Resolution of a pancreatic pseudocyst by spontaneous drainage into the stomach.
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Nausea and vomiting represent a significant problem in patients with advanced cancer, which not only affects their quality of life but also the lives of informal carers. The application of nursing assessment tools, underpinned by a thorough knowledge regarding the physiology and aetiology of nausea and vomiting in this group of patients enables nurses to plan and provide effective interventions, in collaboration with other members of the multidisciplinary team. This article describes the physiological basis of nausea and vomiting. Epidemiological data informs the subsequent discussion, which focuses on assessment in terms of identifying the problem and its cause(s), setting goals with the patient and his/her carers, planning appropriate nursing intervention to support medical interventions and evaluating clinical outcomes. Pharmacological and non-pharmacological interventions for nausea and vomiting are discussed.
Heteronormativity is everywhere. It is always already present in our individual and collective psyches, social institutions, cultural practices, and knowledge systems. In this essay, I provide some sketches for a critical analysis of heteronormativity in the communication discipline. More specifically, I examine the symbolic, discursive, psychological, and material violence of heteronormativity, and begin exploring ways to heal, grow, transform, and contemplate new possibilities in our social world. To accomplish this, this essay is divided into live sections. First, I discuss the study of sexuality in Communication. Next, through the notion of injury, I focus on the violence of heteronormativity. Third, using the concept of healing, I discuss ways of unpacking heteronormativity through a critique of hegemonic heterosexuality. Further, I offer potential ways for queer world-making through the lens of queer theory. I conclude by exploring the need for more sexuality research in the discipline by engaging the productive tensions between constructive and deconstructive impulses.
The author outlines the psychoanalytic theory of stuttering and, discussing material from the analysis of a stutterer and its transference and countertransference processes, puts forward a new hypothesis of the psychodynamics of stuttering in conjunction with Meltzer's theory of the claustrum. He argues that the stutterer is working out intolerable experiences of separation from the primary object and a resulting catastrophic experience of the oedipal situation through an unconscious fantasy in which anal qualities are conferred on the internal maternal object by a predominating hatred. The intrusive identification of parts of the self in the maternal rectum gives rise to a claustrophobic experiential world in which all obstacles that are encountered between self and object must be eliminated. The anal-sadistic object space of the claustrum is projected on to the external object space and thus also on to the mouth as the origin of the sound envelope, where it produces both a lifeless sound envelope and a torn content, i.e. stuttered sounds, words and sentences. Correspondingly, a dead speech melody and broken words have their parallels in object relations that are characterised by an attack on linking and by psychic withdrawal.
In this paper, the author works with the awareness that perversion is a socially, historically and theologically loaded term, at the same time as it may be the latest frontier in psychoanalysis, both clinically, and in relation to contemporary art and culture which emphasize the perverse. Positioning itself against tendencies to deny the existence of a category of 'perversion' or, inversely, to abuse it for the power that accrues from the act of diagnosing, she also points to other liabilities in the history of the treatment of this term, such as the narrowing down of perversion to the exclusively sexual domain, or, alternatively, the overextension of it to polymorphously erotic practices that enhance sexual excitement. The paradoxes of perversion and the difficulties of distinguishing the perverse from the non-perverse are addressed. The case is also made that, in order to understand perversion, one must unlink it from the narrow notion of sexual practice and see what is involved on a deeper level--an approach initiated when psychoanalysis turned to perversion as a defense against psychotic anxieties, and began considering the necessary place of perversion in the transference--countertransference. Two features common to both sexual and non-sexual perverse relations are the seductive and bribing aspects of perversion, and its means-ends reversal. Perversion is a haven for the disguising of hatred and suspicion as excitement and (false) love. Displaced child and beating father, entitled child and seductive mother, are both prototypes of psychoanalytic reflection on parents who excite, deceive and corrupt their children and establish perverse pacts with them. The notion of the perverse pact is foregrounded in Alice's analysis, where first the resurrection and then the dismantling of such a pact were effected through various analytic means.
In summary, looking at some of the ways in which detachment issues are organized and expressed in the psychoanalytic treatment of differing character structures, makes the need for a finely tuned interpersonal environment in analysis particularly compelling. Finding the appropriate spot to occupy in the dimension of distance and closeness with a detached patient depends heavily on the ability to maintain an empathic "feel" for the conflict that is closest to the surface of the detachment, and cannot easily be dealt with by broad rules of thumb or diagnostic conceptualizations of detachment as simply a global entity.
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The patient with borderline personality hospitalized on a medical or surgical ward has a disorganizing effect on the house staff, who may regress in response to the patient's impulsivity, dependency, entitlement, and rage. The psychiatric consultant's role in the management of such a patient should consist of a specialized type of consultee-oriented approach in which countertransference hatred and fear, typically generated in the staff by the borderline, are drawn away from the patient and strategically metabolized within the staff-consultant relationship. The consultant should actively promote a behavioral management practicum, placed in the medical chart for reference and as a symbol of the psychiatrist's helping presence, which discusses: a) clear communication with the patient and among staff, b) understanding the patient's need for constant personnel, c) dealing with the patient's entitlement without confronting the patient's needed defenses, and d) setting firm limits on the patient's dependency, manipulativeness, rage, and self-destructive behaviors. The consultant should work to counteract feelings of helplessness in the staff, to neutralize punitive superego in the staff, and to diminish fearfulness toward the patient.
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This study explored the relationship between grouphate and cohesion, consensus, relational satisfaction, affective learning, and cognitive learning. Participants were 83 undergraduate students enrolled in an introductory course on small group communication. Participants completed the Grouphate scale, the Classroom Cohesion scale, the Consensus scale, the Relational Satisfaction scale, three subscales of the Instructional Affect Assessment Instrument, and the Cognitive Learning Loss measure. Mean grouphate significantly increased during the semester, and negative correlations were found between scores for grouphate and cohesion (-.50), consensus (-.45), relational satisfaction (-.58), attitude toward the behaviors recommended in the course (-.23), the likelihood of developing an appreciation for the course content (-.33), and cognitive learning (-.32). Results may imply that students' grouphate is not associated with prosocial outcomes of the group work in this course.