Sense Of Worthlessness Research Articles

Factors Affecting Nurses’workplace Stress Inyowari Hospital Of Sentani District Jayapura

<p align="center"><strong>ABSTRACT</strong></p><p>Work stress is distress experienced by individuals in the face of work caused by the stressors of work environment factors such as physical environment, organizational systems and individuals. The research objective was to determine what factors are causing stress in nurses who work in Hospital. This research used <em>explanatory research</em> with <em>cross sectional </em>approach. These samples included 55 nurses in hospitalization ward. The instrument of this study is a questionnaire. The data were analyzed using descriptive statistics, bivariate analysis using <em>chi square test, </em>and multivariate analysis using <em>Structural Equation Modeling (SEM).</em>The results of univariate analysis showed that the nurses stress of 61.8% found in the characteristics of the age of 21-40 years (87.3%), female (85.5%) education level Diploma Nurses (74.5%), has a work period ≤ 5 years (60.0%), the status of civil servants (54.5%), were married (76.4%), and working in the internal ward (30.9%), with a personality type extrovert (70.9%). The level of stress is often the case that <em>self esteem</em> (87.3%), despair and a sense of worthlessness (80%), success (72.7%) and interest (72.7%). The bivariate analysis showed that, Stressors that significant with stress were: support, organization, interaction with the <em>p-value</em> (0.012 <0.05). The coping mechanisms were social support as an emotional reason the value of <em>p-value</em>(0.040 <0.05).The closeness to the religious <em>p-value</em>(0.002 <0.05) significantly between closeness to religion with work stress. The most factors that have an effect on the coping mechanisms <em>Equtional Modeling Structural</em> testing with loading value of 0.598 and 7.798 correlated, which means that the coping mechanisms 7 times have influence to reduce stress in the workplace.</p>

ID 8 – Repetitive transcranial magnetic stimulation in chronic anxiety and depression

Objective Presenting the case of a gentleman with chronic treatment resistant depression (TRD) and social anxiety disorder, who first failed ECT and left sided high frequency repetitive transcranial magnetic stimulation (rTMS) but then responded to right sided low frequency rTMS in order to highlight the therapeutic potential of right sided rTMS for the treatment of TRD with co-morbid anxiety. Methods 44 year old married mixed race male with primary symptoms of chronic sadness, deep sense of worthlessness and hopelessness, irritability, anergia, poor concentration, intermittent suicidal ideation and anxiety. Since the mid 1990s, he’s had adequate trials of multiple psychotropic medications and psychotherapy. Twenty sessions of bilateral ECT offered no therapeutic benefit. He thus began left unilateral, high frequency (10 Hz) rTMS. Results Using the Montgomery–Asberg Depression Rating Scale (MADRS), his initial score was 28. He received 32 left sided treatments, but failed to respond. He was switched to right sided rTMS and after 20 sessions his MADRS score decreased to 9. He has been continued on maintenance rTMS therapy monthly and remains in remission. Conclusion This case illustrates that if left sided high frequency rTMS proves ineffective, then right sided, low frequency treatment should be considered in patients suffering with chronic depression and anxiety.

A meta-ethnographic synthesis of fathers׳ experiences of complicated births that are potentially traumatic

Introductionbirth is a natural and for many, life enhancing phenomenon. In rare circumstances however birth can be accompanied with complications that may place the mother and infant at risk of severe trauma or death. Witnessing birth complications or obstetric emergencies can be distressing and potentially traumatic for the father. Aimthe aim of this paper is to report on the findings of a meta-ethnographic synthesis of father’s experiences of complicated births that are potentially traumatic. Methodsdatabases searched included CINAHL, Scopus, PubMed and PsycINFO with Full Text. The search was conducted in February and March 2013 and revised in February 2015 for any new papers, and the search was limited to papers published in English, full text and peer-reviewed journals published between January 2000 to December 2013. Inclusion criteriastudies were included if they focused on fathers/men׳s experiences of witnessing a birth with complications including a caesarean section or an adverse obstetric event. Studies included needed to use qualitative or mixed methods research designs with a substantial qualitative component. Analytic strategya meta-ethnographic approach was used using methods of reciprocal translation guided by the work of Noblit and Hare (1988) on meta-ethnographic techniques. Quality appraisal was undertaken using the Critical Appraisal Skills Programme (CASP) tool. Findingseight qualitative studies with a total of 100 participants were included in the final sample. The men ranged in age from 19 to 50 years. Synthesis: Four major themes were identified: ‘the unfolding crisis’, ‘stripped of my role: powerless and helpless’, ‘craving information’ and ‘scarring the relationship’. Participants described the fear and anxiety they felt as well as having a sense of worthlessness and inadequacy. Men did not receive sufficient information about the unfolding events and subsequently this birth experience impacted on some men׳s interactions and relationships with their partners. Conclusionswitnessing a complicated or unexpected adverse birth experience can be distressing for men and some may report symptoms of birth trauma. Being informed by and receiving support from midwives and other health professionals appears to help mitigate the negative impact of birth complications. Effective support may help address men׳s confusion about their role, however genuinely including men as recipients of care or service in pregnancy, labour and birth raises important questions about whether the father is also a recipient of maternity care and if the transition to fatherhood is itself becoming a medical event?

Negative psychological experience of nursing students during clinical practice in NICU: a qualitative research

Objective To explore the negative psychological experience of nursing students during clinical practice in NICU. Methods The qualitative phenomenological research method was adopted in this study. Semi-structured in-depth interviews were conducted with twelve nursing students during practice in NICU. Data were analyzed by content analysis. Results Four themes were extracted, including high tension, exhaustion of body and mind, lack of confidence, and sense of worthlessness. Conclusions The head nurse and the clinical teachers should pay attention to the negative psychological experience of nursing students during clinical practice in NICU, make a scientific and reasonable practice teaching program, take effective measures, and help them to complete the task of practice better in NICU. Key words: Nursing students; Clinical practice; NICU; Negative psychological; Qualitative research

DSM‐5 grief scorecard: Assessment and outcomes of proposals to pathologize grief

Where does grief stand diagnostically, now that the dust has settled and the DSM-5 has been approved? The DSM-5 Task Force considered an unprecedented series of proposals to identify grief-related mental disorders where now there are assumed to be normal variations. The proposals taken together had the potential to transform psychiatry's conceptualization of grief and the clinician's response to bereaved patients. Targets for pathologization included both depressive symptoms during grief and grief itself – the yearning, disbelief, and other experiences distinctive of grief. Four grief-related proposals made it to the final leg of the DSM-5 revision process, a major event in itself. Here I review the proposals, assess their validity, and present the Task Force's final decisions, providing an overview of the status of grief post-DSM-5.

An econometric assessment of the effect of mental illness on household spending behavior

This paper examines the relationship between individuals’ mental health status and their spending behavior. Compared to individuals without mental health problems, individuals with mental health problems may have higher discount rates and derive greater utility from spending (i.e., retail therapy). If the mentally ill have these characteristics, we would expect them to purchase goods and services that give immediate enjoyment, sacrificing longer-term savings goals. However, mental health disorders may result in a sense of worthlessness and lethargy such that less utility is derived from spending and less energy is available for spending, which would give us the opposite prediction. Using the Panel Study of Income Dynamics, we generally find a negative effect of mental illness on household spending, although the specific effects vary by the measure of mental illness, by the expenditure category, and by gender and couple status. Of particular concern, single and married women with mental illness reduce spending on education, which suggests a long-term financial cost of mental illness. In addition, we find some evidence of retail therapy with respect to a mental health screen for single and married women and with respect to a mental diagnosis for married men.

Gender-related phenomenological and neuropsychological differences in elderly patients with depression

Aim The objectives of this work were to detect phenomenological sex-specific differences in elderly patients with depression for better understanding and to illustrate neuropsychological sex-specific differences in elderly patients with depression for better management. Subjects A comparative study with consecutive samples. Two groups were compared in the study comprising 40 elderly patients of both sexes with depression: 20 depressed men and 20 depressed women aged 60 years or above. They were recruited from the psychiatry outpatient clinic of Kasr Al Aini hospital with no obvious cognitive impairment or substance-related psychiatric disorders. Methods Diagnostic criteria of the Diagnostic and Statistical Manual of Mental Disorders , fourth edition, Symptom Checklist-90, mini-mental state examination (MMSE), Geriatric Depression Scale (GDS), Wechsler Adult Intelligence Scale, and State–Trait Anxiety Inventory were used. Results A comparison between the depressed male and female subgroups revealed that the characteristics of the patients were similar in both sexes except for some significant findings; for example, depression in elderly women is more associated with widowhood, more suffering from a sense of worthlessness, lack of attention, and more disturbance in reasoning and constructional abilities. However, elderly men reported more sexual dysfunction and a significant negative correlation between memory impairment (MMSE) and severity of depression (GDS). Conclusion There were no sex-specific differences in elderly depressed patients except that depression in elderly women was more associated with widowhood, a sense of worthlessness, lack of attention, and more disturbance in reasoning and constructional abilities, whereas elderly men reported more sexual dysfunction and a significant negative correlation between memory impairment (MMSE) and severity of depression (GDS).

Living with suffering as voiced by Thai patients with terminal advanced cancer

Cancer is a leading cause of death in Thailand. Thai cancer patients often seek medical treatment while in advanced stages of the disease. This longitudinal qualitative study aimed to describe the suffering that patients with terminal advanced cancer experience in their everyday life. A series of interviews were conducted and patient observation performed with 15 patients with terminal advanced cancer. Thematic analysis was applied and the overriding theme of the end-of-life experiences was living with suffering. Five inter-related sub-themes regarding the experience of suffering were identified in the informants' accounts, including physical symptom distress, feeling of alienation, sense of worthlessness, sense of burden to others, and desire for hastened death. The findings of this study can be of value for health professionals in cancer care in Thailand. Comprehensive end-of-life care programmes are needed to alleviate suffering in this group of patients.

Validation of the Perinatal Grief Scale for Use in Chinese Women Who Have Experienced Recent Reproductive Loss

The primary objective of this research was to validate the short version of the Perinatal Grief Scale (SVPGS) in the Chinese population. The Chinese SVPGS was administered to a sample of Chinese women who had experienced recent reproductive loss (N = 314). The results of the confirmatory factor analysis rejected the original 3-factor model delineated by Potvin (1989). A follow-up exploratory factor analysis suggested an alternative 3-factor model, consisting of a 12-item Sense of Worthlessness subscale, a 7-item Social Detachment subscale, and a 7-item Painful Recollection subscale. Further analysis showed that both the original and Chinese SVPGS demonstrated good internal consistency. Cronbach's alpha equaled .86, .83, .90, and .95, respectively, for the three subscales of Active Grief, Difficulty Coping, and Despair, and the total original SVPGS, and .85, .93, .91, and .95, respectively, for the new subscales of Sense of Worthlessness, Social Detachment, and Painful Recollection, and the total Chinese SVPGS. Both versions demonstrated satisfactory correlations with the participants' psychological distress and spousal emotional support. The authors suggest that both versions are useful in measuring the responses of Chinese women to reproductive loss; the original SVPGS should be used for cross-cultural studies, whereas the Chinese SVPGS should be used for local studies.

Revisiting Eva Marie Saint's White Glove: On Props, Neurons, Subtext, and Empathy

Revisiting Eva Marie Saint’s White Glove On Props, Neurons, Subtext, and Empathy Andrew Kimbrough In what is known as the “white glove scene” of Elia Kazan and Budd Schulberg’s 1954 film On the Waterfront, Eva Marie Saint’s good-­ girl character, Edie Doyle, does not wish to spend time talking in a New Jersey waterfront park with the longshoreman thug Terry Malloy , played by Marlon Brando. As she turns away from him to walk home alone, she takes her gloves from her coat pocket and accidentally drops one. Terry picks it up and, rather than hand it back to Edie, he sits down on a swing, casually cleans the glove of dirt, and then puts it on his left hand. The behavior was not scripted for the film yet it accompanies Schulberg’s dialogue, which is mostly uncomfortable small talk initiated by Terry in a labored attempt to seek out a connection with Edie.1 For cinephiles the white glove scene has acquired mythic status. It holds a special allure for many reasons, one being that fans of the film appreciate it according to its intended reception. Kazan, providing an authorial, psychoanalytic interpretation of the scene, says, “As they were walking along, she accidentally dropped her glove; and Brando picked up the glove; and by holding it, she couldn’t get away—the glove was his way of holding her. Furthermore, whereas he couldn’t, because of this tension about her brother being killed, demonstrate any sexual or loving feeling towards her, he could towards the glove. And he put his hand inside the glove . . . so that the glove was both his way of holding on to her against her will, and at the same time he was able to express, through the glove, something he couldn’t express to her directly. So the object, in that sense, did it all.”2 In other words, the glove served Brando by allowing him to express through behavior the subtextual yearnings of the character. Because of his guilt for the role he played in Edie’s brother’s 100 A n d r ew K i mb r ou g h death at the start of the film, and because of his own sense of worthlessness , Terry does not feel permitted to express verbally his attraction for Edie. Brando found a way to express the character’s desire behaviorally with the assistance of an object, and appreciative audiences thrilled at the virtuosity of the performance. Looking at the scene from another perspective, Paul Willemen and Noel King call it “epiphanic,” which they define as providing revelations beyond the intention of the performance text and towards “an aspect or dimension of a person . . . which is not choreographed for you to see.”3 In phenomenological terms, something in excess of the character and the story became present in ­ Brando’s performance, even in the filmic medium. In light of Bruce McConachie’s admonition that theatre scholars apply cognitive research to their objects of inquiry whenever feasible, this article reevaluates the kinds of audience responses conjured by moments of performance like the white glove scene.4 McConachie specifically cautions against relying upon twentieth-­ century critical theories like those reflected by Kazan and Willemen and King, but rather than reject those theories, he asks that they meet the demands of falsifiability—that is, that they be tried by the scientific method.5 Yet, as David Saltz points out in his editorial comment to the Theatre Journal issue devoted to cognition , while McConachie tends to regard semiotic and phenomenological theories as “inadequate” to account for audience perception, other theatre scholars find that cognitive science may be used productively with other theoretical approaches, specifically phenomenology.6 This paper argues that common ground exists between psychoanalytical, phenomenological , and neurological considerations of behavior, object use, and audience reception, especially in terms of their understanding of empathy, which is a touchstone issue of central concern to McConachie’s work in cognition. The article seeks a better understanding of how various discourses inform our comprehension of the co-­ affection and empathic responses audiences experience during moments of heightened stage and film behavior. Rather than simply extol further the virtues of...

The Experience of Living With Dementia in Residential Care: An Interpretative Phenomenological Analysis

The subjective psychological experience of people with moderate to severe dementia living in residential care is insufficiently understood. In the present study we aimed to explore the subjective experience of life with dementia in residential care from the perspective of the person with dementia, and to understand the psychological impact of being in this situation. This was an exploratory qualitative study. Eighty individuals with dementia who were living in residential care homes engaged in unstructured conversations with a researcher. We subjected the transcripts of the resultant 304 conversations to interpretative phenomenological analysis in order to develop a thematic account. The experience of living with dementia in residential care was fundamentally one of experiencing difficult and distressing emotions relating to loss, isolation, uncertainty, fear, and a sense of worthlessness. Participants generally tried to cope by accepting and making the best of things and affirming their past sense of self and identity, but some also expressed frustration and anger. Participants were able to describe aspects of their situation and their emotional response to it, grounded in a strong retained sense of self and identity. The participants' experience emphasizes the importance of improving the living situation of elders with dementia in residential care settings.

Manic Switching in Patients Receiving Duloxetine

Back to table of contents Previous article Next article Letters to the EditorFull AccessManic Switching in Patients Receiving DuloxetineCONSUELO de DIOS M.D.ELENA EZQUIAGA M.D.,CONSUELO de DIOS M.D.Search for more papers by this authorELENA EZQUIAGA M.D.Search for more papers by this author,Published Online:1 Jul 2007AboutSectionsPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail To The Editor: Duloxetine is a dual antidepressant. According to Viktrup et al. (1) , duloxetine does not induce mania or hypomania in women without a history of major depression. Moreover, pooled data by Dunner et al. (2) show that the estimated risk of duloxetine-related manic switching is 0.1% to 0.2% in patients with major depression. However, the methodological limitations of the study conducted by Dunner et al. as well as the scarcity of other sources of information lead us to believe that the actual risk of manic switching with duloxetine remains unknown. We present two clinical cases in which manic switching occurred after treatment with duloxetine. A 58-year-old man with a 2-month major depressive episode was seen in our outpatient clinic. There were no psychiatric antecedents, and both the patient and his family denied any episodes suggesting mania or hypomania. The patient did not have a family history of bipolar disorder, and his medical history was unremarkable.Treatment with paroxetine (40 mg daily) resulted in initial partial remission, followed by severe relapse. Duloxetine (60 mg daily) was substituted and rapid recovery was obtained. Four months later—while still on duloxetine—admission was necessary because the patient experienced a manic syndrome with psychotic features. General examination and routine studies (rapid plasma reagin, human immunodeficiency virus, thyroid function, blood chemistry, and computed tomography scan) showed results within normal limits.The second patient was a 40-year-old woman who had previously showed symptoms of bulimia and alcohol abuse. She also had interspersed periods of increased activity with times of more inhibition, for which medical care was never required. Several months before, she suffered a transient, acute psychotic episode that required hospital admission and short treatment with an atypical antipsychotic. Her status at the time included anhedonia, hypersomnia, anergy, difficulty in concentrating, and a sense of worthlessness. Six weeks after beginning treatment with duloxetine, the patient’s mood improved. Nevertheless, after 3 months of treatment (120 mg daily), a sudden manic episode with psychotic symptoms was diagnosed, and inpatient management was required. An increased risk of manic switching with venlafaxine (3) , which is also a dual agent, has been reported. Although anecdotal, our two case studies warn against the risk of duloxetine. In both our patients, episodes were extremely severe. One patient had been treated with a selective serotonin reuptake inhibitor, but only after treatment with duloxetine did manic switching occur. In our opinion, clinicians should carefully observe early warning signs of mania in patients with seemingly unipolar depressive disorders who are undergoing treatment with dual antidepressants.Madrid, SpainDr. de Dios has received honoraria for CME activity from Eli Lilly, Pfizer, Bristol-Myers Squibb, and Wyeth; she has lectured and received grants from AstraZeneca, Eli Lilly, Pfizer, Janssen, Bristol-Myers Squibb, and Wyeth; she has also received travel funds from Eli Lilly and Bristol-Myers Squibb. Dr. Ezquiaga has received honoraria for CME activity from Eli Lilly and Lundbeck; she has lectured and received grants from Eli Lilly and Lundbeck; she has also received travel funds from Eli Lilly.

Manic Switching in Patients Receiving Duloxetine

Back to table of contents Previous article Next article Letters to the EditorFull AccessManic Switching in Patients Receiving DuloxetineCONSUELO de DIOS M.D.ELENA EZQUIAGA M.D.,CONSUELO de DIOS M.D.Search for more papers by this authorELENA EZQUIAGA M.D.Search for more papers by this author,Published Online:1 Jul 2007AboutSectionsPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail To The Editor: Duloxetine is a dual antidepressant. According to Viktrup et al. (1) , duloxetine does not induce mania or hypomania in women without a history of major depression. Moreover, pooled data by Dunner et al. (2) show that the estimated risk of duloxetine-related manic switching is 0.1% to 0.2% in patients with major depression. However, the methodological limitations of the study conducted by Dunner et al. as well as the scarcity of other sources of information lead us to believe that the actual risk of manic switching with duloxetine remains unknown. We present two clinical cases in which manic switching occurred after treatment with duloxetine. A 58-year-old man with a 2-month major depressive episode was seen in our outpatient clinic. There were no psychiatric antecedents, and both the patient and his family denied any episodes suggesting mania or hypomania. The patient did not have a family history of bipolar disorder, and his medical history was unremarkable.Treatment with paroxetine (40 mg daily) resulted in initial partial remission, followed by severe relapse. Duloxetine (60 mg daily) was substituted and rapid recovery was obtained. Four months later—while still on duloxetine—admission was necessary because the patient experienced a manic syndrome with psychotic features. General examination and routine studies (rapid plasma reagin, human immunodeficiency virus, thyroid function, blood chemistry, and computed tomography scan) showed results within normal limits.The second patient was a 40-year-old woman who had previously showed symptoms of bulimia and alcohol abuse. She also had interspersed periods of increased activity with times of more inhibition, for which medical care was never required. Several months before, she suffered a transient, acute psychotic episode that required hospital admission and short treatment with an atypical antipsychotic. Her status at the time included anhedonia, hypersomnia, anergy, difficulty in concentrating, and a sense of worthlessness. Six weeks after beginning treatment with duloxetine, the patient’s mood improved. Nevertheless, after 3 months of treatment (120 mg daily), a sudden manic episode with psychotic symptoms was diagnosed, and inpatient management was required. An increased risk of manic switching with venlafaxine (3) , which is also a dual agent, has been reported. Although anecdotal, our two case studies warn against the risk of duloxetine. In both our patients, episodes were extremely severe. One patient had been treated with a selective serotonin reuptake inhibitor, but only after treatment with duloxetine did manic switching occur. In our opinion, clinicians should carefully observe early warning signs of mania in patients with seemingly unipolar depressive disorders who are undergoing treatment with dual antidepressants.Madrid, SpainDr. de Dios has received honoraria for CME activity from Eli Lilly, Pfizer, Bristol-Myers Squibb, and Wyeth; she has lectured and received grants from AstraZeneca, Eli Lilly, Pfizer, Janssen, Bristol-Myers Squibb, and Wyeth; she has also received travel funds from Eli Lilly and Bristol-Myers Squibb. Dr. Ezquiaga has received honoraria for CME activity from Eli Lilly and Lundbeck; she has lectured and received grants from Eli Lilly and Lundbeck; she has also received travel funds from Eli Lilly.

Breaking Up is Hard to Do

This paper begins by distinguishing between two levels at which ethics has been applied in the past half century. Typically, ethics gets applied at the level of public debate and policy. Much less often, applied ethics centers on the personal level. As a literature search reveals, this is true of recent philosophic discussions of divorce. This paper seeks to begin an alternative philosophic discussion of divorce and separation by considering it at a personal level. I begin this discussion by analyzing two different conceptions of love— eros and agape—and suggest a synthesis of the two. The conception of love that I endorse suggests that the value of the parties in a loving relationship is constructed within the relationship itself. It is this feature of love that helps to explain why so many feel such a sense of worthlessness when experiencing a divorce or separation. Namely, that much of the positive value they had within their relationship has little or no value outside the context of that relationship. DIVORCE IS A FACT OF LIFE in the contemporary world. Although precise statistics are surprisingly hard to come by, in 1996 approximately 40-50% of marriages in the United States ended in divorce (Krieder and Fields 2002). Given this, in combination with the fact that divorce and separation are deeply meaningful, and often painful, experiences for the people involved, it would seem to be a subject

Ill health is powerlessness: a phenomenological study about worthlessness, limitations and suffering.

The aim of the study was to create an understanding of the different dimensions of subjective ill health through discovering the essence of ill health, based on the individual experience. A philosophical, phenomenological method has been employed, and in-depth interviews were conducted with 25 individuals. The findings showed that the essence of ill health is powerlessness, which is made by a self-image of worthlessness, a sense of being imprisoned in one's life situation, and emotional suffering. The individual views her/himself as worthless, based on societal norms, attitudes and human models. Incapability and a sense of worthlessness cause the individual to distrust her/himself and others. She/he is imprisoned in her/his own life situation due to limited choices and ability. Such a situation gives rise to apathy. Destructive feelings of alienation, anguish, shame and guilt take over, and the individual's autonomy and existence are threatened. Stigmatization results from suffering and a sense of worthlessness. The informants compensated for their vulnerability by means of human support, intimacy with others, a society adapted to disability, living in the present and awareness.

“Bad Mothers” and the Threat to Civil Society: Race, Cultural Reasoning, and the Institutionalization of Social Inequality in a Venezuelan Infanticide Trial

A society which penalizes some children because they are not white, others because they are not male, indoctrinating in them a sense of worthlessness, can still lay the blame for the waste of its young on the bad mothers who have somehow failed to be superhuman, who have somehow failed to rear, in a callous and ruthless social order, welladjusted obedient, achieving, nonalienated children. —Adrienne Rich, On Lies, Secrets, and Silence: Selected Prose 1966-1978 Suffering from abdominal pain, a young woman in eastern Venezuela went to a physician. The physician did not examine her but injected her with a sedative and sent her home to the place where she worked as a domestic. Awakening with intense cramps, she went to the bathroom and gave birth to a girl, who fell into the toilet bowl. On the basis of what was construed as a confession, her employer's statement, and medical testimony, the woman was convicted of homicide. The major issue was the legal significance of her racialization as “indigenous.” We suggest that her trial shows how courts construe structural violence directed against poor women of color as criminal conduct; ironically, this transformation was effected through culturally based arguments, presented by the defense, which claimed that the woman was ignorant of “Western culture” and Venezuelan legal norms, including the prohibition against infanticide. In the face of a cholera epidemic, dominant institutions used the case to suggest that “indigenous culture” could explain hundreds of deaths. Comparison with trials in the capital indicates that as globalization forces some 80% of Venezuelans into poverty, these widely publicized trials turn stereotypes of poor citizens as impoverished, immoral, and criminal into arguments that legitimate the repressive functions of the nation-state.

The Problems Experienced By Black Stroke Patients in Soweto, South Africa

A purposeful sample of Black Sowetan residents who had sustained a stroke were studied to identify the problems they were encountering after discharge back to their homes. A descriptive qualitative approach was used comprising semi-structured interviews in the subjects’ homes. Audio recorded data was transcribed in extenso, and coded into themes. The data revealed that the subjects’ lacked knowledge of their disease processes. However, medication non-complianc was largely due to financial and transportation difficulties in attending clinics. Although most of the sample was able to walk, they felt the need for improved walking ability, as they were scared of falling. Most were independent in ADL, yet they, and their families perceived them to be otherwise, leaving the subjects with a sense of worthlessness. Pain in the shoulder and stiffness were the common secondary problems encountered. There is a need to educate stroke victims with regards to their disease, it’s secondary complications and their capabilities following stroke. Safe walking must be ensured before discharge.

The silent cry a finnish child during world war ii and 50 years later

Abstract The author, a former analysand but not a psychoanalyst herself, gives an account of her own history as a child during the II World War in Finland. She was one of the 70,000 children who were sent to Sweden during the war. She reflects on how repeated separations, both from her biological parents and from her foster-parents have affected her in her adult life, as it became clear to her in psychoanalysis. She compares her own experiences with those of other warchildren whom she has met or read about. She also reports on how former warchildren in their forties and fifties, who until then had remained silent, suddenly began to feel the need of giving voice to their experiences and meeting others who could understand what they had been through. Common features among many former warchildren seem to be the lack of a feeling of strong identity, a sense of worthlessness, a need to be in control, an inability to be trusting and to form or maintain close relationships. Underneath a yearning for love can be ...

A future at risk: children having children.

Every day in the US, over 3000 teenagers become pregnant. The US adolescent pregnancy rate is higher than that in most other developed countries and is increasing. About half of the teenage pregnancies result in a live birth, and most of these mothers are unmarried and will not finish high school. The root cause of this problem is that the young women have a sense of worthlessness and hopelessness about their future that makes them establish the relationships that leave them with babies they are ill-equipped to rear. This is creating an ever-growing underclass condemned to poverty, to a dependency on welfare, and to continue the cycle. All of this results in an ever increasing burden on taxpayers. In Missouri, a bill was enacted in 1990 to address a number of school-related issues that are impacted by premature parenthood. Based on research, the bill makes schools responsible for the continued enrollment of pregnant teens. Alternative programs for pregnant and teen parents receive state aid through guidelines established by the Missouri Department of Elementary and Secondary Education which allow local school districts to design their own programs. Nationwide research indicated that the greatest need of the teenage parents is obtaining appropriate child care. Parenting education is also of vital importance as is appropriate prenatal care. These strategies, in addition to intervening in the lives of middle grade students to help them avoid premature parenthood, form the basis of a 5-step program developed by the Committee for Economic Development to address the problem of teen parenthood. In Missouri, emphasis has also been placed on involving teen mothers in the education of their children so that the children are ready for kindergarten. Despite the proven cost-effective nature of these programs for teen parents (which help avoid additional pregnancies), very few states have encouraged such programs, apparently because of the up-front costs. Until Americans decide to devote sufficient resources to this problem, it will continue to place the future of all of society at risk.

Henry James and Masculinity: The Man at the Margins (review)

224 The Henry James Review K. Barnett's Authority and Speech: Language, Society and Self in the American Novel (1993), and Jonathan Freedman's Professions of Taste: Henry James, British Aestheticism, and Commodity Culture (1990). Certainly Bell's Washington Square: Styles of Money is a richly instructive voice in such a dialogue. Kelly Cannon. Henry James and Masculinity: The Man at the Margins. New York: St. Martin's, 1994. 180 pp. $39.95. By Leland S. Person, Southern Illinois University Since I have been working on a study of James and masculinity for some time, readers should be aware that I bring special interests and, undoubtedly, special biases to Kelly Cannon's Henry James and Masculinity. As the first extensive study of the subject, Professor Cannon's book offers a provocative introduction that all subsequent critics will have to engage. His subtitle, however, more accurately describes his focus—on marginal characters who happen to be male rather than on theoretical questions about James's representation or construction of masculine identity. Notable for deviating from normative masculinity, which Cannon equates simply with aggressiveness and heterosexual passion, James's marginal men suggest his "consciousness of alternative masculinity" and his desire to unsettle rather than to appease the "reader's longing for conventional manhood" (1). Cannon posits a straight line of descent (in chapter one) from Rowland Mallet to Ralph Touchett to Hyacinth Robinson to Lambert Strether, and to James himself—each character evidencing his "impaired" manhood by a lack of aggressiveness and desire for women. This gallery of geldings is ingenious, but predicated on a relatively simplistic definition of "conventional manhood" and, in turn, of male characters' deviations from the norm. Given Cannon's subject—and subtitle—Kaja Silverman's Male Subjectivity at the Margins (1992) could have provided useful theoretical ballast; her chapter on James, separately published in 1988 (in Novel), could have illuminated Cannon's analyses of many male characters. As it is, Cannon deals only lightly with theoretical questions involving , for example, the social and/or literary construction of gender identity. Is the marginality he cites simply a condition experienced by many male characters, or is it a condition rooted in masculinity as James conceives it in the late 1800s? Provocatively, however, Cannon does argue that male characters' displacement to the social margins signifies both positively and negatively. That is, marginalization signifies the absence of certain conventional masculine attributes , but it also provides a liberated space. "What James's work finally catalogs, " he asserts, " is not an escape from the margins, but a full embrace of that Book Reviews 225 space" (8). I am not always convinced that the embrace is "full," but the case certainly deserves to be argued. The best chapter in this respect is the second—on the "Private Fictions" that James's marginal males compose to compensate for their marginal conditions. Like James, Cannon argues, these marginal males battle society's "conventional image of masculinity (physical aggression, heterosexual activity)" and yearn "for atypicality (androgyny, homosexuality, passivity)" (41). The results: alternative constructs of male selfhood that protect characters from "internalizing" a "sense of worthlessness," which society would inscribe (32). Rowland Mallet's "in-between" status, for instance, produces imaginative and behavioral failure because he cannot write himself into the role of lover, opting instead for the role of "betrayed father" (45). While the narrator of The Aspern Papers more successfully imagines himself a "scholar-conqueror," he ends up being a "monster" because he denies his heterosexuality. More successful, in Cannon's view, is Lambert Strether because he composes several alternative male selves, including little boy and old man, as well as "an alternative masculinity of surrender as opposed to aggression, risking his survival in a heterosexual society" (51). Cannon's terms and what they suggest about his notion of James's imagination will strike many readers as overly rigid, stereotypical , and totalizing, but the idea of alternative male fictions itself cogently explains James's conception of male possibilities. With help from Michel Foucault, Jeffrey Weeks, and other sexologists in chapter three ("Sexual Surprise"), Cannon surveys various strategies James uses to discover and represent marginal sexual satisfactions, to avoid passionate heterosexual experience without representing a full-blown...