Identity and Community: Erikson Reconsidered.

In this paper, I present a new reading of Erik Erikson's theory of epigenetic stages of development, with particular attention to the concept of identity. I show that Erikson's psychosocial approach requires close attention to the role of the community in the formation of individual identity and to the importance of the stage of generativity as an often overlooked component in understanding both identity and the whole Eriksonian life cycle.

COBRA: COde Blue Retrospective Audit in a metropolitan hospital.

BACKGROUND: Inhospital cardiac arrest (IHCA) is an uncommon but challenging problem. AIMS: To investigate the management and outcomes of IHCA, and to investigate the effect of introducing a medical emergency team (MET) on IHCA prevalence. METHODS: Retrospective medical record review of 176 adult IHCA episodes at Box Hill Hospital, a university-affiliated public hospital in metropolitan Melbourne, from July 2012 to June 2017. Inpatients receiving cardiopulmonary resuscitation for IHCA, in inpatient wards, intensive care unit, cardiac catheterisation laboratory and operating theatres were included. Data collected included demographics, resuscitation management and outcomes. Average treatment effect (ATE) was derived from margins estimates and linear regression fitted to hospital outcome, adjusted for IHCA factors. An exponentially weighed moving average control chart was used to explore IHCA prevalence over time. RESULTS: There were 65.3% of IHCA patients who died in hospital. IHCA prevalence was unchanged after the introduction of a dedicated MET service. Factors associated with higher likelihood of survival to discharge were initial cardiac of rhythm ventricular tachycardia (VT) (ATE 0.10 (95% CI = -0.03 to 0.25)) or ventricular fibrillation (VF) (ATE 0.28 (95% CI = 0.11-0.46)), cardiac monitoring at the time of arrest (ATE 0.06 (95%CI = -0.04 to 0.16)) and time to return of spontaneous circulation (ATE 0.023 (95% CI = 0.015-0.031)). CONCLUSIONS: IHCA is uncommon and is associated with high mortality. IHCA prevalence was unchanged after the introduction of a dedicated MET service. Factors associated with improved survival to hospital discharge were initial rhythm VT or VF, cardiac monitoring and shorter resuscitation times.

Mirror, Mirror: Freud and the Reversible Self-Object Dyad.

Freud is often negatively contrasted with object relations and relational theorists for holding to a metapsychology in which drives are understood as innate and predetermined in their development, are thought to follow the pleasure principle in a "hydraulic" manner, and are not seen as influenced by real objects. While that theory is certainly one dimension of Freud's thinking, it is paralleled by another, quite different model positing a "mirror" relation in which affectively charged reversible self-object dyads, as opposed to purely internal dynamics, are the constituent elements of mental life. This view, more compatible with theories placing greater emphasis on the constitutive role of self-object relations, may further the reconciliation of Freudian and object-relational theories.

Cultural narratives and the succession scenario: Slumdog Millionaire and other popular films and fictions.

An approach to the analysis of cultural narratives is proposed drawing inspiration from Lévi-Strauss's analysis of myths as fantasied resolutions of conflicts and contradictions in culture and of typical dilemmas of human life. An example of such an analysis revolves around contradictions in the Western cultural construction of the succession of generations. The logic of the structural analysis of cultural representations is explicated, the schema of the succession scenario is laid out, and the conflicts that generate it are identified. The movie Slumdog Millionaire is examined in some detail as an illustration of the succession scenario at work, and a comparative analysis shows how the same underlying schema accounts for otherwise obscure aspects of comparable contemporary popular narratives including Harry Potter, The Lion King and Star Wars.

Incest avoidance: oedipal and preoedipal, natural and cultural.

Why do most people experience a subjective aversion to the idea of incestuous sexual relations? To help answer this question, recent strands of thinking in both cultural and evolutionary anthropology are considered together with psychoanalytic theories regarding incest avoidance. Coevolutionary theories that propose ways to think about genetic and cultural inheritance as partially independent of each other, evolutionary arguments about the reproductive advantages of incest avoidance, structuralist theory arguing for a kind of incest aversion unrelated to any possible Darwinian selective advantage, and other trends in biosocial research into the origins of the incest avoidance are considered. Finally, a synthesis is proposed that seeks to expand our understanding of the oedipal and preoedipal dynamics of the aversion as these are conceptualized in psychoanalytic theory.

Piggyback intraocular lens implantation to correct myopic pseudophakic refractive error after penetrating keratoplasty.

PURPOSE: To determine the safety and efficacy of implanting a second intraocular lens (IOL) to correct myopic pseudophakic refractive error after penetrating keratoplasty (PKP). SETTING: Department of Ophthalmology, Toronto Western Hospital, Toronto, Ontario, Canada. METHODS: In this retrospective case series, 6 eyes of 6 post-PKP pseudophakic patients had a second piggyback IOL implantation to correct a residual myopic refractive error. The uncorrected visual acuity (UCVA) and the best corrected visual acuity (BCVA) were measured at regular intervals during a 7-month follow-up. Efficacy was determined by the achieved refractive correction and Snellen UCVA measurements. Safety was measured by loss of BCVA and complications (intraoperative and postoperative). RESULTS: The UCVA improved in all cases. Five patients achieved a BCVA of 20/40 or better postoperatively. Before surgery, the mean spherical equivalent (SE) was -8.08 diopters (D) (range -6.13 to -12.00 D). After surgery, the mean SE was -0.94 D (range -2.38 to +0.25 D). Four patients were within +/-1.50 D of emmetropia. There were no intraoperative or postoperative complications. CONCLUSION: Implanting a piggyback IOL was a safe and effective means of correcting myopic pseudophakic refractive error post PKP.