Care Of Myself Research Articles

If I'd known I was going to live this long, I'd have taken better care of myself:Antioxidants and micronutrients in CF

Asthma and allergy incidence continue to increase globally. We have made significant strides in treating disease, but it is becoming more apparent that we need to advance our knowledge into the origins of asthmatic disease. Much recent work has indicated that microbiome composition influences immune regulation and that multiple health care factors have driven a loss in microbiome diversity in modern human populations. Evidence is growing of microbiota-driven influences on immune development, asthma susceptibility, and asthma pathogenesis. The focus of this review is to highlight the strides the field has made in characterizing the constituents of the human gastrointestinal microbiota, such as Helicobacter pylori, other members of the neonatal intestinal microbiota, and microbial peptides and metabolites that influence host immunity and immune response to allergens. As we delve further into this field of research, the goal will be to find actionable and clinical interventions to identify at-risk populations earlier to prevent disease onset. Manipulation of the host microbial community during infancy might be an especially promising approach.

Overcoming Obstacles to Create the Optimal Healing Environment

Barbara Stanny 1 said, An empty vessel has little to offer. Obligatory or guilt-driven self-denial is always undermining, leading to anger, resentment, and pain. Without taking care of ourselves, we engage in self-sabotage. What? Are you nuts? Are you saying that, if I take better care of myself, the documentation needed to support my facility's Magnet Journey will magically create itself? No, we all wish it were that simple, don't we? What I am saying, nurse leader, is that if you understand that the momentum, energy, commitment, and productivity needed to achieve any quality designation and provide inspirational leadership essential for these tough times, you would be better equipped to start with self-nurturing words and self-loving actions that you offer yourself as you ready in the morning and throughout the day! Radical thought? Think again. Let's examine the link.

Ecology on the Web

Ecology on the Web

Pink ribbon blues: how breast cancer culture undermines women's health

Prologue Chapter 1: What Is Ribbon Culture? Chapter 2: The Development of Ribbon Culture I. The Breast Cancer Movement a. Medical Consumerism b. Aesthetics and Normalization c. Investment in a Women's Health Epidemic d. Solidarity, Fundraising, and Publicity II. Unintended Consequences Chapter 3: Mixed Metaphors: War, Gender, and the Mass Circulation of Cancer Culture I. The Masculine and Feminine Ethos of American Cancer Culture a. LIVESTRONG and the Masculine Ethos b. Gilda's Club and the Feminine Ethos II. Femininity a. Femininity in the PRC b. The She-ro Chapter 4: Consuming Pink: Mass Media and the Conscientious Consumer I. The Special Role of Women's Magazines II. The Breast Cancer Audience III. Branding and the Niche Market of the Socially Aware IV. Warriors in V. The Breast Cancer Brand a. Fear and the Menace b. Hope and Faith in Breast Cancer Awareness c. Goodness, Fundraising, and the Lifestyle VI. Komen's New Logo Chapter 5: Consuming Medicine, Selling Survivorship I. The Breast Cancer Industry II. Disease Classification III. Medical Technology a. The Benefits of Mammography b. The Risks of Mammography c. Cost/Benefit Analysis d. Screening Programs and the Makers of the Machines IV. Big Pharma V. Industry Ties to Advocacy Chapter 6: Optimism, Selfishness, and Guilt I. Ruby's Story II. Becoming a Breast Cancer Survivor: Learning the Rules III. Feeling Rule 1: Optimism a. Incorporation of the She-ro b. Rejecting the She-ro IV. Feeling Rule 2: Selfishness a. She-roic Selfishnes (i.e., Rational Coping Strategy) b. Selfishness as Confessional V. Feeling Rule 3: Guilt a. The Inadequate She-ro b. Embodied Social Stigma c. Family Disruption Chapter 7: The Balancing Act I. Taking Care of Myself II. The Balancing Act a. Setting Boundaries b. Accepting Help c. Asking for Help III. Balancing the Sisterhood IV. Final Thoughts Chapter 8: Shades of I. The Limiting Nature of Words II. Narrating One's Illness a. Realism and Transcendent Subversion b. The Picture Outside the Frame c. The Terrible Stories Chapter 9: Re-Thinking Ribbon Culture I. Not Just Ribbons II. Think Before You Pink

My Dream of a Fantastic Voyage to See the Inner Workings of a Cell

What would I give to be allowed to embark on a Fantastic Voyage at the nanometer scale inside the cell! In the 1960's film, humans were shrunk down to merely micrometer scale, but we now know that “nano” is the ticket. Imagine being able to observe cellular structural biology in real time and to see proteins and nucleic acids in action, in the concentrated environment of the nucleus, let alone in the cytosol. I imagine a complex molecular ballroom full of many intricately choreographed dancers, changing partners, switching locations, dying and being born again. Imagine the purpose and chaos governing the survival of the cellular microcosm, there for me (for you) to see and ultimately understand. Eva Nogales. Photo by Paul Fetters for HHMI. As a structural biologist, initially trained as a physicist, cells often seem too complex and far afield from my own research. My scientific presentations typically borrow images from cell biologists' websites, and I warn my audience after the first introductory slides that no more cells will be seen for the rest of the talk. However, as a molecular electron microscopist working on the cytoskeleton and large macromolecular complexes, I boast in front of crystallographers and nuclear magnetic resonance experts that we study fully functional complexes, in as close to physiological conditions as one can possibly expect outside of a cell. However, this is obviously not as physiological as if we were visualizing the native complexes in their cellular context! With fully annotated genomes providing nearly complete cellular parts lists, and with ever more powerful light microscopy, among other 21st century techniques, we have come a long way toward understanding the inner workings of the cell. Still, the dream of visualizing the intact cell's anatomy with molecular resolution seems like science fiction. Is there any hope for visualizing these molecular machines where they function and when it matters, even if it is not through our atomically shrunk, craving eyes? I really want to think so. It may not come from a single instrument, like the Star Trek scope where magnification can be cranked until the bar code on individual atoms becomes clear. However, combining currently available methodologies and then taking them to the next level may, step by step, get us there. The first combined electron and light microscopes are already producing data wherein the fluorescent colors of choice are superimposed on the gray levels of individual molecular density. Spectroscopy readings, with nanometer cube mapping capability, are being carved out of cellular slices in futuristic attempts at spatial metabolomics. Three-dimensional maps of hydrated cells will soon become routine, and as the resolution moves from 100 to 10 Å in my life time (if I take good care of myself), we will be able to identify macromolecules by shapes, in snapshots of cellular life. We will be able to follow the paths of single proteins as they meander their way along the chaotic cellular freeways of the cytoskeleton, or fluidly traffic between cellular compartments. We are almost there. My own personal dream of “visualizing” the complete kinetochore protein network, carrying out the dynamic engagement of chromosomes to the mitotic spindle and thus revealing the force coupling mechanism, may be just around the corner. It is not that images are worth a thousand gels, or movies a million pulldowns (although perhaps they are), it's just my own preferred means of getting to know and understand nature. My wish for the future of cell biology: I want to “see” the cell (I leave smelling it and listening to it to biochemists and theoretical physicists, respectively).

From Michael Steinberg

from Michael Steinberg Michael Steinberg (bio) Patricia Hampl says about memoir: "You give me your story, I get mine." There's a simple wisdom at the heart of that seemingly off hand remark. Most literary memoirists, it seems, spend a good piece of their lives trying to find their places in the world. What interests me most about that pursuit, however, aren't only the difficulties the narrators suffer, but the ways in which they strive to make sense of those obstacles and confusions. That shared struggle is, I believe, an important part of what connects us as fellow human beings. Here, then, are three recent memoirs that depict that struggle most convincingly: The Road Washes Out in Spring: A Poet's Memoir of Living Off the Grid Baron Wormser University Press Of New England, 2006. 199 Pages, Paper, $19.95. [End Page 185] Baron Wormser's memoir is about the author and his family's non-ideological decision to live in the Maine woods without heat, running water, and electricity. As Wormser discloses, "I wanted to learn how to take care of myself." A former urban Jew, he also learns that "[I] was ready to leave behind the vestiges of assimilated religion and culture that had been bequeathed to me." And he admits that he "craved . . . something different from the largely asphalt landscape I grew up in." Wormser, who ultimately became a fine poet, reveals that in the woods he discovered a "longing to be with words in an undistracted place. 'Woods' and 'words' were almost identical." The Horizontal World: Growing Up Wild in the Middle of Nowhere Debra Marquart Counterpoint, 2006. 267 Pages, Paper, $16.95. Growing up on a North Dakota farm, Debra Marquart felt an urgent need to escape the burdens and constraints of farm life. Over time, she carves out an exotic adult life as a rock-and-roll singer, college writing teacher, and serious writer. But in midlife she discovers that she hasn't really broken free of her past. Just the opposite, in fact. In The Horizontal World, Marquart discloses that "I think about the generations of my family who have dedicated their lives to keeping our name tied to this parcel of land for 110 years, using all their strength, resources, energy, and imagination to outwit the forces, natural or otherwise, that would have so easily stripped us of belonging. And I think about how I have benefited from the sense of rootedness that this place has afforded me as I have cast about rootless in the world." Belonging: Home Away from Home Isabel Huggan Alfred A. Knopf/Canada, 2003. 337 Pages, Cloth, $22.95. Canadian-born writer Isabel Huggan accompanied her husband for many years in his work around the world. She then reluctantly settled with him in the south of France, believing she'd soon return to her native country. In Belonging, Huggan writes that "we were 'only renting temporarily' . . . and that my real home was somewhere else, invisible but enduring—and permanent." After years of struggle to adapt to a new language and culture, Huggan [End Page 186] comes to realize that "Instead, here we are. On the fine, lovely edge of something new. Something other than normal." Unlike Wormser, Marquart, and Huggan, I did not live "off the grid," grow up on a midwestern farm, or suffer a wrenching cultural displacement. How, then, do their narratives become, as Patricia Hampl suggests, my story? V. S. Pritchard writes, "It's all in the art. You get no credit for the living." What connects reader to writer, then, is the adept, skillful manner in which these narrators invite us to enter their most intimate thoughts and feelings. In so doing, they allow us simultaneously to share and understand their deepest human struggles. Michael Steinberg Michael Steinberg, Founding Editor of Fourth Genre, is an award-winning personal essayist/memoirist. For more information, visit mjsteinberg.net. Fourth Genre would like to thank Mimi Schwartz for 11 years as the Reader-to-Reader Reviews editor. Her dedication was an integral part to helping a new journal succeed and we thank her for the ongoing work that is involved in collecting, choosing, and editing...

Abstract B7: Use of risk assessment services and predictive genetic testing (PGT) for hereditary gastrointestinal (GI) cancers: How do men and women differ?

Abstract Background: Uptake of risk assessment and PGT for hereditary GI cancer risk has lagged far behind that of the hereditary breast-ovarian cancer syndrome and BRCA1/2, despite the parallel clinical availability of genetic services for hereditary GI cancers, the proportion of patients with incident colorectal cancers who demonstrate familial risk (∼ 1 in 3), and the prevalence of Lynch syndrome associated mismatch repair gene mutations among incident colorectal cancers (∼ 3–5%). The bulk of data on perceptions of PGT have focused on women considering BRCA1/2 testing for personal and/or familial risk estimation. Studies in men are less plentiful, and have often focused on men's opinions about PGT for prostate cancer risk, although clinical PGT for hereditary prostate cancer is not currently available. Individuals enrolled in a high-risk GI cancer registry represent a unique population in which important differences in perceptions of PGT between men and women may be directly examined to shed light on barriers to risk assessment and PGT, and cancer prevention services in general, that may differ by gender. Methods: The GI Tumor Risk Assessment Program (GI-TRAP) registry at Fox Chase Cancer Center enrolls individuals at increased risk for GI cancers because of a suggestive personal or family history. At enrollment and prior to risk education and counseling, participants are asked to complete a detailed personal and family history and a questionnaire examining screening practices and psychosocial aspects of hereditary cancer risk. The GI-TRAP registry currently contains information collected from members of 269 families. Results: Women (n=293) participants outnumbered men (n=105) almost 3 to 1, were younger (47.0 vs 50.8 yrs)(p=0.01), and were less likely to work full-time (39.9% vs 59.0%)(p<0.001). The most common reasons for wanting testing in both groups were to guide screening (91.4% men, 95.7% women)(p=0.11) and learn children's risks (75.8% men, 83.7% women)(p=0.09). Women were more likely to want testing as a global means to “take better care of myself” (p=0.004), and were more concerned about personal (p=0.05) and family (p=0.04) emotional reactions to testing results, as well as the possible impact of testing on health insurance (p=0.06). Men were more willing to pay for genetic testing (“I plan to get genetic testing even if I have to pay”)(p=0.02) and were more willing to pay larger sums for testing (“I would pay equal to or over $1000 for genetic testing”)(p=0.04). Conclusions: Compared to women, overall fewer men obtain available risk assessment services for hereditary GI cancers. Men seek risk assessment for similar reasons to women, but express lower concern for out-of-pocket costs or adverse personal and familial emotional reactions to testing results. Efforts to make cancer risk assessment services more visible and available to men and working individuals (e.g., expanded clinical hours, on-site education/counseling at places of employment, health clubs, etc) may help to increase the identification of high-risk individuals who would benefit from tailored GI prevention education, genetic counseling, and PGT. Citation Information: Cancer Prev Res 2010;3(1 Suppl):B7.

Never give up, never give in

I am one of the 26 million people you see every day in cities all over the United States who are living with kidney disease. My face may blend in with the crowd, but I am much more than a statistic. With a big smile I will easily pull you aside and tell you a secret that I've learned: Never give up, never give in. This life that I have now is much different from the one I had just a few years ago. However, I can't complain. I am still here. I have been diagnosed and living with focal segmental glomerulosclerosis (FSGS). This is the same disease that former NBA basketball players Alonzo Mourning and Sean Elliott have. Neither I nor my doctor is sure about exactly what caused this problem. Even though I am obese, I did not have high blood pressure or diabetes, which causes kidney failure in many patients. I did have a long-standing use of high-dosage ibuprofen that may have contributed. But again, we don't know for sure. My family and friends are supportive; in particular my wife is my champion without a doubt. She is very encouraging and motivating, especially when I'm having down moments. Your whole life and everyone in it is affected by this disease. One day a friend and fellow church member approached my wife and me with the idea of making a documentary about my fight with kidney disease. We agreed to do it as long as we kept it real, relevant, and engaging so that others would want to watch it. The goal of the film, called Failing Kids, was to make people more aware of the need for kidney donors, and to show that even though we are sick, people on dialysis can still lead fairly active lives. If possible, we will continue making the documentary by following my journey for an extended period–hopefully to transplantation and beyond. In the county where I live, there are 15 dialysis centers that provide treatment for more than 700 patients. In nearby Washington, D.C., there are 100 dialysis centers serving nearly 6,000 patients. I go to a dialysis center every Monday, Wednesday, and Friday. My chair time is 4.5 hours, so overall I am at the center about 5.5 hours each time. I have time to think, read, and even sleep. I am reminded each time how awesome the human body is. God did an amazing thing to design such an intricate system that we try to imitate using technology and machinery. I am extremely grateful for dialysis, though; because of it I am getting stronger and am able to remain otherwise healthy. Dialysis reminds me how awesome the human body is. I know that progress can sometimes seem slow. I am patient. I find that medical care and treatment are readily available. Even financial help is available to those who need it. I know that progress can sometimes seem slow. I am patient. After dialysis my focus is taking good care of myself. I try to limit my fluid intake, which is hard for me because I was accustomed to drinking 1–2 gallons of fluid a day. In addition, I monitor what I eat as well, staying away from or limiting foods that are high in potassium, phosphorus, etc. I also try to exercise three times a week. Like thousands of others, I am on the kidney transplant waiting list, although my status on the list is inactive right now. The transplant surgeons want me to lose weight so that my chances of having complications after the operation are decreased. They also want me to consider having gastric bypass surgery to help me reduce my weight more quickly, but I am not sure about that at this time. No matter what I decide, I know that taking care of my body is important so that I can be in the best possible shape for a transplant. A healthy and active mind keeps me focused to never give up, never give in.

Gender comparisons of perceived benefits of and barriers to physical activity in middle school youth

Perceived benefits of and barriers to physical activity (PA) reported by 206 middle school boys and girls in a survey were compared. Only "take care of myself, stay in shape, and be healthier" emerged as a greater benefit for girls than boys. Among students not on a sports team, boys reported fewer barriers than girls. Among those selecting an active pursuit, boys perceived more barriers than girls. When controlling for sports team participation and perceived benefits and barriers, boys reported more minutes of vigorous PA than girls. As boys and girls reported relatively similar benefits of and barriers to PA, nurse counseling with both groups can focus on the same information. Effort is particularly needed to increase PA among girls.

Copestones for Life

Copestones for Life Claudia Ann Highbaugh (bio) I have spent thirty years in higher education and ministry. In the first fifteen, I worked far too many hours, answering to far too many demands, and letting the priorities of people other than myself guide my work. In the second half of my career, however, I made a strong effort to keep better balance, both in my job and my vocation, and I believe that I have saved my life. Perhaps surprisingly, I am more productive. In the past three years, I have coedited a book and published a few essays and talks. (These tasks are not necessarily a part of the work of ministry in higher education as opposed to the tasks and requirements of the scholar.) I have been able to travel and keep the larger world as a part of my perspective as opposed to the tiny egocentric white male power-maniacal institution where I work. I read across literary expressions, fiction, history, nonfiction, poetry, and sacred text. And as a part of my life work and vocation, I maintain a strong constant, viable, alive, loving, and affirming support system of friends and colleagues. I seek regular medical help from my doctor, dentist, and eye doctor. I take vacation and I sleep six to eight hours a night. I do not have a partner or family of my own. There is no one and never will be anyone to take care of me other than me. If I want to survive and thrive, I have to take care of myself. I am aware that others have many other claims on their time and energy, but I hope the model for life that I offer here resonates for some. Finding Balance At a conference on the arts in religion sponsored by the Disciples Divinity House at the University of Chicago, I was captivated by a paper given by Ronnie Hartfield, an art educator, scholar and writer, and Chicago graduate. Ronnie recounted a short story about a "middle-aged man who is called upon to rebuild by hand a damaged wall, the boundary between his home and a contiguous cemetery."1 [End Page 145] He begins reluctantly and finishes the work with the laying of copestones, meant to assure that his unwilling and careless investment in the repair of nature's damage will sustain. We learn that nature has created more damage than [one man] can repair. He is [assailed] in equal measure by the slipshod fragility of his stone structure and by a tragic loss of faith and trust in his only daughter and his only real friend. The story goes on to tell that the task before the man is to rebuild his own life, not only the sad little stone wall, and not in spite of but in the face of the brokenness around and within himself. Hartfield continued, I would put to you that our mutual task is to inhabit our own stony places and work away at the rebuilding of that which is broken in the sure knowledge that what afflicts you or me is not yours or mine only, but our, as human beings in communitas. [These copestones are given to us] with grace to remind us [that] what we build is at once permanent and entirely transient, requiring our attention in full measure. After hearing this short story and the reference to the copestones, my mind wandered to several amazing places in my memory. These places make a kind of visual pattern for the ideas I would like to share. These places gently point the way to life maintenance and balance. I have grown accustomed in my middle age to the tasks of rebuilding and replacing the all-important copestones that keep the balance and boundary walls of life intact. I am an educated, proud, and unrepentant woman-child, born of the Black Church in the United States of America. I was raised in three black congregations at the same time, each a bit different, but all with the vibrant, powerful, and spirited blessings of music and prayer. Every participant in worship is enlivened by the weekly invigorating sermon, reflective of the sacred biblical...

Putting Humor Into Practice

Putting Humor Into Practice

Attitudes Towards Diet, Exercise, and Body Image in Latino Women: Focus Group Results

Text: Two 90-minute focus groups were conducted in Spanish with 20 women between 18-45 years of age (Mean 35 8 years) self identified as being of Latino origin. Groups, led by a trained moderator, were audio-taped, transcribed and translated into English. Demographic data collected prior to the groups indicated participants were originally from South/Central America or the Caribbean, 85% reported household annual income $20, 000 per year and 55% had not graduated from high school. Analysis of the focus group data determined that some participants were able to incorporate exercise into their life but others were unable to due to family obligations (“We spend time cooking and doing household activities”) and a lack of time (“No time to fit into my life”). Participants reported being less physically active and eating more unhealthy food in the US than in their countries of origin. Participants were divided as to how they viewed their bodies (“I feel good about my body” versus “I feel fat.”) and several women noted gaining weight since coming to the US. Many participants were interested in “mindful eating” and viewed it as a positive way to regulate intake. Participants thought the concept of “taking care of myself” was difficult due to their focus on their families (“We never think of taking care of ourselves” and “I would feel bad; what’s most important is my family”). In conclusion, cultural issues, economic constraints, and acculturation issues may need to be addressed in interventions for Latino women.

Help‐seeking by older husbands caring for wives with dementia

This paper reports a study to gain understanding of the help-seeking process of older husbands caring for wives with dementia. Men comprise 41% of spousal caregivers. However, few reports describe older husbands' caregiving experiences and none specifically explore help-seeking in men caring for wives with dementia. A grounded theory design was used to discover a theory of help-seeking by older caregiver husbands. Audiotaped interviews were conducted during 2004 and 2005 with nine husband participants. The interviews were analysed by a research group to discover the core category and the relationships of related categories to develop a theory of help-seeking that was grounded in the data. Margaret Newman's theory of Health as Expanding Conscious provided a theoretical perspective for interpretation of the findings. The core category, 'Doing the best I can', was preceded by the antecedent of 'changing patterns'. Husbands made choices to use action/interaction strategies of 'Relinquishing', 'Reaching out' and 'Shouldering' which were influenced by a variety of internal, relational, situational, and experiential facilitating or hindering intervening conditions. The consequence of help-seeking process was 'Continuing on', which had categories of: 'Keeping at home', 'Staying together', and 'Taking care of myself'. Help-seeking by older husband caregivers is complex and gender-specific. Interventions to assist these caregivers must also be gender-specific and complement already existing help-seeking patterns. Focusing on helping caregivers to discover their patterns of relating and help-seeking empowers them to find new ways of interacting and to discover possibilities for action.

For South Africa's poor economic justice remains a dream

'Poverty can drive you to educate yourself or it may leave you in the situation it found you in,' says Nomasonto Mthimkhulu, a 31-year-old anti globalisation activist, who lives in Sebokeng, a township in the Vaal region near Gauteng, which is located right next to one of South Africa's key oil plants, Sasol. Mthimkhulu has seen and experienced how economic injustice resulting from globalisation has shaped her life. This is her story: 1 grew up in Zone 13 of Sebokeng, a township with no tar road and a very poor housing infrastructure. I shared my home with my four, younger siblings and my mother, who is a single parent. My mother is disabled, and the six of us depended on her R410 [$56] disability grant. It was difficult being the eldest daughter. I had to provide for the family when my mother's grant ran out in the middle of the month.' 'I started selling sweets at school to generate extra money for home. We would use that money to buy mealie-meal and other essentials for the house. This situation put me in a very compromising position, as I had to support my family and, as a result, took less care of myself. I realised that there was no time to think about myself then, because I had to take care of my mother and my siblings. Even though my mother tried to encourage us to go to school, it was a hurdle because we would go to school hungry. Every one who starts a day without breakfast knows that it can be difficult. Well, I dragged myself through that situation and was able to finish high school/ 'Many environmental issues caused by the Sasol oil plant were and still are the top discussions in our community forums. I started attending community forums at the age of 20, but, initially, most of the discussions didn't make sense to me. Why would people complain about poor living conditions when our government has given them freedom, I would ask. The fact that I was poor did not offend me at all.' To me, it seemed that I should thank my government and go on with my life. I should thank my government despite the fact that my community claims that people are getting sick because of asthma caused by the plant. I should thank the government for my poorly built house and for my mother's grant.' 'After I had completed my high school, I started to look for a job. I remember that, a few times, I would be sent back home because the job was only for men. Sometimes, I would get a low-paid, temporary job at a shop. Applying for university was too far-fetched for me, as I had

Taking good care of myself

Taking good care of myself

Paternalism Incorporated: Fables of American Fatherhood, 1865-1940 by David Leverenz (review)

232 Reviews chapter on missionary writing in Australia is on Lancelot Threlkeld, another liminal figure,who attacked the degeneracy of the white settler community, specifically in its sexual exploitation of Aboriginal people, and championed the rights ofthe indigenous people to survive. The writer approaches the missionaries almost as an ethnographer might, so unfamiliar do their practices seem. Readers, without access to their archival texts, have to decode the writer's attitudes in order to position themselves in relation to missionary activities, as when she critiques the missionary antipathy to Polynesian infanticide: As some missionaries almost suggest, Polynesian infanticide really acted to control population growth and to maintain social stability?but such conclusions are literally unspeakable in missionary texts' (p. 162). There is no indication of the doctrinal and theological perspective of the missionaries, only of their social preoccupations; did they not, forinstance, publish hymns and tracts? Repeated references to the Victorian 'nuclear family' are puzzling, given the size of the average Victorian family,and the Anglican Church is categorized as not being Protestant. None the less, the argument about mutual imbrication is persuasively sustained in this well-researched and infor? mative book. University of Stirling Angela Smith Paternalism Incorporated: Fables ofAmerican Fatherhood, 1865-1940. By David Leverenz . Ithaca, NY, and London: Cornell University Press. 2003. x + 254 pp. $39-95; ?23.95- ISBN 0-8014-4167-6. In his firstbook since the influential Manhood and theAmerican Renaissance (Ithaca, NY: Cornell University Press, 1989), David Leverenz continues to address the ways gender roles alter in the face of shifting economic and social conditions and the liter? ary strategies used by authors to represent and negotiate these conditions. As the title suggests, Leverenz is here concerned with the way writers responded to the corporate transformation of the United States' economy between the Civil War and the Second World War. More particularly, he seeks to recover the complex trajectory of paternal? ism, a concept which has, he suggests, come to signify'an outmoded management style that treats adults as children' and in turn is treated as 'a bad thing; end of story' (p. 1). Leverenz's approach is to see paternalism instead as a discourse that does cultural work at those points where the expansion of corporate business and its bureaucratic imperatives threatens traditional patterns of social relations but offers,by way of compensation , the promise of upward mobility, often formarginalized social groups. Ac? cording to Leverenz, 'from 1865 to the 1920s, white middle-class Americans encountered a modern version of a Contact Period [...]. Surging into the workplace, many African Americans, immigrants, and women dreamed of rising to respectability, and some achieved it' (p. 5). In some cases paternalism supported such dreams of mobility and at other times itbattled to maintain existing class, race, and gender hierarchies. Pa? ternalism, then, is the often contradictory switching-point at which a whole variety of anxieties and ambitions connected to structural economic shiftsmanifest themselves. This is an inventive reconceptualization of paternalism and what it allows Leverenz to do is revisit many of the gendered fictions of the late nineteenth and early twenti? eth centuries with a fresh critical perspective. To clarify his argument, he identifies two key recurring narrative themes: stories of the daddy's girl and the daddy's boy. The figure of the daddy's girl?and the daddy here may or may not be biological? Leverenz reads as a character who is infantilized and sexualized in a paternalistic relationship so as to be made less threatening than the upwardly mobile New Woman who no longer finds comfort in spirituality or marriage. Thus Carrie Meeber, both MLR, 101.1,2006 233 Hurstwood's girl and the girl of the male audiences who adore her, represents the two contradictory messages of the paternalism: ' "Take care of me" and "I can take care of myself, thank you"' (p. 84). It is Dreiser's positioning of Carrie at the border of these two contradictory messages, according to Leverenz, that 'makes gentlemen spectators feel powerful, and powerfully aroused' (p. 84). The story of the daddy's boy is typically a story of mentoring a young man to business success. But, in order to counterbalance the economic, the mentor...

What Floats

What Floats James Nolan (bio) "She's lying down." That's what I told Miss Viola from down the block when she stopped by to see my mother. Miss Viola straightened the strap on her flowered sundress, peering through the half-opened screen door into our messy kitchen. She held a pack of Kools in one hand and looked like she expected coffee. "Jonathan," asked Miss Viola, squinting her mascaraed eyes, "is your mother sick?" "No. I mean, yes. A little." "One of those headaches?" Miss Viola wrinkled her brow, waiting for a response. I said nothing. "Well, tell her to ring me when she feels better." I closed and locked the door, and went back to washing dishes. This was the first Wednesday after it happened, and I'd never cooked for myself before. I didn't even know you have to defrost hamburgers in the freezer before you fry them. The charred lump of meat that I gobbled took an hour to cook. I put a lot of mustard on it. There was no bread. I still had homework to do. I tiptoed into Mother's room and turned up the air conditioner. I don't know why I tiptoed, but it was awfully quiet in there. I flicked on the lamp next to the bed and tried to tug the covers out from under her, but they were tucked tight and wouldn't budge. So I ripped the pages out of my arithmetic workbook and spread them on top of her in case she was chilly. She looked so peaceful in the blue rayon dress she'd been wearing when she rushed home from work on Monday evening. "Just need to lie down for a few minutes," she'd said, sweeping past me into her bedroom. Lately she'd had a lot of headaches, so I knew how to take care of myself while she rested. I peeked into her room every half hour. Usually she asked for a glass of water, but now she wasn't asking for any water. I brought her a glass anyway. She was still lying down. I shook her. She moaned. Then I shook her again. She didn't moan. Her eyes were wide open, staring straight at the ceiling. I let the phone ring and ring, and latched the doors. She was so afraid of burglars and murderers in Gentilly, our neighborhood of raised wooden bungalows behind the race [End Page 1194] track in New Orleans. Mostly there were just kids like me with moms like her, except the other houses had daddies. We lived in my grandparents' house, where my mother had grown up. After my father left us, MawMaw and PawPaw moved to Jackson, Mississippi, and let us live there. But my grandparents thought I was a big mistake. "Look how that boy is growing up." MawMaw would shake her head. "A nine year-old needs a father and brothers and sisters. He can't live alone with a woman who works in a drugstore all day. And kids shouldn't be raised around a man with a temper like that. Should have known that before you started." Whenever I sassed or wouldn't go to bed on time, my mother would say she couldn't do a thing with me. * * * "I'll have to send you to live with your father. He could make you listen." That was my worst fear, that I'd have to go live with my father in California. When he left, he busted up everything. It took us a week to pick the broken glass out of the carpet. He didn't remember my birthday and when he called he was gruff and grouchy and didn't ask to talk with me. "Put your mother on," he'd say when I answered. I was just a nuisance, in the way. I climbed into bed and tried to read the chapter in Faraway Lands and Peoples about the Egyptian pyramids, but I couldn't keep my eyes on the page. So I slid under the bed where no bad thoughts or murderers could get me. Late at night I would often lie there...

Service municipal de santé scolaire et promotion de la santé à Villeurbanne

A school health municipal service has been in existence in Villeurbanne since its creation in 1935. It works throughout the city's schools, and in particularly in places which provide the last year of nursery school and all primary-level schools as well. In 1998 it was integrated into the office of the Directorate for Hygiene and Public Health, which provided an opportunity to reconsider its mission and reflect upon the priorities. The balance between screening and prevention was examined. Furthermore, its approach to thematic issues was put into question given the lack of a strategic overall programming methodology. The new health policy aimed at students was executed through a reorganization of evaluations, leading to the creation and implementation of a new programme called "I take care of myself" specifically targeting all first grade children. The results of this programme, which focuses on the development of a more comprehensive approach, are encouraging. Thanks to the programme, health has been reinstalled in its proper place in the schools, and it has become a matter of great importance for the children, their parents and the teachers. Furthermore, the school health service has consolidated and strengthened its role in this manner.

Follow-up of an intervention program for caregivers of a relative with dementia living in a long-term care setting: Are there any persistent and delayed effects?

The purpose of this randomized study was to test the persistent and delayed effects of an intervention program entitled “Taking Care of Myself ” on selected mental health outcomes of daughter caregivers of a relative with dementia living in a long-term care setting. One group of caregivers took part in the experimental program (EG, n = 45), one in a comparison program offered by an Alzheimer Society (AG, n = 51), and another constituted a control group (CG, n = 41). Effects were verified at the end of the program and 3 months later. Results from prediction analyses reveal that competence dealing with healthcare staff and use of the coping strategy of reframing were persistent effects unique to the EG condition, whereas perceived availability of informal and formal support was a persistent effect in the EG and in the AG. A delayed effect was observed in the AG regarding competence dealing with healthcare staff. These results underline the importance of follow-up assessments of intervention programs and suggest avenues to support caregivers of institutionalized seniors.

‘Taking Care of Myself’

The purpose of this randomized study was to test the efficacy of an intervention programme entitled ‘Taking Care of Myself’ on selected indicators of mental health of daughter caregivers of elderly parents with dementia living in a long-term care setting. The programme is based on an empowerment perspective and on a stress and coping theoretical framework. Three groups of caregivers were compared: one took part in the experimental programme (EG, N= 45), one in a comparison programme offered by a Quebec Alzheimer Society (AG, N = 51), and another was a control group (CG, N = 41). Two successful outcomes are unique to the EG condition, that is, competence dealing with health care staff and perceived challenge of the caregiver role. Prediction analyses also provide statistical support for the efficacy of the EG and AG conditions to produce successful outcomes with respect to common indicators (perceived threat and role overload, control by self, informal/formal social support, and use of the coping strategy of reframing). These results provide avenues of intervention for promoting the mental health of caregivers of an institutionalized relative.