Dysfunctional grieving.

Dysfunctional grieving represents a failure to follow the predictable course of normal grieving to resolution (Lindemann, 1944). When the process deviates from the norm, the individual becomes overwhelmed and resorts to maladaptive coping. The process implies movement toward assimilation to or accommodation of the loss, resulting in progression toward social, psychological, and medical morbidity. Nurses will better assess the needs of the client with adequate information about the client's recent losses and perception of those losses. Such an assessment, in conjunction with an understanding of the signs, symptoms, and predisposing factors of complicated bereavement, will enable the nurse to develop a plan of effective intervention. Both case examples illustrate unresolved grief. In Case Example 1, the patient denied the importance of the relationship, which became masked with displaced anger and therefore delayed the grieving process. In Case Example 2, the patient's attempts at grieving over the loss of her son were complicated by her long-standing struggle with her husband's infidelity at the time of her pregnancy. The revelation of secondary loss is common in dysfunctional grieving. Resolution of grief encompasses not only accommodation to object loss, but also change in the pathological behaviors incorporated into the patient's self-image as a result of the loss (Lazare, 1979). The maladaptive operations employed by these patients to preserve self-image were discarded as the grief resolved. The focus of therapy included the loss of those behaviors as they were relinquished to prevent the patient from experiencing further anxiety and sense of loss (Zisook, 1987).(ABSTRACT TRUNCATED AT 250 WORDS)     

Improving homeless persons' utilisation of primary care: lessons to be learned from an outreach programme in The Netherlands

Elissen AMJ, Van Raak AJA, Derckx EWCC, Vrijhoef HJM. Improving homeless persons' utilisation of primary care: lessons to be learned from an outreach programme in The Netherlands Faced with rising homelessness, countries around the world are in need of innovative approaches to caring for those without shelter, who, more often than not, suffer from severe health problems. We conducted a case study of an innovative Dutch Primary Care for the Homeless (PCH) programme to gain insight into clients' demographic characteristics, health problems and service use, and to develop an explanation for its success in increasing the latter. Our analyses are based on a combination of quantitative and qualitative data. The results of the study suggest that the success of the PCH programme can be explained by the providers' pragmatism and will to adapt their mode of care provision to the behavioural patterns and needs of their homeless clients.     

Incumbent vulnerability and entry in gubernatorial elections: The case of former governors

The vulnerability hypothesis predicts strategic, quality candidates only challenge weak incumbents. House election studies support this hypothesis. State level analyses produce mixed results. We test whether incumbent vulnerability affects the entry of one kind of strategic actor – former governors. Former governors are an ideal test case. Having already served in the state's highest office, they represent the highest quality and perhaps most strategic candidates who run for state office. Our results show that performance in the previous election, one measure of incumbent vulnerability, does not affect former governor entry. However, incumbent vulnerability measured as recent economic performance and number of other quality candidates appearing in a former governor's party primary does affect entry in general elections.     

The New Zealand Refugee Resettlement Strategy: implications for identity,acculturation and civic participation

The process of resettlement as a refugee often involves adapting to, and reconciling with, a new social reality. The complexities associated with acculturation across age, gender and family dynamics are navigated within greater social contexts that may encourage or hinder the processes of adjustment and settlement. This paper addresses the recent New Zealand Refugee Resettlement Strategy in light of contemporary theoretical developments with regard to the segmented assimilation thesis and the forms of social capital that, when available, may be mobilised to help refugee-background individuals, families and communities to forge new routes for participation and belonging. In particular, we examine the strategy and its five main goals of self-sufficiency, participation, health and well-being, education and housing as these relate to the possibilities and tensions at play in the wider acculturation experiences of New Zealand's diverse refugee populations.     

Estimating DEA confidence intervals with statistical panel data analysis

This paper describes a statistical method for estimating data envelopment analysis (DEA) score confidence intervals for individual organizations or other entities. This method applies statistical panel data analysis, which provides proven and powerful methodologies for diagnostic testing and for estimation of confidence intervals. DEA scores are tested for violations of the standard statistical assumptions including contemporaneous correlation, serial correlation, heteroskedasticity and the absence of a normal distribution. Generalized least squares statistical models are used to adjust for violations that are present and to estimate valid confidence intervals within which the true efficiency of each individual decision-making unit occurs. This method is illustrated with two sets of panel data, one from large US urban transit systems and the other from a group of US hospital pharmacies.     

Rent seeking implications for salary increments in academe

In many environments, salary increments consist of two parts: an ‘across the board’ component and a ‘merit’ component. These increments are usually funded from a wages pool which rarely bears any relationship to overall increases in productivity. The resulting competition for limited monies results in two forms of behavior: productive and predatory (or rent seeking). This paper develops a model which considers institutionally controllable variables and their influence on these behaviors in an academic environment. It is found that an increase in a wages fund will not necessarily lead to an increase in either total or productive faculty effort.