Systems psychodynamic coaching for leaders in career transition

The post-modern economy has altered the career landscape – career trajectories are now far more fluid and unpredictable, punctuated by multiple occupational changes, increased job mobility and more frequent and increasingly difficult job transitions. Leaders are frequently ill-prepared for the changing world of work that is progressively dominated by self-managed careers. Taking on a new role is fraught with complexity - for the “chosen one” and for organisations. The implications of successful, failed or derailed job transitions can have strategic and other ramifications for organisations and individuals alike. This study explores the career transition experiences of and the usefulness of career transition executive coaching for eleven individual leaders from various South African organisations. It is a descriptive, explanatory and exploratory qualitative study, employing the systems psychodynamic paradigm, chosen because it focuses on depth psychology and is a developmentally oriented, psycho-educational organisational theory. The study adopted an interpretive stance for understanding leaders’ systemic conscious and unconscious behaviour. The ACIBART model helped to interpret the experiences of leaders in transition. These transitions involve the taking and making of a role, implying the loss which attends leaving a previous role, and adjustment to and being authorised in a new, unfamiliar role, including a liminal period of being “in between”. This inevitably produces an inner drama in which internalised past figures, possibly related to the new role, are brought back to life, and perhaps even amplified in the present. These “unconscious echoes” explain the powerful emotions that frequently attend transitions, especially at the so-called mid-life, and which in turn activate various defence mechanisms. The systems psychodynamic approach to career transition coaching was particularly useful in helping the participants identify personal patterns and link these to their past and thereby develop personal awareness and insight. The “coaching space” thus became a containing, “transitional space” where the participants could safely do the work required to make the adjustment to their new roles. Finally, recommendations to various stakeholders regarding the provision of systems psychodynamic coaching for leaders in career transition are made.PsychologyD. Phil. (Psychology

The Use of Senior Volunteers in the Care of Discharged Geriatric Patients

This article reports on a project that utilized senior volunteers in the role of health advocates for geriatric patients discharged from a hospital. The project was evaluated to determine if healthy and active seniors could make a contribution to the health and social welfare of such discharged elderly persons. The study was conducted in Montreal, Canada and funded by a federal grant from Health Canada. The research collaborators came from a 414-bed secondary care university-affiliated community hospital, a community social service agency with a mandate to respond to the needs of its frail elderly constituents, and a university-based research centr

Open Circuit Potential Shifts of Activated Carbon in Aqueous Solutions During Chemical and Adsorption Interactions

Interaction of certain inorganic and organic compounds with activated carbon and the effect of such interaction on open circuit potential of activated carbon were studied. Open circuit potential shifts were observed for an overwhelming majority of the substances and brands of activated carbons investigated. Both negative and positive potential shifts were observed. It was shown that open circuit potential shifts for organic substances depend on degree of coverage of the activated carbon surface. Whereas adsorption of investigated organic compound on activated carbon led to positive potential shifts, desorption of adsorbates from the activated carbon surface led to potential shifts in the opposite direction. Furthermore, time dependencies of open circuit potential shifts were similar for different carbon brands. The magnitude of the shifts depended on the adsorbate, adsorption activity of the adsorbent, and the steric configuration of potential-determinative pores and adsorbate molecules

The Role of Liver Fibrosis Assessment in the Management of Patients with Chronic Hepatitis B Infection: Lessons Learned from a Single Centre Experience

Background & Aims. Assess the clinical utility of the Prati criteria and normal ALT (<40 IU/L) in a cohort of patients with chronic hepatitis B infection (CHB). Methods. Serology, radiology, and histology were obtained in 140 patients with CHB. Results. HBeAg+ group: 7 patients (7/56−12% HBeAg+ group) misclassified as “immunotolerant”, with HBV DNA > 6 log copies/ml and normal ALT, who in fact had moderate/severe fibrosis on liver biopsy. HBeAg− group: 10 patients with normal ALT and moderate/severe fibrosis on liver biopsy; 4 of these patients had >3 log copies/ml HBV DNA levels and 6 patients misclassified as “inactive carriers” with negative HBV DNA levels normal ALT and moderate/severe fibrosis (6/84−7% HBeAg− group). Two male HBeAg+ and three male HBeAg− patients with ALT between 20 and 30 IU/L and moderate/severe fibrosis on liver biopsy would have been further mischaracterised using the Prati criteria for normal ALT. Age and ethnic group were more important predictors of moderate/severe fibrosis in multivariate analysis. Conclusion. HBeAg status, age, ethnic origin with longitudinal assessment of LFTs and viral load should be studied in patients with “normal ALT” at the upper end of normal range (ALT 20–40 IU/L) to appropriately classify patients and identify patients for liver fibrosis assessment to inform treatment decisions

Monoclonal gammopathy of undetermined significance and risk of lymphoid and myeloid malignancies: 728 cases followed up to 30 years in Sweden.

To access publisher's full text version of this article. Please click on the hyperlink in Additional Links field.In 728 Swedish cases of monoclonal gammopathy of undetermined significance (MGUS), followed up to 30 years (median, 10 years), we estimated the cumulative risk of hematologic disorders originating from lymphoid and myeloid lineages. Using Cox regression models, we examined associations of demographic and laboratory factors with progression and determined the discriminatory power of 3 prediction models for progression. Eighty-four MGUS cases developed a lymphoid disorder, representing a cumulative risk of 15.4%. Multiple myeloma (MM) occurred in 53 patients, and the 30-year cumulative risk was 10.6%; an ∼0.5% annual risk. Three factors were significantly associated with progression: abnormal free light-chain (FLC) ratio (1.65), M-protein concentration (≥1.5 g/dL), and reduction of 1 or 2 noninvolved immunoglobulin isotype levels (immunoparesis). A prediction model with separate effects for these 3 factors and the M-protein isotype had higher discriminatory power than other models, although the differences were not statistically significant. The 30-year cumulative risk for myeloid malignancies was 1.5 g/dL, factors previously considered by Mayo Clinic researchers, are predictors for MM progression and suggests that separate consideration of immunoparesis and the Mayo Clinic risk factors could improve identification of MGUS patients at high risk for progression

Monocyte-macrophage activation is associated with nonalcoholic fatty liver disease and liver fibrosis in HIV monoinfection independently of the gut microbiome and bacterial translocation

Background: Nonalcoholic fatty liver disease (NAFLD) is common among people living with HIV. There are limited data available on the pathophysiology of NAFLD and the development of fibrosis in this population. Objectives: The aim of this study was to investigate the association of bacterial translocation, adipose tissue dysfunction, monocyte activation and gut dysbiosis in patients with HIV monoinfection and NAFLD. Methods: Cases with biopsy-proven NAFLD and HIV monoinfection were age and sexmatched to HIV-positive and HIV-negative controls. Markers of bacterial translocation [lipopolysaccharide-binding protein (LBP), bacterialDNAand lipopolysaccharide (LPS)], adipose tissue dysfunction (leptin, adiponectin) and monocyte activation (sCD14 and sCD163) were measured by ELISA. Hepatic patterns of macrophage activation were explored with immunohistochemistry. 16 s rRNA sequencing was performed with stool. Results: Thirty-three cases were included (F2 fibrosis n¼16), matched to HIV-positive (n¼29) and HIV-negative (n¼17) controls. Cases with NAFLD were more obese (BMI 31.04.4 vs. 24.12.8 kg/m2, P<0.001) and had significantly increased levels of sCD14, sCD163 and higher leptin to adiponectin ratio vs. HIV-positive controls. Cases with F2 verse