The production of therapy:the social process of construction of the mother of a sexually abused child

This study qualitatively examined the perspectives of clinical social workers on non-offending mothers of sexually abused children. The study examined whether clinicians still used collusion to explain mothers' behavior, despite research refuting collusion. Findings revealed that, although workers did not use collusion, they still constructed mothers negatively. Multiple contexts of agency practice influenced constructions. Administrative use of authority to implement external constraints led to workers' resistance, which involved humor with gender and ethnic components. The agency's role as a graduate social work teaching site contributed the following: Field instructors transmitted the belief that incest typified severe family difficulties and posed complex assessment and intervention problems. Implications for effective practice are discussed.     

Systemic lupus erythematosus and hormone replacement therapy

The indications for hormone replacement therapy (HRT) in postmenopausal women is the treatment of climacteric symptoms and the prevention of osteoporosis. Women with systemic lupus erythematosus (SLE) are more likely to have a premature menopause, osteoporosis and cardiovascular disease. HRT can induce SLE flares and cardiovascular or venous thromboembolic events. Therefore it should not be used in women with active disease or those with antiphospholipid (aPL) antibodies. In general, it should be used only for patients without active disease, a history of thrombosis or aPL antibodies. Non-oral administration of estrogen is recommended because of its lesser effect on coagulation. With regard to the progestogen, progesterone or pregnane derivatives are preferred. Otherwise, non-estrogen-based strategies should be used.     

Engaging suffering: towards a mindful re-visioning of family therapy practice

The myth of problem-free living is easily identifiable in Western culture through its childhood fairy tales and modern love stories. Even if inadvertently, the field of mental health perpetuates this myth with the very concept of "mental health," which implies a state without suffering. Using mindfulness, Buddhists assume an alternative stance towards suffering: rather than eliminate it, they compassionately engage it. This article explores the potentials of mindfulness as an alternative approach to suffering within the context of marriage and family therapy. Family therapists can integrate mindfulness principles into their work to help clients shift how they relate to the unique forms of suffering that one encounters in intimate relationships, such as abuse, divorce, rejection, and loss.     

Preventing risk for obesity by promoting self-regulation and decision-making skills: pilot results from the PATHWAYS to health program (PATHWAYS)

The overall aim of the two school-based pilot studies was to evaluate whether an approach to prevention that focused on changing child impulse control, decision making, and social competence can be effective in changing attitudes toward food intake and physical activity as risk factors for obesity. The strategy used was to translate specific components of one evidence-based program for violence prevention (Promoting Alternative Thinking Strategies: PATHS) into an elementary school curriculum program for obesity prevention. Both studies demonstrated significant changes in positive attitudes toward self-regulation of appetitive behavior. In addition, Study 2 demonstrated positive changes in actual food choices and television viewing patterns. Implications are that comprehensive efforts to prevent youth risk for obesity should include as one component school-based curricula that target self-regulation and decision-making skills.     

Four criteria to evaluate providers' service-delivery response to new contraceptive introduction

This article presents an evaluation framework developed to assess the first-level effects of introducing the Standard Days Method (SDM) in Peru Ministry of Health clinics. Four questions are asked: 1) To what extent do providers routinely achieve SDM service delivery standards? 2) Is the time invested in SDM delivery consistent with program norms? 3) How does SDM delivery compare with delivery of established methods? and 4) How does SDM introduction affect delivery of established methods? A study at 62 clinics demonstrated the framework's usefulness. The Standard Days Method introduction had positive overall effects on the quality of care but provider training needed adjustments.     

Relocation stress syndrome in older adults transitioning from home to a long-term care facility: myth or reality?

Relocation stress syndrome is a nursing diagnosis characterized by symptoms such as anxiety, confusion, hopelessness, and loneliness. It usually occurs in older adults shortly after moving from a private residence to a nursing home or assisted-living facility. The primary purpose of this study was to validate the symptoms of relocation stress syndrome. Eight nursing home residents and 8 assisted-living facility residents were interviewed 2 to 10 weeks after admission, when symptoms of relocation stress syndrome are most likely to appear. Results of this study indicate that the incidence of relocation stress syndrome may be overestimated. More accurate diagnosis and treatment of depression in older adults is needed.     

Camera-Related Behaviors during Video Recorded Medical Interactions

Video recording provides an objective record of the content of medical interactions. However, there is concern that cameras may be reactive measurement devices that alter what normally transpires during interactions. This study addressed potential reactivity of cameras in medical interactions. Interactions between 45 patients and 14 medical oncologists were video recorded and coded for camera-related behaviors. Eleven of 45 patients performed none of the behaviors. Among the other patients, camera-related behaviors were infrequent and, on average, constituted about 0.1% (one-tenth of one percent) of total interaction time. Behaviors occurred most often in very early stages of interactions, and when physicians were absent from the room. Seven physicians showed camera-related behaviors, comprising less than 0.1% of the time they were in the interaction. Results suggest video recording can provide nonreactive means of studying medical interactions.