Evaluating the psychosocial and mental health consequences of abuse among Jordanian women.

This cross-sectional, descriptive, correlational study evaluated the mental health consequences of abuse among Jordanian women. Standard tools were used to collect data from 93 abused women seeking help at a welfare centre in relation to forms of abuse, depression, coping, suicidal ideation, substance use, social support and self-efficacy. The most commonly reported form of abuse was psychological abuse. Applying the Beck Depression Inventory showed that 38.7% of the abused women had moderate to severe levels of depression. Although half the women had a low level of perceived social support, abused Jordanian women reported moderate to very high levels of self-efficacy and used approach coping more frequently than avoidance coping strategies. Using the Modified Scale for Suicide Ideation, 15.7% of the women reported that the desire for death was stronger than the desire for life. Abused women in Jordan face mental health and psychosocial risks that could compromise their quality of life.

Evaluating the psychosocial and mental health consequences of abuse among Jordanian women

This cross-sectional, descriptive, correlational study evaluated the mental health consequences of abuse amongjordanian women. Standard tools were used to collect data from 93 abused women seeking help at a welfare centre in relation to forms of abuse, depression, coping, suicidal ideation, substance use, social support and self-efficacy. The most commonly reported form of abuse was psychological abuse. Applying the Beck Depression Inventory showed that 38.7% of the abused women had moderate to severe levels of depression. Although half the women had a low level of perceived social support, abused Jordanian women reported moderate to very high levels of self-efficacy and used coping more frequently than avoidance coping strategies. Using the Modified Scale for Suicide ldeation, 15.7% of the women reported that the desire for death was stronger than the desire for life. Abused women in mental health and psychosocial risks that could compromise their quality of life

Clam dredging effects and subsequent recovery of benthic communities at different depth ranges.

This study aimed to assess the potential effects of clam dredging and the subsequent recovery of the benthic environment. Two experimental areas located at 6 and 18m depth were established in order to analyse whether impacts and recovery of benthic environment are depth-related. Study areas were located within an area closed to dredging and two different plots were established at both depths. One of the plots was subjected to intense clam dredge-fishing, while the other was undisturbed and therefore used as control. Sampling followed a BACI design, with samples for macrobenthic, meiobenthic and sediment particle size analysis being taken by SCUBA divers from both areas before and after fishing stress. For both depths, impacts on the benthic environment were very low resulting in high recovery rates. Nevertheless, at shallower depths communities demonstrated a faster recovery. It was shown that depending on the faunal component used as a bioindicator, different results can be observed. Generally deposit-feeding organisms with scales or chitinous plates and vermiform shape (mainly crustaceans, polychaetes and ophiuroids), without external protection, were the most affected by dredging, while some polychaetes without external protection and with a carnivorous feeding mode seemed to be enhanced by fishing. The low level of perturbations induced by the dredging activities was comparable to the impact of surface waves on the bottom, as experiments were undertaken in wave-dominated environments. The coexistence of storm events during the study period proved to have similar or even more deleterious effects on the benthic environment. It appears that communities from hydrodynamic fishing grounds that are well adapted to natural physical stress are not highly affected by dredging.

Exploring the feasibility of email-mediated interaction in survivors of abuse.

There is a growing use of email-based provision of information, development of health-related skills and interventions; however, use of email to assist women and children experiencing abuse after receiving Protection from Abuse (PFA) court order has not been explored. The specific aim of this research was to test the feasibility of an email device called MIVO for use in interacting with women and children after receiving PFA. This qualitative design used a three-step recruitment, screening and email interaction with mothers and their adolescent child after obtaining informed consent and training in the use of an email device. Sample included six pairs of mother and child (n = 12) who have received a PFA within the past 6 months. Demographic data were gathered using the sociodemographic questionnaire. Qualitative data were gathered using email messages from mother and child pairs. Results showed that email interaction is a feasible and acceptable way of providing support and information to survivors of abuse after their PFA. The following themes in their order and rank of appearance were found in the email interaction between the nurse and survivors: (1) safety issues; (2) job-related issues; (3) school-related issues; (4) parenting-related issues; and (5) health-related issues. Themes identified for the children were school work and friends. Privacy, confidentiality and respect for individual rights are paramount in email interactions. Email interaction is useful in education, screening, safety instructions and follow-up care. Technological devices such as MIVO may have usefulness as an email interaction device among women, their child and a nurse to reduce their risk for further interpersonal violence/abuse and to increase disclosure of abuse. Healthcare providers need to identify technological developments, and through evidence-based research examine their feasibility and adaptability for translation into practice specifically, in caring for survivors of abuse.

Cospeciation in the triplex symbiosis of termite gut protists (Pseudotrichonympha spp.), their hosts, and their bacterial endosymbionts.

A number of cophylogenetic relationships between two organisms namely a host and a symbiont or parasite have been studied to date; however, organismal interactions in nature usually involve multiple members. Here, we investigated the cospeciation of a triplex symbiotic system comprising a hierarchy of three organisms -- termites of the family Rhinotermitidae, cellulolytic protists of the genus Pseudotrichonympha in the guts of these termites, and intracellular bacterial symbionts of the protists. The molecular phylogeny was inferred based on two mitochondrial genes for the termites and nuclear small-subunit rRNA genes for the protists and their endosymbionts, and these were compared. Although intestinal microorganisms are generally considered to have looser associations with the host than intracellular symbionts, the Pseudotrichonympha protists showed almost complete codivergence with the host termites, probably due to strict transmissions by proctodeal trophallaxis or coprophagy based on the social behaviour of the termites. Except for one case, the endosymbiotic bacteria of the protists formed a monophyletic lineage in the order Bacteroidales, and the branching pattern was almost identical to those of the protists and the termites. However, some non-codivergent evolutionary events were evident. The members of this triplex symbiotic system appear to have cospeciated during their evolution with minor exceptions; the evolutionary relationships were probably established by termite sociality and the complex microbial community in the gut.

Maintenance of long-term clinical benefit with sirolimus-eluting coronary stents: three-year results of the RAVEL trial.

BACKGROUND: The use of sirolimus-eluting coronary stents has been associated with a nearly complete elimination of restenosis at 6 months and with a very low 1-year incidence of major adverse cardiac events (MACE). This analysis examined whether these beneficial effects persist over the longer term. METHODS AND RESULTS: This multicenter trial randomly assigned 238 patients to revascularization of single, de novo, native coronary artery lesions with sirolimus-eluting versus conventional bare-metal stents. Survival free from target lesion revascularization (TLR), target vessel failure (TVF), and MACE up to 3 years of follow-up was compared between the 2 treatment groups. Complete data sets were available in 94.2% of patients treated with sirolimus-eluting stents and in 94.1% of patients randomized to the control group. The cumulative 1-, 2-, and 3-year event-free survival rates were 99.2%, 96.5%, and 93.7% for TLR and 95.8%, 92.3%, and 87.9% for TVF, respectively, in the sirolimus-eluting stent group, versus 75.9%, 75.9%, and 75.0% for TLR and 71.2%, 69.4%, and 67.3% for TVF in the control group (P<0.001 for both comparisons at 3 years). Rates of MACE at 3 years were 15.8% in patients randomly assigned to sirolimus-eluting stents versus 33.1% in patients assigned to bare-metal stents (P=0.002). One patient treated with a sirolimus-eluting stent died of a cardiac cause between 12 and 36 months. CONCLUSIONS: Treatment of de novo coronary stenosis with sirolimus-eluting stents was associated with a sustained clinical benefit and very low rates of TLR and of other MACE up to 3 years after device implantation.

Group intervention for widowed survivors of suicide.

This study evaluates the effects of two group interventions, the Bereavement Group Postvention (BGP) and the Social Group Postvention (SGP), on the bereavement outcomes in widowed survivors of suicide. The goals were to determine if the group interventions would significantly decrease levels of depression, psychological distress, and grief, as well as significantly increase the level of social adjustment among widowed survivors of suicide. Sixty widowed survivors of suicide were randomized to either the BGP or SGP intervention for 1-1/2 hour weekly sessions over an 8-week period. Study participants were recruited through various media and community referrals and initiated telephone contact with the study investigators. Statistically significant changes were found on all measures when the SGP and the BGP were combined for analyses on posttreatment assessments at 3 to 5 days after completion of the group intervention, and 6 months and 12 months after the intervention. Participants experienced a significant reduction in overall depression, psychological distress, and grief, as well as an increase in social adjustment. Further research with tighter controls of confounding variables as well as the inclusion of a no-treatment control group is indicated.

Negative life experiences, depression, and immune function in abused and nonabused women.

Abuse of women by their intimate partner is a staggering national problem. Abused women have a higher number of medically unexplained somatic symptoms, more functional disability, a lower self-rating of general health, and higher health care utilization when compared to nonabused women. The authors' purpose in this study was to examine differences in occurrences of negative life experiences, level of depression, and T-cell function between abused and nonabused women. The sample consisted of abused women (n = 12) and nonabused women (n = 12). Hypotheses tested were (1) abused women will have more negative life experiences than nonabused women, (2) abused women will have higher levels of depression than nonabused women, and (3) abused women will have reduced T-cell function compared to nonabused women. A cross-sectional cohort design was used to compare differences in negative life experiences, levels of depression, and T-cell function. Independent sample t-tests were performed comparing the abused versus nonabused women on the dependent measures. Significant differences were found between the groups for negative life experiences (LES; t = 2.29, p < 0.05), level of depression (BDI; t = 3.48, p < 0.01), and T-cell function (TMR; t = -5.62, p < 0.01). These findings are descriptive and do not establish causal links. However, this is an inquiry into the psychological and biobehavioral responses of women experiencing abuse and their potential health problems. The study shows that abused women reported more negative life experiences, experienced higher levels of depression, and experienced lower T-cell function when compared with nonabused women.

Restraining an aggressive suicidal, paraplegic patient: a look at the ethical and legal issues.

This paper focuses on a case of an intently suicidal, paraplegic patient in a critical care unit and the need for collaboration among nursing leaders to provide a safe environment through the use of wrist restraints. Ethical questions regarding patient rights, liberties, and privileges are reviewed. Legal points of negligence and intentional torts are also included in the analysis of the case.

Assessing abuse in female suicide survivors.

The article reports a study examining the level of rejection of the suicide victim by the surviving widow and the suicide survivor's experiences of abuse. The 49 female suicide survivors who participated in this study were part of a larger nursing postvention study. Descriptive statistics and the nonparametric Spearman correlation for a two-tailed test (a < 0.05) were used to analyze the data. Results showed that 65.3% of the survivors of suicide had experienced some form of abuse, the most frequent being verbal abuse. Experiences of abuse may affect the bereavement process and coping strategies in surviving the suicide of a spouse.

Nursing postvention for spousal survivors of suicide.

There is a scarcity of information available with respect to postbereavement outcomes for survivors of the suicide of a loved one. Few studies have focused on postvention therapies for the bereaved, particularly the bereaved survivors of suicide. The major aim of this study as to compare the effects of two theoretically derived nursing postventions, Bereavement Group Postvention (BGP) and Social Group Postvention (SGP), among the widowed whose spouses died of suicide. The findings suggest that both groups experienced an overall reduction in depression and distress. Although participants in the SGP generally showed significant improvement in social adjustment, they tended to be less well adjusted with respect to their parental roles at the end of the 8-week postvention sessions. Comparison of the psychoemotional correlates of grief varied such that there were no significant differences between the postvention groups for social isolation, loss of control, somatization, or death anxiety. The BGP participants experienced significantly reduced levels of anger/hostility and guilt; however, feelings of anger/hostility actually increased for those receiving the SGP. There was a significant reduction in feelings of despair, rumination, and depersonalization for both groups. Although social isolation was not significantly reduced for participants in either group, those receiving the BGP tended to experience a reduction in social isolation and those receiving the SGP showed no changes.

Exploring widows' experiences after the suicide of their spouse.

1. The widow of a spouse who committed suicide must cope with issues related to depression, anger, blame, guilt, and the stigma associated with suicide that makes recovery from this type of loss different for the survivors. 2. The predominant need of widows and widowers of suicide victims was to talk in an environment of acceptance and understanding, which could only be provided by other people who have had the same kind of experience. 3. There is no precise formula that exists to guide caregivers when assisting survivors of suicide victims, however suggestions include communicating with compassion; demonstrating care and concern; accepting the individual's grief; and offering and providing information.

Escorting the family out of the ICU: ethical and legal issues.

This article presents an interesting case where nurses touched a family member to escort her out of the ICU against her wishes. In the case analysis, the nurse attorney author reviews the ethical and legal issues in this case.

Saphenous vein coronary bypass graft revisited.

To establish a benchmark for the clinical efficacy of PTCA and the IMA graft in our institution, the data from 79 patients who underwent isolated SVBG to the LAD between July, 1971, and December, 1984, were analyzed. Follow-up averaged 96.16 months/patient. Actuarial freedom from reoperation was 100% at 12 months, 95% at 60 months, and 89.4% at 120 months. Actuarial freedom from cardiac death was 100% at 12 months, 94% at 60 months, and 87% at 120 months. Actuarial freedom from an LAD graft failure myocardial event was 100% at 12 month, 94% at 60 months, and 77% at 120 months. Our SVBG failure rate did increase from 1.2%/year during the first 5 years to 3.4%/year during the second 5 years. We are presently selectively employing IMA grafts to the LAD. Our results with the SVBG and the palliative nature of all coronary artery bypass graft procedures remove the imperative to always use the IMA. Individual patient considerations such as age, clinical stability, IMA flow, and the residual anatomy for the potential reoperation are important considerations.

Long-term experience with mitral valve replacement: an evolving strategy for prosthesis selection.

MVR was examined in 181 patients undergoing 188 consecutive operations during a 12 1/2-year observation time. Hospital mortality for MVR without aortic valve disease was 7 of 156 or 4.5% and was independent of the valve type employed and the presence of coronary artery pathology. Late cardiac mortality in isolated MVR was significantly greater in those patients receiving a Starr-Edward 6120 prosthesis when compared to those receiving an MPX. The presence of coronary artery pathology, however, defines the patient subgroup with the poorest late survival. Tissue durability has not significantly altered late survival after MPX. However, the actuarial analysis of tissue failure reveals important increases in tissue failure incidence 5 years after placement. Although MPX is our prosthesis of choice for MVR, limited tissue durability creates an important subgroup for judicious use of a mechanical prosthesis. We conclude that no valve type should be championed as "the valve" for all patients undergoing MVR. The selection of a valve for MVR remains a difficult judgment which must be tempered by the patients age, history of previous operations, severity of his present illness, and the feasibility of a second MVR.

Comparison of Slosson and McCarthy Scales for exceptional preschool children.

A comparison of scores from the Slosson and McCarthy Scales with exceptional preschool children (both retarded and gifted) showed Slosson scores were significantly higher. Caution is recommended when using the Slosson as a screening instrument.