of death-related stimuli among individuals with elevated, or diagnosable, levels of PG.
Martín Rodríguez Alvaro
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.
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.
Tay, A K; Rees, S; Steel, Z; Liddell, B; Nickerson, A; Tam, N; Silove, D
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
Boelen, Paul A
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.
Stone, Joseph B.
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...
de Groot, M.; Neeleman, J.; van der Meer, K.; Burger, H.
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
Coelho, Alexandra; Barbosa, António
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.
Tay, Alvin Kuowei; Rees, Susan; Chen, Jack; Kareth, Moses; Silove, Derrick
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.
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.
Whitaker, Claudia; Kavanaugh, Karen; Klima, Carrie
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.
Spaten, Ole Michael; Byrialsen, Mia Nørremark; Langdridge, Darren
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....
Egnoto, Michael J; Sirianni, Joseph M; Ortega, Christopher R; Stefanone, Michael
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.
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…
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…
de Groot, Marieke; Neeleman, Jan; van der Meer, Klaas; Burger, Huibert
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…
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...
Albuquerque, Sara; Narciso, Isabel; Pereira, Marco
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 ...
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...
Kristensen, Pal; Weisaeth, Lars; Heir, Trond
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…
Balk, David E.; Zaengle, Donna; Corr, Charles A.
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…
Radosh, Alice; Simkin, Linda
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.
Holly G Prigerson
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.
Carmassi, Claudia; Shear, M Katherine; Socci, Chiara; Corsi, Martina; Dell'osso, Liliana; First, Michael B
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.
Maciejewski, Paul K; Maercker, Andreas; Boelen, Paul A|info:eu-repo/dai/nl/174011954; Prigerson, Holly G
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
Snaman, Jennifer M; Kaye, Erica C; Torres, Carlos; Gibson, Deborah V; Baker, Justin N
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.
Walker, Rebecca J.; Pomeroy, Elizabeth C.
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)
Shear, M Katherine
Avoidance can be adaptive and facilitate the healing process of acute grief or it can be maladaptive and hinder this same process. Maladaptive cognitive or behavioral avoidance comprises the central feature of the condition of complicated grief. This article explores the concept of experiential avoidance as it applies to bereavement, including when it is adaptive when it is problematic. Adaptive avoidance is framed using an attachment theory perspective and incorporates insights from the dual process model (DPM). An approach to clinical management of experiential avoidance in the syndrome of complicated grief is included.
Ruwaard, J.; Lange, A.; Lindefors, N.; Andersson, G.
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
Heaton, Kenneth W
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.
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....
Germain, Anne; Shear, Katherine M.; Walsh, Colleen; Buysse, Daniel J.; Monk, Timothy H.; Reynolds, Charles F., III; Frank, Ellen; Silowash, Russell
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…
Gassin, Elizabeth A; Lengel, Gregory J
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.
Harner, Holly M.; Hentz, Patricia M.; Evangelista, Maria Carmela
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...
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)
Nakajima, Naomi; Kodama, Kenichi
The purposes of this study are to clarify the characteristics of college students' bereavement and separation and the relationship between coping strategies and grief reactions in bereavement and separation. 212 college students completed questionnaires. The results indicated that the majority of the respondents have experienced some bereavement or separation, in particular, separation from the lover. Multiple regression analyses showed that coping strategies such as "avoidance", "abandonment...
Chen, Lin; Fu, Fang; Sha, Wei; Chan, Cecilia L W; Chow, Amy Y M
The purpose of this study is to explore the grief experiences of mothers after they lost their children in the 2008 China earthquake. Informed by the Dual Process Model, this study conducted in-depth interviews to explore how six bereaved mothers coped with such grief over a 2-year period. Right after the earthquake, these mothers suffered from intensive grief. They primarily coped with loss-oriented stressors. As time passed, these mothers began to focus on restoration-oriented stressors to face changes in life. This coping trajectory was a dynamic and integral process, which bereaved mothers oscillated between loss- and restoration-oriented stressors. This study offers insight in extending the existing empirical evidence of the Dual Process Model.
Boelen, Paul A; Reijntjes, Albert; J Djelantik, A A A Manik; Smid, Geert E
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
Høeg, Beverley Lim; Appel, Charlotte W.; von Heymann-Horan, Annika B.
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...
Sandler, Irwin; Tein, Jenn-Yun; Cham, Heining; Wolchik, Sharlene; Ayers, Tim
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
Breen, L J; O'Connor, M
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.
Feen-Calligan, Holly; McIntyre, Barbara; Sands-Goldstein, Margaret
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…
Penzo, Jeanine A.; Harvey, Pat
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…
Spiwak, Rae; Sareen, Jitender; Elias, Brenda; Martens, Patricia; Munro, Garry; Bolton, James
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.
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…
Lafarge, Caroline; Mitchell, Kathryn; Fox, Pauline
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.
Lee, So Hee; Nam, Hee Sun; Kim, Hak Beom; Kim, Eun Ji; Noh, Jin-Won; Chae, Jeong-Ho
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.
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,…
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...
Stroebe, Margaret; Schut, Henk; Boerner, Kathrin
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
Lenferink, Lonneke I.M.; Eisma, Maarten C.; de Keijser, Jos; Boelen, Paul A.
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
Sveen, Carl-Aksel; Walby, Fredrik A.
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…
Harper, Mairi; O'Connor, Rory C; O'Carroll, Ronan E
Previous research has identified a number of individual risk factors for parental bereavement including the sex of the parent, the sex of the child, avoidance-focussed coping style and time since death. These factors emerged from research where variables were tested univariately and their relative importance is currently unknown. The current research, therefore, aims to investigate which risk factors are important, multivariately, for the outcomes of grief and depression in parents following the death of their child. Psychosocial measures were completed by 106 bereaved parents four years post-loss, recruited from death records in Scotland. The cause of the child's death included long-term illness and stillbirths as well as sudden and violent deaths. In multivariate regression analyses, depression was predicted by higher avoidance-focussed coping and higher number of restoration-oriented stressors such as relationship difficulties, problems at work and financial issues. Grief was predicted by higher avoidance, restoration stressors and level of continuing bonds. The present study adds to the knowledge about the phenomenon of parental bereavement with participants recruited directly from death records rather than through support, clinical or obituary sources. Factors previously found to be associated with outcomes when tested univariately such as sudden, violent death or sex of the parent were not significant when tested multivariately. This study highlights that different vulnerability factors exist for grief and depression in bereaved parents.
Kostopoulou, Sotiria; Parpa, Efi; Tsilika, Eleni; Katsaragakis, Stylianos; Papazoglou, Irene; Zygogianni, Anna; Galanos, Antonis; Mystakidou, Kyriaki
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.
Parker, Gordon; Paterson, Amelia; Hadzi-Pavlovic, Dusan
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
Chambers, R Andrew; Wallingford, Sue C
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.
Coombs, Maureen A
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.
Glackin, Michelle; Higgins, Agnes
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.
Al-Gamal, Ekhlas; Long, Tony
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
Grassetti, Stevie N.; Williamson, Ariel A.; Herres, Joanna; Kobak, Roger; Layne, Christopher M.; Kaplow, Julie B.; Pynoos, Robert S.
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…
Kavanaugh, Karen; Andreoni, V. Ann; Wilkie, Diana J.; Burgener, Sandra; Buschmann, MaryBeth Tank; Henderson, Gloria; Hsiung, Yi-Fang Yvonne; Zhao, Zhongsheng
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
Pledger, Carolyn Brastow
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.…
Kroeker, B. J.; And Others
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…
Victoria Eugenia Diaz.
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.
Lenferink, Lonneke; Eisma, Maarten; de Keijser, Jos; Boelen, P.A.
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
Bruce, E J; Schultz, C L; Smyrnios, K X
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.
Schaal, Susanne; Dusingizemungu, Jean-Pierre; Jacob, Nadja; Neuner, Frank; Elbert, Thomas
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…
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.
Mystakidou, Kyriaki; Tsilika, Eleni; Parpa, Efi; Katsouda, Emmanuela; Vlahos, Lambros
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.
Calandra, C; Finocchiaro, G; Raciti, L; Alberti, A
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.
Recently, full scale fixed-film or mixed suspended have been applied in many wastewater treatments plants. These processes no longer depend on biomass settle ability and can be used to improve the performance of existing plants as required by more stringent discharge permit limits, especially for nutrients suspended solids. Also, processes may work at high rates making is possible to build small footprint installations. Fixed-film processes include trickling filters (and combined suspended and fixed-films processes), rotating biological contactors, biological aerated submerged, filters moving bed reactors, fluidized bed reactors. In the first part, the theoretical based governing fixed-film processes are briefly outlined, with some simple examples of calculations, underlining the main differences with conventional activate sludge processes. In the second part, the most common types of reactors are reviewed [it
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
Chua, Kao-Wei; Richler, Jennifer J; Gauthier, Isabel
Attention helps us focus on what is most relevant to our goals, and prior work has shown that aspects of attention can be learned. Learned inattention to parts can abolish holistic processing of faces, but it is unknown whether learned attention to parts is sufficient to cause a change from part-based to holistic processing with objects. We trained subjects to individuate nonface objects (Greebles) from 2 categories: Ploks and Glips. Diagnostic information was in complementary halves for the 2 categories. Holistic processing was then tested with Plok-Glip composites that combined the kind of part that was diagnostic or nondiagnostic during training. Exposure to Greeble parts resulted in general failures of selective attention for nondiagnostic composites, but face-like holistic processing was only observed for diagnostic composites. These results demonstrated a novel link between learned attentional control and the acquisition of holistic processing. (c) 2015 APA, all rights reserved).
PAULO DANIEL ACERO RODRÍGUEZ
Full Text Available The conflict of which is setting Colombia, has brought with himself the utilization of anti-perssonel mines which the groups use to protect their territories of influence and in the moments in which they are pursued for the public force. This paper shows the results obtained from the investigation realised by the authors with a group of the military who key in minefields thus took place amputations, the central objectives were to describe the grief process that these people by the lost one of members of their body confront and to explore on the elements that affect the facing of the traumatic event. A qualitative methodology was used, interviewing to 8 members of Colombian army affected by mines person. The results allow to observe two classes of psychological mechanisms of facing: the mechanisms of defense before the originating anguish of the hostility of external means, (negation, minimisation regression, rationalization, repression and isolation which make its appearance at the first the psychological moments of the explosive impact and mechanisms that help the amputee to adapt to their new condition, (comparison, atemporality, importance and spirituality which they appear at a second moment when the amputation is realised under surgical conditions and therefore already is perceived like a measurement for the preservation of the life.
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
Gisele Ferreira Paris
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.
Burton, Charles L.; Yan, Oscar H.; Pat-Horenczyk, Ruth; Chan, Ide S. F.; Ho, Samuel; Bonanno, George A.
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
Gastil, Richard W.
Many researchers have speculated over the nature of the divorce recovery process. Is the process similar to Kubler-Ross's stages of grief or does divorce recovery follow a unique process? This paper examines the current body of empirical research in an attempt to answer these questions. From the 91 sources analyzed, it was discovered that most of…
Full Text Available For long-term care (LTC home staff who work directly with residents, death, dying, and grief are day-to-day experiences in their working life. However, staff are often overlooked for grief and bereavement support. This exploratory research used a qualitative approach to understand LTC staff’s grief and bereavement experience and to identify the perceived support needs of nurses and personal support workers who work in two faith-based non-profit care homes in Thunder Bay, Ontario, Canada. Findings indicated that participants’ experiences are complex, shaped by the emotional impact of each loss, the cumulative burden of ongoing grief, an organizational culture in LTC where death is hidden, and the lack of organizational attention to staffs’ support and education needs. Eight recommendations were developed from the findings. It is hoped that this research will assist in the development of organizational policy and procedures, addressing the health and well-being of direct care workers in LTC homes.
Hinton, Devon E.; Field, Nigel P.; Nickerson, Angela; Bryant, Richard A.; Simon, Naomi
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…
Hooghe, An; Rosenblatt, Paul C; Rober, Peter
Within Western cultural traditions, the idea that parents should talk about the death of their child with each other is deeply rooted. However, across bereaved parent couples there are wide variations in communication about their grief with each other. In this study, we explored the experiences of bereaved couples related to the process of talking and not talking. We used a thematic coding approach to analyze 20 interviews with 26 bereaved parents (11 interviewed as couples, four as individuals). Four main meanings emerged out of our analysis: not talking because of the inadequacy and pointlessness of words in grief, not talking as a way to regulate emotions in daily life, not talking as an expression of a personal, intimate process, and not talking because the partner has the same loss but a different grief process. In addition, we found that the process of talking and not talking can partly be understood as an emotional responsive process on an intrapersonal and interpersonal level. In this process partners search for a bearable distance from their own grief and their partner's, and attune with their relational context. A better understanding of this process is sought in a dialectical approach, emphasizing the value of both talking and not talking in a tense relationship with each other. Implications for clinical work are described. © 2017 Family Process Institute.
Willis, Erin; Ferrucci, Patrick
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.
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.
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...
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.
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.
Creighton, Genevieve; Oliffe, John; Matthews, Jennifer; Saewyc, Elizabeth
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…
Heather Cherie Moore
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.
Recently, full scale fixed-film or mixed suspended and fixed biomass bioreactors have been applied in many wastewater treatments plants. These process no longer depend on biomass settle ability and can be used to improve the performance of existing plants as required by more stringent discharge permit limits, especially for nutrients and suspended solid. Also, processes may work at high rates making it possible to build small footprint installations. Fixed-film process include trickling filter, moving bed reactors fluidized bed reactors. In the first part, the theoretical base governing fixed-film processes are briefly outlined with some simple examples of calculations underlining the main differences with conventional activated sludge processes [it
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.
Taubert, Mark; Norris, James
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
Tramel, Terri L.; Welker, Roger; Lowery, Niki; Mitchell, Mark
Additive Manufacturing of metallic components for aerospace applications offers many advantages over traditional manufacturing techniques. As a new technology, many aspects of its widespread utilization remain open to investigation. Among these are the cleaning processes that can be used for post finishing of parts and measurements to verify effectiveness of the cleaning processes. Many cleaning and drying processes and measurement methods that have been used for parts manufactured using conventional techniques are candidates that may be considered for cleaning and verification of additively manufactured parts. Among these are vapor degreasing, ultrasonic immersion and spray cleaning, followed by hot air drying, vacuum baking and solvent displacement drying. Differences in porosity, density, and surface finish of additively manufactured versus conventionally manufactured parts may introduce new considerations in the selection of cleaning and drying processes or the method used to verify their effectiveness. This presentation will review the relative strengths and weaknesses of different candidate cleaning and drying processes as they may apply to additively manufactured metal parts for aerospace applications. An ultrasonic cleaning technique for exploring the cleanability of parts will be presented along with an example using additively manufactured Inconel 718 test specimens to illustrate its use. The data analysis shows that this ultrasonic cleaning approach results in a well-behaved ultrasonic cleaning/extraction behavior. That is, it does not show signs of accelerated cavitation erosion of the base material, which was later confirmed by neutron imaging. In addition, the analysis indicated that complete cleaning would be achieved by ultrasonic immersion cleaning at approximately 5 minutes, which was verified by subsequent cleaning of additional parts.
Gee, Robert; Springer, Paul; Bitar, George; Drew, Faith; Graff, Chad
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…
Emanuel, Linda; Johnson, Rebecca; Taromino, Caroline
This short report contributes to the expanding body of qualitative research literature about the cognitive processes of newly diagnosed cancer patients as they adjust to a diagnosis of cancer. The study is based on secondary qualitative analysis of audio records collected as part of a larger NIH study (RO1D: An Interdisciplinary Perspective: A Social Science Examination of Oncofertility RL1 HD058296). Core categories illustrate the processes of "naming it," "dealing with dealing with it," and finding the "new norm" and were based on nine patient experiences. We observe that our substantive conceptual categories have equivalents in bereavement and grief literature where researchers have posited the theory that processing the diagnosis of a terminal illness is the equivalent to adjusting to a bereavement. These findings emphasize the importance of understanding real-time patient thoughts and feelings as soon after diagnosis as was possible with full patient consent.
Probst, Danielle R; Gustin, Jillian L; Goodman, Lauren F; Lorenz, Amanda; Wells-Di Gregorio, Sharla M
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.
Wittmann, Daniela; Foley, Sallie; Balon, Richard
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.
Janusz, Bernadetta; Drozdzowicz, Lucyna
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.
Tosello, Guido; Hansen, Hans Nørgaard; Schoth, Andreas
The influence of process parameters on μ-injection molding (μIM) and on μ-injection molded parts has been investigated using Design of Experiments. A mold with a sensor applied at injection location was used to monitor actual injection pressure and to determine the cavity filling time. Flow markers...... position was measured on the polymer μ-parts to evaluate filling behavior of the polymer melt flowing through μ-features. Experimental results obtained under different processing conditions were evaluated to correlate the process parameter levels influence on the selected responses. Results showed...... that the injection speed in one of the most influencing process parameters on the μIM process and on the μ-parts filling....
富田, 拓郎; 太田, ゆず; 小川, 恭子; 杉山, 晴子; 鏡, 直子; 上里, 一郎
Grief for bereavement influence the psychosomatic status of the bereaved negatively. This paper aimed at reviewing studies on the psychological process of grief, psychological interventions and help for the bereaved. First, we reconsidered and evaluated two basic theories: psychoanalytical grief theory (attachment theory) and stress theory. The grief theory, Freud's traditional theory, induced a number of studies on grief. ln this theory, the bereaved must experience grief work，the task of mo...
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.
Otani, Hiroyuki; Yoshida, Saran; Morita, Tatsuya; Aoyama, Maho; Kizawa, Yoshiyuki; Shima, Yasuo; Tsuneto, Satoru; Miyashita, Mitsunori
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.
Silove, D M; Tay, A K; Steel, Z; Tam, N; Soares, Z; Soares, C; Dos Reis, N; Alves, A; Rees, S
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.
..., and appliances. 21.305 Section 21.305 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION..., Parts, Processes, and Appliances § 21.305 Approval of materials, parts, processes, and appliances. Whenever a material, part, process, or appliance is required to be approved under this chapter, it may be...
Thompson, Mary Kathryn; Mischkot, Michael
The minimum feature size and obtainable tolerances of additive manufacturing processes are linked to the smallest volumetric elements (voxels) that can be created. This work presents the iterative design of a test part to investigate the resolution of AM processes with voxel sizes at the micro...... scale. Each design iteration reduces the test part size, increases the number of test features, improves functionality, and decreases coupling in the part. The final design is a set of three test parts that are easy to orient and measure, and that provide useful information about micro additive...... manufacturing processes....
Sentimentos de Apego e Perda em Processos de Mudanças OrganizacionaisFeelings of Attachment and Grief in Organizational Change ProcessesSentimientos de Apego y Pérdida en Procesos de Cambios Organizacionales
CESAR, Ana Maria Roux Valentini Coelho
existence of bereavement amongst 400 employees of a public bank after a big reengineering process. The study was carried out three years after the changes occurred, since after this period of time the feeling of bereavement and grief should have given place to the recovering process, with a predominance of states of positive spirit. The data suggests the existence of a pathological state of bereavement, with strong attachment to previous situations to change. It points out that it is not enough to prepare people to organizational changes that are coming and are inevitable. It is necessary to give them conditions so they can elaborate the feeling of grief in situations that already happened and were part of their lives. It is necessary to give them the opportunity to ‘say goodbye’ to past things, so that they can embrace the new ones.RESUMENGlobalización, tecnología y cambios sociales han contribuido al surgimiento de nuevos mercados y competidores, creando mayor competitividad. En contrapartida, se requiere de las personas flexibilidad para adaptarse a los constantes cambios y minimización del apego a situaciones pasadas. Sin embargo las rupturas que se exigen en los cambios pueden percibirse como muertes simbólicas, frente a su condición de irreversibilidad a los estados anteriores; esto genera estados de luto entre los involucrados. Partiendo del planteamiento etológico con relación al luto, este estudio analiza la existencia de estado de luto en 400 empleados de un banco estatal después de un importante proceso de reestructuración. El estudio se realizó tres años después de los cambios, momento en que después de este tiempo el sentimiento de luto por las pérdidas ya debería haber dado lugar a procesos de recuperación, con predominancia de estados de ánimo positivos. Los datos indican la existencia de estado de luto patológico, con fuerte apego a las situaciones anteriores al cambio. Esto señala que no basta preparar a las personas para los cambios
Badalamenti, A F
This paper presents evidence that six of the seven parts of speech occur in written text as Poisson processes, simple or recurring. The six major parts are nouns, verbs, adjectives, adverbs, prepositions, and conjunctions, with the interjection occurring too infrequently to support a model. The data consist of more than the first 5000 words of works by four major authors coded to label the parts of speech, as well as periods (sentence terminators). Sentence length is measured via the period and found to be normally distributed with no stochastic model identified for its occurrence. The models for all six speech parts but the noun significantly distinguish some pairs of authors and likewise for the joint use of all words types. Any one author is significantly distinguished from any other by at least one word type and sentence length very significantly distinguishes each from all others. The variety of word type use, measured by Shannon entropy, builds to about 90% of its maximum possible value. The rate constants for nouns are close to the fractions of maximum entropy achieved. This finding together with the stochastic models and the relations among them suggest that the noun may be a primitive organizer of written text.
Full Text Available The paper deals with the importance of logistics in innovation process. The issue is focused on management of different logistic processes building on the innovation and on innovation process. However, logistics is an essential part of this process. The results describe logistics chain within innovation process for the satisfaction of customers´ demand and fulfilment of customers’ requests on the innovation. This approach involves “7S of logistics” which means: “create proper innovation, in the proper quality, for the right place and in the right time, as well as, with the proper price and package”.
Miyanaji, Hadi; Orth, Morgan; Akbar, Junaid Muhammad; Yang, Li
Originally developed decades ago, the binder jetting additive manufacturing (BJ-AM) process possesses various advantages compared to other additive manufacturing (AM) technologies such as broad material compatibility and technological expandability. However, the adoption of BJ-AM has been limited by the lack of knowledge with the fundamental understanding of the process principles and characteristics, as well as the relatively few systematic design guideline that are available. In this work, the process design considerations for BJ-AM in green part fabrication were discussed in detail in order to provide a comprehensive perspective of the design for additive manufacturing for the process. Various process factors, including binder saturation, in-process drying, powder spreading, powder feedstock characteristics, binder characteristics and post-process curing, could significantly affect the printing quality of the green parts such as geometrical accuracy and part integrity. For powder feedstock with low flowability, even though process parameters could be optimized to partially offset the printing feasibility issue, the qualities of the green parts will be intrinsically limited due to the existence of large internal voids that are inaccessible to the binder. In addition, during the process development, the balanced combination between the saturation level and in-process drying is of critical importance in the quality control of the green parts.
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…
Van Belle, Laurent
Selective Laser Melting (SLM) process belonging to the family of the Additive Manufacturing (AM) technologies, enable to build parts layer by layer, from metallic powder and a CAD model. Physical phenomena that occur in the process have the same issues as conventional welding. Thermal gradients generate significant residual stresses and distortions in the parts. Moreover, the large and complex parts to manufacturing, accentuate the undesirable effects. Therefore, it is essential for manufacturers to offer a better understanding of the process and to ensure production reliability of parts with high added value. This paper focuses on the simulation of manufacturing turbine by SLM process in order to calculate residual stresses and distortions. Numerical results will be presented.
Sandvik, Kjetil; Christensen, Dorthe Refslund
This paper demonstrates how everyday practices among those who suffer the loss of a child include the use of both analogue and digital means and media to create meaningful relations to the dead child, the bereaved as well as to the surrounding world. A dead child – be it a stillborn or dead....... In this situation, the process of grief becomes a way of reinstalling meaning by establishing an ongoing relationship to the dead child by which the child – who in life was barely there – gains existence and through which the identity as parents (however to a dead child) is established, communicated and socially...... acknowledged. Based on observation studies and qualitative content analyses of both children’s graves and online memory profiles (Christensen & Sandvik 2013, 2014) combined with interviews with bereaved parents, we present some reflections on how these practices of commemoration, meaning...
... 12 Banks and Banking 5 2010-01-01 2010-01-01 false Consumer Grievance Process A Appendix A to Part 536 Banks and Banking OFFICE OF THRIFT SUPERVISION, DEPARTMENT OF THE TREASURY CONSUMER PROTECTION IN SALES OF INSURANCE Pt. 536, App. A Appendix A to Part 536—Consumer Grievance Process Any consumer who...
... 12 Banks and Banking 1 2010-01-01 2010-01-01 false Consumer Grievance Process A Appendix A to Part 14 Banks and Banking COMPTROLLER OF THE CURRENCY, DEPARTMENT OF THE TREASURY CONSUMER PROTECTION IN SALES OF INSURANCE Pt. 14, App. A Appendix A to Part 14—Consumer Grievance Process Any consumer who...
Burden, Christy; Bradley, Stephanie; Storey, Claire; Ellis, Alison; Heazell, Alexander E P; Downe, Soo; Cacciatore, Joanne; Siassakos, Dimitrios
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
Downey, A M
Living, loving and losing - we live, we love and we lose - this is an integral part of life's unending circle. Throughout the lifecycle, we are confronted continually with experiences of loss and separation. The loss of a loved one through separation, divorce, or death is one of the most difficult experiences to be dealt with in a lifetime. How do we cope with the "crisis of loss" in our lives? If education is supposed to prepare one for life, then Death Education is crucial in assisting individuals to cope with "myriad loss issues." This paper will explore the implications of loss for health and well-being, and briefly review some of the research findings regarding the negative impact of grief and bereavement upon health. The stages of the grief process will be cited, mentioning some of the barriers to grief resolution. Most importantly, the positive aspects of loss upon life and health will be elaborated.
Hinton, Devon E; Peou, Sonith; Joshi, Siddharth; Nickerson, Angela; Simon, Naomi M
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.
Spina, Roberto; Cavalcante, Bruno; Lavecchia, Fulvio
The main objective of the presented work is to evaluate the thermal behavior of Poly-lactic acid (PLA) parts made with a Fused Deposition Modelling (FDM) process. By using a robust framework for the testing sequence of PLA parts, with the aim of establishing a standard testing cycle for the optimization of the part performance and quality. The research involves study the materials before and after 3D printing. Two biodegradable PLA polymers are investigated, characterized by different colors (one black and the other transparent). The study starts with the examination of each polymeric material and measurements of its main thermal properties.
Davoudinejad, Ali; Pedersen, David Bue; Tosello, Guido
The process capability of additive manufacturing (AM) for direct production of miniaturized polymer components with micro features is analyzed in this work. The consideration of the minimum printable feature size and obtainable tolerances of AM process is a critical step to establish a process...... chains for the production of parts with micro scale features. A specifically designed direct light processing (DLP) AM machine suitable for precision printing has been used. A test part is designed having features with different sizes and aspect ratios in order to evaluate the DLP AM machine capability...
Cooper, Mark S.
Many high-reliability systems, including space systems, use selected commercial parts (including Plastic Encapsulated Microelectronics or PEMs) for unique functionality, small size, low weight, high mechanical shock resistance, and other factors. Predominantly this usage is subjected to certain 100% tests (typically called screens) and certain destructive tests usually (but not always) performed on the flight lot (typically called qualification tests). Frequently used approaches include those documented in EEE-INST-002 and JPL DocID62212 (which are sometimes modified by the particular aerospace space systems manufacturer). In this study, approaches from these documents and several space systems manufacturers are compared to approaches from a launch systems manufacturer (SpaceX), an implantable medical electronics manufacturer (Medtronics), and a high-reliability transport system process (automotive systems). In the conclusions section, these processes are outlined for all of these cases and presented in tabular form. Then some simple comparisons are made. In this introduction section, the PEM technology qualification process is described, as documented in EEE-INST-002 (written by the Goddard Space Flight Center, GSFC), as well as the somewhat modified approach employed at the Jet Propulsion Laboratory (JPL). Approaches used at several major NASA contractors are also described
Watanabe, Akiko; Suwa, Sayuri
To explore the mourning process of people with dementia who have lost their spouse, using family caregivers' and professionals' perspectives and to devise grief care for people with dementia. There have been studies on the loss of one's spouse; however, little is known about widows and widowers with dementia as they may find it hard to tell their perception and feelings to others accurately because of cognitive impairment. Qualitative descriptive study using semi-structured interviews. Seven family caregivers and six professional caregivers from day care centres were interviewed between June and September 2015. Qualitative content analysis was used to identify mourning behaviours of people with dementia. In the mourning process of people with dementia, different behaviours were found according to dementia stages and different circumstances. In FAST2, they could remember their spouse's death. In FAST4 -6, it took 1 year to be able to perceive their spouse's death and more time to store it. In FAST 7, people with dementia did not discern his spouse's death throughout the process. Furthermore, it was revealed that people with dementia followed a different mourning process from conventional ones. In the care of widows and widowers with dementia it is crucial to adjust circumstances to allow people with dementia to guess reality. Further studies are needed to clarify differences between the mourning process of people with dementia and that of intact older people to develop a grief model and educational programmes. © 2017 John Wiley & Sons Ltd.
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.
Rodriguez, Valerie J.; Glover-Graf, Noreen M.; Blanco, E. Lisette
The role of religiosity and spirituality in the process of adjustment to disability is of increasing interest to rehabilitation professionals. Beginning with the Kubler-Ross models of grief and adjustment to disability and terminal illness, a number of stage models have included spiritual and religious interactions as a part of the adjustment…
Russell, Bonnie; Uhlemann, Max R.
Surveys literature regarding women in abusive relationships focusing on key issues related to the change process that are consistent with the grieving process. Examines constructs of depression, guilt, and decision-making difficulty by comparing them within perspective of normal grieving. Discusses implications for counseling practice. Includes 35…
Plyatsuk L. D.
Full Text Available The present technical solution refers to the field of electrophysical and electrochemical processing of parts, in particular, to the electroerosion alloying (EEA of the surfaces of steel parts with aluminum (aluminizing and sulfur (sulfidizing, and it can be used to treat the surfaces of heat-treated steel parts in order to increase their hardness, wear resistance, to prevent frictional seizure and improve the resistance to atmospheric corrosion. When aluminizing steel parts with the use of the method of electroerosion alloying (EEA by aluminum electrode at discharge energy Wp = 0.52–6.8 J and productivity of 1.0–3.0 cm2 / min, before the EEA process by an aluminum electrode, to the surface of the part to be aluminized, there is applied a consistency substance containing sulfur and aluminum powder, and thereafter, not having waited for drying of the consistency substance, the process of aluminizing by the EEL method with an aluminum electrode is carried out, and the consistency substance should have the aluminum powder content of not more than 56 %. There have been carried out metallographic and durametric analyses of the features of the surface layers made of carbon steels after simultaneous aluminizing and sulfidizing them by the EEA method. It is shown that the structure of the layer consists of three portions, namely, a “white” layer, a diffusion zone and a base metal. Such qualitative surface layer parameters as thickness, “white” layer and transition zone microhardness values, and also roughness increase with increasing discharge energy. The “white” layer continuity for all the investigated discharge energies of Wp = 0.52, 2.60 and 6.80 J is 100 %.
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.
Ghani, Saiful Anwar Che; Mohamed, Siti Rohaida; Harun, Wan Sharuzi Wan; Noar, Nor Aida Zuraimi Md
In recent years, additive manufacturing with highly design customization has gained an important technique for fabrication in aerospace and medical fields. Despite the ability of the process to produce complex components with highly controlled architecture geometrical features, maintaining the part's accuracy, ability to fabricate fully functional high density components and inferior surfaces quality are the major obstacles in producing final parts using additive manufacturing for any selected application. This study aims to evaluate the physical properties of cobalt chrome molybdenum (Co-Cr-Mo) alloys parts fabricated by different additive manufacturing techniques. The full dense Co-Cr-Mo parts were produced by Selective Laser Melting (SLM) and Direct Metal Laser Sintering (DMLS) with default process parameters. The density and relative density of samples were calculated using Archimedes' principle while the surface roughness on the top and side surface was measured using surface profiler. The roughness average (Ra) for top surface for SLM produced parts is 3.4 µm while 2.83 µm for DMLS produced parts. The Ra for side surfaces for SLM produced parts is 4.57 µm while 9.0 µm for DMLS produced parts. The higher Ra values on side surfaces compared to the top faces for both manufacturing techniques was due to the balling effect phenomenon. The yield relative density for both Co-Cr-Mo parts produced by SLM and DMLS are 99.3%. Higher energy density has influence the higher density of produced samples by SLM and DMLS processes. The findings of this work demonstrated that SLM and DMLS process with default process parameters have effectively produced full dense parts of Co-Cr-Mo with high density, good agreement of geometrical accuracy and better surface finish. Despite of both manufacturing process yield that produced components with higher density, the current finding shows that SLM technique could produce components with smoother surface quality compared to DMLS
The present invention relates to a method for manufacturing a tool part for an injection molding process, a hot embossing process, nano-imprint process or an extrusion process. First, there is provided a master structure (10) with a surface area comprising nanometre-sized protrusions (11...
Chua, Kao-Wei; Richler, Jennifer J; Gauthier, Isabel
Faces are processed holistically, but the locus of holistic processing remains unclear. We created two novel races of faces (Lunaris and Taiyos) to study how experience with face parts influences holistic processing. In Experiment 1, subjects individuated Lunaris wherein the top, bottom, or both face halves contained diagnostic information. Subjects who learned to attend to face parts exhibited no holistic processing. This suggests that individuation only leads to holistic processing when the whole face is attended. In Experiment 2, subjects individuated both Lunaris and Taiyos, with diagnostic information in complementary face halves of the two races. Holistic processing was measured with composites made of either diagnostic or nondiagnostic face parts. Holistic processing was only observed for composites made from diagnostic face parts, demonstrating that holistic processing can occur for diagnostic face parts that were never seen together. These results suggest that holistic processing is an expression of learned attention to diagnostic face parts. PsycINFO Database Record (c) 2014 APA, all rights reserved.
... POLICY CONSUMER PROTECTION IN SALES OF INSURANCE Pt. 343, App. A Appendix A to Part 343—Consumer... Consumer Protection (DSC), Federal Deposit Insurance Corporation, at the following address: 550 17th Street... 12 Banks and Banking 4 2010-01-01 2010-01-01 false Consumer Grievance Process A Appendix A to Part...
Jacobs, Bonita; Towns, James E.
Emphasizes the responsibility for residence hall staff to understand the grief process. An adaptation of Kubler-Ross's stages of death has produced helpful techniques for successfully accepting the death. Through understanding these principles, staff can become aware of the grief process and can assist residents. (JAC)
Mingareev, Ilya; Gehlich, Nils; Bonhoff, Tobias; Meiners, Wilhelm; Kelbassa, Ingomar; Biermann, Tim; Richardson, Martin C.
Additive manufacturing, also known as 3D-printing, is a near-net shape manufacturing approach, delivering part geometry that can be considerably affected by various process conditions, heat-induced distortions, solidified melt droplets, partially fused powders, and surface modifications induced by the manufacturing tool motion and processing strategy. High-repetition rate femtosecond and picosecond laser radiation was utilized to improve surface quality of metal parts manufactured by laser additive techniques. Different laser scanning approaches were utilized to increase the ablation efficiency and to reduce the surface roughness while preserving the initial part geometry. We studied post-processing of 3D-shaped parts made of Nickel- and Titanium-base alloys by utilizing Selective Laser Melting (SLM) and Laser Metal Deposition (LMD) as additive manufacturing techniques. Process parameters such as the pulse energy, the number of layers and their spatial separation were varied. Surface processing in several layers was necessary to remove the excessive material, such as individual powder particles, and to reduce the average surface roughness from asdeposited 22-45 μm to a few microns. Due to the ultrafast laser-processing regime and the small heat-affected zone induced in materials, this novel integrated manufacturing approach can be used to post-process parts made of thermally and mechanically sensitive materials, and to attain complex designed shapes with micrometer precision.
Csikós, Ágnes; Menyhért, Mónika; Radványi, Ildikó; Busa, Csilla
Grief is a natural part of life and it is always individual. Researchers have tried and still try to develop different theories to interpret, explain, and approach this particular phenomenon. The aim of the authors was to review the theoretical literature of mourning and to present new bereavement theories for domestic professionals. From the first half of the 20th century until presently mourning theories have undergone significant changes. Today the determinant models includes the flexible, coping-oriented dual process model, meaning reconstruction model which focuses on the meaning making, and the model which focuses on the development after the loss. The authors conclude that experts, who work in the clinical area should know the prevailing theories of grief, because they encounter often with loss at work. The presented models may contribute to more efficient work, to better understanding of the mourning process and to a better support of families.
Hussein, Jeylan Wolyie
The paper is an inquiry into the poetics of mourning and faith-based intervention in maladaptive grieving processes in Ethiopia. The paper discusses the ways that loss is signified and analyzes the meanings of ethnocultural and psychospiritual practices employed to deal with maladaptive grief processes and their psychological and emotional after-effects. Hermeneutics provided the methodological framework and informed the analysis. The thesis of the paper is that the poetics of mourning and faith-based social interventions are interactionally based meaning making processes. The paper indicates the limitations of the study and their implications for further inquiry.
Full Text Available Based on different design processes for innovative products, the paper presents a new approach of the process. The new method studies the problem of replacing the wooden components of the resistance structure of furniture with other materials. This is a reverse engineering process, that starts with the entire component, following a series of steps to the part drawings, ready for manufacturing. The method was validated by redesigning some parts of the upholstered products manufactured by TAPARO Company, by replacing the wooden parts of the resistance structure of sofas with composite material.
Kerns, Jennifer L; Mengesha, Biftu; McNamara, Blair C; Cassidy, Arianna; Pearlson, Geffan; Kuppermann, Miriam
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.
Full Text Available Consideration is given to a mathematical representation for manufacturing of batch parts on a metal-cutting machine tool. Linear dimensions of machined parts are assumed to be the major quality indicator, deviation from these dimensions is determined by size setting of machine tool and ensemble of random factors. It is allowed to have absolutely precise pre-setting of machine tool, effects from setup level offsetting due to deformation in process equipment on the specified indicator are disregarded. Consideration is given to factors which affect the tool wear, with two definitions of tool wear being provided. Reasons for development of random error in processing, dependence of measurement results on error as well as distribution laws and some parameters of random values are provided. To evaluate deviation of size setting value in each cycle, it is proposed to apply a recursive algorithm in description of investigated dynamic discrete process in the space state. Kalman filter equations are used in description of process model by means of first-order difference equations. The algorithm of recursive estimation is implemented in the mathematical software Maple. Simulation results which prove effectiveness of algorithm application to investigate the given dynamic system are provided. Variants of algorithm application and opportunities of further research are proposed.
The microstructure and performances of the Co-base alloy coatings that are formed by laser cladding, plasma spurt welding and arc surfacing on the nuclear valve-sealing surface have been studied and compared. The combination costs of laser cladding, plasma spurt welding and arc, surfacing have been analyzed and compared. The results showed that the laser cladding processing has the advantages of high efficiency, low energy cost, a little machining allowance, high rate of finished products and low combination cost, compared with plasma spurt welding processing and arc surfacing processing. The laser cladding technology can improve the qualities of nuclear valve parts and increase their service life. Therefore, the laser cladding processing is a new technology with developing potential
Alfieri, Vittorio; Argenio, Paolo; Caiazzo, Fabrizia; Sergi, Vincenzo
Optimization of processing parameters and exposure strategies is usually performed in additive manufacturing to set up the process; nevertheless, standards for roughness may not be evenly matched on a single complex part, since surface features depend on the building direction of the part. This paper aims to evaluate post processing treating via laser surface modification by means of scanning optics and beam wobbling to process metal parts resulting from selective laser melting of stainless steel in order to improve surface topography. The results are discussed in terms of roughness, geometry of the fusion zone in the cross-section, microstructural modification, and microhardness so as to assess the effects of laser post processing. The benefits of beam wobbling over linear scanning processing are shown, as heat effects in the base metal are proven to be lower.
Product tolerance requirements for small, cylindrical, piece parts produced on swiss automatic screw machines have progressed to the reliability limits of inspection equipment. The miniature size, configuration, and tolerance requirements (plus or minus 0.0001 in.) (0.00254 mm) of these parts preclude the use of screening techniques to accept product or adjust processes during setup and production runs; therefore, existing means of product acceptance and process adjustment must be refined or new techniques must be developed. The purpose of this endeavor has been to determine benefits gained through the implementation of a process acceptance technique (PAT) to swiss automatic screw machine processes. PAT is a statistical approach developed for the purpose of accepting product and centering processes for parts produced by selected, controlled processes. Through this endeavor a determination has been made of the conditions under which PAT can benefit a controlled process and some specific types of screw machine processes upon which PAT could be applied. However, it was also determined that PAT, if used indiscriminately, may become a record keeping burden when applied to more than one dimension at a given machining operation
Mª Trinidad Pérez Vallejo
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.
One of the major problems when producing powder metallurgy parts through hot isostatic pressing (HIP) is the non homogeneous shrinkage of HIP-capsule during the process. This leads to time and cost consuming machining of the HIP parts. In order to reduce the machining to a minimum, one can try to simulate the HIP-process by means of numerical methods. Hereby, the part distortion can be predicted, and hence a new HIP-capsule can be designed in such a way to prevent the distortion partly or even completely. In the following, a finite element method is used, on one hand, to simulate part shrinkage during HIP process; on the other hand a method is integrated in this simulation to optimize the HIP-capsule geometry. For the determination of material dependent parameters, a mixture of theoretical and experimental methods is used. Results of simulation are verified for a complex 3d HIP part out of TiAl6V4
Cheng, Joanna Oi-Yue; Lo, Raymond; Chan, Faye; Woo, Jean
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.
Full Text Available This article follows on the Part I, where the basic processes on uncontrolled aerodromes were introduced. The uncontrolled aerodromes face with the growing traffic and from that result the higher workload on AFIS officer. This means a higher potential for dangerous situations.The article describes some models of sub-processes and creates several safety indicators related to the operation at uncontrolled aerodromes. Thanks to monitoring and evaluation of safety indicators can be adopted targeted safety measures and thus increase safety on small uncontrolled aerodromes.
O Connor, Maja; Nickerson, Angela; Aderka, Idan M.
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...
Lyerly, Anne Drapkin
Childbirth is often understood as a paradigmatically "happy" event where good outcomes are expected and the process anticipated as a reason for celebration. Yet the narratives in this volume reflect sadness and grief, even when a healthy child is born. In this essay, I interrogate the genesis of and our relationship to grief in birth. To the extent such grief is a product of the chasm between the imagined ideal and what women experience, we may redress such grief by orienting around a more robust and woman-centered notion of the "good birth". Yet there is a way in which grief is also intrinsic to birth, and turning away from the loss that birth by its nature entails may compound the suffering of childbearing women. Beginning with the observation that the one narrative in which grief is accepted and attended to-a full term stillbirth-also stands out for the exemplary care provided, I consider the possibility that making space for grief in births, including those with good outcomes, will lead us to better ways of thinking about birth and providing care for childbearing women.
Process planning of sheet metal part is an important activity in the design of compound die. Traditional methods of carrying out this task are manual, tedious, time-consuming, error-prone and experiencebased. This paper describes the research work involved in the development of an expert system for process planning of ...
Elliott, R.; Coley, K.; Mostaghel, S.; Barati, M.
The increasing demand for high-performance steel alloys has led to development of transformation-induced plasticity (TRIP) and twinning-induced plasticity (TWIP) alloys over the past three decades. These alloys offer exceptional combinations of high tensile strength and ductility. Thus, the mechanical behavior of these alloys has been a subject of significant work in recent years. However, the challenge of economically providing Mn in the quantity and purity required by these alloys has received considerably less attention. To enable commercial implementation of ultrahigh-Mn alloys, it is desirable to lower the high material costs associated with their production. Therefore, the present work reviews Mn processing routes in the context of the chemical requirements of these alloys. The aim of this review is to assess the current state of the art regarding reduction of manganese ores and provide a comprehensive reference for researchers working to mitigate material processing costs associated with Mn production. The review is presented in two parts: Part 1 introduces TRIP and TWIP alloys, current industrial practice, and pertinent thermodynamic fundamentals; Part 2 addresses available literature regarding reduction of Mn ores and oxides, and seeks to identify opportunities for future process development.
... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Decision-making Process for E.O. 11988 A Appendix A to Part 9 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT..., App. A Appendix A to Part 9—Decision-making Process for E.O. 11988 EC02FE91.074 ...
Barlach, Anders; Simonsen, Jesper
Subject: Which parts of an electronic patient record (EPR) can initially form a stable standard solution to be used by all clinicians? And which parts of an EPR can we predict needs initial as well as on-going re-configuration to meet the needs from diverse medical specialties. Purpose: To analyze...... which screen types in a clinical process that can be standard configured and which are subject to initial as well as on-going re-configuration. Methods and results: A pilot-project implementing a fully functional clinical process EPR was configured and used at a neurological ward, replacing all paper...... records 24/7. The analysis characterizes the different types of screens, a total of 243 included in the EPR solution. All screens have been extracted from the application and analyzed for changes – in total 222 changes. Discussion and conclusion: Most screens (87%) are very stable. Few (13%) are subjected...
Mouron , Philippe
National audience; La Commission, dans cette communication du 20 avril 2016, énonce plusieurs griefs à l'encontre de Google, ceux-ci pouvant faire état d’un abus de position dominante :- les contrats passés avec les fabricants d’appareils mobiles subordonneraient l’octroi de licences pour des applications propriétaires (telles que Playstore) à la préinstallation d’autres applications, dont les plus essentielles pour l’utilisation des smartphones et tablettes (Google Search ou Chrome) ;- ces m...
Ghesquiere, Angela; Bagaajav, Ariunsanaa
After a hospice patient dies, hospice providers can experience a variety of emotional responses. While work has been done on social workers' and nurses' reactions to patient death, home health aides (HHAs) have been overlooked. To address this gap, we conducted focus groups and individual qualitative interviews with 14 hospice HHAs. Questions covered HHAs' grief responses and how they coped with grief. We found a high burden of grief reactions; many HHAs often developed very close patient relationships. HHAs also noted that they often started working with new patients almost immediately after a death, leaving little time to process the loss. However, HHAs found support from other HHAs, their supervisors, as well as family, friends, and spiritual practices to be helpful in coping with their grief. Future work should enhance support to HHAs around patient loss; for example, grief support may be embedded into hospice team activities.
Egorova, Yu.B.; Il'in, A.A.; Levochkin, A.A.
The regularities of the effect of hydrogen on cutting machinability of titanium alloys are generalized. The main principles of mechanohydrogen treatment are founded. The effectiveness of titanium alloys machining with the use of reversible hydrogen alloying depends on hydrogen content, hydrogen pickup temperature and cutting modes. High-performance technological processes of manufacturing parts and constructions made of titanium alloys are proposed [ru
Fenske, Joan M
This article describes an "advanced practice" registered nurse's skill in using multiple theoretical frameworks to make meaning of her severely developmentally disabled son's untimely death. Aspects of religion, spirituality, and philosophy are presented plus how related practices, such as used within Alcoholics Anonymous, are incorporated into everyday life are referenced. Creating unique rituals and ceremonies demonstrates the power of the mind as a partner in the healing process when grief seems insurmountable. This article, titled "Soul Mate" discusses how individuals create their own healing narratives when confronted with grief and tragedy. Nursing interventions, sensitive to this process, support and promote the grief process. Eliciting, recognizing, and accepting a patient's unique self-made rituals and ceremonies as they cope with a beloved's death and dying enhances their nursing interventions. © 2011 The Author(s)
Pierson, Margaret Hauser
Designed to provide parents with basic information about the physical and emotional aspects of amputation, the booklet gives information about the grief response, body image, phantom limb sensation, stump care, and the prosthesis. The section on the grief process describes normal reactions to loss: denial, anger, bargaining, depression, and…
Cohal, V.; Cohal, A.
The profit of a factory can be improved by reusing the discarded components produced. This paper is based on the case of a manufacturing process where rectangular metallic sheets of different sizes are produced. Using an artificial vision system, the shapes and the sizes of the produced parts can be determined. Those sheets which do not respect the requirements imposed are labeled as discarded. Instead of throwing these parts, a decision algorithm can analyze if another metallic sheet with smaller dimensions can be obtained from these. Two methods of decision are presented in this paper, considering the restriction that the sides of the new sheet has to be parallel with the axis of the coordinate system. The coordinates of each new part obtained from a discarded sheet are computed in order to be delivered to a milling machine. Details about implementing these algorithms (image processing and decision respectively) in the MATLAB environment using Image Processing Toolbox are given.
Hansen, Hans Nørgaard; Tosello, Guido; Gasparin, Stefania
dimensions are scaled down and geometrical complexity of objects is increased, the available measurement technologies appear not sufficient. New solutions for measuring principles and instrumentation, tolerancing rules and procedures as well as traceability and calibration are necessary if micro......Micro manufacturing has gained interest over the last decade as the demand for micro mechanical components has increased. The need for dimensional metrology at micro scale is evident both in terms of quality assurance of components and products and in terms of process control. As critical...... manufacturing is to develop into industrial manufacturing solutions. In this paper the application of dimensional precision metrology to both component and process quality control will be demonstrated. The parts investigated are micro injection moulded polymer parts, typical for the field of micro manufacturing....
Sunday, Mackenzie A; Richler, Jennifer J; Gauthier, Isabel
The part-whole paradigm was one of the first measures of holistic processing and it has been used to address several topics in face recognition, including its development, other-race effects, and more recently, whether holistic processing is correlated with face recognition ability. However the task was not designed to measure individual differences and it has produced measurements with low reliability. We created a new holistic processing test designed to measure individual differences based on the part-whole paradigm, the Vanderbilt Part Whole Test (VPWT). Measurements in the part and whole conditions were reliable, but, surprisingly, there was no evidence for reliable individual differences in the part-whole index (how well a person can take advantage of a face part presented within a whole face context compared to the part presented without a whole face) because part and whole conditions were strongly correlated. The same result was obtained in a version of the original part-whole task that was modified to increase its reliability. Controlling for object recognition ability, we found that variance in the whole condition does not predict any additional variance in face recognition over what is already predicted by performance in the part condition.
Broglia, Ricardo A
Combining elastic and inelastic processes with transfer reactions, this two-part volume explores how these events affect heavy ion collisions. Special attention is given to processes involving the transfer of two nucleons, which are specific for probing pairing correlations in nuclei. This novel treatment provides, together with the description of surface vibration and rotations, a unified picture of heavy ion reactions in terms of the elementary modes of nuclear excitation. Heavy Ion Reactions is essential reading for beginning graduate students as well as experienced researchers.
Harris, Alison; Vyas, Daivik B; Reed, Catherine L
Although holistic processing has been documented extensively for upright faces, it is unclear whether it occurs for other visual categories with more extensive substructure, such as body postures. Like faces, body postures have high social relevance, but they differ in having fine-grain organization not only of basic parts (e.g., arm) but also subparts (e.g., elbow, wrist, hand). To compare holistic processing for whole bodies and body parts, we employed a novel stereoscopic depth manipulation that creates either the percept of a whole body occluded by a set of bars, or of segments of a body floating in front of a background. Despite sharing low-level visual properties, only the stimulus perceived as being behind bars should be holistically "filled in" via amodal completion. In two experiments, we tested for better identification of individual body parts within the context of a body versus in isolation. Consistent with previous findings, recognition of body parts was better in the context of a whole body when the body was amodally completed behind occluders. However, when the same bodies were perceived as floating in strips, performance was significantly worse, and not significantly different, from that for amodally completed parts, supporting holistic processing of body postures. Intriguingly, performance was worst for parts in the frontal depth condition, suggesting that these effects may extend from gross body organization to a more local level. These results provide suggestive evidence that holistic representations may not be "all-or-none," but rather also operate on body regions of more limited spatial extent.
set of production rules and frames for process planning of axisymmetric deep ... parameters for design of stamping die for manufacturing of circular cup with ..... proper sequence of operations to manufacture sheet metal part correctly and ...
Sbarra, David A; Borelli, Jessica L
This paper uses attachment theory as a lens for reviewing contemporary research on how adults cope with marital separation and loss. The first section of the paper discusses the process of normative attachment reorganization, or the psychology of adaptive grief responses following relationship transitions. We argue that changes two processes, in particular, can be uses to track changes in this normative reorganization process: narrative coherence and self-concept clarity. The second section of the paper suggest that individual differences in attachment anxiety and avoidance shape the variability in this normative reorganization process, largely as a result of the characteristic ways in which these styles organize emotion-regulatory tendencies. The paper closes with a series of integrative questions for future research, including a call for new studies aimed at understanding under what contexts anxiety and avoidance may be adaptive in promoting emotion recovery to separation and divorce experiences. Copyright © 2018 Elsevier Ltd. All rights reserved.
Al Omar, A.; Cabrera, J.M.; Prado, J.M.
Part 1 of this work presents a revision of the general characteristics of the so called dynamic materials model on which processing maps are developed. In this part following the methodology described in part 1, processing maps of a microalloyed medium carbon steel are developed over a temperature range varying from 900 to 1.150 degree centigree at different true strain rates ranging from 10''-4 to 10s''-1. The analysis of these maps revealed a domain of dynamic recrystallization centred at about 1.1.50 degree centigree and strain rate 10 s''-1 and a domain of dynamic recovery centred at 900 degree centigree and 0,1 s''-1. (Author) 20 refs
Full Text Available Background: Prolonged grief disorder (PGD is a potentially disabling condition affecting approximately 10% of bereaved people. It has been suggested that the impaired integration of the loss memory, as expressed in recurrent memories of the loss and disorganization of memory, is involved in the development of PGD. Narrative reconstruction (NR, originally designed for the treatment of posttraumatic stress disorder (PTSD in an integrative therapy module, and consisting of exposure to the loss memory, detailed written reconstruction of the loss memory narrative and an elaboration of the personal significance of that memory for the bereaved, has been shown to be effective in the treatment of intrusion symptoms. Objective: In light of findings that cognitive behavior therapy (CBT, including cognitive restructuring and exposure, is effective in the treatment of PGD, we suggest the implementation of a somewhat novel therapy module, NR, for the treatment of intrusive phenomena in bereaved patients. Method: The rationale for the implementation of NR for PGD and a case study of the treatment of a woman suffering from PGD after the death of her father are presented. Therapy took place in a university outpatient training clinic. Results: Evaluations conducted before and after treatment and at a 3-month follow-up demonstrated the effectiveness of NR in reducing symptoms of PGD and depression. The analysis of spontaneous narratives recorded before and after treatment showed an increased organization of the narratives. Conclusions: This case report demonstrates an adaptation of NR for the treatment of PGD. The results provide preliminary support for the effectiveness of NR for PGD. The significance of the study and its limitations are discussed.
Poole, S.; Simon, M; Sweatman, A.
, Central Europe, and the USA are carrying out ecodesign. The survey also investigated the successes and failures that compnies have experienced and the lessons learned along the way. Part 1 of this two-part paper focuses on the early stages of the product development process. It shows how products can...
Hassanin, A. El; Astarita, A.; Scherillo, F.; Velotti, C.; Squillace, A.; Liguori, A.
Metal spinning processes represents an interesting alternative to traditional sheet metal forming processes in several industrial contexts, such as automotive and aerospace. In this work, the production of a combustion chamber liner top prototype using AISI 304L stainless steel is proposed, in order to evaluate the process feasibility for the required part geometry. The prototypes production was carried out using a two-stage semiautomatic spinning process. The effects in terms of wall thickness reduction were investigated. Using optical microscopy and Scanning Electron Microscopy (SEM) techniques, the microstructural behavior of the metal subjected to the forming process was investigated, while for an evaluation of the influence on the mechanical properties Vickers micro-indentation tests were performed. The main result of the process, as observed from all the investigation techniques adopted, is the formation of strain induced martensite due to the severe plastic deformation and cold reduction of the material, ranging in this case from 30% to 50%. In some areas of the part section, some rips indicating an excessive tensile stress were also detected.
This thesis deals with numerical simulations of gravity sand casting processes for the production of large steel parts. The entire manufacturing process is numerically modeled and evaluated, taking into consideration mould filling, solidification, solid state cooling and the subsequent stress build...... and to defects occurrence. In other words, it is desired to eliminate all of the potential casting defects and at the same time to maximize the casting yield. The numerical optimization algorithm then takes these objectives and searches for a set of the investigated process, design or material parameters e.......g. chill design, riser design, gating system design, etc., which would satisfy these objectives the most. The first step in the numerical casting process simulation is to analyze mould filling where the emphasis is put on the gating system design. There are still a lot of foundry specialists who ignore...
User's guide to image processing applications of the NOAA satellite HRPT/AVHRR data. Part 1: Introduction to the satellite system and its applications. Part 2: Processing and analysis of AVHRR imagery
Huh, Oscar Karl; Leibowitz, Scott G.; Dirosa, Donald; Hill, John M.
The use of NOAA Advanced Very High Resolution Radar/High Resolution Picture Transmission (AVHRR/HRPT) imagery for earth resource applications is provided for the applications scientist for use within the various Earth science, resource, and agricultural disciplines. A guide to processing NOAA AVHRR data using the hardware and software systems integrated for this NASA project is provided. The processing steps from raw data on computer compatible tapes (1B data format) through usable qualitative and quantitative products for applications are given. The manual is divided into two parts. The first section describes the NOAA satellite system, its sensors, and the theoretical basis for using these data for environmental applications. Part 2 is a hands-on description of how to use a specific image processing system, the International Imaging Systems, Inc. (I2S) Model 75 Array Processor and S575 software, to process these data.
Price, Rebecca H.
Both undergraduate and graduate students face similar challenges when tasked with writing literature reviews. Breaking down the literature review into a four-part process helps students decrease frustration and increase quality. This article provides usable advice for anyone teaching or writing literature reviews. Tips and illustrations illuminate…
Pedersen, David Bue
This Ph.D dissertation,ffAdditive Manufacturing: Multi Material Processing and Part Quality Controlff, deal with Additive Manufacturing technologies which is a common name for a series of processes that are recognized by being computer controlled, highly automated, and manufacture objects...... by a layered deposition of material. Two areas of particular interest is addressed. They are rooted in two very different areas, yet is intended to fuel the same goal. To help Additive Manufacturing technologies one step closer to becoming the autonomous, digital manufacturing method of tomorrow. Vision...... systems A paradox exist in the field of Additive Manufacturing. The technologies allow for close-to unrestrained and integral geometrical freedom. Almost any geometry can be manufactured fast, e"ciently and cheap. Something that has been missing fundamental capability since the entering of the industrial...
Full Text Available The paper deals with the process of 3D digitization as a tool for increasing production efficiency of complex shaped parts. Utilizes the concept of reverse engineering and new the model of NC program generation STEP-NC, for the of templates production for winding the stator coil of electromotors that is for electric household appliances. The manual production of prototype was substituted by manufacturing with NC machines. A 3D scanner was used for data digitizing, CAD/CAM system Pro/Engineering was used for NC program generation, and 3D measuring equipment was used for verification of new produced parts. The company estimated that only due to the implementation of STEP NC standard into production process it was allowed to read the 3D geometry of the product without problems. It helps the workshop to shorten the time needed for part production by about 30%.
Kim, H S; Yoo, Y S; Cho, O H
The purpose of this study was to investigate the satisfaction of the families of brain dead donors with regard to donation processes as well as their emotions after the donation. A cross-sectional survey study was performed that included 45 families of brain-dead donors in 1 hospital-based organ procurement organization (HOPO) in Korea between February 2007 and April 2011. Donor willingness and desire in life was the most frequent reason organs were donated (34.5%), followed by the advice of family members or friends (31.0%). Satisfaction with the organ donation processes was 4.04 of 6 points. In each category, the satisfaction with the decision of donation was the highest (4.96 points) and the satisfaction with the procedure of donation was the lowest (3.07 points); of each question, the satisfaction of "information and help on funeral arrangements was enough" and "the process of preparing the relevant documents was cumbersome" was the lowest. "Missing" the dead person and "pride" were the most common emotions experienced after organ donation (69.0% and 62.1%, respectively), followed by "grief," "family coherence," and "guilt." Religious practices were observed to be most helpful for psychological stress relief after donation, followed by spending time with family and friends. Moreover, 24.1% responded that they had not yet overcome their suffering. Because donors' own willingness is the most common reason that families choose donation, it is necessary to remind the public of the importance of organ donation through education and public relations using mass communication approaches. Additionally, because the families felt grief and guilt as well as missing their loved ones and pride regarding their dead loved ones after organ donation, continuous and systematic supports are needed to promote their psychological stability. Copyright © 2014 The Authors. Published by Elsevier Inc. All rights reserved.
Pablo RODRÍGUEZ HERRERO
Full Text Available It is needed a foundation and some orientations to act in loss and grief situations with adults with intellectual disabilities. In this article, through a relevant literature review, we based the educational accompaniment as a pedagogic methodology of support with three principal elements: a The conception of grief from its formative potential, b The prevention of disorders associated to grief complications, c The pedagogic intervention preferably from the tutorship or from the actuation of educators or professionals near to intellectual disabilities people. The educational accompaniment model is a proposal that can be placed on humanist models of grief since it considers both the characteristics of the grieving process and the formative possibilities of its elaboration. The article’s conclusions present some of the benefits of the educational accompaniment for adults with intellectual disabilities.
Al Omar, A.; Prado, J. M.
Hot working processes often induce high levels of deformation at high strain rates, and impose very complex multiaxial modes of solicitation. These processes are essentially limited by apparition and development of plastic instabilities. These may be the direct cause of rapid crack propagation, which lead to a possible final rupture. The complexity of deformation modes and the simultaneous intervention of several parameters have led many researchers to develop various criteria, with different approaches, to predict the occurrence of defects and to optimize process control parameters. The aim of the present paper is to summarize the general characteristics of some instability criteria, widely used in the literature, for the prediction of plastic instabilities during hot working. It was considered appropriate to divide the work into two parts: part I presents the phenomenological criteria for the prediction of plastic instabilities, based on descriptive observation of microscopic phenomena of the deformation (strain hardening and strain rate sensitivity), and discusses the continuum criteria based on the principle of maximum rate of entropy production of irreversible thermodynamics applied to continuum mechanics of large plastic flow. Also, this part provides a bibliographical discussion among several authors with regard to the physical foundations of dynamic materials model. In part II, of the work, a comparative study has been carried out to characterize the flow instability during a hot working process of a medium carbon microalloyed using phenomenological and continuum criteria. (Author) 83 refs.
Robben, Antonius C G M
This article uses the dual process model (DPM) in an analysis of the national mourning of tens of thousands of disappeared in Chile and Argentina by adapting the model from the individual to the collective level where society as a whole is bereaved. Perpetrators are also involved in the national mourning process as members of a bereaved society. This article aims to (a) demonstrate the DPMs significance for the analysis of national mourning in post-conflict societies and (b) explain oscillations between loss orientation and restoration orientation in coping with massive losses that seem contradictory from a grief work perspective.
Kealy, David; Sierra-Hernandez, Carlos A; Piper, William E; Joyce, Anthony S; Weideman, Rene; Ogrodniczuk, John S
Psychological mindedness is regarded as an important patient characteristic that can influence the course of psychotherapy. The purpose of this study was to investigate the relationship between patients' capacity for psychological mindedness and aspects of the group psychotherapy process as experienced and rated by therapists and other group members. Participants were 110 patients who completed two forms of short-term group therapy for the treatment of complicated grief. Psychological mindedness was assessed at pretreatment by external raters using a video-interview procedure. Group therapists assessed patients' therapeutic work and therapeutic alliance following each group therapy session. Therapists and other group members rated each patient's expression of emotion and provided appraisals of their cohesion to each patient throughout the course of therapy. Psychological mindedness was found to be positively associated with several group process variables as rated by the therapist and other group members.
Many important post-acquisition aspects of breast tomosynthesis imaging can impact its clinical performance. Chief among them is the reconstruction algorithm that generates the representation of the three-dimensional breast volume from the acquired projections. But even after reconstruction, additional processes, such as artifact reduction algorithms, computer aided detection and diagnosis, among others, can also impact the performance of breast tomosynthesis in the clinical realm. In this two part paper, a review of breast tomosynthesis research is performed, with an emphasis on its medical physics aspects. In the companion paper, the first part of this review, the research performed relevant to the image acquisition process is examined. This second part will review the research on the post-acquisition aspects, including reconstruction, image processing, and analysis, as well as the advanced applications being investigated for breast tomosynthesis. PMID:23298127
Islam, Aminul; Hansen, Hans Nørgaard; Esteves, N.M.
Metal injection moulding is gaining more and more importance over the time and needs more research to be done to understand the sensitivity of process to different process parameters. The current paper makes an attempt to better understand the effects of holding pressure and process temperatures...... on the moulded metallic parts. Stainless steel 316L is used in the investigation to produce the specimen by metal injection moulding (MIM) and multiple analyses were carried out on samples produced with different combinations of holding pressure, mould temperature and melt temperature. Finally, the parts were...... characterized to investigate mechanical properties like density, ultimate tensile strength, shrinkage etc. The results are discussed in the paper. The main conclusion from this study is unlike plastic moulding, the tensile properties of MIM parts doesn’t vary based on the flow direction of the melt, and tensile...
Drossel, Welf-Guntram; Lies, Carsten; Albert, André; Haase, Rico; Müller, Roland; Scholz, Peter
The usage of innovative lightweight materials and processing technologies gains importance in manifold industrial scopes. Especially for moving parts and mobility products the weight is decisively. The aerospace and automotive industries use light and high-strength materials to reduce weight and energy consumption and thereby improve the performance of their products. Composites with reinforced plastics are of particular importance. They offer a low density in combination with high specific s...
Streit, R.D.; Couture, S.A.
The purpose of this document is to establish the foundation for the selection and implementation of technologies to be demonstrated in the Mixed Waste Management Facility, and to select the technologies for initial pilot-scale demonstration. Criteria are defined for judging demonstration technologies, and the framework for future technology selection is established. On the basis of these criteria, an initial suite of technologies was chosen, and the demonstration implementation scheme was developed. Part 1, previously released, addresses the selection of the primary processes. Part II addresses process support systems that are considered ''demonstration technologies.'' Other support technologies, e.g., facility off-gas, receiving and shipping, and water treatment, while part of the integrated demonstration, use best available commercial equipment and are not selected against the demonstration technology criteria
Davoudinejad, Ali; Pedersen, David Bue; Tosello, Guido
Micro manufacturing scale feature production by Additive Manufacturing (AM) processes for the direct production of miniaturized polymer components is analysed in this work. The study characterizes the AM processes for polymer micro parts productions using the vat photopolymerization method...
Delalibera, Mayra; Presa, Joana; Coelho, Alexandra; Barbosa, António; Franco, Maria Helena Pereira
The loss of a loved one can affect family dynamics by changing the family system and creating the need for family members to reorganize. Good family functioning, which is characterized by open communication, expression of feelings and thoughts and cohesion among family members, facilitates adaptive adjustment to the loss. This study conducted a systematic review of the literature on family dynamics during the grieving process. A search was conducted in the EBSCO, Web of Knowledge and Bireme databases for scientific articles published from January 1980 to June 2013. Of the 389 articles found, only 15 met all the inclusion criteria. The selected studies provided evidence that dysfunctional families exhibit more psychopathological symptoms, more psychosocial morbidity, poorer social functioning, greater difficulty accessing community resources, lower functional capacity at work, and a more complicated grieving process. Family conflicts were also emphasized as contributing to the development of a complicated grieving process, while cohesion, expression of affection and good communication in families are believed to mitigate grief symptoms.
Drossel, W-G; Lies, C; Albert, A; Haase, R; Müller, R; Scholz, P
The usage of innovative lightweight materials and processing technologies gains importance in manifold industrial scopes. Especially for moving parts and mobility products the weight is decisively. The aerospace and automotive industries use light and high-strength materials to reduce weight and energy consumption and thereby improve the performance of their products. Composites with reinforced plastics are of particular importance. They offer a low density in combination with high specific stiffness and strength. A pure material substitution through reinforced plastics is still not economical. The approach of using hybrid metal-plastic structures with the principle of “using the right material at the right place” is a promising solution for the economical realization of lightweight structures with a high achievement potential. The article shows four innovative manufacturing possibilities for the realization of metal-plastic-hybrid parts. (paper)
Faiz, J. M.; Shayfull, Z.; Nasir, S. M.; Fathullah, M.; Rashidi, M. M.
This study is carried out to focus on optimisation of process parameters by simulation using Autodesk Moldflow Insight (AMI) software. The process parameters are taken as the input in order to analyse the warpage value which is the output in this study. There are some significant parameters that have been used which are melt temperature, mould temperature, packing pressure, and cooling time. A plastic part made of Polypropylene (PP) has been selected as the study part. Optimisation of process parameters is applied in Design Expert software with the aim to minimise the obtained warpage value. Response Surface Methodology (RSM) has been applied in this study together with Analysis of Variance (ANOVA) in order to investigate the interactions between parameters that are significant to the warpage value. Thus, the optimised warpage value can be obtained using the model designed using RSM due to its minimum error value. This study comes out with the warpage value improved by using RSM.
Vollmer, R.; Palm, C.
The increasing number of hot stamped parts in the automotive industry is challenging different process areas. This paper presents a method how to improve the production rates over the whole life cycle of a hot forming part. In the core element of a hot forming line, the hydraulic press, mainly two processing steps are performed. Forming and quenching of the sheet metal part. In addition to the forming operation, it is inevitable to optimize the quenching condition in the bottom dead centre in order to reach a fully martensitic structure and tight geometrical tolerances of the part. Deviations in the blank thickness, tool wear, polishing of classical tools impair the quenching condition and therefore the part quality over the time. A new press and tool design has been developed to counter this effect by providing homogenous contact pressure over the whole die. Especially with a multi cavity tool, the new method is advantageous. Test series have shown that the new tool and press concept can produce parts with a blank thickness of 1.0 mm within 8.0 s cycle time. The so called PCH flex principle makes it possible to produce such high output rates under reliable conditions.
... 41 Public Contracts and Property Management 1 2010-07-01 2010-07-01 true 250-Review of Personnel Processes C Appendix C to Part 60 Public Contracts and Property Management Other Provisions Relating to Public Contracts OFFICE OF FEDERAL CONTRACT COMPLIANCE PROGRAMS, EQUAL EMPLOYMENT OPPORTUNITY, DEPARTMENT...
The second part of this text-book brings a complex and comprehensive view on the places of mining and processing of ore resources in the Slovak Republic. Environmental impact of mining and processing of the ores is also presented.
Kwong, Marilyn J; Bartholomew, Kim
We explored individuals' relationships with an assistance dog from an attachment-theory perspective. We used both inductive and deductive thematic methods to analyze semi-structured interviews with 25 participants who had lost an assistance dog to retirement or death. Analyses revealed attachment processes of safe haven, secure base, and separation anxiety. Although attachment dynamics were an important feature of these relationships, caregiving was equally important. When confronted with the loss of their dog, almost all participants experienced intense grief. Most grief responses were consistent with the loss of a caregiving relationship. Findings suggest that grief is a natural response to the loss of a beloved companion who fulfilled fundamental needs for attachment and caregiving.
Alcedo Rodríguez, M Ángeles; Cristóbal Fernández, Leticia; Gómez Sánchez, Laura E; Arias González, Víctor B
The aim of this study was to examine the characteristics associated with the grieving process among a population with intellectual disability and the influence of particular variables. The sample was composed of 380 participants with intellectual disability, on whose behalf 149 professionals completed a 20-item questionnaire with four Likert-type answer options, developed to evaluate the grieving process: Inventory of Grief and Coping Strategies in Intellectual Disability (IGCS-ID). The IGCS-ID shows adequate levels of reliability. It covers three dimensions: understanding of the concept of death, coping with the loss and post-bereavement reactions. The level of intellectual disability, the time elapsed since the loss and the residential setting gave rise to significant differences in the three dimensions based on the participants. An assessment of the grieving process would help to put in place effective resources to help people with intellectual disability overcome the loss and cope with the changes that it brings. © 2018 John Wiley & Sons Ltd.
This document has been prepared to aid in the development of Regulating guidelines for the Privatization of Hanford underground storage tank waste remediation. The document has been prepared it two parts to facilitate their preparation. Part II is the primary focus of this effort in that it describes the technical basis for established and potential chemical processing hazards associated with Underground Storage Tank (UST) nuclear waste remediation across the DOE complex. The established hazards involve those at Sites for which Safety Analysis Reviews (SARs) have already been prepared. Potential hazards are those involving technologies currently being developed for future applications. Part I of this document outlines the scope of Part II by briefly describing the established and potential technologies. In addition to providing the scope, Part I can be used as a technical introduction and bibliography for Regulatory personnel new to the UST waste remediation, and in particular Privatization effort. Part II of this document is not intended to provide examples of a SAR Hazards Analysis, but rather provide an intelligence gathering source for Regulatory personnel who must eventually evaluate the Privatization SAR Hazards Analysis
Measurement and processing of vibration signals registered on the moving parts of the electrical machines using the diagnostic information-measuring system that uses Bluetooth wireless standard for the transmission of the measured data from moving parts of electrical machine is discussed.
Lansing, Amy E; Virk, Agam; Notestine, Randy; Plante, Wendy Y; Fennema-Notestine, Christine
Delinquent youth have substantial trauma exposure, with life-course persistent delinquents [LCPD] demonstrating notably elevated cross-diagnostic psychopathology and cognitive deficits. Because adolescents remain in the midst of brain and neurocognitive development, tailored interventions are key to improving functional outcomes. This structural magnetic resonance imaging study compared neuroanatomical profiles of 23 LCPD and 20 matched control adolescent boys. LCPD youth had smaller overall gray matter, and left hippocampal, volumes alongside less cortical surface area and folding within the left pars opercularis and supramarginal cortex. LCPD youth had more adversity-related exposures, and their higher Cumulative Trauma, Adversity and Grief [C-TAG] symptoms were associated with less surface area and folding in the pars opercularis and lingual gyrus. Neuroanatomical differences between LCPD and control youth overlap with data from both maltreatment and antisocial literatures. The affected left frontal regions also share connections to language- and executive-related functions, aligning well with LCPD youths' cognitive and behavioral difficulties. These data also dovetail with research suggesting the possibility of neurodevelopmental delays or disruptions related to cumulative adversity burden. Thus, concurrent treatment of LCPD youths' C-TAG symptoms and, cognitive deficits with overlapping neuroanatomical bases, may be most effective in improving outcomes and optimizing neurodevelopmental trajectories. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.
Kharzeev, Dima E; McLerran, L; 10.1016/S0370-2693(03)00420-9
We argue that the suppression of high p/sub t/ hadrons discovered recently in heavy ion collisions at RHIC may be a consequence of saturation in the color glass condensate. We qualitatively and semi- quantitatively describe the data, in particular, the dependence upon the number of nucleon participants. We show that if parton saturation sets in at sufficiently small energy, then in nucleus-nucleus collisions at RHIC and LHC energies the cross sections of semi-hard processes should scale approximately with the number of participants, N/sub part/. Our results provide a possible explanation of both the absence of apparent jet quenching at SPS energies and its presence at RHIC. Under the same assumption we predict that in semi-central and central pA (dA) collisions at collider energies the dependence of semi-hard processes on the number of participating nucleons of the nucleus will change to ~(N/sub part//sup A/)/sup 1/2/. The forthcoming data on dA collisions will provide a crucial test of this description. (61 ...
V. I. Shynkarenko
Full Text Available Purpose.The second part of the paper completes presentation of constructive and the productive structures (CPS, modeling adaptation of data structures in memory (RAM. The purpose of the second part in the research is to develop a model of process of adaptation data in a RAM functioning in different hardware and software environments and scenarios of data processing. Methodology. The methodology of mathematical and algorithmic constructionism was applied. In this part of the paper, changes were developed the constructors of scenarios and adaptation processes based on a generalized CPS through its transformational conversions. Constructors are interpreted, specialized CPS. Were highlighted the terminal alphabets of the constructor scenarios in the form of data processing algorithms and the constructor of adaptation – in the form of algorithmic components of the adaptation process. The methodology involves the development of substitution rules that determine the output process of the relevant structures. Findings. In the second part of the paper, system is represented by CPS modeling adaptation data placement in the RAM, namely, constructors of scenarios and of adaptation processes. The result of the implementation of constructor of scenarios is a set of data processing operations in the form of text in the language of programming C#, constructor of the adaptation processes – a process of adaptation, and the result the process of adaptation – the adapted binary code of processing data structures. Originality. For the first time proposed the constructive model of data processing – the scenario that takes into account the order and number of calls to the various elements of data structures and adaptation of data structures to the different hardware and software environments. At the same the placement of data in RAM and processing algorithms are adapted. Constructionism application in modeling allows to link data models and algorithms for
This article deals with critical psychic transformation in a schizoid personality disorder that evolves in an object relations psychoanalysis in which "developmental mourning" plays a central role. Within a mourning process that allows for the grieving of loss related to arrested separation-individuation development, the analysand confronts the existential grief of regret that had always unconsciously haunted her. The unconscious guilt related to the existential grief of regret had caused much dissociation of self-experience and affect states. The analysand acknowledges her own part in the destruction of primal and current relationships after the traumatic impact of her early life is understood. This allows her to repair current relationships, both within her internal and external worlds so that she can open to capacities for love and creativity. The analysand's courage to consciously grapple with her regret (loss and guilt combined) allows her to relinquish self-sabotaging character defenses such as contempt and emotional withdrawl. Consequently, a second marriage is salvaged and enriched, and the analysand's relationship with her two children is dramatically improved.
This study proposes through a case illustration that psychoanalytic patients who can process both aggression and loss through a mourning process are able to free themselves from pathological self attack when the object relations work of attachment, psychic holding, and separation transpires. In the case of Helen discussed here, transformation through a "developmental mourning process" results in the evolution of powerful psychological capacities for interiority, self agency, and interpersonal compassion. This developmental mourning process is endowed with the assimilation and psychic fantasy symbolization of aggression.
Full Text Available The loss of a loved one can affect family dynamics by changing the family system and creating the need for family members to reorganize. Good family functioning, which is characterized by open communication, expression of feelings and thoughts and cohesion among family members, facilitates adaptive adjustment to the loss. This study conducted a systematic review of the literature on family dynamics during the grieving process. A search was conducted in the EBSCO, Web of Knowledge and Bireme databases for scientific articles published from January 1980 to June 2013. Of the 389 articles found, only 15 met all the inclusion criteria. The selected studies provided evidence that dysfunctional families exhibit more psychopathological symptoms, more psychosocial morbidity, poorer social functioning, greater difficulty accessing community resources, lower functional capacity at work, and a more complicated grieving process. Family conflicts were also emphasized as contributing to the development of a complicated grieving process, while cohesion, expression of affection and good communication in families are believed to mitigate grief symptoms.
Full Text Available Metal additive manufacturing (AM is increasingly used to create complex 3D components at near net shape. However, the surface finish (SF of the metal AM part is uneven, with surface roughness being variable over the facets of the design. Standard post-processing methods such as grinding and linishing often meet with major challenges in finishing parts of complex shape. This paper reports on research that demonstrated that mass finishing (MF processes are able to deliver high-quality surface finishes (Ra and Sa on AM-generated parts of a relatively complex geometry (both internal features and external facets under select conditions. Four processes were studied in this work: stream finishing, high-energy (HE centrifuge, drag finishing and disc finishing. Optimisation of the drag finishing process was then studied using a structured design of experiments (DOE. The effects of a range of finishing parameters were evaluated and optimal parameters and conditions were determined. The study established that the proposed method can be successfully applied in drag finishing to optimise the surface roughness in an industrial application and that it is an economical way of obtaining the maximum amount of information in a short period of time with a small number of tests. The study has also provided an important step in helping understand the requirements of MF to deliver AM-generated parts to a target quality finish and cycle time.
Barnes, Andrew J; Hanoch, Yaniv; Martynenko, Melissa; Wood, Stacey; Rice, Thomas; Federman, Alex D
Many patients expect their doctor to help them choose a Medicare prescription drug plan. Whether the size of the choice set affects clinicians' decision processes and strategy selection, and the quality of their choice, as it does their older patients, is an important question with serious financial consequences. Seventy medical students and internal medicine residents completed a within-subject design using Mouselab, a computer program that allows the information-acquisition process to be examined. We examined highly numerate physician trainees' decision processes, strategy, and their ability to pick the cheapest drug plan-as price was deemed the most important factor in Medicare beneficiaries' plan choice-from either 3 or 9 drug plans. Before adjustment, participants were significantly more likely to identify the lowest cost plan when facing three versus nine choices (67.3% vs. 32.8%, pinformation on each attribute (pdecision strategies focusing on comparing alternate plans across a single attribute (search pattern, pdecision process and strategy, numeracy, and amount of medical training, the odds were 10.75 times higher that trainees would choose the lowest cost Medicare Part D drug plan when facing 3 versus 9 drug plans (pdecision environment are needed and suggest physicians' role in their patients' Part D choices may be most productive when assisting seniors with forecasting their expected medication needs and then referring them to the Medicare website or helpline.
Qian, Xueming; Ma, Yanqiao; Liang, Dezhi
To successfully design parts with a free-formed surface, the critical issue of how to evaluate and select a favourable evaluation strategy before design is raised. The evaluation of free-formed surface parts is a multiple criteria decision-making (MCDM) problem that requires the consideration of a large number of interdependent factors. The analytic network process (ANP) is a relatively new MCDM method that can systematically deal with all kinds of dependences. In this paper, the factors, which come from the life-cycle and influence the design of free-formed surface parts, are proposed. After analysing the interdependence among these factors, a Hybrid ANP (HANP) structure for evaluating the part’s curved surface is constructed. Then, a HANP evaluation of an impeller is presented to illustrate the application of the proposed method.
Matsumoto, Shimpei; Okuhara, Koji; Ueno, Nobuyuki; Ishii, Hiroaki
We are interested in the print process on the manufacturing processes of auto parts supplier as an actual problem. The purpose of this research is to apply our scheduling technique developed in university to the actual print process in mass customization environment. Rationalization of the print process is depending on the lot sizing. The manufacturing lead time of the print process is long, and in the present method, production is done depending on worker’s experience and intuition. The construction of an efficient production system is urgent problem. Therefore, in this paper, in order to shorten the entire manufacturing lead time and to reduce the stock, we reexamine the usual method of the lot sizing rule based on heuristic technique, and we propose the improvement method which can plan a more efficient schedule.
The description is given of a process for joining by diffusion two parts in different metals and having a first and second surface identical in shape. This process, which is particularly advantageous for parts in nickel and in an alloy of silver, indium and cadmium, is characterised by the fact that a third and fourth surface parallel to the first and second surface are made on the parts and that the first and second surface are pressed one against the other by means of pressure applied on the third and fourth surface, so as to cause a metal substance to diffuse in the other [fr
I. I. Kravchenko
Full Text Available Experience in application of multi-operational machines CNC (MOM CNC shows that they are efficient only in case of significantly increasing productivity and dramatically reducing time-to-market cycle of new products. Most full technological MOM capabilities are revealed when processing the complex body parts. The more complex is a part design and the more is its number of machined surfaces, the more tools are necessary for its processing and positioning, the more is an efficiency of their application. At the same time, the case history of using these machines in industry shows that MOM CNC are, virtually, used mostly for technological processes of universal equipment, which is absolutely unacceptable. One way to improve the processing performance on MOM CNC is to reduce nonproductive machine time through reducing the mutual idle movements of the working machine. This problem is solved using dynamic programming methods, one of which is the solution of the traveling salesman problem (Bellman's method. With a known plan for treatment of all elementary surfaces of the body part, i.e. the known number of performed transitions, each transition is represented as a vertex of some graph, while technological links between the vertices are its edges. A mathematical model is developed on the Bellman principle, which is adapted to technological tasks to minimize the idle time of mutual idle movements of the working machine to perform all transitions in the optimal sequence. The initial data to fill matrix of time expenditures are time consumed by the hardware after executing the i-th transition, and necessary to complete the j-transition. The programmer fills in matrix cells according to known routing body part taking into account the time for part and table positioning, tool exchange, spindle and table approach to the working zone, and the time of table rotation, etc. The mathematical model was tested when machining the body part with 36 transitions on the
Stouder, Donald B; Schmid, Adam; Ross, Sharon S; Ross, Larry G; Stocks, Lisa
Understanding how organ donors' families recover from their grief can help organ procurement organizations improve consent rates and increase the number of deceased donor organs available for transplant. To determine what helps the loved ones of deceased organ donors heal from their grief and loss, and to better understand families' needs during the consent process as a way of improving overall consent rates for organ donation. Written survey of all organ and tissue donors' families in the San Diego and Imperial County (California) service area during 2006 and 2007. Responses to the 20-question survey addressing factors that help healing from grief, as well as contextual information about the families' experience at the hospital and the consent process. Most respondents (84%) indicated that family support was the most helpful thing in dealing with their grief, followed by the support of friends (74%) and religious and cultural beliefs (37%). Most (75%) indicated that they agreed to donation so that something positive could result from their loss. Most respondents (93%) felt that they were given enough information to make an informed decision about donation, and 6% indicated that the donation process interfered with funeral or memorial arrangements. More than 95% understood that their loved one had died before they were approached for consent. Consistent with previous studies, 12% said they still had unanswered questions about aspects of donation, and 15% of respondents indicated that the discussion about organ donation added more emotional stress to their overall experience.
Hessel, V.; Wang, Q.
Novel Process Windows (NPW) is the use of highly intensified, unusual and typically harsh process conditions to boost micro process technology and flow chemistry for the production of high-added value fine chemicals, pharmaceuticals, etc.. It is far from conventional processing and also from
American Society for Testing and Materials. Philadelphia
1.1 This practice describes a general procedure for using the process compensated resonance testing (PCRT) via swept sine input method to identify metallic and non-metallic parts’ resonant pattern differences that can be used to indentify parts with anomalies causing deficiencies in the expected performance of the part in service. This practice is intended for use with instruments capable of exciting, measuring, recording, and analyzing multiple whole body mechanical vibration resonant frequencies within parts exhibiting acoustical ringing in the audio, or ultrasonic, resonant frequency ranges, or both. PCRT is used in the presence of manufacturing process variance to distinguish acceptable parts from those containing significant anomalies in physical characteristics expected to significantly alter the performance. Such physical characteristics include, but are not limited to, cracks, voids, porosity, shrink, inclusions, discontinuities, grain and crystalline structure differences, density related anomalies...
This article draws on interviews with women who experienced the death of their mothers during early childhood to explore the grieving process of a child for a lost parent. The author describes the women's recollections of how the loss was talked about, or not, in their families and how this impacted the women's mourning and coping. Most women who…
The process is suitable for remote position inspection of the parts of the plant in a large hot cell, for example of a reprocessing plant. A device with a TV camera was selected as the inspection system, where pictures obtained by photography are compared (photogrammetry). The possible resolution is considerably increased by using two spatially movable separate picture systems with the associated drawing media. (DG) [de
... 40 Protection of Environment 26 2010-07-01 2010-07-01 false Mercury Bearing Wastes That May Be Processed in Exempt Mercury Recovery Units XIII Appendix XIII to Part 266 Protection of Environment... XIII to Part 266—Mercury Bearing Wastes That May Be Processed in Exempt Mercury Recovery Units These...
Sundar Raj, S.I.; Sreedhar, B.K.; Gurumoorthy, K.; Rajan, K.K.; Kalyanasundaram, P.; Rajan, M.; Vaidyanathan, G.
Sodium is the primary and secondary coolant in fast reactors. Primary and secondary circuits components like Control and Safety Rod Drive Mechanism (CSRDM), pumps, heat exchangers etc. handle liquid sodium. Sodium has good affinity to oxygen and reacts vigorously with water. Hence sodium cleaning is the first and important activity in the maintenance of the components. In reactor components this cleaning process also helps in removing a major part of radioactive contaminants after which they are subjected to chemical decontamination. There are several methods available for removing sodium from components. Out of these, the water vapour-CO 2 process is selected for large components such as pumps, heat exchangers etc. while steam cleaning is used for the core sub assemblies. The cleaning processes are to be closely monitored to ensure safety because the release of hydrogen is to be kept below 4 % during the process. This paper discusses the in house facility and the experience in the successful use of the process in the cleaning of CSRDM. (author)
preparation , implementation, and operation of a Parts, Materials, and Processes (PMP) control program for use during the design, development...Processes List CDR Critical Design Review CDRL Contract Data Requirements List CMOS Complementary Metal Oxide Semiconductor CONOPS Concept of Operations...Failure Review Board GFE Government Furnished Equipment GIDEP Government Industry Data Exchange Program HBT Heterojunction Bipolar Transistor IPT
Solange Maria dos Anjos Gesteira
sirvan como instrumentos de reflexión sobre el desempeño profesional y contribuya, consecuentemente, en la mejoría de la calidad de la asistencia prestada por la enfermería.To describe the feeling of loss and grief of women who had an abortion. This conceptual served for this qualitative study. Discussion technique was the main approach to explore and comprehend women's experiences with the loss and the abortion process. Because abortion has been regarded for many years as taboo, this prejudice causes nursing care to be focused on the technical aspect of care only. Although nurses might be prepared to assist women who had an abortion, little opportunity is given to those women to express their loss and grief. Focusing attention on this problem may stimulate nurses to reflect upon the need of women who had experienced loss and abortion, which in turn may lead to better nursing quality care.
Tseng, Ying-Fen; Chen, Chung-Hey; Wang, Hsiu-Hung
The purpose of this qualitative descriptive study was to portray the recovery process of Taiwanese women after stillbirth. Data were generated through individual in-depth interviews with 21 women selected using purposeful sampling. Three stages in an emotional journey of recovery were suffering from silent grief, searching for a way out, and achieving peace of mind and mental stability. Throughout their journey, the women's overarching concern was where the deceased child had gone and whether it was well. Together these stages composed A pathway to peace of mind, a mental journey on which women struggled to spiritually connect with the lost baby and finally sought a personal pathway to emotional peace. Findings can inform healthcare providers in providing culturally sensitive care for Taiwanese women to facilitate healing after a stillbirth. © 2014 Wiley Periodicals, Inc.
Kaltenbrunner, Oliver; McCue, Justin; Engel, Philip
Process modeling can be a useful tool to aid in process development, process optimization, and process scale-up. When modeling a chromatography process, one must first select the appropriate models that describe the mass transfer and adsorption that occurs within the porous adsorbent. The theoret......Process modeling can be a useful tool to aid in process development, process optimization, and process scale-up. When modeling a chromatography process, one must first select the appropriate models that describe the mass transfer and adsorption that occurs within the porous adsorbent...
Dong, Guojiang; Zhao, Changcai; Peng, Yaxin; Li, Ying
High strength aluminum alloy plate has a low elongation at room temperature, which leads to the forming of its components need a high temperature. Liquid or gas is used as the pressure-transfer medium in the existing flexible mould forming process, the heat resistance of the medium and pressurizing device makes the application of aluminum alloy plate thermoforming restricted. To solve this problem, the existing medium is replaced by the heat-resisting solid granules and the general pressure equipments are applied. Based on the pressure-transfer performance test of the solid granules medium, the feasibility that the assumption of the extended Drucker-Prager linear model can be used in the finite element analysis is proved. The constitutive equation, the yield function and the theoretical forming limit diagram(FLD) of AA7075 sheet are established. Through the finite element numerical simulation of hot granules medium pressure forming(HGMF) process, not only the influence laws of the process parameters, such as forming temperature, the blank-holder gap and the diameter of the slab, on sheet metal forming performance are discussed, but also the broken area of the forming process is analyzed and predicted, which are coincided with the technological test. The conical part whose half cone angle is 15° and relative height H/d 0 is 0.57, is formed in one process at 250°C. The HGMF process solves the problems of loading and seal in the existing flexible mould forming process and provides a novel technology for thermoforming of light alloy plate, such as magnesium alloy, aluminium alloy and titanium alloy.
... REGULATIONS PROCESSING GARNISHMENT ORDERS FOR CHILD SUPPORT AND/OR ALIMONY Pt. 581, App. A Appendix A to Part... Supervisor, 1969 So. Sheridan Ave., Sheridan, WY 82801, (307) 672-0751 Medicine Bow—Forest Supervisor, 2468...
Dolimont, Adrien; Rivière-Lorphèvre, Edouard; Ducobu, François; Backaert, Stéphane
Additive manufacturing is growing faster and faster. This leads us to study the functionalization of the parts that are produced by these processes. Electron Beam melting (EBM) is one of these technologies. It is a powder based additive manufacturing (AM) method. With this process, it is possible to manufacture high-density metal parts with complex topology. One of the big problems with these technologies is the surface finish. To improve the quality of the surface, some finishing operations are needed. In this study, the focus is set on chemical polishing. The goal is to determine how the chemical etching impacts the dimensional accuracy and the surface roughness of EBM parts. To this end, an experimental campaign was carried out on the most widely used material in EBM, Ti6Al4V. Different exposure times were tested. The impact of these times on surface quality was evaluated. To help predicting the excess thickness to be provided, the dimensional impact of chemical polishing on EBM parts was estimated. 15 parts were measured before and after chemical machining. The improvement of surface quality was also evaluated after each treatment.
Faiz, J. M.; Shayfull, Z.; Nasir, S. M.; Fathullah, M.; Hazwan, M. H. M.
This study conducts the simulation on optimisation of injection moulding process parameters using Autodesk Moldflow Insight (AMI) software. This study has applied some process parameters which are melt temperature, mould temperature, packing pressure, and cooling time in order to analyse the warpage value of the part. Besides, a part has been selected to be studied which made of Polypropylene (PP). The combination of the process parameters is analysed using Analysis of Variance (ANOVA) and the optimised value is obtained using Response Surface Methodology (RSM). The RSM as well as Genetic Algorithm are applied in Design Expert software in order to minimise the warpage value. The outcome of this study shows that the warpage value improved by using RSM and GA.
MYRIAM ABAUNZA DE GONZÁLEZ
Full Text Available El principal propósito de este artículo es dar respuesta al siguiente interrogante: ¿El proceso de enfermería hace parte de la calidad del cuidado? Para sustentar la respuesta a la pregunta, se parte de referenciar varios autores que han hecho estudios sobre la utilización del método científico, del método de solución de problemas y del proceso de atención de enfermería y su relación con la calidad del servicio y del cuidado de enfermería, al mismo tiempo que se introducen experiencias relacionadas con proyectos de investigación tipo NIPE y Grupos relacionados con el Dx, y experiencias de evaluación de servicios de enfermería en algunos hogares y hospitales en Colombia, México, Cuba y Chile, en donde se aprecia que el proceso de enfermería es el que define el concepto enfermero aplicado. Se concluye que el proceso de enfermería como parte fundamental del cuidado de enfermería, al acortar estancias, disminuir el número de complicaciones y evitar los reingresos, contribuye a mejorar la calidad de su servicio y la calidad de vida de los pacientes/usuarios.The main purpose of this article is to answer the question: Is the nursing process part of quality care? In order to back the answer, it starts by mentioning several authors that have performed studies on the use of scientific methods, problem solving methods and the attention to care -innursing method and its relationship to the quality of service and the nursing care, while at the same time it introduces related experiences associated with NIPE research projects and related Groups with Dx, and evaluation experiences for nursing services in various homes and hospitals in Colombia, México, Cuba and Chile. There, one can appreciate that the nursing process is that which is defined by the concept of applied nurse. It concludes that by saying that the nursing process is fundamental to nursing care, because it shortens distances, reduces the number of complications and avoids
ABAUNZA DE GONZÁLEZ MYRIAM
Full Text Available The main purpose of this article is to answer the question: Is the nursing process part of quality care? In order to back the answer, it starts by mentioning several authors that have performed studies on the use of scientific methods, problem solving methods and the attention to care -innursing method and its relationship to the quality of service and the nursing care, while at the same time it introduces related experiences associated with NIPE research projects and related Groups with Dx, and evaluation experiences for nursing services in various homes and hospitals in Colombia, México, Cuba and Chile. There, one can appreciate that the nursing process is that which is defined by the concept of applied nurse. It concludes that by saying that the nursing process is fundamental to nursing care, because it shortens distances, reduces the number of complications and avoids risks, while contributing to improve the quality of service and the quality of life of patients /users.El principal propósito de este artículo es dar respuesta al siguiente interrogante: ¿El proceso de enfermería hace parte de la calidad del cuidado? Para sustentar la respuesta a la pregunta, se parte de referenciar varios autores que han hecho estudios sobre la utilización del método científico, del método de solución de problemas y del proceso de atención de enfermería y su relación con la calidad del servicio y del cuidado de enfermería, al mismo tiempo que se introducen experiencias relacionadas con proyectos de investigación tipo NIPE y Grupos relacionados con el Dx, y experiencias de evaluación de servicios de enfermería en algunos hogares y hospitales en Colombia, México, Cuba y Chile, en donde se aprecia que el proceso de enfermería es el que define el concepto enfermero aplicado. Se concluye que el proceso de enfermería como parte fundamental del cuidado de enfermería, al acortar estancias, disminuir el número de complicaciones y evitar los
An article in NASA Tech Briefs describing a vacuum bagging process for forming composite parts helped a small Oklahoma Company to improve its manufacturing process. President of Performance Extremes, Larry Ortega, and his partners make motorcycle parts from carbon/epoxy to reduce weight. Using vacuum bags, parts have a better surface and fewer voids inside. When heat used in the vacuum bag process caused deformation upon cooling, a solution found in another tech brief solved the problem. A metal plate inside the vacuum bag made for more even heat transfer. A third article described a simple procedure for repairing loose connector pins, which the company has also utilized.
The anion exchange method used in treatment of uranium-containing effluent in the process of metallic parts is the subject of the paper. The results of the experiments shows that the uranium concentration in created water remains is less than 10 μg/l when the waste water flowed through 10000 column volume. A small facility with column volume 150 litre was installed and 1500 m 3 of waste water can be cleaned per year. (1 tab.)
The purpose of the present study is twofold. On the one hand, it should provide us with a deeper insight into the mechanism of these processes. On the other hand, we shall arrive at some new forms of asymptotic results not commonly known, in particular those pertaining to an extended dead time. In addition, the novel approach permits independent checking of earlier results (some of which had been at variance with previous claims). In view of the usually quite cumbersome arithmetic involved, such controls are certainly most welcome. In this first part all the relations concerning the asymptotic expectation values will be discussed; the second part will do the same for the variances. A more elegant treatment of these problems, based on some general asymptotic results for renewal processes of the type first derived by Smith must be postponed for the moment since the corresponding formulae for a modified process are not yet readily available. We hope to be able to fill this gap in a near future
Baran, Ismet; Hattel, Jesper Henri; Akkerman, Remko
Numerical process simulation of an industrially pultruded rectangular hollow profile is presented. The product contains the continuous filament mat (CFM) and the uni-directional (UD) roving layers made of glass/polyester. The distortion and stress evolutions together with the temperature and degree...... of fields are predicted by the simulation tool developed by the authors. The predicted deformation pattern at the end of the process is found to agree quite well with the one for the real pultruded part in a commercial pultrusion company. A parametric study is also performed based on the total volumetric...... shrinkage of the resin system during curing. The process induced residual stresses are calculated in the in-plane directions which have the potential to influence the internal stress levels during the service loading conditions....
Friedrich, Rose Marie; Lively, Sonja; Rubenstein, Linda; Buckwalter, Kathleen
Siblings of persons with schizophrenia may provide primary or secondary care for their sibling and support to parents who are primary care givers. These siblings experience stress and the accompanying sequelae of decreased quality of life, grief, chronic illness, and symptoms of depression and anxiety. Comprehensive measures of sibling stress have not been published. Before interventions to help siblings can be created, health professionals need such an assessment. The Friedrich-Lively Instrument to Assess the Impact of Schizophrenia on Siblings (FLIISS) has been developed to meet the needs of both health workers and siblings. The instrument has a strong conceptual basis adapted from Pearlin's model of stress in caregiving and was preceded by pilot work that evaluated both quantitative and qualitative data. In this article, (Part I), the development of the instrument and its relationships to the conceptual model are described. Health professionals can use the instrument for collecting information that will increase their ability to identify sources of stress faced by siblings of persons with schizophrenia, and from this assessment they may develop interventions for this underserved population.
Tarifa, Enrique E.; Scenna, Nicolas J.
In Part I, an efficient method for identifying faults in large processes was presented. The whole plant is divided into sectors by using structural, functional, or causal decomposition. A signed directed graph (SDG) is the model used for each sector. The SDG represents interactions among process variables. This qualitative model is used to carry out qualitative simulation for all possible faults. The output of this step is information about the process behaviour. This information is used to build rules. When a symptom is detected in one sector, its rules are evaluated using on-line data and fuzzy logic to yield the diagnosis. In this paper the proposed methodology is applied to a multiple stage flash (MSF) desalination process. This process is composed of sequential flash chambers. It was designed for a pilot plant that produces drinkable water for a community in Argentina; that is, it is a real case. Due to the large number of variables, recycles, phase changes, etc., this process is a good challenge for the proposed diagnosis method
Yasir Ahmad; Danial Saeed Pirzada
This article uses analytical hierarchy process (AHP) to find prioritization of functional strategies (manufacturing, marketing, human resource, and financial management) by small and medium enterprises (SMEs) operating in auto parts manufacturing sector of Pakistan. SMEs are major part of the industrial structure and have significant contribution toward generating jobs in Pakistan. These enterprises are generally famil...
Tompa, Emile; Dolinschi, Roman; Laing, Andrew
We assess the costs and consequences of a participatory ergonomics process at a Canadian car parts manufacturer from the perspective of the firm. Regression modeling was used with interrupted time series data to assess the impact of the process on several health measures. Consequences were kept in natural units for cost-effectiveness analysis, and translated into monetary units for cost-benefit analysis. The duration of disability insurance claims and the number of denied workers' compensation claims was significantly reduced. The cost-effectiveness ratio is $12.06 per disability day averted. The net present value is $244,416 for a 23-month period with a benefit-to-cost ratio of 10.6, suggesting that the process was worth undertaking (monetary units in 2001 Canadian dollars). Our findings emphasize the importance of considering a range of outcomes when evaluating an occupational health and safety intervention. Participatory ergonomics process can be cost-effective for a firm.
Mammography is a very well-established imaging modality for the early detection and diagnosis of breast cancer. However, since the introduction of digital imaging to the realm of radiology, more advanced, and especially tomographic imaging methods have been made possible. One of these methods, breast tomosynthesis, has finally been introduced to the clinic for routine everyday use, with potential to in the future replace mammography for screening for breast cancer. In this two part paper, the extensive research performed during the development of breast tomosynthesis is reviewed, with a focus on the research addressing the medical physics aspects of this imaging modality. This first paper will review the research performed on the issues relevant to the image acquisition process, including system design, optimization of geometry and technique, x-ray scatter, and radiation dose. The companion to this paper will review all other aspects of breast tomosynthesis imaging, including the reconstruction process. PMID:23298126
Williams, Christopher Bryant
Low-density cellular materials, metallic bodies with gaseous voids, are a unique class of materials that are characterized by their high strength, low mass, good energy absorption characteristics, and good thermal and acoustic insulation properties. In an effort to take advantage of this entire suite of positive mechanical traits, designers are tailoring the cellular mesostructure for multiple design objectives. Unfortunately, existing cellular material manufacturing technologies limit the design space as they are limited to certain part mesostructure, material type, and macrostructure. The opportunity that exists to improve the design of existing products, and the ability to reap the benefits of cellular materials in new applications is the driving force behind this research. As such, the primary research goal of this work is to design, embody, and analyze a manufacturing process that provides a designer the ability to specify the material type, material composition, void morphology, and mesostructure topology for any conceivable part geometry. The accomplishment of this goal is achieved in three phases of research: (1) Design---Following a systematic design process and a rigorous selection exercise, a layer-based additive manufacturing process is designed that is capable of meeting the unique requirements of fabricating cellular material geometry. Specifically, metal parts of designed mesostructure are fabricated via three-dimensional printing of metal oxide ceramic powder followed by post-processing in a reducing atmosphere. (2) Embodiment ---The primary research hypothesis is verified through the use of the designed manufacturing process chain to successfully realize metal parts of designed mesostructure. (3) Modeling & Evaluation ---The designed manufacturing process is modeled in this final research phase so as to increase understanding of experimental results and to establish a foundation for future analytical modeling research. In addition to an analysis of
Chan, S C; Mohd Amin, S; Lee, T W
The College of General Practitioners of Malaysia and the Royal Australian College of General Practitioners held the first Conjoint Member of the College of General Practitioners (MCGP)/Fellow of Royal Australian College of General Practitioners (FRACGP) examination in 1982, later renamed the Conjoint MAFP/FRACGP examinations. The examination assesses competency for safe independent general practice and as family medicine specialists in Malaysia. Therefore, a defensible standard set pass mark is imperative to separate the competent from the incompetent. This paper discusses the process and issues encountered in implementing standard setting to the Conjoint Part 1 examination. Critical to success in standard setting were judges' understanding of the process of the modified Angoff method, defining the borderline candidate's characteristics and the composition of judges. These were overcome by repeated hands-on training, provision of detailed guidelines and careful selection of judges. In December 2013, 16 judges successfully standard set the Part 1 Conjoint examinations, with high inter-rater reliability: Cronbach's alpha coefficient 0.926 (Applied Knowledge Test), 0.921 (Key Feature Problems).
Willis, Clarissa A.
Provides an overview of how young children understand death, and offers concrete strategies for talking to children about death and suggestions for teachers about how to help children of various ages through grief and mourning. Highlights developmental differences in four components of children's understanding of death: irreversibility, finality,…
Mendikute, Alberto; Yagüe-Fabra, José A; Zatarain, Mikel; Bertelsen, Álvaro; Leizea, Ibai
Photogrammetry methods are being used more and more as a 3D technique for large scale metrology applications in industry. Optical targets are placed on an object and images are taken around it, where measuring traceability is provided by precise off-process pre-calibrated digital cameras and scale bars. According to the 2D target image coordinates, target 3D coordinates and camera views are jointly computed. One of the applications of photogrammetry is the measurement of raw part surfaces prior to its machining. For this application, post-process bundle adjustment has usually been adopted for computing the 3D scene. With that approach, a high computation time is observed, leading in practice to time consuming and user dependent iterative review and re-processing procedures until an adequate set of images is taken, limiting its potential for fast, easy-to-use, and precise measurements. In this paper, a new efficient procedure is presented for solving the bundle adjustment problem in portable photogrammetry. In-process bundle computing capability is demonstrated on a consumer grade desktop PC, enabling quasi real time 2D image and 3D scene computing. Additionally, a method for the self-calibration of camera and lens distortion has been integrated into the in-process approach due to its potential for highest precision when using low cost non-specialized digital cameras. Measurement traceability is set only by scale bars available in the measuring scene, avoiding the uncertainty contribution of off-process camera calibration procedures or the use of special purpose calibration artifacts. The developed self-calibrated in-process photogrammetry has been evaluated both in a pilot case scenario and in industrial scenarios for raw part measurement, showing a total in-process computing time typically below 1 s per image up to a maximum of 2 s during the last stages of the computed industrial scenes, along with a relative precision of 1/10,000 (e.g. 0.1 mm error in 1 m) with
The first part of this text-book brings a complex and comprehensive view on the places of mining and processing of ore resources in the Slovak Republic. Environmental impact of mining is also presented.
Kamath, C. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States)
In our earlier work, we described an approach for determining the process parameters that re- sult in high-density parts manufactured using the additive-manufacturing process of selective laser melting (SLM). Our approach, which combines simple simulations and experiments, was demon- strated using 316L stainless steel. We have also used the approach successfully for several other materials. This short note summarizes the results of our work in determining process parameters for Ti-6Al-4V using a Concept Laser M2 system.
A. S. Chumadin
Full Text Available The main objective of this study is to reduce a manufacturing complexity of bottom sheet metal parts by improving the accuracy of parts produced. This study is aimed at using the finite element analysis to prove assumptions that there is a transition frontier between the processes of forming and drawing, and there are capabilities to control springback effect by moving this frontier positions.The process, the stress-strain state of which in the dome corresponds to the process of forming parts, and in the flange area to the drawing process, was considered to be a formingdrawing process.Based on previous studies, techniques to reduce a springback have been proposed which enable us to use three calculation schemes for the process simulation:The frontier transition position control between the processes of forming and drawing by changing the contact pressure on the flange by varying the frictions coefficients on the die and binder surfaces;Springback manage through the additional tensile forces in the flange area of the blank;Springback manage through the technological insert at the first process stage.For ease of comparison with previous research results the same geometric parameters and material properties of the items are used in the simulation.The springback analysis used a finite element method in the AutoFormTM incremental module with automatically mashed and standard tolerance computation properties. The blank, binder, punch, and die were then imported to the module by CATIATM interface in .iges format.The calculation has shown that the optimal value for the least thinning and springback parts are available for the second scheme whereby ring punch makes additional tension in the flange area (from 1.09 to 0.35 mm with thinning from 0.80 to 0.73 mm. The use of flange retention of sheet blank at the expense of variable frictional forces showed the springback value reduction by 4 times (from 1.09 to 0.27 mm. However thinning was 16% (from 0.80 to
Full Text Available New meaning of life within grief. From the perspecive of pastoral care and counselling, one often finds that people experience a lack of meaning in their lives when confronted with grief. Thesalvation through Jesus Christ, and the way it is incorporated in one's life, doesn't bring existential hope and meaning any more. This article attempts to give new meaning to an old discussion of "grief" the conscious and unconscious mind, aswell as the emotions of grief, in such a way that new meaning of life within grief becomes a spiritual way of living, a life coram Deo.
Olesen, Martin F.; Madsen, Claus; Olsen, Lars
The Isolated System Energy Charging (ISEC) concept allows for a high efficiency of a heat pump system for hot water production. The ISEC concept consists of two water storage tanks, one charged and one discharged. The charged tank is used for the industrial process, while the discharged tank...... is charging. The charging of the tank is done by recirculating water through the condenser and thereby gradually heating the water. The modelling of the system is described in Part I . In this part, Part II, an experimental test setup of the tank system is reported, the results are presented and further...... modelling of the heat pump and tank system is performed (in continuation of Part I). The modelling is extended to include the system performance with different natural refrigerants and the influence of different types of compressors....
Gilmore, Delwyn L.; Neiser, Richard A. Jr.; Wan, Yuepeng; Sampath, Sanjay
This is the first paper of a two part series based on an integrated study carried out at Sandia National Laboratories and the State University of New York at Stony Brook. The aim of the study is to develop a more fundamental understanding of plasma-particle interactions, droplet-substrate interactions, deposit formation dynamics and microstructural development as well as final deposit properties. The purpose is to create models that can be used to link processing to performance. Process maps have been developed for air plasma spray of molybdenum. Experimental work was done to investigate the importance of such spray parameters as gun current, auxiliary gas flow, and powder carrier gas flow. In-flight particle diameters, temperatures, and velocities were measured in various areas of the spray plume. Samples were produced for analysis of microstructures and properties. An empirical model was developed, relating the input parameters to the in-flight particle characteristics. Multi-dimensional numerical simulations of the plasma gas flow field and in-flight particles under different operating conditions were also performed. In addition to the parameters which were experimentally investigated, the effect of particle injection velocity was also considered. The simulation results were found to be in good general agreement with the experimental data
How does online mourning differ from offline mourning? Throughout history, demographic, social and technological changes have altered mourners' social relationships with both the living and the dead, and hence their experiences of grief. Online technologies comprise the latest chapter in this story; earlier chapters include family/community mourning (pre-industrial), private mourning (twentieth century) and public mourning (turn of the millennium). Pervasive social media in which users generate their own content have significantly shifted mourners' social interactions and the norms that govern them, partly in new directions (such as enfranchising previously stigmatised griefs; more potential for conflict between mourners and others) but partly returning to something more like the relationships of the pre-industrial village (such as everyday awareness of mortality, greater use of religious imagery, more potential for conflict among mourners). Online, mourners can experience both greater freedom to be themselves and increased social pressure to conform to group norms as to who should be mourned and how.
Donato, A.; Arcuri, L.; Dotti, M.; Pace, A.; Pietrelli, L.; Ricci, G.; Basta, M.; Cali, V.; Pagliai, V.
This paper reports the second part of a general study carried out at the Nuclear Fuel Division aiming at verifying the possible application of the radioactive waste solidification processes to industrial hazardous wastes (RTN). The cement solidification of several RTN types has been taken into consideration, both from the technical and from the economic point of view. After a short examination of the Italian juridical and economical situation in the field, which demonstrates the need of the RTN solidification, the origin and characteristics of the RTN considered in the study and directly provided by the producing industries are reviewed. The laboratory experimental results of the cementation of RTN produced by gold manufacturing industries and by galvanic industries are reported. The cementation process can be considered a very effective mean for reducing both the RTN management costs and the environmental impact of RTN disposal. (author)
Full Text Available The paper provides an overview of some possible usage of the software described in the Part I. It contains the real examples of image quality improvement, distortion simulations, objective and subjective quality assessment and other ways of image processing that can be obtained by the individual applications.
Cosma, C.; Heikkinen, P.; Pekonen, S.
The purpose of the high resolution borehole seismics project has been to improve the reliability and resolution of seismic methods in the particular environment of nuclear waste repository sites. The results obtained, especially the data processing and interpretation methods developed, are applicable also to other geophysical methods (e.g. Georadar). The goals of the seismic development project have been: the development of processing and interpretation techniques for mapping fractured zones, and the design and construction of a seismic source complying with the requirements of repository site characterization programs. Because these two aspects of the work are very different in nature, we have structured the report as two self contained parts. Part 1 describes the development of interpretive techniques. We have used for demonstrating the effect of different methods a VSP data set collected at the SCV site during Stage 1 of the project. Five techniques have been studied: FK-filtering, three versions of Tau-p filtering and a new technique that we have developed lately, Image Space filtering. Part 2 refers to the construction of the piezoelectric source. Earlier results obtained over short distances with low energy piezoelectric transmitters let us believe that the same principle could be applied for seismic signal transmitters, if solutions for higher energy and lower frequency output were found. The instrument which we have constructed is a cylindrical unit which can be placed in a borehole and is able to produce a radial strain when excited axially. The minimum borehole diameter is 56 mm. (au)
It is my observation that the current school mathematics curriculum in Ethiopia is not producing competent mathematics students. Many mathematicians in Ethiopia and other part of the world have often expressed grief that the majority of students do not understand mathematical concepts, or do not see why mathematical ...
Wang, S.L.; Cao, Q.X.
In part I of this work (preceding paper), single-reduction results on the FM forging process were reported. In the work reported in this paper, the cavity closing laws of the consecutive reduction process were investigated, the appropriate turn-over and feed procedure being obtained, along with the
... 960—Application of the System and Technical Guidelines During the Siting Process 1. This appendix... 10 Energy 4 2010-01-01 2010-01-01 false Application of the System and Technical Guidelines During the Siting Process III Appendix III to Part 960 Energy DEPARTMENT OF ENERGY GENERAL GUIDELINES FOR THE...
There is an old German saying which implies that he who courts risk eventually comes to grief. Nobody likes to come to grief, and we all know that our health and that of our families and our colleagues is most important. On the other hand, we must master a variety of dangerous situations every day, at home, on the road and, especially, at work. Unfortunately, it is wrong working techniques and incorrect working habits which again and again entail considerable accident risks. Although we have learned from experience over many years, and also from training and instruction on the job, how to recognize dangers early enough to counteract them effectively, negligence may develop over time and lead to wrong assessments. Accidents don't happen by chance. And it is better to be safe than sorry. This short video is to upgrade your knowledge, bring your experience up to date, and alert you to hazardous situations. (orig.)
О. С. Кленов
Full Text Available The basic conditions to reduce the cost of processing technology and improve productivity through the use of modern cutting tools produced by leading foreign firms producing tools have been appraised from theory in the work. Theoretically, it has been found that an increase in the cost of processing varies according to extremum dependence, passing the minimum point. It is possible to reduce the minimum processing cost due to the increase of productivity using cutting edge tools, characterized by a high capacity for work in high cutting temperatures. The criterion showing the technological price cost minimum is the ratio of the expenditures on workers’ wages to the expenditures on the cutting tools, it being quite specific for various processing conditions. To analyze the possibilities of practical use of the proposed criterion, a complex of experimental researches of the technological prime cost and productivity of the processing with hard alloy cutting tools with wear-resistant coatings produced by the company «Iscar» has been carried out. It has been established that their use makes it possible by more than one half to reduce the labour consumption and overall costs as compared to the hard alloy cutting tools traditionally used in home industry. It has been shown that this effect is achieved by increasing the cutting speed and feed due to increased wear resistance and heat resistance of the «Iscar» company tools. It was established that it is much more possible to achieve low processing cost at milling than at turning. It was stated with regard to all major expenditures including the workers' wages, the cost of the cutting tools, equipment and other costs, allowing more correctly estimate the cost-effectiveness of mechanical processing. Experiments confirmed that the main condition for reducing the processing cost to its minimum value is to increase the processing performance through the use of a heat-resistant and wear-resistant cutting
Avelin, Pernilla; Gyllenswärd, Göran; Erlandsson, Kerstin; Rådestad, Ingela
Although there is an increasing interest in siblings' experiences of loss and grief there is limited knowledge of adolescent's own perspectives, especially in a unique situation as after stillbirth in a reconstituted family. The authors interviewed 13 bereaved adolescents. They were sad that their family was not the same and expressed feelings of being inside family grief, yet outside, because they did not have full access in their reconstituted family. An implication of present findings is that it is important to include all the members of the family in the grieving process, even half-siblings of the deceased child.
Klepp, Anne; Niccolai, Valentina; Sieksmeyer, Jan; Arnzen, Stephanie; Indefrey, Peter; Schnitzler, Alfons; Biermann-Ruben, Katja
The interaction of action-related language processing with actual movement is an indicator of the functional role of motor cortical involvement in language understanding. This paper describes two experiments using single action verb stimuli. Motor responses were performed with the hand or the foot. To test the double dissociation of language-motor facilitation effects within subjects, Experiments 1 and 2 used a priming procedure where both hand and foot reactions had to be performed in response to different geometrical shapes, which were preceded by action verbs. In Experiment 1, the semantics of the verbs could be ignored whereas Experiment 2 included semantic decisions. Only Experiment 2 revealed a clear double dissociation in reaction times: reactions were facilitated when preceded by verbs describing actions with the matching effector. In Experiment 1, by contrast, there was an interaction between verb-response congruence and a semantic variable related to motor features of the verbs. Thus, the double dissociation paradigm of semantic motor priming was effective, corroborating the role of the motor system in action-related language processing. Importantly, this effect was body part specific. Copyright © 2017 Elsevier B.V. All rights reserved.
Terefe, Netsanet Shiferaw; Buckow, Roman; Versteeg, Cornelis
Pulsed electric field (PEF) processing is an effective technique for the preservation of pumpable food products as it inactivates vegetative microbial cells at ambient to moderate temperature without significantly affecting the nutritional and sensorial quality of the product. However, conflicting views are expressed about the effect of PEF on enzymes. In this review, which is part 2 of a series of reviews dealing with the effectiveness of novel food preservation technologies for controlling enzymes, the scientific literature over the last decade on the effect of PEF on plant enzymes is critically reviewed to shed more light on the issue. The existing evidence indicates that PEF can result in substantial inactivation of most enzymes, although a much more intense process is required compared to microbial inactivation. Depending on the processing condition and the origin of the enzyme, up to 97% inactivation of pectin methylesterase, polyphenol oxidase, and peroxidase as well as no inactivation have been reported following PEF treatment. Both electrochemical effects and Ohmic heating appear to contribute to the observed inactivation, although the relative contribution depends on a number of factors including the origin of the enzyme, the design of the PEF treatment chamber, the processing condition, and the composition of the medium.
Full Text Available In filtration processes it is necessary to consider both, the interaction of thefluid with the solid parts as well as the effect of particles carried in the fluidand accumulated on the solid. While part 1 of this paper deals with themodelling of fluid structure interaction effects, the accumulation of dirtparticles will be addressed in this paper. A closer look is taken on theimplementation of a spherical, LAGRANGIAN particle model suitable forsmall and large particles. As dirt accumulates in the fluid stream, it interactswith the surrounding filter fibre structure and over time causes modificationsof the filter characteristics. The calculation of particle force interactioneffects is necessary for an adequate simulation of this situation. A detailedDiscrete Phase Lagrange Model was developed to take into account thetwo-way coupling of the fluid and accumulated particles. The simulation oflarge particles and the fluid-structure interaction is realised in a single finitevolume flow solver on the basis of the OpenSource software OpenFoam.
wft*:¥A:ft:i:ft& OFFICE OF THE INSPECTOR GENERAL AV-8B REMANUFACTURE PROGRAM AS PART OF THE AUDIT OF THE DEFENSE ACQUISITION BOARD...Part of the Audit of the Defense Acquisition Board Review Process - FY 1994 B. DATE Report Downloaded From the Internet: 03/23/99 C. Report’s Point...NAVY FOR RESEARCH DEVELOPMENT AND ACQUISITION SUBJECT: Audit Report on the AV-8B Remanufacture Program as Part of the Audit of the Defense
Full Text Available Experimental studies have revealed evidence of both parts-based and holistic representations of objects and faces in the primate visual system. However, it is still a mystery how such seemingly contradictory types of processing can coexist within a single system. Here, we propose a novel theory called mixture of sparse coding models, inspired by the formation of category-specific subregions in the inferotemporal (IT cortex. We developed a hierarchical network that constructed a mixture of two sparse coding submodels on top of a simple Gabor analysis. The submodels were each trained with face or non-face object images, which resulted in separate representations of facial parts and object parts. Importantly, evoked neural activities were modeled by Bayesian inference, which had a top-down explaining-away effect that enabled recognition of an individual part to depend strongly on the category of the whole input. We show that this explaining-away effect was indeed crucial for the units in the face submodel to exhibit significant selectivity to face images over object images in a similar way to actual face-selective neurons in the macaque IT cortex. Furthermore, the model explained, qualitatively and quantitatively, several tuning properties to facial features found in the middle patch of face processing in IT as documented by Freiwald, Tsao, and Livingstone (2009. These included, in particular, tuning to only a small number of facial features that were often related to geometrically large parts like face outline and hair, preference and anti-preference of extreme facial features (e.g., very large/small inter-eye distance, and reduction of the gain of feature tuning for partial face stimuli compared to whole face stimuli. Thus, we hypothesize that the coding principle of facial features in the middle patch of face processing in the macaque IT cortex may be closely related to mixture of sparse coding models.
Christodoulou, N; Kasiakogia, K
In the second part of this diptych, we shall deal with psychiatric training in the United Kingdom in detail, and we will compare it--wherever this is meaningful--with the equivalent system in Greece. As explained in the first part of the paper, due to the recently increased emigration of Greek psychiatrists and psychiatric trainees, and the fact that the United Kingdom is a popular destination, it has become necessary to inform those aspiring to train in the United Kingdom of the system and the circumstances they should expect to encounter. This paper principally describes the structure of the United Kingdom's psychiatric training system, including the different stages trainees progress through and their respective requirements and processes. Specifically, specialty and subspecialty options are described and explained, special paths in training are analysed, and the notions of "special interest day" and the optional "Out of programme experience" schemes are explained. Furthermore, detailed information is offered on the pivotal points of each of the stages of the training process, with special care to explain the important differences and similarities between the systems in Greece and the United Kingdom. Special attention is given to The Royal College of Psychiatrists' Membership Exams (MRCPsych) because they are the only exams towards completing specialisation in Psychiatry in the United Kingdom. Also, the educational culture of progressing according to a set curriculum, of utilising diverse means of professional development, of empowering the trainees' autonomy by allowing initiative-based development and of applying peer supervision as a tool for professional development is stressed. We conclude that psychiatric training in the United Kingdom differs substantially to that of Greece in both structure and process. Τhere are various differences such as pure psychiatric training in the United Kingdom versus neurological and medical modules in Greece, in
Arriandiaga, Ander; Portillo, Eva; Sánchez, Jose A; Cabanes, Itziar; Pombo, Iñigo
Grinding is an advanced machining process for the manufacturing of valuable complex and accurate parts for high added value sectors such as aerospace, wind generation, etc. Due to the extremely severe conditions inside grinding machines, critical process variables such as part surface finish or grinding wheel wear cannot be easily and cheaply measured on-line. In this paper a virtual sensor for on-line monitoring of those variables is presented. The sensor is based on the modelling ability of Artificial Neural Networks (ANNs) for stochastic and non-linear processes such as grinding; the selected architecture is the Layer-Recurrent neural network. The sensor makes use of the relation between the variables to be measured and power consumption in the wheel spindle, which can be easily measured. A sensor calibration methodology is presented, and the levels of error that can be expected are discussed. Validation of the new sensor is carried out by comparing the sensor's results with actual measurements carried out in an industrial grinding machine. Results show excellent estimation performance for both wheel wear and surface roughness. In the case of wheel wear, the absolute error is within the range of microns (average value 32 μm). In the case of surface finish, the absolute error is well below Ra 1 μm (average value 0.32 μm). The present approach can be easily generalized to other grinding operations.
Gonzalez, R.; Treasure, T.; Phillips, R.; Jameel, H.; Saloni, D.; Wright, J.; Abt, R.
The technical and financial performance of high yield Eucalyptus biomass in a co-current dilute acid pretreatment followed by enzymatic hydrolysis process was simulated using WinGEMS registered and Excel registered . Average ethanol yield per dry Mg of Eucalyptus biomass was approximately 347.6 L of ethanol (with average carbohydrate content in the biomass around 66.1%) at a cost of 0.49 L -1 of ethanol, cash cost of ∝0.46 L -1 and CAPEX of 1.03 L -1 of ethanol. The main cost drivers are: biomass, enzyme, tax, fuel (gasoline), depreciation and labor. Profitability of the process is very sensitive to biomass cost, carbohydrate content (%) in biomass and enzyme cost. Biomass delivered cost was simulated and financially evaluated in Part I; here in Part II the conversion of this raw material into cellulosic ethanol using the dilute acid process is evaluated. (author)
Full Text Available The waste from electric and electronic equipment and discarded automobiles in the past grew rapidly and resulted with waste in billions of tones. The aim of this paper is to present an improved non-destructive disassembly process of electromechanical products using augmented reality based devices, such as glasses, tablets or mobile phones, and RFID technology for valuable product/part tracking. The proposed method includes tagging of components of interest in the product assembly by using a RFID tag. The valuable product is marked with specific ID number written in the RFID tag, in order to declare the product. The relevant data such as material and weight of components, guidelines for non-destructive disassembly for the valuable product and removing of component of interest will be obtained with the assistance of RFID tag and a centralized database. This modular system offers guidelines for the non-destructive disassembly process for obtaining valuable component of interest intended for easy repairs, remanufacture, reuse or recycling. The guidelines are in video presentation format using augmented reality for easy visualization of non-destructive disassembly process. The benefits of proposed modular system includes biggest percentage of reuse of the valuable components, easy maintaining, improved material recycling, environmental protection and greater total return form end of life products.
Kristjansdottir, Katrin; Shafiee, Sara; Hvam, Lars
Engineering-To-Order (ETO) companies have to respond to increasing demands to provide highly customized and complex products with high quality at competitive prices. In order to respond to those challenges ETO companies have started to implement product configuration systems (PCS) to increase...... to be supported with the PCSs is not described in the current literature. This paper aims to pursue that research opportunity by presenting a framework, which aims to identifying the critical parts of the engineering processes in order to identify where it most beneficial to implement a PCSs and how to prioritize...
Full Text Available BACKGROUND: Faces are arguably one of the most important object categories encountered by human observers, yet they present one of the most difficult challenges to both the human and artificial visual systems. A variety of experimental paradigms have been developed to study how faces are represented and recognized, among which is the part-spacing paradigm. This paradigm is presumed to characterize the processing of both the featural and configural information of faces, and it has become increasingly popular for testing hypotheses on face specificity and in the diagnosis of face perception in cognitive disorders. METHODOLOGY/PRINCIPAL FINDINGS: In two experiments we questioned the validity of the part task of this paradigm by showing that, in this task, measuring pure information about face parts is confounded by the effect of face configuration on the perception of those parts. First, we eliminated or reduced contributions from face configuration by either rearranging face parts into a non-face configuration or by removing the low spatial frequencies of face images. We found that face parts were no longer sensitive to inversion, suggesting that the previously reported inversion effect observed in the part task was due in fact to the presence of face configuration. Second, self-reported prosopagnosic patients who were selectively impaired in the holistic processing of faces failed to detect part changes when face configurations were presented. When face configurations were scrambled, however, their performance was as good as that of normal controls. CONCLUSIONS/SIGNIFICANCE: In sum, consistent evidence from testing both normal and prosopagnosic subjects suggests the part task of the part-spacing paradigm is not an appropriate task for either measuring how face parts alone are processed or for providing a valid contrast to the spacing task. Therefore, conclusions from previous studies using the part-spacing paradigm may need re-evaluation with
Baran, Ismet; Tutum, Cem C.; Hattel, Jesper H.; Akkerman, Remko
A novel three dimensional thermo-chemical simulation of the pultrusion process is presented. A simulation is performed for the pultrusion of a NACA0018 blade profile having a curved geometry, as a part of the DeepWind project. The finite element/nodal control volume (FE/NCV) technique is used.
Baran, Ismet; Tutum, Cem Celal; Hattel, Jesper Henri
novel three dimensional thermo-chemical simulation of the pultrusion process is presented. A simulation is performed for the pultrusion of a NACA0018 blade profile having a curved geometry, as a part of the DeepWind project. The finite element/nodal control volume (FE/NCV) technique is used. First...
Roffey, R.; Hjalmarsson, K.
On Commission of SKBF/KBS the microbial processes that are likely to occur in the silo part of SFR, the final repository for medium- and low-level nuclear wastes, have been put together. The experimental studies concerning microbial degradation of bitumen are described. From a microbial point of view it is the biodegradation of bitumen that constitutes the greatest risk in the silo part of SFR. The degradation, aerobic as well as anaerobic, leads to production of carbon dioxide which might cause a decrease in pH to such an extent that hydrogen-gas producing corrosion of metal could occur. This production of gas can cause an increase in internal pressure of the repository. A culture of bacteria able to degrade bitumen aerobically has been enriched. Uptil now no culture degrading bitumen under anaerobic conditions have been obtained. When making a risk assessment of the SFR at the present time it is not possible to completely disregard the microbial activity. An account is also given for some international contacts in this area. 11 references
In his mourning diaries, Roland Barthes circles around a distinction between the ‘emotivity’ of grief and what he terms ‘suffering’ in grief. The emotivity of grief, we are told, passes with time. Suffering, however, does not. While emotivity manifests in waves, like brushes of emotional states...
Cunningham, Adam; Smart, Robert
In 1991, Ford Motor Company began deployment of CAPE (computer-aided parts estimating system), a highly advanced knowledge-based system designed to generate, evaluate, and cost automotive part manufacturing plans. cape is engineered on an innovative, extensible, declarative process-planning and estimating knowledge representation language, which underpins the cape kernel architecture. Many manufacturing processes have been modeled to date, but eventually every significant process in motor veh...
Paine, Drew; Lee, Charlotte
Slides from Charlotte P. Lee's presentation at the 2015 iConference on our paper "Examining Data Processing Work as Part of the Scientific Data Lifecycle: Comparing Practices Across Four Scientific Research Groups".
Swarte, Nikkie B; van der Lee, Marije L; van der Bom, Johanna G; van den Bout, Jan; Heintz, A Peter M
To assess how euthanasia in terminally ill cancer patients affects the grief response of bereaved family and friends. Cross sectional study. Tertiary referral centre for oncology patients in Utrecht, the Netherlands. 189 bereaved family members and close friends of terminally ill cancer patients who died by euthanasia and 316 bereaved family members and close friends of comparable cancer patients who died a natural death between 1992 and 1999. Symptoms of traumatic grief assessed by the inventory of traumatic grief, current feelings of grief assessed by the Texas revised inventory of grief, and post-traumatic stress reactions assessed by the impact of event scale. The bereaved family and friends of cancer patients who died by euthanasia had less traumatic grief symptoms (adjusted difference -5.29 (95% confidence interval -8.44 to -2.15)), less current feeling of grief (adjusted difference 2.93 (0.85 to 5.01)); and less post-traumatic stress reactions (adjusted difference -2.79 (-5.33 to -0.25)) than the family and friends of patients who died of natural causes. These differences were independent of other risk factors. The bereaved family and friends of cancer patients who died by euthanasia coped better with respect to grief symptoms and post-traumatic stress reactions than the bereaved of comparable cancer patients who died a natural death. These results should not be interpreted as a plea for euthanasia, but as a plea for the same level of care and openness in all patients who are terminally ill.
... Information (FOI) Processing Cost” ER25NO98.000 ER25NO98.001 ... 32 National Defense 2 2010-07-01 2010-07-01 false DD Form 2086, âRecord of Freedom of Information (FOI) Processing Costâ C Appendix C to Part 286 National Defense Department of Defense (Continued...
Korićanac, V.; Vranić, D.; Trbović, D.; Petronijević, R.; Parunović, N.
In the period January 2016 to May 2017, the presence and levels of sulfite were examined in 270 samples of hamburger, sausage (various types), pljeskavica (Serbian-style meat patties of various types) and ćevapi or ćevapčići (grill kebabs) from the Serbian market. Some (12.59%) of these partly processed meat products contained sulfites, expressed as SO2, at levels above 10 mg/kg, and so did not meet requirements laid down in the National Regulation. In the remainder of the meat products (87.41%), sulfite contents were below 10 mg/kg, which is considered as “not detected”. By groups, 100% of hamburgers, 91.76% of sausages and 90.48% of pljeskavica met requirements of National Regulation. The meat product group with the biggest percentage of non-compliant meat products in which sulfites were detected was the ćevapi or ćevapčići - 18.10% of them contained sulfites. All in all, most of the partly processed meat products from the Serbian market met the National Regulation regarding sulfite content, and they were safe for consumption. Nonetheless, the high percentage of ćevapi or ćevapčići that contained sulfites leads us to conclude that regular and periodic control is necessary and one of the most important steps in ensuring safe and quality meat products for consumers.
Fernandez, P.; Cruz, L. J.; Coleto, J.
With its interesting and particular characteristics, cellular metals are taking part of the great family of new materials. They can have open or closed porosity. At the present time, the major challenge for the materials researchers is based in the manufacturing techniques improvement in order to obtain reproducible and reliable cellular metals with quality. In the present paper, the different production methods to manufacture cellular metals by liquid route are reviewed; making a short description about the main parameters involved and the advantages and drawbacks in each of them. (Author) 106 refs
Fry, T F
Data Processing discusses the principles, practices, and associated tools in data processing. The book is comprised of 17 chapters that are organized into three parts. The first part covers the characteristics, systems, and methods of data processing. Part 2 deals with the data processing practice; this part discusses the data input, output, and storage. The last part discusses topics related to systems and software in data processing, which include checks and controls, computer language and programs, and program elements and structures. The text will be useful to practitioners of computer-rel
Full Text Available Abstract Background The number of new cases of type 1 diabetes mellitus (T1DM has increased substantially in recent years and it is now one of the most common long-term endocrine disorders in childhood. In Sweden the child and family are hospitalised in accordance with the national guidelines for one to two weeks at diagnosis. The purpose of this study was to describe parents’ perceptions of the educational process when their child is newly diagnosed with T1DM. Methods Qualitative interviews were performed in the south western part of Sweden with ten mothers and eight fathers of children, diagnosed with T1DM, at three to six months after they had received the diagnosis. The interviews were analysed using deductive content analysis and Mol’s philosophical theory. Results The results show that almost all parents had experienced the educational process as being satisfactory. However, most parents felt that the teaching needed to be adapted to the individual families and to help them to learn to live with diabetes in their everyday lives. Rather than merely teaching according to a fixed schedule and cramming knowledge, the education should be parent-centered and provide time for grief and shock. There should also be a greater emphasis on why certain things should be done rather than on what should be done. The routines learned at the hospital made the efforts to be good parents managing the child’s disease, and continuing to lead a normal family life, a difficult task. Conclusions In order to optimize the educational process for families with children newly diagnosed with T1DM an increased focus on the families’ perceptions might be helpful in that this could lead to further revelations of the educational process thus making it more understandable for the family members involved.
The multibarrier concept for the solidification and storage of radioactive waste utilizes up to three barriers to isolate radionuclides from the environment: a solidified waste inner core, an impervious coating, and a metal matrix. The coating and metal matrix give the composite waste form enhanced inertness with improvements in thermal stability, mechanical strength, and leach resistance. Preliminary process flow rates and material costs were evaluated for four multibarrier waste forms with the process complexity increasing thusly: glass marbles, uncoated supercalcine, glass-coated supercalcine, and PyC/Al 2 O 3 -coated supercalcine. This report discusses the process variables and their effect on optimization of product quality, processing simplicity, and material cost. 11 figures, 2 tables
Lopez-Delgado, A.; Guerrero, A.; Lopez, F. A.; Perez, C.; Alguacil, F. J.
Under the European LIFE Program a microencapsulation process was developed for liquid mercury using Sulfur Polymer Stabilization/Solidification (SPSS) technology, obtaining a stable concrete-like sulfur matrix that allows the immobilization of mercury for long-term storage. The process description and characterization of the materials obtained were detailed in Part I. The present document, Part II, reports the results of different tests carried out to determine the durability of Hg-S concrete samples with very high mercury content (up to 30 % w/w). Different UNE and RILEM standard test methods were applied, such as capillary water absorption, low pressure water permeability, alkali/acid resistance, salt mist aging, freeze-thaw resistance and fire performance. The samples exhibited no capillarity and their resistance in both alkaline and acid media was very high. They also showed good resistance to very aggressive environments such as spray salt mist, freeze-thaw and dry-wet. The fire hazard of samples at low heat output was negligible. (Author)
Christensen, Dorthe Refslund; Sandvik, Kjetil
This chapter demonstrates how everyday practices among parents who suffer the loss of a child include the use of both analogue and digital means, both established media and materialities occasionally functioning as media in order to create meaning-making relations to the dead child, the bereaved...... as well as to the surrounding world. Based on an in-depth interview with a mother to a dead child combined with 8 years of observation studies and qualitative content analyses of both children’s graves and online memory profiles, this chapter explains how these are articulated through everyday media use....... The chapter focuses on the cross media connection between offline and online activities and demonstrates how the loss of a child initiates processes which are not about letting go and moving on but rather keeping hold while moving on articulated through communicational practices of keeping a sense of presence...
Zhang, Yaning; Xu, Fei; Li, Bingxi; Kim, Yong-Song; Zhao, Wenke; Xie, Gongnan; Fu, Zhongbin
This study aims to validate the three-phase heat and mass transfer model developed in the first part (Three phase heat and mass transfer model for unsaturated soil freezing process: Part 1 - model development). Experimental results from studies and experiments were used for the validation. The results showed that the correlation coefficients for the simulated and experimental water contents at different soil depths were between 0.83 and 0.92. The correlation coefficients for the simulated and experimental liquid water contents at different soil temperatures were between 0.95 and 0.99. With these high accuracies, the developed model can be well used to predict the water contents at different soil depths and temperatures.
Joo, B. D.; Jang, J. H.; Choi, M. K.; Moon, Y. H.
Tube hydroforming is the technology that utilizes hydraulic pressure to form a tube into desired shapes inside die cavities. Recently, tube hydroforming technology draws attentions of automotive industries due to its advantages such as weight reduction, increased strength, improved quality and reduced tooling cost. Hydroformed automotive parts used as structural components in vehicle body frame or subframe often have to be structurally joined at some point. Therefore it is useful if the hydroformed automotive parts can be given a localized attachment flange. In this study, a tube hydroformed product which has flange has been formed at various processing conditions. To accomplish successful flange hydroforming process, thorough investigation on proper combination of process parameters such as internal hydraulic pressure and tool geometry has been performed. For the process design FE analysis was performed with Dynaform 5.5. With optimized die parting angle and circumferential expansion ratio, hydroforming experiments to form flange were performed and forming characteristics at various process conditions were analyzed. The results show that flanged parts can be successfully produced by tube hydroforming process.
11 Des 2009 ... Narrative therapy is suggested as a means of grief counselling, as it makes use of the story analogy, which supports the notion of an open end to the ... narrative approach to grief will generate the consolation needed by the grief-stricken on their ...... International Journal of Practical Theology 8(2), 1–14.
Schuler, Tammy A; Zaider, Talia I; Li, Yuelin; Masterson, Melissa; McDonnell, Glynnis A; Hichenberg, Shira; Loeb, Rebecca; Kissane, David W
Screening and baseline data on 170 American families (620 individuals), selected by screening from a palliative care population for inclusion in a randomized controlled trial of family-focused grief therapy, were examined to determine whether family dysfunction conferred higher levels of psychosocial morbidity. We hypothesized that greater family dysfunction would, indeed, be associated with poorer psychosocial outcomes among palliative care patients and their family members. Screened families were classified according to their functioning on the Family Relationships Index (FRI) and consented families completed baseline assessments. Mixed-effects modeling with post hoc tests compared individuals' baseline psychosocial outcomes (psychological distress, social functioning, and family functioning on a different measure) according to the classification of their family on the FRI. Covariates were included in all models as appropriate. For those who completed baseline measures, 191 (30.0%) individuals were in low-communicating families, 313 (50.5%) in uninvolved families, and 116 (18.7%) in conflictual families. Family class was significantly associated (at ps ≤ 0.05) with increased psychological distress (Beck Depression Inventory and Brief Symptom Inventory) and poorer social adjustment (Social Adjustment Scale) for individual family members. The family assessment device supported the concurrent accuracy of the FRI. As predicted, significantly greater levels of individual psychosocial morbidity were present in American families whose functioning as a group was poorer. Support was generated for a clinical approach that screens families to identify those at high risk. Overall, these baseline data point to the importance of a family-centered model of care. Copyright © 2017 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.
Shannon, Robin Adair; Yonkaitis, Catherine Falusi
This is the second of two articles outlining the professional school nurse's role in the special education process for students with disabilities. The Individuals with Disabilities in Education Improvement Act of 2004 mandates the special education process: identification, full and individual evaluation, eligibility determination, and development of the individual education program (IEP), including special education placement. Part 1 focused on the importance of the school nurse's role in student identification, response to intervention, and the full and individual evaluation. Part 2 highlights the school nurse's vital and unique contribution to the subsequent special education steps of eligibility determination, IEP development, and special education services placement and minutes.
Marhöfer, David Maximilian; Tosello, Guido; Islam, Aminul
. In the reported work, process simulations using Autodesk Moldflow Insight 2015® are applied to a micro mechanical part to be fabricated by micro injection molding and with over-all dimensions of 12.0 × 3.0 × 0.8 mm³ and micro features (micro hole, diameter of 580 μm, and sharp radii down to 100 μm). Three...
Acosta, S.; Lewis, C.
One of the technical requirements of the standard IRAM ISO 17025 for the accreditation of testing laboratories, is the assurance of the quality of the results through the control and monitoring of the factors influencing the reliability of them. The grade the factors contribute to the total measurement uncertainty, determines which of them should be considered when developing a quality assurance plan. The laboratory of environmental measurements of strontium-90 in the accreditation process, performs most of its determinations in samples with values close to the detection limit. For this reason the correct characterization of the white, is a critical parameter and is verified through a letter for statistical process control. The scope of the present work is concerned the control of whites and so it was collected a statistically significant amount of data, for a period of time that is covered of different conditions. This allowed consider significant variables in the process, such as temperature and humidity, and build a graph of white control, which forms the basis of a statistical process control. The data obtained were lower and upper limits for the preparation of the charter white control. In this way the process of characterization of white was considered to operate under statistical control and concludes that it can be used as part of a plan of insurance of the quality
Full Text Available In recent years, the rolling densification process has become increasingly widely used to strengthen powder metallurgy parts. The original composition of the rolled powder metallurgy blank has a significant effect on the rolling densification technology. The present work investigated the effects of different carbon contents (0 wt. %, 0.2 wt. %, 0.45 wt. %, and 0.8 wt. % on the rolling densification. The selection of the raw materials in the surface rolling densification process was analyzed based on the pore condition, structure, hardness, and friction performance of the materials. The results show that the 0.8 wt. % carbon content of the surface rolling material can effectively improve the properties of iron-based powder metallurgy parts. The samples with 0.8 wt. % carbon have the highest surface hardness (340 HV0.1 and the lowest surface friction coefficient (0.35. Even if the dense layer depth is 1.13 mm, which is thinner than other samples with low carbon content, it also meets the requirements for powder metallurgy parts such as gears used in the auto industry.
Hornsveld, R.H.J.; Nijman, H.L.I.
The present study evaluated the progress of four groups of chronically psychotic patients in treatment at De Kijvelanden Forensic Psychiatric Hospital. The psychotic patients were offered a cognitive-behavioral program, including psycho education, grief processing, stress management, functional
Netjes, M.; Reijers, H.A.; Aalst, van der W.M.P.
For companies to sustain competitive advantages, it is required to redesign and improve business processes continuously by monitoring and analyzing process enactment results. Furthermore, organizational structures must be redesigned according to the changes in business processes. However, there are
... 40 Protection of Environment 26 2010-07-01 2010-07-01 false Nickel or Chromium-Bearing Materials that may be Processed in Exempt Nickel-Chromium Recovery Furnaces XII Appendix XII to Part 266... FACILITIES Pt. 266, App. XII Appendix XII to Part 266—Nickel or Chromium-Bearing Materials that may be...
Weinreich, André; Funcke, Jakob Maria
Drawing on recent findings, this study examines whether valence concordant electromyography (EMG) responses can be explained as an unconditional effect of mere stimulus processing or as somatosensory simulation driven by task-dependent processing strategies. While facial EMG over the Corrugator supercilii and the Zygomaticus major was measured, each participant performed two tasks with pictures of album covers. One task was an affective evaluation task and the other was to attribute the album covers to one of five decades. The Embodied Emotion Account predicts that valence concordant EMG is more likely to occur if the task necessitates a somatosensory simulation of the evaluative meaning of stimuli. Results support this prediction with regard to Corrugator supercilii in that valence concordant EMG activity was only present in the affective evaluation task but not in the non-evaluative task. Results for the Zygomaticus major were ambiguous. Our findings are in line with the view that EMG activity is an embodied part of the evaluation process and not a mere physical outcome.
Bonanno, G A; Keltner, D
The common assumption that emotional expression mediates the course of bereavement is tested. Competing hypotheses about the direction of mediation were formulated from the grief work and social-functional accounts of emotional expression. Facial expressions of emotion in conjugally bereaved adults were coded at 6 months post-loss as they described their relationship with the deceased; grief and perceived health were measured at 6, 14, and 25 months. Facial expressions of negative emotion, in particular anger, predicted increased grief at 14 months and poorer perceived health through 25 months. Facial expressions of positive emotion predicted decreased grief through 25 months and a positive but nonsignificant relation to perceived health. Predictive relations between negative and positive emotional expression persisted when initial levels of self-reported emotion, grief, and health were statistically controlled, demonstrating the mediating role of facial expressions of emotion in adjustment to conjugal loss. Theoretical and clinical implications are discussed.
Chae, Jeong-Ho; Huh, Hyu Jung; Choi, Won Joon
On Wednesday, April 16, 2014, 261 high school students on a field trip died in the sinking of the Sewol ferry. The bereaved family of the Sewol ferry accident experienced one of the most painful traumatic losses such as the sudden death of one's child through an accident. This article reviewed and discussed embitterment related to traumatic loss through the example of the Sewol ferry accident. Embitterment-related issues and problems in coping with the accident that is caused by societal factors were described. In addition, embitterment-related findings of several previous studies based on bereaved families' mental health cohort study were reviewed. Traumatic loss of the human-made ferry accident was accompanied with feelings of being cheated, injustice, incompetence, wrongdoing by a perpetrator, and the destruction of one's belief and value system, causing severe embitterment. Embitterment was related to other mental health problems including depression, anxiety, and complicated grief. Social support and positive individual resource including optimism and wisdom can be helpful for recovery from posttraumatic embitterment. The goal of grief is to remember the decedent, understand the changes created by the loss, and determine how to reinvest in life. Embitterment may disturb the process of grief. Without the management of the embitterment, true grief may not be possible. The breakdown of value systems and severe embitterment should get more attention in future research. (PsycINFO Database Record (c) 2018 APA, all rights reserved).
Full Text Available ABSTRACTGrieving is allowedGrief is a human experience. Every form of loss shapes you into the human being you are today. Contrary to what earlier, unproven grief models postulate, grief does not have an end point. That is, bereavement does not have to be completely processed, but it should be integrated into someone’s life. The outdated grief models were often interpreted and used in a normative way, which led to a normative standard model. This portraits the belief that every mourner would experience similar symptoms and would go through a fixed pattern of phases. However, the updated vision emphasizes the individual and unique process of coping with loss: norms concerning grief should be banned. By means of literature research, interviews with professionals and personal experiences, it became clear that finding an equilibrium between restoration-orientated and loss-orientated coping styles is most beneficial. An important aspect in finding this balance is meaningfulness. Furthermore, the ability to bear a loss and to adapt accordingly are important components. Lastly, attaching significance to a loss is a constructive way of integrating the loss into one’s life. The death of a loved one should therefore not be forgotten or tucked away. After all, grief is the price we pay for love. SAMENVATTINGRouw mag er zijnRouw is een menselijke ervaring en elk verlies vormt je als mens. Rouw heeft, in tegenstelling tot wat de verouderde, niet bewezen rouwmodellen beweren, geen eindpunt. Verlies hoeft namelijk niet verwerkt te worden, maar moet juist geïntegreerd worden in iemands leven. De verouderde rouwmodellen zijn vaak normatief opgevat en toegepast, waaruit een normatief standaardmodel is ontstaan. Daarbij werd gedacht dat elke rouwende dezelfde symptomen zou vertonen en het rouwproces volgens vaste fasen zou verlopen. Binnen de vernieuwde visie wordt er juist van uitgegaan dat elk individu een unieke manier van reageren op rouw heeft. Er zou
Timerbaev, Rais Mingalievich; Muhutdinov, Rafis Habreevich; Danilov, Valeriy Fedorovich
The article addresses issues related to the methodology of intensifying self-development process when performing design and settlement works on the "Machine Parts" course for the students studying in such areas of training as "Technology" and "Vocational Education" with the use of computer technologies. At the same…
Benoot, Charlotte; Saelaert, Marlies; Hannes, Karin; Bilsen, Johan
When confronted with cancer, a prominent challenge for patients and their partners is their changed sexual relationship. An empirically based theoretical model of the sexual adaptation process during cancer might be helpful in guiding the development of adequate interventions for couples who struggle with their sexual relationship. Therefore, the purpose of this study was to synthesize evidence from primary qualitative research studies and to arrive at a detailed description of the process of sexual adjustment during cancer. We conducted a qualitative evidence synthesis of a purposeful sample of 16 qualitative papers, using the meta-ethnography approach to synthesis. We found that the subsequent studies used different theoretical approaches to describe the sexual adaptation process. This led to three divergent sexual adaptation processes: (1) the pathway of grief and mourning, depicting sexual changes as a loss; (2) the pathway of restructuring, depicting the adjustment process toward sexual changes as a cognitive process with a strong focus on the social and cultural forces that shape the values and experiences of sexuality; and (3) the pathway of sexual rehabilitation, depicting sexual changes as a bodily dysfunction that needs treatment and specific behavioral strategies. All three pathways have their own opportunities and challenges. A greater awareness of these different pathways could help healthcare providers to better understand the ways a particular couple might cope with changed sexuality, offering them opportunities to discover alternative pathways for sexual adjustment.
... conforms to the drawings in the design; and (4) That the fabrication processes, construction, and assembly... AIRCRAFT CERTIFICATION PROCEDURES FOR PRODUCTS AND PARTS Approval of Materials, Parts, Processes, and... the configuration of the part; and (ii) Information on dimensions, materials, and processes necessary...
Boerner, Kathrin; Gleason, Hayley; Jopp, Daniela S
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.
Hong, Jintae; Ahn, Sung Ho; Joung, Chang Young; Kim, Ka Hye; Heo, Sung Ho [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of)
In general, brazing is used to seal out the feed through part of thin wires, and several studies in nuclear fields used brazing as a sealing method. However, previous techniques using a manual torch or an induction brazing by blowing Ar gas as a shield gas cannot avoid soot, which is difficult to remove. In addition, because their brazing quality is not uniform, instrumentation cables cannot deliver signals due to damage of excessive heat. In this study, an automatically controlled induction brazing system has been developed including a vacuum chamber to prevent generation of soot. A loop is a facility to carry out irradiation test for nuclear fuels and materials in a research reactor by measuring the irradiation behavior of them in a timely manner. Because flow condition of coolant in a loop should be the same with that of NPPs', highly pressurized (15.5 MPa) and highly heated (300 .deg. C) coolant is circulated through the loop. Therefore, sealing of the pressure boundary is one of the most important processes in fabricating the in-pile test section (IPS). In particular, sensors such as thermocouples, LVDTs and SPNDs are attached in a test rig and deliver signals to the measuring device at the outside of the reactor pool through instrumentation cables, which pass through the pressure boundary of the test rig. Therefore, it needs to seal out the instrumentation feed through part to not leak the coolant.
Full Text Available Background : Recent clinical and animal experimental studies postulate that the pathogenetic mechanisms of vitiligo could be of systemic origin as vitiligo is associated with ocular and auditory abnormalities as well as other autoimmune disorders.Hence, we studied genetic factors, systemic associations, ocular and auditory abnormalities of vitiligo. Methods: The study group included 150 new cases of various types of vitiligo. One hundred age- and sex-matched nonvitiligo cases were included as controls in the study. A complete family history was taken for all patients. Examination was carried out taking note of the type of vitiligo and approximate percentage of body surface involved. All relevant laboratory investigations, a thorough audiological examination including pure tone audiometry and a complete ophthalmologic examination were carried out in all patients and controls. Statistical analysis was done using the Chi square test. Results: Fifty-four vitiligo patients (36% had a family history of vitiligo. Anemia was present in 30 (20% vitiligo patients but only in five (5% controls, a difference that was statistically significant (c2 = 15.8, P < 0.001. Diabetes mellitus was present in 24 (16% vitiligo patients and only 2 (2% of controls (Chi square, c2 = 12.4, P < 0.001. Hypothyroidism and alopecia areata were present in 18 (12% and 11 (7.4% vitiligo patients respectively and none of the controls. Hypoacusis was seen in 30 (20% vitiligo patients and two (2% controls (c2 = 8.19, P < 0.005. Twenty-four vitiligo patients (16% and five controls (5% had specific ocular abnormalities like uveitis, iris and retinal pigmentary abnormalities (c2 = 7.39, P < 0.001. Conclusion: This study demonstrates statistically significant clinical evidence confirming that vitiligo is a part of systemic autoimmune process.
Full Text Available Abstract: The Naval Maintenance and Repair Command Acquisition Management Unit (NMRC-AMU of the Taiwan Navy suffered from poor stock control of spare parts and inadequate modification of requested items and manufacturer/part codes during recent years. Therefore, the purpose of this study is to investigate core categorization, coordination, and procurement (CCP problems, to formulate feasible solutions and then to improve the CCP performances of spare parts in NMRC-AMU. The Teoriya Resheniya Izobreatatelskih Zadatch (TRIZ method was applied to solve this issue. A problem hierarchy analysis (PHA was first used to identify the core problems. Then, the 40 principles were used to determine the ideal improvement solution and formulate a solution strategy that simultaneously simplified CCP processed and enhanced the correctness of procurement tasks, thereby elevating CCP efficiency, supporting the Taiwan Navy repair missions, and satisfying fleet maintenance and servicing demands. The results indicated that total 6925 requests for coordination and procurement were submitted. Of these requests, 4366 requests had been completed (with total 102 cases, and the CCP efficiency is 63.0%. After improvement by this study, a total of 4529 items were submitted and 3592 executed items were completed (with a total of 172 cases, and the CCP efficiency is 79.3%. The improvement percentage of the CCP efficiency and completed cases are 30.6% and 68.6%, respectively. The performances are good and the TRIZ could be applied for other military forces.
Laakso, Petri; Riipinen, Tuomas; Laukkanen, Anssi; Andersson, Tom; Jokinen, Antero; Revuelta, Alejandro; Ruusuvuori, Kimmo
This paper demonstrates the successful printing and optimization of processing parameters of high-strength H13 tool steel by Selective Laser Melting (SLM). D-Optimal Design of Experiments (DOE) approach is used for parameter optimization of laser power, scanning speed and hatch width. With 50 test samples (1×1×1cm) we establish parameter windows for these three parameters in relation to part density. The calculated numerical model is found to be in good agreement with the density data obtained from the samples using image analysis. A thermomechanical finite element simulation model is constructed of the SLM process and validated by comparing the calculated densities retrieved from the model with the experimentally determined densities. With the simulation tool one can explore the effect of different parameters on density before making any printed samples. Establishing a parameter window provides the user with freedom for parameter selection such as choosing parameters that result in fastest print speed.
Bonanno, G A; Keltner, D; Holen, A; Horowitz, M J
It has been widely assumed that emotional avoidance during bereavement leads to either prolonged grief, delayed grief, or delayed somatic symptoms. To test this view, as well as a contrasting adaptive hypothesis, emotional avoidance was measured 6 months after a conjugal loss as negative verbal-autonomic response dissociation (low self-rated negative emotion coupled with heightened cardiovascular activity) and compared with grief measured at 6 and 14 months. The negative dissociation score evidenced reliability and validity but did not evidence the assumed link to severe grief. Rather, consistent with the adaptive hypothesis, negative dissociation at 6 months was associated with minimal grief symptoms across 14 months. Negative dissociation scores were also linked to initially high levels of somatic symptoms, which dropped to a low level by 14 months. Possible explanations for the initial cost and long-term adaptive quality of emotional avoidance during bereavement, as well as implications and limitations of the findings, are discussed.
O. M. Dyakonov
Full Text Available The main calculation methods for heat- and mass transfer in porous heterogeneous medium have been considered. The paper gives an evaluation of the possibility to apply them for calculation of metal chip heating process. It has been shown that a description of transfer processes in a chip has its own specific character that is attributed to difference between thermal and physical properties of chip material and lubricant-coolant components on chip surfaces. It has been determined that the known expressions for effective heat transfer coefficients can be used as basic ones while approaching mutually penetrating continuums. A mathematical description of heat- and mass transfer in chip medium can be considered as a basis of mathematical modeling, numerical solution and parameter optimization of the mentioned processes.
Schmidt, C J; Singer, R B
Structured settlement underwriting is the underwriting of medically impaired lives for the purchase of an annuity to fund the settlement. Other than risk assessment, structured settlement (SS) underwriting has little in common with traditional life insurance underwriting. Most noteworthy of these differences is the relative lack of actuarial data on which to base decisions about mortality and the necessity for prospective thinking about risk assessment. The purpose of this paper is to provide a foundation for understanding the structured settlement business and to contrast the underwriting of structured settlements with that of traditional life insurance. This is the first part of a two-part article on SS annuities. Part 2 deals with the mortality experience in SS annuitants and the life-table methodology used to calculate life expectancy for annuitants at increased mortality risk.
XIANGYANG, JIANG; MATEJICEK, JIRI; KULKARNI, ANAND; HERMAN, HERBERT; SAMPATH, SANJAY; GILMORE, DELWYN L.; NEISER A, RICHARD Jr.
This is the second paper of a two part series based on an integrated study carried out at the State University of New York at Stony Brook and Sandia National Laboratories. The goal of the study is the fundamental understanding of the plasma-particle interaction, droplet/substrate interaction, deposit formation dynamics and microstructure development as well as the deposit property. The outcome is science-based relationships, which can be used to link processing to performance. Molybdenum splats and coatings produced at 3 plasma conditions and three substrate temperatures were characterized. It was found that there is a strong mechanical/thermal interaction between droplet and substrate, which builds up the coatings/substrate adhesion. Hardness, thermal conductivity, and modulus increase, while oxygen content and porosity decrease with increasing particle velocity. Increasing deposition temperature resulted in dramatic improvement in coating thermal conductivity and hardness as well as increase in coating oxygen content. Indentation reveals improved fracture resistance for the coatings prepared at higher deposition temperature. Residual stress was significantly affected by deposition temperature, although not significant by particle energy within the investigated parameter range. Coatings prepared at high deposition temperature with high-energy particles suffered considerably less damage in wear tests. Possible mechanisms behind these changes are discussed within the context of relational maps which are under development
cycle cost ; and 4. Improve procurement and test of small quantities of parts and materials that meet system requirements. This document supersedes...the reliability of program PMP to reduce PMP failures at all levels of assembly and test 3. Reduce program lifecycle cost 4. Improve procurement and...part shall be procured in single lots directly from the manufacturer or its authorized franchised distributor. The contractor shall be able to
Segerstad, Ylva Hård Af; Kasperowski, Dick
The purpose of this paper was to study bereaved parents' use of a closed peer grief support community on Facebook and the features of the community that are important to them. The death of a child is an uncomfortable subject in most contemporary societies. This limits the exploration of experiences and possibilities for coping with grief. However, with the introduction of social media, this has changed. Theoretical perspectives on parental grief recognizing the importance of continued relational bonds with the lost child are used, together with the ontological assumption that social media enhance the dissolving of private/public and time/space. This study is based on questionnaire, interviews, and content from the closed peer grief support community, to which the research team has insider access. The community encompasses a diverse range of experiences and stages of grief, independent of the time elapsed since the loss of a child. Bereavement of children of all ages and from all conceivable causes of death is distributed among the members. The results show how the affordances of social media become vital resources for coping with grief in ways not available previously, comprising aspects of the closed nature of the group, shared experiences, time, and accessibility.
Tarifa, Enrique E.; Scenna, Nicolas J.
This work presents a new strategy for fault diagnosis in large chemical processes (E.E. Tarifa, Fault diagnosis in complex chemistries plants: plants of large dimensions and batch processes. Ph.D. thesis, Universidad Nacional del Litoral, Santa Fe, 1995). A special decomposition of the plant is made in sectors. Afterwards each sector is studied independently. These steps are carried out in the off-line mode. They produced vital information for the diagnosis system. This system works in the on-line mode and is based on a two-tier strategy. When a fault is produced, the upper level identifies the faulty sector. Then, the lower level carries out an in-depth study that focuses only on the critical sectors to identify the fault. The loss of information produced by the process partition may cause spurious diagnosis. This problem is overcome at the second level using qualitative simulation and fuzzy logic. In the second part of this work, the new methodology is tested to evaluate its performance in practical cases. A multiple stage flash desalination system (MSF) is chosen because it is a complex system, with many recycles and variables to be supervised. The steps for the knowledge base generation and all the blocks included in the diagnosis system are analyzed. Evaluation of the diagnosis performance is carried out using a rigorous dynamic simulator
Pang, Jie; Wang, De-Zhen; Zou, Zong-Yao; Wang, Yan-Zhi; Gao, Qian; Li, Xue-Gang
To investigate the effect of different parts, harvesting time and processing technologies on alkaloids content of Coptis chinensis adventitious root. The content of alkaloids were analyzed by HPLC. The content of total alkaloids in adventitious root harvested in different time was ranged from 2.5% to 2.9%, in which that of berberine and coptisine were the highest, reaching to 1%, and that of palmatine was only 0.1%. It suggested there was no significant difference of total alkaloids at different harvesting time. Nevertheless, the difference of the alkaloids content from different parts was much significant. The content of total alkaloid of adventitious root near to rhizome was about 4%, 2 times higher than that away from rhizome (only 2%). In addition, different processing technologies would affect alkaloids content obviously. There was hardly loss of alkaloids when the fresh adventitious root was washed with water, but it would decrease alkaloids content when the dried adventitious root was washed. Medicine value of Coptis chinensis adventitious root near to rhizome is higher than that away from rhizome. And fresh Coptis chinensis adventitious root can be washed with water.
Pablo RODRÍGUEZ HERRERO; Agustín DE LA HERRÁN GASCÓN; Dolores IZUZQUIZA GASSET
It is needed a foundation and some orientations to act in loss and grief situations with adults with intellectual disabilities. In this article, through a relevant literature review, we based the educational accompaniment as a pedagogic methodology of support with three principal elements: a) The conception of grief from its formative potential, b) The prevention of disorders associated to grief complications, c) The pedagogic intervention preferably from the tutorship or from the actuation o...
Lukić, Bratislav B.; Saletti, Dominique; Forquin, Pascal
This paper presents a second part of the study aimed at investigating the fracture behavior of concrete under high strain rate tensile loading. The experimental method together with the identified stress-strain response of three tests conducted on ordinary concrete have been presented in the paper entitled Part I (Forquin and Lukić in Journal of Dynamic Behavior of Materials, 2017. https://doi.org/10.1007/s40870-017-0135-1). In the present paper, Part II, the investigation is extended towards directly determining the specific fracture energy of each observed fracture zone by visualizing the dynamic cracking process with a temporal resolution of 1 µs. Having access to temporal displacement fields of the sample surface, it is possible to identify the fracture opening displacement (FOD) and the fracture opening velocity of any principle (open) and secondary (closed) fracture at each measurement instance, that may or may not lead to complete physical failure of the sample. Finally, the local Stress-FOD curves were obtained for each observed fracture zone, opposed to previous works where indirect measurements were used. The obtained results indicated a much lower specific fracture energy compared to the results often found in the literature. Furthermore, numerical simulations were performed with a damage law to evaluate the validity of the proposed experimental data processing and compare it to the most often used one in the previous works. The results showed that the present method can reliably predict the specific fracture energy needed to open one macro-fracture and suggested that indirect measurement techniques can lead to an overestimate of specific fracture energy due to the stringent assumption of linear elasticity up-to the peak and the inability of having access to the real post-peak change of axial stress.
Masselot, Y.; Bataller, S.; Ganivet, M.; Guillet, H.; Robillard, A.; Stosskopf, F.
This report is the first in a series of three describing the processes, results and peculiar technical problems related to the manufacture of the first core of the fast reactor Rapsodie. A detailed study of manufacturing processes(pellets, pins, fissile sub-assemblies), the associated testings (raw materials, processed pellets and pins, sub-assemblies before delivery), manufacturing facilities and improvements for a second campaign are described. (author) [fr
Pirouzpanah, V.; Khoshbakhti Saray, R.; Sohrabi, A.; Niaei, A.
Dual fuel engines at part load inevitably suffer from lower thermal efficiency and higher emission of carbon monoxide and unburned fuel. This work is conducted to investigate the combustion characteristics of a dual fuel (Diesel-gas) engine at part loads using a single zone combustion model with detailed chemical kinetics for combustion of natural gas fuel. In this home made software, the presence of the pilot fuel is considered as a heat source that is deriving form two superposed Wiebe's combustion functions to account for its contribution to ignition of the gaseous fuel and the rest of the total released energy. The chemical kinetics mechanism consists of 112 reactions with 34 species. This combustion model is able to establish the development of the combustion process with time and the associated important operating parameters, such as pressure, temperature, heat release rate (HRR) and species concentration. Therefore, this work is an attempt to investigate the combustion phenomenon at part load and using exhaust gas recirculation (EGR) to improve the above mentioned problems. Also, the results of this work show that each of the different cases of EGR (thermal, chemical and radical cases) has an important role on the combustion process in dual fuel engines at part loads. It is found that all the different cases of EGR have positive effects on the performance and emission parameters of dual fuel engines at part loads despite the negative effect of some diluent gases in the chemical case, which moderates too much the positive effects of the thermal and radical cases of EGR. Predicted values show good agreement with corresponding experimental values over the whole range of engine operating conditions. Implications will be discussed in detail
A sterile medical device is one that is free of viable microorganisms. International Standards, which specify requirements for validation and routine control of sterilization processes, require, when it is necessary to supply a sterile medical device, that adventitious microbiological contamination of a medical device prior to sterilization be minimized. Even so, medical devices produced under standard manufacturing conditions in accordance with the requirements for quality management systems (see, for example, ISO 13485) may, prior to sterilization, have microorganisms on them, albeit in low numbers. Such medical devices are non-sterile. The purpose of sterilization is to inactivate the microbiological contaminants and thereby transform the nonsterile medical devices into sterile ones. The kinetics of inactivation of a pure culture of microorganisms by physical and/or chemical agents used to sterilize medical devices can generally best be described by an exponential relationship between the numbers of microorganisms surviving and the extent of treatment with the sterilizing agent; inevitably this means that there is always a finite probability that a microorganism may survive regardless of the extent of treatment applied. For a given treatment, the probability of survival is determined by the number and resistance of microorganisms and by the environment in which the organisms exist during treatment. It follows that the sterility of any one medical device in a population subjected to sterilization processing cannot be guaranteed and the sterility of a processed population is defined in terms of the probability of there being a viable microorganism present on a medical device. This part of ISO 11137 describes requirements that, if met, will provide a radiation sterilization process intended to sterilize medical devices, that has appropriate microbicidal activity. Furthermore, compliance with the requirements ensures that this activity is both reliable and
Kristensen, Pål; Heir, Trond; Herlofsen, Pål H; Langsrud, Øyvind; Weisæth, Lars
We prospectively studied parental mental health after suddenly losing a son in a military training accident. Parents (N = 32) were interviewed at 1, 2 and 23 years after the death of their son. The General Health Questionnaire and Expanded Texas Inventory of Grief were self-reported at 1, 2, 5, and 23 years; the Inventory of Complicated Grief was self-reported at 23 years. We observed a high prevalence of psychiatric disorders at 1- and 2-year follow-ups (57% and 45%, respectively), particularly major depression (43% and 31%, respectively). Only one mental disorder was diagnosed at the 23-year follow-up. Grief and psychological distress were highest at 1- and 2-year follow-ups. Spouses exhibited a high concordance of psychological distress. Mothers reported more intense grief reactions than did fathers. The loss of a son during military service may have a substantial impact on parental mental health particularly during the first 2 years after death. Spouses' grief can be interrelated and may contribute to their psychological distress.
Different connections between high-dose dosimetry and radiation processing are discussed. Radiation processing cannot be performed without proper dosimetry. Accurate high dose and high dose rate dosimetry exhibits several aspects: first of all it is the preservation of the quality of the product, then fulfillment of legal aspects and last but not the least the safety of processing. Further, seldom discussed topics are as follow: dosimetric problems occurring with double-side EB irradiations, discussed in connection with the deposition of electric charge during electron beam irradiation. Although dosimetry for basic research and for medical purposes are treated here only shortly, some conclusions reached from these fields are considered in dosimetry for radiation processing. High-dose dosimetry of radiation has become a separate field, with many papers published every year, but applied dosimetric projects are usually initiated by a necessity of particular application. (author)
A miscarriage can be very traumatic for a couple and their immediate family. The aim of this study was to assess, using the Perinatal Grief Scale (PGS), whether the type of early pregnancy loss influences the severity of grief and whether the presence of living children influences the severity of grief. Over a period of 6 months in 2008, seventy five patients were recruited for the study, of which 7 (9.3%) had molar pregnancies, 20 (26.7%) had ectopic pregnancies, 43 (573%) had a miscarriage and 5 (6.7%) had recurrent miscarriages. In this study there was no significant difference in severity of grief, between women that had a miscarriage and ectopic pregnancy (p = 0.14) or, between women that had a miscarriage and a molar pregnancy (p = 0.85). Women who had experienced a ectopic pregnancy did not have a higher grief intensity than the women that had a molar pregnancy (p = 0.75). However, for women with a child, the grief intensity significantly increases with the number of miscarriages (p = 0.015). Women with no children with an ectopic pregnancy grieve significantly more than those with a child (p = 0.019). An appointment for the \\'Miscarriage Clinic\\' should be offered to all of these women but special attention should be paid to those in the categories most at risk
Solidification process for toxic and hazardous wastes. Second part: Cement solidification matrices; Inertizzazione di rifiuti tossici e nocivi (RTN). Parte seconda: Inertizzazione in matrici cementizie
Donato, A; Arcuri, L; Dotti, M; Pace, A; Pietrelli, L; Ricci, G [ENEA - Dipartimento Ciclo del Combustibile, Centro Ricerche Energia, Casaccia (Italy); Basta, M; Cali, V; Pagliai, V [ENEA - Dipartimento Ciclo del Combustibile, Centro Ricerche Energia, Saluggia (Italy)
This paper reports the second part of a general study carried out at the Nuclear Fuel Division aiming at verifying the possible application of the radioactive waste solidification processes to industrial hazardous wastes (RTN). The cement solidification of several RTN types has been taken into consideration, both from the technical and from the economic point of view. After a short examination of the Italian juridical and economical situation in the field, which demonstrates the need of the RTN solidification, the origin and characteristics of the RTN considered in the study and directly provided by the producing industries are reviewed. The laboratory experimental results of the cementation of RTN produced by gold manufacturing industries and by galvanic industries are reported. The cementation process can be considered a very effective mean for reducing both the RTN management costs and the environmental impact of RTN disposal. (author)
Lee, Wan-Lin; Hou, Yi-Chen; Lin, Yaw-Sheng
In the present study, we used the phenomenological approach to rediscover the ontological meaning of relationships with the deceased in Taiwanese widows/widowers. We first revised the original Western definitions of grief, bereavement, and mourning to fit Taiwanese culture. We used the word bei dao to indicate the mixed nature of grief and mourning in the Taiwanese bereavement process. Then we reanalyzed data from a previous study, which was conducted in 2006. In the previous qualitative research, each subject was interviewed 3 to 4 times in the mourning state over an 18-month interval that began at the point of the spouse's death. Results showed that two main themes emerged in the present analysis: (a) a blurred boundary of life and death and (b) a transformation of ethical bonds. The present study reveals the culturally unique aspects of the Taiwanese bei dao process. Limitations of the present study and future directions are discussed and reflected.
Lepelaar, Mark; Hoogendoorn, Alwin; Blok, Rijk; Teuffel, Patrick; Kawaguchi, K.; Ohsaki, M.; Takeuchi, T.
The Bio-based composite bridge is a 3TU project which aims to design and realize a 14m span pedestrian bridge made from fibre-reinforced polymers (FRP) and which is introduced in part 1 of this paper. Part 2 will focus on various studies about bio-based materials, which are suitable for structural
Although terrorism has always formed part of social existence (Rapoport. 1984) .... religious viewpoint and the promises of the next world are primary motivating ... Following independence, the first major experience of organised religious .... places of worship, media houses, and the United Nations Headquarters in Abuja.
... Work Working Through Grief About Us The Bereaved Employee: Returning to Work By Helen Fitzgerald, CT After ... One employer called a grief therapist to help employees after a co-worker reported the death of ...
... near death. Patients and their families may have cultural or religious beliefs and customs that are important ... counselors while palliative sedation is used. Grief and Loss Grief is a normal reaction to the loss ...
... 32 National Defense 2 2010-07-01 2010-07-01 false DD Form 2086-1, âRecord of Freedom of Information (FOI) Processing Cost for Technical Dataâ D Appendix D to Part 286 National Defense Department of... FREEDOM OF INFORMATION ACT PROGRAM REGULATION Pt. 286, App. D Appendix D to Part 286—DD Form 2086-1...
Boyle, C.M.; Hidalgo, S.P.; Martinez, B.J.
The Controlled Parts Management (CPM) system is based on industry standard practices for managing inventory. CPM is designed to record the movement of any type of inventory in a defined region referred to as an Account or SubAccount. The system is used to track the receiving, processing, storing and transfer of inventory parts. CPM provides information on parts, quantity and the exact location of the inventory. CPM is a barcode-based-part tracking system currently used to track controlled parts that are used in the R and D and testing of weapons; this tracking helps maintain the part pedigree that is required for certification of a weapon or weapon test. CPM includes bar code data collection software programmed into portable bar code readers for automating physical inventory services and remote transaction capture. CPM interfaces to other Engineering systems and supports a 'material content' of a weapons test through the test Bill of Materials and assignment of a unique inventory part in CPM. Additional functionality includes the ability to group or join parts, logically or physically and temporary or permanent, to represent discrete parts, containers, subassemblies and assemblies, and groupings.
Knight Thomas F
Full Text Available Abstract Background The underlying goal of synthetic biology is to make the process of engineering biological systems easier. Recent work has focused on defining and developing standard biological parts. The technical standard that has gained the most traction in the synthetic biology community is the BioBrick standard for physical composition of genetic parts. Parts that conform to the BioBrick assembly standard are BioBrick standard biological parts. To date, over 2,000 BioBrick parts have been contributed to, and are available from, the Registry of Standard Biological Parts. Results Here we extended the same advantages of BioBrick standard biological parts to the plasmid-based vectors that are used to provide and propagate BioBrick parts. We developed a process for engineering BioBrick vectors from BioBrick parts. We designed a new set of BioBrick parts that encode many useful vector functions. We combined the new parts to make a BioBrick base vector that facilitates BioBrick vector construction. We demonstrated the utility of the process by constructing seven new BioBrick vectors. We also successfully used the resulting vectors to assemble and propagate other BioBrick standard biological parts. Conclusion We extended the principles of part reuse and standardization to BioBrick vectors. As a result, myriad new BioBrick vectors can be readily produced from all existing and newly designed BioBrick parts. We invite the synthetic biology community to (1 use the process to make and share new BioBrick vectors; (2 expand the current collection of BioBrick vector parts; and (3 characterize and improve the available collection of BioBrick vector parts.
Kamsul Abraha; Yateman Arryanto; Sri Jauhari S; Agus Taftazani; Kris Tri Basuki; Djoko Sardjono, Ign.; Sukarsono, R.; Samin; Syarip; Suryadi, MS; Sardjono, Y.; Tri Mardji Atmono; Dwiretnani Sudjoko; Tjipto Sujitno, BA.
The Scientific Meeting and Presentation on Basic Research in Nuclear Science and Technology is a routine activity held by Centre for Accelerator Technology and Material Process, National Nuclear Energy Agency, for monitoring the research activity which achieved in National Nuclear Energy Agency. The Meeting was held in Yogyakarta on July 10, 2007. The proceedings contains papers presented on the meeting about Nuclear Chemistry and Process Technology and there are 47 papers which have separated index. The proceedings is the second part of the three parts which published in series. (PPIN)
... Grief at Work Working Through Grief About Us Death at the Worksite: Helping Grieving Family Members By ... fatal heart attacks occur in the workplace. Other deaths — from accidents, for example — can also happen during ...
The data indicate that the lecturers experienced emotional phases similar to those described in Kübler-Ross' 'stages of grief' model. The need for a more humane approach to incorporation processes has implications for the successful transformation of higher education institutions. SAJHE Vol.18(1) 2004: 153-164 ...
Sotov, A. V.; Agapovichev, A. V.; Smelov, V. G.; Kyarimov, R. R.
The technology of the selective laser melting (SLM) allows making products from powders of aluminum, titanium, heat-resistant alloys and stainless steels. Today the use of SLM technology develops at manufacture of the functional parts. This in turn requires development of a methodology projection of technological processes (TP) for manufacturing parts including databases of standard TP. Use of a technique will allow to exclude influence of technologist’s qualification on made products quality, and also to reduce labor input and energy consumption by development of TP due to use of the databases of standard TP integrated into a methodology. As approbation of the developed methodology the research of influence of the modes of a laser emission on a roughness of a surface of synthesized material was presented. It is established that the best values of a roughness of exemplars in the longitudinal and transversal directions make 1.98 μm and 3.59 μm respectively. These values of a roughness were received at specific density of energy 6.25 J/mm2 that corresponds to power and the speed of scanning of 200 W and 400 mm/s, respectively, and a hatch distance of 0.08 mm.
Full Text Available ... unit (NICU) Birth defects & other health conditions Loss & grief Tools & Resources Frequently asked health questions Calculating your ... unit (NICU) Birth defects & other health conditions Loss & grief Tools & Resources Frequently asked health questions Calculating your ...
Full Text Available ... unit (NICU) Birth defects & other health conditions Loss & grief Tools & Resources Frequently asked health questions Calculating your ... unit (NICU) Birth defects & other health conditions Loss & grief Tools & Resources Frequently asked health questions Calculating your ...
Full Text Available ... unit (NICU) Birth defects & other health conditions Loss & grief Tools & Resources Frequently asked health questions Calculating your ... unit (NICU) Birth defects & other health conditions Loss & grief Tools & Resources Frequently asked health questions Calculating your ...
Baran, Ismet; Hattel, Jesper Henri; Tutum, Cem Celal
This paper in particular deals with the integrated modeling of a pultruded NACA0018 blade profile being a part of EU funded DeepWind project. The manufacturing aspects of the pultrusion process are associated with the preliminary subsequent service loading scenario. A 3D thermochemical analysis...
In 1987 the English National Board (1987) made it clear that it supported a move towards an andragogical approach to nurse education. Recently such moves have been questioned as has the validity of andragogy (Darbyshire 1993). In response to such challenges this paper extends some of the arguments made in the article 'In defence of andragogy' (Milligan 1995). It is argued that andragogy provides a framework within which care and other crucial aspects of the nurse-patient/client relationship can be mirrored and thereby facilitated in future practitioners. In the socialization processes inherent in nurse education, care is surely difficult to teach or facilitate unless the philosophy and methods are consistent with such ends. Furthermore, it is frequently argued that as educationalists we need to be consistent in our approach to students with that which we hope to see in their future practice (Bevis & Murray 1990). Andragogy offers a medium through which this can be facilitated. It is essentially a humanistic educational process that values the individual. The power relationship between the educator and student is much more horizontal than is found in the historically common hierarchical educational relationship. An educational process based upon andragogy therefore mirrors important parts of the nurse-patient/client relationship. It offers a theory of education consistent with the aims of modern day nursing practice. We should seek to improve our understanding of andragogy and no longer conceptualize it as one end of a false dichotomy with pedagogy.
Full Text Available Some abortions can result in prolonged, complex grief reactions where the effects endure in problematic ways. Research findings suggest that such women suffer a turbulent spiral of often contradictory emotions and, if insufficiently acknowledged at the time of the abortion by self or other, this emotional turmoil can become pushed down and disenfranchised. This paper discusses the nature of this entrapped grief by reviewing the literature and reporting on some phenomenological case study research. A final section discusses integrative psychotherapy approaches to working in this area. Better understanding of the experience of traumatic abortion may enable therapists to be more present to this phenomenon, in particular the voicelessness some clients may experience, rendering them unable to process their feelings about the event and associated loss.
Full Text Available The presented paper shows the design and development process of sandwich parts. A spoiler plate and a main landing gear door are developed. Sandwich parts are made of C/E composite facings and a foam core. FE models have been used for optimization of structures. Emphasis has been placed on deformations of parts under a few load cases. Experimental tests have been used for a verification of structure parts loaded by concentrated forces.
Social media, such as YouTube, is increasingly a site of collective remembering where personal tributes to celebrity figures become sites of public mourning. YouTube, especially, is rife with celebrity commemorations. Examining fans' online mourning practices on YouTube, this paper examines video tributes dedicated to the late Steve Jobs, with a focus on collective remembering and collective construction of memory. Combining netnography with critical discourse analysis, the analysis focuses on the user comments where the past unfolds in interaction and meanings are negotiated and contested. The paper argues that celebrity death may, for avid fans, be a source of disenfranchised grief, a type of grief characterised by inadequate social support, usually arising from lack of empathy for the loss. The paper sheds light on the functions digital memorials have for mourning fans (and fandom) and argues that social media sites have come to function as spaces of negotiation, legitimisation and alleviation of disenfranchised grief. It is also suggested that when it comes to disenfranchised grief, and grief work generally, the concept of community be widened to include communities of weak ties, a typical form of communal belonging on social media.
Baran, Ismet; Hattel, Jesper H.; Tutum, Cem C.; Akkerman, Remko
This paper in particular deals with the integrated modeling of a pultruded NACA0018 blade profile being a part of EU funded DeepWind project. The manufacturing aspects of the pultrusion process are associated with the preliminary subsequent service loading scenario. A 3D thermo-chemical analysis of
Nardella, A.; Norian, B.
A process is described for the environmentally safe and economical disposal of used fluorescent lamp potted ballast housing assemblies comprising removing from the housing the potted assembly with its embedded electrical component assemblies including a component capacitor containing environmentally hazardous material PCB's; after or before such removing, immersing the potted assembly in a cryogenic bath and freezing the same to reader the potting sufficiently brittle to fragment into small pieces upon being impacted; impacting the potting thoroughly to crush and fragment the same into small pieces and to cleanly remove substantially all traces of the potting from all the electrical components and parts embedded therein and without imparting damage to the components and parts; disconnecting the component containing the environmentally hazardous material; and incinerating only the component containing the environmentally hazardous material, leaving all other components and parts including the housing and potting fragments for salvage, re-use and/or recycling.