Felt Guilty Research Articles

Autonomous Motivation among Employees of Public Sector Medical University: The Role of Demographic Characteristics

To determine employee autonomous motivation and find out the effect of age and Gender on autonomous motivation among employees working in public sector medical university, Karachi. A Cross-sectional study design was used to conduct this study among employees of public sector medical university. The duration of the study was three months. The sample size of the study was 384. The response rate was 78%, 300 out of 384 duly filled questionnaires were collected. A probability random sampling technique was used to collect data. SPSS software was applied to analyze the collected data. Mean ±SD and % & n were explored for Quantitative and Qualitative variables, respectively. T-Test and one-way ANOVA were applied to test hypotheses. P-Value <0.05 was considered significant. 59.3% (n=178) were males. 46% (n=138) were females in age between 25 to 31 years. 53.7 % (n=161) respondent reported their marital status as single. The mean age of the respondents was 30.16±7.03. Factors that motivate employees included salary (34%), positive feedback (26.3%), felt very proud when did well at work (52%), learnt new things (57.7%), , had a feeling of accomplishment (35.3%), Solving work issues made them feel important (26.7%), felt guilty if didn’t accomplish a job-related task (45.3%). The t-test and ANOVA revealed significant effect of gender; t (298) = -2.81, p-value = 0.005, CI [-3.77, -0.66] and age; F (5,294) =2.56, p-Value = 0.027 on employees’ autonomous motivation. It was observed proven that there was a significant effect of gender and age on employee’s autonomous motivation.

Misoginia y exculpación: el canto a Teresa

En el poema autobiográfico de Espronceda, ciertas circunstancias de sus amores adulterinos con Teresa Mancha de Bayo se expresan en forma tan sutil y poética, que hace falta confrontarlas con la historia para aclararlas. El Canto es la versión pública de estos amores, que llevaron a la corrupción moral y muerte de Teresa, y en ella Espronceda convierte a su amante en la única culpable, aunque ese papel le correspondía enteramente a él. En su fuero interno el poeta se sentía culpable, pero por las normas sociales del tiempo no podía decirlo. Compara su papel con el de Adán y el de Teresa con el de Eva. Por su concepto de la mujer, no hay poema romántico más odioso, pero por su nostalgia, sus imágenes y su versificación no hay ninguno más hermoso. Espronceda recurre al metro de la épica culta, para simbolizar su lucha romántica con sus cuitas amorosas.

Sanksi Pidana Terhadap Tindak Pidana Pembobolan Rekening Melalui Anjungan Tunai Mandiri (ATM)

Negara hukum menghendaki agar hukum senantiasa harus ditegakkan, dihormati dan ditaati oleh siapapun tanpa ada alasan pengecualian. Menyikapi hal ini, hukum positif di Indonesia dituntut untuk bisa merespon terhadap fenomena-fenomena kejahatan yang dilakukan dengan memanfaatkan teknologi tersebut. Permasalahan dari penelitian ini adalah 1) Bagaimana pengaturan sanksi pidana terhadap tindak pidana pembobolan rekening melalui Anjungan Tunai Mandiri (ATM)? 2) Bagaimana pertimbangan Hakim dalam memutus perkara pembobolan rekening melalui Anjungan Tunai Mandiri (ATM)? Metode penelitian yang digunakan adalah metode penelitian hukum normatif, dengan studi kepustakaan dari bahan hukum primer dan sekunder. Hasil penelitian dapat disimpulkan bahwa: 1) Pengaturan sanksi pidana terhadap tindak pidana pembobolan rekening melalui Anjungan Tunai Mandiri (ATM) dalam KUHP, Undang-Undang ITE, Undang-Undang Transfer Dana, Undang-Undang Pemberantasan Tindak Pidana Pencucian Uang. 2) Pertimbangan Hakim dalam memutus perkara Pembobolan Rekening Melalui Anjungan Tunai Mandiri (ATM) bahwa terdakwa TEGUH T KHASAN telah terbukti secara sah. Hal-hal yang memberatkan Perbuatan terdakwa dapat meresahkan masyarakat dan dapat menimbulkan kerugian bagi orang lain. Hal-hal yang meringankan, terdakwa mengaku belum pernah dihukum, terdakwa sopan dipersidangan dan mengakui terus terang perbuatannya, terdakwa merasa bersalah dan menyesal.

The day I left the lab

I finished my experiment and hurried to store my samples. I had a train to catch, and I was cutting it close. “Ugh, I should just stay in the lab to get a few more experiments done. I'm not even sure what I'll get out of the career development symposium,” I thought to myself. I had started a postdoc position 8 months earlier and needed to gather preliminary data to bulk up a fellowship application and extend my postdoc appointment. But I also knew that I needed to cultivate contacts in industry, in case I wanted to pursue a career outside academia. A friend working in biotechnology had told me, “Sometimes you need to get out of the lab to make meaningful connections.” He was right, I decided. I washed my hands and headed to the train. > “Cultivating connections and exploring career options outside the lab proved difficult.” When I started my postdoc, I aimed to become a professor at a liberal arts college. But as time wore on, I had doubts. I didn't want to do a second postdoc, which I feared would be necessary to land a faculty position. My partner and I were also settled in Chicago after 5 years of juggling a long-distance relationship, so the prospect of moving to a new city didn't appeal to me. Yet cultivating connections and exploring career options outside the lab proved difficult. My weekly calendar was always filled with seminars, student presentations, and lab meetings. I felt guilty taking time away from my work—but just as guilty about neglecting my future. So when an email circulated about the career development symposium, I signed up. As I stood awkwardly in the lunch line that day, I chatted with a technology transfer specialist. We found a table together and met a medical science liaison, who told me about how much he enjoys communicating medical research with health care providers. That piqued my interest because I'd always enjoyed communicating science, but I hadn't seriously considered it as a career option. He told me to check out a science writing panel that afternoon, where he'd be a panelist. A few hours later, I spotted him up on the stage. He and the other panelists—all of whom had Ph.D.s—clearly loved their jobs. They made frequent use of skills they had honed through their graduate training: critical thinking, project management, and the ability to learn quickly. I sat in the audience feeling I, too, could be a medical writer—and that it would suit me. I knew that I needed a varied, intellectually stimulating career that would keep me on my toes. I wanted to spend time thinking about how to present data, because that's something I enjoyed doing in academia. The more I thought about it, the more I felt science communication might be the perfect fit for me. It took me 2 months, but eventually I reached out to a medical writer who had served on the panel, and she agreed to meet for tea. As she spoke about her job at a medical communications agency, time flew by and I wanted to know more. I asked her for advice about how I could launch my own medical writing career, and she responded by asking for my resume. One week later, I had a phone interview with her agency. Two months later, I started a new job as a medical writer working alongside her. I've been at the company for 1.5 years now, and I'm thankful I found a career that's such a good fit. I work collaboratively with my colleagues on projects that communicate medical research for our clients, mainly pharmaceutical companies. And I use many core skills from my scientific training, such as rapidly sifting through the literature to find relevant information and communicating data visually. During my postdoc, it was challenging to figure out where my career path would take me next. For me, the catalyst was talking to people. I realize it can be hard to get out and network in person these days. But virtual networking is always an option—and you won't even have to worry about missing a train.

Self-reported alcohol consumption in doctors.

The UK government has prioritized reducing the harmful effects of excessive alcohol consumption on mental and physical well-being. To assess self-reported alcohol consumption amongst doctors at an acute London Trust. An opportunistic, anonymous, survey was conducted by Postgraduate Education Fellows over 2 weeks in December 2018. This included all grades of doctors from Foundation Year One to Consultant. The survey consisted of nine questions, modified from the alcohol use disorders identification test (AUDIT) and CAGE questionnaire. Of 446 doctors within our institution, 109 completed the survey (24%). Fourteen per cent of those surveyed abstained from alcohol, 21% drank monthly or less, 31% drank between two to four times per month, 25% drank two to three times per week and 9% drank greater than four times per week. In the preceding 2 years, 9% reported being unable to do what was expected of them on at least one occasion due to alcohol. Five per cent were concerned about alcohol affecting their performance. Two per cent were annoyed by criticism of their drinking, 9% felt guilty about drinking and 4% needed an eye-opener. Eighteen per cent wanted to reduce their alcohol consumption; however, 43% of the 109 doctors surveyed were uncertain where to seek help. Twenty per cent of surveyed doctors reported consuming potentially hazardous levels of alcohol and 18% of respondents wanted to cut down. Forty-three per cent were unaware of sources of support. Our findings suggest a role for collaboration between Occupational Health departments and Postgraduate Education teams to support doctors misusing alcohol.

Negotiating screen time: A mother’s struggle over ‘no screen time’ with her infant son

The literature on infant and toddler screen time has been built on two traditions—cognitive models of learning and sociocultural models of learning. Cognitive studies have cautioned against the use of screen time for young children because clinical research has not shown children can learn as effectively from screens as they do from human interaction and might delay children’s cognitive development. Conversely, qualitative research has described the social ways children learn and use digital technology through social interactions with other people in their homes. This paper reports on an autoethnographic study of how digital tools were embedded in the everyday ways of life in my home during my son’s first 18 months of life. I present a first-hand account of the tensions I experienced as I grappled with the American Academy of Pediatrics’ recommendation of no, ‘digital media use (except video-chatting) in children younger than 18–24 months’ (p. 3). I juxtapose screen time recommendations with the everyday realities of my life as a first-time mother in the 21st century. Throughout the study, I was enmeshed in two roles—researcher and mother—and drew on phenomenology to describe my infant son and my lived experiences using digital technology in our home. My researcher persona was influenced by the traditions and perspectives of sociocultural theories and new literacy studies and the positive learning that can occur while using digital technology. I noted how digital tools were ingrained in daily moments and ways of life, particularly those which used the TV and smartphones, and could not be removed. Yet, my mother persona felt guilty about our use of digital technology and I struggled with the messages I received from news and social media that warned against screen time for infants and toddlers.

Redeployment to COVID-19 Care Is Like Treading Water but Deeply Gratifying

Back to table of contents Previous article Next article Residents’ ForumFull AccessRedeployment to COVID-19 Care Is Like Treading Water but Deeply GratifyingRuth McCann, M.D.Ruth McCannSearch for more papers by this author, M.D.Published Online:28 Apr 2020https://doi.org/10.1176/appi.pn.2020.5a36AbstractAs a third-year psychiatry resident in New York, I’ve been redeployed to care for COVID-19 patients in our hospital. For now, I’m working in a medical intensive care unit (ICU), functioning in the role of an intern. I am, truly, more than happy to do this.The word “redeployment” feels odd, though. Was I ever “deployed” to begin with? I’ve never thought of doctors as soldiers. But if we’re now at war, it feels tricky—if not impossible—to say what or who the enemy is and what winning or losing might look like.After the shelter-in-place orders began, I spent two weeks doing remote visits with my outpatients by phone and Zoom. Ambulance sirens were almost constant. I felt guilty being at home and safe when I might reasonably be able to help in the hospital. So I volunteered for so-called redeployment, and my clinic director very kindly offered to cover my outpatients.After a few days of waiting, I was sent to work in a surgical ICU that had been converted into a COVID ICU. In fact, almost every available space in our hospital is now functioning as an ICU, including most of the operating rooms.Seven of my co-residents have also been redeployed to medical wards or ICU settings, and others are manning a new palliative care team. Still others have volunteered and are awaiting assignments. Thankfully, our intern years involved rotations in internal medicine (wards and ICU), neurology, and emergency medicine, so we arrived not entirely unprepared.So far, I’ve been working overnight shifts alongside many others who’ve been redeployed, including residents and fellows from anesthesia, surgery, orthopedics, and pediatrics. Our current supervisors are extremely competent cardiologists who’ve stepped up to run the ICU in which I am working.I’m essentially an intern again. I follow up lab results and order X-rays. I help nurses turn patients in bed. I call families and consults. I write admission notes, transfer notes, and death notes (of which there’ve been a heartbreaking number). In essence, I provide basic, hands-on assistance to my supervisors and the outstanding ICU nurses. And I do have an N95 that I use and reuse.The hospital—my home institution since medical school—is eerily tense and often quiet. Medical students have been sent home, and visitors are no longer allowed.It has admittedly been an adjustment to go from being a competent third-year psychiatry resident to being—again—an intern treading water. I am, in this new setting, not particularly special or talented or authoritative. No one looks to me for any kind of answer. I do what I can and what I’m asked. The experience is somewhat similar to how it felt to stay at home and isolated from the people I love—difficult but not unique. We’re all doing it; we’re all in this together.There are, I know, grave ethical, political, and social questions to be asked right now. People everywhere are suffering and dying. Our medical system is broken and breaking further. Many health care workers across the country are not being adequately protected, supported, or compensated during this crisis.But to push myself from today into tomorrow, I’ve sometimes avoided thinking about the forest. I’ve relied, instead, on the solidity of various trees. I wish, for example, that I could adequately express to you the joy I felt the other night as I watched my attending care for patients on our unit. She flew, seemingly tireless, from room to room, putting out fire after fire, changing ventilator settings, running codes, calling families, and answering every question the nurses and I came to her with. She was dedicated, kind, and indefatigable. I wished the patients’ families could see her, ministering so beautifully and intently to their loved ones.There’s been a nightly 7 p.m. “Clap for Carers” in Manhattan, and I’ll admit that I sometimes ignore it, because it hurts to think about what’s happening. But yesterday, when the clapping started, I went to the window and joined in. I clapped for that particular attending and for the work I’d seen her do—something like war, maybe, but more like love. ■Ruth McCann, M.D., is a PGY-3 psychiatry resident at Columbia University Irving Medical Center/New York State Psychiatric Institute. ISSUES NewArchived

MOSES’ ANXIETY AND DEFENSE MECHANISM IN EXODUS: GODS AND KINGS MOVIE

Anxiety is part of the defense mechanism. Defense mechanisms are psychological strategies unconsciously used to defend a person from anxiety arising from unacceptable thoughts or feelings. This study found the types of Moses’ anxiety and investigate the defense mechanism that Moses employed in reducing his anxiety by employing Freud’s concept as the main theory. The design of this research was qualitative research with content analysis as its approach. As the data, this study employed words including narrations and dialogues that were taken from Exodus Gods and Kings’ movie script. This study showed that Moses character experienced three types of anxieties covering neurotic anxiety, moral anxiety, and realistic anxiety. Furthermore, Moses employed five types of the defense mechanism covering repression, formation, isolation, denial, and aggression. The conclusion of this research considered Moses character experienced neurotic anxiety when he identified a boy that represented as the authority figure who was punishing him. The moral anxiety experienced in four times, overall happened when he felt guilty and realistic anxiety experienced three times because he managed some threats from the outer world. Moreover, all these features of the defense mechanism used to cope with Moses’s anxious feeling. The implication of this research provided another point of view in seeing Exodus: Gods and Kings' movie as the portrayal of the way how people can't suffer anxiety easily because anxious feeling happened from many factors and how people tried to use the defense mechanism to reduce anxiety.

Alcohol consumption of UK members of parliament: cross-sectional survey

ObjectivesThis study examined the prevalence of risky drinking by members of parliament (MPs), as well as the relationship between risky drinking and age, years spent as an MP, working outside...

Factors Influencing Oral Health-Related Quality of Life Among Preschool Children in District of Kota Bharu, Malaysia: A Cross-Sectional Study

Objective: To assess caries experience and its association with oral health-related quality of life (OHRQoL) of preschool children in Kota Bharu, Kelantan, Malaysia. Material and Methods: A sample of 169 preschool children of 5-6-year-old at a private preschool in the district of Kota Bharu, Kelantan was participated and were subjected to an oral examination to determine their caries experience by a single calibrated dentist. The parents were responding to self-administered Malay-ECOHIS and their socio-demographic background. Descriptive, Chi-square test and Spearman correlation were done to analyse the data required in this study. Results: Subjects comprised of girls (55.6%) with most parents (39%) had a secondary level of education, and 47.9% of them had a monthly income of RM1000-RM2999. Caries prevalence was 74.6% with a mean (SD) dmft was 5.27(5.22). The impacts on OHRQoL were more prevalent in the family section of Malay-ECOHIS (12.5%; 95%CI: 7.5%-17.5%) than the child section (4.2%; 95%CI: 1.16%-7.24%). Items related to ‘felt guilty’ (22.5%; 95%CI: 16%-29%) and ‘been upset’ (20.2%; 95%CI: 14.1%-26.3%) were the frequently reported on the family impact section. In child impact section, the item related to ‘pain’ (36.7%; 95%CI: 30%-43%) and ‘difficulty eating’ (20.8%; 95%CI: 14.7%-26.9%) were reported more frequently. Children with caries experience were significantly associated with the impact on family OHRQoL (p<0.05). Conclusion: The presence of dental caries was a significant predictor of poor OHRQoL.

True Confessions

True Confessions Speer Morgan In 2007, during the events surrounding the funeral of my mother, Betty Speer Morgan, who was one of my heroes, my brother and I shared childhood stories, including one that our mother herself had told us not that long before. When we were children—he about six, I three—we had driven her nuts with endless sibling bickering, breaking things, and chasing each other around the house. One day, when one of us broke yet another china dish, she had had enough. She got so angry that she proceeded to throw the rest of her china, all of it, piece by piece, out the front door of the house. In the confessional mode, I then remembered that for three or four years after our family had moved to the small motel where we lived, and which we ran as a business, with both my brother and I renting rooms to soldiers and their families from Fort Chaffee, I had stolen money out of the cigar box that we used for a cash register— as much as a couple of dollars at a time to go to the movie or buy cokes. My brother was surprised and mildly shocked by this and expressed as much. Later, as we were driving past the place where the motel had stood, he asked if I had forgiven him for throwing me through the glass shower door. I told him that I hadn’t because I didn’t remember his doing it. “I did it three separate times,” he told me. “I felt guilty about it for years afterward.” Almost all of us have things we feel guilty about, many of them more substantial than childhood misconduct. Serious literature explores human flaws and follies and people’s efforts to change, whether failing or successful. Because of that, confession is an inevitable part of both its methods and subjects. One of the more interesting aspects of literary [End Page 5] confession is that it is less about guilt or shame than an effort to be truthful and engage the hearer on a personal level, or even to suggest humankind’s higher abilities. One of the best-remembered passages in St. Augustine’s Confessions is not the account of his more dramatic youthful deceptions, cruelty, or “jungle of erotic adventures” but his and his teenaged friends’ seemingly innocuous theft of a basket of pears. He takes the pears home and forgets to even eat them. Speculating on it from a nonplatonic point of view, he sees this as an example of how the restlessness, misconduct, and sinfulness of humankind is ultimately an urge to be like God—in part to possess and control but finally also to be at peace. Rousseau’s highly influential two-volume Confessions, published during the French Enlightenment, is similarly honest and paradoxical. Rousseau readily admits to flaws and failures and prurient behavior, including being beaten as a child by his effective guardian Mlle. Lambercier and enjoying it so much that he desperately wants to be beaten by her again. Yet Rousseau feels that he and all of us are fundamentally good, with all our physical experiences and personal oddities. Because of his belief in the value and relevance of the subjective and the sensory, he is often seen as one of the inspirations for the Romantic movement. Thomas de Quincey’s 1821 Confessions of an English Opium-Eater, another contribution to Romantic literature, is less philosophically driven. It speaks of his slide into drug dependency as a homeless youth and the terrible symptoms in later life of full addiction, yet it is also filled with a contradictory appreciation for opium’s mind-altering “assuaging,” transcendent visions, and gift of the “hopes of youth,” no matter how delusional. The poetry that interested me as a young reader was the confessional work of Sylvia Plath and Robert Lowell from the late 1950s and ’60s. Among the paradoxes in their poetry was that they and indeed many of the memorable poets of that generation spoke with a raw personal sublimity reminiscent of the Romantic classics of Wordsworth, Coleridge, and Thoreau. The broad themes of true confession indeed come from the...

HIV Related Stigma Among People Living with HIV and AIDS in Limbe Health District, Cameroon

The background to thr article is that, the Human Immuno-deficiency Virus (HIV) - related stigma tends to create a vicious cycle of fear, ignorance, mistrust, misinformation, denial and self-isolation, which tend to further spread the virus because stigma affects the way people will take their treatment. The objective of this study was to assess the forms of stigma, and determine the role of stigma and other factors among HIV and the Acquired Immuno-Deficiency Syndrome (AIDS) patients on Anti- Retroviral Therapy (ART) in Limbe Health District. For the method, a cross-sectional design with a sample size of 389 was used. Interviewer- administered questionnaire was used to collect data from HIV and AIDS patients belonging to HIV support groups in Limbe Health District found at the treatment centre of the Limbe Regional Hospital. Data was collected on socio-demographic characteristics of respondents, forms of stigma and factors in association. Data was analyzed using STATA version 7.0. Results have shown that in all, stigma was experienced by 76.7% respondents. Among this group, self-stigma was experienced by 95% of the respondents while 28% experienced external stigma. Majority of respondents (92.8%) admitted it was not easy to disclose their status, 7.2% felt dirty while 20.05% felt guilty of contracting HIV. Association of overall stigma with adherence to treatment showed no statistical significance, however respondents who did not experience self-stigma were more adherent (76.9%) than those who experienced overall stigma (71.01%). It can thus be concluded that people living with HIV/AIDS (PLWHA) belonging to HIV support groups in LHD experienced both internalized and external stigma, with the former experienced by almost all the respondents. Although stigma was not significantly associated with adherence to treatment, the very high level of internalized stigma warrants the implementation of stigma reduction measures.

Attitude and perceptions toward miscarriage: a survey of a general population in Japan

Miscarriage is the greatest complication of pregnancy, and 70-80% of early miscarriages are mostly due to chromosomal abnormalities in the embryo. There is no evidence that stress is a direct cause of miscarriage. Despite these findings, in a national US survey on the causes of miscarriage, many Americans mistakenly attributed miscarriage to the mental state or behavior of the women. We conducted a survey to assess public attitudes and perceptions regarding the cause and prevalence of miscarriage in Japan. We sent out a questionnaire consisting of 17 questions. The 5000 recipients consisted of men and women (1:1 ratio) aged 18-69 who resided in Aichi Prefecture. A total of 1257 recipients (25%) responded to the questionnaire and 1219 valid respondents (24%) were included in the analyses. Of these, 62% considered a genetic abnormality of the fetus as the cause of miscarriage. Participants who were female, highly educated, married and healthy gave significantly more correct responses. On the other hand, the majority wrongly assumed that a stressful event (65%) and long-standing stress (75%) to be causes of miscarriage. Participants who had no history of miscarriage as well as males answered significantly more incorrectly. Sixty-five percent of respondents thought that miscarriage occurred less than 15% of all pregnancies. Among respondents who had experienced miscarriage personally, 53 and 36% felt guilty and lonely, respectively. Many respondents blamed the woman for the miscarriage either in terms of her behavior or mental stress and considered the frequency of miscarriage to be lower than it actually is.

ABORDAGEM BIOPSICOSSOCIAL DE UM CASO DE DISFUNÇÃO SEXUAL MASCULINA

Diagnósticos biopsicossociais, incluindo mecanismos de medicações, são importantes para o tratamento das disfunções sexuais. Um homem de 23 anos referia ser muito tímido e exigente consigo mesmo. Às masturbações fazia estimulação anal e apresentava ejaculação precoce (EP). Só tentou ter a sua primeira relação sexual há nove meses, quando teve disfunção erétil (DE). Desde então teve poucas tentativas, sempre com DE e EP. Estava com varicocele e espermograma alterado. Tem pai idoso e com dificuldades para deambular. Os diagnósticos foram DE, EP, fobia social, fortes traços obsessivos de personalidade, reação depressiva e excitação por estimulação anal pela qual tinha sentimento de culpa. O tratamento incluiu psicoterapia, Sertralina 25 mg, Diazepam e Sildenafila se necessário, além de exercícios sexuais e avaliação urológica. Foi sugerida cirurgia para a varicocele, mas esta não justificava as disfunções sexuais. Relutou em iniciar o tratamento e manteve a DE e a EP. Quando usou Sildenafila, não teve DE mas apresentou EP. Quando iniciou a Sertralina conseguiu o retardo ejaculatório. A Sertralina trata a fobia social e retarda a ejaculação pelo efeito da serotonina, melhorando a EP. Foi usada em dose bem baixa, mesmo porque inibe a libido. O Diazepam também causa disfunções sexuais, por isso foi evitado. Assim, com essas medicações associadas à psicoterapia passou a ter relações normalmente. Pouco tempo depois, suspendeu as drogas sem prejuízo da função sexual. Continuou a psicoterapia na qual foram trabalhados os seguintes aspectos: o sentimento de culpa em relação às fantasias de estimulação anal; a baixa autoestima; o medo de ser criticado; as fantasias em relação à varicocele e à perda de mobilidade dos espermatozoides; a auto cobrança excessiva e o fraco pai interno. Com a melhora da autoestima e da autoconfiança, passou a ter uma vida sexual saudável.

Fighting through the gray.

I roll over in bed and reach for my phone to check the time. “It's 8:30 a.m.!” I say to myself. “How did that happen? I must have turned my alarm off and fallen back to sleep.” After some deep breaths, I manage to drag myself out of bed, get dressed, and make breakfast. At work I try to focus, but most of the day I just sit in a fog, struggling to stay awake. When I head home, I lack the motivation to go to the gym, do errands, or hang out with friends. Instead, I fall asleep on the couch shortly after dinner, only making it to bed after some gentle prodding from my dog. ![Figure][1] ILLUSTRATION: ROBERT NEUBECKER > “I realized that my tiredness and depression came during the gloomy winter months.” Early in my Ph.D., this felt like my near daily routine. I attributed my newfound difficulties to the stress of starting a Ph.D. program and being far from home. But it was odd: Before graduate school, I was an early riser and thought most clearly in the mornings. I couldn't understand why I was suddenly unable to get out of bed. I felt guilty about my lack of focus and frustrated that I was no longer capitalizing on my best working hours. After 2 years, a light bulb went off in my head. I realized that my tiredness and depression came during the gloomy winter months. That was the clue that pointed me toward a solution. I had grown up and gone to college in Arizona, where a lack of sunlight was never an issue. My first experience living elsewhere came when I started graduate school in upstate New York, which is notoriously gray during the winters, with low-hanging clouds blanketing the region day in and day out. The prospect of cold and snowy winters was scary, but I was thrilled to have the opportunity to study in a top program in my field. Once there, I heard people on campus talk—and, unfortunately, joke—about seasonal affective disorder (SAD), a severe form of “winter blues” that's triggered by low light levels. As my health and well-being took a downturn each winter, eventually I realized that SAD might be the cause, and I needed to do something about it. A website suggested an alarm clock that simulates the sunrise, becoming brighter and brighter as your wake-up time approaches. I decided to give that a try. It turned out to be a lifesaver, helping me get out of bed in the morning on time and feeling rested. That first taste of a successful solution spurred me to visit a doctor, who confirmed my self-diagnosis and suggested a few other things I could try. It was a relief to discover that my condition had a name and that I could take steps to feel better. Now in the fifth year of my Ph.D., I no longer dread the arrival of winter because I finally have a solid strategy to deal with SAD. I have a much easier time getting up and starting my day if I stick with a regular routine. So, I wake up when my sunrise-simulating alarm clock tells me to—at the same time each day—and soak up a daily dose of artificial rays by basking in front of a full-spectrum light therapy box. And as much as possible, I make the journey home to sunny Arizona for a few weeks during the winter months, although that's not always feasible on my grad student stipend. Most important, I've learned to be kinder to myself. I've always been a high achiever in all aspects of my life, so it has been difficult to give myself a break when I fall short of my ambitious self-imposed deadlines. The reality is that, despite my best efforts, my winter self still struggles to muster the kind of energy and motivation that propels me during the summer months—and I've come to accept that. My experience with SAD has also heightened my awareness that I need to prioritize my health in the future, when choosing a place to live long term. I'm still glad I chose to attend the grad school I did, but I don't want to keep paying the psychological cost of living in a gloomy place. I know my need for sunshine will limit potential job options, but it's important for me to find a place that works for both my personal and professional life. For now, though, I'm celebrating the fact that the days are getting longer, and spring is just around the corner. [1]: pending:yes

Impact of Early Childhood Caries on Oral Health-related Quality of Life Among 4-6-year-old Children Attending Delhi Schools: A Cross-sectional Study.

ABSTRACTIntroductionOral diseases like early childhood caries (ECC), trauma, teething pain, and eruption disturbances are widely prevalent among the 4–6-year subgroup of population and are considered a public health problem worldwide.AimTo assess the impact of ECC on oral health-related quality of life (OHRQoL) among 4–6-year-old children attending schools in Delhi.Materials and methodsA cross-sectional epidemiological study was carried out to assess the impact of ECC on OHRQoL among 4–6-year old children. Data were collected by a combination of the structured questionnaire of sociodemographic details and early childhood oral health impact scale (ECOHIS). The clinical examination was conducted for the assessment of dentition status and pufa index according to WHO criteria 2013. Statistical analysis was performed using the Chi-square test, the Kruskal–Wallis test, and the Mann–Whitney U test.ResultsThe prevalence of ECC was found to be 20% among preschoolers which was lower among younger children and increased with age. The ECOHIS responses reported that items related to pain, irritation, difficulty in eating some foods, and difficulty to drink hot or cold beverages, felt guilty, feeling of frustration, and been upset were the most frequent on the child impact section (CIS).How to cite this articleJaggi A, Marya CM, et al. Impact of Early Childhood Caries on Oral Health-related Quality of Life Among 4–6-year-old Children Attending Delhi Schools: A Cross-sectional Study. Int J Clin Pediatr Dent 2019;12(3):215–221.

A Womb with a Pew

A Womb with a Pew Lisa Lanser Rose (bio) Before the vasectomy, sex with Joe was never my favorite pastime. After the vasectomy, his blanks shot me full of anger. Forgiving my self-sterilized husband didn’t end at seventy times seven. Every act reminded me he’d snipped off future babies, amputated our daughter’s siblings, lopped branches off the family tree I was made for. The longer I refused, the angrier he got. When he thumped around the house upright, thin-lipped, and grim, it was impossible to lie down with him. Even the dogs avoided him. But Joe worked long hours and otherwise tried to be an unimpeachable Catholic husband. I felt guilty, ungrateful. I wondered if I were frigid. Joe decided I was frigid. I went to a counselor. She said, “Think of having sex with your husband as baking him a chocolate cake.” I said, “I’d rather pick it up at the Safeway.” Videos of our only child captured the beginning and the ending of motherhood at once—the first-and-last first steps, the first-and-last first birthday, the first-and-last first bike ride, the first-and-last first day of school. To rub salt into all those first-and-last firsts, my friends who said they’d never have a baby had one. Then they said they’d never have another one, and they had another one. My own sister had three, the last a happy accident. One day my sister-in-law smiled saucily, swatted one of my husband’s five brothers—the one she’d married—and said, “Fertile Myrtle here keeps getting me pregnant.” And, lo, she had another baby. One of my friends got her tubes tied after her third son. A month later, she called me. “Just my luck,” she said. “An egg must’ve squeaked through.” Eight months later, she had her fourth son. That’s when the recurring dreams about Fertile Myrtle began. He pumped me so full of super-semen I woke up thinking I was six months pregnant. At work, tall, lean, curly-haired men started gassing the cubicles with their pheromones. Worried they could hear my ovaries yowl, I couldn’t talk to them or even meet their gazes, but as I scurried home, their long, pale, male bodies sprawled nude on the furniture in my mind. Once in a while, someone asked when we were going to have another child. “It’s up to God,” I lied. I was too ashamed of the truth to tell it. I was also lying to myself, telling myself something went wrong in the delivery room—my uterus hopped away slippery like a wet toad, and the doctors couldn’t catch it, so now I was barren. That had to be my story. Otherwise, I might murder Joe. [End Page 16] ________ I took my lustful heart to confession. The priest told me to confess to my husband, so I did. I even admitted I was cuckolding him in my dreams. “I don’t want to cheat,” I told Joe through earnest tears. “I want another child.” “The vasectomy was a mistake,” he admitted. “You were robbed.” He was making good money, and we had a peaceful home. I wanted to adopt a foster child, someone who’d lost her family and needed us. He said, “I don’t want other people’s problems in my house.” He might have been born and raised Catholic, but he went to Mass for the same reason he mowed the front lawn—people saw it. “If you were a real Catholic,” I said, “you’d show a little charity to an orphan or two.” He agreed to speak to a priest, but only someone in another town, not our priest, the one who supposedly sanctioned a twenty-eight-year-old first-time father’s vasectomy in the first place. I made the appointment, and we drove to another town. We sat in the cleric’s office in separate chairs, clutching our own hands. The priest put his listening face on, and I confessed our self-inflicted infertility, my longing for another child, my aversion to sex...

Half As Sad: A Plea for Narrative Medicine in Pediatric Residency Training.

During my third year of general pediatrics residency training, a patient well known to me and my fellow residents died unexpectedly. The child was an extremely bright and mature 8-year-old who had spent much of the last year of her life in our hospital being treated for cancer. Seemingly overnight, she became “too” sick (ICU sick, intubated and ventilated, on dialysis sick). She began to have intractable seizures, and with her family by her side, she died. The next morning, a colleague in his first year of residency asked how I was. I said that it had been a difficult week and I felt profoundly sad about the death of our patient. A look of relief came over his face. He told me that he was feeling despair. This was the first child he had cared for that had died. He had never felt such sadness before and felt guilty for feeling sad. He said that in medical school he had been told by a senior physician that it was the professional responsibility of a physician to “never feel more than 50% as sad as a patient’s family.” Faced with the reality of the death of a child, my colleague was left feeling confused, distressed, and disenfranchised from his own emotional response. “You put on the waterworks and it makes the parents feel better,” my genetics attending said. She seemed proud to have arrived at this simple remedy. She had just finished counseling a couple whose child had been diagnosed with a lethal genetic condition. Were the tears an act simulating empathy for … Address correspondence to Malgorzata Nowaczyk, MD, FRCPC, FCCMG, FACMG, Department of Pediatrics, McMaster Children’s Hospital, 1200 Main St W, Hamilton, ON L8N 3Z5, Canada. E-mail: nowaczyk{at}hhsc.ca

At the end of the road, a new start.

I never thought my mom's first tour of Stanford University would be of the psychiatric ward. When I arrived in sunny California 2 years earlier to start my Ph.D. studies, I was on top of the world. But that feeling of triumph vanished quickly. The uncertainty that had nagged at me for years grew overwhelming. I loved learning new things and talking about science, yet I couldn't envision working at the bench for the rest of my life. But after building my identity around being a scientist, how could I turn away? Stanford was, in many ways, my Hail Mary. If I was going to be happy, it had to be there—right? ![Figure][1] ILLUSTRATION: ROBERT NEUBECKER > “I didn't see my problems as legitimate, so I didn't seek help.” I loved the students in my program. My classes were marvelously interesting and challenging. I found a mentor who cared about his students. I was pursuing fascinating research questions. I had a nice apartment, the most supportive and wonderful girlfriend imaginable, and loving parents. Despite all this, I was profoundly unhappy. When you have so much to be thankful for, are you really going through a hard time? I was suffering under the simmering pressure of graduate school. But graduate students are expected to work hard. I didn't see my problems as legitimate, so I didn't seek help. That was my biggest mistake. I had behaved similarly a few years earlier, when the end of a long-term relationship sent me spiraling into a deep depression. I didn't seek help then either, and I was proud of the fact that I didn't need any. I had more important things to do than focus on my own sadness. In grad school, I kept giving myself milestones when I thought I would stumble upon happiness. Maybe after I passed my classes, I'd be happy. Maybe after I found the right lab and project, I'd be happy. I tried to kick the proverbial can so far down the road that it would disappear over the horizon. But there it was, staring me in the face: joy, just beyond my reach. It's difficult to describe what it feels like to reach the end of the road. For me, it meant months of leaving the lab in the middle of the day because I couldn't breathe, anxiety wrapped around my throat and refusing to let go. I would sneak to a secluded corner under a staircase to cry or sit in the pews of the beautiful campus church, hoping that the heavy doors would keep terrible thoughts from breaking in. One day, I stayed home from lab. I made my coffee, answered emails—and prepared to end my life. But as I talked to my girlfriend that afternoon, I found myself telling her that I was having bad thoughts. She dropped everything, ran home to see me, and called a hotline. The therapist recommended that I go to the emergency room. The doctors diagnosed me with major depressive disorder, with episodes of anxiety. After 6 days in the psychiatric ward, I spent 3 months going to therapy for 20 hours a week and started to take antidepressants. My graduate school life came to a screeching halt. I felt guilty for leaving the lab so abruptly, but my graduate program director sent a simple, welcome message: Take all the time you need, and we'll be ready to talk when you are. Hitting a brick wall as fast as I did was a pretty clear sign that I needed to make some changes. A few months after leaving the hospital, I set up a meeting with the program director, bracing myself for what I thought was the inevitable end of my graduate school career. My director, however, proposed a solution I hadn't thought possible: What if I stayed in the program but left the bench and studied what I really love? Now, that's exactly what I'm doing, exploring the world of science communication research. And before you ask, no, I have no idea where it will lead. But thinking about my future now fills me with a grand sense of adventure—not the dread I used to feel when I considered working another day in the lab. My director has made it clear that my mental health is his priority, and that it should be mine as well. That expectation has made a world of difference. [1]: pending:yes

Are Those Once Bad Doomed to Be Bad? The Power of Felt Guilty after Acting UPB

We examined the consequence of unethical pro-organizational (UPB) acting from the perspective of the actors themselves. Drawing on moral cleansing theory, we hypothesize that previous UPB acting pr...