Knowing Terrible Things: Engaging Survivors of Extreme Violence in Treatment

Survivors of extreme violence can be difficult to engage in treatment. Often this is caused by a sense of isolation drawn from the belief that no one who has not shared their experience can comprehend it. The only others who know what they know are those who have died of the violence, fellow survivors and the perpetrators. The clinician attempting to treat such patients may be placed in a dilemma: how to convey the capacity to know terrible things without being destroyed by the survivor, while at the same time not conveying that one is dangerous oneself. This paper suggests a method of utilizing unconscious aggressive fantasy to access the capacity to convey to the survivor that it is possible to hear, understand and contain violent experience. Case illustrations indicate how such capacity might be conveyed, so that a treatment alliance can begin.

Osteoporosis knowledge and attitudes: a cross-sectional study among college-age students

OBJECTIVE: The authors' purpose in this study was to investigate the influence of knowledge of osteoporosis, attitudes regarding osteoporosis, and knowledge of dietary calcium on dairy product intake in both male and female college-age students. PARTICIPANTS: The authors conducted this cross-sectional study on 911 men and women enrolled in 2 demographically similar universities. METHODS: A modified osteoporosis knowledge questionnaire assessed participant's general osteoporosis knowledge and perceived disease risk. RESULTS: The authors found that knowledge of osteoporosis and calcium did not significantly influence dairy product intake. Attitude regarding osteoporosis was a significant predictor of dairy product intake in men but was not significant for the women. CONCLUSIONS: The authors recommend development and implementation of educational programs designed to increase awareness of calcium-rich food sources as well as other risk factors of this crippling disease.     

Bleeding with menopausal hormone therapy: physiological or pathological?

Abnormal bleeding is a common reason for discontinuation of hormone replacement therapy. There is little consensus regarding when to investigate abnormal bleeding, what to do about persistent bleeding or when reinvestigation is indicated. Transvaginal ultrasound, endometrial biopsy and hysteroscopy are discussed. The mechanisms of this bleeding are poorly understood and do not correlate well with endometrial histology or the type or dose of hormone therapy used. Endometrial bleeding requires breakdown of endometrial vessels and their overlying epithelium. Endometrial vascular breakdown appears to be largely locally regulated. Potential mechanisms involved in endometrial bleeding include: changes in the ratio of vascular endothelial growth factor (pro-angiogenic) to thrombospondin-1 (anti-angiogenic); alterations in matrix metalloproteinases and their tissue inhibitors; changes in endometrial haemostasis due to tissue factor; and increased endometrial leucocytes.     

Social Work Practice in Higher Education

This article examines two cases of social work practice in higher education within the context of identifying a model of social practice for use in postsecondary educational settings. The case studies provide insight into a model of social work practice that reflects both the traditional clinical model, which focuses on individual change, and the school-community-pupil relations model, which focuses on system change. The author also discusses implications for social work educators who see college/university counseling centers as an arena for social work practice.     

U.S. Latinas' Knowledge and Attitudes toward Mammography: Meta-synthesis

Breast cancer is the leading cause of cancer death among Latinas in the United States. The primary purpose of this meta-synthesis was to integrate findings on qualitative studies related to Latinas' knowledge, attitudes, and perceptions regarding breast cancer and its prevention through mammography. After applying inclusion criteria, eleven studies were located. Results were organized around four areas of inquiry that cross-cut primary studies: 1) Latina participants' knowledge of breast cancer and its prevention; 2) barriers for regular mammography; 3) facilitators that encouraged such screening; and 4) recommendations on how to provide screening for Latina women.     

Step Up Love Story: Futari Etchi. By Katsu Aki

REPRODUCTIVE ETHICS. Michael D. Bayles. Englewood Cliffs, NJ: Prentice‐Hall, 1984; 141 pages; $10.95.

EXPLORING GENDER RELATIONS: A CANADIAN PERSPECTIVE. Marlene Mackie. Toronto: Butterworths, 1983; 358 pages; $17.95 (pa.).

SARAH: A SEXUAL BIOGRAPHY. Paul R. Abramson. Albany, NY: State University of New York Press, 1984; 142 pages; $9.95 (pa.); $29.50 (cl.).

SENSUOUS SPACES: DESIGNING YOUR EROTIC INTERIORS. Sivon Reznikoff. New York: Whitney Library of Design, Watson‐Guptill Publications, 1983; 204 pages; $32.50.

SEXUALLY TRANSMITTED DISEASES: AN ANNOTATED, SELECTIVE BIBLIOGRAPHY. Stephen Margolis. New York: Garland, 1985; 176 pages; $23.00.

WOMEN AND DEVIANCE: ISSUES IN SOCIAL CONFLICT AND CHANGE; AN ANNOTATED BIBLIOGRAPHY. Nanette J. Davis and Jone M. Keith. New York: Garland, 1984; 236 pages; $35.00     

Disability stigmatization as a barrier to employment equity for legally-blind Canadians

Canada has expressed a strong commitment to the rights of its citizens against discrimination, including those with disabilities. A question remains whether Canadians with disabilities are able to practice these rights. Our mixed-methods study sheds light on the situation of one important sub-group of people with disabilities – those who are legally blind. Our survey results show that the labour-force participation rate for this population is very low compared with those without disabilities, and also lower than the rate for persons with other disabilities. Legally-blind working-age Canadians have significantly higher rates of unemployment and underemployment, and perceive major barriers to employment. In-person interviews reveal the negative impact of one major barrier – disability stigmatization – on accessing meaningful employment and other societal assets. We discuss the implications of these findings and suggest policy directions.