Nursing students doing gender: Implications for higher education and the nursing profession.

The average age of women nursing students in Australia is rising. With this comes the likelihood that more now begin university with family responsibilities, and with their lives structured by the roles of mother and partner. Women with more traditionally gendered ideas of these roles, such as nurturing others and self-sacrifice, are known to be attracted to nursing as a profession; once at university, however, these students can be vulnerable to gender role stress from the competing demands of study. A qualitative research design, guided by Gadamer's hermeneutic philosophy, explored the gendered behaviours and experiences of 22 women nursing students, all of whom had children and began university in a heterosexual intimate relationship. The findings reveal traditional ideas of gender were almost universal among participants, and these ideas had a significant influence on the nursing degree experience. Participants commonly prioritised family over the university and practiced maternal gatekeeping (prevention of male partner involvement in domestic work). These traditionally gendered behaviours, coupled with experiences of gender role stress, had a detrimental impact on participants' capacity to study and their personal wellbeing. The importance of these findings to the burgeoning nursing workforce shortage nursing is considered in terms of student retention and the supply of graduates into the profession. The implications to the nursing profession are also explored against the evidence that nursing students with traditional gender beliefs are less likely to develop as autonomous, critical thinking nurses compared to their gender-egalitarian peers. The introduction of gender theory via critical pedagogy in the undergraduate nursing degree curriculum is recommended to enlighten and empower women nursing students and promote the competence, agility, and sustainability of the nursing profession.

What is alexithymia? Using factor analysis to establish its latent structure and relationship with fantasizing and emotional reactivity.

OBJECTIVE: There is ongoing uncertainty about the structure and definition of alexithymia. Conceptually, alexithymia has traditionally been defined as a multidimensional trait with four components: difficulty identifying feelings, difficulty describing feelings, externally orientated thinking, and difficulty fantasizing. However, some authors suggest that difficulty fantasizing might not be a component, and others suggest low emotional reactivity is a fifth component. In this study, we sought to clarify this issue using factor analysis. METHOD: In a sample of adults (N = 508), we administered a comprehensive battery of psychometric measures and analyzed their latent structure using exploratory factor analysis. RESULTS: Subscales assessing difficulty identifying feelings, difficulty describing feelings, and externally orientated thinking all loaded well together on the alexithymia factor. However, none of the subscales assessing aspects of difficulty fantasizing (i.e., daydreaming frequency, vividness, content, or use of daydreams to regulate emotions) loaded on the alexithymia factor. Similarly, no emotional reactivity subscales loaded on the alexithymia factor, and alexithymia was associated with higher (not lower) levels of emotional reactivity for negative emotions. CONCLUSIONS: Difficulty fantasizing and low emotional reactivity are not components of the latent alexithymia construct. The traditional four-component definition of alexithymia likely warrants refinement to a more parsimonious three-component solution.

The Emotion Regulation Questionnaire: Psychometric Properties in General Community Samples.

The Emotion Regulation Questionnaire (ERQ) is a 10-item self-report measure of 2 emotion regulation strategies, cognitive reappraisal and expressive suppression. It is a widely used measure of emotion regulation, but its factor structure has rarely been examined outside of university student samples, and some authors have recently questioned its factorial validity in general community samples. In this study, we examine the psychometric properties of the ERQ (original English version) in 3 Australian general community samples (N = 300, 400, 348). Confirmatory factor analyses in each sample demonstrated that the traditional 2-factor model (comprised of cognitive reappraisal and expressive suppression factors) was replicable and an excellent fit to the data. In all samples, ERQ cognitive reappraisal (α = .89-.90) and expressive suppression (α = .76-.80) scores had acceptable to excellent levels of internal consistency reliability. As expected, cognitive reappraisal scores were significantly negatively correlated with psychological distress and alexithymia, whereas expressive suppression scores were significantly positively correlated with psychological distress and alexithymia. We conclude that, similar to previous findings in student samples, the ERQ has strong psychometric properties in general community samples and can therefore be used confidently regardless of participants' student status.

Empathy, tact and the freedom to be natural.

This paper explores the concepts of tact and empathy in the context of the Freud-Ferenczi correspondence around Ferenczi's "The Elasticity of Psycho-Analytic Technique" paper. It goes on to explore the problems that they encounter in the neighborhood of reconciling science and subjectivity, in relation to the work on personal knowledge of the Hungarian philosopher Michael Polanyi and concludes with some implications for psychoanalytic training.

The Perth Alexithymia Questionnaire-Short Form (PAQ-S): A 6-item measure of alexithymia.

BACKGROUND: Alexithymia is a trait characterized by difficulties identifying feelings, difficulties describing feelings, and externally orientated thinking. It is widely regarded as an important transdiagnostic risk factor for a range of psychopathologies, including depressive and anxiety disorders. Whilst several well-validated psychometric measures of alexithymia exist, these are relatively lengthy, thus limiting their utility in time-pressured settings. In this paper, we address this gap by introducing and validating a brief 6-item version of the Perth Alexithymia Questionnaire, called the Perth Alexithymia Questionnaire-Short Form (PAQ-S). METHOD: Across two studies with adult samples (Study 1 N = 508 United States community; Study 2 = 378 Australian college students), we examined the psychometric properties of the PAQ-S in terms of its factor structure, reliability, and concurrent/criterion validity. RESULTS: In exploratory and confirmatory factor analyses, all PAQ-S items loaded well on a single general alexithymia factor. The PAQ-S total score had high reliability, and correlated as expected with the long-form of the PAQ, as well as other established markers of alexithymia, emotion regulation, and affective disorder symptoms. LIMITATIONS: Our samples were general community or college student samples from two Western countries; future validation work in clinical samples and more diverse cultural groups is thus needed. CONCLUSIONS: The PAQ-S retains the psychometric strengths of the PAQ. As such, the PAQ-S can be used as a quick, robust measure of overall alexithymia levels. The introduction of the PAQ-S hence enables valid assessments of alexithymia in a more diverse range of settings and research designs.

Why is alexithymia a risk factor for affective disorder symptoms? The role of emotion regulation.

BACKGROUND: Ever since alexithymia was defined in the 1970s, robust associations have been observed between alexithymia and a variety of symptoms of psychopathology. Alexithymia is now widely regarded as an important transdiagnostic risk factor, and it is frequently assessed in clinical and research settings. However, despite this strong interest, it remains unclear exactly why (i.e., by which mechanisms) alexithymia is linked to psychopathology. In this paper, we hypothesise that alexithymia is linked to affective disorder symptoms because alexithymia impairs people's ability to regulate their emotions, and we empirically test this hypothesis. METHOD: We administered a battery of psychometric measures to 501 adults in the United States, and examined the direct and indirect effects between alexithymia (Perth Alexithymia Questionnaire), emotion regulation ability (Perth Emotion Regulation Competency Inventory), and affective disorder symptoms (Depression Anxiety Stress Scales-21). RESULTS: In the Pearson bivariate correlation matrix, alexithymia, emotion regulation difficulties, and affective disorder symptoms were all significantly correlated. In the modelling of direct and indirect effects, alexithymia was indirectly associated with affective disorder symptoms through emotion regulation difficulties (no significant direct effect). LIMITATIONS: Our online survey data were all self-report data and cross-sectional. Future longitudinal work would be beneficial. CONCLUSIONS: Our findings support contemporary theorising that alexithymia is linked to affective disorder symptoms via emotion regulation difficulties. These results help to clarify the mechanisms by which alexithymia may predispose people to affective disorder symptoms, and highlight the importance of considering the roles of alexithymia and emotion regulation in case conceptualisations and treatment planning.

Psychoanalytic identity: Charles Rycroft and the British Freudian tradition.

This paper explores Rycroft's views on narcissistic barriers to the formation of analytic identity, together with the analyst's relation to (or ablation of) his forbears. It sketches Rycroft's relation to his training analysts, Ella Sharpe and Sylvia Payne and the British Freudian tradition, delineating a line of descent running from Hanns Sachs, through Sharpe and Payne to Rycroft. Rycroft defined himself in creative dialogue with Freud and his own contemporaries within the British Freudian tradition.

Peptide mimetic compounds can activate or inhibit cardiac and skeletal ryanodine receptors.

AIMS: Our aim was to characterise the actions of novel BIT compounds with structures based on peptides and toxins that bind to significant regulatory sites on ryanodine receptor (RyR) Ca2+ release channels. RyRs, located in sarcoplasmic reticulum (SR) Ca2+ store membranes of striated muscle, are essential for muscle contraction. Although severe sometimes-deadly myopathies occur when the channels become hyperactive following genetic or acquired changes, specific inhibitors of RyRs are rare. MAIN METHODS: The effect of BIT compounds was determined by spectrophotometric analysis of Ca2+ release from isolated SR vesicles, analysis of single RyR channel activity in artificial lipid bilayers and contraction of intact and skinned skeletal muscle fibres. KEY FINDINGS: The inhibitory compounds reduced: (a) Ca2+ release from SR vesicles with IC50s of 1.1-2.5 µM, competing with activation by parent peptides and toxins; (b) single RyR ion channel activity with IC50s of 0.5-1.5 µM; (c) skinned fibre contraction. In contrast, activating BIT compounds increased Ca2+ release with an IC50 of 5.0 µM and channel activity with AC50s of 2 to 12 nM and enhanced skinned fibre contraction. Sub-conductance activity dominated channel activity with both inhibitors and activators. Effects of all compounds on skeletal and cardiac RyRs were similar and reversible. Competition experiments suggest that the BIT compounds bind to the regulatory helical domains of the RyRs that impact on channel gating mechanisms through long-range allosteric interactions. SIGNIFICANCE: The BIT compounds are strong modulators of RyR activity and provide structural templates for novel research tools and drugs to combat muscle disease.

Exploiting Peptidomimetics to Synthesize Compounds That Activate Ryanodine Receptor Calcium Release Channels.

Ryanodine receptor (RyR) Ca2+ -release channels are essential for contraction in skeletal and cardiac muscle and are prime targets for modification of contraction in disorders that affect either the skeletal or heart musculature. We designed and synthesized a number of compounds with structures based on a naturally occurring peptide (A peptides) that modifies the activity of RyRs. In total, 34 compounds belonging to eight different classes were prepared. The compounds were screened for their ability to enhance Ca2+ release from isolated cardiac sarcoplasmic reticulum (SR) vesicles, with 25 displaying enhanced Ca2+ release. Competition studies with the parent peptides indicated that the synthetic compounds act at a competing site. The activity of the most effective of the compounds, BIT 180, was further explored using Ca2+ release from skeletal SR vesicles and contraction in intact skeletal muscle fibers. The compounds did not alter tension in intact fibers, indicating that (as expected) they are not membrane permeable, but importantly, that they are not toxic to the intact cells. Proof in principal that the compounds would be effective in intact muscle fibers if rendered membrane permeable was obtained with a structurally related membrane-permeable scorpion toxin (imperatoxin A), which was found to enhance contraction.

The influence of intimate partnerships on nurse student progression: An integrative literature review.

OBJECTIVE: To identify the best available evidence on the influence of intimate partnerships (marriage or de facto relationships) on nurse student progression. BACKGROUND: Projections of future nursing workforce shortages have provided renewed impetus to study pre-registration nurse student progression. Factors external to the university are highly influential for non-traditional student groups such as nursing. As the average age of nurse students' rise, the influence of intimate partnerships requires investigation. DATA SOURCES: An international integrative review was conducted in literature from 1990 to 2015 across a range of databases. REVIEW METHODS: A structured approach was used for data collection, analysis and evaluation, resulting in a selection of 17 international papers. RESULTS: There were few common definitions, and little agreement regarding measurement of key factors and variables across the literature. Research into partnership influences on nurse student progression was minimal however findings across a range of disciplines revealed partner support as a principal influence; enabling or hindering the student's social and academic university involvement. Given that nursing is a highly feminised profession, the finding that support was less forthcoming from female students' male partners than vice versa was a particular concern. Women students reported challenging their partners' traditional domestic gender role expectations, which sometimes led, to relationship conflict and breakdown, further impeding their ability to progress. CONCLUSION: Lesser support from their male partners may have unwelcome implications for the progression of the increasing population of mature-age women nurse students. The comparatively few studies and their diversity limit the applicability of the review findings to current nurse education. With workforce sustainability threatened, studies directly investigating the influence of partnerships on nurse student progression are required, employing standardised and transparent terms and measurements.

The character of the exception as a defense against deformity.

There is a tendency to regard Freud's paper on "the exception" (1916) as describing a general narcissistic defensive organization, but this paper argues that Freud was primarily concerned with the character of the exception as a defense against acknowledging bodily deformity. Two cases of bodily deformity, one fictional, one drawn from the author's practice, are presented to explore the role of magical identification with an ego-ideal in the regulation of self-esteem in the exception. The first shows a case irrevocably stuck in the character of the exception; the second example shows how analysis can help to effect some lessening of the defense. The paper ends with brief observations on technique in relation to the exception.

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