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Healing the mind and spirit as the body fails.
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Curing fixer-pleaser syndrome.
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When is a table an umbrella?
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When your patient has acute facial paralysis.
Learn to distinguish between Bell's palsy and Ramsay Hunt syndrome.
Helping patients with heart failure manage stress.
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Helping your patient manage Parkinson's disease.
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Helping patients who need a permanent pacemaker.
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Are you a help-aholic? How to avoid compassion fatigue.
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The community initiative on depression: report from a multiphase work site depression intervention.
OBJECTIVE: We sought to further understand depression, a common, disabling condition with considerable ramifications for the workplace, including higher costs, absenteeism, and reduced work performance. METHODS: A multidisciplinary health care coalition recently implemented a multiphase workplace depression initiative in Kansas City. We report results from its first phase, a 22-item, self-administered survey of depression knowledge and attitudes among employees of 13 large, local work sites. RESULTS: There were 6,399/38,945 respondents (16% response rate). Most respondents (>90%) appropriately recognized the signs and symptoms of depression. A minority (29%) would feel comfortable discussing depression with their supervisor. Sixty-two percent knew how to access company resources for depression care. CONCLUSIONS: Employees were knowledgeable about depression but were less aware of employee-assistance programs for depression care. These findings support increased attempts to raise the awareness of depression and promote of help-seeking behavior in the workplace. CLINICAL SIGNIFICANCE: Depression is a prevalent illness with risk for many deleterious outcomes if under-recognized or undertreated. Depression is a leading cause of work-related disability worldwide. Most people with depression are employed (an estimated 68%). Recognizing and initiating depression care in the workplace will facilitate depression treatment in clinical settings.
Stress response syndromes in women undergoing mammography: a comparison of women with and without a history of breast cancer.
OBJECTIVE: The purpose of this study was to assess the incidence, severity, and correlates of acute stress responses in women undergoing diagnostic mammographic surveillance and to explore the moderating impact of physician support on these symptoms. METHODS: Sixty-six female breast cancer outpatients (at least 12 months after diagnosis and primary treatment) and 69 healthy women undergoing mammographic surveillance completed measures of: acute stress response, somatization, trauma history, psychiatric history, social support, and physician satisfaction. RESULTS: Previous cancer, pre-mammography breast complaints, lower income, previous psychiatric medication use, greater instrumental support, greater somatization, greater perceived physician disengagement, and less perceived physician support were all associated with increased stress responses. Among women with a previous cancer diagnosis, those with greater distress reported higher levels of physician support. In contrast, among those without a previous cancer diagnosis, those with greater perceived physician support reported less distress. CONCLUSIONS: These findings suggest that cancer-related cues, such as follow-up surveillance, may trigger a sensitizing response in women with a previous cancer diagnosis. The association of distress with physician support may arise from the responsiveness of physicians to identified distress, from increased help-seeking behavior by those who are distressed, or both. The benefit of support provided by health care professionals to those at risk of developing stress response syndromes deserves further study.
Relationship of laterality of stroke to emotional and functional outcome.
The role of hemispheric laterality and emotion in the stroke population has been studied less than in other brain-damaged populations. Neuroscience nurses caring for stroke patients need knowledge about the anatomical placement of ischemic deficits and the relationship of emotions to that placement to understand observed affect and behavior. Knowing how to assess negative affect and behavior will help nurses design interventions to produce optimal recovery.
Acoustic neuroma: suggestions for helping the patient adapt after translabyrinthine surgery.
An acoustic neuroma is a benign, slow growing tumor which arises from the eighth cranial nerve and produces a variety of symptoms. The translabyrinthine approach is one of the most common surgical procedures employed to remove an acoustic neuroma. Surgical removal may result in frustrating alterations to which the individual must adapt. Patient education can prepare the patient for these alterations and facilitate adaptation.
Strategic growth decisions in helper cichlids.
Recently, it has been shown that group-living subordinate clownfish Amphiprion percula increase their growth rate after acquiring the dominant breeder male position in the group. Evidence was found for strategic growth adjustments of subordinate fishes depending on the threat of eviction, i.e. subordinates adjust their growth rates so they remain smaller than the dominant fish and thereby limit the threat of being expelled from the territory. However, it is impossible to exclude several alternative factors that potentially could have influenced the observed changes in growth, owing to the nature of that experiment (removing the second-ranking fish--the breeder male--caused the third-ranking fish to change sex to become breeder male and change rank). We studied strategic growth decisions in the group-living Lake Tanganyika cichlid Neolamprologus pulcher under controlled laboratory conditions with ad libitum food availability. First, we show that male breeders grow faster than subordinate male helpers of the same initial size and confirm that N. pulcher shows status-dependent growth. Second, we improved on the experimental design by not removing the dominant breeder male in the group; instead we replaced the breeder male with a new breeder male in a full factorial design and measured growth of the subordinate male helpers is a function of the size difference with the old and the new breeder male. As predicted, male helpers showed strategic growth adjustments, i.e. growing faster when the size difference with the breeder male is large. Strategic growth adjustments were less pronounced than status-dependent growth adjustments.
Experimental evidence that kin discrimination in the Seychelles warbler is based on association and not on genetic relatedness.
In cooperative breeding systems driven by kin selection, effective kin-recognition cues are important. Recognition could be achieved by the direct assessment of the genetic relatedness of individuals or by learning through association. In the Seychelles warbler, Acrocephalus sechellensis, female subordinates maximize indirect fitness by preferentially helping genetically related nestlings. Help seems to be based on the continued presence of the primary female who previously fed the subordinate in the nest but it has, so far, been impossible to discount the direct assessment of genetic relatedness. We used a cross-fostering experiment to separate the two possible cues. Adult birds did not discriminate between their own and cross-fostered eggs or nestlings. Cross-fostering resulted in nestlings that were unrelated to the primary female that raised them, but control nestlings were closely related to their primary females. The proportions of cross-fostered and control female offspring that stayed and became helpers on their 'natal' territory were similar. However, for both groups the chance of becoming a subordinate helper was associated with the continued presence of the primary female and not with any other factor tested. Our study provides strong evidence that helping decisions are based on associative-learning cues.
Helpers in a cooperatively breeding cichlid stay and pay or disperse and breed, depending on ecological constraints.
The theory of family-group dynamics predicts that group structure, helping behaviour and social interactions among group members should vary with the opportunities of subordinates to breed independently. We investigated experimentally whether unrelated mature helpers in the cooperatively breeding cichlid Neolamprologus pulcher reduce costly social and cooperative behaviour and choose to disperse and breed independently when offered vacant breeding sites. As predicted by the ecological constraints hypothesis,when breeding substrate was available, (i) helpers spent more time in dispersal areas and it was mainly large helpers that left the group to breed independently; (ii) all helpers invested less in costly submissive behaviours towards other group members and large helpers reduced help, supporting the 'pay-to-stay' hypothesis; and (iii) large helpers, particularly those that dispersed and bred, increased more in body mass in the treatment than those without breeding options, suggesting status-dependent strategic growth of helpers. We conclude that helpers of N. pulcher decide whether to stay and pay or disperse and breed in response to constraints on independent breeding.
A one-dimensional numerical model of acoustic wave propagation in a multilayered structure of a resistance spot weld.
A one-dimensional model of acoustic wave propagation in a multilayered structure of a spot weld is developed. The inhomogeneity of the material properties due to the thermal inhomogeneity is included in the equation of motion. The model enables us to deal with arbitrary spatial distributions of Lamé constants and density. The model allows analysis of travel time, multiple reflections, and interference in a given geometry. Use of this model could provide information to help predict behavior of the waves in the transmission (reflection) mode at different plate thicknesses and welding settings.
Ego development and the ethics of care and justice: the relations among them revisited.
This study examined the links among ego development and the ethics of care and justice in 144 Norwegian men and women, 15 to 48 years old, taking into consideration age, sex, education, and verbal intelligence. As expected, the relationship between Loevinger's model of ego development and care-based moral reasoning as measured with Skoe's Ethic of Care Interview (ECI) was significantly stronger than the one between ego development and justice as measured with Rest's Defining Issues Test (DIT). Both ethics correlated significantly with verbal ability. Analyses showed that beyond its overlap with verbal intelligence, the variance shared between the ECI and ego development was substantial. By contrast, when verbal intelligence was controlled, the DIT was not significantly related to ego development or to the care ethic.