Do dreams protect sleep? Testing the Freudian hypothesis of the function of dreams

Includes bibliographical references.A review of the literature indicates that a physiological function for dreaming has not yet been empirically established. Based on recent findings regarding the neural correlates of dreaming, this study tested the Freudian hypothesis that dreams protect sleep. In order to do this, sleep architecture in patients who had experienced dream loss as a result of thrombotic stroke in the region of the posterior cerebral arteries was compared with that of patients with the same pathology who had not experienced dream loss. Using medical records, structural neuro-imaging, clinical interviews, neuropsychological testing, analysis of subjective sleep quality, and polysomnographic data collected over two consecutive nights in the sleep laboratory, two non-dreaming and three dreaming cases were studied. Analysis of the individual case studies indicates that sleep was disrupted in both non-dreaming cases

Captives

In Captives: How Stolen People Changed the World archaeologist Catherine M. Cameron provides an eye-opening comparative study of the profound impact that captives of warfare and raiding have had on small- scale societies through time. Cameron provides a new point of orientation for archaeologists, anthropologists, historians, and other scholars by illuminating the impact that captive-taking and enslavement have had on cultural change, with important implications for understanding the past.Focusing primarily on indigenous societies in the Americas while extending the comparative reach to include Europe, Africa, and Island Southeast Asia, Cameron draws on ethnographic, ethnohistoric, historic, and archaeological data to examine the roles that captives played in small-scale societies. In such societies, captives represented an almost universal social category consisting predominantly of women and children and constituting 10 to 50 percent of the population in a given society. Cameron demonstrates how captives brought with them new technologies, design styles, foodways, religious practices, and more, all of which changed the captor culture.This book provides a framework that will enable archaeologists to understand the scale and nature of cultural transmission by captives and it will also interest anthropologists, historians, and other scholars who study captive-taking and slavery. Cameron’s exploration of the peculiar amnesia that surrounds memories of captive-taking and enslavement around the world also establishes a connection with unmistakable contemporary relevance

Siege and Response: Families’ Everyday Lives and Experiences with Children’s Residential Mental Health Services (FULL REPORT)

Purpose Our purpose in interviewing parents with a child placed in residential mental health treatment was threefold: (1) to understand the functioning of children requiring residential mental health treatment before, during, and after treatment; (2) to characterize parents’ perceptions of their families’ involvement with residential treatment; and, (3) to address the popular notion that children requiring residential treatment come from highly dysfunctional and potentially harmful families by describing prevalent family functioning patterns. Methodology|This report is based on information obtained by interviewing 29 primary caregivers who had a child placed in residential care at one of two Ontario children’s mental health agencies. Parents were visited in their homes by an interviewer to engage in one-on-one dialogue to explore dimensions of their everyday lives and reflect on their service experiences. Interviews consisted of a series of open ended questions and were approximately 1 ½ to 2 hours in length. Because of the labour intensive nature of qualitative investigations, there are limitations to the number of cases that can practically be included in a study; however, what is lost in generalizability is compensated for by a richer sense of the struggles facing these families. Parents’ Perceptions of Residential Services Parents were generally pleased with their child’s placement in a residential treatment center. Parents feel respected, valued, and understood by service providers. They experience staff as competent, compassionate, and helpful. Residential services offered respite for families and containment for focal children. Many parents reported gains made for themselves and their children. Yet only 17% of parents felt that sufficient gains had been made to warrant the discharge of their child from the center. Parents tended not to blame the residential center for the lack of progress. The also seemed unable to articulate what the residential center could have done differently. Yet these parents, extremely hopeful when they first had their child placed in residence, had to come to terms with the realization that service outcomes had not matched their hopes. These stories highlight both the complexity and the tenacious nature of these children’s mental health difficulties. They also provide a challenge to service providers. What do we do when good is not good enough? Changes in Child Functioning Before, During and After Residential CareThese stories provide dramatic testimony that most of the older cohort children in this study leaving residential care had very serious ongoing problems in daily living. Problems which in many cases rivaled or exceeded the challenges faced prior to entering residential care. About one-third of these children had left home and many had unstable living arrangements or were “on the streets”. With the exception of living on their own and involvement in delinquent activities, and notwithstanding moderately more evidence of “successful” or partially “successful” adaptations, the after care daily living portraits of younger cohort residential care graduates were not notably more encouraging. About half of these younger children did not return to their original homes 6 after residential care. Serious areas of concern shared by both groups of children include continuing major adaptation problems at school and continued high levels of pressure on the parents and siblings of many of these children. Parent and Family FunctioningCaring for the focal child permeates every facet of daily life for these families including work, health, and relationships. Parents experience prolonged elevated levels of daily stress trying to juggle work schedules, appointments with professionals, household activities, and the needs of family members with caring for the focal child. Family climate is markedly tense and frequently involves conflict, particularly with the focal child. Relationships among other family members suffer as well, with parents reporting increased marital strain and little time to devote to siblings of the focal child. Caring for the focal child is taxing on parents’ own physical and mental health. Most families (70%) reported experiencing substantial relief, at least for a short period of time, from tensions within the home when the focal child entered residential care. Child Functioning Over Three Selected Developmental PeriodsOne of the interpretative challenges inherent in these stories is understanding the connection between the behaviour of these children, which is strikingly similar, and evidence suggestive of these children having a variety of problems, life histories and family environments. It can be argued that these children arrive at a similar point from many different trajectories. Who are the children represented in this sample? How are we to understand their difficulties? When it comes to understanding the behaviour of the focal children, both its presentation and its genesis, these stories raise as many questions as they answer. These stories challenge the notion of a single or root cause of extreme unmanageable behaviour. Instead they offer a complex and unsettling portrayal of these children, their familial and social environments, life histories, their strengths and challenges. These stories caution against the use of blanket or catch-all interpretations to help us understand the problematic behaviour of these children. ConclusionDespite the positive view of residential treatment held by parents long after treatment ends, the data suggest relatively poor outcome patterns for children leaving residential care. Serious areas of concern shared by both groups of children include continuing major adaptation problems at school and continued high levels of pressure on the parents and siblings of many of these children. The clearest area of benefit from these residential placements, at least in the short run, is for family members other than the focal child. This is an important consideration, given the incredible pressures families manage when the focal child is at home, and the extreme disruptions in family life described in these stories. An obvious question emanating from these stories is what can be expected for these children - in school, employment and relationships - over the years ahead. There is almost no support in our study for helping strategies predicated on “curing” or changing the focal child through short-term or medium-term interventions so that he or she can prosper in everyday life. Variations in living arrangements, enhancing school and employment opportunities, and continuing support to these children and their families with the challenges of daily living merit serious attention

Siege and Response: Families’ Everyday Lives and Experiences with Children’s Residential Mental Health Services (SUMMARY REPORT)

Our purpose in interviewing families who had a child placed in residential children’s mental health treatment was to provide insight into the lives and service experiences of these families as they struggle to care for their child and find appropriate services. As we endeavored to code, categorize, and make sense of the information shared with us by families several other more pointed purposes emerged as integral to our efforts. More specifically we became interested in understanding the functioning of children requiring residential mental health treatment before, during, and after treatment with the aim to comment on general patterns of change for these children across these three time periods. Secondly, we also aimed to characterize parents’ perceptions of their families’ involvement with residential treatment. In particular we address parents’ understanding of the services, their relationships with service providers, and parents’ perceptions of their children’s experiences. And thirdly, in order to provide a family context for children’s difficulties and the ensuing service involvement, we also discuss family functioning highlighting key family patterns under the domains of work, daily life, and relationships. The inclusion of prevalent family functioning patterns also helps us to address the popular notion that children requiring residential treatment come from highly dysfunctional and potentially 3 harmful families. Each of these three purposes are addressed in turn in an effort to provide a more complete picture of the families involved in residential treatment and their service experiences. We conclude with some implications for service delivery and thoughts to pursue in future investigations

Performance and impact assessment: Emerging systems among development agencies

This paper covers the key findings of a desk review of current practice in performance review and impact assessment (M&E broadly defined), among selected development agencies, and briefly outlines opportunities for future developments. The target audience is development agencies, both government and non-government, who are concerned with modification and adaptation of existing arrangements for M&E in the light of recent changes in development policy and strategy

Community hospitals – the place of local service provision in a modernising NHS: an integrative thematic literature review

Background: Recent developments within the United Kingdom's (UK) health care system have reawakened interest in community hospitals (CHs) and their role in the provision of health care. This integrative literature review sought to identify and assess the current evidence base for CHs. Methods: A range of electronic reference databases were searched from January 1984 to either December 2004 or February 2005: Medline, Embase, Web of Knowledge, BNI, CINAHL, HMIC, ASSIA, PsychInfo, SIGLE, Dissertation Abstracts, Cochrane Library, Kings Fund website, using both keywords and text words. Thematic analysis identified recurrent themes across the literature; narrative analyses were written for each theme, identifying unifying concepts and discrepant issues. Results: The search strategy identified over 16,000 international references. We included papers of any study design focussing on hospitals in which care was led principally by general practitioners or nurses. Papers from developing countries were excluded. A review of titles revealed 641 potentially relevant references; abstract appraisal identified 161 references for review. During data extraction, a further 48 papers were excluded, leaving 113 papers in the final review. The most common methodological approaches were cross-sectional/descriptive studies, commentaries and expert opinion. There were few experimental studies, systematic reviews, economic studies or studies that reported on longer-term outcomes. The key themes identified were origin and location of CHs; their place in the continuum of care; services provided; effectiveness, efficiency and equity of CHs; and views of patients and staff. In general, there was a lack of robust evidence for the role of CHs, which is partly due to the ad hoc nature of their development and lack of clear strategic vision for their future. Evidence for the effectiveness and efficiency of the services provided was limited. Most people admitted to CHs appeared to be older, suggesting that admittance to CHs was age-related rather than condition-related. Conclusion: Overall the literature surveyed was long on opinion and short of robust studies on CHs. While lack of evidence on CHs does not imply lack of effect, there is an urgent need to develop a research agenda that addresses the key issues of health care delivery in the CH setting

Taking Action for Looked After Children in School: A Knowledge Exchange Programme

This book will become a teaching resource for all professionals concerned with the education of children in care, such as designated teachers and Virtual School colleagues