A historical and contemporary literature review of rejection sensitivity in marginalized populations

As healthcare research continues to uncover health disparities in marginalized populations, it is critical to work toward understanding the origin of these disparities. Rejection sensitivity (RS) is a phenomenon that may illuminate reasons that disparities continue to exist. The purpose of this paper is to review the literature on RS in marginalized populations, explore outcomes of RS as they relate to interpersonal relationships, valued life goals, and health, and identify gaps in the literature for proposing future research. Titles and abstracts were reviewed yielding 50 articles. Those 50 articles were further reduced to include select articles that focused on marginalized populations, contributed to the diversity of literature, or provided historical context for the development of the concept of rejection sensitivity after 1995. Articles were chosen to highlight the state of the science and subsequent gaps specifically associated with aspects important to healthcare. The final process of elimination resulted in 20 articles for review. Four themes emerged in the literature. The first two themes related to the experience of RS and marginalized groups, including race-based RS and gender and sexual minority-based RS. The second two themes related to the outcomes and consequences of RS, including effects on interpersonal relationships and effects on health. Many areas for future research are identified throughout this literature review that can contribute to future understanding of why health disparities occur in marginalized populations

Implementation and Outcomes of Complementary Therapies in Hospice Care: An Integrative Review

Complementary therapies are increasingly integrated into hospice care, emphasizing the need to examine the evidence regarding implementation and effects on end-of-life outcomes. This review synthesizes the evidence regarding the implementation of complementary therapies and effects on end-of-life outcomes in hospice care. Whittemore and Knafl’s five-step integrative review process was applied. Using predefined search terms, research-based articles between 2006 and 2020 were reviewed. Twenty-three quantitative/mixed method studies conducted across eight countries met the final review criteria. Most commonly used complementary therapies were music, biofield therapies (reiki, therapeutic touch), and massage therapy. Most studies reported significant findings on physical symptoms (pain, dyspnea, fatigue, gastrointestinal symptoms, agitation) and/or psychosocial/spiritual symptoms (anxiety, depression, spirituality, well-being, quality of life); 40% of studies had both significant and nonsignificant findings. Methodological limitations included study design (few randomized controlled trials), small sample size, high attrition rate, lack of racial/ethnic diversity, unstandardized intervention implementation, and multiple outcome measurement instruments. Complementary therapies are promising components of hospice care; however, rigorous studies are needed to validate the effect on end-of-life outcomes and determine the most efficacious implementation. Complementary therapy studies face challenges consistent with end-of-life research; however, efforts to design rigorous trials and address methodological issues are required to enhance the state of the science

Between Revolutionary Rupture and Historic Inhibition: The Novels of Katharine Susannah Prichard

This thesis provides a long overdue Marxist analysis of the novels of Katharine Susannah Prichard. I argue that an acknowledgement of overdetermined social/political activity, as described and defined by Louis Althusser in his explanation of Marxist dialectics, is crucial to an understanding of the discrepancy between Prichard's stated intentions for her novels and their actual impact. Tracing the "trajectory" of Prichard's novel canon along a "continuum" between 'revolutionary rupture' and 'historical inhibition', I examine each novel according to its political potency and aesthetic power. Prichard's early novels although not designed to deliver a specific or defined political message, accommodate an overdetermined dialectical discourse which ensures their political potency. In the later novels, her efforts to conform to the demands of Socialist Realism (a theory of production which was impossible to fulfil in a pre-revolutionary society) interrupt the dialectical process and displace the energy of her previous writing. As a result, these later novels are rendered politically impotent and aesthetically weak

Combined effect of hypothermia and caspase-2 gene deficiency on neonatal hypoxic-ischemic brain injury

International audienceINTODUCTION: Hypoxia-ischemia (HI) injury in term infants develops with a delay during the recovery phase, opening up a therapeutic window after the insult. Hypothermia is currently an established neuroprotective treatment in newborns with neonatal encephalopathy (NE), saving one in nine infants from developing neurological deficits. Caspase-2 is an initiator caspase, a key enzyme in the route to destruction and, therefore, theoretically a potential target for a pharmaceutical strategy to prevent HI brain damage. METHODS: The aim of this study was to explore the neuroprotective efficacy of hypothermia in combination with caspase-2 gene deficiency using the neonatal Rice-Vannucci model of HI injury in mice. RESULTS: HI brain injury was moderately reduced in caspase-2-imice as compared with wild-type (WT) mice. Five hours of hypothermia (33 degrees C) vs. normothermia (36 degrees C) directly after HI provided additive protection overall (temperature P = 0.0004, caspase-2 genotype P = 0.0029), in the hippocampus and thalamus, but not in other gray matter regions or white matter. Delayed hypothermia initiated 2 h after HI in combination with caspase-2 gene deficiency reduced injury in the hippocampus, but not in other brain areas. DISCUSSION: In conclusion, caspase-2 gene deficiency combined with hypothermia provided enhanced neuroprotection as compared with hypothermia alone