The art of stained glass: metaphor for the art of nursing

The aesthetic is a way of knowing the meaning of and the meaning in the art of nursing. The art of creating stained glass offers a personal metaphor for nursing's essence; the art of caring. Both arts aim to fulfil the potential of their subjects to achieve a harmony that goes beyond their individual components. Stained glass artistry and caring in nursing require technical expertise, yet technical skill and knowledge are not the substance of either art. Both transcend space and time, and the art of stained glass and the art of nursing are influenced by the artist's/nurse's personal, social and cultural history. Just as the artisan transforms the glass and lead and is transformed in the creative moment, so does the caring transaction transform both patient and nurse. This personal reflection explores the nature of caring in nursing as mirrored by the author's work with stained glass.     

Dancing in the sky: Enhancing quality of life for people with AIDS-related dementia and their caregivers.

Among the many feared consequences of contracting AIDS is the possibility of HIV or AIDS dementia complex (ADC). As the individual with dementia becomes progressively unable to communicate with his or her caregivers (therapists, loved ones, and medical professionals), the quality of life for both the individual and the caregiver can deteriorate. The person with ADC, faced with a foreshortened future as well as confronted with impending death, must suddenly attend to developmental tasks of dying when he or she may have been in the prime of life. As dementia takes hold, caregivers may disengage because communication becomes disjointed and nonsensical. One of the authors found that, by entering the metaphorical world of the person with ADC, communication could be not only prolonged but deepened, enhancing the relationship between the caregiver and the individual with dementia. Using case examples, this article describes the process of communicating in metaphor with people with ADC. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of Transitions in Dying and Bereavement: A Psychosocial Guide for Hospice and Palliative Care.

Reviews the book by the Victoria Hospital Society et al (2003), which describes what palliative and bereavement counselors do and how they do it. The specific goal was to examine the psychosocial needs and care of individuals who are dying or bereaved, with the ultimate goal being the improvement of the quality of palliative psychosocial care services. The major strength of the book is the wealth of practical knowledge addressing the needs of dying individuals and their families, particularly if the family members are adults. The sensitive and caring approach described throughout the book gives the reader a great sense of respect for those clinicians who have mastered the art of treating dying individuals and their families with dignity and compassion. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Metaphor: Theoretical and empirical research.

Metaphor plays a major role in our understanding of language and of the world we use language to talk about. Traditional definitions and theories of metaphor are reviewed, and it is suggested that many definitions err in equating metaphors with comparisons rather than merely implicating comparisons. Empirical research is reviewed that reveals serious problems, particularly in the developmental research. These problems often relate to inadequate underlying theories about the nature of metaphor, inadequate controls over preexisting knowledge, and conclusions that children cannot understand metaphors. Related research on the comprehension of proverbs and analogies is discussed. It is suggested that metaphor be redefined and an investigative approach be employed that will permit adequate controls of preexisting knowledge, surface structure, and meaning. This approach could emphasize and takes advantage of the context-dependent nature of metaphors. Finally, the role of comparisons is reexamined. (69 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Selective impairment of endothelium-mediated vasodilation in liver transplant recipients with cyclosporin A-induced hypertension

An understanding of the importance of language as a symbolic artefact, particularly with reference to metaphor, has been little addressed within the nursing literature. Consequently, the potential richness of people's accounts may be missed. Data from a study which explored the nature of hospice work and nurses' experiences of professional and personal bereavements are used to illustrate the different understanding which an exploration of metaphor can bring to research. Meanings of metaphor and its role in language are initially presented before drawing on data concerned with the emotional aspects of hospice work. Root metaphors of emotion are identified and examples from nurses' accounts indicate how nurses draw on these metaphors to articulate their experiences. The strategies nurses employ to continue working within the hospice culture are identified both practically in their work and metaphorically in the language they use.     

Language in child and chimp?

Recent successes teaching chimpanzees to engage in symbolic communication have again brought into question the Cartesian supposition that language is uniquely possessed by homo sapiens . Despite the very remarkable achievements of Washoe and Sarah, an objective comparison of these chimps' linguistic performances with those of a typical 3-yr-old child provides scant evidence for rejecting Descartes' view. An organism uses human language if and only if it uses structures characteristic of those languages. The ability of apes or even 2-yr-olds to communicate and use simple names is not sufficient reason to attribute the use of human language to them. The creative or projective aspect of human language cannot be overlooked. Efforts to explain the language deficits of apes in terms of impoverished language experience, anatomical deficits, or cognitive-structure differences are not convincing. (74 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

How common is medical training in palliative care? A postal survey of general practitioners

BACKGROUND: General practitioners (GPs) have a central role in palliative care, yet research continues to reveal room for improvement in symptom control at home. There is a need to evaluate how well-prepared GPs are for this task of caring for the dying at home. AIM: To evaluate the training in palliative care GPs have received throughout their careers. METHOD: Postal survey of 450 randomly selected East Anglian GP principals, investigating training in five areas of palliative care (pain control, control of other symptoms, communication skills, bereavement care, use of syringe driver), as clinical students, junior hospital doctors, GP trainees (registrars), and GP principals. RESULTS: A response rate of 86.7% was obtained. While GPs were clinical students, training was uncommon, (32% reported no training in pain control, and 58% no training in bereavement care), although there has been a significant increase in more recent years. Training as junior doctors was particularly uncommon (over 70% report no training in communication skills or bereavement care); there was some evidence of an increase in more recent years. During the GP trainee year, training was much more common. For GP principals, most areas had been covered, although over 20% reported no training in communication skills and bereavement care. During the community-based years as trainee and principal, training was significantly more common than during the hospital-based years of training as clinical student and junior doctor. CONCLUSIONS: There is a continuing need for medical education in palliative care. Particular attention should be paid to the basic medical education of clinical students and the training of junior doctors, especially regarding communication skills and bereavement care.     

Ethical issues related to the use of facilitated communication techniques with persons with autism.

Addresses the ethical issues concerning the benefits and the risks involved with the use of facilitated communication techniques (F/C), particularly with autistic clients. F/C involves the physical support of a client by a facilitator in order to enable the client to use equipment for the purposes of communication. Much controversy stems from the fact that the validity of messages communicated when using a facilitator remains to be established empirically. The principles of respect for the client's dignity, informed consent, confidentiality, responsible caring, and the issue of the risk of inadvertant misuse and misinterpretation are discussed from an ethical viewpoint. Well controlled research is recommended in order to further understand the processes involved in the widespread acceptance of this technique. (French abstract) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The effect of metaphor on processing style in a persuasion task: A motivational resonance model.

Previous research on metaphor and persuasion has suggested that metaphorical language elicits an assimilation effect wherein positive metaphors elicit positive attitudes toward the communication topic and negative metaphors elicit negative evaluations. The authors of this article propose that metaphorical content can increase or decrease motivation to systematically scrutinize a persuasive communication depending on the extent to which it "resonates" with the listener's preferences and interests. Consistent with this model, 2 experiments demonstrate that a sports metaphor increases message-relevant elaboration and sensitivity to argument strength among individuals who enjoy sports. Conversely, the sports metaphor reduces message-relevant elaboration and sensitivity to argument strength among individuals who dislike sports. Findings are discussed in the context of related research that suggests metaphor can serve alternative functions in a persuasive communication task. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Special not different: general practitioners' accounts of their care of dying people

In modern Britain the majority of terminal care occurs in people's own homes and many dying people and their carers would prefer the death itself to occur in the home. The quality of terminal care in the home and the possibility of a home death depend to a great extent upon the care provided by GPs and community nurses. This paper reports on GPs' experiences of caring for dying people and their attitudes towards such work. It is based on unstructured interviews with 25 GPs who graduated from the 1979 entry cohort to the University of Leicester medical school. The respondents were recruited via a questionnaire following up previous research with this cohort on 'fear of death'. Although self-selecting, interviewees were not significantly different from those who did not volunteer for interview in any of the statistical analyses of the questionnaire data. There were a number of similarities in their accounts of their care of dying people. Common themes were that the care of dying people was important, rewarding and satisfying; that the GPs saw themselves as part of a team of carers, frequently as team co-ordinators; good working relationships with district nurses but less satisfactory relationships with hospitals and social workers; that patient and family were both recipients of care; and honesty in communication with dying people, albeit tempered. Three issues of contemporary relevance were: tensions over the role of hospice and specialist terminal care services; care of people with chronic terminal illnesses other than cancer; and the role of GPs in the social construction of bereavement.     

Individualized doll therapy with children experiencing limb loss

Caring for the child and family experiencing a limb loss can be one of the most challenging opportunities for the health care worker. A family-centered approach provides a caring and compassionate way for the child and family to view the complicated medical world. One method that bridges communication between the health care team, patient, family, and community is doll therapy. Individualized doll therapy can help the child understand the amputation, physical limits, prosthetic care, and body image.     

Factors to consider before participating in a hastened death: Issues for medical professionals.

An emerging problem that health professionals face in working with terminally ill patients is how to respond to the concerns and conflicts that emerge near the end of life. Most important are those that challenge the traditional healing, caring, and therapeutic roles. Among these, perhaps none has drawn as much attention as the issue of physician-assisted dying—particularly what has been termed assisted suicide. Although the ethics of assisted dying have been actively debated by ethicists for decades, the topic is now being discussed with increasing frequency in medical, psychiatric, psychological, and legal journals. Interest has been driven by the interrelationship of changing public opinion, demographics, and the nature of the dying process; admissions of assistance by numerous physicians; and several statewide attempts at legal change, culminating in a successful voters' initiative in Oregon. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Design of a non-verbal method of communication using cartoons

INTRODUCTION: Nursery care to patients with serious disorders of language expression is complex and arises nervousness in the patient, his relatives and in the professionals caring for him. OBJECTIVE: Our aim has been to design a number of drawings which allow us to improve our ability to connect with patients suffering from serious disorders of verbal language. MATERIAL AND METHODS: We have applied a booklet of drawings, representing the most common needs of this kind of patients, to a group of 34 patients affected of severe dysarthria or motor aphasia. RESULTS: Most of our patients have used this booklet to express their basic needs and that has resulted in a lower degree of anxiety in these patients. CONCLUSIONS: Our intention was not to design a new language but to use a very simple form of language, visual language, to standardize the most basic communication with patients affected of severe language disorders. We invite other groups on neurological nursing in our country to use this strategy so as to connect with their patients.     

In vivo voltammetric studies of the effects of intrathecal morphine on noxious heat stimuli-induced serotonin release in the nucleus raphe magnus of anesthetized rats

MOTIVATION: The principal motivation was to design an environment for the development of image-analysis applications which would allow the integration of independent modules into one frame and make available tools for their build-up, running, management and mutual communication. RESULTS: The system was designed as modular, consisting of the core and work modules. The system core focuses on overall management and provides a library of classes for build-up of the work modules, their user interface and data communication. The work modules carry practical implementation of algorithms and data structures for the solution of a particular problem, and were implemented as dynamic-link libraries. They are mutually independent and run as individual threads, communicating with each other via a unified mechanism. The environment was designed to simplify the development and testing of new algorithms or applications. An example of implementation for the particular problem of the analysis of two-dimensional (2D) gel electrophoretograms is presented. The environment was designed for the Windows NT operating system with the use of Microsoft Foundation Class Library employing the possibilities of C++ programming language. AVAILABILITY: Available on request from the authors.     

Family physicians' involvement with dying patients and their families. Attitudes, difficulties, and strategies

OBJECTIVE: To determine family physicians' perceptions of the difficulty in caring for dying patients and how prepared they are to provide such care relative to strategies used with difficulties encountered, personal need for support and development, and cooperation with other caregivers. DESIGN: Exploratory. SETTING: Physicians' offices. SUBJECTS: Thirty-five randomly selected family physicians (doctors of medicine and doctors of osteopathy) representative of family physicians practicing in Franklin County, Ohio. INTERVENTIONS: None. MAJOR OUTCOME MEASURES: A semistructured interview guide corresponding to a three-dimensional theoretical model developed prior to the study was used to determine family physicians' perceptions regarding care of dying patients and their families. The three dimensions include family physicians' involvement with dying patients and their families, their personal needs and development, and their cooperation with other caregivers. RESULTS: Participants agreed that the care of dying patients and their families is an important and special component of practicing family medicine. Generally seeing themselves as adequately prepared, they still found such care difficult and desired more education and training to increase comfort of their patients and of themselves. Their perceptions regarding the care of dying patients and their families could be categorized in terms of communication as part of the care process, family issues, legal and ethical issues, coordination of care, physicians' feelings, and physicians' influence and support. CONCLUSIONS: Family physicians require formal training in death issues and need to find a way to maximize learning through personal experiences. Discussion of cases in a support group may be beneficial.     

语言艺术在现代舞蹈中的运用

语言艺术在现代舞蹈中具有很强的感染力,从舞蹈创作、舞蹈表演中分析了其在现代舞蹈中的表现形式,以促进舞蹈艺术的发展.     

Studies on cell communication with enucleated human fibroblasts

Metabolic cooperation, the correction of the mutant phenotype in cells deficient in hypoxanthine phosphoribosyltransferase (HPRT-) by intimate contact with normal cells (HPRT+), represents a form of cell communication that is easily studied with radioautography. In the present study it was found that the formation of cell junctions needed for communication does not require protein synthesis nor is it under the immediate control of the cell nucleus. Enucleated normal cells efficiently communicate with HPRT- mutant cells. The effectiveness of enucleated cells as donors in metabolic cooperation provides evidence that it is the transfer of small molecules, nucleotide, or nucleotide derivatives that is responsible for correction of the mutant phenotype. Karyoplasts (nuclei with small amounts of cytoplasm surrounded by a plasma membrane) are unable to efficiently communicate with intact cells. The utilization of [3H]hypoxanthine by communicating mixtures of HPRT+ and HPRT- human cells is not significantly different than in the normal cells alone. Metabolic cooperation, as studied involves a redistribution of purine-containing compounds among communicating cells.     

Review of Forms of feeling: The heart of psychotherapy.

Reviews the book, Forms of feeling: The heart of psychotherapy by Robert F. Hobson. Robert Hobson calls this book his autobiography as a therapist. As such it provides interesting glimpses into some of his more meaningful sessions with clients, illuminating his approach to therapy and enabling the reader to see a master therapist at work. Hobson also presents a new method of therapy, which he calls the conversational model. On this level, his book is considerably less satisfying. Hobson succinctly outlines the general principles of the conversational model and basic skills required of the therapist, but in so doing offers essentially little new information, however valid the points may be. According to Hobson, the conversational model is designed for clients whose problems arise from disturbances in their significant relationships, and those problems are best solved not by talking about them but by being in a relationship such as therapy that provides "a special kind of friendship." Hobson puts great stress on the use of metaphorical language in therapy and learning how to use the language of art as well as of science. He relies heavily on literary quotations, prefacing each section with one or two, and liberally interspersing many more within the pages of text. The net result is not so much illuminating as it is wearisome, and the general tone is slightly pretentious and, when Hobson addresses his "dear Reader" directly, somewhat condescending. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Nonverbal communication in the context of dissociative processes.

Nonverbal communication, at both conscious and unconscious levels, can be portrayed as a type of "body language," a communication between the psychic bodies of patient and therapist. In this article, the author provides several examples of this communication process in the context of a psychoanalytic treatment with a patient who has a history of trauma resulting in frequent dissociative states. Motoric actions (drawing), somatosensory symptoms, and intense affect states represent the media through which she "informs" the analyst of her painful experiences. The analyst's surrender to countertransference states, such as deadness, constitutes the beginning of attunement to the patient's body communications. In one particularly unusual symptom of dissociation, the patient exhibits physical abilities that she is incapable of in more integrated states. An attempt is made to understand this event from a phenomenological and neurobiological perspective. Using an information-processing model, the author illustrates one instance of how the patient's subsymbolic information may be converted to the verbal symbolic via the analyst's use of evoked images. (PsycINFO Database Record (c) 2010 APA, all rights reserved)