The presence of grief: Research-based art and arts-based research on grief

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Winther-Lindqvist, Ditte Alexandra; Køster, Allan; Brinkmann, Svend

2018-01-01

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...

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

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Sas, Corina; Coman, Alina

2016-10-01

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

Building metaphors and extending models of grief.

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VandeCreek, L

1985-01-01

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.

Grief and mourning gone awry: pathway and course of complicated grief.

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Shear, M Katherine

2012-06-01

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.

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

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Gisele Ferreira Paris

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

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

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Grzegorz Godawa

2012-09-01

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

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

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Burhan KILIÇ

2011-06-01

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

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

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

2015-02-01

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

Bereaved parents’ online grief communities

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

2017-01-01

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

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

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Livingston, Kathy

2010-01-01

This article explores the concepts of unmourned and disenfranchised grief as a way to understand the experiences of adult children of Nazi perpetrators, who grew up with cultural norms of grieving alone or in silence. The scholarly literature on descendants of Nazis reflects a group unlikely to warrant empathy or support from others because of the stigma surrounding their family's possible involvement in the Holocaust atrocities. This article uses, as a case study approach, the testimony given by Monika Hertwig, the adult daughter of a high ranking Nazi, who appears in the documentary film, Inheritance. From the perspective of disenfranchised grief, defined as grief that is not socially recognized or supported, the article links Monika's testimony with existing research from in-depth interviews with other descendants of Nazis to suggest that, as a group, they lacked permission to grieve their deceased parents, acknowledgment of their grief, and opportunities to mourn. Based on the theory that the effects of grief can be transgenerational, the disenfranchisement experienced by the "children of the Third Reich" does not have to pass to subsequent generations if opportunities for mourning are made possible and some resolution of grief occurs. Studies have shown that ongoing dialogue groups between Holocaust survivors and descendants of Nazis provide opportunities for mourning to both groups.

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

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Kurotori, Isaku; Kato, Satoshi

2015-01-01

Auditory or visual hallucinations of a deceased person are well known in the normal course of the bereavement process. According to DSM-5, this symptom is included in the associated features supporting diagnosis of persistent complex bereavement disorder. In Japan, however, little is known about these hallucinatory experiences during grieving, and few reports on their prevalence are available. Here, we have reported a clinical case of such experiences following the loss of a spouse. A 66-year-old patient presented to the outpatient department with insomnia after her husband's death. She was preoccupied with a sense of loss and absolute loneliness. One day, she confessed to regularly encountering her husband's ghost at night; the ghost was distinguishable from a dream and provided the bereaved wife with some degree of comfort. The appearances lasted for 15 months and occurred several times a week without disturbing her social functioning. She gradually became aware that her husband was returning from the spirit world to give her solace. Her treatment was focused on resolving her conflicting feelings concerning her grief at his death and her relief at his no longer suffering from disease. While accepting her experiences, she started to review the days they spent together and appreciated his attachment. Therefore she completed the work of mourning and the ghost no longer appeared. One year after the departure of the ghost, she still attends the hospital regularly and there has been no recurrence. A reconstruction of her internal world leads us to conclude that the support of normal grief with such hallucinations prevents the intense experience of loss from generating pathological grief. Furthermore, we suggest reconsidering the importance of the mourning work and the inclusion of both the bereaved and deceased person in the medical context.

Financial Perils in Higher Education--Good Grief!

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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,…

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

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Hildebrandt, Lori

2012-12-01

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

Neuropsychological correlates of complicated grief in older spousally bereaved adults.

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

2014-01-01

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

The Grief Account: Dimensions of a Contemporary Bereavement Genre

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Dennis, Michael Robert

2008-01-01

The genre of the grief account is identified to include published narratives of surviving grief. Thematic analysis of Andrew Holleran's (2006) "Grief: A Novel," Lolly Winston's (2004) "Good Grief: A Novel," Joan Didion's (2005) "The Year of Magical Thinking," and J. Canfield and M. V. Hansen's (2003) "Chicken Soup for the Grieving Soul: Stories…

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

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Taggart H

2015-07-01

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

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

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

2015-04-01

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

Grief and culture: a checklist

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Walter, Tony

2010-01-01

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

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

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遠藤, 野ゆり

2016-01-01

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

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

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Lin, Yeh-Jen; Lin, Chi Yun; Li, Yu-Chan

2014-01-01

In 2008, the Taiwan Association for Care and Counseling for Loss organized a workshop about Horticultural Therapy, conducted as a participatory action research (PAR). Nineteen grief caregivers participated. Specific goals were designed according to a survey of participant expectations and focus-group discussions. The workshop content included lectures and interactive activities. Results demonstrated that most participants displayed an increased awareness of personal loss and meaning in grief, indicating that horticulture and nature appreciation might relieve individual grief and stress. The report introduces the rationale, evolution, execution, and results of the program development.

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

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Wayment, Heidi A; Silver, Roxane Cohen

2018-03-01

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

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

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

2017-07-01

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

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

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Moayedoddin, Babak; Markowitz, John C

2015-01-01

Grief, the psychological reaction to the loss of a significant other, varies complexly in its cause, experience, evolution, and prognosis. Although most bereaved individuals experience a normal grieving process, some develop complicated grief (CG) or major depressive disorder (MDD). The DSM-5, which controversially altered the nosology, recognizes grief-related major depression (GRMD) as a diagnostic subtype if a patient meets MDD criteria two weeks post bereavement. The (DSM-5) tries to distinguish between grief and MDD, but remains a symptom-based, centered approach to grief that is not patient centered. This article reviews grief in its normal and abnormal dimensions. Using an illustrative clinical case in which interpersonal psychotherapy (IPT) was employed, we discuss the need for a more patient-centered approach to treating abnormal grief, considering the patient's personal history, perceptions, experiences of bereavement, and interpersonal environment. Clinical studies need to better identify subgroups of individuals susceptible to abnormal grief and to evaluate their response to early interventions.

The Grief Resolution Process in Divorce.

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Crosby, John F.; And Others

1983-01-01

Compares grief in divorce to the Kubler-Ross model of grief resolution in bereavement in 17 persons who wrote essays about their divorce. The results suggested a conceptual model based on three chronological stages with linear progression through the stages, characterized by circularity within each stage. (JAC)

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

DEFF Research Database (Denmark)

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

2010-01-01

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

Culinary Grief Therapy: Cooking for One Series.

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Nickrand, Heather L; Brock, Cara M

2017-02-01

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.

Integrating Buddhist Psychology into Grief Counseling

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Wada, Kaori; Park, Jeeseon

2009-01-01

The field of grief counseling has yet to see an integration of Buddhist psychology. Drawing on Buddhist psychology literature and Western models of grief, this article explores possible integrations of two approaches. To lay the foundation for this discussion, the authors introduced a brief overview of the history of Buddhism as well as a Buddhist…

Tweeting Prayers and Communicating Grief over Michael Jackson Online

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Sanderson, Jimmy; Cheong, Pauline Hope

2010-01-01

Death and bereavement are human experiences that new media helps facilitate alongside creating new social grief practices that occur online. This study investigated how people's postings and tweets facilitated the communication of grief after pop music icon Michael Jackson died. Drawing on past grief research, religion, and new media studies, a…

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

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

2017-06-01

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

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

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Granek, Leeat; Peleg-Sagy, Tal

2017-06-01

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

Music Therapy with Bereaved Youth: Expressing Grief and Feeling Better

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McFerran, Katrina

2011-01-01

Music therapy is a promising intervention with bereaved youth. In comparison to other programs, it appears particularly effective for promoting the resolution of grief-related feelings; providing opportunities to express and release feelings through musical participation. Descriptions from music therapy participants are supported by research…

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

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Ozge Enez

2017-12-01

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

Grief Processing and Deliberate Grief Avoidance: A Prospective Comparison of Bereaved Spouses and Parents in the United States and the People's Republic of China

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Bonanno, George A.; Papa, Anthony; Lalande, Kathleen; Zhang, Nanping; Noll, Jennie G.

2005-01-01

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…

The Child in Grief: Implications for Teaching.

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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…

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

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Dennis, Michael Robert

2012-01-01

Grief therapy and psychology literatures of the modern Western world conceptualized bereavement and grief as processes to be "worked through" so that other relationships could be pursued. In the last decade or so, however, grief theorists have endorsed the value of attaining new meaning(s) and continuing bonds with our lost loved ones instead of…

Effectiveness of a grief intervention for caregivers of people with dementia

OpenAIRE

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

2017-01-01

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

Strengthening Health Information Systems to Support Post-Disaster ...

International Development Research Centre (IDRC) Digital Library (Canada)

Strengthening Health Information Systems to Support Post-Disaster Healthcare in Haiti. The occurrence of a natural disaster may seem to carry repercussions that are indiscriminate in nature; however, it is the vulnerable populations that suffer most during such events, and in the days, months and years that follow. In Haiti ...

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

Science.gov (United States)

Dennis, Michael Robert

2012-01-01

Grief therapy and psychology literatures of the modern Western world conceptualized bereavement and grief as processes to be "worked through" so that other relationships could be pursued. In the last decade or so, however, grief theorists have endorsed the value of attaining new meaning(s) and continuing bonds with our lost loved ones instead of "moving on from," "letting go of" or "achieving closure from" them. This article tracks the evolution of thought pertaining to this shift and examines its relevance to grief self-help books that may offer Americans guidance in the ways of grieving.

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

Science.gov (United States)

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

2017-08-01

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

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

NARCIS (Netherlands)

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

2017-01-01

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

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

NARCIS (Netherlands)

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

2017-01-01

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

The grief process for patient, family, and physician.

Science.gov (United States)

Bruce, Christine A

2002-09-01

In the grieving process, patient, family, and health professionals have the same needs-rest, relaxation, nourishment, a sense of security, trust, hope in the future, and humor among them. Grief, defined as a shared, universal, and natural neuropsychobiologic expression in response to loss, is distinct from mourning, a practice that varies in expression across diverse cultures. To aid in an understanding of grief and its effects, the author looks at the models for grief proposed by Kubler-Ross, Bowlby, Parkes, Worden, and Wolfelt. Addressing patients' concerns requires physicians be empathic, attentive, and respective and have willingness to take time, be present, and listen.

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

Science.gov (United States)

Cunsolo, Ashlee; Ellis, Neville R.

2018-04-01

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

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

Science.gov (United States)

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

2017-08-01

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

Alexithymia and Grief Reactions in Bereaved Japanese Women

Science.gov (United States)

Nakao, Mutsuhiro; Kashiwagi, Masayo; Yano, Eiji

2005-01-01

To examine the relationship between grief reactions and alexithymia, 54 Japanese women (33 outpatients attending a psychosomatic clinic and 21 normal healthy participants) completed the Texas Inventory of Grief (TIG), the 20-item Toronto Alexithymia Scale (TAS-20), and the Profile of Mood States (POMS). Each woman had experienced the death of a…

Public stigma of prolonged grief disorder : An experimental study

NARCIS (Netherlands)

Eisma, Maarten C.

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

Understanding Grief and Loss

Science.gov (United States)

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

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

Science.gov (United States)

Smith, Andrew J; Abeyta, Andrew A; Hughes, Michael; Jones, Russell T

2015-03-01

This study tested a conceptual model merging anxiety buffer disruption and social-cognitive theories to predict persistent grief severity among students who lost a close friend, significant other, and/or professor/teacher in tragic university campus shootings. A regression-based path model tested posttraumatic stress (PTS) symptom severity 3 to 4 months postshooting (Time 1) as a predictor of grief severity 1 year postshootings (Time 2), both directly and indirectly through cognitive processes (self-efficacy and disrupted worldview). Results revealed a model that predicted 61% of the variance in Time 2 grief severity. Hypotheses were supported, demonstrating that Time 1 PTS severity indirectly, positively predicted Time 2 grief severity through undermining self-efficacy and more severely disrupting worldview. Findings and theoretical interpretation yield important insights for future research and clinical application. (PsycINFO Database Record (c) 2015 APA, all rights reserved).

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

Science.gov (United States)

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

2016-07-01

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

Cultural perspectives of death, grief, and bereavement.

Science.gov (United States)

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

2003-07-01

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

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

Science.gov (United States)

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

2016-09-01

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

Complicated grief in a two-and-a-half-year-old child.

Science.gov (United States)

Mendhekar, D N; Lohia, D

2010-02-01

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.

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

Science.gov (United States)

Sedney, Mary Anne

2002-04-01

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

Rhetorical Dimensions of the Post-September Eleventh Grief Process

Science.gov (United States)

Schwartzman, Roy; Tibbles, David

2005-01-01

This essay examines Presidential rhetoric and popular culture practices in light of the stages of grief enumerated by Elisabeth Kubler-Ross. The authors find a consistent retrenchment of grief into the anger phase, where the pain of losing national invulnerability is transferred to externalized aggression. Reconciliation is suggested by means of…

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

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

2011-02-01

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

Coping with Death and Grief: A Strategy for Army Leadership

National Research Council Canada - National Science Library

Smith, Albert

1999-01-01

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

A COMPLICATED GRIEF INTERVENTION MODEL

African Journals Online (AJOL)

2010-07-29

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

End of Life: Suicide Grief

Science.gov (United States)

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 ...

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

Science.gov (United States)

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

2016-03-01

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

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

African Journals Online (AJOL)

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

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

NARCIS (Netherlands)

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

2017-01-01

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

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

NARCIS (Netherlands)

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

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

Exploring oncology nurses' grief: A self-study

Directory of Open Access Journals (Sweden)

Lisa C Barbour

2016-01-01

Full Text Available Oncology nursing, like many other nursing fields, often provides nurses with the opportunity to get to know their patients and their families well. This familiarity allows oncology nurses to show a level of compassion and empathy that is often helpful to the patient and their family during their struggle with cancer. However, this familiarity can also lead to a profound sense of grief if the patient loses that struggle. This self-study provided me the opportunity to systematically explore my own experience with grief as an oncology nurse, helping me to identify specific stressors and also sources of stress release.

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

Directory of Open Access Journals (Sweden)

Ruth Malkinson

2010-12-01

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

A COMPLICATED GRIEF INTERVENTION MODEL

African Journals Online (AJOL)

2010-07-29

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

A COMPLICATED GRIEF INTERVENTION MODEL

African Journals Online (AJOL)

2010-07-29

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

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

Science.gov (United States)

Lafarge, Caroline; Mitchell, Kathryn; Fox, Pauline

2013-12-01

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

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

Science.gov (United States)

Glackin, Michelle; Higgins, Agnes

2008-06-01

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

The ties that bind: a reflection on physician grief.

Science.gov (United States)

Giddings, Gordon

2010-10-01

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

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

OpenAIRE

Malkinson, Ruth

2010-01-01

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

Resolving Child and Adolescent Traumatic Grief: Creative Techniques and Interventions

Science.gov (United States)

Edgar-Bailey, Meredith; Kress, Victoria E.

2010-01-01

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

Grief: Lessons from the Past, Visions for the Future

Directory of Open Access Journals (Sweden)

Colin Murray Parkes

2010-09-01

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

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

Science.gov (United States)

Zupanick, Corinne E.

1994-01-01

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

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

Science.gov (United States)

MacGregor, Peggy

1994-01-01

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

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

Science.gov (United States)

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

1996-03-01

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

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

Science.gov (United States)

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

2017-12-01

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

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

Science.gov (United States)

Smid, Geert E; Kleber, Rolf J; de la Rie, Simone M; Bos, Jannetta B A; Gersons, Berthold P R; Boelen, Paul A

2015-01-01

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.

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

Science.gov (United States)

Dellmann, Thomas

2018-07-01

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

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

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Seibert, Phyllis M.; Pastorello, Thomas

Literature on health professionals describes the problems associated with unresolved or poorly resolved grief. Previous research has indicated that the most important reason why health professionals stay in their jobs is their relationship to patients. This study examined how nursing home personnel resolve their grief following deaths of clients.…

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

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

2009-01-01

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

A Nationwide Random Sampling Survey of Potential Complicated Grief in Japan

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Mizuno, Yasunao; Kishimoto, Junji; Asukai, Nozomu

2012-01-01

To investigate the prevalence of significant loss, potential complicated grief (CG), and its contributing factors, we conducted a nationwide random sampling survey of Japanese adults aged 18 or older (N = 1,343) using a self-rating Japanese-language version of the Complicated Grief Brief Screen. Among them, 37.0% experienced their most significant…

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

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Furnes, Bodil; Dysvik, Elin

2010-12-06

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

General Psychological Implications of the Human Capacity for Grief.

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Brinkmann, Svend

2018-06-01

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.

Coping with Grief: Life After Loss

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

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

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

2013-05-01

Young men can have an uncomfortable relationship with grief. Socially constructed masculine ideals dictate that men be stoic in the aftermath of loss, most often expressing their sadness and despair as anger. Perhaps because of alignment to such masculine ideals little research has been done to explore young men's grief--and chronicle the ways they think about loss, their responses and how they go about describing their identities after a tragic event. Using qualitative individual interviews and photo elicitation methods, we investigated the ways in which 25 men aged 19-25 grieved the accidental death of a male friend. The study was conducted from April 2010-December 2011. Causes of death were diverse, and included motor vehicle accidents, adventure sports, drug overdose and fights. The findings revealed men's predominant grief responses as emptiness, anger, stoicism and sentimentality. Participants' description of their grief responses illustrated the ways in which they struggled to reconcile feelings of vulnerability and manly ideals of strength and stoicism. We gained insight into men's grief practices by looking at the ways in which they aligned themselves with a post-loss masculine identity. These identities, which included the adventurer, father-figure and the lamplighter, revealed gender-specific processes through which men understood and actively dealt with their tragic loss. The results offer novel insights to men's grief and identity work that may serve to affirm other men's experiences as well as guide counselling services targeted to young men. Copyright © 2013 Elsevier Ltd. All rights reserved.

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

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

2018-03-19

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

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

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

2018-01-01

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

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

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Rossetto, Kelly R

2014-01-01

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

Cultural manifestations of grief and bereavement: a clinical perspective.

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Hardy-Bougere, Marilyn

2008-01-01

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

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

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Bodil Furnes

2010-05-01

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

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

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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.

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

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

2012-01-01

Bereavement and its accompanying psychological response (grief) constitute potent experiences that necessitate the reorganization of cognitive-affective representations of lost significant attachment figures during both wakefulness and dreaming. The goals of this preliminary study were to explore whether the dream content of 77 adults with complicated grief (CG) differed from that of a normative sample, and to explore whether CG patients who dream of the deceased differ from CG patients who do not dream of the deceased on measures of daytime emotional distress. CG dreams were characterized by more family and familiar characters including the deceased (in women), and fewer social interactions and emotions compared to norms. Increased representations of familiar characters in CG dreams may reflect attempts to reorganize relational cognitive schemas to compensate for the loss. PMID:24524436

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

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Brennan, F; Dash, M

2008-06-01

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

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

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Holly G Prigerson

2009-08-01

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

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

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Albuquerque, Sara; Narciso, Isabel; Pereira, Marco

2018-01-01

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

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

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

2015-01-01

Young men can have an uncomfortable relationship with grief. Socially constructed masculine ideals dictate that men be stoic in the aftermath of loss, most often expressing their sadness and despair as anger. Perhaps because of alignment to such masculine ideals little research has been done to explore young men’s grief – and chronicle the ways they think about loss, their responses and how they go about describing their identities after a tragic event. Using qualitative individual interviews and photo elicitation methods, we investigated the ways in which 25 men aged 19–25 grieved the accidental death of a male friend. The study was conducted from April 2010–December 2011. Causes of death were diverse, and included motor vehicle accidents, adventure sports, drug overdose and fights. The findings revealed men’s predominant grief responses as emptiness, anger, stoicism and sentimentality. Participants’ description of their grief responses illustrated the ways in which they struggled to reconcile feelings of vulnerability and manly ideals of strength and stoicism. We gained insight into men’s grief practices by looking at the ways in which they aligned themselves with a post-loss masculine identity. These identities, which included the adventurer, father-figure and the lamplighter, revealed gender-specific processes through which men understood and actively dealt with their tragic loss. The results offer novel insights to men’s grief and identity work that may serve to affirm other men’s experiences as well as guide counselling services targeted to young men. PMID:23517702

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

African Journals Online (AJOL)

Introduction: grief is a universal experience faced at one time or another by most people during their lives. Response to grief and bereavement losses can lead to psychiatric disorders such as mood disorders, post traumatic responses, insomnia loss of appetite, anxiety, and depression. The aim of our study is to value in our ...

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

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

2018-04-01

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

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

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

2013-12-01

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

Understanding Grief within a Cultural Context

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

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

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Lafarge, Caroline; Mitchell, Kathryn; Fox, Pauline

2017-09-01

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

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

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

2018-03-15

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

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

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Yudi Zhang

2018-05-01

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

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

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

2010-11-01

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

Grief, Bereavement, and Coping with Loss (PDQ)

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

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

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

2018-03-01

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

Grief Experiences and Expectance of Suicide

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Wojtkowiak, Joanna; Wild, Verena; Egger, Jos

2012-01-01

Suicide is generally viewed as an unexpected cause of death. However, some suicides might be expected to a certain extent, which needs to be further studied. The relationships between expecting suicide, feeling understanding for the suicide, and later grief experiences were explored. In total, 142 bereaved participants completed the Grief…

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

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

2016-01-01

We aimed to validate the Inventory of Complicated Grief (ICG)-Korean version among 1,138 Korean adolescents, representing a response rate of 57% of 1,997 students. Participants completed a set of questionnaires including demographic variables (age, sex, years of education, experience of grief), the ICG, the Children's Depression Inventory (CDI) and the Lifetime Incidence of Traumatic Events-Child (LITE-C). Exploratory factor analysis was performed to determine whether the ICG items indicated complicated grief in Korean adolescents. The internal consistency of the ICG-Korean version was Cronbach's α=0.87. The test-retest reliability for a randomly selected sample of 314 participants in 2 weeks was r=0.75 (PKaiser-Meyer-Olkin Measure of Sampling Adequacy=0.911; Bartlett's Test of Sphericity, χ(2)=13,144.7, P<0.001). After omission of 3 items, the value of Cronbach's α increased from 0.87 for the 19-item ICG-Korean version to 0.93 for the 16-item ICG-Korean version. These results suggest that the ICG is a useful tool in assessing for complicated grief in Korean adolescents. However, the 16-item version of the ICG appeared to be more valid compared to the 19-item version of the ICG. We suggest that the 16-item version of the ICG be used to screen for complicated grief in Korean adolescents.

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

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Bryant, Richard A

2014-01-01

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

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

OpenAIRE

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

2018-01-01

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

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

Directory of Open Access Journals (Sweden)

Klikovac Tamara

2017-01-01

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

Strengthening Self-efficacy through Supportive Mentoring

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Haacker, R.

2015-12-01

The geosciences have had a chronic problem of underrepresentation of students from diverse ethnic, cultural, gender and socio-economic backgrounds. As a community we need to strengthen our support of young scientists from all backgrounds to sustain their enthusiasm and ensure their success in our field. Investing in mentoring programs that empower students and young professionals is one of the best ways to do so. The Significant Opportunities in Atmospheric Research and Science (SOARS) program, now entering its 20th year, has successfully developed and tested several mentoring models. The personalized, caring and consistent support is one of the key elements of the program's success; since its inception, 90% of SOARS participants have entered graduate school, research or science related careers after graduation. Many of our alumni who are now faculty apply the same mentoring strategies to build self-esteem and perseverance in their students. This presentation will cover the design and implementation of our four mentoring strategies, and provide insights on potential challenges, training aspects and impact assessment. The mentoring strategies include: 1) Multi-faceted, long-term mentoring of undergraduate and graduate students from diverse backgrounds. 2) Empowering advanced students to serve as peer mentors and role models. 3) Training faculty and professional scientists from all backgrounds to become mentors who are aware of diversity issues. 4) Providing mentor training for partner programs and laboratories. All four strategies have contributed to the creation of a mentoring culture in the geosciences.

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

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Jacobsen, Juliet C.; Zhang, Baohui; Block, Susan D.; Maciejewski, Paul K.; Prigerson, Holly G.

2010-01-01

Several studies have shown that the symptoms of grief are different from symptoms of depression among bereaved family members. This study is an attempt to replicate this finding among advanced cancer patients and examine clinical correlates of patient grief and depression. Analyses were conducted on data from interviews with 123 advanced cancer…

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

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Corr, Charles A; Coolican, Margaret B

2010-06-01

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

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

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

2018-01-01

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

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

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

2014-06-01

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

The relative importance of avoidance and restoration-oriented stressors for grief and depression in bereaved parents.

Science.gov (United States)

Harper, Mairi; O'Connor, Rory C; O'Carroll, Ronan E

2015-01-01

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.

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

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Markin, Rayna D; Zilcha-Mano, Sigal

2018-03-01

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

Grief and Horses: Putting the Pieces Together

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Symington, Ashley

2012-01-01

The effectiveness of grief counseling may be enhanced through the utilization of equine-assisted psychotherapy (EAP). An experiential, solution-focused, and natural approach, EAP provides clients with the opportunity to discover solutions to challenges that exist within themselves. Counselors and equine specialists team with horses to provide a…

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

Science.gov (United States)

Lyon, D S

2000-07-01

Medicine is as old as the human species, and medical literature is among the earliest writing. Current research is of great help in identifying new interventions, but a great deal of the art of medicine is showcased in ancient works. The 20th century saw a plethora of books, articles, and monographs on the subjects of grief, death and dying, and suffering, but none of these has provided greater insight than the biblical book of Job. Excerpts from Job illustrate both the nature of grief and appropriate intervention when it is confronted.

Grief as a Social Emotion: Theoretical Perspectives

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Jakoby, Nina R.

2012-01-01

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

A community for grieving: affordances of social media for support of bereaved parents

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Segerstad, Ylva Hård Af; Kasperowski, Dick

2015-04-01

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.

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

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

2017-01-01

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

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

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Wagner, B; Müller, J; Maercker, A

2012-10-01

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

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

Science.gov (United States)

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

2017-01-01

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.

Grief Interrupted: The Experience of Loss Among Incarcerated Women

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

2011-01-01

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

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

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Perluxo, Diana; Francisco, Rita

2018-02-01

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

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

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Al-Gamal, Ekhlas; Long, Tony

2014-07-01

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

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

Science.gov (United States)

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

2010-07-06

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

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

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Granek, Leeat; Peleg-Sagy, Tal

2015-01-01

The authors examined representations of African Americans in the grief literature to assess (a) frequencies; (b) content; and (c) use of universalist or a contextualized framework. They conducted searches in 3 databases that target the grief literature published in the last 15 years. Fifty-nine articles met the criteria. There are a small number of studies published on African Americans and these tend to focus on homicide. Many studies had incomplete methods. Comparison studies were common and pathological grief outcomes that were validated on White populations were used as outcome variables with African American participants.

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

Science.gov (United States)

Bellali, Thalia; Papadatou, Danai

2006-01-01

The purpose of this study was to investigate the grieving process of parents who were faced with the dilemma of donating organs and tissues of their underage brain dead child, and to explore the impact of their decision on their grief process. A grounded theory methodology was adopted and a semi-structured interview was conducted with 11 bereaved…

Using Narrative Approach for Anticipatory Grief Among Family Caregivers at Home

Science.gov (United States)

Toyama, Hiroko; Honda, Akiko

2016-01-01

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

The American Indian Holocaust: Healing Historical Unresolved Grief.

Science.gov (United States)

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

1998-01-01

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

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

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Kaplow, Julie B.; Layne, Christopher M.; Saltzman, William R.; Cozza, Stephen J.; Pynoos, Robert S.

2015-01-01

To date, the U.S. military has made major strides in acknowledging and therapeutically addressing trauma and Posttraumatic Stress Disorder (PTSD) in service members and their families. However, given the nature of warfare and high rates of losses sustained by both military members (e.g., deaths of fellow unit members) and military families (e.g., loss of a young parent who served in the military), as well as the ongoing threat of loss that military families face during deployment, we propose that a similar focus on grief is also needed to properly understand and address many of the challenges encountered by bereaved service members, spouses, and children. In this article, we describe a newly developed theory of grief (Multidimensional Grief Theory) and apply it to the task of exploring major features of military-related experiences during the phases of deployment, reintegration, and the aftermath of combat death—especially as they impact children. We also describe implications for designing preventive interventions during each phase and conclude with recommended avenues for future research. Primary aims are to illustrate: (1) the indispensable role of theory in guiding efforts to describe, explain, predict, prevent, and treat maladaptive grief in military service members, children, and families; (2) the relevance of multidimensional grief theory for addressing both losses due to physical death as well as losses brought about by extended physical separations to which military children and families are exposed during and after deployment; and (3) a focus on military-related grief as a much-needed complement to an already-established focus on military-related PTSD. PMID:23760905

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

Science.gov (United States)

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

2015-01-01

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

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

NARCIS (Netherlands)

Smid, Geert E.; Kleber, Rolf J.; de la Rie, Simone M.; Bos, Jannetta B. A.; Gersons, Berthold P. R.; Boelen, Paul A.

2015-01-01

Background: Traumatic events such as disasters, accidents, war, or criminal violence are often accompanied by the loss of loved ones, and may then give rise to traumatic grief. Traumatic grief refers to a clinical diagnosis of persistent complex bereavement disorder (PCBD) with comorbid (symptoms

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

NARCIS (Netherlands)

Smid, Geert E; Kleber, Rolf J; de la Rie, Simone M; Bos, Jannetta B A; Gersons, Berthold P R; Boelen, Paul A

2015-01-01

BACKGROUND: Traumatic events such as disasters, accidents, war, or criminal violence are often accompanied by the loss of loved ones, and may then give rise to traumatic grief. Traumatic grief refers to a clinical diagnosis of persistent complex bereavement disorder (PCBD) with comorbid (symptoms

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

Directory of Open Access Journals (Sweden)

Isaac Rahimian-Boogar

2015-10-01

Full Text Available Objective: Identification of the risk factors and psychological correlates of prolonged grief disorder is vital for health promotions in relatives of persons who died of cancer. The aim of this research was to investigate the role of defense mechanisms, character dimension of personality and demographic factors on complicated grief following a loss of a family member to cancer .Method: A number of 226 persons who had lost a family member to cancer in a cancer institute at Tehran University of Medical Science were selected through compliance sampling and completed the Inventory of complicated Grief-Revised (ICG-R, the Defense Styles Questionnaire (DSQ, the Character dimension of Temperament and Character Inventory (TCI, and the Demographical questionnaire. Data were analyzed by stepwise multiple regression analysis, using the PASW version 18 .Results: Findings revealed that neurotic defense style had a significant positive predictive role in the complicated grief; and cooperativeness, age of the deceased person, self-transcendence and mature defense style had a significant negative predictive role in complicated grief (p<0.001. R2 was 0.73 for the final model (p<.001.Conclusion: The results revealed that two character dimensions (low cooperativeness and self-transcendence, high neurotic defense style and young age of the deceased person were involved in the psychopathological course of the complicated and prolonged grief. It was concluded that personality characteristics of the grieving persons and demographics of the deceased person should be addressed in designing tailored interventions for complicated grief.

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

Science.gov (United States)

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

2015-12-01

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

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

Science.gov (United States)

Haley, Melinda; Hammond, Helen; Ingalls, Lawrence; Marín, Merranda Romaro

2013-01-01

Parental grief reactions have typically been examined in situations where parents have a child diagnosed with a major medical or mental health condition. This study used the grief and loss model as conceptualized by Kubler-Ross (1969), Lamb (1988), and Kubler-Ross and Kessler (2005) as a foundation in examining parental reactions when a child has…

End of Life: Dealing with Grief and Confronting Painful Emotions

Science.gov (United States)

... who aren't prepared for the avalanche of emotions that sweep over them when the final moment ... know how challenging and devastating the raw, intense emotions of grief can be, because it's happened to ...

Do anticipatory grief and preparedness affect distress in bereaved caregivers?

DEFF Research Database (Denmark)

Nielsen, Mette Kjærgaard

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

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

OpenAIRE

McRitchie, Robyn

2012-01-01

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

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

Science.gov (United States)

Kaplow, Julie B; Layne, Christopher M; Saltzman, William R; Cozza, Stephen J; Pynoos, Robert S

2013-09-01

To date, the US military has made major strides in acknowledging and therapeutically addressing trauma and post-traumatic stress disorder (PTSD) in service members and their families. However, given the nature of warfare and high rates of losses sustained by both military members (e.g., deaths of fellow unit members) and military families (e.g., loss of a young parent who served in the military), as well as the ongoing threat of loss that military families face during deployment, we propose that a similar focus on grief is also needed to properly understand and address many of the challenges encountered by bereaved service members, spouses, and children. In this article, we describe a newly developed theory of grief (multidimensional grief theory) and apply it to the task of exploring major features of military-related experiences during the phases of deployment, reintegration, and the aftermath of combat death--especially as they impact children. We also describe implications for designing preventive interventions during each phase and conclude with recommended avenues for future research. Primary aims are to illustrate: (1) the indispensable role of theory in guiding efforts to describe, explain, predict, prevent, and treat maladaptive grief in military service members, children, and families; (2) the relevance of multidimensional grief theory for addressing both losses due to physical death as well as losses brought about by extended physical separations to which military children and families are exposed during and after deployment; and (3) a focus on military-related grief as a much-needed complement to an already-established focus on military-related PTSD.

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

Science.gov (United States)

Heeke, Carina; Stammel, Nadine; Knaevelsrud, Christine

2015-03-01

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

Grief in Two Guises: "Mourning and Melancholia" Revisited

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Green, Viviane

2013-01-01

This paper is a re-reading of Freud's classic paper. The themes of mourning and melancholia are viewed in relation to children and adolescents with illustrations from case histories. Mourning is interpreted in a broader sense: not only as grief (both expectable and traumatic) but as a response to the developmental process itself as phases of…

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

Directory of Open Access Journals (Sweden)

Martín Rodríguez Alvaro

2008-09-01

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

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

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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.

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

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Boelen, Paul A

2015-06-30

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

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

OpenAIRE

Stone, Joseph B.

1998-01-01

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

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

NARCIS (Netherlands)

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

2010-01-01

Grief interventions are more effective for high risk individuals. The presence of suicide ideation following suicide bereavement was examined to determine whether it indicates a high risk status. Using data from a randomized controlled trial (n =122) on the effectiveness of cognitive-behavior

Family Anticipatory Grief: An Integrative Literature Review.

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Coelho, Alexandra; Barbosa, António

2017-09-01

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

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

Science.gov (United States)

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

2014-01-01

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

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

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

2013-06-01

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

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

Directory of Open Access Journals (Sweden)

Heather Cherie Moore

2016-11-01

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

Perinatal grief in Latino parents.

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Whitaker, Claudia; Kavanaugh, Karen; Klima, Carrie

2010-01-01

Extensive research exists that describes the meaning of perinatal loss to some parents, but the experience of loss from the perspective of Latino parents is not clearly understood. Additionally, current perinatal bereavement practices used often to facilitate memory making for parents (such as viewing or holding the baby, taking photographs, or collecting mementos) are based on research done primarily with non-Latino families. Are these common practices appropriate for this population? Because there is a paucity of research on this topic, this article describes what has been written over the past 30 years on the topic of grief and perinatal loss in Latino culture.

Men’s Grief, Meaning and Growth

DEFF Research Database (Denmark)

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

2012-01-01

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

OA12 When grief and work collide.

Science.gov (United States)

Rosenberg, Kathryn

2015-04-01

There is a significant price to pay for organisations that fail to take seriously the challenges involved in supporting grieving employees in the workplace, including loss of productivity, sickness absence, and low morale. The purpose of this study was to look at how social service organisations implement their bereavement policies and support bereaved staff. The study aimed to raise awareness of current issues and practices in the implementation of bereavement policies and the management and support of grieving employees on their return to work. A generic qualitative method was used and recruitment of six participants from social service organisations within New Zealand was undertaken. Non-probability purposive sampling was used. Data collection was via email interviews. While New Zealand employees are legally entitled to three days paid bereavement leave, how flexible and supportive employers were willing to be beyond that varied. Participants felt out of their depth in dealing with grieving employees and lack of training around grief and loss meant a heavy reliance on external sources of support. The study also exposed a possible lack of understanding in relation to cultural mourning rituals. This study uncovered several areas of concern relating to organisational attitudes towards grieving employees and their ability to adequately support bereaved staff on their return to work. It poses the question for future research as to whether organisations can afford not to care and serves as a springboard for examining the detrimental consequences of neglecting the realities of loss. © 2015, Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

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

Science.gov (United States)

Marshak, David

1996-01-01

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

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

Science.gov (United States)

Chur-Hansen, Anna

2010-01-01

Companion animals play various roles in people's lives and these roles can impact on loss, grief, bereavement and mourning when the animal has been lost, whether that is through death, when missing, or when relinquished. This paper considers not only companion animal owners, but also those who own farm animals and those who work in animal service…

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

Science.gov (United States)

de Groot, Marieke; Neeleman, Jan; van der Meer, Klaas; Burger, Huibert

2010-01-01

Grief interventions are more effective for high risk individuals. The presence of suicide ideation following suicide bereavement was examined to determine whether it indicates a high risk status. Using data from a randomized controlled trial (n = 122) on the effectiveness of cognitive-behavior therapy, the effect of suicide ideation on the…

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

DEFF Research Database (Denmark)

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

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

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

OpenAIRE

Albuquerque, Sara; Narciso, Isabel; Pereira, Marco

2018-01-01

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

Inviting Grief into Games

DEFF Research Database (Denmark)

Harrer, Sabine; Schoenau-Fog, Henrik

2015-01-01

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

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

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Kristensen, Pal; Weisaeth, Lars; Heir, Trond

2010-01-01

The authors examined predictors of complicated grief (CG) in Norwegians 2 years after bereavement in the 2004 South-East Asian tsunami. A cross-sectional postal survey retrospectively covering disaster experiences and assessing CG according to the Inventory of Complicated Grief yielded 130 respondents (35 directly disaster-exposed and 95 not…

Strengthening quitter self-identity: An experimental study.

Science.gov (United States)

Meijer, Eline; Gebhardt, Winifred A; van Laar, Colette; van den Putte, Bas; Evers, Andrea W M

2018-06-10

Smoking-related self-identity processes are important for smoking cessation. We examined whether quitter self-identity (i.e. identification with quitting smoking) could be strengthened through a writing exercise, and whether expected social support for quitting, manipulated through vignettes, could facilitate identification with quitting. Participants (N = 339 daily smokers) were randomly assigned to a 2 (identity: strengthened quitter self-identity vs. control) × 3 (social support: present vs. absent vs. neutral control) between-participants design. The main outcome was post-test quitter self-identity. Post-test quitter self-identity was not strengthened successfully. Only a small and marginally significant intervention effect was found on quitter self-identity, which did not generalise to positively influence quit-intention or behaviour. The social support manipulation did not facilitate quitter self-identity. Secondary content analyses showed that quitter self-identity was strengthened among participants who linked quitting smoking to their lifestyle, wanted to become quitters for health reasons, and whose reasons for becoming quitters included approach of positive aspects of quitting, but not among participants who linked quitter self-identity to their self-perceptions. Results provide insight into the content of smokers' self-conceptualizations as quitters. Writing exercises should be improved and tested to eventually successfully strengthen quitter identities.

Acknowledging sexual bereavement: a path out of disenfranchised grief.

Science.gov (United States)

Radosh, Alice; Simkin, Linda

2016-11-01

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

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

Science.gov (United States)

Carmassi, Claudia; Shear, M Katherine; Socci, Chiara; Corsi, Martina; Dell'osso, Liliana; First, Michael B

2013-09-01

Based on the recommendations of the sub-workgroup on trauma and dissociative disorders, the American Psychiatric Association (APA) removed the "bereavement exclusion" from the criteria for major depression in DSM-5. In addition, proposed DSM-5 research criteria for persistent complex bereavement disorder (PCBD) were included in the new manual in a section for conditions and criteria needing further research. We describe a case that warranted such a diagnosis. The patient was a 52- year-old woman who was admitted to the inpatient unit of our clinic on the birthday of her son who had died 18 months earlier. She was diagnosed with a manic episode with psychotic symptoms according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) criteria and was treated accordingly. Three months after discharge, she made a suicide attempt and was admitted and re-assessed. During this admission, she completed the Inventory of Complicated Grief (ICG), the Mood-Spectrum Rating Scale (MOODS-SR), and the Trauma and Loss Spectrum questionnaire (TALS-SR). She endorsed symptoms of intense yearning for her son, feelings of shock and disbelief, anger and bitterness related to his death, estrangement from others, auditory, tactile and visual hallucinations of the deceased, and intense emotional reactivity to memories of her son. These symptoms were sufficiently prolonged and severe to meet criteria for complicated grief. While complicated grief appeared to be the primary diagnosis for this patient, when she was diagnosed using only DSMIV-TR criteria, her treatment failed to address herprimary problem. This case draws attention to the occurrence of manic-like symptoms as well as depression-like manifestations following bereavement and highlights the importance of including the syndrome of complicated grief in the diagnostic nomenclature.

"Prolonged grief disorder" and "persistent complex bereavement disorder", but not "complicated grief", are one and the same diagnostic entity : an analysis of data from the Yale Bereavement Study

NARCIS (Netherlands)

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

2016-01-01

There exists a general consensus that prolonged grief disorder (PGD), or some variant of PGD, represents a distinct mental disorder worthy of diagnosis and treatment. Nevertheless, confusion remains over whether different names and proposed symptom criteria for this disorder identify the same or

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

Science.gov (United States)

Walker, Rebecca J.; Pomeroy, Elizabeth C.

1996-01-01

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

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

Science.gov (United States)

Nesteruk, Olena

2017-12-14

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

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

NARCIS (Netherlands)

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

2016-01-01

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

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

Science.gov (United States)

Heaton, Kenneth W

2012-10-01

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

The existential realities of grief and bereavement

DEFF Research Database (Denmark)

Køster, Allan; Winther-Lindqvist, Ditte

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

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

Science.gov (United States)

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

2013-01-01

Bereavement and its accompanying psychological response (grief) constitute potent experiences that necessitate the reorganization of cognitive-affective representations of lost significant attachment figures during both wakefulness and dreaming. The goals of this preliminary study were to explore whether the dream content of 77 adults with…

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

Science.gov (United States)

Gassin, Elizabeth A; Lengel, Gregory J

2014-01-01

Clarity about the utility of continuing bonds (CB) continues to be evasive in the research. In 2 different correlational studies, the authors explored the relationship between CB and 2 other variables: 1 representing mental health (forgiveness of the deceased) and the other representing psychological distress (prolonged grief). Although researchers have addressed the latter relationship in the literature, assessing the relationship between CB and forgiveness has not been undertaken. Results suggest that forgiveness in general, and affective aspects of forgiveness in particular, predict psychological forms of CB. Results related to grief depended on how CB was assessed. These findings provide evidence of the relative health of certain types of relationship with deceased persons and also suggest that forgiveness interventions may be a way of promoting such healthy bonds.

Grief Interrupted: The Experience of Loss Among Incarcerated Women

OpenAIRE

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

2010-01-01

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

Writing Strengthens Orthography and Alphabetic-Coding Strengthens Phonology in Learning to Read Chinese

NARCIS (Netherlands)

Guan, C.Q.; Liu, Y.; Chan, D.H.L.; Ye, F.F.; Perfetti, C.A.

2011-01-01

Learning to write words may strengthen orthographic representations and thus support word-specific recognition processes. This hypothesis applies especially to Chinese because its writing system encourages character-specific recognition that depends on accurate representation of orthographic form.

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

Science.gov (United States)

Brabant, Sarah

1990-01-01

Draws on work of George Herbert Mead to question premise that acute grief that continues or reoccurs two or more years following loss of loved one is pathological. Suggests that onset of intense pain years after loss may be response to "new" death or loss. (Author/NB)

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

Science.gov (United States)

Courtney, Jeanne

2008-01-01

Based on observations from my psychotherapy practice, I apply Kubler-Ross' five stages of grief (denial, anger, bargaining, depression, and acceptance) to the process a woman goes through when she learns about size acceptance and lets go of the unrealistic wish to make her body size conform to fat-phobic societal ideals of female beauty. Clients' presentations, therapeutic interventions, and countertransference are discussed for each stage. Lesbian feminists are likely to embrace size acceptance politics but may retain negative feelings about their own body size. In the bargaining stage, they may confound health concerns with body image issues, and it is important in their therapy to provide a holding environment that can tolerate ambivalence. My own depression stage was marked by countertransference that caused me to avoid the topic of body image with my clients. Therapists can help women in the size acceptance grief process by exploring their own evolving feelings about body image, bringing up the topic, and providing a non-judgmental holding environment.

College Students' Grief and Coping Strategies in Bereavement and Separation

OpenAIRE

Nakajima, Naomi; Kodama, Kenichi

2013-01-01

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...

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

NARCIS (Netherlands)

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

2016-01-01

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

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

DEFF Research Database (Denmark)

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

2017-01-01

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

Supporting countries in establishing and strengthening NITAGs: lessons learned from 5 years of the SIVAC initiative.

Science.gov (United States)

Adjagba, Alex; Senouci, Kamel; Biellik, Robin; Batmunkh, Nyambat; Faye, Pape Coumba; Durupt, Antoine; Gessner, Bradford D; da Silva, Alfred

2015-01-29

To empower governments to formulate rational policies without pressure from any group, and to increase the use of evidence-based decision-making to adapt global recommendations on immunization to their local context, the WHO has recommended on multiple occasions that countries should establish National Immunization Technical Advisory Groups (NITAGs). The World Health Assembly (WHA) reinforced those recommendations in 2012 when Member States endorsed the Decade of Vaccines Global Vaccine Action Plan (GVAP). NITAGs are multidisciplinary groups of national experts responsible for providing independent, evidence-informed advice to health authorities on all policy-related issues for all vaccines across all populations. In 2012, according to the WHO-UNICEF Joint Reporting Form, among 57 countries eligible for immunization program financial support from the GAVI Alliance, only 9 reported having a functional NITAG. Since 2008, the Supporting Independent Immunization and Vaccine Advisory Committees (SIVAC) Initiative (at the Agence de Médecine Préventive or AMP) in close collaboration with the WHO and other partners has been working to accelerate and systematize the establishment of NITAGs in low- and middle-income countries. In addition to providing direct support to countries to establish advisory groups, the initiative also supports existing NITAGs to strengthen their capacity in the use of evidence-based processes for decision-making aligned with international standards. After 5 years of implementation and based on lessons learned, we recommend that future efforts should target both expanding new NITAGs and strengthening existing NITAGs in individual countries, along three strategic lines: (i) reinforce NITAG institutional integration to promote sustainability and credibility, (ii) build technical capacity within NITAG secretariats and evaluate NITAG performance, and (iii) increase networking and regional collaborations. These should be done through the development

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

Science.gov (United States)

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

2016-08-01

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

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

Science.gov (United States)

Feen-Calligan, Holly; McIntyre, Barbara; Sands-Goldstein, Margaret

2009-01-01

This article reviews the history of dollmaking that is relevant to art therapy, and the application of dolls as therapeutic media in clinical and educational settings. The authors describe their experiences using dollmaking in the resolution of grief, in professional identity construction, and in community service. The article addresses the…

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

Science.gov (United States)

Penzo, Jeanine A.; Harvey, Pat

2008-01-01

Parents who are raising children with mental illness struggle with feelings of grief and loss. Kubler-Ross' (1969) stages of grieving (denial, anger, bargaining, depression, and acceptance) are examined as experienced by parents raising children with chronic mental illness. Practice implications for social workers who are working with children and…

Complicated grief in Aboriginal populations.

Science.gov (United States)

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

2012-06-01

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

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

OpenAIRE

2014-01-01

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

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

NARCIS (Netherlands)

Stroebe, Margaret; Schut, Henk; Boerner, Kathrin

2017-01-01

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

Immediate psycho-social support for disaster survivors

DEFF Research Database (Denmark)

Berliner, Peter; Navarro Gongóra, José; Espaillat, Vanessa

2011-01-01

. The support was centered on (1) providing information; (2) facilitating social regulation of emotions; (3) supporting a social support network for the patient; (4) focusing coping efforts; and (5) normalization of reactions. Finally it is described how the crisis made values of caring, compassion......The article describes how psychosocial support in the immediate and mid-term disaster response for Haitian earthquake survivors in hospitals in the Dominican Republic could ameliorate some of the suffering and prevent the crisis from becoming crystallized into symptoms and complex grief...

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

OpenAIRE

Lovey, Christina

2016-01-01

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

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

Science.gov (United States)

Blank, Nancee M; Werner-Lin, Allison

2011-01-01

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

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

NARCIS (Netherlands)

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

2017-01-01

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

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

Science.gov (United States)

Hogan, Nancy; Schmidt, Lee; Coolican, Maggie

2014-09-01

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

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

Science.gov (United States)

Sveen, Carl-Aksel; Walby, Fredrik A.

2008-01-01

There has been a debate over several decades whether suicide survivors experience more severe mental health consequences and grief reactions than those who have been bereaved through other causes of death. This is the first systematic review of suicide survivors' reactions compared with survivors after other modes of death. Studies were identified…

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

Science.gov (United States)

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

2015-04-01

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

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

Science.gov (United States)

Coombs, Maureen A

2010-12-01

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

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

Science.gov (United States)

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

2018-01-01

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

Developing a Blended Course on Dying, Loss, and Grief

Science.gov (United States)

Kavanaugh, Karen; Andreoni, V. Ann; Wilkie, Diana J.; Burgener, Sandra; Buschmann, MaryBeth Tank; Henderson, Gloria; Hsiung, Yi-Fang Yvonne; Zhao, Zhongsheng

2010-01-01

An important component of end-of-life education is to provide health professionals with content related to dying, loss, and grief. The authors describe the strategies used to develop and offer a blended course (integration of classroom face-to-face learning with online learning) that addressed the sensitive and often emotional content associated with grieving and bereavement. Using Kolb’s experiential learning theory, a set of 4 online learning modules, with engaging, interactive elements, was created. Course evaluations demonstrated the success of the blended course in comparison to the traditional, exclusive face-to-face approach. PMID:19412055

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

Science.gov (United States)

Pledger, Carolyn Brastow

1985-01-01

Examines Kubler-Ross' five stages of grief (denial, anger, bargaining, depression, acceptance) as they are experienced not by terminally ill persons, but by 20 criminal offenders and their families during incarceration. Concludes that shock of arrest and incarceration stimulates reactions similar to those of persons coping with terminal diagnosis.…

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

Science.gov (United States)

Kroeker, B. J.; And Others

1994-01-01

The experiences of the Windsor, Ontario, Canada, chapter of Mothers Against Drunk Driving (MADD), in its development and progress through the grief-anger-social action continuum, are described. This article also portrays a model for problem resolution which emphasizes incorporating the respective strengths and efficiencies of self-help groups and…

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

NARCIS (Netherlands)

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

2017-01-01

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

HIV communication capacity strengthening: a critical review.

Science.gov (United States)

Lettenmaier, Cheryl; Kraft, Joan Marie; Raisanen, Keris; Serlemitsos, Elizabeth

2014-08-15

HIV communication is most effective and sustainable when it is designed and implemented locally and tailored to the local context. This requires capacity strengthening at national, subnational, and community levels. Through a review of the published and selected "grey" literature, we examine HIV communication capacity strengthening: definitions, measurements, implementation, and effects. We found limited documentation of HIV communication capacity needs or systematic approaches to address them. Most HIV communication capacity strengthening to date has focused on building individual competencies to design and manage social and behavior change communication programs through training courses, often coupled with networking opportunities for participants, post-training mentoring, and technical assistance. A few of these efforts have been evaluated through pre- and post-training tests and qualitative interviews with participants and have shown potential for improvement in individual skills and knowledge. Health communication capacity assessment tools that measure individual and organizational competencies exist, but they have most often been used to identify capacity building needs, not for evaluating capacity strengthening efforts. A new definition of capacity strengthening, grown out of recent efforts to improve effectiveness of international health and development programs, focuses on improving organizational and societal systems that support performance and individual competencies. We propose a holistic model for HIV communication capacity strengthening and call for rigorous documentation and evaluation to determine and scale-up optimal capacity building interventions for strengthening social and behavior change communication for HIV prevention, care, and treatment in developing countries.

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

Science.gov (United States)

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

2016-08-01

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

Strengthened glass for high average power laser applications

International Nuclear Information System (INIS)

Cerqua, K.A.; Lindquist, A.; Jacobs, S.D.; Lambropoulos, J.

1987-01-01

Recent advancements in high repetition rate and high average power laser systems have put increasing demands on the development of improved solid state laser materials with high thermal loading capabilities. The authors have developed a process for strengthening a commercially available Nd doped phosphate glass utilizing an ion-exchange process. Results of thermal loading fracture tests on moderate size (160 x 15 x 8 mm) glass slabs have shown a 6-fold improvement in power loading capabilities for strengthened samples over unstrengthened slabs. Fractographic analysis of post-fracture samples has given insight into the mechanism of fracture in both unstrengthened and strengthened samples. Additional stress analysis calculations have supported these findings. In addition to processing the glass' surface during strengthening in a manner which preserves its post-treatment optical quality, the authors have developed an in-house optical fabrication technique utilizing acid polishing to minimize subsurface damage in samples prior to exchange treatment. Finally, extension of the strengthening process to alternate geometries of laser glass has produced encouraging results, which may expand the potential or strengthened glass in laser systems, making it an exciting prospect for many applications

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

Science.gov (United States)

Maccallum, Fiona; Bryant, Richard A

2013-08-01

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

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

Science.gov (United States)

McMahon, Lucia

2012-01-01

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

Bereavement and Loss: Developing a Memory Box to Support a Young Woman with Profound Learning Disabilities

Science.gov (United States)

Young, Hannah; Garrard, Brenda

2016-01-01

Supporting bereaved people with profound learning disabilities still remains an under-researched area. Moreover, the barriers of communication and disenfranchised grief mean that they often do not receive the support they require, leading to emotional and behavioural difficulties. This article describes research using a case study design, which…

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

Science.gov (United States)

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

2012-01-01

A number of studies have demonstrated that symptoms of prolonged grief disorder (PGD) represent a symptom cluster distinct from bereavement-related depression, anxiety, and posttraumatic stress disorder (PTSD). The aim of the present study was to confirm and extend these findings using the most recent criteria defining PGD. The authors interviewed…

Strengthening Science-based Environmental Policy Development in ...

International Development Research Centre (IDRC) Digital Library (Canada)

Strengthening Science-based Environmental Policy Development in Burma's Democratic ... IDRC is providing funding to Simon Fraser University to support a network of ... The project will also encourage and assist in the creation of a business ...

Grief and mourning in schizophrenia.

Science.gov (United States)

Wittmann, Daniela; Keshavan, Matcheri

2007-01-01

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

Strengthening entrepreneurship through coaching and developing competencies

NARCIS (Netherlands)

Beldman, A.C.G.

2011-01-01

Strengthening entrepreneurship is an important strategy for stimulating the transition to sustainable agriculture. But how is that done? One example is the Interactive Strategic Management method, which supports entrepreneurs in the creation and execution of future-focused strategies.

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

OpenAIRE

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

2014-01-01

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

Strengthening partnerships among Africa's science granting ...

International Development Research Centre (IDRC) Digital Library (Canada)

The project will support regional training courses and on-site coaching to strengthen the capacity of participating councils to design and manage collaborative agreements. It will also co-fund demand-led collaborative research projects in selected areas of interest to the private sector. Sharing of evidence, lessons learned ...

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

Science.gov (United States)

Rachamim, Lilach

2017-09-01

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

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

Science.gov (United States)

Mystakidou, Kyriaki; Tsilika, Eleni; Parpa, Efi; Katsouda, Emmanuela; Vlahos, Lambros

2003-12-01

Death has been conceptualised in different ways by different cultures and civilizations. It is increasingly entering into the public consciousness and society is now more ready to discuss and lessen the fear of dying and grief than it has been in the past few decades. In Greece, by Classical times there was an increase in burial rituals and commemorative practices compared to earlier periods. When Christianity was introduced into Greece it attempted to change the way the dead were mourned, preaching immortality of the soul and resurrection of the dead. Nevertheless, the way people grieve and bury their dead in Greece has not changed greatly since before the introduction of Christianity, except for the difficulty experienced in witnessing burial procedures observed in the large cities. Burial and bereavement traditions were introduced to help Greeks cope with death and bereavement. In Greece today beliefs about grief and death are based both on the ancient and the Christian Orthodox traditions. Healthcare professionals need to develop cultural competence to improve nursing and future health care. If care is culturally informed and tailored its quality is improved.

General Practitioners’ experiences of bereavement care and their educational support needs: a qualitative study

Science.gov (United States)

2014-01-01

Background General Practitioners (GPs) are well-positioned to provide grief support to patients. Most GPs view the provision of bereavement care as an important aspect of their role and the GP is the health professional that many people turn to when they need support. We aimed to explore GPs’ understandings of bereavement care and their education and professional development needs in relation to bereavement care. Methods An in-depth qualitative design was adopted using a social constructionist approach as our aims were exploratory and applied. Nineteen GPs (12 women and 7 men) living in Western Australia were interviewed; 14 were based in metropolitan Perth and 5 in rural areas. GPs were invited, via a letter, to participate in a semi-structured interview. The interviews occurred within each GP’s workplace or, for the rural GPs, via telephone, and all interviews were digitally audio-recorded and transcribed. Results Analysis was based upon constant comparison and began as soon as possible after each interview. The data revealed four tensions or opposing views concerning bereavement and bereavement care. These were (1) whether grief is a standardised versus an individual process, (2) the role of the GP in intervening versus promoting resilience, (3) the GP as a broker of services versus a service provider, and (4) the need for formal education and professional development versus ‘on-the-job’ experiential learning. Conclusions GPs have a critical role in exploring distress, including grief. However, changes need to be made to ensure GPs have up-to-date knowledge of contemporary theories and approaches. GPs urgently need education both at the undergraduate and postgraduate degree levels, and in continuing professional development. Otherwise GPs will rely on out-dated theories and constructions of grief, which may be detrimental to patient care. PMID:24670040

Effect of counseling quality on anxiety, grief, and coping after second-trimester abortion for pregnancy complications.

Science.gov (United States)

Kerns, Jennifer L; Mengesha, Biftu; McNamara, Blair C; Cassidy, Arianna; Pearlson, Geffan; Kuppermann, Miriam

2018-06-01

We sought to explore the relationship between counseling quality, measured by shared decision making and decision satisfaction, and psychological outcomes (anxiety, grief, and posttraumatic stress) after second-trimester abortion for pregnancy complications. We conducted a cross-sectional study of women who underwent second-trimester abortion for complications. We recruited participants from Facebook and online support groups and surveyed them about counseling experiences and psychosocial issues. We used multivariate linear regression to evaluate relationships between counseling quality and psychological outcomes. We analyzed data from 145 respondents. Shared decision making and decision satisfaction scores were positively and strongly correlated in bivariate analysis (r=0.7, pCounseling quality may be especially important in this setting given the sensitive nature of decisions regarding pregnancy termination for complications. These results highlight the importance of patient-centered counseling for women seeking pregnancy termination. Copyright © 2018. Published by Elsevier Inc.

Grief elaboration in families with handicapped member.

Science.gov (United States)

Calandra, C; Finocchiaro, G; Raciti, L; Alberti, A

1992-01-01

Families with handicapped member seem to follow the same five stages (rejection and isolation, anger, dealing with the problem, depression, acceptance) of Kubler-Ross grief elaboration theory while dealing with the narcissistic wound of a handicapped child. Some of these families show a block in one of the stages. The effort of psychotherapy is to remove the block and let them reach the last stage. In this paper families under systemic psychotherapeutic treatment are analyzed, who had in common the birth of a child with low or modest invalidating signs and psychotic or autistic features. The families structure did not show the characteristics of a psychotic family. Nevertheless either one or both parents ignored the evidence of their child disease and they built a "disease-incongrous" wait around the child, trying to push away the painful reality. The authors explain the importance of this approach for the improvement of the autistic traits.

Delamination of carbon-fiber strengthening layer from concrete beam during deformation (infrared thermography)

OpenAIRE

Shardakov, I. N.; Shestakov, A. P.; Bykov, A.A.

2016-01-01

Technology of strengthening reinforced concrete structures with composite materials has found wide application. The effectiveness of strengthening of concrete structures with externally bonded reinforcement is supported by a great deal of experimental evidence. However, the problem of serviceability of such structures has not been adequately explored. The present work describes the results of experimental studies on the loadcarrying capacity of concrete beams strengthened with carbon fiber re...

Strengthening of Shear Walls

DEFF Research Database (Denmark)

Hansen, Christian Skodborg

The theory for concrete structures strengthened with fiber reinforced polymer materials has been developing for approximately two decades, and there are at the present time numerous guidelines covering strengthening of many commonly encountered structural building elements. Strengthening of in...... that describes a unit width strip of a strengthened disk. The unit width strip is named a strengthened concrete tension member and contains a single tensile crack and four debonding cracks. Analysis of the member results in closed form expressions for the load-crack opening relationship. Further analysis...... of the response, results in the ability to determine and characterize the two-way crack propagation, i.e. the relationship between tensile cracking in the concrete and interface debonding between strengthening and concrete. Using the load-crack opening relationship from the strengthened concrete tension member...

Avoidance of Bereavement-Related Stimuli in Chinese Individuals Experiencing Prolonged Grief: Evidence from a Dot-Probe Task

Directory of Open Access Journals (Sweden)

Meng Yu

2017-07-01

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.

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

OpenAIRE

Gallo Acosta, Jairo; Muhete, Magnolia

2012-01-01

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

IDRC-GDN: A Strengthened Partnership for Research Capacity ...

International Development Research Centre (IDRC) Digital Library (Canada)

IDRC-GDN: A Strengthened Partnership for Research Capacity Building. This project provides core funding to the Global Development Network (GDN) over three years. GDN supports social science researchers in developing and transition countries. Its core mission is to enhance policy-relevant research capacity by ...

Strengthening foodborne disease surveillance in the WHO African

African Journals Online (AJOL)

OMS

2012-06-04

Jun 4, 2012 ... region including acute aflatoxicosis in Kenya in 2004 and bromide poisoning in ... Global Food Infections Network (GFN), has been supporting countries to strengthen ... The surveillance system uses standard case definitions for classifying .... Figure 4: Participating countries and training sites for foodborne.

STRENGTHENING OF TRENCH COVER PLATES FOR SWITCHGEAR BUILDING

International Nuclear Information System (INIS)

M.S. RUBEN

2000-01-01

The objective of this calculation is to strengthen the existing trench cover plates of the Electrical Switchgear Building (BLDG 5010) of the Exploratory Studies Facility. A remodeling effort will change the portion of the facility that has the trenches for electrical cables to a craft/shop area. The users of the building will be using a forklift in this area (Clark CGP 30 forklift with a capacity of 3 tons). The trench covers require strengthening to support the wheel loads from the forklift. The output of this calculation will be sketches revising the floor plate details of DWG YMP-025-1-7007-ST103,2. (Details 4 and 5)

Clinical correlates of complicated grief among individuals with acute coronary syndromes

Directory of Open Access Journals (Sweden)

Pini S

2015-10-01

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

Strengthening policy research on infant and young child feeding: An imperative to support countries in scaling up impact on nutrition.

Science.gov (United States)

Menon, Purnima; Thow, Anne Marie

2017-06-13

Enabling policy environments for nutrition require require evidence to support best practice and engagement with political and policy contexts, as well as leadership, resourcing, advocacy, and technical support. However, research on nutrition policy contexts is limited. The papers in this special supplement on policy contexts for infant and young child feeding (IYCF) in South Asia makes a valuable contribution to understanding the policy landscape and political dynamics in the region and the global literature. Studies included in this special supplement analyzed policy content and stakeholder influence on IYCF in Bangladesh, India, Nepal, Pakistan and Sri Lanka, and assess the role of advocacy in addressing multiple elements of the policy environment. These analyses highlight opportunities to harmonize and manage the demands and interests of multiple actors while strengthening policy to strategically support optimal IYCF as the ultimate goal. They also provide robust examples of research on policy environments and policy change. Further investments in research on policy contexts for nutrition can help to understand and support continued progress towards improved actions for nutrition.

Strengthening policy research on infant and young child feeding: An imperative to support countries in scaling up impact on nutrition

Directory of Open Access Journals (Sweden)

Purnima Menon

2017-06-01

Full Text Available Abstract Enabling policy environments for nutrition require require evidence to support best practice and engagement with political and policy contexts, as well as leadership, resourcing, advocacy, and technical support. However, research on nutrition policy contexts is limited. The papers in this special supplement on policy contexts for infant and young child feeding (IYCF in South Asia makes a valuable contribution to understanding the policy landscape and political dynamics in the region and the global literature. Studies included in this special supplement analyzed policy content and stakeholder influence on IYCF in Bangladesh, India, Nepal, Pakistan and Sri Lanka, and assess the role of advocacy in addressing multiple elements of the policy environment. These analyses highlight opportunities to harmonize and manage the demands and interests of multiple actors while strengthening policy to strategically support optimal IYCF as the ultimate goal. They also provide robust examples of research on policy environments and policy change. Further investments in research on policy contexts for nutrition can help to understand and support continued progress towards improved actions for nutrition.

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

Science.gov (United States)

Kelley, Melissa M.; Chan, Keith T.

2012-01-01

Research has examined the relationship of styles of attachment to others and meaning with grief and the stress-related growth process. Less has been written on styles of attachment to God and patterns of religious coping and how these constructs may impact adjustment in persons dealing with loss. This study examines the roles of attachment to God,…

Development of Austenitic ODS Strengthened Alloys for Very High Temperature Applications

Energy Technology Data Exchange (ETDEWEB)

Stubbins, James [Univ. of Illinois, Urbana-Champaign, IL (United States); Heuser, Brent [Univ. of Illinois, Urbana-Champaign, IL (United States); Robertson, Ian [Kyushu Univ. (Japan); Sehitoglu, Huseyin [Univ. of Illinois, Urbana-Champaign, IL (United States); Sofronis, Petros [Kyushu Univ. (Japan); Gewirth, Andrew [Kyushu Univ. (Japan)

2015-04-22

overall properties. With this understanding, the major materials development challenge is to provide a high uniformly distributed population of very fine ODS particles to be able to realize the full promise of dispersion strengthening. This should be a major goal of future work. This program had the further goal to develop graduate student researcher with the experience and capabilities to move this field forward. The support in this program was used for graduate student support and for research expenses; none of the program funds directly supported the faculty in the program. In this sense, the program was successful in supporting several very promising graduate researchers. Four of the graduate students supported here will complete their PhDs in 2015.

A Review on Strengthening Steel Beams Using FRP under Fatigue

Directory of Open Access Journals (Sweden)

Mohamed Kamruzzaman

2014-01-01

Full Text Available In recent decades, the application of fibre-reinforced polymer (FRP composites for strengthening structural elements has become an efficient option to meet the increased cyclic loads or repair due to corrosion or fatigue cracking. Hence, the objective of this study is to explore the existing FRP reinforcing techniques to care for fatigue damaged structural steel elements. This study covers the surface treatment techniques, adhesive curing, and support conditions under cyclic loading including fatigue performance, crack propagation, and failure modes with finite element (FE simulation of the steel bridge girders and structural elements. FRP strengthening composites delay initial cracking, reduce the crack growth rate, extend the fatigue life, and decrease the stiffness decay with residual deflection. Prestressed carbon fibre-reinforced polymer (CFRP is the best strengthening option. End anchorage prevents debonding of the CRRP strips at the beam ends by reducing the local interfacial shear and peel stresses. Hybrid-joint, nanoadhesive, and carbon-flex can also be attractive for strengthening systems.

A review on strengthening steel beams using FRP under fatigue.

Science.gov (United States)

Kamruzzaman, Mohamed; Jumaat, Mohd Zamin; Sulong, N H Ramli; Islam, A B M Saiful

2014-01-01

In recent decades, the application of fibre-reinforced polymer (FRP) composites for strengthening structural elements has become an efficient option to meet the increased cyclic loads or repair due to corrosion or fatigue cracking. Hence, the objective of this study is to explore the existing FRP reinforcing techniques to care for fatigue damaged structural steel elements. This study covers the surface treatment techniques, adhesive curing, and support conditions under cyclic loading including fatigue performance, crack propagation, and failure modes with finite element (FE) simulation of the steel bridge girders and structural elements. FRP strengthening composites delay initial cracking, reduce the crack growth rate, extend the fatigue life, and decrease the stiffness decay with residual deflection. Prestressed carbon fibre-reinforced polymer (CFRP) is the best strengthening option. End anchorage prevents debonding of the CRRP strips at the beam ends by reducing the local interfacial shear and peel stresses. Hybrid-joint, nanoadhesive, and carbon-flex can also be attractive for strengthening systems.

A Review on Strengthening Steel Beams Using FRP under Fatigue

Science.gov (United States)

Jumaat, Mohd Zamin; Ramli Sulong, N. H.

2014-01-01

In recent decades, the application of fibre-reinforced polymer (FRP) composites for strengthening structural elements has become an efficient option to meet the increased cyclic loads or repair due to corrosion or fatigue cracking. Hence, the objective of this study is to explore the existing FRP reinforcing techniques to care for fatigue damaged structural steel elements. This study covers the surface treatment techniques, adhesive curing, and support conditions under cyclic loading including fatigue performance, crack propagation, and failure modes with finite element (FE) simulation of the steel bridge girders and structural elements. FRP strengthening composites delay initial cracking, reduce the crack growth rate, extend the fatigue life, and decrease the stiffness decay with residual deflection. Prestressed carbon fibre-reinforced polymer (CFRP) is the best strengthening option. End anchorage prevents debonding of the CRRP strips at the beam ends by reducing the local interfacial shear and peel stresses. Hybrid-joint, nanoadhesive, and carbon-flex can also be attractive for strengthening systems. PMID:25243221

ADAPTAÇÃO TRANSCULTURAL E EVIDÊNCIAS DE VALIDAÇÃO DA PERINATAL GRIEF SCALE

Directory of Open Access Journals (Sweden)

Gisele Ferreira Paris

2017-01-01

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

Seismic strengthening of RC structures with exterior shear walls

Indian Academy of Sciences (India)

Nowadays, most of the strengthening strategies are based on global ..... In the present work, sliding shear capacity was calculated based on the code formulations, ... This study has been carried out with the financial support of State Planning ...

Strengthening capacity to apply health research evidence in policy making: experience from four countries

Science.gov (United States)

Hawkes, Sarah; K Aulakh, Bhupinder; Jadeja, Nidhee; Jimenez, Michelle; Buse, Kent; Anwar, Iqbal; Barge, Sandhya; Odubanjo, M Oladoyin; Shukla, Abhay; Ghaffar, Abdul; Whitworth, Jimmy

2016-01-01

Increasing the use of evidence in policy making means strengthening capacity on both the supply and demand sides of evidence production. However, little experience of strengthening the capacity of policy makers in low- and middle- income countries has been published to date. We describe the experiences of five projects (in Bangladesh, Gambia, India and Nigeria), where collaborative teams of researchers and policy makers/policy influencers worked to strengthen policy maker capacity to increase the use of evidence in policy. Activities were focused on three (interlinked) levels of capacity building: individual, organizational and, occasionally, institutional. Interventions included increasing access to research/data, promoting frequent interactions between researchers and members of the policy communities, and increasing the receptivity towards research/data in policy making or policy-implementing organizations. Teams were successful in building the capacity of individuals to access, understand and use evidence/data. Strengthening organizational capacity generally involved support to infrastructure (e.g. through information technology resources) and was also deemed to be successful. There was less appetite to address the need to strengthen institutional capacity—although this was acknowledged to be fundamental to promoting sustainable use of evidence, it was also recognized as requiring resources, legitimacy and regulatory support from policy makers. Evaluation across the three spheres of capacity building was made more challenging by the lack of agreed upon evaluation frameworks. In this article, we propose a new framework for assessing the impact of capacity strengthening activities to promote the use of evidence/data in policy making. Our evaluation concluded that strengthening the capacity of individuals and organizations is an important but likely insufficient step in ensuring the use of evidence/data in policy-cycles. Sustainability of evidence

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

Science.gov (United States)

Riches, Gordon; Dawson, Pam

1996-01-01

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

Strategy for Strengthening Farmer Groups by Institutional Strengthening

Directory of Open Access Journals (Sweden)

Purbayu Budi Santoso

2015-08-01

Full Text Available Agriculture sector becomes a spotlight because this sector will be full of potential but the welfare of farmers who become the leading actor is not guaranteed and has a poor tendency. The purpose of this study is to formulate strategies to strengthen farmers' groups in order to create the marketing of the agricultural sector that benefit farmers. The method used to achieve this goal is to use a qualitative approach and Analytical Network Process. In addition to the secondary data obtained from several agencies, this study also uses primary data obtained by in-depth interviews and observations. This research results a priority of aspects of the institutional strengthening of farmer groups as well as priority issues and priorities of the solution of each aspect. In addition, the priority of alternative strategies resulted based on the problems and solutions that have been analyzed in order to solve the problems in the institutional strengthening of farmer groups in Demak.

Elements for harnessing participatory action research to strengthen health managers' capacity: a critical interpretative synthesis.

Science.gov (United States)

Tetui, Moses; Zulu, Joseph Mumba; Hurtig, Anna-Karin; Ekirapa-Kiracho, Elizabeth; Kiwanuka, Suzanne N; Coe, Anna-Britt

2018-04-19

Health managers play a key role in ensuring that health services are responsive to the needs of the population. Participatory action research (PAR) is one of the approaches that have been used to strengthen managers' capacity. However, collated knowledge on elements for harnessing PAR to strengthen managers' capacity is missing. This paper bridges this gap by reviewing existing literature on the subject matter. A critical interpretive synthesis method was used to interrogate eight selected articles. These articles reported the use of PAR to strengthen health managers' capacity. The critical interpretive synthesis method's approach to analysis guided the synthesis. Here, the authors interpretively made connections and linkages between different elements identified in the literature. Finally, the Atun et al. (Heal Pol Plann, 25:104-111, 2010) framework on integration was used to model the elements synthesised in the literature into five main domains. Five elements with intricate bi-directional interactions were identified in the literature reviewed. These included a shared purpose, skilled facilitation and psychological safety, activity integration into organisational procedures, organisational support, and external supportive monitoring. A shared purpose of the managers' capacity strengthening initiative created commitment and motivation to learn. This purpose was built upon a set of facilitation skills that included promoting participation, self-efficacy and reflection, thereby creating a safe psychological space within which the managers interacted and learnt from each other and their actions. Additionally, an integrated intervention strengthened local capacity and harnessed organisational support for learning. Finally, supportive monitoring from external partners, such as researchers, ensured quality, building of local capacity and professional safety networks essential for continued learning. The five elements identified in this synthesis provide a basis upon

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

Science.gov (United States)

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

2008-02-01

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

Information collection strategies to support strengthened safeguards

International Nuclear Information System (INIS)

Costantini, L.; Hill, J.

2001-01-01

The IAEA Board of Governors approved the implementation of Part 1 of Strengthened Safeguards in June 1995. Since then, the collection and analysis of information beyond that provided by States parties and acquired by inspectors under NPT Safeguards Agreements has been an integral part of IAEA safeguards. The Agency has formally established internal structures and procedures to facilitate the effective use of open-source and other information not previously used in safeguards. Over this period the IAEA Division of Safeguards Information Technology (SGIT) has been building its collections of electronically held open source information. Some of these collections are quite nuclear-specific, such as material from the Monterey Institute in California, and nuclear news collections provided voluntarily by a number of Member States. Others are completely general news sources. Several of these collections contain many more reports than could possibly be reviewed by a human analyst. So a need has arisen for computerised search facilities to identify nuclear-relevant items from those collections. The Agency has more than one piece of software available to help searching and analysis of substantial collections of reports. Search 97 from Verity was chosen for this particular application because it is very straightforward to use, and it was expected that personnel from all over the Department of Safeguards would carry out these searches on a routine basis. The approach whereby special-purpose search mechanisms are designed for use by a large number of users, who are unfamiliar with the details of the search software, seems to be unusual if not unique to the Agency

Strengthening Masonry Arches with Lime-Based Mortar Composite

Directory of Open Access Journals (Sweden)

Valerio Alecci

2017-06-01

Full Text Available In recent decades, many strengthening interventions on masonry elements were performed by using fiber reinforced polymers (FRPs. These advanced materials proved to be effective to increase the load-carrying capacity of masonry elements and to improve their structural behavior, avoiding the most critical failure modes. Despite the advantages of this technique compared to more traditional methods, FRP systems have disadvantages related to their low resistance to high temperatures, impossibility of application on wet surfaces, low permeability, and poor compatibility with masonry supports. Therefore, composite materials made of a fiber textile embedded in an inorganic matrix were recently proposed as alternatives to FRPs for strengthening historic masonry constructions. These composite materials are easier to install, have higher resistance to high temperatures, and permit higher vapor permeability than FRPs. The inorganic matrix is frequently a cement-based mortar, and the composite materials made of a fiber textile embedded in a cement-based mortar are usually identified as FRCM (fabric reinforced cementitious matrix composites. More recently, the use of natural lime mortar as an inorganic matrix has been proposed as an alternative to cement-based mortars when historic compatibility with the substrate is strictly required, as in case of restoration of historic buildings. In this paper, the effectiveness of a fabric made of basalt fibers embedded in lime mortar matrix (Basalt-FRLM for the strengthening of masonry arches is investigated. An experimental investigation was performed on 1:2 scaled brick masonry arches strengthened at the extrados with a layer of Basalt-FRLM and tested under vertical load. The results obtained are compared with previous results obtained by the authors by testing masonry arches strengthened at their extrados with FRCM and FRP composites. This investigation highlights the effectiveness of Basalt-FRLM in increasing load

Strengthening the non proliferation regime: French views

International Nuclear Information System (INIS)

Delaune, P.

2013-01-01

3 main issues can be identified in the French policy concerning the backing of non proliferation: 1) responding resolutely to proliferation crises, 2) reinforcing substantive efforts to prevent and impede proliferation, and 3) strengthening the non-proliferation regime. The first issue is very important because combating proliferation is vital to the security of all. Concerning the second issue, France attaches particular importance to strengthening specific measures to prevent and check proliferation. Let me mention a few proposals that we put forward: exports need to be controlled more effectively, proliferation activities have to be criminalized, or the development of proliferation-resistant technologies should be supported. Concerning the third issue it means the strengthening of the non-proliferation regime, France proposes several means: -) aiming at the universalization of the additional protocol; -) ensuring that the Agency continues to have sufficient human, financial and technical resources to fulfill its verification mission effectively; -) encouraging the IAEA to make full use of the authority available to it; -) enhancing the use of information relevant to the delivery of the IAEA mandate; and -) sharing more accurate information concerning the breaches of commitments that happen. The paper is followed by the slides of the presentation. (A.C.)

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

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Hinton, Devon E.; Field, Nigel P.; Nickerson, Angela; Bryant, Richard A.; Simon, Naomi

2013-01-01

The authors investigated the importance of dreams of the deceased in the experiencing of prolonged grief (PG) and posttraumatic stress disorder (PTSD) among Cambodian refugees who survived the Pol Pot genocide (1975-1979). Such dreams were frequent in the last month (52% of those surveyed), and most often involved a relative who died in the Pol…

Strengthening the role of Community Health Representatives in the Navajo Nation

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Caroline King

2017-04-01

Full Text Available Abstract Background Strengthening Community Health Worker systems has been recognized to improve access to chronic disease prevention and management efforts in low-resource communities. The Community Outreach and Patient Empowerment (COPE Program is a Native non-profit organization with formal partnerships with both the Navajo Nation Community Health Representative (CHR Program and the clinical facilities serving the Navajo Nation. COPE works to better integrate CHRs into the local health care system through training, strengthening care coordination, and a standardized culturally appropriate suite of health promotion materials for CHRs to deliver to high-risk individuals in their homes. Methods The objective of this mixed methods, cross sectional evaluation of a longitudinal cohort study was to explore how the COPE Program has effected CHR teams over the past 6 years. COPE staff surveyed CHRs in concurrent years (2014 and 2015 about their perceptions of and experience working with COPE, including potential effects COPE may have had on communication among patients, CHRs, and hospital-based providers. COPE staff also conducted focus groups with all eight Navajo Nation CHR teams. Results CHRs and other stakeholders who viewed our results agree that COPE has improved clinic-community linkages, primarily through strengthened collaborations between Public Health Nurses and CHRs, and access to the Electronic Health Records. CHRs perceived that COPE’s programmatic support has strengthened their validity and reputation with providers and clients, and has enhanced their ability to positively effect health outcomes among their clients. CHRs report an improved ability to deliver health coaching to their clients. Survey results show that 80.2% of CHRs feel strongly positive that COPE trainings are useful, while 44.6% of CHRs felt that communication and teamwork had improved because of COPE. Conclusions These findings suggest that CHRs have experienced

Effect of CFRP and TRM Strengthening of RC Slabs on Punching Shear Strength

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Husain Abbas

Full Text Available Abstract The paper presents experiments involving punching of RC slabs strengthened using externally bonded carbon fiber reinforced polymer (CFRP sheet and textile reinforced mortar (TRM. Twelve RC slab specimens of two concrete grades (39.9 and 63.2 MPa and employing two strengthening schemes (CFRP and TRM were tested. Specimens were supported on two opposite edges. Experimental load-displacement variations show two peak loads in strengthened slabs and one peak followed by a plateau in control. Second peak or the plateau corresponds to the combined action of aggregate interlock and the dowel action of back face rebars and strengthening layers. The dowel action of back face rebars and strengthening layers had no role in ultimate punching load (i.e. first peak. Strengthened slabs showed 9-18% increase in ultimate punching load (i.e. first peak whereas there was significant increase in the second peak load (190-276% for CFRP; 55-136% for TRM and energy absorption (~66% for CFRP and 22-56% for TRM. An analytical model was also developed for predicting the punching shear strength (first and second peaks of strengthened slabs showing good comparison with experiments.

Strengthening Dairy Cooperative through National Development of Livestock Region

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Priyono

2016-02-01

Full Text Available Establishment of dairy cattle development region needs to be conducted in accordance with the national dairy industry development plan. Dairy cattle regions have been designed and equipped with infrastructure supplies, supporting facilities, technologies, finance, processing, marketing, institutional and human resources. Dairy cooperative is one of the marketing channels of milk and milk products which have strategic roles to support the national dairy industry. Collaborations between dairy cooperatives and smallholder farmers within a district region have to be done based on agricultural ecosystems, agribusiness system, integrated farming and participatory approach. This may improve dairy cooperatives as an independent and competitive institution. Strengthening dairy cooperatives in national region dairy cattle was carried out through institutional inventory and dairy cooperatives performance; requirement of capital access, market and networks as well as education and managerial training; certification and accreditation feasibility analysis and information and technology utilization. Establishment of emerging dairy cooperatives towards small and micro enterprises is carried out by directing them to establish cooperatives which have legal certainty and business development opportunities. The impact of strengthening dairy cooperative may support dairy cattle development through increase population and milk production. Sustainable dairy cattle development needs to be supported by regional and national government policies.

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

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Willis, Erin; Ferrucci, Patrick

2017-12-01

Facebook not only changed the way we communicate but also the way we mourn and express grief. The social networking site allows users to interact with deceased users' walls after death. This study utilized textual analysis to categorize Facebook posts ( N = 122) on 30 deceased users' walls according to uses and gratifications theory. Most posts were found to be motivated by entertainment, followed by integration and social interaction. Facebook users posted memories, condolences, and interacted with friends and family members in the deceased user's network. Implications and potential future research are discussed.

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

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Houck, Dereen

2014-08-01

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

The Impact of Supporting Family Caregivers Before Bereavement on Outcomes After Bereavement: Adequacy of End-of-Life Support and Achievement of Preferred Place of Death.

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Aoun, Samar M; Ewing, Gail; Grande, Gunn; Toye, Chris; Bear, Natasha

2018-02-01

The investigation of the situation of bereaved family caregivers following caregiving during the end-of-life phase of illness has not received enough attention. This study investigated the extent to which using the Carer Support Needs Assessment Tool (CSNAT) intervention during the caregiving period has affected bereaved family caregivers' perceptions of adequacy of support, their grief and well-being, and achievement of their preferred place of death. All family caregivers who participated in a stepped-wedge cluster trial of the CSNAT intervention in Western Australia (2012-2014) and completed the pre-bereavement study (n = 322) were invited to take part in a caregiver survey by telephone four to six months after bereavement (2015). The survey measured the adequacy of end-of-life support, the level of grief, the current physical and mental health, and the achievement of the preferred place of death. The response rate was 66% (152, intervention; 60, control). The intervention group perceived that their pre-bereavement support needs had been adequately met to a significantly greater extent than the control group (d = 0.43, P death more often according to their caregivers (79.6% vs. 63.6%, P = 0.034). There was also a greater agreement on the preferred place of death between patients and their caregivers in the intervention group (P = 0.02). The results from this study provide evidence that the CSNAT intervention has a positive impact on perceived adequacy of support of bereaved family caregivers and achievement of preferred place of death according to caregivers. The benefits gained by caregivers in being engaged in early and direct assessment of their support needs before bereavement reinforce the need for palliative care services to effectively support caregivers well before the patient's death. Copyright © 2017 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

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

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Steve Holmes

2013-12-01

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

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

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Wittmann, Daniela

2015-01-01

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

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

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Creighton, Genevieve; Oliffe, John; Matthews, Jennifer; Saewyc, Elizabeth

2016-01-01

Background: The death of a male friend can be challenging for men because expressions of grief can be governed and restrained by dominant ideals of masculinity. It is common for young men to engage in health risk practices, such as alcohol overuse, to deal with feelings of sadness. Objective: This qualitative study investigated the ways that young…

Infusing Mindfulness-Based Interventions in Support Groups for Grieving College Students

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Newton, Therese L.; Ohrt, Jonathan H.

2018-01-01

Approximately 39-49% of college students have experienced grief due to death in the past 24 months. Students' grief is often complicated due to the nature of their developmental characteristics (e.g., searching for autonomy, identity development, career direction, academic pressure, and formation of intimate relationships). Group mindfulness-based…

Mechanical behavior and strengthening mechanisms in ultrafine grain precipitation-strengthened aluminum alloy

International Nuclear Information System (INIS)

Ma, Kaka; Wen, Haiming; Hu, Tao; Topping, Troy D.; Isheim, Dieter; Seidman, David N.; Lavernia, Enrique J.; Schoenung, Julie M.

2014-01-01

To provide insight into the relationships between precipitation phenomena, grain size and mechanical behavior in a complex precipitation-strengthened alloy system, Al 7075 alloy, a commonly used aluminum alloy, was selected as a model system in the present study. Ultrafine-grained (UFG) bulk materials were fabricated through cryomilling, degassing, hot isostatic pressing and extrusion, followed by a subsequent heat treatment. The mechanical behavior and microstructure of the materials were analyzed and compared directly to the coarse-grained (CG) counterpart. Three-dimensional atom-probe tomography was utilized to investigate the intermetallic precipitates and oxide dispersoids formed in the as-extruded UFG material. UFG 7075 exhibits higher strength than the CG 7075 alloy for each equivalent condition. After a T6 temper, the yield strength (YS) and ultimate tensile strength (UTS) of UFG 7075 achieved 734 and 774 MPa, respectively, which are ∼120 MPa higher than those of the CG equivalent. The strength of as-extruded UFG 7075 (YS: 583 MPa, UTS: 631 MPa) is even higher than that of commercial 7075-T6. More importantly, the strengthening mechanisms in each material were established quantitatively for the first time for this complex precipitation-strengthened system, accounting for grain-boundary, dislocation, solid-solution, precipitation and oxide dispersoid strengthening contributions. Grain-boundary strengthening was the predominant mechanism in as-extruded UFG 7075, contributing a strength increment estimated to be 242 MPa, whereas Orowan precipitation strengthening was predominant in the as-extruded CG 7075 (∼102 MPa) and in the T6-tempered materials, and was estimated to contribute 472 and 414 MPa for CG-T6 and UFG-T6, respectively

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

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Claire White

2013-07-01

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

Flexural Behavior of Self-Compacting RC Continuous Beams Strengthened by CFRP Sheets

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Sabih Z. Al-Sarraf

2018-01-01

Full Text Available This search presented an experimental study of the flexural behavior of self-compacting reinforced concrete continuous beams externally strengthened by carbon fiber reinforced polymer (CFRP Sheets. The practical study contained eight self-compacting reinforced concrete continuous beams (with two span, each span had (1500 mm length and (150x250 mm cross sectional dimensions. Seven of these beams strengthened externally by CFRP sheets with and without external anchorage. The experimental variables included location of CFRP sheets and anchor type and location. The results, shows that the beams strengthened externally by CFRP sheets provided improvement in ultimate loads reached (60.71%. The usage of CFRP in the anchorage zone indicated an effective method in comparison to increasing the CFRP sheets lengths or extending them up to the support or under the loading points. Test results also showed that side strengthening provided an effective tool for increasing the load at the cracking stage and also the load capacity and reducing flexural crack widths.

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

Science.gov (United States)

Taubert, Mark; Norris, James

2015-04-01

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

Retrofitting Heritage Buildings by Strengthening or Using Seismic Isolation

International Nuclear Information System (INIS)

Danieli, Moshe; Bloch, Jacob; Ribakov, Yuri

2008-01-01

Many heritage buildings in the Mediterranean area include stone domes as a structural and architectural element. Present stage of these buildings often requires strengthening or retrofitting in order to increase their seismic resistance. Strengthening is possible by casting above existing dome a thin reinforced concrete shell with a support ring. It yields reduction of stresses and strains in the dome. This paper deals with examples of actual restoration and strengthening of three structures in Georgia, two of them damaged by an earthquake in 1991, (a temple in Nikortzminda and a synagogue in Oni, built in 11 th and 19 r century, respectively) and a mosque in Akhaltzikhe, built in 18th century. Retrofitting of these structures was aimed at preservation of initial geometry and appearance by creating composite (stone--reinforced concrete, or stone--shotcrete) structures, which were partially or fully hidden. Further improving of seismic response may be achieved by using hybrid seismic isolation decreasing the seismic forces and adding damping. A brief description of the design procedure for such cases is presented

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

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Victoria Eugenia Diaz.

2008-12-01

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

Preloading Effect on Strengthening Efficiency of RC Beams Strengthened with Non- and Pretensioned NSM Strips

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Renata Kotynia

2018-02-01

Full Text Available The near surface mounted (NSM technique has been shown to be one of the most promising methods for upgrading reinforced concrete (RC structures. Many tests carried out on RC members strengthened in flexure with NSM fiber-reinforced polymer (FRP systems have demonstrated greater strengthening efficiency than the use of externally-bonded (EB FRP laminates. Strengthening with simultaneous pretensioning of the FRP results in improvements in the serviceability limit state (SLS conditions, including the increased cracking moment and decreased deflections. The objective of the reported experimental program, which consisted of two series of RC beams strengthened in flexure with NSM CFRP strips, was to investigate the influence of a number of parameters on the strengthening efficiency. The test program focused on an analysis of the effects of preloading on the strengthening efficiency which has been investigated very rarely despite being one of the most important parameters to be taken into account in strengthening design. Two preloading levels were considered: the beam self-weight only, which corresponded to stresses on the internal longitudinal reinforcement of 25% and 14% of the yield stress (depending on a steel reinforcement ratio, and the self-weight with the additional superimposed load, corresponding to 60% of the yield strength of the unstrengthened beam and a deflection equal to the allowable deflection at the SLS. The influence of the longitudinal steel reinforcement ratio was also considered in this study. To reflect the variability seen in existing structures, test specimens were varied by using different steel bar diameters. Finally, the impact of the composite reinforcement ratio and the number of pretensioned FRP strips was considered. Specimens were divided into two series based on their strengthening configuration: series “A” were strengthened with one pretensioned and two non-pretensioned carbon FRP (CFRP strips, while series �

Strategic process strengthens and orientates the regional RandD capacity

Energy Technology Data Exchange (ETDEWEB)

Knuuttila, Kirsi [JAMK Univ. of Applied Sciences, Jyvaeskylae (Finland)], e-mail: kirsi.knuuttila@jamk.fi; Krissakova, Ingrid [National Forest Centre-Forest Research Inst., Zvolen (Slovakia); Barbena, Goizeder [Centro Nacional de Energias Renovables/ Departamento de Biomasa, CENER, Pamplona (Spain); Hryniewicz, Marek [Inst. of Technology and Life Sciences, ITP, Raszyn (Poland); Ketikidis, Chrysovalantis [Centre for Research and Technology Hellas, CERTH/ Inst. for Solid Fuels Technology and Applications, Thessaloniki (Greece); Wihersaari, Margareta [Jyvaeskylae Univ., Jyvaeskylae (Finland)

2012-11-01

The use of biomasses and competition for biomass resources are rapidly increasing in Europe due to the positive environmental advantages that this energy source entails, including climate change prevention. Central Finland, Navarra (Spain), Western Macedonia (Greece), Slovakia and Wielkopolska (Poland) have taken the joint initiative to strengthen the regional expertise, cooperation capacities and innovation environment in the field of sustainable use of biomass resources. The initiative to develop the regional research driven clusters is supported by BIOCLUS project (www.bioclus.eu) co-financed by FP7 Regions of Knowledge Programme. The biomass research orientated clusters have built up Regional Strategic RandD Agendas (SRA) and Joint Action Plans (JAP) based on the SRAs. The starting point for SRA is the comprehensive understanding of regional biomass resources. SRA and JAP process orientates and strengthens research activities and capacity building in the selected research fields related to sustainable use of biomass. The agenda supports expertise development and cooperation in the regional research-driven cluster. It identifies the focus of research activities in the future and supports the authorities in directing the use of human and financial resources.

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

Science.gov (United States)

Gee, Robert; Springer, Paul; Bitar, George; Drew, Faith; Graff, Chad

2005-01-01

Individuals with co-occurring mental health and substance use disorder (COD) present unique challenges for counselors. When individuals are incarcerated, they suffer unique forms of losses, including the loss and grief of their family members. In addition, they often struggle with stigma and cultural stereotypes that are oppressive and…

Opportunities for strengthening infant and young child feeding policies in South Asia: Insights from the SAIFRN policy analysis project.

Science.gov (United States)

Thow, Anne Marie; Karn, Sumit; Devkota, Madhu Dixit; Rasheed, Sabrina; Roy, S K; Suleman, Yasmeen; Hazir, Tabish; Patel, Archana; Gaidhane, Abhay; Puri, Seema; Godakandage, Sanjeeva; Senarath, Upul; Dibley, Michael J

2017-06-13

South Asian countries experience some of the highest levels of child undernutrition in the world, strongly linked to poor infant and young child feeding (IYCF) practices. Strong and responsive policy support is essential for effective interventions to improve IYCF. This study aimed to identify opportunities for strengthening the policy environment in the region to better support appropriate infant and young child feeding. We mapped policies relevant to infant and young child feeding in India, Pakistan, Bangladesh, Sri Lanka and Nepal, based on a common matrix. The matrix described potentially relevant policies ranging from high-level strategic policy documents to implementation-level guidelines. We analyzed the data based on themes focused on caregiver interactions with IYCF interventions: provision of correct information to mothers, training of frontline workers, enabling mothers to engage with service providers and strategic support for IYCF. Policy support for IYCF was present in relation to each of the themes assessed. In all countries, there was support for nutrition in National Development Plans, and all countries had some level of maternity protection and restrictions on marketing of breast milk substitutes. Sectoral and implementation-level policy documents contained provisions for system strengthening for IYCF and for training of frontline workers. The key opportunities for strengthening IYCF policy support were in relation to translating strategic directives into implementation level documents; improving multi-sectoral support and coordination; and increased clarity regarding roles and responsibilities of frontline workers interacting with mothers. These findings can support efforts to strengthen IYCF policy at the national and regional level.

Opportunities for strengthening infant and young child feeding policies in South Asia: Insights from the SAIFRN policy analysis project

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Anne Marie Thow

2017-06-01

Full Text Available Abstract Background South Asian countries experience some of the highest levels of child undernutrition in the world, strongly linked to poor infant and young child feeding (IYCF practices. Strong and responsive policy support is essential for effective interventions to improve IYCF. This study aimed to identify opportunities for strengthening the policy environment in the region to better support appropriate infant and young child feeding. Methods We mapped policies relevant to infant and young child feeding in India, Pakistan, Bangladesh, Sri Lanka and Nepal, based on a common matrix. The matrix described potentially relevant policies ranging from high-level strategic policy documents to implementation-level guidelines. We analyzed the data based on themes focused on caregiver interactions with IYCF interventions: provision of correct information to mothers, training of frontline workers, enabling mothers to engage with service providers and strategic support for IYCF. Results Policy support for IYCF was present in relation to each of the themes assessed. In all countries, there was support for nutrition in National Development Plans, and all countries had some level of maternity protection and restrictions on marketing of breast milk substitutes. Sectoral and implementation-level policy documents contained provisions for system strengthening for IYCF and for training of frontline workers. Conclusions The key opportunities for strengthening IYCF policy support were in relation to translating strategic directives into implementation level documents; improving multi-sectoral support and coordination; and increased clarity regarding roles and responsibilities of frontline workers interacting with mothers. These findings can support efforts to strengthen IYCF policy at the national and regional level.

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

Science.gov (United States)

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

2016-04-01

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

"We Take Care of People; What Happens to Us Afterwards?": Home Health Aides and Bereavement Care in Hospice.

Science.gov (United States)

Ghesquiere, Angela; Bagaajav, Ariunsanaa

2018-01-01

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.

Long Term Monitoring of Microbial Induced Soil Strengthening Processes

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Saneiyan, S.; Ntarlagiannis, D.; Werkema, D. D., Jr.; Colwell, F. S.; Ohan, J.

2016-12-01

Soil strengthening/stabilization processes are used to address some of soil quality issues. Microbial induced calcite precipitation (MICP) is a promising soil stabilization process that could offer long term solution by overcoming problems of commonly used methods (e.g. injecting cement slurry). MICP can be applied in larger spatial scales, allowing the enhanced soils to be maintained in an economic sustainable and environmental friendly way. Methods are sought for the long term monitoring of MICP enhanced soils. The spectral induced polarization (SIP) method is one promising method due to sensitivity on such processes and the ability for long term, even autonomous, operation as well as cost effectiveness. Previous laboratory tests showed the sensitivity of the SIP method on soil strengthening as a result of abiotic calcite precipitation. We extended this work to biotic calcite precipitation through MICP. Early results suggest that the MICP formed calcite is denser and could provide improved strengthening capabilities. Our results are supported by geophysical (SIP and shear-wave velocity), geo-chemical and microbiological monitoring. Destructive analysis and visualization (scanning electron imaging - SEM) is expected to provide conclusive evidence on the MICP long term effectiveness.

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

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Wittmann, Daniela; Foley, Sallie; Balon, Richard

2011-01-01

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

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

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Janusz, Bernadetta; Drozdzowicz, Lucyna

2013-01-01

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

National viewpoints: Views on strengthened safeguards from Australia, Cuba and South Africa

International Nuclear Information System (INIS)

Biggs, I.; Saburido, E.F.; Mxakato-Diseko, N.J.

1999-01-01

This paper presents views of Australia, Cuba and South Africa concerned with strengthened safeguards regime. Australia has been involved with the IAEA safeguards system since the first plenary meeting of the Conference on the IAEA Statute in 1956, joined the NPT in 1973 and began concluding bilateral safeguards agreements in 1977. Australia has the greatest respect for the IAEA coordinated efforts started in 1998 to strengthen and integrate the safeguards system. Cuba has always attached special importance to nuclear safeguards activities, recognizing their high priority as well as the important role they have in respect to international disarmament and security. South Africa supports the efforts in strengthening the safeguards activities and remains hopeful that the international community will address the challenges posed by the Trilateral Initiative between Russian federation, USA and IAEA in a mature and cooperative way

Cognitive health benefits of strengthening exercise for community-dwelling older adults.

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Anderson-Hanley, Cay; Nimon, Joseph P; Westen, Sarah C

2010-11-01

While aerobic exercise has been linked to improved performance on cognitive tasks of executive functioning among older adults, not all older adults can avail themselves of such exercise due to physical limitations. In this study, community-dwelling older adults were evaluated on tasks of executive functioning before and after a month-long strengthening, nonaerobic exercise program. A total of 16 participants who engaged in such exercise showed significantly improved scores on Digits Backward and Stroop C tasks when compared to 16 participants who were on an exercise waiting list. Positive benefits of strengthening exercise on cognition are supported. Additional research is needed to clarify the generalizability of these findings.

Narrative reconstruction therapy for prolonged grief disorder—rationale and case study

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Tuvia Peri

2016-05-01

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.

Challenges to implementing Gavi's health system strengthening support in Chad and Cameroon: results from a mixed-methods evaluation.

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Dansereau, Emily; Miangotar, Yodé; Squires, Ellen; Mimche, Honoré; El Bcheraoui, Charbel

2017-11-16

Since 2005, Gavi has provided health system strengthening (HSS) grants to address bottlenecks affecting immunization services. This study is the first to evaluate the Gavi HSS implementation process in either Cameroon or Chad, two countries with significant health system challenges and poor achievement on the child and maternal health Millennium Development Goals. We triangulated quantitative and qualitative data including financial records, document review, field visit questionnaires, and key informant interviews (KII) with representatives from the Ministries of Health, Gavi, and other partners. We conducted a Root Cause Analysis of key implementation challenges, guided by the Consolidated Framework for Implementation Research. We conducted 124 field visits and 43 KIIs in Cameroon, and 57 field visits and 39 KIIs in Chad. Cameroon's and Chad's HSS programs were characterized by delayed disbursements, significant deviations from approved expenditures, and reprogramming of funds. Nearly a year after the programs were intended to be complete, many district and facility-level activities were only partially implemented and significant funds remained unabsorbed. Root causes of these challenges included unpredictable Gavi processes and disbursements, poor communication between the countries and Gavi, insufficient country planning without adequate technical assistance, lack of country staff and leadership, and weak country systems to manage finances and promote institutional memory. Though Chad and Cameroon both critically needed support to strengthen their weak health systems, serious challenges drastically limited implementation of their Gavi HSS programs. Implementation of future HSS programs in these and similar settings can be improved by transparent and reliable procedures and communication from Gavi, proposals that account for countries' programmatic capacity and the potential for delayed disbursements, implementation practices that foster learning and adaptation

Women’s well-being improves after missed miscarriage with more active support and application of Swanson’s Caring Theory

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Annsofie Adolfsson

2010-12-01

Full Text Available Annsofie Adolfsson1,21Department of Obstetrics and Gynecology, Skaraborgs Sjukhus, Skövde, Sweden; 2School of Life Sciences, The University of Skövde, SwedenPurpose: The purpose of this study was to provide better organization and more efficient use of resources within the health care system in order to identify women with nonviable pregnancy earlier in their gestation terms and also to identify those women who experience severe grief reaction after the miscarriage. The proposed solution is to offer an appointment with a gynecologist during regular office hours after consultation with the patient’s midwife to women experiencing symptoms and who are concerned with the viability of their pregnancy. Unnecessary contact with the emergency room by the patients would be reduced as a result of this improvement in organization. The aim of the study was to give the women experiencing missed miscarriage an increased sense of well-being by applying Swanson’s Caring Theory to their recovery, in addition to the better organization and more efficient use of resources.Method: Both the original study from 2002 to 2003 and the later study from 2004 to 2005 applied Swanson’s Caring Theory in the follow-up care management of the women, but only the later study was influenced by the changes made in the health care system. In the past, diagnosis of missed miscarriage was delayed because women experiencing minor symptoms were not highly prioritized in the health care system. More active support was introduced in order to get the proper information to the patient throughout the health care system. The size of the original study database was n = 43, compared with the later study database, which was n = 56. All of the women answered the Perinatal Grief Scale (PGS questions twice, 1 month and 4 months after their diagnosis. Some additional questions about their circumstances unrelated to the PGS were also mailed to the women 4 months after their diagnosis

Strengthening regional safeguards

International Nuclear Information System (INIS)

Palhares, L.; Almeida, G.; Mafra, O.

1996-01-01

Nuclear cooperation between Argentina and Brazil has been growing since the early 1980's and as it grew, so did cooperation with the US Department of Energy (DOE). The Brazilian-Argentine Agency for Accounting and Control of Nuclear Materials (ABACC) was formed in December 1991 to operate the Common System of Accounting and Control of Nuclear Materials (SCCC). In April 1994, ABACC and the DOE signed an Agreement of Cooperation in nuclear material safeguards. This cooperation has included training safeguards inspectors, exchanging nuclear material measurement and containment and surveillance technology, characterizing reference materials, and studying enrichment plant safeguards. The goal of the collaboration is to exchange technology, evaluate new technology in Latin American nuclear facilities, and strengthen regional safeguards. This paper describes the history of the cooperation, its recent activities, and future projects. The cooperation is strongly supported by all three governments: the Republics of Argentina and Brazil and the United States

Burnout After Patient Death: Challenges for Direct Care Workers.

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

2017-09-01

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

No effect of forearm band and extensor strengthening exercises for the treatment of tennis elbow: a prospective randomised study.

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Luginbühl, Rolf; Brunner, Florian; Schneeberger, Alberto G

2008-01-01

The objective of this prospective randomised study was to analyse the effect of the forearm support band and of strengthening exercises for the treatment of tennis elbow. Twenty-nine patients with 30 tennis elbows were randomised into 3 groups of treatment: (I) forearm support band, (II) strengthening exercises and (III) both methods. The patients had a standardised examination at their first visit, and then after 6 weeks, 3 months and 1 year. At the latest follow-up, there was a significant improvement of the symptoms compared to before treatment (p<0.0001), considering all patients independently of the methods of treatment. However, no differences in the scores were found between the 3 groups of treatment (p=0.27), indicating that no beneficial influence was found either for the strengthening exercises or for the forearm support band. Improvement seems to occur with time, independent of the method of treatment used.

The Impact of Staff Training on the Knowledge of Support Staff in Relation to Bereavement and People with an Intellectual Disability

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Watters, Laura; McKenzie, Karen; Wright, Rachel

2012-01-01

This study aimed to investigate whether a 1-day training course improved support staff knowledge about bereavement and grief in people with a learning disability. A questionnaire based, mixed design was used. Forty-eight participants were randomly assigned to one of two equal groups. A staggered design allowed for group 2 to act both as a control…

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

Science.gov (United States)

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

2017-09-01

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

Seismic evaluation and strengthening of Bohunice nuclear power plant structures

International Nuclear Information System (INIS)

Shipp, J.G.; Short, S.A.; Grief, T.; Borov, V.; Kuzma, J.

2001-01-01

A seismic assessment and strengthening investigation is being performed for selected structures at the Bohunice V1 Nuclear Power Plant in Slovakia. Structures covered in this paper include the reactor building complex and the emergency generator station. The emergency generator station is emphasized in the paper as work is nearly complete while work on the reactor building complex is ongoing at this time. Seismic evaluation and strengthening work is being performed by a cooperative effort of Siemens and EQE along with local contractors. Seismic input is the interim Review Level Earthquake (horizontal peak ground acceleration of 0.3 g). The Bohunice V1 reactor building complex is a WWER 4401230 nuclear power plant that was originally built in the mid-1970s but had extensive seismic upgrades in 1991. Siemens has performed three dimensional dynamic analyses of the reactor building complex to develop seismic demand in structural elements. EQE is assessing seismic capacities of structural elements and developing strengthening schemes, where needed. Based on recent seismic response analyses for the interim Review Level Earthquake which account for soil-structure interaction in a rigorous manner, the 1991 seismic upgrade has been found to be inadequate in both member/connection strength and in providing complete load paths to the foundation. Additional strengthening is being developed. The emergency generator station was built in the 1970s and is a two-story unreinforced brick masonry (URM) shear wall building above grade with a one story reinforced concrete shear wall basement below grade. Seismic analyses and testing of the URM walls has been performed to assess the need for building strengthening. Required structural strengthening for in-plane forces consists of revised and additional vertical steel framing and connections, stiffening of horizontal roof bracing, and steel connections between the roof and supporting walls and pointing of two interior transverse URM

Palliative care and support for persons with HIV/AIDS in 7 African countries: implementation experience and future priorities.

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Alexander, Carla S; Memiah, Peter; Henley, Yvonne B; Kaiza-Kangalawe, Angela; Shumbusho, Anna Joyce; Obiefune, Michael; Enejoh, Victor; Stanis-Ezeobi, Winifred; Eze, Charity; Odion, Ehekhaye; Akpenna, Donald; Effiong, Amana; Miriti, Kenneth; Aduda, Samson; Oko, John; Melaku, Gebremedhin D; Baribwira, Cyprien; Umutesi, Hassina; Shimabale, Mope; Mugisa, Emmanuel; Amoroso, Anthony

2012-06-01

To combat morbidity and mortality from the worldwide epidemic of the human immunodeficiency virus (HIV), the United States Congress implemented a President's Emergency Plan for AIDS Relief (PEPFAR) in 30 resource-limited countries to integrate combination antiretroviral therapy (ART) for both prevention and cure. Over 35% of eligible persons have been successfully treated. Initial legislation cited palliative care as an essential aspect of this plan but overall health strengthening became critical to sustainability of programming and funding priorities shifted to assure staffing for care delivery sites; laboratory and pharmaceutical infrastructure; data collection and reporting; and financial management as individual countries are being encouraged to assume control of in-country funding. Given infrastructure requisites, individual care delivery beyond ART management alone has received minimal funding yet care remains necessary for durable viral suppression and overall quality of life for individuals. Technical assistance staff of one implementing partner representing seven African countries met to clarify domains of palliative care compared with the substituted term "care and support" to understand potential gaps in on-going HIV care. They prioritized care needs as: 1) mental health (depression and other mood disorders); 2) communication skills (age-appropriate disclosure of HIV status); 3) support of care-providers (stress management for sustainability of a skilled HIV workforce); 4) Tied Priorities: symptom management in opportunistic infections; end-of-life care; spiritual history-taking; and 5) Tied Priorities: attention to grief-related needs of patients, their families and staff; and management of HIV co-morbidities. This process can inform health policy as funding transitions to new priorities.

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

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

2014-01-01

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

Loss and grief process and Occupational Therapy assistance in scalping situations

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Andreza Mourão Lopes

2013-08-01

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

Impact of health research capacity strengthening in low- and middle-income countries: the case of WHO/TDR programmes.

Science.gov (United States)

Minja, Happiness; Nsanzabana, Christian; Maure, Christine; Hoffmann, Axel; Rumisha, Susan; Ogundahunsi, Olumide; Zicker, Fabio; Tanner, Marcel; Launois, Pascal

2011-10-01

Measuring the impact of capacity strengthening support is a priority for the international development community. Several frameworks exist for monitoring and evaluating funding results and modalities. Based on its long history of support, we report on the impact of individual and institutional capacity strengthening programmes conducted by the UNICEF/UNDP/World Bank/WHO Special Programme for Research and Training in Tropical Diseases (TDR) and on the factors that influenced the outcome of its Research Capacity Strengthening (RCS) activities. A mix of qualitative and quantitative methods (questionnaires and in-depth interviews) was applied to a selected group of 128 individual and 20 institutional capacity development grant recipients that completed their training/projects between 2000 and 2008. A semi-structured interview was also conducted on site with scientists from four institutions. Most of the grantees, both individual and institutional, reported beneficial results from the grant. However, glaring inequities stemming from gender imbalances and a language bias towards English were identified. The study showed that skills improvement through training contributed to better formulation of research proposals, but not necessarily to improved project implementation or communication of results. Appreciation of the institutional grants' impact varied among recipient countries. The least developed countries saw the programmes as essential for supporting basic infrastructure and activities. Advanced developing countries perceived the research grants as complementary to available resources, and particularly suitable for junior researchers who were not yet able to compete for major international grants. The study highlights the need for a more equitable process to improve the effectiveness of health research capacity strengthening activities. Support should be tailored to the existing research capacity in disease endemic countries and should focus on strengthening

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

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

2017-01-01

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

Oxide dispersion strengthened ferritic steels: a basic research joint program in France

Science.gov (United States)

Boutard, J.-L.; Badjeck, V.; Barguet, L.; Barouh, C.; Bhattacharya, A.; Colignon, Y.; Hatzoglou, C.; Loyer-Prost, M.; Rouffié, A. L.; Sallez, N.; Salmon-Legagneur, H.; Schuler, T.

2014-12-01

AREVA, CEA, CNRS, EDF and Mécachrome are funding a joint program of basic research on Oxide Dispersion Strengthened Steels (ODISSEE), in support to the development of oxide dispersion strengthened 9-14% Cr ferritic-martensitic steels for the fuel element cladding of future Sodium-cooled fast neutron reactors. The selected objectives and the results obtained so far will be presented concerning (i) physical-chemical characterisation of the nano-clusters as a function of ball-milling process, metallurgical conditions and irradiation, (ii) meso-scale understanding of failure mechanisms under dynamic loading and creep, and, (iii) kinetic modelling of nano-clusters nucleation and α/α‧ unmixing.

Oxide dispersion strengthened ferritic steels: a basic research joint program in France

Energy Technology Data Exchange (ETDEWEB)

Boutard, J.-L., E-mail: jean-louis.boutard@cea.fr [Cabinet du Haut-Commissaire, CEA/Saclay, 91191 Gif sur Yvette Cedex (France); Badjeck, V. [LPS, UMR CNRS 8502, Building 510, Université Paris-Sud 11, 91405 Orsay Cedex (France); Barguet, L. [LAUM, UMR CNRS 6613, Building IAM – UFR Sciences, Avenue O. Messiaen, 72085 Le Mans Cedex 9 (France); Barouh, C. [DMN/SRMP, CEA/Saclay, Building 520, 91191 Gif sur Yvette Cedex (France); Bhattacharya, A. [DMN/SRMP, CEA/Saclay, Building 520, 91191 Gif sur Yvette Cedex (France); CSNSM, UMR CNRS 8609, Université Paris-Sud 11, Buildings 104 and 108, 91405 Orsay Campus (France); Colignon, Y. [IM2NP, UMR CNRS 7334, Case 142, Faculté des Sciences, Campus de Saint Jérôme, Aix Marseille Université, 13397 Marseille Cedex 20 (France); Hatzoglou, C. [GPM, UMR CNRS 6634, Technopôle du Madrillet, Avenue de l’Université, BP12, 76801 Saint Etienne du Rouvray Cedex (France); Loyer-Prost, M. [DMN/SRMP, CEA/Saclay, Building 520, 91191 Gif sur Yvette Cedex (France); Rouffié, A.L. [DMN/SRMA, CEA/Saclay, Building 455, 91191 Gif sur Yvette Cedex (France); Sallez, N. [SIMAP, UMR CNRS 5266, INPG, Domaine Universitaire, 1130 rue de la Piscine, BP75, 38402 Saint Martin d’Hères Cedex (France); Salmon-Legagneur, H. [DMN/SRMA, CEA/Saclay, Building 455, 91191 Gif sur Yvette Cedex (France); Schuler, T. [DMN/SRMP, CEA/Saclay, Building 520, 91191 Gif sur Yvette Cedex (France)

2014-12-15

AREVA, CEA, CNRS, EDF and Mécachrome are funding a joint program of basic research on Oxide Dispersion Strengthened Steels (ODISSEE), in support to the development of oxide dispersion strengthened 9–14% Cr ferritic–martensitic steels for the fuel element cladding of future Sodium-cooled fast neutron reactors. The selected objectives and the results obtained so far will be presented concerning (i) physical–chemical characterisation of the nano-clusters as a function of ball-milling process, metallurgical conditions and irradiation, (ii) meso-scale understanding of failure mechanisms under dynamic loading and creep, and, (iii) kinetic modelling of nano-clusters nucleation and α/α′ unmixing.

Oxide dispersion strengthened ferritic steels: a basic research joint program in France

International Nuclear Information System (INIS)

Boutard, J.-L.; Badjeck, V.; Barguet, L.; Barouh, C.; Bhattacharya, A.; Colignon, Y.; Hatzoglou, C.; Loyer-Prost, M.; Rouffié, A.L.; Sallez, N.; Salmon-Legagneur, H.; Schuler, T.

2014-01-01

AREVA, CEA, CNRS, EDF and Mécachrome are funding a joint program of basic research on Oxide Dispersion Strengthened Steels (ODISSEE), in support to the development of oxide dispersion strengthened 9–14% Cr ferritic–martensitic steels for the fuel element cladding of future Sodium-cooled fast neutron reactors. The selected objectives and the results obtained so far will be presented concerning (i) physical–chemical characterisation of the nano-clusters as a function of ball-milling process, metallurgical conditions and irradiation, (ii) meso-scale understanding of failure mechanisms under dynamic loading and creep, and, (iii) kinetic modelling of nano-clusters nucleation and α/α′ unmixing

A mechanical model for FRP-strengthened beams in bending

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P. S. Valvo

2012-10-01

Full Text Available We analyse the problem of a simply supported beam, strengthened with a fibre-reinforced polymer (FRP strip bonded to its intrados and subjected to bending couples applied to its end sections. A mechanical model is proposed, whereby the beam and FRP strip are modelled according to classical beam theory, while the adhesive and its neighbouring layers are modelled as an interface having a piecewise linear constitutive law defined over three intervals (elastic response – softening response – debonding. The model is described by a set of differential equations with appropriate boundary conditions. An analytical solution to the problem is determined, including explicit expressions for the internal forces, displacements and interfacial stresses. The model predicts an overall non-linear mechanical response for the strengthened beam, ranging over several stages: from linearly elastic behaviour to damage, until the complete detachment of the FRP reinforcement.

Strengthening health workforce capacity through work-based training

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Matovu Joseph KB

2013-01-01

Full Text Available Abstract Background Although much attention has been given to increasing the number of health workers, less focus has been directed at developing models of training that address real-life workplace needs. Makerere University School of Public Health (MakSPH with funding support from the Centers for Disease Control and Prevention (CDC developed an eight-month modular, in-service work-based training program aimed at strengthening the capacity for monitoring and evaluation (M&E and continuous quality improvement (CQI in health service delivery. Methods This capacity building program, initiated in 2008, is offered to in-service health professionals working in Uganda. The purpose of the training is to strengthen the capacity to provide quality health services through hands-on training that allows for skills building with minimum work disruptions while encouraging greater involvement of other institutional staff to enhance continuity and sustainability. The hands-on training uses practical gaps and challenges at the workplace through a highly participatory process. Trainees work with other staff to design and implement ‘projects’ meant to address work-related priority problems, working closely with mentors. Trainees’ knowledge and skills are enhanced through short courses offered at specific intervals throughout the course. Results Overall, 143 trainees were admitted between 2008 and 2011. Of these, 120 (84% from 66 institutions completed the training successfully. Of the trainees, 37% were Social Scientists, 34% were Medical/Nursing/Clinical Officers, 5.8% were Statisticians, while 23% belonged to other professions. Majority of the trainees (80% were employed by Non-Government Organizations while 20% worked with the public health sector. Trainees implemented 66 projects which addressed issues such as improving access to health care services; reducing waiting time for patients; strengthening M&E systems; and improving data collection and

Supporting youth grieving the dying or death of a sibling or parent: considerations for parents, professionals, and communities.

Science.gov (United States)

Warnick, Andrea L

2015-03-01

The aim of this article is to highlight considerations for parents, professionals, and communities regarding supporting children and adolescents who are grieving the dying or death of a parent or sibling. Current research is directly engaging the voices of youth who have experienced a parent or sibling's death. Although there continues to be much evidence about the distressing effect of such deaths on children and adolescents, there is a welcome emerging tendency to distinguish between adaptive and maladaptive grief. Although the literature strongly encourages parents to take an open and honest approach to supporting youth prior to a death, many barriers remain to them doing so. The literature identifies healthcare providers as being ideally positioned to provide guidance to families around best practice in the area of preparing youth for the death of a parent or sibling. Following a death, there is now encouraging evidence regarding the efficacy of certain interventions for bereaved youth, both in the short and long term, which is an important development in the field. Youth benefit from being involved in open and honest conversations about a family member's cancer diagnosis, treatment, prognosis, and end-of-life care. Although advances are being made with regard to understanding the grief experience of youth, there remains a wide gap between the current theoretical knowledge and the availability of practical well informed support for grieving youth.

Strengthening the Canadian alcohol advertising regulatory system.

Science.gov (United States)

Heung, Carly M; Rempel, Benjamin; Krank, Marvin

2012-05-24

Research evidence points to harmful effects from alcohol advertising among children and youth. In particular, exposure to alcohol advertising has been associated with adolescents drinking both earlier and heavier. Although current federal and provincial guidelines have addressed advertising practices to prevent underage drinking, practice has not been supported by existing policy. While protective measures such as social marketing campaigns have the potential for counteracting the effects from alcohol advertising, the effectiveness of such measures can be easily drowned out with increasing advertising activities from the alcohol industry, especially without effective regulation. Research reviewed by the European Focus on Alcohol Safe Environment (FASE) Project has identified a set of key elements that are necessary to make alcohol advertising policy measures effective at protecting children and youth from the harmful effects of alcohol marketing. Using these key elements as an evaluation framework, there are critical components in the Canadian alcohol advertising regulatory system that clearly require strengthening. To protect impressionable children and youth against the harmful effects of alcohol advertising, 13 recommendations to strengthen current alcohol advertising regulations in Canada are provided for Canadian policy-makers, advertising standard agencies, and public health groups.

Foot muscles strengthener

Directory of Open Access Journals (Sweden)

Boris T. Glavač

2012-04-01

Full Text Available Previous experience in the correction of flat feet consisted of the use of insoles for shoes and exercises with toys, balls, rollers, inclined planes, etc. A device for strengthening foot muscles is designed for the correction of flat feet in children and, as its name suggests, for strengthening foot muscles in adults. The device is made of wood and metal, with a mechanism and technical solutions, enabling the implementation of specific exercises to activate muscles responsible for the formation of the foot arch. It is suitable for home use with controlled load quantities since it has calibrated springs. The device is patented with the Intellectual Property Office, Republic of Serbia, as a petty patent.

Flexural Strength Of Prestressed Concrete Beams With Openings And Strengthened With CFRP Sheets

Directory of Open Access Journals (Sweden)

Dr. Mustafa B. Dawood

2015-06-01

Full Text Available Abstract This paper presents an experimental investigation of flexural strength of pretensioned prestressed concrete beams with openings and strengthened with CFRP sheets tested as simply supported span subjected under two-point loading. The experimental work includes testing of nine prestressed concrete beams specimens with dimensions effective length 1800mm depth 300mm width 130mm two of which were without openings as a control beams one without and the other with strengthening by CFRP three were with openings and the remaining four with openings and strengthened with CFRP sheets. The opening was made at square shape 100100 mm in flexure zone at mid span of beam. Several design parameters were varied such as opening width opening depth and strengthening of openings of beams by CFRP sheets at compression and tension zone. Experimental results showed that the presence of square opening with ratio hH 0.333 and rectangular opening with ratio hH from 0.333-0.5 at mid span of beams decreased the ultimate load about 5.5 and 5.5-33.1 respectively when compared with beam without openings control beam. The externally strengthened prestressed concrete beams with bonded CFRP sheets showed a significant increase at the ultimate load this increase was about 10.9-28.8 for flexure beams when compared with the unstrengthened beams. Moreover the load-deflection curves for flexure beams strengthened with CFRP sheets were stiffer than the unstrengthened beams. Therefore this results gave a good indication about using CFRP sheets in improvement of deflection.

Strengthening rural Latinos' civic engagement for health: The Voceros de Salud project.

Science.gov (United States)

López-Cevallos, Daniel; Dierwechter, Tatiana; Volkmann, Kelly; Patton-López, Megan

2013-11-01

This article describes the Latino Health Ambassadors Network (Voceros de Salud ) project created to support and mobilize Latino community leaders to address health inequalities in a rural Oregon county. Voceros de Salud is discussed as a model that other rural communities may implement towards strengthening Latino civic engagement for health.

Oxide dispersion-strengthened ferritic alloys

International Nuclear Information System (INIS)

Asbroeck, P. van.

1976-10-01

The publication gives the available data on the DTO2 dispersion-strengthened ferritic alloy developed at C.E.N./S.C.K. Mol, Belgium. DTO2 is a Fe-Cr-Mo ferritic alloy, strengthened by addition of titanium oxide and of titanium leading to the formation of Chi phase. It was developed for use as canning material for fast breeder reactors. (author)

275---11 Dec 2009 [Final version].indd

African Journals Online (AJOL)

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.

Social workers' experiences as the family support person during cardiopulmonary resuscitation attempts.

Science.gov (United States)

Firn, Janice; DeVries, Keli; Morano, Dawnielle; Spano-English, Toni

2017-07-01

During inhospital cardiopulmonary resuscitation attempts, a designated family support person (FSP) may provide guidance and support to family members. Research on nurses and chaplains in this role has been published. Social workers also regularly fulfill this service, however, little is known about how they perceive and enact this role. To explore their experiences, qualitative interviews (n = 10) were conducted with FSP social workers. Critical realist thematic analysis identified five themes: walking in cold, promoting family presence, responding to the whole spectrum of grief, going beyond the family support role, and repercussions of bearing witness. Social workers perform a variety of tasks to promote family presence during resuscitation attempts and provide psychosocial support over the continuum of care. The FSP role impacts social workers emotionally and professionally. Implications for hospital policy, staffing, and clinical practice are discussed.

“Death Is Part of the Job” in Long-Term Care Homes

Directory of Open Access Journals (Sweden)

Jill Marcella

2015-03-01

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.

Seriously Implementing Health Capacity Strengthening Programs in Africa; Comment on “Implementation of a Health Management Mentoring Program: Year-1 Evaluation of Its Impact on Health System Strengthening in Zambézia Province, Mozambique”

Directory of Open Access Journals (Sweden)

Luis Velez Lapão

2015-10-01

Full Text Available Faced with the challenges of healthcare reform, skills and new capabilities are needed to support the reform and it is of crucial importance in Africa where shortages affects the health system resilience. Edwards et al provides a good example of the challenge of implementing a mentoring program in one province in a sub-Saharan country. From this example, various aspects of strengthening the capacity of managers in healthcare are examined based on our experience in action-training in Africa, as mentoring shares many characteristics with action-training. What practical lessons can be drawn to promote the strengthening so that managers can better intervene in complex contexts? Deeper involvement of health authorities and more rigorous approaches are seriously desirable for the proper development of health capacity strengthening programs in Africa.

[Strengthening primary health care: a strategy to maximize coordination of care].

Science.gov (United States)

de Almeida, Patty Fidelis; Fausto, Márcia Cristina Rodrigues; Giovanella, Lígia

2011-02-01

To describe and analyze the actions developed in four large cities to strengthen the family health strategy (FHS) in Brazil. Case studies were carried out in Aracaju, Belo Horizonte, Florianópolis, and Vitória based on semi-structured interviews with health care managers. In addition, a cross-sectional study was conducted with questionnaires administered to a sample of FHS workers and services users. Actions needed to strengthen primary health care services were identified in all four cities. These include increasing the number of services offered at the primary health care level, removing barriers to access, restructuring primary services as the entry point to the health care system, enhancing problem-solving capacity (diagnostic and therapeutic support and networking between health units to organize the work process, training, and supervision), as well as improving articulation between surveillance and care actions. The cities studied have gained solid experience in the reorganization of the health care model based on a strengthening of health primary care and of the capacity to undertake the role of health care coordinator. However, to make the primary care level the customary entry point and first choice for users, additional actions are required to balance supplier-induced and consumer-driven demands. Consumer driven demand is the biggest challenge for the organization of teamwork processes. Support for and recognition of FHS as a basis for primary health care is still an issue. Initiatives to make FHS better known to the population, health care professionals at all levels, and civil society organizations are still needed.

Carbon fiber epoxy composites for both strengthening and health monitoring of structures.

Science.gov (United States)

Salvado, Rita; Lopes, Catarina; Szojda, Leszek; Araújo, Pedro; Gorski, Marcin; Velez, Fernando José; Castro-Gomes, João; Krzywon, Rafal

2015-05-06

This paper presents a study of the electrical and mechanical behavior of several continuous carbon fibers epoxy composites for both strengthening and monitoring of structures. In these composites, the arrangement of fibers was deliberately diversified to test and understand the ability of the composites for self-sensing low strains. Composites with different arrangements of fibers and textile weaves, mainly unidirectional continuous carbon reinforced composites, were tested at the dynamometer. A two-probe method was considered to measure the relative electrical resistance of these composites during loading. The measured relative electrical resistance includes volume and contact electrical resistances. For all tested specimens, it increases with an increase in tensile strain, at low strain values. This is explained by the improved alignment of fibers and resulting reduction of the number of possible contacts between fibers during loading, increasing as a consequence the contact electrical resistance of the composite. Laboratory tests on strengthening of structural elements were also performed, making hand-made composites by the "wet process", which is commonly used in civil engineering for the strengthening of all types of structures in-situ. Results show that the woven epoxy composite, used for strengthening of concrete elements is also able to sense low deformations, below 1%. Moreover, results clearly show that this textile sensor also improves the mechanical work of the strengthened structural elements, increasing their bearing capacity. Finally, the set of obtained results supports the concept of a textile fabric capable of both structural upgrade and self-monitoring of structures, especially large structures of difficult access and needing constant, sometimes very expensive, health monitoring.

Effective educator-student relationships in nursing education to strengthen nursing students' resilience.

Science.gov (United States)

Froneman, Kathleen; Du Plessis, Emmerentia; Koen, Magdelene P

2016-06-10

Little research has been conducted in private nursing schools with regard to the educator-student relationship to strengthen the resilience of nursing students and to improve the educator-student relationship. An effective educator-student relationship is a key factor to ensure a positive learning climate where learning can take place and resilience can be strengthened. The purpose was to explore and describe nursing students' view on the basic elements required for an effective educator-student relationship to strengthen their resilience and the educator-student relationship. This study followed an explorative, descriptive and contextual qualitative design in a private nursing education institution in the North West Province. Purposive sampling was used. The sample consisted of 40 enrolled nursing auxiliary students. The World Café Method was used to collect data, which were analysed by means of content analysis. The following five main themes were identified and included: (1) teaching-learning environment, (2) educator-student interaction, (3) educator qualities, (4) staying resilient and (5) strategies to strengthen resilience. Students need a caring and supportive environment; interaction that is constructive, acknowledges human rights and makes use of appropriate non-verbal communication. The educator must display qualities such as love and care, respect, responsibility, morality, patience, being open to new ideas, motivation, willingness to 'go the extra mile' and punctuality. Students reported on various ways how they manage to stay resilient. It thus seems that basic elements required in an effective educator-student relationship to strengthen the resilience of students include the environment, interaction, educator and student's qualities and resilience.

Impact of health research capacity strengthening in low- and middle-income countries: the case of WHO/TDR programmes.

Directory of Open Access Journals (Sweden)

Happiness Minja

2011-10-01

Full Text Available BACKGROUND: Measuring the impact of capacity strengthening support is a priority for the international development community. Several frameworks exist for monitoring and evaluating funding results and modalities. Based on its long history of support, we report on the impact of individual and institutional capacity strengthening programmes conducted by the UNICEF/UNDP/World Bank/WHO Special Programme for Research and Training in Tropical Diseases (TDR and on the factors that influenced the outcome of its Research Capacity Strengthening (RCS activities. METHODOLOGY AND PRINCIPAL FINDINGS: A mix of qualitative and quantitative methods (questionnaires and in-depth interviews was applied to a selected group of 128 individual and 20 institutional capacity development grant recipients that completed their training/projects between 2000 and 2008. A semi-structured interview was also conducted on site with scientists from four institutions. Most of the grantees, both individual and institutional, reported beneficial results from the grant. However, glaring inequities stemming from gender imbalances and a language bias towards English were identified. The study showed that skills improvement through training contributed to better formulation of research proposals, but not necessarily to improved project implementation or communication of results. Appreciation of the institutional grants' impact varied among recipient countries. The least developed countries saw the programmes as essential for supporting basic infrastructure and activities. Advanced developing countries perceived the research grants as complementary to available resources, and particularly suitable for junior researchers who were not yet able to compete for major international grants. CONCLUSION: The study highlights the need for a more equitable process to improve the effectiveness of health research capacity strengthening activities. Support should be tailored to the existing research

Antenatal Care Strengthening in Jimma, Ethiopia: A Mixed-Method Needs Assessment

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Sarah Fredsted Villadsen

2014-01-01

Full Text Available Objective. We assessed how health system priorities matched user expectations and what the needs for antenatal care (ANC strengthening were for improved maternal health in Jimma, Ethiopia. Methods. A questionnaire survey among all recent mothers in the study area was conducted to study the content of ANC and to identify the predictors of low ANC satisfaction. Further, a qualitative approach was applied to understand perceptions, practices, and policies of ANC. Results. There were no national guidelines for ANC in Ethiopia. Within the health system, the teaching of health professional students was given high priority, and that contributed to a lack of continuity and privacy. To the women, poor user-provider interaction was a serious concern hindering the trust in the health care providers. Further, the care provision was compromised by the inadequate laboratory facilities, unstructured health education, and lack of training of health professionals. Conclusions. Health system trials are needed to study the feasibility of ANC strengthening in the study area. Nationally and internationally, the leadership needs to be strengthened with supportive supervision geared towards building trust and mutual respect to protect maternal and infant health.

Strengthening family coping resources: the feasibility of a multifamily group intervention for families exposed to trauma.

Science.gov (United States)

Kiser, Laurel J; Donohue, April; Hodgkinson, Stacy; Medoff, Deborah; Black, Maureen M

2010-12-01

Families exposed to urban poverty face a disproportionate risk of exposure to repeated trauma. Repeated exposures can lead to severe and chronic reactions in multiple family members with effects that ripple throughout the family system. Interventions for distressed families residing in traumatic contexts, such as low-income, urban settings are desperately needed. This report presents preliminary data in support of Strengthening Family Coping Resources, a trauma-focused, multifamily, skill-building intervention. Strengthening Family Coping Resources is designed for families living in traumatic contexts with the goal of reducing symptoms of posttraumatic stress disorder and other trauma-related disorders in children and caregivers. Results from open trials suggest Strengthening Family Coping Resources is a feasible intervention with positive effects on children's symptoms of trauma-related distress.

Strengthening Low-Income Families: A Research Agenda for Parenting, Relationship, and Fatherhood Programs

Science.gov (United States)

MDRC, 2013

2013-01-01

Policymakers need to decide how to invest in strengthening the most basic foundation for early childhood development: family relationships. The challenges: (1) help parents provide the responsive and stimulating environments that will prepare young children for school; and (2) support fathers' engagement with their children regardless of whether…

Strengthening CRTD-A's Organizational and Program Capacity ...

International Development Research Centre (IDRC) Digital Library (Canada)

Strengthening CRTD-A's Organizational and Program Capacity (Lebanon) ... Women's Rights and Citizenship framework; to strengthen and rationalize its institutional ... IDRC “unpacks women's empowerment” at McGill University Conference.

Outcomes following Hip and Quadriceps Strengthening Exercises for Patellofemoral Syndrome: A Systematic Review and Meta-Analysis

Directory of Open Access Journals (Sweden)

Adebisi Bisi-Balogun

2015-10-01

Full Text Available There is growing evidence to support change in the rehabilitation strategy of patellofemoral pain syndrome (PFPS from traditional quadriceps strengthening exercises to inclusion of hip musculature strengthening in individuals with PFPS. Several studies have evaluated effects of quadriceps and hip musculature strengthening on PFPS with varying outcomes on pain and function. This systematic review and meta-analysis aims to synthesize outcomes of pain and function post-intervention and at follow-up to determine whether outcomes vary depending on the exercise strategy in both the short and long term. Electronic databases including MEDLINE, EMBASE, CINAHL, Web of Science, PubMed, Pedro database, Proquest, Science direct, and EBscoHost databases were searched for randomized control trials published between 1st of January 2005 and 31st of June 2015, comparing the outcomes of pain and function following quadriceps strengthening and hip musculature strengthening exercises in patients with PFPS. Two independent reviewers assessed each paper for inclusion and quality. Means and SDs were extracted from each included study to allow effect size calculations and comparison of results. Six randomized control trials met the inclusion criteria. Limited to moderate evidence indicates that hip abductor strengthening was associated with significantly lower pain post-intervention (SMD −0.88, −1.28 to −0.47 95% CI, and at 12 months (SMD −3.10, −3.71 to −2.50 95% CI with large effect sizes (greater than 0.80 compared to quadriceps strengthening. Our findings suggest that incorporating hip musculature strengthening in management of PFPS tailored to individual ability will improve short-term and long-term outcomes of rehabilitation. Further research evaluating the effects of quadriceps and hip abductors strengthening focusing on reduction in anterior knee pain and improvement in function in management of PFPS is needed.

Evaluation of regional project to strengthen national health research systems in four countries in West Africa: lessons learned.

Science.gov (United States)

Sombié, Issiaka; Aidam, Jude; Montorzi, Gabriela

2017-07-12

Since the Commission on Health Research for Development (COHRED) published its flagship report, more attention has been focused on strengthening national health research systems (NHRS). This paper evaluates the contribution of a regional project that used a participatory approach to strengthen NHRS in four post-conflict West African countries - Guinea-Bissau, Liberia, Sierra Leone and Mali. The data from the situation analysis conducted at the start of the project was compared to data from the project's final evaluation, using a hybrid conceptual framework built around four key areas identified through the analysis of existing frameworks. The four areas are governance and management, capacities, funding, and dissemination/use of research findings. The project helped improve the countries' governance and management mechanisms without strengthening the entire NHRS. In the four countries, at least one policy, plan or research agenda was developed. One country put in place a national health research ethics committee, while all four countries could adopt a research information management system. The participatory approach and support from the West African Health Organisation and COHRED were all determining factors. The lessons learned from this project show that the fragile context of these countries requires long-term engagement and that support from a regional institution is needed to address existing challenges and successfully strengthen the entire NHRS.

Strengthening of RC bridge slabs using CFRP sheets

Directory of Open Access Journals (Sweden)

Fahmy A. Fathelbab

2014-12-01

Full Text Available Many old structures became structurally insufficient to carry the new loading conditions requirements. Moreover, they suffer from structural degradation, reinforcement steel bars corrosion, bad weather conditions…etc. Many official authorities in several countries had recognized many old bridges and buildings as structurally deficient by today’s standards. Due to these reasons, structural strengthening became an essential requirement and different strengthening techniques appeared in market. Fiber Reinforced Polymer (FRP strengthening techniques established a good position among all other techniques, giving excellent structural results, low time required and moderate cost compared with the other techniques. The main purpose of this research is to study analytically the strengthening of a reinforced concrete bridge slabs due to excessive loads, using externally bonded FRP sheets technique. A commercial finite element program ANSYS was used to perform a structural linear and non-linear analysis for strengthened slab models using several schemes of FRP sheets. A parametric study was performed to evaluate analytically the effect of changing both FRP stiffness and FRP schemes in strengthening RC slabs. Comparing the results with control slab (reinforced concrete slab without strengthening it is obvious that attaching FRP sheets to the RC slab increases its capacity and enhances the ductility/toughness.

Carbon Fiber Epoxy Composites for Both Strengthening and Health Monitoring of Structures

Directory of Open Access Journals (Sweden)

Rita Salvado

2015-05-01

Full Text Available This paper presents a study of the electrical and mechanical behavior of several continuous carbon fibers epoxy composites for both strengthening and monitoring of structures. In these composites, the arrangement of fibers was deliberately diversified to test and understand the ability of the composites for self-sensing low strains. Composites with different arrangements of fibers and textile weaves, mainly unidirectional continuous carbon reinforced composites, were tested at the dynamometer. A two-probe method was considered to measure the relative electrical resistance of these composites during loading. The measured relative electrical resistance includes volume and contact electrical resistances. For all tested specimens, it increases with an increase in tensile strain, at low strain values. This is explained by the improved alignment of fibers and resulting reduction of the number of possible contacts between fibers during loading, increasing as a consequence the contact electrical resistance of the composite. Laboratory tests on strengthening of structural elements were also performed, making hand-made composites by the “wet process”, which is commonly used in civil engineering for the strengthening of all types of structures in-situ. Results show that the woven epoxy composite, used for strengthening of concrete elements is also able to sense low deformations, below 1%. Moreover, results clearly show that this textile sensor also improves the mechanical work of the strengthened structural elements, increasing their bearing capacity. Finally, the set of obtained results supports the concept of a textile fabric capable of both structural upgrade and self-monitoring of structures, especially large structures of difficult access and needing constant, sometimes very expensive, health monitoring.

Strengthening malaria service delivery through supportive supervision and community mobilization in an endemic Indian setting: an evaluation of nested delivery models.

Science.gov (United States)

Das, Ashis; Friedman, Jed; Kandpal, Eeshani; Ramana, Gandham N V; Gupta, Rudra Kumar Das; Pradhan, Madan M; Govindaraj, Ramesh

2014-12-08

Malaria continues to be a prominent global public health challenge. This study tested the effectiveness of two service delivery models for reducing the malaria burden, e.g. supportive supervision of community health workers (CHW) and community mobilization in promoting appropriate health-seeking behaviour for febrile illnesses in Odisha, India. The study population comprised 120 villages from two purposively chosen malaria-endemic districts, with 40 villages randomly assigned to each of the two treatment arms, one with both supportive supervision and community mobilization and one with community mobilization alone, as well as an observational control arm. Outcome measures included changes in the utilization of bed nets and timely care-seeking for fever from a trained provider compared to the control group. Analysis was by intention-to-treat. Significant improvements were observed in the reported utilization of bed nets in both intervention arms (84.5% in arm A and 82.4% in arm B versus 78.6% in the control arm; p skilled provider within 24 hours than fever cases from the control arm (50.1%). In particular, women from the combined interventions arm were more likely to have received timely treatment from a skilled provider (61.6% vs. 47.2%; p = 0.028). A community-based intervention combining the supportive supervision of community health workers with intensive community mobilization and can be effective in improving care-seeking and preventive behaviour and may be used to strengthen the national malaria control programme.

Exploring Organizational Barriers to Strengthening Clinical Supervision of Psychiatric Nursing Staff

DEFF Research Database (Denmark)

Gonge, Henrik; Buus, Niels

2016-01-01

This article reports findings from a longitudinal controlled intervention study of 115 psychiatric nursing staff. The twofold objective of the study was: (a) To test whether the intervention could increase clinical supervision participation and effectiveness of existing supervision practices, and...... in the experienced effectiveness of supervision. It is concluded that organizational support is an imperative for implementation of clinical supervision......., and (b) To explore organizational constraints to implementation of these strengthened practices. Questionnaire responses and registration of participation in clinical supervision were registered prior and subsequent to the intervention consisting of an action learning oriented reflection on staff......'s existing clinical supervision practices. Major organizational changes in the intervention group during the study period obstructed the implementation of strengthened clinical supervision practices, but offered an opportunity for studying the influences of organizational constraints. The main findings were...

Mutual research capacity strengthening: a qualitative study of two-way partnerships in public health research

Directory of Open Access Journals (Sweden)

Redman-MacLaren Michelle

2012-12-01

Full Text Available Abstract Introduction Capacity building has been employed in international health and development sectors to describe the process of ‘experts’ from more resourced countries training people in less resourced countries. Hence the concept has an implicit power imbalance based on ‘expert’ knowledge. In 2011, a health research strengthening workshop was undertaken at Atoifi Adventist Hospital, Solomon Islands to further strengthen research skills of the Hospital and College of Nursing staff and East Kwaio community leaders through partnering in practical research projects. The workshop was based on participatory research frameworks underpinned by decolonising methodologies, which sought to challenge historical power imbalances and inequities. Our research question was, “Is research capacity strengthening a two-way process?” Methods In this qualitative study, five Solomon Islanders and five Australians each responded to four open-ended questions about their experience of the research capacity strengthening workshop and activities: five chose face to face interview, five chose to provide written responses. Written responses and interview transcripts were inductively analysed in NVivo 9. Results Six major themes emerged. These were: Respectful relationships; Increased knowledge and experience with research process; Participation at all stages in the research process; Contribution to public health action; Support and sustain research opportunities; and Managing challenges of capacity strengthening. All researchers identified benefits for themselves, their institution and/or community, regardless of their role or country of origin, indicating that the capacity strengthening had been a two-way process. Conclusions The flexible and responsive process we used to strengthen research capacity was identified as mutually beneficial. Using community-based participatory frameworks underpinned by decolonising methodologies is assisting to redress

Internet support groups for suicide survivors: a new mode for gaining bereavement assistance.

Science.gov (United States)

Feigelman, William; Gorman, Bernard S; Beal, Karyl Chastain; Jordan, John R

2008-01-01

Taken among parents who sustained the loss of a child to suicide this study explores the participation of parents in Internet support groups, comparing their demographic and loss-related characteristics (N = 104) to other parent survivors participating in face-to-face support groups (N = 297). Contrary to expectations that Internet affiliates would be concentrated in under-served rural areas, we found similar levels of urban, suburban, small city and rural residents in both Internet and face-to-face subsamples. Bivariate and multivariate analyses suggested several important factors contributing to interest in Internet grief support including: 24/7 availability and opportunities to invest more time into this type of support group experience. Compared to their face-to-face group counterparts, Internet affiliates experienced greater suicide stigmatization from their families and other associates. Unable to find ready comfort and support from their personal communities, Internet users-and especially highly depressed survivors-sought and obtained valuable help from the Internet support resource.

An approach to health system strengthening in the Democratic Peoples Republic of Korea (North Korea).

Science.gov (United States)

Grundy, John; Moodie, Rob

2009-01-01

The Democratic Peoples Republic of Korea (DPRK), under the leadership of the Ministry of Public Health (MOPH), undertook the development of a Health System Strengthening (HSS) proposal through the support of the Global Alliance for Vaccines and Immunization (GAVI). The aim of this paper is to outline the approach to the development of the HSS strategy in DPRK, and describe opportunities and challenges associated with its development and future implementation. Sources of information for this review have included national programme plans, in country social sector reviews, information generated through HSS proposal developments and the international literature. Updated assessments in DPRK indicate some recent improvements in the health situation for women and children, but there remain ongoing concerns regarding health management, human resource and physical infrastructure barriers to health services access. In response to this situation, the DPRK developed a health system strengthening strategy, the main elements of which are the strengthening of health management and service delivery systems at the implementing agency levels of county (district) and Ri (sub district). Three success factors were associated with the reaching of consensus on HSS strategy in DPRK. These were partnerships formed between system planners and programme planners, the identification of an overall health sector strategic framework, and high-level leadership of the MOPH. Although DPRK is in the very early stages of health system reconstruction, there are significant and new opportunities to alleviate the health conditions of women and children in DPRK, through implementation of health system strengthening strategies that are nationally coordinated and internationally supported.

Numerical Investigation of Masonry Strengthened with Composites

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Giancarlo Ramaglia

2018-03-01

Full Text Available In this work, two main fiber strengthening systems typically applied in masonry structures have been investigated: composites made of basalt and hemp fibers, coupled with inorganic matrix. Starting from the experimental results on composites, the out-of-plane behavior of the strengthened masonry was assessed according to several numerical analyses. In a first step, the ultimate behavior was assessed in terms of P (axial load-M (bending moment domain (i.e., failure surface, changing several mechanical parameters. In order to assess the ductility capacity of the strengthened masonry elements, the P-M domain was estimated starting from the bending moment-curvature diagrams. Key information about the impact of several mechanical parameters on both the capacity and the ductility was considered. Furthermore, the numerical analyses allow the assessment of the efficiency of the strengthening system, changing the main mechanical properties. Basalt fibers had lower efficiency when applied to weak masonry. In this case, the elastic properties of the masonry did not influence the structural behavior under a no tension assumption for the masonry. Conversely, their impact became non-negligible, especially for higher values of the compressive strength of the masonry. The stress-strain curve used to model the composite impacted the flexural strength. Natural fibers provided similar outcomes, but a first difference regards the higher mechanical compatibility of the strengthening system with the substrate. In this case, the ultimate condition is due to the failure mode of the composite. The stress-strain curves used to model the strengthening system are crucial in the ductility estimation of the strengthened masonry. However, the behavior of the composite strongly influences the curvature ductility in the case of higher compressive strength for masonry. The numerical results discussed in this paper provide the base to develop normalized capacity models able to

Community gardens as sites of solace and end-of-life support: a literature review.

Science.gov (United States)

Marsh, Pauline; Spinaze, Anna

2016-05-01

In a pilot project, members of a community garden explored how they might provide better end-of-life support for their regional community. As part of the project, a literature review was undertaken to investigate the nexus between community gardens and end-of-life experiences (including grief and bereavement) in academic research. This article documents the findings of that review. The authors discovered there is little academic material that focuses specifically on community gardens and end-of-life experiences, but nonetheless the two subjects were seen to intersect. The authors found three points of commonality: both share a need and capacity for a) social/informal support, b) therapeutic space, and c) opportunities for solace.

Sleep On It: How Snoozing Strengthens Memories

Science.gov (United States)

... Special Issues Subscribe April 2013 Print this issue Sleep On It How Snoozing Strengthens Memories Send us ... the best way to remember it is to sleep on it. That’s because sleeping helps strengthen memories ...

Computationally efficient and quantitatively accurate multiscale simulation of solid-solution strengthening by ab initio calculation

Czech Academy of Sciences Publication Activity Database

Ma, D.; Friák, Martin; von Pezold, J.; Raabe, D.; Neugebauer, J.

2015-01-01

Roč. 85, FEB (2015), s. 53-66 ISSN 1359-6454 Institutional support: RVO:68081723 Keywords : Solid-solution strengthening * DFT * Peierls–Nabarro model * Ab initio * Al alloys Subject RIV: BM - Solid Matter Physics ; Magnetism Impact factor: 5.058, year: 2015

Strengthening of defected beam–column joints using CFRP

Directory of Open Access Journals (Sweden)

Mohamed H. Mahmoud

2014-01-01

Full Text Available This paper presents an experimental study for the structural performance of reinforced concrete (RC exterior beam–column joints rehabilitated using carbon-fiber-reinforced polymer (CFRP. The present experimental program consists of testing 10 half-scale specimens divided into three groups covering three possible defects in addition to an adequately detailed control specimen. The considered defects include the absence of the transverse reinforcement within the joint core, insufficient bond length for the beam main reinforcement and inadequate spliced implanted column on the joint. Three different strengthening schemes were used to rehabilitate the defected beam–column joints including externally bonded CFRP strips and sheets in addition to near surface mounted (NSM CFRP strips. The failure criteria including ultimate capacity, mode of failure, initial stiffness, ductility and the developed ultimate strain in the reinforcing steel and CFRP were considered and compared for each group for the control and the CFRP-strengthened specimens. The test results showed that the proposed CFRP strengthening configurations represented the best choice for strengthening the first two defects from the viewpoint of the studied failure criteria. On the other hand, the results of the third group showed that strengthening the joint using NSM strip technique enabled the specimen to outperform the structural performance of the control specimen while strengthening the joints using externally bonded CFRP strips and sheets failed to restore the strengthened joints capacity.

Strengthening of defected beam-column joints using CFRP.

Science.gov (United States)

Mahmoud, Mohamed H; Afefy, Hamdy M; Kassem, Nesreen M; Fawzy, Tarek M

2014-01-01

This paper presents an experimental study for the structural performance of reinforced concrete (RC) exterior beam-column joints rehabilitated using carbon-fiber-reinforced polymer (CFRP). The present experimental program consists of testing 10 half-scale specimens divided into three groups covering three possible defects in addition to an adequately detailed control specimen. The considered defects include the absence of the transverse reinforcement within the joint core, insufficient bond length for the beam main reinforcement and inadequate spliced implanted column on the joint. Three different strengthening schemes were used to rehabilitate the defected beam-column joints including externally bonded CFRP strips and sheets in addition to near surface mounted (NSM) CFRP strips. The failure criteria including ultimate capacity, mode of failure, initial stiffness, ductility and the developed ultimate strain in the reinforcing steel and CFRP were considered and compared for each group for the control and the CFRP-strengthened specimens. The test results showed that the proposed CFRP strengthening configurations represented the best choice for strengthening the first two defects from the viewpoint of the studied failure criteria. On the other hand, the results of the third group showed that strengthening the joint using NSM strip technique enabled the specimen to outperform the structural performance of the control specimen while strengthening the joints using externally bonded CFRP strips and sheets failed to restore the strengthened joints capacity.

Do existing research summaries on health systems match immunisation managers' needs in middle- and low-income countries? Analysis of GAVI health systems strengthening support

Directory of Open Access Journals (Sweden)

Kelly Marion

2011-06-01

Full Text Available Abstract Background The GAVI Alliance was created in 2000 to increase access to vaccines. More recently, GAVI has supported evidence-based health systems strengthening to overcome barriers to vaccination. Our objectives were: to explore countries' priorities for health systems strengthening; to describe published research summaries for each priority area in relation to their number, quality and relevance; and to describe the use of national data from surveys in identifying barriers to immunisation. Methods From 44 health systems strengthening proposals submitted to GAVI in 2007 and 2008, we analysed the topics identified, the coverage of these topics by existing systematic reviews and the use of nation-wide surveys with vaccination data to justify the needs identified in the proposals. Results Thirty topics were identified and grouped into three thematic areas: health workforce (10 topics; organisation and management (14; and supply, distribution and maintenance (6. We found 51 potentially relevant systematic reviews, although for the topic that appeared most frequently in the proposals ('Health information systems' no review was identified. Thematic and geographic relevance were generally categorised as "high" in 33 (65% and 25 (49% reviews, respectively, but few reviews were categorised as "highly relevant for policy" (7 reviews, 14%. With regard to methodological quality, 14 reviews (27% were categorised as "high". The number of topics that were addressed by at least one high quality systematic review was: seven of the 10 topics in the 'health workforce' thematic area; six of the 14 topics in the area of 'organisation and management'; and none of the topics in the thematic area of 'supply, distribution and maintenance'. Only twelve of the 39 countries with available national surveys referred to them in their proposals. Conclusion Relevant, high quality research summaries were found for few of the topics identified by managers. Few proposals

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

Science.gov (United States)

Hinton, Devon E; Peou, Sonith; Joshi, Siddharth; Nickerson, Angela; Simon, Naomi M

2013-09-01

This article profiles bereavement among traumatized Cambodian refugees and explores the validity of a model of how grief and post-traumatic stress disorder (PTSD) interact in this group to form a unique bereavement ontology, a model in which dreams of the dead play a crucial role. Several studies were conducted at a psychiatric clinic treating Cambodian refugees who survived the Pol Pot genocide. Key findings included that Pol Pot deaths were made even more deeply disturbing owing to cultural ideas about "bad death" and the consequences of not performing mortuary rites; that pained recall of the dead in the last month was common (76 % of patients) and usually caused great emotional and somatic distress; that severity of pained recall of the dead was strongly associated with PTSD severity (r = .62); that pained recall was very often triggered by dreaming about the dead, usually of someone who died in the Pol Pot period; and that Cambodians have a complex system of interpretation of dreams of the deceased that frequently causes those dreams to give rise to great distress. Cases are provided that further illustrate the centrality of dreams of the dead in the Cambodian experiencing of grief and PTSD. The article shows that not assessing dreams and concerns about the spiritual status of the deceased in the evaluation of bereavement results in "category truncation," i.e., a lack of content validity, a form of category fallacy.

Improving the use of health data for health system strengthening

Directory of Open Access Journals (Sweden)

Tara Nutley

2013-02-01

Full Text Available Background: Good quality and timely data from health information systems are the foundation of all health systems. However, too often data sit in reports, on shelves or in databases and are not sufficiently utilised in policy and program development, improvement, strategic planning and advocacy. Without specific interventions aimed at improving the use of data produced by information systems, health systems will never fully be able to meet the needs of the populations they serve. Objective: To employ a logic model to describe a pathway of how specific activities and interventions can strengthen the use of health data in decision making to ultimately strengthen the health system. Design: A logic model was developed to provide a practical strategy for developing, monitoring and evaluating interventions to strengthen the use of data in decision making. The model draws on the collective strengths and similarities of previous work and adds to those previous works by making specific recommendations about interventions and activities that are most proximate to affect the use of data in decision making. The model provides an organizing framework for how interventions and activities work to strengthen the systematic demand, synthesis, review, and use of data. Results: The logic model and guidance are presented to facilitate its widespread use and to enable improved data-informed decision making in program review and planning, advocacy, policy development. Real world examples from the literature support the feasible application of the activities outlined in the model. Conclusions: The logic model provides specific and comprehensive guidance to improve data demand and use. It can be used to design, monitor and evaluate interventions, and to improve demand for, and use of, data in decision making. As more interventions are implemented to improve use of health data, those efforts need to be evaluated.

Evaluating the performance of skewed prestressed concrete bridge after strengthening

Science.gov (United States)

Naser, Ali Fadhil; Zonglin, Wang

2013-06-01

The objectives of this paper are to explain the application of repairing and strengthening methods on the damaged members of the bridge structure, to analyze the static and dynamic structural response under static and dynamic loads after strengthening, and to evaluate the structural performance after application of strengthening method. The repairing and strengthening methods which are used in this study include treatment of the cracks, thickening the web of box girder along the bridge length and adding internal pre-stressing tendons in the thickening web, and construct reinforced concrete cross beams (diaphragms) between two box girders. The results of theoretical analysis of static and dynamic structural responses after strengthening show that the tensile stresses are decreased and become less than the allowable limit values in the codes. The values of vertical deflection are decreased after strengthening. The values of natural frequencies after strengthening are increased, indicating that the strengthening method is effective to reduce the vibration of the bridge structure. Therefore, the strengthening methods are effective to improve the bearing capacity and elastic working state of the bridge structure and to increase the service life of the bridge structure.

Strengthening the role of the ward manager: a review of the literature.

Science.gov (United States)

Pegram, Anne M; Grainger, Michelle; Sigsworth, Janice; While, Alison E

2014-09-01

The role of the ward manager is integral to service delivery, however, they may lack the necessary authority and autonomy to achieve the organisation and delivery of patient care. To identify initiatives that have strengthened the ward manager role. A review of published literature was undertaken. Data included were drawn from a variety of sources, including policy, professional literature and research studies. Three policy initiatives were identified along with two innovations from ward managers and two recent professional organisation campaigns. One innovation was identified that could improve the process of care delivery thus empowering ward managers' decision making. The literature identified the need for a review of the role, and adequate administrative support and training for the role. The literature reviewed provided little evidence of initiatives to strengthen the role of the ward manager, highlighting the imperative to develop an evidence base. There was consensus on the importance of education and training before and during appointment to the position. The role of the ward manager remains pivotal in care delivery. The focus should be on how best to support ward managers in achieving their role within health-care systems. © 2013 John Wiley & Sons Ltd.

Timber Elements: Traditional and Modern Strengthening Techniques

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Raluca Hohan

2010-01-01

Full Text Available The main idea of this paper is to analyse the means for the rehabilitation of our cultural heritage timber structures. Several methods together with their application techniques are described, and also, the reasons for what these strengthening operations become imminent at a point. First of all, the necessity of the timber structural elements strengthening is explained through a short presentation of the factors which are degrading the material. Then, certain precautions and strengthening procedures are presented, all involving the usage of traditional materials like wood, metal, or concrete, and of modern materials like fiber reinforced polymeric composite.

The use of rites of passage in strengthening the psychosocial wellbeing of orphaned children in Botswana.

Science.gov (United States)

Thamuku, Masego; Daniel, Marguerite

2012-10-01

Children who have been bereaved in the context of AIDS may experience many challenges to their psychosocial wellbeing. Programmes to help orphaned children are usually anchored in child rights. As the individual focus of rights-based approaches is inept in African collectivist culture, NGOs tend to make use of group approaches in psychosocial support programmes. One orphan-strengthening programme in Botswana, called the Ark for Children, uses rites of passage and rites of affirmation as part of a therapeutic retreat. This study explored how rites of passage and rites of affirmation contribute to psychosocial strengthening of orphaned children in Botswana. Ten orphaned children were involved in five rounds of data collection during a 16-day therapeutic retreat; and eight social workers answered questions on the effectiveness of the therapy. A supplementary document analysis was also completed, which included retreat reports since 2001 and correspondence from community-based support workers and graduates of the programme. Participants reported that the rites used during the retreat helped them to commit to therapeutic transformation. During a retreat, all the participants witness and support each individual going through each rite - a process reported to foster and strengthen group formation. It was documented that the symbols used as part of the themed rites of affirmation are used by participants for years afterwards as reminders of their transformation and commitment to the group. We conclude that rites of passage can provide a powerful tool to help children commit to therapeutic transformation, build the supportive group, and enable the community to recognise and affirm that the children return as changed individuals and members of the group.

The basis for the strengthening of safeguards

International Nuclear Information System (INIS)

Goldschmidt, P.

1999-01-01

For the past 30 years, the International Atomic Energy Agency's safeguards system has contributed to the international non-proliferation regime, by providing, inter alia, assurances regarding the peaceful uses of declared nuclear material. However, the discovery of a clandestine nuclear weapons programme in Iraq in 1991 drew world-wide attention to the need to strengthen the system to address the absence of undeclared nuclear material and activities. Efforts to strengthen the IAEA's safeguards system began in 1991 and culminated in 1997 when the IAEA's Board of Governors approved a Model Protocol Additional to IAEA Safeguards Agreements which greatly expands the legal basis and scope of IAEA safeguards. Within this strengthened system it is expected that the IAEA be able to provide assurance not only of the absence of diversion of declared nuclear material but also on the absence of undeclared nuclear material and activities. This is to be done within a safeguards system that uses an optimal combination of all safeguards measures available, thereby achieving maximum effectiveness and efficiency within the available resources. This paper will summarize the evolution of the safeguards system, describe strengthened safeguards, report on the status of implementing the strengthening measures, and outline plans for integrating all available safeguards measures. (author)

Small fatigue crack propagation in Y2O3 strengthened steels

Czech Academy of Sciences Publication Activity Database

Hutař, Pavel; Kuběna, Ivo; Ševčík, Martin; Šmíd, Miroslav; Kruml, Tomáš; Náhlík, Luboš

2014-01-01

Roč. 452, 1-3 (2014), s. 370-377 ISSN 0022-3115 R&D Projects: GA MŠk(CZ) EE2.3.30.0063; GA MŠk(CZ) ED1.1.00/02.0068; GA ČR(CZ) GP13-28685P Institutional support: RVO:68081723 Keywords : oxide dispersion strengthened steel * small fatigue crack * J-integral * fatigue life prediction Subject RIV: JL - Materials Fatigue, Friction Mechanics Impact factor: 1.865, year: 2014

Perceived Family Functioning Predicts Baseline Psychosocial Characteristics in U.S. Participants of a Family Focused Grief Therapy Trial.

Science.gov (United States)

Schuler, Tammy A; Zaider, Talia I; Li, Yuelin; Masterson, Melissa; McDonnell, Glynnis A; Hichenberg, Shira; Loeb, Rebecca; Kissane, David W

2017-07-01

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.

Cable strengthened arches

NARCIS (Netherlands)

Kamerling, M.W.

2013-01-01

The structural efficiency of arches, subjected to several variable loads, can be increased by strengthening these arches with cables. For these structures it can be necessary, especially in case the permanent load is small, to post-tension the cables to avoid any compression acting on the cables. A

Modeling of crack propagation in strengthened concrete disks

DEFF Research Database (Denmark)

Hansen, Christian Skodborg; Stang, Henrik

2013-01-01

Crack propagation in strengthened concrete disks is a problem that has not yet been addressed properly. To investigate it, a cracked half-infinite disk of concrete is strengthened with a linear elastic material bonded to the surface, and analyzed using two different finite element modeling...... instead of 3D calculations to predict the response of a structure and that it opens up for simpler evaluation of strengthened concrete structures using the finite element method....

Empowering Smallholder Farmers in Markets: strengthening the advocacy capacities of national farmer organisations through collaborative research

NARCIS (Netherlands)

Ton, G.; Grip, de K.; Lançon, F.; Onumah, G.; Proctor, F.J.

2014-01-01

The Empowering Smallholder Farmers in Markets programme (ESFIM) supported the advocacy capacities of national farmer organisations (NFOs) for improving smallholder market access. The programme gave NFOs in 11 countries the opportunity to contract local experts to strengthen the evidence-base of

Ecrire et souffrir : L’inspiration partagée de Constance Fenimore Woolson et de Henry James Literature and Grief: Constance Fenimore Woolson and Henry James, A Common Inspiration

Directory of Open Access Journals (Sweden)

Jeannine Hayat

2007-01-01

Full Text Available Miss Grief is a story by Constance Fenimore Woolson, an American novelist who often wrote about the difficulty a woman had in becoming an artist — a writer or a painter — in the nineteenth century. This tale is a very strange text, a kind of anticipation of a meeting to come, in Italy, in 1880, between Woolson and Henry James, and a friendship which lasted until the former’s death in 1894. For thirteen years, both writers would share a common inspiration. Death itself could not break the links between the two authors, who were connected even when settled in different European countries. William James, who was a member of the American Society for Psychical Research, probably helped his brother Henry to communicate — or so it appears — in some way with Woolson, even after her fatal accident, or possible suicide, in Venice. Henry James probably had in mind Miss Grief, a story by his dead friend, before writing some of his books. Indeed, Woolson had been the first to develop the image of “the figure in the carpet,” which was later transformed by Henry James. Woolson was also the first to devise a plot which Henry James would later use as a canvas for his novel The Wings of the Dove. What is an author and what is authorship? It seems impossible to separate what is Woolson’s and what is Henry James’s in four works of fiction that are in fact to be read together : Miss Grief, The Figure in the Carpet, The Beast in the Jungle, The Wings of the Dove.

Pedagogical guidelines for educational accompaniment for grieving to adults with intellectual disabilities

OpenAIRE

Pablo RODRÍGUEZ HERRERO; Agustín DE LA HERRÁN GASCÓN; Dolores IZUZQUIZA GASSET

2013-01-01

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...

Ion exchange for glass strengthening

International Nuclear Information System (INIS)

Gy, Rene

2008-01-01

This paper presents a short overview of silicate glass strengthening by exchange of alkali ions in a molten salt, below the glass transition temperature (chemical tempering). The physics of alkali inter-diffusion is briefly explained and the main parameters of the process, which control the glass reinforcement, are reviewed. Methods for characterizing the obtained residual stress state and the strengthening are described, along with the simplified modelling of the stress build-up. The fragmentation of chemically tempered glass is discussed. The concept of engineered stress profile glass is presented, and finally, the effect of glass and salt compositions is overviewed

Sleep Strengthens but does Not Reorganize Memory Traces in a Verbal Creativity Task.

Science.gov (United States)

Landmann, Nina; Kuhn, Marion; Maier, Jonathan-Gabriel; Feige, Bernd; Spiegelhalder, Kai; Riemann, Dieter; Nissen, Christoph

2016-03-01

Sleep after learning promotes the quantitative strengthening of new memories. Less is known about the impact of sleep on the qualitative reorganization of memory content. This study tested the hypothesis that sleep facilitates both memory strengthening and reorganization as indexed by a verbal creativity task. Sixty healthy university students (30 female, 30 male, 20-30 years) were investigated in a randomized, controlled parallel-group study with three experimental groups (sleep, sleep deprivation, daytime wakefulness). At baseline, 60 items of the Compound Remote Associate (CRA) task were presented. At retest after the experimental conditions, the same items were presented again together with 20 new control items to disentangle off-line incubation from online performance effects. Sleep significantly strengthened formerly encoded memories in comparison to both wake conditions (improvement in speed of correctly resolved items). Offline reorganization was not enhanced following sleep, but was enhanced following sleep-deprivation in comparison to sleep and daytime wakefulness (solution time of previously incubated, newly solved items). Online performance did not differ between the groups (solution time of new control items). The results support the notion that sleep promotes the strengthening, but not the reorganization, of newly encoded memory traces in a verbal creativity task. Future studies are needed to further determine the impact of sleep on different types of memory reorganization, such as associative thinking, creativity and emotional memory processing, and potential clinical translations, such as the augmentation of psychotherapy through sleep interventions. © 2016 Associated Professional Sleep Societies, LLC.

Microstructure characterization and strengthening mechanisms of oxide dispersion strengthened (ODS) Fe-9%Cr and Fe-14%Cr extruded bars

Science.gov (United States)

Chauhan, A.; Bergner, F.; Etienne, A.; Aktaa, J.; de Carlan, Y.; Heintze, C.; Litvinov, D.; Hernandez-Mayoral, M.; Oñorbe, E.; Radiguet, B.; Ulbricht, A.

2017-11-01

The collaborative study is focused on the relationship between microstructure and yield stress for an ODS Fe-9%Cr-based transformable alloy and an ODS Fe-14%Cr-based ferritic alloy. The contributions to the total room temperature yield stress arising from various strengthening mechanisms are addressed on the basis of a comprehensive description of the microstructures uncovered by means of transmission electron microscopy (TEM), electron backscatter diffraction (EBSD), small-angle neutron scattering (SANS) and atom probe tomography (APT). While these methods provide a high degree of complementarity, a reasonable agreement was found in cases of overlap of information. The derived set of microstructure parameters along with reported strengthening equations was used to calculate the room temperature yield stress. The estimates were critically compared with the measured yield stress for an extended set of alloys including data reported for Fe-Cr model alloys and steels thus covering one order of magnitude or more in grain size, dislocation density, particle density and yield stress. The comparison shows that particle strengthening, dislocation forest strengthening, and Hall-Petch strengthening are the major contributions and that a mixed superposition rule reproduces the measured yield stress within experimental scatter for the whole extended set of alloys. The wide variation of microstructures additionally underpins the conclusions and goes beyond previous work, in which one or few ODS steels and narrow microstructure variations were typically covered.

Approaches and impact of non-academic research capacity strengthening training models in sub-Saharan Africa: a systematic review.

Science.gov (United States)

Mugabo, Lambert; Rouleau, Dominique; Odhiambo, Jackline; Nisingizwe, Marie Paul; Amoroso, Cheryl; Barebwanuwe, Peter; Warugaba, Christine; Habumugisha, Lameck; Hedt-Gauthier, Bethany L

2015-06-09

Research is essential to identify and prioritize health needs and to develop appropriate strategies to improve health outcomes. In the last decade, non-academic research capacity strengthening trainings in sub-Saharan Africa, coupled with developing research infrastructure and the provision of individual mentorship support, has been used to build health worker skills. The objectives of this review are to describe different training approaches to research capacity strengthening in sub-Saharan Africa outside academic programs, assess methods used to evaluate research capacity strengthening activities, and learn about the challenges facing research capacity strengthening and the strategies/innovations required to overcome them. The PubMed database was searched using nine search terms and articles were included if 1) they explicitly described research capacity strengthening training activities, including information on program duration, target audience, immediate program outputs and outcomes; 2) all or part of the training program took place in sub-Saharan African countries; 3) the training activities were not a formal academic program; 4) papers were published between 2000 and 2013; and 5) both abstract and full paper were available in English. The search resulted in 495 articles, of which 450 were retained; 14 papers met all inclusion criteria and were included and analysed. In total, 4136 people were trained, of which 2939 were from Africa. Of the 14 included papers, six fell in the category of short-term evaluation period and eight in the long-term evaluation period. Conduct of evaluations and use of evaluation frameworks varied between short and long term models and some trainings were not evaluated. Evaluation methods included tests, surveys, interviews, and systems approach matrix. Research capacity strengthening activities in sub-Saharan Africa outside of academic settings provide important contributions to developing in-country capacity to participate in and

Optimal cost for strengthening or destroying a given network

Science.gov (United States)

Patron, Amikam; Cohen, Reuven; Li, Daqing; Havlin, Shlomo

2017-05-01

Strengthening or destroying a network is a very important issue in designing resilient networks or in planning attacks against networks, including planning strategies to immunize a network against diseases, viruses, etc. Here we develop a method for strengthening or destroying a random network with a minimum cost. We assume a correlation between the cost required to strengthen or destroy a node and the degree of the node. Accordingly, we define a cost function c (k ) , which is the cost of strengthening or destroying a node with degree k . Using the degrees k in a network and the cost function c (k ) , we develop a method for defining a list of priorities of degrees and for choosing the right group of degrees to be strengthened or destroyed that minimizes the total price of strengthening or destroying the entire network. We find that the list of priorities of degrees is universal and independent of the network's degree distribution, for all kinds of random networks. The list of priorities is the same for both strengthening a network and for destroying a network with minimum cost. However, in spite of this similarity, there is a difference between their pc, the critical fraction of nodes that has to be functional to guarantee the existence of a giant component in the network.

Strengthening Mechanisms in Microtruss Metals

Science.gov (United States)

Ng, Evelyn K.

Microtrusses are hybrid materials composed of a three-dimensional array of struts capable of efficiently transmitting an externally applied load. The strut connectivity of microtrusses enables them to behave in a stretch-dominated fashion, allowing higher specific strength and stiffness values to be reached than conventional metal foams. While much attention has been given to the optimization of microtruss architectures, little attention has been given to the strengthening mechanisms inside the materials that make up this architecture. This thesis examines strengthening mechanisms in aluminum alloy and copper alloy microtruss systems with and without a reinforcing structural coating. C11000 microtrusses were stretch-bend fabricated for the first time; varying internal truss angles were selected in order to study the accumulating effects of plastic deformation and it was found that the mechanical performance was significantly enhanced in the presence of work hardening with the peak strength increasing by a factor of three. The C11000 microtrusses could also be significantly reinforced with sleeves of electrodeposited nanocrystalline Ni-53wt%Fe. It was found that the strength increase from work hardening and electrodeposition were additive over the range of structures considered. The AA2024 system allowed the contribution of work hardening, precipitation hardening, and hard anodizing to be considered as interacting strengthening mechanisms. Because of the lower formability of AA2024 compared to C11000, several different perforation geometries in the starting sheet were considered in order to more effectively distribute the plastic strain during stretch-bend fabrication. A T8 condition was selected over a T6 condition because it was shown that the plastic deformation induced during the final step was sufficient to enhance precipitation kinetics allowing higher strengths to be reached, while at the same time eliminating one annealing treatment. When hard anodizing

STRENGTHENING OF A REINFORCED CONCRETE BRIDGE WITH PRESTRESSED STEEL WIRE ROPES

Directory of Open Access Journals (Sweden)

Kexin Zhang

2017-10-01

Full Text Available This paper describes prestressed steel wire ropes as a way to strengthen a 20-year-old RC T-beam bridge. High strength, low relaxation steel wire ropes with minor radius, high tensile strain and good corrosion resistance were used in this reinforcement. The construction process for strengthening with prestressed steel wire ropes—including wire rope measuring, extruding anchor heads making, anchorage installing, tensioning steel wire ropes and pouring mortar was described. Ultimate bearing capacity of the bridge after strengthening was discussed based on the concrete structure theory. The flexural strength of RC T-beam bridges strengthened with prestressed steel wire ropes was governed by the failure of concrete crushing. To investigate effectiveness of the strengthening method, fielding-load tests were carried out before and after strengthening. The results of concrete strain and deflection show that the flexural strength and stiffness of the strengthened beam are improved. The crack width measurement also indicates that this technique could increase the durability of the bridge. Thus, this strengthened way with prestressed steel wire rope is feasible and effective.

Coping Flexibility and Complicated Grief: A Comparison of American and Chinese Samples

Science.gov (United States)

Burton, Charles L.; Yan, Oscar H.; Pat-Horenczyk, Ruth; Chan, Ide S. F.; Ho, Samuel; Bonanno, George A.

2011-01-01

Background The ability to process a death, and the ability to remain optimistic and look beyond the loss, are both thought to be effective means of coping with loss and other aversive events. Recently, these seemingly contrary dimensions have been integrated into the idea of coping flexibility. Method In this study we assessed the ability of married and bereaved individuals in the US and Hong Kong to use both coping approaches as operationalized by the trauma-focused and forward-focused coping scales of a previously validated questionnaire. We also calculated a single flexibility score. Results Bereaved participants reported greater trauma-focused coping ability than did married participants. However, bereaved participants meeting criteria for complicated grief (CG) reported less forward-focused coping than both asymptomatic bereaved and married participants. The CG group also showed less overall coping flexibility than the asymptomatic bereaved and married groups. Country was not a factor. Conclusions Findings suggest that deficits in coping flexibility are indicative of pathology in bereaved individuals, and that this relationship extends across cultures. Limitations of the study and directions for future research are discussed. PMID:21898713

Child survival in England: Strengthening governance for health.

Science.gov (United States)

Wolfe, Ingrid; Mandeville, Kate; Harrison, Katherine; Lingam, Raghu

2017-11-01

The United Kingdom, like all European countries, is struggling to strengthen health systems and improve conditions for child health and survival. Child mortality in the UK has failed to improve in line with other countries. Securing optimal conditions for child health requires a healthy society, strong health system, and effective health care. We examine inter-sectoral and intra-sectoral policy and governance for child health and survival in England. Literature reviews and universally applicable clinical scenarios were used to examine child health problems and English policy and governance responses for improving child health through integrating care and strengthening health systems, over the past 15 years. We applied the TAPIC framework for analysing policy governance: transparency, accountability, participation, integrity, and capacity. We identified strengths and weaknesses in child health governance in all the five domains. However there remain policy failures that are not fully explained by the TAPIC framework. Other problems with successfully translating policy to improved health that we identified include policy flux; policies insufficiently supported by delivery mechanisms, measurable targets, and sufficient budgets; and policies with unintended or contradictory aspects. We make recommendations for inter-sectoral and intra-sectoral child health governance, policy, and action to improve child health in England with relevant lessons for other countries. Copyright © 2017 The Author(s). Published by Elsevier B.V. All rights reserved.

Factors related to alcohol and drug consumption in Swedish widows.

Science.gov (United States)

Grimby, Agneta; Johansson, Asa K

2009-01-01

The use of alcohol and medications among Swedish widows was analyzed in relation to various background variables. In Total, 1053 widows (640 widows younger than 65 years and 413 widows older than 65 years) answered the questionnaire. Many reported increased fatigue and sleeping problems. Around one-third of the widows reported drinking alcohol for relief of grief and inadequate support. Association existed between grief and increased intake of sedatives and sleeping pills, and between grief and drinking for relief of grief, as well as increase in intake of sedatives. In widows older than 65 years, perception of bad health, negative outlook for the future, and insufficient support seemed to increase the risk of more sedatives and sleeping pills. Negative outlook for the future also tended to lead to a heightened risk for increased intake of alcohol. There seems to be remaining health problems a long time after bereavement, and counseling may be needed especially when drugs and alcohol are extensively used.

Condition assessment and strengthening of residential units

Directory of Open Access Journals (Sweden)

Tatheer Zahra

2014-01-01

Full Text Available About 40, ground plus one (G+1 residential units were designed using a hybrid structural framing system (RC frame and load bearing walls. A few months after the completion of the ground floor of the residential units, cracks appeared at several locations in the structure. Field and Laboratory testing was conducted to ascertain the in situ strength of concrete and steel reinforcement. The results of the experimental work were used in the analytical ETABS model for the structural stability calculations. The results indicated that residential units were marginally safe in the existing condition (completed ground floor, but the anticipated construction of the floor above the ground floor (G+1 could not be carried out as the strength of the structural system was inadequate. To increase the safety of existing ground floor and to provide the option of the construction of one floor above, rehabilitation and strengthening design was performed. The proposed strengthening design made use of welded wire fabric (WWF and carbon fibre reinforced polymer (CFRP laminates/sheets for the strengthening of walls, columns and slabs. The residential units will be strengthened in the near future.

Strengthening and expanding the capacity of health worker education in Zambia.

Science.gov (United States)

Michelo, Charles; Zulu, Joseph Mumba; Simuyemba, Moses; Andrews, Benjamin; Katubulushi, Max; Chi, Benjamin; Njelesani, Evariste; Vwalika, Bellington; Bowa, Kasonde; Maimbolwa, Margaret; Chipeta, James; Goma, Fastone; Nzala, Selestine; Banda, Sekelani; Mudenda, John; Ahmed, Yusuf; Hachambwa, Lotti; Wilson, Craig; Vermund, Sten; Mulla, Yakub

2017-01-01

Zambia is facing a chronic shortage of health care workers. The paper aimed at understanding how the Medical Education Partnership Initiative (MEPI) program facilitated strengthening and expanding of the national capacity and quality of medical education as well as processes for retaining faculty in Zambia. Data generated through documentary review, key informant interviews and observations were analyzed using a thematic approach. The MEPI program triggered the development of new postgraduate programs thereby increasing student enrollment. This was achieved by leveraging of existing and new partnerships with other universities and differentiating the old Master in Public Health into specialized curriculum. Furthermore, the MEPI program improved the capacity and quality of training by facilitating installation and integration of new technology such as the eGranary digital library, E-learning methods and clinical skills laboratory into the Schools. This technology enabled easy access to relevant data or information, quicker turn around of experiments and enhanced data recording, display and analysis features for experiments. The program also facilitated transforming of the academic environment into a more conducive work place through strengthening the Staff Development program and support towards research activities. These activities stimulated work motivation and interest in research by faculty. Meanwhile, these processes were inhibited by the inability to upload all courses on to Moodle as well as inadequate operating procedures and feedback mechanisms for the Moodle. Expansion and improvement in training processes for health care workers requires targeted investment within medical institutions and strengthening local and international partnerships.

Self-flowing mortar for ferrocement in strengthening applications

Directory of Open Access Journals (Sweden)

Shamir Sakir

2016-09-01

Full Text Available Ferrocement technology is becoming more and more important nowadays for strengthening and retrofitting of concrete structures mainly due to its inherent strength properties. However, its labour intensive nature makes it undesirable for rapid strengthening works. In narrow spaces, strengthening with conventional ferrocement is very critical and also time consuming. Self-flowing mortar (SFM could be used with this technology to overcome these limitations. This article discusses the applicability of SFM in ferrocement technology. The aim of this study is to summarize available knowledge on SFM to make it feasible for optimization in different industrial applications.

Effect of horizontal reinforcement in strengthening of masonry members

International Nuclear Information System (INIS)

Farooq, S.H.; Ilyas, M.; Ggaffar, A.

2008-01-01

An experimental research program was undertaken to ascertain the effectiveness of a new technique for strengthening masonry wall panels using steel strips on compressive and shear strength enhancement. The experimental work includes eight wall panels, four each for compressive and shear strength evaluation. This work was the phase I of extensive research project which include testing of strengthened masonry wall panels under monotonic load (Phase-I), static cyclic load (Phase-2) and dynamic load (Phase-3). The wall panels were strengthened with different steel strip arrangements, which consist of single/double face application of coarse and fine steel strip mesh with reduced spacing of horizontal strips. This paper investigates only the effectiveness of horizontal steel strips on strength enhancement. Four masonry wall panels are considered in two groups and in each group, one wall was retrofitted with coarse steel mesh on single face and on second wall fine steel mesh was applied on one side. Furthermore, test results of strengthened specimens are also compared with the un-strengthened specimen (REFE). The mechanisms by which load was carried were observed, varying from the initial, uncracked state, and the final, fully cracked state. The results demonstrate a quite significant increase in the compressive and shear capacity of strengthened panels as compared to REFE-panel. However, increase in the compressive strength of fine mesh above that of coarse mesh is negligible. The technique/approach is found quite viable for strengthening of masonry walls, for rehabilitation of old deteriorated buildings and unreinforced masonry structures in seismic zones. (author)

Strengthening from Nb-rich clusters in a Nb-microalloyed steel

International Nuclear Information System (INIS)

Xie, Kelvin Y.; Zheng, Tianxiao; Cairney, Julie M.; Kaul, Harold; Williams, James G.; Barbaro, Frank J.; Killmore, Chris R.; Ringer, Simon P.

2012-01-01

We demonstrate that a Nb-microalloyed ultra-thin cast strip steel can be strengthened substantially without compromising ductility by performing a simple heat treatment at 700 °C for 4 min. The strengthening was attributed to a fine dispersion of Nb-rich solute atom clusters. These clusters had an average size of ∼60 atoms at peak hardness and resembled Guinier–Preston zones in Al–Cu alloys. The application of the Ashby–Orowan equation indicates that these clusters are potent strengthening agents when compared to conventional Nb(C,N) precipitation strengthening.

Improving the engineering strength of heat strengthened glass

NARCIS (Netherlands)

Veer, F.A.; Rodichev, YM

2016-01-01

Although glass is increasingly used as a structural material, glass is not produced to strength standards, like steel and concrete. Of the three types of glass: annealed, heat strengthened and fully tempered, only heat strengthened glass has the properties to function as a safe structural material.

Complicated Grief

Science.gov (United States)

... one Death of a child Close or dependent relationship to the deceased person Social isolation or loss of a support system or friendships Past history of depression, separation anxiety or post-traumatic stress disorder (PTSD) Traumatic childhood experiences, such as abuse ...

New concept of critical infrastructure strengthening

International Nuclear Information System (INIS)

Gazizov, Talgat R.; Orlov, Pavel E.; Zabolotsky, Alexander M.; Kuksenko, Sergey P.

2016-01-01

Strengthening of critical infrastructure is considered. Modal reservation of electronics is proposed as a new concept of the strengthening. The concept combines a widely used cold backup and a recently proposed modal filtration. It makes electronics reliable as well as protected against electromagnetic interference, especially the ultra-wide band pulses. New printed circuit board structure is suggested for implementation of the proposed concept. Results of simulation in time and frequency domains are presented for the suggested structures. Considerable attenuation of dangerous excitations shows that the new concept and structure are promising.

New concept of critical infrastructure strengthening

Energy Technology Data Exchange (ETDEWEB)

Gazizov, Talgat R.; Orlov, Pavel E.; Zabolotsky, Alexander M.; Kuksenko, Sergey P. [Tomsk State University of Control Systems and Radioelectronics, 634050, Lenin Ave., Tomsk (Russian Federation)

2016-06-08

Strengthening of critical infrastructure is considered. Modal reservation of electronics is proposed as a new concept of the strengthening. The concept combines a widely used cold backup and a recently proposed modal filtration. It makes electronics reliable as well as protected against electromagnetic interference, especially the ultra-wide band pulses. New printed circuit board structure is suggested for implementation of the proposed concept. Results of simulation in time and frequency domains are presented for the suggested structures. Considerable attenuation of dangerous excitations shows that the new concept and structure are promising.

Strengthening of metallic alloys with nanometer-size oxide dispersions

Science.gov (United States)

Flinn, John E.; Kelly, Thomas F.

1999-01-01

Austenitic stainless steels and nickel-base alloys containing, by wt. %, 0.1 to 3.0% V, 0.01 to 0.08% C, 0.01 to 0.5% N, 0.05% max. each of Al and Ti, and 0.005 to 0.10% O, are strengthened and ductility retained by atomization of a metal melt under cover of an inert gas with added oxygen to form approximately 8 nanometer-size hollow oxides within the alloy grains and, when the alloy is aged, strengthened by precipitation of carbides and nitrides nucleated by the hollow oxides. Added strengthening is achieved by nitrogen solid solution strengthening and by the effect of solid oxides precipitated along and pinning grain boundaries to provide temperature-stabilization and refinement of the alloy grains.

Practical approaches to implementing facility wide equipment strengthening programs

International Nuclear Information System (INIS)

Kincaid, R.H.; Smietana, E.A.

1989-01-01

Equipment strengthening programs typically focus on components required to ensure operability of safety related equipment or to prevent the release of toxic substances. Survival of non-safety related equipment may also be crucial to ensure rapid recovery and minimize business interruption losses. Implementing a strengthening program for non-safety related equipment can be difficult due to the large amounts of equipment involved and limited budget availability. EQE has successfully implemented comprehensive equipment strengthening programs for a number of California corporations. Many of the lessons learned from these projects are applicable to DOE facilities. These include techniques for prioritizing equipment and three general methodologies for anchoring equipment. Pros and cons of each anchorage approach are presented along with typical equipment strengthening costs

Strengthening of metallic alloys with nanometer-size oxide dispersions

Science.gov (United States)

Flinn, J.E.; Kelly, T.F.

1999-06-01

Austenitic stainless steels and nickel-base alloys containing, by wt. %, 0.1 to 3.0% V, 0.01 to 0.08% C, 0.01 to 0.5% N, 0.05% max. each of Al and Ti, and 0.005 to 0.10% O, are strengthened and ductility retained by atomization of a metal melt under cover of an inert gas with added oxygen to form approximately 8 nanometer-size hollow oxides within the alloy grains and, when the alloy is aged, strengthened by precipitation of carbides and nitrides nucleated by the hollow oxides. Added strengthening is achieved by nitrogen solid solution strengthening and by the effect of solid oxides precipitated along and pinning grain boundaries to provide temperature-stabilization and refinement of the alloy grains. 20 figs.

Challenges in strengthening radiation safety and security programme in Malaysia

International Nuclear Information System (INIS)

Noriah, M.A.

2010-01-01

This paper illustrates the Malaysian experience in implementing steps in strengthening radiation safety and security through certification of radiation safety personnel, which is dedicated to meet the current and future needs in sustainability of radiation safety and security systems. Commitment from the workforce to treat safety as a priority and the ability to turn a requirement into a practical language is also important in implementing the radiation safety policy efficiently. Through this effort, we are able to create a basis for adequate protection of workers, the public and the environment and encourage licensees to manage radiation safety and security based on performance, and not on compliance culture, with the final objective of professing a safety culture through self regulation. This will certainly benefit an organisation with ultimate goals are to continuously strive for a healthy, accident free and environmentally sound workplace and community, while providing the technical support needed to meet the national mission. This will strengthen the radiation safety and security programme and could be used to assist in manpower development once Malaysia makes the decision to embark on a nuclear power programme. (author)

Polycrystalline strengthening

DEFF Research Database (Denmark)

Hansen, Niels

1985-01-01

for the understanding of polycrystalline strengthening is obtained mainly from surface relief patterns and from bulk structures observed by transmission electron microscopy of thin foils. The results obtained by these methods are discussed and correlations are proposed. A number of features characterizing the deformed...... structure are summarized and the behavior of a number of metals and alloys is reviewed with emphasis on the structural changes in the interior of the grains and in the vicinity of the grain boundaries. The models for strain accommodation during deformation are discussed on the basis of the microstructures...

RC T beams strengthened to shear with carbon fiber composites

Directory of Open Access Journals (Sweden)

L. A. Spagnolo JR

Full Text Available This paper presents the experimental data of the behavior of reinforced concrete beams strengthened to shear with carbon fiber composites. The tests were composed of eight T beams, b w=15 cm, h=40 cm, flange width 40 cm, flange height 8 cm, and length 300 cm, divided into two series with the same longitudinal steel reinforcement and a reference beam without strengthening in each series. The beams had two types of arrangement of internal steel stirrups. The test variables were the internal and external geometric ratio of the transverse reinforcement and the mechanical ratio of carbon fiber composites stirrups. All the beams were loaded at two points. The strengthened beams were submitted to a preloading and the strengthening was applied to the cracked beam. All the beams were designed in order to guarantee shear failure, and the ultimate load of the strengthened beams was 36% to 54% greater than the reference beams. The Cracking Sliding Model applied to the strengthened beams was evaluated and showed good agreement with the experimental results.

Strengthening the infrastructure for RI applications in cooperation with the IAEA

Energy Technology Data Exchange (ETDEWEB)

Park, Kyung Bae; Hong, Young Don; Kim, Seung Yun; Kim, Kyoung Pyo; Lee, Jeong Kong

2000-12-01

The future direction for nuclear cooperation should be implemented with the aim of enhancing the status of Korea within the international society as well as carrying out the established national nuclear policy goal. Strategies for implementing cooperation with the IAEA were described into four separate parts; 'strategies for strengthening cooperation in general areas', 'strategies for implementing IAEA technical cooperation programs', 'strategies for implementing IAEA CRP programs' and 'Strategies for effective participation in the area of radiation and RI application'. As for strategies for implementing IAEA technical cooperation programs, i) expanding domestic personnel's entering into the IAEA ii) establishment of a liaison office for support of IAEA technical cooperation iii) expanding domestic experts entering into member of consultation group for a director-general of the IAEA and more participation in the international meetings iv) cooperation with IAEA's Seibersdorf Laboratories. For the strengthening of IAEA technical cooperation, strategies for effective implementation of technical cooperation programs such as i) strengthening role of national TC liaison officer ii) strengthening application of Model Project concept iii) Implementing End-user oriented programs iv) Establishment of measure to increase the TC implementation rate v) hosting of fellowship, scientific visitors, support for expert mission, were presented. Strategies for expanding domestic participation in the IAEA technical cooperation programs were also described for producing the benefits from implementing the IAEA technical cooperation programs. As for strategies for implementing the IAEA CRP programs, i) measures for active participation in the IAEA CRP programs and ii) measures for gradual participation in the IAEA CRP programs were separately described. To maximize the utilization of HANARO, a multi-purpose research reactor, the on

Strengthening the infrastructure for RI applications in cooperation with the IAEA

International Nuclear Information System (INIS)

Park, Kyung Bae; Hong, Young Don; Kim, Seung Yun; Kim, Kyoung Pyo; Lee, Jeong Kong

2000-12-01

The future direction for nuclear cooperation should be implemented with the aim of enhancing the status of Korea within the international society as well as carrying out the established national nuclear policy goal. Strategies for implementing cooperation with the IAEA were described into four separate parts; 'strategies for strengthening cooperation in general areas', 'strategies for implementing IAEA technical cooperation programs', 'strategies for implementing IAEA CRP programs' and 'Strategies for effective participation in the area of radiation and RI application'. As for strategies for implementing IAEA technical cooperation programs, i) expanding domestic personnel's entering into the IAEA ii) establishment of a liaison office for support of IAEA technical cooperation iii) expanding domestic experts entering into member of consultation group for a director-general of the IAEA and more participation in the international meetings iv) cooperation with IAEA's Seibersdorf Laboratories. For the strengthening of IAEA technical cooperation, strategies for effective implementation of technical cooperation programs such as i) strengthening role of national TC liaison officer ii) strengthening application of Model Project concept iii) Implementing End-user oriented programs iv) Establishment of measure to increase the TC implementation rate v) hosting of fellowship, scientific visitors, support for expert mission, were presented. Strategies for expanding domestic participation in the IAEA technical cooperation programs were also described for producing the benefits from implementing the IAEA technical cooperation programs. As for strategies for implementing the IAEA CRP programs, i) measures for active participation in the IAEA CRP programs and ii) measures for gradual participation in the IAEA CRP programs were separately described. To maximize the utilization of HANARO, a multi-purpose research reactor, the on-going development and development project are actively

[Strengthening of social participation of Turkish seniors].

Science.gov (United States)

Fietz, Jennifer; Stupp, Barbara

2018-05-04

Traditional municipal services are not successful at reaching Turkish seniors. Compared to native Germans Turkish seniors have a lower social participation. Do native language groups hosted by a German organization promote the social participation of Turkish seniors? How does social participation take place in the ZWAR networks (between work and retirement; a project to strengthen social participation of seniors) and which factors promote or reduce social participation? Qualitative structuring content analysis of two group discussions, which were based on guided interviews. The social participation of Turkish-speaking seniors was strengthened on three levels: (1) through regular meetings of the Turkish ethnic group social relationships were promoted and German language skills and other skills were improved. Through mutual sharing and understanding of the stressors specific to migration, emotional support was provided. The sharing of mutual cultural and linguistic backgrounds created a sense of community and meetings were perceived as an antidote to migrants' exhausting lives in German society. (2) At the organizational level, participation was promoted through extensive group events. Regardless of their cultural background all participants identified as equal ZWAR members. The ZWAR project functioned as an umbrella organization for participation in the intercultural context. (3) Participation in community events created contacts with community stakeholders and fostered volunteer work. Hence, participants were able to use their skills, and therefore broaden their horizons. Turkish ZWAR networks promoted the social participation of members because integration with their ethnic group reduced access barriers, broadened members' scopes of action, and created new opportunities for participation.

Nanostructured thin film coatings with different strengthening effects

Directory of Open Access Journals (Sweden)

Panfilov Yury

2017-01-01

Full Text Available A number of articles on strengthening thin film coatings were analyzed and a lot of unusual strengthening effects, such as super high hardness and plasticity simultaneously, ultra low friction coefficient, high wear-resistance, curve rigidity increasing of drills with small diameter, associated with process formation of nanostructured coatings by the different thin film deposition methods were detected. Vacuum coater with RF magnetron sputtering system and ion-beam source and arc evaporator for nanostructured thin film coating manufacture are represented. Diamond Like Carbon and MoS2 thin film coatings, Ti, Al, Nb, Cr, nitride, carbide, and carbo-nitride thin film materials are described as strengthening coatings.

Structural improvement of strengthened deck panels with externally bonded plates

International Nuclear Information System (INIS)

Sim, Jongsung; Oh, Hongseob

2005-01-01

Concrete bridge decks require eventual replacement and rehabilitation due to decreasing load-carrying capacity. This paper compares different strengthening design procedures that improve the usability and structural performance of bridge decks. The failure characteristics of bridge decks strengthened with various materials such as carbon fiber sheet, glass fiber sheet, steel plate, and grid CFRP and GFRP are analyzed, and the theoretical load-carrying capacities are evaluated using traditional beam and yield line theory, and punching shear analysis. The strengthening materials increase the punching shear strength of the deck and change the failure mode of the strengthened panel

Strengthening of radiation protection in the Baltic Sea Region and North west-Russia

International Nuclear Information System (INIS)

Ake Persson, B.; Olof Snihs, Jan

2000-01-01

There are a number of strong radiation sources in the Baltic Sea Region and Northwest Europe (Northwest Russia). They include more than 30 nuclear power reactors, various other operating facilities with radiation sources, a number of radioactive waste repositories and several stores for spent nuclear fuel. Many of these facilities are in good shape and under good control from the authorities. Others are in a very poor condition and there is a need of immediate actions to be taken. This is particular the case in the Northwest part of Russia. The strengthening of radiation protection in the two regions mentioned above is made by national efforts and through international co-operation including various support activities. The close geographical position with common seas, the developing economical and cultural co-operation between the countries as well as connections with historical background means that there is an interest and common benefit to strengthen the co-operation in the field of radiation protection and radiological emergency planning. Sweden has since the disintegration of the Soviet Union a policy to assist and support the Baltic States and the Russian Federation in the field of radiation protection and to strengthen the preparedness for co-operation between the countries in the event of a severe nuclear accident or radiological emergency. The problems, strategies, results and failures up to now will be described as well as how these efforts are integrated in and put into perspective of the development of radiation protection in the donor countries. There are also efforts to integrate most of the countries in common policy work, research and technical development in the field of radiation protection. Some perspectives into the next millennium are discussed. (author)

Design and initial implementation of the WHO FP umbrella project- to strengthen contraceptive services in the sub Saharan Africa.

Science.gov (United States)

Kabra, Rita; Ali, Moazzam; Kiarie, James

2017-06-15

Strengthening contraceptive services in sub Saharan Africa is critical to achieve the FP 2020 goal of enabling 120 million more women and girls to access and use contraceptives by 2020 and the Sustainable Development Goals (SDG) targets of universal access to sexual and reproductive health (SRH) services including family planning by 2030. The World Health Organization (WHO) and partners have designed a multifaceted project to strengthen health systems to reduce the unmet need of contraceptive and family planning services in sub Saharan Africa. The plan leverages global, regional and national partnerships to facilitate and increase the use of evidence based WHO guidelines with a specific focus on postpartum family planning. The four key approaches undertaken are i) making WHO Guidelines adaptable & appropriate for country use ii) building capacity of WHO regional/country staff iii) providing technical support to countries and iv) strengthening partnerships for introduction and implementation of WHO guidelines. This paper describes the project design and elaborates the multifaceted approaches required in initial implementation to strengthen contraceptive services. The initial results from this project reflect that simultaneous application these approaches may strengthen contraceptive services in Sub Saharan Africa and ensure sustainability of the efforts. The lessons learned may be used to scale up and expand services in other countries.

Pumping Iron in Australia: Prevalence, Trends and Sociodemographic Correlates of Muscle Strengthening Activity Participation from a National Sample of 195,926 Adults.

Directory of Open Access Journals (Sweden)

Jason A Bennie

Full Text Available The current Australian Physical Activity Guidelines recommend that adults engage in regular muscle-strengthening activity (e.g. strength or resistance training. However, public health surveillance studies describing the patterns and trends of population-level muscle-strengthening activity participation are sparse. The aim of this study is to examine the prevalence, trends and sociodemographic correlates of muscle-strengthening activity participation in a national-representative sample of Australians aged 15 years and over.Between 2001 and 2010, quarterly cross-sectional national telephone surveys were conducted as part of the Australian Sports Commission's 'Exercise, Recreation and Sport Survey'. Pooled population-weighted proportions were calculated for reporting: [i] no muscle-strengthening activity; [ii] insufficient muscle-strengthening activity, and [iii] sufficient muscle-strengthening activity. Associations with sociodemographic variables were assessed using multiple logistic regression analyses.Out of 195,926 participants, aged 15-98 years, only 10.4% (95% CI: 10.1-10.7 and 9.3% (95% CI: 9.1-9.5 met the muscle-strengthening activity recommendations in the past two weeks and in the past year, respectively. Older adults (50+ years, and those living in socioeconomically disadvantaged, outer regional/remote areas and with lower education were less likely to report sufficient muscle-strengthening activity (p<0.001. Over the 10-year monitoring period, there was a significant increase in the prevalence of sufficient muscle-strengthening activity (6.4% to 12.0%, p-value for linear trend <0.001.A vast majority of Australian adults did not engage in sufficient muscle-strengthening activity. There is a need for public health strategies to support participation in muscle-strengthening activity in this population. Such strategies should target older and lower educated adults, and those living in socioeconomically disadvantaged, outer regional

Electron-microscopic investigations of dispersion-strengthened superalloys

International Nuclear Information System (INIS)

Schroeder, J.H.; Arzt, E.

1988-01-01

Oxide dispersion strengthened (ODS) superalloys possess a high creep strength up to temperatures above 1000 0 C. This is due to a fine dispersion of incoherent Y 2 O 3 particles in connection with a highly elongated grain structure. To investigate the production and properties of ODS alloys, the grain structure was studied and the shape and distribution of dispersoids were characterized after each of the various production steps. Because the interactions between lattice dislocations and dispersoids control the deformation behaviour at high temperatures, the dislocation-dispersoid configurations in crept specimens have been studied by a TEM stereo technique and under weak-beam conditions. It was possible to detect strain fields around the dispersoids using TEM. The results lead to an improved understanding of dispersion strengthening at high temperatures and provide guidelines for the optimum use of this strengthening mechanism. (orig.) [de

Supporting surveillance capacity for antimicrobial resistance: Laboratory capacity strengthening for drug resistant infections in low and middle income countries [version 1; referees: 2 approved, 1 approved with reservations

Directory of Open Access Journals (Sweden)

Anna C. Seale

2017-09-01

Full Text Available Development of antimicrobial resistance (AMR threatens our ability to treat common and life threatening infections. Identifying the emergence of AMR requires strengthening of surveillance for AMR, particularly in low and middle-income countries (LMICs where the burden of infection is highest and health systems are least able to respond. This work aimed, through a combination of desk-based investigation, discussion with colleagues worldwide, and visits to three contrasting countries (Ethiopia, Malawi and Vietnam, to map and compare existing models and surveillance systems for AMR, to examine what worked and what did not work. Current capacity for AMR surveillance varies in LMICs, but and systems in development are focussed on laboratory surveillance. This approach limits understanding of AMR and the extent to which laboratory results can inform local, national and international public health policy. An integrated model, combining clinical, laboratory and demographic surveillance in sentinel sites is more informative and costs for clinical and demographic surveillance are proportionally much lower. The speed and extent to which AMR surveillance can be strengthened depends on the functioning of the health system, and the resources available. Where there is existing laboratory capacity, it may be possible to develop 5-20 sentinel sites with a long term view of establishing comprehensive surveillance; but where health systems are weaker and laboratory infrastructure less developed, available expertise and resources may limit this to 1-2 sentinel sites. Prioritising core functions, such as automated blood cultures, reduces investment at each site. Expertise to support AMR surveillance in LMICs may come from a variety of international, or national, institutions. It is important that these organisations collaborate to support the health systems on which AMR surveillance is built, as well as improving technical capacity specifically relating to AMR

Strengthening Laboratory Capacity for Early Warning Alert and Response System (EWARS) in Indonesia

OpenAIRE

Kandel, Nirmal; Hapsari, Ratna Budi; Riana, Dyah Armi; Setiawaty, Vivi; Larasati, Wita; Wulandari, Endang; Purwanto, Edy

2017-01-01

Background: Establishment of Early Warning Alert and Response System (EWARS) in Indonesia was initiated since 2009 in few selected provinces and government was planning to roll out in other provinces. Before initiating this roll out the assessment of performance of EWARS in 2012 was conducted. The aim of the assessment is to strengthen laboratory for supporting to EWARS for alerts testing. Methods: Laboratory capacity mapping tool and laboratory algorithm for twenty two priority diseases of ...

How can policy strengthen community support for children in military families?

Science.gov (United States)

Boberiene, Liepa V; Hornback, Bradley J

2014-09-01

The extraordinary demands of recent wars have increased burdens on many military families and existing systems of care. The sacrifices made by service members are made also by their children and families, and these sacrifices can have long-term consequences. Therefore, military children and families cannot go unrecognized and unsupported. Policy responses should be less about diagnosing and treating individuals and more about recognizing and supporting families' and communities' resilience in the face of wartime deployment. Policy should focus on identifying military children in diverse communities and supporting them where they live, learn, and receive care. A range of community-based prevention strategies could decrease stress before it escalates into serious mental health issues. Efforts to develop family resilience during deployment and reintegration are extremely important in facilitating children's healthy development and veterans' recovery. Military personnel should partner with community leaders to implement effective programs providing emotional, social, and practical support to families. Emphasizing family cohesion, community social support, and comprehensive programs through education and health care organizations would go a long way in fostering families' resilience. At the same time, pro- grams should be monitored and evaluated, and military and civilian researchers should share data on family risk and resilience to improve evidence- based approaches. Such efforts would benefit not only military children, but also larger populations as programs improve family and community capacity to support thriving and mitigate challenges in the face of adversity.

'Twin2twin' an innovative method of empowering midwives to strengthen their professional midwifery organisations.

Science.gov (United States)

Cadée, Franka; Perdok, Hilde; Sam, Betty; de Geus, Myrte; Kweekel, Liselotte

2013-10-01

midwives need professional support from a national midwifery organisation to be able to provide the services that are by regulatory mechanisms and accreditation expected of them. Not all midwives in the world are united in a professional organisation. The aim of this project was to strengthen the midwifery organisations of Sierra Leone and the Netherlands. During the process of the project it was realised that the development of a platform of exchange at organisational level would be enhanced by introducing personal exchange between individual midwives. In response to this new insight the original project plan was adjusted by incorporating the twin2twin method. twin2twin is a feminist methodology of mutual exchange between twenty pairs of midwives from different organisations (in this case Sierra Leone and the Netherlands). The method can be distinguished by 10 specific steps. It was developed, used and (re)evaluated through focus group discussions, storytelling and written evaluations. twinning of organisations was strengthened by adding a human component to the process. With the use of the 'twin2twin' method, midwives were encouraged to invested in a professional and personal bond with their 'twin sister'. This bond was independent and went beyond the relatively short four year project period. Through personal engagement and mutual exchange of knowledge and skills, midwives empowered each other to build and strengthen their midwifery organisations both in Sierra Leone and the Netherlands. (Empowerment refers to the expansion in people's ability to make strategic life choices in a context where this ability was previously denied to them (Narayan, 2005); organisational empowerment includes processes and structures that enhance members' skills and provides them with the mutual support necessary to effect community level change (Zimmerman, 1995).). despite challenges we are convinced that twin2twin can be of additional benefit for the success of other projects

Scaling up antiretroviral therapy in Uganda: using supply chain management to appraise health systems strengthening

Directory of Open Access Journals (Sweden)

Neuhann Florian

2011-08-01

Full Text Available Abstract Background Strengthened national health systems are necessary for effective and sustained expansion of antiretroviral therapy (ART. ART and its supply chain management in Uganda are largely based on parallel and externally supported efforts. The question arises whether systems are being strengthened to sustain access to ART. This study applies systems thinking to assess supply chain management, the role of external support and whether investments create the needed synergies to strengthen health systems. Methods This study uses the WHO health systems framework and examines the issues of governance, financing, information, human resources and service delivery in relation to supply chain management of medicines and the technologies. It looks at links and causal chains between supply chain management for ART and the national supply system for essential drugs. It combines data from the literature and key informant interviews with observations at health service delivery level in a study district. Results Current drug supply chain management in Uganda is characterized by parallel processes and information systems that result in poor quality and inefficiencies. Less than expected health system performance, stock outs and other shortages affect ART and primary care in general. Poor performance of supply chain management is amplified by weak conditions at all levels of the health system, including the areas of financing, governance, human resources and information. Governance issues include the lack to follow up initial policy intentions and a focus on narrow, short-term approaches. Conclusion The opportunity and need to use ART investments for an essential supply chain management and strengthened health system has not been exploited. By applying a systems perspective this work indicates the seriousness of missing system prerequisites. The findings suggest that root causes and capacities across the system have to be addressed synergistically to

Scaling up antiretroviral therapy in Uganda: using supply chain management to appraise health systems strengthening.

Science.gov (United States)

Windisch, Ricarda; Waiswa, Peter; Neuhann, Florian; Scheibe, Florian; de Savigny, Don

2011-08-01

Strengthened national health systems are necessary for effective and sustained expansion of antiretroviral therapy (ART). ART and its supply chain management in Uganda are largely based on parallel and externally supported efforts. The question arises whether systems are being strengthened to sustain access to ART. This study applies systems thinking to assess supply chain management, the role of external support and whether investments create the needed synergies to strengthen health systems. This study uses the WHO health systems framework and examines the issues of governance, financing, information, human resources and service delivery in relation to supply chain management of medicines and the technologies. It looks at links and causal chains between supply chain management for ART and the national supply system for essential drugs. It combines data from the literature and key informant interviews with observations at health service delivery level in a study district. Current drug supply chain management in Uganda is characterized by parallel processes and information systems that result in poor quality and inefficiencies. Less than expected health system performance, stock outs and other shortages affect ART and primary care in general. Poor performance of supply chain management is amplified by weak conditions at all levels of the health system, including the areas of financing, governance, human resources and information. Governance issues include the lack to follow up initial policy intentions and a focus on narrow, short-term approaches. The opportunity and need to use ART investments for an essential supply chain management and strengthened health system has not been exploited. By applying a systems perspective this work indicates the seriousness of missing system prerequisites. The findings suggest that root causes and capacities across the system have to be addressed synergistically to enable systems that can match and accommodate investments in

Strengthening health facilities for maternal and newborn care: experiences from rural eastern Uganda

Directory of Open Access Journals (Sweden)

Gertrude Namazzi

2015-03-01

Full Text Available Background: In Uganda maternal and neonatal mortality remains high due to a number of factors, including poor quality of care at health facilities. Objective: This paper describes the experience of building capacity for maternal and newborn care at a district hospital and lower-level health facilities in eastern Uganda within the existing system parameters and a robust community outreach programme. Design: This health system strengthening study, part of the Uganda Newborn Study (UNEST, aimed to increase frontline health worker capacity through district-led training, support supervision, and mentoring at one district hospital and 19 lower-level facilities. A once-off supply of essential medicines and equipment was provided to address immediate critical gaps. Health workers were empowered to requisition subsequent supplies through use of district resources. Minimal infrastructure adjustments were provided. Quantitative data collection was done within routine process monitoring and qualitative data were collected during support supervision visits. We use the World Health Organization Health System Building Blocks to describe the process of district-led health facility strengthening. Results: Seventy two per cent of eligible health workers were trained. The mean post-training knowledge score was 68% compared to 32% in the pre-training test, and 80% 1 year later. Health worker skills and competencies in care of high-risk babies improved following support supervision and mentoring. Health facility deliveries increased from 3,151 to 4,115 (a 30% increase in 2 years. Of 547 preterm babies admitted to the newly introduced kangaroo mother care (KMC unit, 85% were discharged alive to continue KMC at home. There was a non-significant declining trend for in-hospital neonatal deaths across the 2-year study period. While equipment levels remained high after initial improvement efforts, maintaining supply of even the most basic medications was a challenge, with

Structural Parameters and Strengthening Mechanisms in Cold-Drawn Pearlitic Steel Wires

DEFF Research Database (Denmark)

Zhang, Xiaodan; Godfrey, Andy; Huang, Xiaoxu

2012-01-01

Pearlitic steel wires have a nanoscale structure and a strength which can reach 5 GPa. In order to investigate strengthening mechanisms, structural parameters including interlamellar spacing, dislocation density and cementite decomposition, have been analyzed by transmission electron microscopy...... and high resolution electron microscopy in wires cold drawn up to a strain of 3.7. Three strengthening mechanisms, namely boundary strengthening, dislocation strengthening and solid solution hardening have been analyzed and good agreement has been found between the measured flow stress and the value...

Possible Role of Hadley Circulation Strengthening in Interdecadal Intensification of Snowfalls Over Northeastern China Under Climate Change

Science.gov (United States)

Zhou, Botao; Wang, Zunya; Shi, Ying

2017-11-01

This article revealed that strengthening of winter Hadley circulation in the context of climate change may partially contribute to interdecadal increasing of snowfall intensity over northeastern China in recent decades. This hypothesis is well supported by the process-based linkage between Hadley circulation and atmospheric circulations over the Asian-Pacific region on the interdecadal time scale. The strengthening of winter Hadley circulation corresponds to a weakening of the Siberian high, an eastward shifting of the Aleutian low, a reduction of the East Asian trough, and anomalous southwesterly prevailing over northeastern China. These atmospheric situations weaken the East Asian winter monsoon and lead to an increase of air temperature over northeastern China. Increased local evaporation due to the increase of air temperature, concurrent with more water vapor transported from the Pacific Ocean, can significantly enhance atmospheric water vapor content in the target region. Meanwhile, the ascending of airflows is also strengthened over northeastern China. All of these provide favorable interdecadal backgrounds for the occurrence of intense snowfalls, and thus, snowfall intensity is intensified over northeastern China after the 1980s. Further analysis suggests that the circum-Pacific-like teleconnection pattern may play an important role in connecting Hadley circulation strengthening signal and atmospheric circulation anomalies favoring interdecadal intensification of snowfalls over northeastern China.

Initial Semantics for Strengthened Signatures

Directory of Open Access Journals (Sweden)

André Hirschowitz

2012-02-01

Full Text Available We give a new general definition of arity, yielding the companion notions of signature and associated syntax. This setting is modular in the sense requested by Ghani and Uustalu: merging two extensions of syntax corresponds to building an amalgamated sum. These signatures are too general in the sense that we are not able to prove the existence of an associated syntax in this general context. So we have to select arities and signatures for which there exists the desired initial monad. For this, we follow a track opened by Matthes and Uustalu: we introduce a notion of strengthened arity and prove that the corresponding signatures have initial semantics (i.e. associated syntax. Our strengthened arities admit colimits, which allows the treatment of the λ-calculus with explicit substitution.

South-South cooperation as a mechanism to strengthen public ...

African Journals Online (AJOL)

South-South cooperation as a mechanism to strengthen public health services in Africa: ... PROMOTING ACCESS TO AFRICAN RESEARCH ... Implementation of new models of development cooperation have been on the increase ... health system strengthening, aid effectiveness, sustainable development goals, Africa ...

ESTIMATION OF SUBGRADE STRENGTHENING INFLUENCE USING SOILCEMENT ELEMENTS

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V. D. Petrenko

2016-08-01

Full Text Available Purpose. The aim of this work is to identify dependencies and options to strengthen the roadbed and a weak base by grouting piles. Analysis of software package SCAD to assess the effect of the selected option of strengthening the construction of spatial subgrade models. Methodology. In this paper the method of calculation of the soil mass in the software package SCAD is considered, which is a universal accounting system of finite-element analysis of structures and is focused on solving problems of designing buildings and structures rather complex structure. The finite element method is among the most modern and effective methods for the calculation of structures for various purposes. In the simulation, we get a complete picture of the stress-strain state of the study area, as well as the value of the limit load, rainfall, and so on. The spatial model based on the finite element volume, to better address the real characteristics of the soil mass, meets all the geometric characteristics of size and natural subgrade and the top structure the path that has been adopted in Ukraine. Findings. It was found that the most effective option to strengthen the roadbed, when applying grouting piles at the base of the subgrade and body, is to strengthen the five piles. At the same time there is even strengthen the soil mass at the level of 25 … 30% of the entire depth. However, even with the strengthening of the only two piles at the base of the effect of the strengthening of 14.1%. Established equation is linear and describes the decrease in strain. Taking into account the results of the research can be concluded that the consolidation is proportional to the depth with any number of piles. The dependence of the strain on the number of piles adheres to a polynomial function. Strengthening the bases of the subgrade and body depth also occurs in proportion with any number of piles. Originality. Design scheme generation algorithm for the calculation of the

Behavior of masonry strengthened infilled reinforced concrete frames under in-plane load

Directory of Open Access Journals (Sweden)

Lila M. Abdel-Hafez

2015-08-01

The ductility of infilled frame strengthened with ferrocement was the best of all strengthened frames, while strengthening with GFRP increases its ultimate load carrying capacity but reduces its ductility.

Building and strengthening infrastructure for data exchange: lessons from the beacon communities.

Science.gov (United States)

Torres, Gretchen W; Swietek, Karen; Ubri, Petry S; Singer, Rachel F; Lowell, Kristina H; Miller, Wilhelmine

2014-01-01

The Beacon Community Cooperative Agreement Program supports interventions, including care-delivery innovations, provider performance measurement and feedback initiatives, and tools for providers and consumers to enhance care. Using a learning health system framework, we examine the Beacon Communities' processes in building and strengthening health IT (HIT) infrastructures, specifically successes and challenges in sharing patient information to improve clinical care. In 2010, the Office of the National Coordinator for Health Information Technology (ONC) launched the three-year program, which provided $250 million to 17 Beacon Communities to invest in HIT and health information exchange (HIE) infrastructure. Beacon Communities used this funding to develop and disseminate HIT-enabled quality improvement practices found effective in particular community and practice environments. NORC conducted 7 site visits, November 2012-March 2013, selecting Communities to represent diverse program features. From August-October 2013, NORC held discussions with the remaining 10 Communities. Following each visit or discussion, NORC summarized the information gathered, including transcripts, team observations, and other documents the Community provided, to facilitate a within-Community analysis of context and stakeholders, intervention strategies, enabling factors, and challenges. Although each Community designed and implemented data-sharing strategies in a unique environment, similar challenges and enabling factors emerged across the Beacons. From a learning health system perspective, their strategies to build and strengthen data-sharing infrastructures address the following crosscutting priorities: promoting technical advances and innovations by helping providers adapt EHRs for data exchange and performance measurement with customizable IT and offering technical support to smaller, independent providers; engaging key stakeholders; and fostering transparent governance and stewardship

Flexural Strengthening of RC Slabs with Prestressed CFRP Strips Using Different Anchorage Systems

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José Sena-Cruz

2015-10-01

Full Text Available Externally Bonded Reinforcement (EBR technique has been widely used for flexural strengthening of concrete structures by using carbon fiber-reinforced polymers (CFRP. EBR technique offers several structural advantages when the CFRP material is prestressed. This paper presents an experimental and numerical study on reinforced (RC slabs strengthened in flexure with prestressed CFRP strips as a structural strengthening system. The strips are applied as an externally bonded reinforcement (EBR and anchored with either a mechanical or a gradient anchorage. The former foresees metallic anchorage plates fixed to the concrete substrate, while the latter is based on an accelerated epoxy resin curing followed by a segment-wise prestress force decrease at the strip ends. Both anchorage systems, in combination with different CFRP strip geometries, were subjected to static loading tests. It could be demonstrated that the composite strip’s performance is better exploited when prestressing is used, with slightly higher overall load carrying capacities for mechanical anchorages than for the gradient anchorage. The performed investigations by means of a cross-section analysis supported the experimental observation that in case a mechanical anchorage is used, progressive strip debonding changes the fully bonded configuration to an unbonded end-anchored system. The inclusion of defined debonding criteria for both the anchorage zones and free length between the anchorage regions allowed to precisely capture the ultimate loading forces.

Dislocation Strengthening without Ductility Trade-off in Metastable Austenitic Steels

Science.gov (United States)

Liu, Jiabin; Jin, Yongbin; Fang, Xiaoyang; Chen, Chenxu; Feng, Qiong; Liu, Xiaowei; Chen, Yuzeng; Suo, Tao; Zhao, Feng; Huang, Tianlin; Wang, Hongtao; Wang, Xi; Fang, Youtong; Wei, Yujie; Meng, Liang; Lu, Jian; Yang, Wei

2016-10-01

Strength and ductility are mutually exclusive if they are manifested as consequence of the coupling between strengthening and toughening mechanisms. One notable example is dislocation strengthening in metals, which invariably leads to reduced ductility. However, this trend is averted in metastable austenitic steels. A one-step thermal mechanical treatment (TMT), i.e. hot rolling, can effectively enhance the yielding strength of the metastable austenitic steel from 322 ± 18 MPa to 675 ± 15 MPa, while retaining both the formability and hardenability. It is noted that no boundaries are introduced in the optimized TMT process and all strengthening effect originates from dislocations with inherited thermal stability. The success of this method relies on the decoupled strengthening and toughening mechanisms in metastable austenitic steels, in which yield strength is controlled by initial dislocation density while ductility is retained by the capability to nucleate new dislocations to carry plastic deformation. Especially, the simplicity in processing enables scaling and industrial applications to meet the challenging requirements of emissions reduction. On the other hand, the complexity in the underlying mechanism of dislocation strengthening in this case may shed light on a different route of material strengthening by stimulating dislocation activities, rather than impeding motion of dislocations.

On Mourning and Recovery: Integrating Stages of Grief and Change Toward a Neuroscience-Based Model of Attachment Adaptation in Addiction Treatment.

Science.gov (United States)

Chambers, R Andrew; Wallingford, Sue C

2017-01-01

Interpersonal attachment and drug addiction share many attributes across their behavioral and neurobiological domains. Understanding the overlapping brain circuitry of attachment formation and addiction illuminates a deeper understanding of the pathogenesis of trauma-related mental illnesses and comorbid substance use disorders, and the extent to which ending an addiction is complicated by being a sort of mourning process. Attention to the process of addiction recovery-as a form of grieving-in which Kubler-Ross's stages of grief and Prochaska's stages of change are ultimately describing complementary viewpoints on a general process of neural network and attachment remodeling, could lead to more effective and integrative psychotherapy and medication strategies.

Strengthening global practices for protecting nuclear material (NUMAT). Book of Abstracts

International Nuclear Information System (INIS)

Steinhaeusler, F.; Heissl, C.

2002-08-01

The International Conference on Physical Protection 'Strengthening Global Practices for Protecting Nuclear Material' was organized by the Institute of Physics and Biophysics, Salzburg University in cooperation with/supported by the European Commission, Lawrence Livermore National Laboratory, European Forum of the Stanford University's Institute for International Studies and Austria Institute for European Security. Its purpose was fostering exchange of information on the policy and technical aspects require to ensure the security of nuclear material around the world. There is a general concern that the international community needs to establish effective measures to counter theft, sabotage, and other illicit uses of nuclear fissile and other radioactive materials. The main subjects addressed by this conference were: a) global and local threat development and 'design basis'; b) standards for physical protection (PP), its adequacy and future needs; c) national practices in PP of nuclear materials (how to strengthen national security culture?); d) current R and D in security and detection technologies (identification of focus points for future R and D); e) programmes to aid in training, design, and implementation of physical protection systems (how to improve efficiency and assure sustainability of assistance programmes?). (nevyjel)

On the superposition of strengthening mechanisms in dispersion strengthened alloys and metal-matrix nanocomposites: Considerations of stress and energy

Science.gov (United States)

Ferguson, J. B.; Schultz, Benjamin F.; Venugopalan, Dev; Lopez, Hugo F.; Rohatgi, Pradeep K.; Cho, Kyu; Kim, Chang-Soo

2014-03-01

Yield strength improvement in dispersion strengthened alloys and nano particle-reinforced composites by well-known strengthening mechanisms such as solid solution, grain refinement, coherent and incoherent dispersed particles, and increased dislocation density resulting from work-hardening can all be described individually. However, there is no agreed upon description of how these mechanisms combine to determine the yield strength. In this work, we propose an analytical yield strength prediction model combining arithmetic and quadratic addition approaches based on the consideration of two types of yielding mechanisms; stress-activated and energy-activated. Using data available in the literature for materials of differing grain sizes, we consider the cases of solid solutions and coherent precipitates to show that they follow stress-activated behavior. Then, we applied our model with some empirical parameters to precipitationhardenable materials of various grain sizes in both coherent and incoherent precipitate conditions, which demonstrated that grain boundary and Orowan-strengthening can be treated as energy-activated mechanisms.

Strengthening Leadership Competencies of Thai Secondary School Teachers

OpenAIRE

Chaiyot Wanutha; Kowat Tesaputa; Anan Sri-Ampai

2017-01-01

The research aimed 1) to investigate components and indicators of the leadership competencies of secondary school teachers, 2) to explore the existing situations and desirable situations of secondary school teachers’ leadership competencies, 3) to study the techniques to strengthen teachers’ leadership competencies, 4) to develop the teacher-leadership competencies strengthening program, and 5) to find out the results of implementing the program to improve the teacher’s ...

Squeeze strengthening of magnetorheological fluids using mixed mode operation

Science.gov (United States)

Becnel, A. C.; Sherman, S. G.; Hu, W.; Wereley, N. M.

2015-05-01

This research details a novel method of increasing the shear yield stress of magnetorheological fluids by combining shear and squeeze modes of operation to manipulate particle chain structures, so-called squeeze strengthening. Using a custom built Searle cell magnetorheometer, which is a model device emulating a rotary magnetorheological energy absorber (MREA), the contribution of squeeze strengthening to the total controllable yield force is experimentally investigated. Using an eccentric rotating inner cylinder, characterization data from large (1 mm) and small (0.25 mm) nominal gap geometries are compared to investigate the squeeze strengthening effect. Details of the experimental setup and method are presented, and a hybrid model is used to explain experimental trends. This study demonstrates that it is feasible, utilizing squeeze strengthening to increase yield stress, to either (1) design a rotary MREA of a given volume to achieve higher energy absorption density (energy absorbed normalized by active fluid volume), or (2) reduce the volume of a given rotary MREA to achieve the same energy absorption density.

Direct dorsal hippocampal-prelimbic cortex connections strengthen fear memories.

Science.gov (United States)

Ye, Xiaojing; Kapeller-Libermann, Dana; Travaglia, Alessio; Inda, M Carmen; Alberini, Cristina M

2017-01-01

The ability to regulate the consolidation and strengthening of memories for threatening experiences is critical for mental health, and its dysregulation may lead to psychopathologies. Re-exposure to the context in which the threat was experienced can either increase or decrease fear response through distinct processes known, respectively, as reconsolidation or extinction. Using a context retrieval-dependent memory-enhancement model in rats, we report that memory strengthens through activation of direct projections from dorsal hippocampus to prelimbic (PL) cortex and activation of critical PL molecular mechanisms that are not required for extinction. Furthermore, while sustained PL brain-derived neurotrophic factor (BDNF) expression is required for memory consolidation, retrieval engages PL BDNF to regulate excitatory and inhibitory synaptic proteins neuroligin 1 and neuroligin 2, which promote memory strengthening while inhibiting extinction. Thus, context retrieval-mediated fear-memory enhancement results from a concerted action of mechanisms that strengthen memory through reconsolidation while suppressing extinction.

Towards Rational Design Method for Strengthening of Concrete Structures by External Bonding

Directory of Open Access Journals (Sweden)

Furuuchi H.

2012-01-01

Full Text Available Many infrastructures need to be repaired or strengthened due to various reasons, such as unexpected deterioration and changes in performance requirement. This paper presents the following recent achievements by the authors’ group on design method for flexural strengthening of concrete structures by external bonding; (i fracture characteristics of interface between substrate concrete and cementitious overlay, (ii crack spacing of flexural strengthened beams, which affects debonding strength, (iii strengths of intermediate crack (IC debonding and end peeling, (iv strength of concrete cover separation, and (v effectiveness of strengthening by external bonding. A unified approach for flexural strengthening by steel plate, fiber reinforced polymer lami¬nate and cementitious overlay, for both intermediate crack (IC debonding, including end peeling, and concrete cover separation is pre¬sented with consideration of crack spacing in the streng¬thened members. Appropriate interfacial rough¬¬¬ness to achieve efficient interface bond property is clari¬fied and the concept of effectiveness of strengthen¬ing is proposed for better strengthening design.

Bonding techniques for flexural strengthening of R.C. beams using CFRP laminates

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Alaa Morsy

2013-09-01

Full Text Available This paper presents an experimental study of an alternative method of attaching FRP laminates to reinforced concrete beams by the way of fasting steel rivets through the FRP laminate and concrete substrate. Five full scale R.C. beams were casted and strengthened in flexural using FRP laminate bonded with conventional epoxy and compared with other beams strengthened with FRP laminate and bonded with fastener “steel rivets” of 50 mm length and 10 mm diameter. Based on experimental evidence the beam strengthened with conventional bonding methods failed due to de-bonding with about 13% increase over the un-strengthened beam. On the other hand, the beams strengthened with FRP laminate and bonded by four steel fastener rivets only failed by de-bonding also but at higher flexural capacity with increase 19% over the un-strengthened beam.

Shear Strengthening of Concrete Structures with the use of mineral based composites

DEFF Research Database (Denmark)

Blanksvärd, Thomas; Täljsten, Björn; Carolin, Anders

2009-01-01

concrete (RC) beams strengthened in shear with the use of cementitious bonding agents and carbon fiber grids, denoted mineral based composites (MBC). In this study it is shown that the MBC system has a strengthening effect corresponding to that of strengthening systems using epoxy bonding agents and carbon...... for rehabilitation. In addition, more traffic and heavier loads lead to the need for upgrading. Existing externally bonded strengthening systems using FRP (fiber reinforced polymers) and epoxy as bonding agents have been proven to be a good approach to repair and strengthen concrete structures. However, the use...... fiber sheets. Different designs and material properties of the MBC system have been tested. An extensive monitoring set-up has been carried out using traditional strain gauges and photometric strain measurements to obtain strains in steel reinforcement, in FRP and strain fields on the strengthened...

Numerical Study Of The Effects Of Preloading, Axial Loading And Concrete Shrinkage On Reinforced Concrete Elements Strengthened By Concrete Layers And Jackets

International Nuclear Information System (INIS)

Lampropoulos, A. P.; Dritsos, S. E.

2008-01-01

In this study, the technique of seismic strengthening existing reinforced concrete columns and beams using additional concrete layers and jackets is examined. The finite element method and the finite element program ATENA is used in this investigation. When a reinforced jacket or layer is being constructed around a column it is already preloaded due to existing service loads. This effect has been examined for different values of the axial load normalized to the strengthened column. The techniques of strengthening with a concrete jacket or a reinforced concrete layer on the compressive side of the column are examined. Another phenomenon that is examined in this study is the shrinkage of the new concrete of an additional layer used to strengthen an existing member. For this investigation, a simply supported beam with an additional reinforced concrete layer on the tensile side is examined. The results demonstrate that the effect of preloading is important when a reinforced concrete layer is being used with shear connectors between the old and the new reinforcement. It was also found that the shrinkage of the new concrete reduces the strength of the strengthened beam and induces an initial sliding between the old and the new concrete

FRP strengthening of RC walls with openings

DEFF Research Database (Denmark)

Hansen, Christian Skodborg; Sas, Gabriel; Täljsten, Björn

2009-01-01

Strengthening reinforced concrete (RC) walls with openings using fibre reinforced polymers (FRP) has been experimentally proven to be a viable rehabilitation method. However, very few theoretical investigations are reported. In this paper two methods of analysis are presented. Since openings vary...... in size, the analysis of a strengthened wall can be divided into frame idealization method for large openings, and combined disk and frame analysis for smaller openings. The first method provides an easy to use tool in practical engineering, where the latter describes the principles of a ductile...

"It takes more than a fellowship program": reflections on capacity strengthening for health systems research in sub-Saharan Africa.

Science.gov (United States)

Izugbara, Chimaraoke O; Kabiru, Caroline W; Amendah, Djesika; Dimbuene, Zacharie Tsala; Donfouet, Hermann Pythagore Pierre; Atake, Esso-Hanam; Ingabire, Marie-Gloriose; Maluka, Stephen; Mumah, Joyce N; Mwau, Matilu; Ndinya, Mollyne; Ngure, Kenneth; Sidze, Estelle M; Sossa, Charles; Soura, Abdramane; Ezeh, Alex C

2017-12-04

Sub-Saharan Africa (SSA) experiences an acute dearth of well-trained and skilled researchers. This dearth constrains the region's capacity to identify and address the root causes of its poor social, health, development, and other outcomes. Building sustainable research capacity in SSA requires, among other things, locally led and run initiatives that draw on existing regional capacities as well as mutually beneficial global collaborations. This paper describes a regional research capacity strengthening initiative-the African Doctoral Dissertation Research Fellowship (ADDRF) program. This Africa-based and African-led initiative has emerged as a practical and tested platform for producing and nurturing research leaders, strengthening university-wide systems for quality research training and productivity, and building a critical mass of highly-trained African scholars and researchers. The program deploys different interventions to ensure the success of fellows. These interventions include research methods and scientific writing workshops, research and reentry support grants, post-doctoral research support and placements, as well as grants for networking and scholarly conferences attendance. Across the region, ADDRF graduates are emerging as research leaders, showing signs of becoming the next generation of world-class researchers, and supporting the transformations of their home-institutions. While the contributions of the ADDRF program to research capacity strengthening in the region are significant, the sustainability of the initiative and other research and training fellowship programs on the continent requires significant investments from local sources and, especially, governments and the private sector in Africa. The ADDRF experience demonstrates that research capacity building in Africa is possible through innovative, multifaceted interventions that support graduate students to develop different critical capacities and transferable skills and build, expand, and

Experimental Investigation on Strengthening of Bolted Connections in Transmission/Communication Towers

Science.gov (United States)

Balagopal, R.; Prasad Rao, N.; Rokade, R. P.; Umesha, P. K.

2018-02-01

Due to increase in demand for power supply and increase in bandwidth for communication industry, the existing transmission line (TL) and communication towers needs to be strengthened. The strengthening of existing tower is economical rather than installation of new towers due to constraints in acquisition of land. The size of conductors have to be increased or additional number of antenna needs to be installed in existing TL/communication tower respectively. The compression and tension capacity of members in the existing towers have to be increased to sustain the additional loads due to wind and self-weight of these components. The tension capacity enhancement of existing angle sections in live line condition without power shut-down is a challenging task. In the present study, the use of Glass Fiber Reinforced Plastic (GFRP) plate/angle sections is explored to strengthen existing bolted connections in TL/communication towers. Experimental investigation conducted at component level on strengthening of existing two types of single cover steel butt joint, one made of steel plate and another joint made of steel angle sections respectively. First series of experiment conducted on strengthening the connection using GFRP plate/cleat angle sections. The second series of strengthening experiment is conducted using steel plate/angle sections to replace GFRP sections. The load sharing behaviour of strengthened GFRP and steel section is compared and suitable recommendations are given.

Experimental Investigation on Strengthening of Bolted Connections in Transmission/Communication Towers

Science.gov (United States)

Balagopal, R.; Prasad Rao, N.; Rokade, R. P.; Umesha, P. K.

2018-06-01

Due to increase in demand for power supply and increase in bandwidth for communication industry, the existing transmission line (TL) and communication towers needs to be strengthened. The strengthening of existing tower is economical rather than installation of new towers due to constraints in acquisition of land. The size of conductors have to be increased or additional number of antenna needs to be installed in existing TL/communication tower respectively. The compression and tension capacity of members in the existing towers have to be increased to sustain the additional loads due to wind and self-weight of these components. The tension capacity enhancement of existing angle sections in live line condition without power shut-down is a challenging task. In the present study, the use of Glass Fiber Reinforced Plastic (GFRP) plate/angle sections is explored to strengthen existing bolted connections in TL/communication towers. Experimental investigation conducted at component level on strengthening of existing two types of single cover steel butt joint, one made of steel plate and another joint made of steel angle sections respectively. First series of experiment conducted on strengthening the connection using GFRP plate/cleat angle sections. The second series of strengthening experiment is conducted using steel plate/angle sections to replace GFRP sections. The load sharing behaviour of strengthened GFRP and steel section is compared and suitable recommendations are given.

Contribution of the Japan International Cooperation Agency health-related projects to health system strengthening.

Science.gov (United States)

Yuasa, Motoyuki; Yamaguchi, Yoshie; Imada, Mihoko

2013-09-22

The Japan International Cooperation Agency (JICA) has focused its attention on appraising health development assistance projects and redirecting efforts towards health system strengthening. This study aimed to describe the type of project and targets of interest, and assess the contribution of JICA health-related projects to strengthening health systems worldwide. We collected a web-based Project Design Matrix (PDM) of 105 JICA projects implemented between January 2005 and December 2009. We developed an analytical matrix based on the World Health Organization (WHO) health system framework to examine the PDM data and thereby assess the projects' contributions to health system strengthening. The majority of JICA projects had prioritized workforce development, and improvements in governance and service delivery. Conversely, there was little assistance for finance or medical product development. The vast majority (87.6%) of JICA projects addressed public health issues, for example programs to improve maternal and child health, and the prevention and treatment of infectious diseases such as AIDS, tuberculosis and malaria. Nearly 90% of JICA technical healthcare assistance directly focused on improving governance as the most critical means of accomplishing its goals. Our study confirmed that JICA projects met the goals of bilateral cooperation by developing workforce capacity and governance. Nevertheless, our findings suggest that JICA assistance could be used to support financial aspects of healthcare systems, which is an area of increasing concern. We also showed that the analytical matrix methodology is an effective means of examining the component of health system strengthening to which the activity and output of a project contributes. This may help policy makers and practitioners focus future projects on priority areas.

FIRE PROTECTION OF TIMBER STRUCTURES STRENGTHENED WITH FRP MATERIALS

Directory of Open Access Journals (Sweden)

Radek Zigler

2015-12-01

Full Text Available Modern, progressive methods of structures’ strengthening based on the use of composite materials composed of high strength fibers (carbon, glass, aramid or basalt and matrices based on epoxy resins brings, among many indisputable advantages (low weight, high effectiveness, easy application etc. also some disadvantages. One of the major disadvantages is a low fire resistance of these materials due to the low glass transition temperature Tg of the resin used. Based on an extensive research of strengthening of historic structures with FRP materials [1], the article outlines possible approaches to this problem, especially while strengthening timber load- bearing structures of historic buildings.

Afrontar el proceso de duelo To deal with grief

Directory of Open Access Journals (Sweden)

Mª Trinidad Pérez Vallejo

2008-06-01

Full Text Available Ana, con su testimonio y con su vida nos enseña como afrontar los procesos de duelo. La muerte de su esposo se produce en febrero de 2005, este suceso fue probablemente la experiencia más difícil e importante que ha pasado durante sus 74 años de vida. Ana cuidó a su esposo durante la enfermedad con celo, dedicación y sobre todo con mucho amor. Ahora nos cuenta su experiencia para que pueda servir a aliviar a todas aquellas personas que se hallan en una situación semejante, a la vez, que rinde homenaje a su esposo que con su vida llena de salud y vitalidad le enseñó a morir. Ana tiene una vida plena dedicada a ayudar a los más necesitados, y canaliza esa ayuda con la gente de su barrio visitando a los enfermos, a los que se encuentran solos y los que tienen condiciones económicas más adversas.Anne, in her testimony and life, teaches us how to deal with grief. The death of her husband, on February, 2005, was probably the most difficult and important occurance in the 74 years of her life. Anne had cared for her husband with zeal, dedication and most importantly, love. Anne shares her experience with us so that it may help to alleviate those of us who find ourselves in a similar situation, and at the same time, pays homage to her husband who, when he was filled whit health and vitality, taught to die. Now Anne has a full life dedicated to helping the most needy as she channels this help through the people of her neighbourhood, visiting the ill, the lonely and those in the most adverse economic circumstances.

Strengthening the sports data infrastructure

NARCIS (Netherlands)

Annet Tiessen-Raaphorst; Jos de Haan; with contributions from Remco van den Dool

2012-01-01

Original title: Versterking data-infrastructuur sport Sports research in the Netherlands has developed rapidly over the last ten years; strengthening the data infrastructure will facilitate its further growth in the future. Currently, however, there is no clear overall picture of the available

Behaviour of Strengthened RC Frames with Eccentric Steel Braced Frames

Science.gov (United States)

Kamanli, Mehmet; Unal, Alptug

2017-10-01

After devastating earthquakes in recent years, strengthening of reinforced concrete buildings became an important research topic. Reinforced concrete buildings can be strengthened by steel braced frames. These steel braced frames may be made of concentrically or eccentrically indicated in Turkish Earthquake Code 2007. In this study pushover analysis of the 1/3 scaled 1 reinforced concrete frame and 1/3 scaled 4 strengthened reinforced concrete frames with internal eccentric steel braced frames were conducted by SAP2000 program. According to the results of the analyses conducted, load-displacement curves of the specimens were compared and evaluated. Adding eccentric steel braces to the bare frame decreased the story drift, and significantly increased strength, stiffness and energy dissipation capacity. In this strengthening method lateral load carrying capacity, stiffness and dissipated energy of the structure can be increased.

Strengthening health-related rehabilitation services at national levels.

Science.gov (United States)

Gutenbrunner, Christoph; Bickenbach, Jerome; Melvin, John; Lains, Jorge; Nugraha, Boya

2018-04-18

One of the aims of the World Health Organization's Global Disability Action Plan is to strengthen rehabilitation services. Some countries have requested support to develop (scale-up) rehabilitation services. This paper describes the measures required and how (advisory) missions can support this purpose, with the aim of developing National Disability, Health and Rehabilitation Plans. It is important to clarify the involvement of governments in the mission, to define clear terms of reference, and to use a systematic pathway for situation assessment. Information must be collected regarding policies, health, disability, rehabilitation, social security systems, the need for rehabilitation, and the existing rehabilitation services and workforce. Site visits and stakeholder dialogues must be done. In order to develop a Rehabilitation Service Implementation Framework, existing rehabilitation services, workforce, and models for service implementation and development of rehabilitation professions are described. Governance, political will and a common understanding of disability and rehabilitation are crucial for implementation of the process. The recommendations of the World Report on Disability are used for reporting purposes. This concept is feasible, and leads to concrete recommendations and proposals for projects and a high level of consensus stakeholders.

Strengthening health-related rehabilitation services at national levels

Directory of Open Access Journals (Sweden)

Christoph Gutenbrunner

2017-04-01

Full Text Available Objective: One of the aims of the World Health Organization’s Global Disability Action Plan is to strengthen rehabilitation services. Some countries have requested support to develop (scale-up rehabilitation services. This paper describes the measures required and how (advisory missions can support this purpose, with the aim of developing National Disability, Health and Rehabilitation Plans. Recommendations: It is important to clarify the involvement of governments in the mission, to define clear terms of reference, and to use a systematic pathway for situation assessment. Information must be collected regarding policies, health, disability, rehabilitation, social security systems, the need for rehabilitation, and the existing rehabilitation services and workforce. Site visits and stakeholder dialogues must be done. In order to develop a Rehabilitation Service Implementation Framework, existing rehabilitation services, workforce, and models for service implementation and development of rehabilitation professions are described. Governance, political will and a common understanding of disability and rehabilitation are crucial for implementation of the process. The recommendations of the World Report on Disability are used for reporting purposes. Conclusion: This concept is feasible, and leads to concrete recommendations and proposals for projects and a high level of consensus stakeholders.

A pilot study on the effectiveness of anticipatory grief therapy for elderly facing the end of life.

Science.gov (United States)

Cheng, Joanna Oi-Yue; Lo, Raymond; Chan, Faye; Woo, Jean

2010-01-01

This pilot study evaluates the benefits of anticipatory grief therapy (AGT) for day hospice patients and long-term care (LTC) residents with cancer and non-malignant chronic diseases. Twenty-six elderly people (69.2 percent female; average age 81.8 years) participated in experiential, expressive activities and discussions during AGT. The McGill Quality of Life Questionnaire-Hong Kong version and the 15-item Geriatrics Depression Scale (Chinese version) were administered immediately before and after AGT, and at a four-week follow-up. Focus groups were held to collect qualitative feedback. Significant post-AGT improvements were found in physical (Z = -2.12, p art, perceived benefits of AGT, and comments and suggestions for improving AGT in the future. We conclude that AGT delivered in both day hospice and LTC settings could be acceptable, feasible, and useful for elderly people facing the end of life.

Ubiquitous media in everyday practices of grief and commemoration on children’s graves and online memorial sites

DEFF Research Database (Denmark)

Sandvik, Kjetil; Christensen, Dorthe Refslund

is not allocated to a specific period of time (a time of mourning) but that grieving and the social technologies like media, materiality and ritualization related to it are embedded in everyday life practices and have to be conceived of as processes rather than events that (suddenly) occur and then are over......’s graves in urban cemeteries. It is, however, also similarly apparent in the formation of network and peer-to-peer associations and, not the least, in the establishment of online networks and sites of grief and commemoration on social media. Facebook, Twitter and YouTube are media alive with discussions...... as such (Featherstone 1992, Elias 1998) and in relation to death practices (Gibson 2008). In recent years, media research has contributed to the field of death studies. Mediatization studies have focused on how various societal practices are influenced by media logics (Livingstone 2009, Lundby 2009) including religious...

Strengthening Nordic-Baltic Defense Capabilities

DEFF Research Database (Denmark)

Breitenbauch, Henrik Ø.

2014-01-01

and troubling challenge to the way international security has been structured in Europe since the end of the Cold War. While most of the existing defense cooperation with a view of strengthening defense capabilities has been carried out within the internationally renowned framework of NORDEFCO...

Global health initiative investments and health systems strengthening: a content analysis of global fund investments.

Science.gov (United States)

Warren, Ashley E; Wyss, Kaspar; Shakarishvili, George; Atun, Rifat; de Savigny, Don

2013-07-26

Millions of dollars are invested annually under the umbrella of national health systems strengthening. Global health initiatives provide funding for low- and middle-income countries through disease-oriented programmes while maintaining that the interventions simultaneously strengthen systems. However, it is as yet unclear which, and to what extent, system-level interventions are being funded by these initiatives, nor is it clear how much funding they allocate to disease-specific activities - through conventional 'vertical-programming' approach. Such funding can be channelled to one or more of the health system building blocks while targeting disease(s) or explicitly to system-wide activities. We operationalized the World Health Organization health system framework of the six building blocks to conduct a detailed assessment of Global Fund health system investments. Our application of this framework framework provides a comprehensive quantification of system-level interventions. We applied this systematically to a random subset of 52 of the 139 grants funded in Round 8 of the Global Fund to Fight AIDS, Tuberculosis and Malaria (totalling approximately US$1 billion). According to the analysis, 37% (US$ 362 million) of the Global Fund Round 8 funding was allocated to health systems strengthening. Of that, 38% (US$ 139 million) was for generic system-level interventions, rather than disease-specific system support. Around 82% of health systems strengthening funding (US$ 296 million) was allocated to service delivery, human resources, and medicines & technology, and within each of these to two to three interventions. Governance, financing, and information building blocks received relatively low funding. This study shows that a substantial portion of Global Fund's Round 8 funds was devoted to health systems strengthening. Dramatic skewing among the health system building blocks suggests opportunities for more balanced investments with regard to governance, financing, and

Microstructure and strengthening mechanisms in cold-drawn pearlitic steel wire

DEFF Research Database (Denmark)

Zhang, Xiaodan; Godfrey, Andy; Huang, Xiaoxu

2011-01-01

Strengthening mechanisms and strength–structure relationships have been analyzed in a cold-drawn pearlitic steel with a structural scale in the nanometer range and a flow stress of about 3.5GPa. The wires have been drawn up to a strain of 3.7 and the structures analyzed and quantified by transmis......Strengthening mechanisms and strength–structure relationships have been analyzed in a cold-drawn pearlitic steel with a structural scale in the nanometer range and a flow stress of about 3.5GPa. The wires have been drawn up to a strain of 3.7 and the structures analyzed and quantified...... by transmission electron microscopy and high resolution electron microscopy. The mechanical properties have been determined by tensile testing. It is found that the interlamellar spacing and the thickness of the cementite lamellae are reduced in accordance with the changes in wire diameter up to a strain of 2...... at the ferrite/cementite interface. Three strengthening mechanisms have been analyzed: (i) boundary strengthening, (ii) dislocation strengthening and (iii) solid solution hardening. The individual and combined contributions, based on an assumption of linear additivity, of these mechanisms to the wire strength...

Transforming the Roles of a Public Extension Agency to Strengthen Innovation: Lessons from the National Agricultural Extension Project in Bangladesh

Science.gov (United States)

Chowdhury, Ataharul Huq; Odame, Helen Hambly; Leeuwis, Cees

2014-01-01

Purpose: The rapidly evolving nature of agricultural innovation processes in low-income countries requires agricultural extension agencies to transform the classical roles that previously supported linear information dissemination and adoption of innovation. In Bangladesh, strengthening agricultural innovation calls for facilitation of interactive…

Behaviour of Strengthened RC Frames with Eccentric Steel Braced Frames

Directory of Open Access Journals (Sweden)

Kamanli Mehmet

2017-01-01

Full Text Available After devastating earthquakes in recent years, strengthening of reinforced concrete buildings became an important research topic. Reinforced concrete buildings can be strengthened by steel braced frames. These steel braced frames may be made of concentrically or eccentrically indicated in Turkish Earthquake Code 2007. In this study pushover analysis of the 1/3 scaled 1 reinforced concrete frame and 1/3 scaled 4 strengthened reinforced concrete frames with internal eccentric steel braced frames were conducted by SAP2000 program. According to the results of the analyses conducted, load-displacement curves of the specimens were compared and evaluated. Adding eccentric steel braces to the bare frame decreased the story drift, and significantly increased strength, stiffness and energy dissipation capacity. In this strengthening method lateral load carrying capacity, stiffness and dissipated energy of the structure can be increased.

The temporal relationship between change in symptoms of prolonged grief and posttraumatic stress following old age spousal bereavement

DEFF Research Database (Denmark)

O Connor, Maja; Nickerson, Angela; Aderka, Idan M.

2015-01-01

Background: High levels of both prolonged grief symptoms (PGS) and posttraumatic stress symptoms (PTSS) are relatively common following bereavement, and the two types of bereavement complications share some of the same features. Little research has studied which of the two precedes the other...... following the death of a loved one. The purpose of this study was to examine the temporal relationship between change in high levels of PGS and PTSS during the first four years following old age spousal loss. Methods: Participants were 237 Danes (40% male; mean age = 73 years, SD = 4.4; range 65-81) who....... Results: Lower-level mediation analyses wereas performed. Results indicated that PGS mediated 83% of the relationship between time and PTSS, while PTSS only mediated 17% of the relationship between time and PGS. These results suggest that changes in PGS mediated changes in PTSS following spousal...

Mechanical properties of metastable austenitic steels, strengthened by hydroextruction and structural hardening

International Nuclear Information System (INIS)

Beresnev, B.I.; Georgieva, I.Ya.; Eshchenko, R.N.; Teplov, V.A.

1981-01-01

Different regimes of complex strengthening of steels of Fe-Ni-Mo-C system by phase hardening and plastic deformation by hydroextrusion are investigated. It is stated that the degree of strengthening depends on consequence of strengthening operations. Plastic deformation by hydroextrusion of steels stre--ngthened by phase hardening ensures increase of strength (Δσsub(0.2)=500 MPa) at high plasticity (delta=25%). Maximal values of strength properties can be achieved if hydroextrusion is conducted before and after thansverse α→γ-transformation [ru

Strengthening method of concrete structure

Science.gov (United States)

Inge, Wewin; Audrey; Nugroho, Sofie; Njo, Helen

2018-03-01

Building extension in Indonesia is not favored, and not many people know the advantages of the method because architects and engineers tend to lack the knowledge and experience. The aim of this paper is to explain a method on how to strengthen a concrete building structure that people can use/learn as a better way to cut potential cost and save time. The strengthening method explained in this paper is steel jacketing, providing a case study of this method in the extension of a restaurant located in Medan, Indonesia. In this study, engineers calculated that the tensile stress of the existing RC column and beam is not strong enough to reinforce the building extension applied load. Therefore, the steel jacketing method can be applied to improve the column and beam strength and ductility. The result of the case study proves that this is one of the best methods for building extension applied in Indonesia.

Strengthening the Uganda nurses' and midwives' association for a motivated workforce.

Science.gov (United States)

Zuyderduin, A; Obuni, J D; McQuide, P A

2010-12-01

The Ugandan Association of Nurses and Midwives (UNANM) is a dynamic proactive community. This survey of nurses, both members and non-members of the association, was implemented in April 2007. It was the first phase of a programme-funded Capacity Project/USAID to strengthen professional associations as part of a strategy to retain nurses. To better understand the needs and strengths of the association and to develop policy recommendations on how to strengthen the UNANM to retain nurses in the health sector. Three hundred self-completion questionnaires were distributed, of which 217 (72%) were returned. The participants were 126 non-members and 91 members of the UNANM. Just over a third of the 91 members rated the UNANM to be very effective in promoting nursing (35%) and information sharing (36%). Non-members want to receive nursing information from the UNANM (89%) and were less critical of the UNANM than members. Respondents were interested in counselling training (83%), research capacity building (80%) and sharing best practice (74%). Nurses under 30 years (12%) look to more experienced peers for guidance on coping in a stressful profession. The nurses lack continuing professional development, mentoring and networking opportunities. Tangible support for communication, nurse education and research is needed and will stimulate the development of nursing in Uganda. Most nurses do not have the means to pay for training, research or travel to attend professional meetings. Motivation to stay in nursing and quality of care can increase through investing in nursing, and this support can be channelled through associations such as the UNANM. © 2010 The Authors. International Nursing Review © 2010 International Council of Nurses.

Fracture mechanical analysis of strengthened concrete tension members with one crack

DEFF Research Database (Denmark)

Hansen, Christian Skodborg; Stang, Henrik

2012-01-01

A concrete tension member strengthened 2 with fiber reinforced polymer plates on two sides 3 is analyzed with non-linear fracture mechanics. The 4 analysis of the strengthened tension member incorpo5 rates cohesive properties for both concrete and inter6 face between concrete and strengthening...... the structural classification parameters, is inves13 tigated in a non-dimensional analysis, and found to 14 depend strongly on the ratio between interfacial and 15 concrete fracture energies....

Relationships between organizational and individual support, nurses' ethical competence, ethical safety, and work satisfaction.

Science.gov (United States)

Poikkeus, Tarja; Suhonen, Riitta; Katajisto, Jouko; Leino-Kilpi, Helena

2018-03-12

Organizations and nurse leaders do not always effectively support nurses' ethical competence. More information is needed about nurses' perceptions of this support and relevant factors to improve it. The aim of the study was to examine relationships between nurses' perceived organizational and individual support, ethical competence, ethical safety, and work satisfaction. A cross-sectional questionnaire survey was conducted. Questionnaires were distributed to nurses (n = 298) working in specialized, primary, or private health care in Finland. Descriptive statistics, multifactor analysis of variance, and linear regression analysis were used to test the relationships. The nurses reported low organizational and individual support for their ethical competence, whereas perceptions of their ethical competence, ethical safety, and work satisfaction were moderate. There were statistically significant positive correlations between both perceived individual and organizational support, and ethical competence, nurses' work satisfaction, and nurses' ethical safety. Organizational and individual support for nurses' ethical competence should be strengthened, at least in Finland, by providing more ethics education and addressing ethical problems in multiprofessional discussions. Findings confirm that organizational level support for ethical competence improves nurses' work satisfaction. They also show that individual level support improves nurses' sense of ethical safety, and both organizational and individual support strengthen nurses' ethical competence. These findings should assist nurse leaders to implement effective support practices to strengthen nurses' ethical competence, ethical safety, and work satisfaction.

Pedagogical guidelines for educational accompaniment for grieving to adults with intellectual disabilities

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Pablo RODRÍGUEZ HERRERO

2013-11-01

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.

Modeling and characterization of strengthened concrete tension members

DEFF Research Database (Denmark)

Hansen, Christian Skodborg; Stang, Henrik

2011-01-01

The structural potential for cracking of externally strengthened concrete tension members, can be predicted with three parameters, describing the structural cracking potential based on fracture mechanical properties of the of concrete and interface between concrete and strengthening medium....... With these parameters, it is possible to design reinforcement and obtain a required cracking behavior of a given structure. Design recommendations for single and multiple cracking of the tension specimen are given in terms of fracture mechanical parameters, and a structural stiffness parameter....

Development of the strengthened safeguards system and the Additional Protocol

International Nuclear Information System (INIS)

Vidaurre-Henry, Jaime

2001-01-01

For the past 30 years, the IAEA's safeguards system has contributed to the international non-proliferation regime by providing, inter alia, assurances regarding the peaceful uses of declared nuclear material. However, the discovery of a clandestine nuclear weapons program in Iraq in 1991 drew world-wide attention to the need to strengthen the system to address the absence of undeclared nuclear material and activities. Efforts to strengthen the IAEA's safeguards system began in 1991 and culminated in 1997 when the IAEA's Board of Governors approved a Model Protocol Additional to IAEA Safeguards Agreements which greatly expands the legal basis and scope of IAEA safeguards. Within this strengthened system it is expected that the IAEA be able to provide assurance not only of the absence of diversion of declared nuclear material but also on the absence of undeclared nuclear material and activities. This is to be done within a safeguards system that uses an optimal combination of all safeguards measures available, thereby achieving maximum effectiveness and efficiency within the available resources. The paper summarizes the evolution of the safeguards system, describes strengthened safeguards, reports on the status of implementing the strengthening measures, and outlines plans for integrating all available safeguards measures. (author)

Flexure Behavior of Hybrid Continuous Deep Beam Strengthened by Carbon Fiber Reinforced Polymer

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Hayder M.K.Al-Mutairee

2017-08-01

Full Text Available This study present an experimental investigation for overall flexure behavior of reinforced concrete continuous deep beams (RCCDB made of hybrid concrete, normal strength concrete (NSC and high strength concrete (HSC at different location and percentage. The experimental work includes testing of sixteen specimens of RCCDB under two points loads. The effects of HSC layer thickness and CFRP on strength of RCCDB had been studied. The experimental results showed that the strengthening of RCCDB by HSC layer from top is better than from bottom, where the increment in the ultimate flexural strength increased by (14,21,27% for top strengthening and (12,15,13% for bottom strengthening for (25,50,75% thickness of total depth of beam respectively. The optimal strengthening of RCCDB by HSC layer at top was of 25%. The results also proved that the strengthening of hybrid RCCDB by (10,15cm CFRP strip at the bottom for flexure gave increment in the ultimate strength by (32, 29% respectively, and the strengthening by CFRP strip for flexure at the bottom is better than at top for hybrid RCCDB. The shear strengthening of hybrid RCCDB increases the ultimate strength by 23.4% and 13.8% if the strengthening has O and U shape respectively

Dispersion strengthening

International Nuclear Information System (INIS)

Scattergood, R.O.; Das, E.S.P.

1976-01-01

Using digital computer-based methods, models for dispersion strengthening can now be developed which take into account many of the important effects that have been neglected in the past. In particular, the self interaction of a dislocation can be treated, and a computer simulation method was developed to determine the flow stress of a random distribution of circular, impenetrable obstacles, taking into account all such interactions. The flow stress values depended on the obstacle sizes and spacings, over and above the usual 1/L dependence where L is the average obstacle spacing. From an analysis of the results, it was found that the main effects of the self interactions can be captured in a line tension analogue in which the obstacles appear to be penetrable

Ab initio identified design principles of solid-solution strengthening in Al

International Nuclear Information System (INIS)

Ma Duancheng; Friák, Martin; Pezold, Johann von; Raabe, Dierk; Neugebauer, Jörg

2013-01-01

Solid-solution strengthening in six Al–X binary systems is investigated using first-principle methods. The volumetric mismatch parameter and the solubility enthalpy per solute were calculated. We derive three rules for designing solid-solution strengthened alloys: (i) the solubility enthalpy per solute is related to the volumetric mismatch by a power law; (ii) for each annealing temperature, there exists an optimal solute–volume mismatch to achieve maximum strength; and (iii) the strengthening potential of high volumetric mismatch solutes is severely limited by their low solubility. Our results thus show that the thermodynamic properties of the system (here Al–X alloys) set clear upper bounds to the achievable strengthening effects owing to the reduced solubility with increasing volume mismatch. (paper)

The influence of resin flexural modulus on the magnitude of ceramic strengthening.

LENUS (Irish Health Repository)

Fleming, Garry J P

2012-07-01

The aim was to determine the magnitude of ceramic resin-strengthening with resin-based materials with varying flexural moduli using a regression technique to assess the theoretical strengthening at a \\'zero\\' resin-coating thickness. The hypothesis tested was that experimentally, increasing resin flexural modulus results in increased resin-strengthening observed at a theoretical \\'zero\\' resin-coating thickness.

Characterization of strengthening mechanism and hot deformation behavior of powder metallurgy molybdenum

International Nuclear Information System (INIS)

Xiao, Meili; Li, Fuguo; Xie, Hangfang; Wang, Yufeng

2012-01-01

Highlights: → Dynamic recrystallization of powder metallurgy molybdenum occurs in the temperature region (1200-1450 o C). → The value of strain hardening index n decreases along with the temperature rising. → The value of strain-rate sensitivity exponent m increases slowly at first and achieves a peak value at 1350 o C. → Deformation strengthening is the main strengthening mechanism at low temperature. → Rheological strengthening becomes the primary strengthening mechanism at high temperature. -- Abstract: The high-temperature deformation behavior of powder metallurgy molybdenum has been investigated based on a series of isothermal hot compression tests, which were carried out on a Gleeble-1500 thermal mechanical simulator in a wide range of temperatures (900-1450 o C) and strain rates (0.01-10 s -1 ). Through the research on the experimental stress-strain curves, it reveals that dynamic recrystallization softening effect of powder metallurgy molybdenum occurs in the temperature range from 1200 o C to 1450 o C, in which the flow stress is significantly sensitive to temperature. In comparison with the value of strain hardening index n which decreases along with the temperature rising, the value of strain-rate sensitivity exponent m does not change obviously; however, it increases slowly with the increasing of temperature at first and achieves a peak value at 1350 o C. Furthermore, relying on the comparison of mean value of n and m, it is suggested that deformation strengthening is the main strengthening mechanism at low temperature while the rheological strengthening changes into the primary strengthening mechanism at high temperature.

Laboratory system strengthening and quality improvement in Ethiopia

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Tilahun M. Hiwotu

2014-11-01

Full Text Available Background: In 2010, a National Laboratory Strategic Plan was set forth in Ethiopia to strengthen laboratory quality systems and set the stage for laboratory accreditation. As a result, the Strengthening Laboratory Management Toward Accreditation (SLMTA programme was initiated in 45 Ethiopian laboratories. Objectives: This article discusses the implementation of the programme, the findings from the evaluation process and key challenges. Methods: The 45 laboratories were divided into two consecutive cohorts and staff from each laboratory participated in SLMTA training and improvement projects. The average amount of supportive supervision conducted in the laboratories was 68 hours for cohort I and two hoursfor cohort II. Baseline and exit audits were conducted in 44 of the laboratories and percent compliance was determined using a checklist with scores divided into zero- to five-star ratinglevels. Results: Improvements, ranging from < 1 to 51 percentage points, were noted in 42 laboratories, whilst decreases were recorded in two. The average scores at the baseline and exit audits were 40% and 58% for cohort I (p < 0.01; and 42% and 53% for cohort II (p < 0.01,respectively. The p-value for difference between cohorts was 0.07. At the exit audit, 61% ofthe first and 48% of the second cohort laboratories achieved an increase in star rating. Poor awareness, lack of harmonisation with other facility activities and the absence of a quality manual were challenges identified. Conclusion: Improvements resulting from SLMTA implementation are encouraging. Continuous advocacy at all levels of the health system is needed to ensure involvement of stakeholders and integration with other improvement initiatives and routine activities.

Experimental and analytical investigation of reinforced high strength concrete continuous beams strengthened with fiber reinforced polymer

International Nuclear Information System (INIS)

Akbarzadeh, H.; Maghsoudi, A.A.

2010-01-01

Carbon and glass fiber reinforced polymer (CFRP and GFRP) are two materials suitable for strengthening the reinforced concrete (RC) beams. Although many in situ RC beams are of continuous constructions, there has been very limited research on the behavior of such beams with externally applied FRP laminate. In addition, most design guidelines were developed for simply supported beams with external FRP laminates. This paper presents an experimental program conducted to study the flexural behavior and redistribution in moment of reinforced high strength concrete (RHSC) continuous beams strengthened with CFRP and GFRP sheets. Test results showed that with increasing the number of CFRP sheet layers, the ultimate strength increases, while the ductility, moment redistribution, and ultimate strain of CFRP sheet decrease. Also, by using the GFRP sheet in strengthening the continuous beam reduced loss in ductility and moment redistribution but it did not significantly increase ultimate strength of beam. The moment enhancement ratio of the strengthened continuous beams was significantly higher than the ultimate load enhancement ratio in the same beam. An analytical model for moment-curvature and load capacity are developed and used for the tested continuous beams in current and other similar studies. The stress-strain curves of concrete, steel and FRP were considered as integrity model. Stress-strain model of concrete is extended from Oztekin et al.'s model by modifying the ultimate strain. Also, new parameters of equivalent stress block are obtained for flexural calculation of RHSC beams. Good agreement between experiment and prediction values is achieved.

Strengthening Performance of PALF-Epoxy Composite Plate on Reinforced Concrete Beams

Science.gov (United States)

Chin, Siew C.; Tong, Foo S.; Doh, Shu I.; Gimbun, Jolius; Ong, Huey R.; Serigar, Januar P.

2018-03-01

This paper presents the effective strengthening potential of pineapple leaves fiber (PALF)-epoxy composite plate on reinforced concrete (RC) beam. At first the PALF is treated with alkali (NaOH) and its morphology is observed via scanning electron microscope (SEM). The composite plates made of PALF and epoxy with fiber loading ranging from 0.1 to 0.4 v/v was tested for its flexural behaviour. The composite was then used for external RC beam strengthening. The structural properties of RC beams were evaluated and all the beams were tested under four-point bending. It was found that the flexural strength increased as the fiber volume ratio increases. The maximum flexural strength (301.94 MPa) was obtained at the fiber volume ratio of 40%. The beam strengthened with PALF-epoxy composite plate has a 7% higher beam capacity compared to the control beam. Cracks formed at the edge of the plate of PALF-strengthened beams resulted in diagonal cracking. Result from this work shows that the PALF-epoxy composite plate has the potential to be used as external strengthening material for RC beam.

Epidemiological investigation of muscle-strengthening activities and cognitive function among older adults.

Science.gov (United States)

Loprinzi, Paul D

2016-06-01

Limited research has examined the association of muscle-strengthening activities and executive cognitive function among older adults, which was this study's purpose. Data from the 1999-2002 NHANES were employed (N = 2157; 60-85 years). Muscle-strengthening activities were assessed via self-report, with cognitive function assessed using the digit symbol substitution test. After adjusting for age, age-squared, gender, race-ethnicity, poverty level, body mass index, C-reactive protein, smoking, comorbid illness and physical activity, muscle-strengthening activities were significantly associated with cognitive function (βadjusted = 3.4; 95% CI: 1.7-5.1; P cognitive function score. In conclusion, muscle-strengthening activities are associated with executive cognitive function among older U.S. adults, underscoring the importance of promoting both aerobic exercise and muscle-strengthening activities to older adults. © The Author(s) 2016.

Cardiovascular fitness strengthening using portable device.

Science.gov (United States)

Alqudah, Hamzah; Kai Cao; Tao Zhang; Haddad, Azzam; Su, Steven; Celler, Branko; Nguyen, Hung T

2016-08-01

The paper describes a reliable and valid Portable Exercise Monitoring system developed using TI eZ430-Chronos watch, which can control the exercise intensity through audio stimulation in order to increase the Cardiovascular fitness strengthening.

Relations of meeting national public health recommendations for muscular strengthening activities with strength, body composition, and obesity: the Women's Injury Study.

Science.gov (United States)

Trudelle-Jackson, Elaine; Jackson, Allen W; Morrow, James R

2011-10-01

We examined the relations of meeting or not meeting the 2008 Physical Activity Guidelines for Americans recommendations for muscular strengthening activities with percentage of body fat, body mass index (BMI; defined as weight in kilograms divided by height in meters, squared), muscular strength, and obesity classification in women. We analyzed data on 918 women aged 20 to 83 years in the Women's Injury Study from 2007 to 2009. A baseline orthopedic examination included measurement of height, body weight, skinfolds, and muscle strength. Women who met muscle strengthening activity recommendations had significantly lower BMI and percentage of body fat and higher muscle strength. Women not meeting those recommendations were more likely to be obese (BMI ≥ 30) compared with women who met the recommendations after we adjusted for age, race, and aerobic physical activity (odds ratio = 2.28; 95% confidence interval = 1.61, 3.23). There was a small but significant positive association between meeting muscle strengthening activity recommendations and muscular strength, a moderate inverse association with body fat percentage, and a strong inverse association with obesity classification, providing preliminary support for the muscle strengthening activity recommendation for women.

Strengthening of structurally damaged wide shallow RC beams using externally bonded CFRP plates

Directory of Open Access Journals (Sweden)

Rajeh A. Al-Zaid

Full Text Available Reinforced concrete wide shallow beams (WSBs are commonly used in the joist flooring systems. The structural behavior of WSBs strengthened with carbon fiber reinforced polymer (CFRP reinforcement was studied on isolated beams and as part of full-scale building. The effect of structural damage on the performance of WSBs flexurally strengthened with CFRP plates was investigated and presented in this paper. Eight full-scale WSBs were tested under four-point bending up to failure. Seven beams were strengthened with CFRP plates bonded to the soffit of the beams and one beam was unstrengthened serving as control. Prior to strengthening, the beams were subjected to different levels of damaging by preloading to 30-95% of the beams' flexural capacity. One beam was fully damaged by preloading to failure and repaired before strengthening by replacing the crushed concrete. The data showed that the pre-damaged strengthened beams exhibited ultimate capacities up to 8% lower than those of the undamaged strengthened beams. However, the load carrying capacities of pre-damaged strengthened beams were more than those predicted by ACI 440 design guide, fib Bulletin 14, and JSCE design recommendations. Both fib Bulletin 14 and JSCE design recommendations gave very conservative predictions with average ratios of experimental to predicted ultimate capacity of 2.02 and 2.35, respectively. More accurate predictions were obtained by ACI 440 design guide as the corresponding ratio was 1.24. These results indicate that strong confidence and reliability can be placed in applying CFRP strengthening to structurally damaged WSBs.

Google (encore) encore soupçonné d'abus de position dominante : Observations sur la Communication des griefs de la Commission Européenne du 20 avril 2016

OpenAIRE

Mouron , Philippe

2016-01-01

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...

The Effect of CFRP Length on the Failure Mode of Strengthened Concrete Beams

Directory of Open Access Journals (Sweden)

Jun Ding

2014-06-01

Full Text Available This paper reports the effects of carbon fiber-reinforced polymer (CFRP length on the failure process, pattern and crack propagation for a strengthened concrete beam with an initial notch. The experiments measuring load-bearing capacity for concrete beams with various CFRP lengths have been performed, wherein the crack opening displacements (COD at the initial notch are also measured. The application of CFRP can significantly improve the load-bearing capacity, and the failure modes seem different with various CFRP lengths. The stress profiles in the concrete material around the crack tip, at the end of CFRP and at the interface between the concrete and CFRP are then calculated using the finite element method. The experiment measurements are validated by theoretical derivation and also support the finite element analysis. The results show that CFRP can significantly increase the ultimate load of the beam, while such an increase stops as the length reaches 0.15 m. It is also concluded that the CFRP length can influence the stress distribution at three critical stress regions for strengthened concrete beams. However, the optimum CFRP lengths vary with different critical stress regions. For the region around the crack tip, it is 0.15 m; for the region at the interface it is 0.25 m, and for the region at the end of CFRP, it is 0.30 m. In conclusion, the optimum CFRP length in this work is 0.30 m, at which CFRP strengthening is fully functioning, which thus provides a good reference for the retrofitting of buildings.

Social play among juvenile wild Japanese macaques (Macaca fuscata) strengthens their social bonds.

Science.gov (United States)

Shimada, Masaki; Sueur, Cédric

2018-01-01

Social play and grooming are typical affiliative interactions for many primate species, and are thought to have similar biological functions. However, grooming increases with age, whereas social play decreases. We proposed the hypothesis that both social grooming and social play in juveniles strengthen their social bonds in daily activities. We carried out field research on the social relationships among juvenile wild Japanese macaques in a troop in Kinkazan, Miyagi Prefecture, Japan, from fall 2007 to spring 2008 to investigate this hypothesis. We evaluated three relationships among juveniles, play indices (PI), grooming indices (GI), and 3-m-proximity indices (3mI) of each dyad (i.e., interacting pair), and compared these social networks based on the matrices of the indices. The play and grooming networks were correlated with the association network throughout the two research periods. The multiple network level measurements of the play network, but not the grooming network, resembled those of the association network. Using a causal step approach, we showed that social play and grooming interactions in fall seem to predict associations in the following spring, controlling for the PI and GI matrix in spring, respectively. Social play and grooming for each juvenile were negatively correlated. The results partially support our predictions; therefore, the hypothesis that the biological function of social play among immature Japanese macaques is to strengthen their social bonds in the near future and develop their social life appears to be correct. For juvenile macaques, social play, rather than grooming, functions as an important social mechanism to strengthen affiliative relationships. © 2017 Wiley Periodicals, Inc.

77 FR 38017 - Regulation Strengthening Accountability of Attorneys and Non-Attorney Representatives Appearing...

Science.gov (United States)

2012-06-26

...-2168-01] RIN 0625-AA92 Regulation Strengthening Accountability of Attorneys and Non- Attorney... strengthens the accountability of attorneys and non-attorney representatives who appear in proceedings before... administration of the U.S. AD and CVD laws. One proposal addressed strengthening the accountability of attorneys...

Strengthening human resources for health through information, coordination and accountability mechanisms: the case of the Sudan.

Science.gov (United States)

Badr, Elsheikh; Mohamed, Nazar A; Afzal, Muhammad Mahmood; Bile, Khalif Mohamud

2013-11-01

Human resources for health (HRH) in the Sudan were limited by shortages and the maldistribution of health workers, poor management, service fragmentation, poor retention of health workers in rural areas, and a weak health information system. A "country coordination and facilitation" process was implemented to strengthen the national HRH observatory, provide a coordination platform for key stakeholders, catalyse policy support and HRH planning, harmonize the mobilization of resources, strengthen HRH managerial structures, establish new training institutions and scale up the training of community health workers. The national government of the Sudan sanctioned state-level governance of the health system but many states lacked coherent HRH plans and policies. A paucity of training institutions constrained HRH production and the adequate and equitable deployment of health workers in rural areas. The country coordination and facilitation process prompted the establishment of a robust HRH information system and the development of the technical capacities and tools necessary for data analysis and evidence-based participatory decision-making and action. The success of the country coordination and facilitation process was substantiated by the stakeholders' coordinated support, which was built on solid evidence of the challenges in HRH and shared accountability in the planning and implementation of responses to those challenges. The support led to political commitment and the mobilization of resources for HRH. The leadership that was promoted and the educational institutions that were opened should facilitate the training, deployment and retention of the health workers needed to achieve universal health coverage.

A new 12% chromium steel strengthened by Z-phase precipitates

DEFF Research Database (Denmark)

Liu, Fang; Rashidi, Masoud; Johansson, Lennart

2016-01-01

In order to increase the corrosion resistance and simultaneously maintain the creep resistance of 9-12% Cr steels at 650 degrees C, a new alloy design concept was proposed, using thermodynamically stable Z-phase (CrTaN) precipitates to strengthen the steel. A new trial Z-phase strengthened 12% Cr...

Polio Eradication Initiative (PEI) contribution in strengthening public health laboratories systems in the African region.

Science.gov (United States)

Gumede, Nicksy; Coulibaly, Sheick Oumar; Yahaya, Ali Ahmed; Ndihokubwayo, Jean-Bosco; Nsubuga, Peter; Okeibunor, Joseph; Dosseh, Annick; Salla, Mbaye; Mihigo, Richard; Mkanda, Pascal; Byabamazima, Charles

2016-10-10

The laboratory has always played a very critical role in diagnosis of the diseases. The success of any disease programme is based on a functional laboratory network. Health laboratory services are an integral component of the health system. Efficiency and effectiveness of both clinical and public health functions including surveillance, diagnosis, prevention, treatment, research and health promotion are influenced by reliable laboratory services. The establishment of the African Regional polio laboratory for the Polio Eradication Initiative (PEI) has contributed in supporting countries in their efforts to strengthen laboratory capacity. On the eve of the closing of the program, we have shown through this article, examples of this contribution in two countries of the African region: Côte d'Ivoire and the Democratic Republic of Congo. Descriptive studies were carried out in Côte d'Ivoire (RCI) and Democratic Republic of Congo (DRC) from October to December 2014. Questionnaires and self-administered and in-depth interviews and group discussions as well as records and observation were used to collect information during laboratory visits and assessments. The PEI financial support allows to maintain the majority of the 14 (DRC) and 12 (RCI) staff involved in the polio laboratory as full or in part time members. Through laboratory technical staff training supported by the PEI, skills and knowledge were gained to reinforce laboratories capacity and performance in quality laboratory functioning, processes and techniques such as cell culture. In the same way, infrastructure was improved and equipment provided. General laboratory quality standards, including the entire laboratory key elements was improved through the PEI accreditation process. The Polio Eradication Initiative (PEI) is a good example of contribution in strengthening public health laboratories systems in the African region. It has established strong Polio Laboratory network that contributed to the

Elements of Social Learning Supporting Transformative Change

African Journals Online (AJOL)

sound, ontologically congruent methodology to support their social-learning ..... role in strengthening democratisation of the decision-making of the participants. ... powers of the contextual social structures and cultural systems (Lindley, 2014). ... participatory practice in integrated water resource management in South Africa.

Using Evidence to Strengthen Health Systems in Africa and the ...

International Development Research Centre (IDRC) Digital Library (Canada)

The project is timely for Lebanon, a country that is working to strengthen its primary health care system to respond to current priorities such as the emerging crisis of Syrian refugees. Timely access to information The project will strengthen institutional and individual abilities to conduct and use systematic and rapid reviews to ...

Strengthening a consolidated memory: the key role of the reconsolidation process.

Science.gov (United States)

Forcato, Cecilia; Fernandez, Rodrigo S; Pedreira, María E

2014-01-01

The reconsolidation hypothesis posits that the presentation of a specific cue, previously associated with a life event, makes the stored memory pass from a stable to a reactivated state. In this state, memory is again labile and susceptible to different agents, which may either damage or improve the original memory. Such susceptibility decreases over time and leads to a re-stabilization phase known as reconsolidation process. This process has been assigned two biological roles: memory updating, which suggests that destabilization of the original memory allows the integration of new information into the background of the original memory; and memory strengthening, which postulates that the labilization-reconsolidation process strengthens the original memory. The aim of this review is to analyze the strengthening as an improvement obtained only by triggering such process without any other treatment. In our lab, we have demonstrated that when triggering the labilization-reconsolidation process at least once the original memory becomes strengthened and increases its persistence. We have also shown that repeated labilization-reconsolidation processes strengthened the original memory by enlarging its precision, and said reinforced memories were more resistant to interference. Finally, we have shown that the strengthening function is not operative in older memories. We present and discuss both our findings and those of others, trying to reveal the central role of reconsolidation in the modification of stored information. Copyright © 2014 Elsevier Ltd. All rights reserved.

Performance-based financing with GAVI health system strengthening funding in rural Cambodia: a brief assessment of the impact.

Science.gov (United States)

Matsuoka, Sadatoshi; Obara, Hiromi; Nagai, Mari; Murakami, Hitoshi; Chan Lon, Rasmey

2014-07-01

Though Cambodia made impressive gains in immunization coverage between the years 2000 and 2005, it recognized several health system challenges to greater coverage of immunization and sustainability. The Global Alliance for Vaccines and Immunization (GAVI) opened a Health System Strengthening (HSS) funding window in 2006. To address the health system challenges, Cambodia has been receiving the GAVI HSS fund since October 2007. The major component of the support is performance-based financing (PBF) for maternal, neonatal and child health (MNCH) services. To examine the impact of the PBF scheme on MNCH services and administrative management in rural Cambodia. Quantitative and qualitative studies were conducted in Kroch Chhmar Operational District (OD), Cambodia. Quantitative analyses were conducted on the trends of the numbers of MNCH services. A brief analysis was conducted using qualitative data. After the commencement of the PBF support, the volume of MNCH services was significantly boosted. In addition, strengthened financial and operational management was observed in the study area. However, the quality of the MNCH services was not ensured. Technical assistance, rather than the PBF scheme, was perceived by stakeholders to play a vital role in increasing the quality of the services. To improve the quality of the health services provided, it is better to include indicators on the quality of care in the PBF scheme. Mutual co-operation between PBF models and technical assistance may ensure better service quality while boosting the quantity. A robust but feasible data validation mechanism should be in place, as a PBF could incentivize inaccurate reporting. The capacity for financial management should be strengthened in PBF recipient ODs. To address the broader aspects of MNCH, a balanced input of resources and strengthening of all six building blocks of a health system are necessary. Published by Oxford University Press in association with The London School of Hygiene

Strengthening of Steel Columns under Load: Torsional-Flexural Buckling

Directory of Open Access Journals (Sweden)

Martin Vild

2016-01-01

Full Text Available The paper presents experimental and numerical research into the strengthening of steel columns under load using welded plates. So far, the experimental research in this field has been limited mostly to flexural buckling of columns and the preload had low effect on the column load resistance. This paper focuses on the local buckling and torsional-flexural buckling of columns. Three sets of three columns each were tested. Two sets corresponding to the base section (D and strengthened section (E were tested without preloading and were used for comparison. Columns from set (F were first preloaded to the load corresponding to the half of the load resistance of the base section (D. Then the columns were strengthened and after they cooled, they were loaded to failure. The columns strengthened under load (F had similar average resistance as the columns welded without preloading (E, meaning the preload affects even members susceptible to local buckling and torsional-flexural buckling only slightly. This is the same behaviour as of the tested columns from previous research into flexural buckling. The study includes results gained from finite element models of the problem created in ANSYS software. The results obtained from the experiments and numerical simulations were compared.

Carbon fiber-reinforced polymer strengthening and monitoring of the grondals bridge in Sweden

DEFF Research Database (Denmark)

Täljsten, Björn; Hejll, Arvid; James, Gerard

2007-01-01

to be strengthened. The strengthening methods used were CFRP plates at the serviceability limit state and prestressed dywidag stays at the ultimate limit state. The strengthening was carried out during 2002. At the same time monitoring of the bridge commenced, using LVDT crack gauges as well as optical fiber sensors....

Theoretical multi-physics approaches to solid-solution strengthening of Al

Energy Technology Data Exchange (ETDEWEB)

Ma, Duancheng; Friak, Martin; Raabe, Dierk; Neugebauer, Joerg [Max-Planck-Institut fuer Eisenforschung GmbH, Duesseldorf (Germany)

2009-07-01

The strengthening of soft metallic materials has a long tradition and is an important metallurgical topic since the time when ancient smiths forged the first swords. Intense materials research revealed a combination of three mechanisms as decisive for solid-solution strengthening phenomena: (i) the size mismatch of components (Mott and Nabarro's parelastic concept), (ii) the elastic modulus mismatch of atoms (Fleischer's dielastic contribution), and (iii) the concentration of solutes (statistical concept of Friedel and Labusch). Combining density functional theory calculations and linear-elasticity theory, the key parameters that are essential for the classical strengthening theories are determined in order to test them and identify their possible validity limits. The strengthening of fcc aluminium is chosen as an example and a series of binary systems Al-X (with X=Ca,Sr,Ir,Li,Mg,Cu) was considered. Comparing our results with those obtained by applying classical theories we find clear deviations. These deviations originate from non-classical lattice distortions due to the size mismatch of solute atoms in their first coordination shells.

FRP Composites Strengthening of Concrete Columns under Various Loading Conditions

Directory of Open Access Journals (Sweden)

Azadeh Parvin

2014-04-01

Full Text Available This paper provides a review of some of the progress in the area of fiber reinforced polymers (FRP-strengthening of columns for several loading scenarios including impact load. The addition of FRP materials to upgrade deficiencies or to strengthen structural components can save lives by preventing collapse, reduce the damage to infrastructure, and the need for their costly replacement. The retrofit with FRP materials with desirable properties provides an excellent replacement for traditional materials, such as steel jacket, to strengthen the reinforced concrete structural members. Existing studies have shown that the use of FRP materials restore or improve the column original design strength for possible axial, shear, or flexure and in some cases allow the structure to carry more load than it was designed for. The paper further concludes that there is a need for additional research for the columns under impact loading senarios. The compiled information prepares the ground work for further evaluation of FRP-strengthening of columns that are deficient in design or are in serious need for repair due to additional load or deterioration.

Strengthening and Fostering Science and Technology Programs in Latinamerica and the Caribbean

Science.gov (United States)

Fucugauchi, J. U.

2013-05-01

An overview and discussion of the status of research and education in Latinamerica and the Caribbean is used for developing a proposal for a research foundation or agency in the region and establishing initiatives for capacity building and promoting and strengthening scientific programs and cooperation. Scientific research increasingly requires global multi- and inter-disciplinary approaches and infrastructure. Developing countries face challenges resulting from small academic communities, limited economic resources, and pressing social and political issues. Science and education are not major priorities as compared with more pressing issues related to poverty, diseases, conflicts, drugs and famine. However, solving major problems require improved educational and research programs. International research collaboration, north-south and south-south, has an immense potential, but basic infrastructure and internal organization at national and regional levels are required. For the analysis we concentrate on current situation, size and characteristics of research community, education programs, facilities, economic support, and bilateral and multinational collaborations. Analysis also includes the São Paulo Research Foundation (FAPESP) and the Yucatan Science and Technology System (SIIDETEY). FAPESP is a highly successful public foundation started more than 50 years ago, dedicated to foster scientific and technological development in the State of São Paulo and which has had a major impact in Brazil. SIIDETEY is a more recent effort of the Yucatan Government, also dedicated to support research and technology innovation within the state. We then move to discussion on perspectives for future development and capacity building in regional and international contexts, including international collaboration programs. We propose to establish a Science Foundation for the Latinamerica and Caribbean and develop an agenda for strengthening scientific programs in the region.

75 FR 32145 - Safeguarding Child Support Information

Science.gov (United States)

2010-06-07

... theft; (2) the questionable practices and fiscal instability of several large private child support... stability, and strengthen, not undermine, parent-child relationships. As indicated previously, consumer... official of a political subdivision); (2) the court which has authority to issue an order against a...

Strengthening health system to improve immunization for migrants in China.

Science.gov (United States)

Fang, Hai; Yang, Li; Zhang, Huyang; Li, Chenyang; Wen, Liankui; Sun, Li; Hanson, Kara; Meng, Qingyue

2017-07-01

Immunization is the most cost-effective method to prevent and control vaccine-preventable diseases. Migrant population in China has been rising rapidly, and their immunization status is poor. China has tried various strategies to strengthen its health system, which has significantly improved immunization for migrants. This study applied a qualitative retrospective review method aiming to collect, analyze and synthesize health system strengthening experiences and practices about improving immunizations for migrants in China. A conceptual framework of Theory of Change was used to extract the searched literatures. 11 searched literatures and 4 national laws and policies related to immunizations for migrant children were carefully studied. China mainly employed 3 health system strengthening strategies to significantly improve immunization for migrant population: stop charging immunization fees or immunization insurance, manage immunization certificates well, and pay extra attentions on immunization for special children including migrant children. These health system strengthening strategies were very effective, and searched literatures show that up-to-date and age-appropriate immunization rates were significantly improved for migrant children. Economic development led to higher migrant population in China, but immunization for migrants, particularly migrant children, were poor. Fortunately various health system strengthening strategies were employed to improve immunization for migrants in China and they were rather successful. The experiences and lessons of immunization for migrant population in China might be helpful for other developing countries with a large number of migrant population.

Escapist Motives for On-line Gaming and Strengthening of Weak Ties

DEFF Research Database (Denmark)

Sudzina, Frantisek; Razmerita, Liana

on-line gaming. The research investigates Facebook and other on-line games separate-ly. A surprising result is that while most of the investigated escapist motives are positively correlated with strengthening of weak ties, the mundane breaking motive is negatively correlated with strengthening...

The Strengthening Nuclear Security Implementation initiative: evolution, status and next steps

NARCIS (Netherlands)

Dal, B.; Herbach, J.; Luongo, K.N.

2015-01-01

The "Strengthening Nuclear Security Implementation" initiative broke new ground at the 2014 Nuclear Security Summit in the effort to harmonize and strengthen the global nuclear security regime. This report discusses the significance of the initiative, the importance of expanding its signatories, and

The experiences of staff who support people with intellectual disability on issues about death, dying and bereavement: A metasynthesis.

Science.gov (United States)

Lord, Ailsa J; Field, Stephen; Smith, Ian C

2017-11-01

Historically, people with intellectual disabilities have tended to be excluded from knowing about death, dying and bereavement. Staff in intellectual disability services can play a valuable role in improving understanding of these issues in those they support. This qualitative metasynthesis aimed to understand the experiences of staff supporting adults with intellectual disabilities with issues of death, dying and bereavement. Thirteen papers were identified following a systematic review of six databases. Three themes were developed following a lines-of-argument synthesis: (i) talking about death is hard: negotiating the uncertainty in death, dying and bereavement; (ii) the commitment to promoting a "good death"; and (iii) the grief behind the professional mask. "A cautious silence: The taboo of death" was an overarching theme. A more open culture around issues of death, dying and bereavement in intellectual disability settings is essential and could be promoted through staff training and support. © 2017 John Wiley & Sons Ltd.

Notch-strengthening in two-dimensional foams

NARCIS (Netherlands)

Onck, P.R.

Metallic foams show notch-strengthening behavior when analyzing double-edge notched specimen in compression and tension. A discrete microstructural model has been used to simulate the effect of notch depth and specimen size on the net-section-strength. The non-uniform deformation behavior is

Strengthening Information Society Research Capacity Alliance ...

International Development Research Centre (IDRC) Digital Library (Canada)

2011-09-13

The project is expected to strengthen the body of theoretically based, methodologically sound, interdisciplinary research on information society issues. Project ID. 106618. Project status. Closed. Start Date. September 13, 2011. End Date. August 12, 2014. Duration. 24 months. IDRC Officer. Smith, Matthew. Total funding.

Experimental study on tunnel lining joints temporarily strengthened by SMA bolts

International Nuclear Information System (INIS)

Wu, Bo; Ou, Yunlong

2014-01-01

Shield tunnels have been widely used in city metros all over the world. During the long-term period of the metro operation, the joints of shield tunnel’s neighboring segments may degrade due to some environmental factors, leading to the increasing of the joint opening and some resulting adverse consequences. In this paper, a temporary strengthening method by using shape memory alloy (SMA) bolts is proposed and experimentally studied for the joints of neighboring segments, and a revised electric heating method which suits with the strengthening method is presented and experimentally validated for the SMA bolts. The purpose of the proposed temporary strengthening method is to create favorable conditions for the following permanent strengthening. Test results show that: (a) for the joints of shield tunnel’s neighboring segments, the strengthening method can effectively reduce the joint opening, joint deflection, concrete strain in joint’s compression zone, and strain of joint’s steel bolts; (b) the revised electric heating method can be used to heat the SMA rod to a temperature higher than the SMA’s austenite finish temperature quickly, and the average heating rate related to Type 2 inner resistance element is larger than that related to Type 1 inner resistance element; and (c) the reduction percentages of the joint opening increment, joint deflection, concrete strain in joint’s compression zone, and strain of joint’s steel bolts for Specimen I are all larger than those for Specimen II, implying that the less the joint opening is, the more significant the strengthening effect is. (paper)

Strengthening of the Cooperative Framework for ANENT

International Nuclear Information System (INIS)

Han, K. W.; Lee, E. J.; Min, B. J.

2007-01-01

The Asian Network for Education in Nuclear Technology (ANENT) was established in February 2004 to promote nuclear education and training in Asia. Initially ANENT member countries cooperated with 5 group activities encompassing broad areas. As of 2006, the cooperative framework was strengthened in a way to focus on web-based nuclear education and training for a period of several years to come. In this context, the Nuclear Training Center (NTC) of KAERI has contributed, in particular, to the development of the ANENT web-portal including a cyber platform, and making available relevant courses and materials on the web-portal. This paper discusses details of the strengthened cooperative framework in terms of NTC's effort for realizing web-based education and training through regional networking

Limit analysis on FRP-strengthened RC members

Directory of Open Access Journals (Sweden)

D. De Domenico

2014-07-01

Full Text Available Reinforced concrete (RC members strengthened with externally bonded fiber-reinforced-polymer (FRP plates are numerically investigated by a plasticity-based limit analysis approach. The key-concept of the present approach is to adopt proper constitutive models for concrete, steel reinforcement bars (re-bars and FRP strengthening plates according to a multi-yield-criteria formulation. This allows the prediction of concrete crushing, steel bars yielding and FRP rupture that may occur at the ultimate limit state. To simulate such limitstate of the analysed elements, two iterative methods performing linear elastic analyses with adaptive elastic parameters and finite elements (FEs description are employed. The peak loads and collapse mechanisms predicted for FRP-plated RC beams are validated by comparison with the corresponding experimental findings.

In-plane cyclic behaviour of unfired clay and earth brick walls in both unstrengthened and strengthened conditions

Czech Academy of Sciences Publication Activity Database

Hračov, Stanislav; Pospíšil, Stanislav; Garofano, A.; Urushadze, Shota

2016-01-01

Roč. 49, č. 8 (2016), s. 3293-3308 ISSN 1359-5997 R&D Projects: GA ČR(CZ) GP13-41574P EU Projects: European Commission(XE) 244123 - NIKER Institutional support: RVO:68378297 Keywords : seismic strengthening * retrofitting * earth brick walls * experimental tests * energy dissipation * earthquake engineering Subject RIV: JM - Building Engineering Impact factor: 2.607, year: 2016 http://link.springer.com/article/10.1617/s11527-015-0720-5

Strengthening rural health placements for medical students ...

African Journals Online (AJOL)

Strengthening rural health placements for medical students: Lessons for South Africa ... rural health, primary healthcare and National Health Insurance strategies. ... preferential selection of students with a rural background, positioning rural ...

Strengthening Democratic Governance through ICTs : Post Election ...

International Development Research Centre (IDRC) Digital Library (Canada)

Strengthening Democratic Governance through ICTs : Post Election ... has had several consequences, culminating in the disputed general elections of December 2007. ... Linking research to urban planning at the ICLEI World Congress 2018.

Socially shared mourning: construction and consumption of collective memory

Science.gov (United States)

Harju, Anu

2015-04-01

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.

Strategy of Strengthening Institutional Fishermen Groups for Increasing Income

Directory of Open Access Journals (Sweden)

Edy Yusuf Agunggunanto

2016-10-01

Full Text Available The community development and empowerment are two inseparable sides in the efforts to overcome the phenomenon of the fishermen communities, especially in the efforts to increase the welfare through the increasing income in the fishermen communities. One of the media in implementing the community development and empowerment is through the fishermen groups. The role of fishermen groups has not run optimally yet in improving the fishermen’s welfare, so it requires a strategy of developing the fishermen groups through the strategy of strengthening the economy in order to increase the fishermen’s income. This research aims to determine the priority of aspects to determine the strategies and to analyze the priority of strategy of strengthening the economy through the development of the institutional fishermen groups in order to increase the fishermen income in Central Java. The method of analysis in this research uses the Analytic Hierarchy Process (AHP. The result of AHP analysis indicates the priority of aspects in the strategy of strengthening the economy those are: aspects of participation,aspects of capital, aspects of partnership, and aspects of technology. The priority of alternatives in the strategy of strengthening the fishermen’s economy shows three sequences of 12 alternatives of strategies those are:  the  socialization of the importance of groups, the increase in the active participation, and the increase in the number of meetings.

Strengthening and Stabilization of the Weak Water Saturated Soils Using Stone Columns

Directory of Open Access Journals (Sweden)

Sinyakov Leonid

2016-01-01

Full Text Available The article considers innovative modern materials and structures for strengthening of weak soils. In this paper describes a method of strengthening of weak saturated soils using stone columns. The method of calculating the physical-mechanical characteristics of reinforced soil mass is presented. Two approaches to determining the stress-strain state and timeframe of consolidation of strengthened soil foundation using the finite element technique in two-dimensional formulation are proposed. The first one approach it is a modeling of reinforced soil mass, where each pile is represented as a separate 2D stripe. The second approach is to the simulation of the strengthened mass the equivalent composite block with improved physical-mechanical characteristics. The use of the equivalent composite block can significantly reduce the time spent on the preparation of a design scheme. The results of calculations were compared. They show the allowable divergence of results of calculation by two methods were presented, and the efficiency of the strengthening of weak water saturated soils by stone column is proved.

Evaluation of the increased load bearing capacity of steel beams strengthened with pre-stressed FRP laminates

Directory of Open Access Journals (Sweden)

S. Bennati

2016-10-01

Full Text Available We analyse the problem of a simply supported steel beam subjected to uniformly distributed load, strengthened with a pre-stressed fibre-reinforced polymer (FRP laminate. We assume that the laminate is first put into tension, then bonded to the beam bottom surface, and finally fixed at both its ends by suitable connections. The beam and laminate are modelled according to classical beam theory. The adhesive is modelled as a cohesive interface with a piecewise linear constitutive law defined over three intervals (elastic response, softening response, debonding. The model is described by a set of differential equations with suitable boundary conditions. An analytical solution to the problem is determined, including explicit expressions for the internal forces and interfacial stresses. As an application, we consider the standard IPE series for the steel beam and the Sika® CarboDur® system for the adhesive and laminate. For each considered cross section, we first carry out a preliminary design of the unstrengthened steel beam. Then, we imagine to apply the FRP strengthening and calculate the loads corresponding to the elastic limit states in the steel beam, adhesive, and laminate. Lastly, we take into account the ultimate limit state corresponding to the plasticisation of the mid-span steel cross section and evaluate the increased load bearing capacity of the strengthened beam

Strengthening Indonesia's health workforce through partnerships.

Science.gov (United States)

Kurniati, A; Rosskam, E; Afzal, M M; Suryowinoto, T B; Mukti, A G

2015-09-01

Indonesia faces critical challenges pertaining to human resources for health (HRH). These relate to HRH policy, planning, mismatch between production and demand, quality, renumeration, and mal-distribution. This paper provides a state of the art review of the existing conditions in Indonesia, innovations to tackle the problems, results of the innovations to date, and a picture of the on-going challenges that have yet to be met. Reversing this crisis level shortage of HRH requires an inclusive approach to address the underlying challenges. In 2010 the government initiated multi-stakeholder coordination for HRH, using the Country Coordination and Facilitation approach. The process requires committed engagement and coordination of relevant stakeholders to address priority health needs. This manuscript is a formative evaluation of the program using documentary study and analysis. Consistent with Indonesia's decentralized health system, since 2011 local governments also started establishing provincial multi-stakeholder committees and working groups for HRH development. Through this multi-stakeholder approach with high level government support and leadership, Indonesia was able to carry out HRH planning by engaging 164 stakeholders. Multi-stakeholder coordination has produced positive results in Indonesia by bringing about a number of innovations in HRH development to achieve UHC, fostered partnerships, attracted international attention, and galvanized multi-stakeholder support in improving the HRH situation. This approach also has facilitated mobilizing technical and financial support from domestic and international partners for HRH development. Applying the multi-stakeholder engagement and coordination process in Indonesia has proved instrumental in advancing the country's work to achieve Universal Health Coverage and the Millennium Development Goals by 2015. Indonesia continues to face an HRH crisis but the collaborative process provides an opportunity to achieve

Strengthening primary healthcare through community involvement in ...

African Journals Online (AJOL)

Strengthening primary healthcare through community involvement in Cross River State, Nigeria: a descriptive study. Hilary Adie, Thomas Igbang, Akaninyene Otu, Ekanem Braide, Okpok Okon, Edet Ikpi, Charles Joseph, Alexander Desousa, Johannes Sommerfeld ...

An Experimental Study on Strengthening of Reinforced Concrete Flexural Members using Steel Wire Mesh

Directory of Open Access Journals (Sweden)

Al Saadi Hamza Salim Mohammed

2017-01-01

Full Text Available One of the major challenges and contemporary research in the field of structural engineering is strengthening of existing structural elements using readily available materials in the market. Several investigations were conducted on strengthening of various structural components using traditional and advanced materials. Many researchers tried to enhance the reinforced concrete (RC beams strength using steel plate, Glass and Carbon Fibre Reinforced Polymers (GFRP & CFRP. For the reason that high weight to the strength ratio and compatibility in strength between FRP composites and steel bars, steel plates and GFRP and CFRP composites are not used for strengthening works practically. Hence, in this present work the suitability of using wire mesh for the purpose of strengthening the RC flexural members is studied by conducting experimental works. New technique of strengthening system using wire mesh with a view to improve sectional properties and subsequently flexural strength of RC beams is adopted in this work. The results for experimental and theoretical analysis were compared and found that good correlation exists between them. The experimental results indicate that RC beams strengthened with steel wire mesh are easy technique for strengthening of existing flexural members.

Nanoscale strengthening mechanisms in metallic thin film systems

Science.gov (United States)

Schoeppner, Rachel Lynn

Nano-scale strengthening mechanisms for thin films were investigated for systems governed by two different strengthening techniques: nano-laminate strengthening and oxide dispersion strengthening. Films were tested under elevated temperature conditions to investigate changes in deformation mechanisms at different operating temperatures, and the structural stability. Both systems exhibit remarkable stability after annealing and thus long-term reliability. Nano-scale metallic multilayers with smaller layer thicknesses show a greater relative resistance to decreasing strength at higher temperature testing conditions than those with larger layer thicknesses. This is seen in both Cu/Ni/Nb multilayers as well as a similar tri-component bi-layer system (Cu-Ni/Nb), which removed the coherent interface from the film. Both nanoindentation and micro-pillar compression tests investigated the strain-hardening ability of these two systems to determine what role the coherent interface plays in this mechanism. Tri-layer films showed a higher strain-hardening ability as the layer thickness decreased and a higher strain-hardening exponent than the bi-layer system: verifying the presence of a coherent interface increases the strain-hardening ability of these multilayer systems. Both systems exhibited hardening of the room temperature strength after annealing, suggesting a change in microstructure has occurred, unlike that seen in other multilayer systems. Oxide dispersion strengthened Au films showed a marked increase in hardness and wear resistance with the addition of ZnO particles. The threshold for stress-induced grain-refinement as opposed to grain growth is seen at concentrations of at least 0.5 vol%. These systems exhibited stable microstructures during thermal cycling in films containing at least 1.0%ZnO. Nanoindentation experiments show the drop in hardness following annealing is almost completely attributed to the resulting grain growth. Four-point probe resistivity

Seismic Strengthening of Carpentry Joints in Traditional Timber Structures

International Nuclear Information System (INIS)

Parisi, Maria A.; Cordie, Cinzia; Piazza, Maurizio

2008-01-01

The static and dynamic behavior of timber structures largely depends on their connections. In traditional timber construction, elements are usually connected with carpentry joints based on contact pressure and friction, often with only minor reinforcement generically intended to avoid disassembling. In current practice, interventions for the upgrading of carpentry joints are mainly based on empirical knowledge according to tradition. Often they produce a general strengthening of the connection, but are not specific for the case of seismic action. Strengthening on heuristic bases may be only partially effective or possibly disproportioned. The behavior of the carpentry joints most used in roof structures is examined. The birdsmouth joint, connecting rafters to the tie beam, has been studied first, characterizing its behavior numerically and experimentally in monotonic and cyclic conditions. Other forms of the rafter-to-tie connection, the double notch joint and the case of parallel rafters, are discussed. Some general criteria for the seismic strengthening of these joints are presented

Seismic Strengthening of Carpentry Joints in Traditional Timber Structures

Science.gov (United States)

Parisi, Maria A.; Cordié, Cinzia; Piazza, Maurizio

2008-07-01

The static and dynamic behavior of timber structures largely depends on their connections. In traditional timber construction, elements are usually connected with carpentry joints based on contact pressure and friction, often with only minor reinforcement generically intended to avoid disassembling. In current practice, interventions for the upgrading of carpentry joints are mainly based on empirical knowledge according to tradition. Often they produce a general strengthening of the connection, but are not specific for the case of seismic action. Strengthening on heuristic bases may be only partially effective or possibly disproportioned. The behavior of the carpentry joints most used in roof structures is examined. The birdsmouth joint, connecting rafters to the tie beam, has been studied first, characterizing its behavior numerically and experimentally in monotonic and cyclic conditions. Other forms of the rafter-to-tie connection, the double notch joint and the case of parallel rafters, are discussed. Some general criteria for the seismic strengthening of these joints are presented.

Adaptive force regulation of muscle strengthening rehabilitation device with magnetorheological fluids.

Science.gov (United States)

Dong, Shufang; Lu, Ke-Qian; Sun, Jian Qiao; Rudolph, Katherine

2006-03-01

In rehabilitation from neuromuscular trauma or injury, strengthening exercises are often prescribed by physical therapists to recover as much function as possible. Strengthening equipment used in clinical settings range from low-cost devices, such as sandbag weights or elastic bands to large and expensive isotonic and isokinetic devices. The low-cost devices are incapable of measuring strength gains and apply resistance based on the lowest level of torque that is produced by a muscle group. Resistance that varies with joint angle can be achieved with isokinetic devices in which angular velocity is held constant and variable torque is generated when the patient attempts to move faster than the device but are ineffective if a patient cannot generate torque rapidly. In this paper, we report the development of a versatile rehabilitation device that can be used to strengthen different muscle groups based on the torque generating capability of the muscle that changes with joint angle. The device is low cost, is smaller than other commercially available machines, and can be programmed to apply resistance that is unique to a particular patient and that will optimize strengthening. The core of the device, a damper with smart magnetorheological fluids, provides passive exercise force. A digital adaptive control is capable of regulating exercise force precisely following the muscle strengthening profile prescribed by a physical therapist. The device could be programmed with artificial intelligence to dynamically adjust the target force profile to optimize rehabilitation effects. The device provides both isometric and isokinetic strength training and can be developed into a small, low-cost device that may be capable of providing optimal strengthening in the home.