Universal difference? Understanding relationality and difference in transpersonal psychotherapy

As a working class, black, male, who is the son of immigrants who travelled from the Caribbean with the Windrush Generation, I often feel at odds with my psychotherapy profession, dominated as it is by middle class, white, women, who typically have a British family line flowing back generations. My sense of otherness is with me throughout my working day, in my psychotherapy practice, as I sit with a diverse range of clients within the complex context of contemporary ‘multicultural’ Britain. The sense of ‘the other’, the sense of myself as ‘other’ impacts on, and to some degree constitutes therapeutic relationality. Within most styles of psychotherapy difference is mainly understood in terms of the acknowledgement of the various categories, consideration of power imbalances, which we try as therapists to work with, work around, work through. But I am a transpersonal psychotherapist, and within this modality, there is very little consideration of ‘difference’, or otherness, except to highlight the apparent universality of us all. In this paper, we will explore ways of carving out a space within transpersonal ways of thinking to consider the relational context of therapy, and to explore the constitution of ‘othering’ within this transpersonal therapeutic context. This paper outlines how the use of creative techniques common to Transpersonal psychotherapy, such as visualisations, drawing, and Sand Tray work can be used in research on therapy to explore the emotional bodily and relational experience of difference, between therapist and client, and between researcher and researche

'I don't know if you want to know this': Carers' understandings of intimacy in long-term relationships when one partner has dementia

This article explores experiences of relational intimacy (including sexual intimacy) in long- term relationships when one partner has dementia. An emerging body of research focuses on living with dementia, but work on relationships between people with dementia and their family and loved ones tends to focus on understanding the experience of caring and on constructs like ‘care burden’ (Etters, Goodall and Harrison 2008: 423). Research concerned with the lived experience of relationships themselves is less frequent, and very little published work focuses experiences of sex and intimacy. This qualitative study explores how six participants experience their intimate relationships with their partners with dementia. Semi-structured interviews provided a rich source of data which were analysed using interpretive phenomenological analysis. Three master themes emerged from our analysis: a) everydayness, b) absent presence, and c) I don’t know if you want to know this. Participants explored how living with dementia constructed specific, everyday relational challenges, and disrupted everyday intimacies. Intimacy, including sexual intimacy, remains an important element of older couple relationships. Relational experiences present specific and difficult to articulate experiences for the partners of people living with dementia – particularly experiences related to sex and sexuality. Representations of older adults (particularly older adults with a long term illness) as relatively asexual beings can make elements of these relational challenges particularly difficult to express

Capturing cases of distal symmetric polyneuropathy in a community

Introduction: Little is known about what constitutes appropriate diagnostic testing in patients with distal symmetric polyneuropathy (DSP). Methods: Utilizing an ICD‐9 screening method and medical record abstraction, we determined the number of new cases of DSP within community neurology practices in Nueces County, Texas. We then compared 2 case capture methods (ICD‐9 vs. all‐case review screening). Results: The ICD‐9 case capture method identified 52 cases over a 3‐month period. Comparing case capture methods, the ICD‐9 method identified 16 of 17 cases identified by the all‐case review method (94%). The ICD‐9 method required screening of 84% fewer charts compared with the all‐case review. Conclusions: Many new cases of DSP occur each month within Nueces County. The ICD‐9 screening technique combined with medical abstraction is an efficient method to identify new DSP cases in this community. These findings are critical for future epidemiological investigations into patients with DSP. Muscle Nerve, 2012Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/94499/1/23449_ftp.pd

Choosing Wisely: Highest‐cost tests in outpatient neurology

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/98329/1/ana23865.pd

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Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/106672/1/ana24034.pd

Electrodiagnostic tests are unlikely to change management in those with a known cause of typical distal symmetric polyneuropathy

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/138297/1/mus25713_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/138297/2/mus25713.pd

Virulence of an emerging respiratory pathogen, genus Pandoraea, in vivo and its interactions with lung epithelial cells

Pandoraea species have emerged as opportunistic pathogens among cystic fibrosis (CF) and non-CF patients. Pandoraea pulmonicola is the predominant Pandoraea species among Irish CF patients. The objective of this study was to investigate the pathogenicity and potential mechanisms of virulence of Irish P. pulmonicola isolates and strains from other Pandoraea species. Three patients from whom the P. pulmonicola isolates were isolated have since died. The in vivo virulence of these and other Pandoraea strains was examined by determining the ability to kill Galleria mellonella larvae. The P. pulmonicola strains generally were the most virulent of the species tested, with three showing a comparable or greater level of virulence in vivo relative to another CF pathogen, Burkholderia cenocepacia, whilst strains from two other species, Pandoraea apista and Pandoraea pnomenusa, were considerably less virulent. For all Pandoraea species, whole cells were required for larval killing, as cell-free supernatants had little effect on larval survival. Overall, invasive Pandoraea strains showed comparable invasion of two independent lung epithelial cell lines, irrespective of whether they had a CF phenotype. Pandoraea strains were also capable of translocation across polarized lung epithelial cell monolayers. Although protease secretion was a common characteristic across the genus, it is unlikely to be involved in pathogenesis. In conclusion, whilst multiple mechanisms of pathogenicity may exist across the genus Pandoraea, it appears that lung cell invasion and translocation contribute to the virulence of P. pulmonicola strains

Docosahexaenoic acid stability in ready-to-use therapeutic food

Ready-to-use therapeutic food (RUTF) is used to treat young children diagnosed with severe acute malnutrition. RUTF with low and balanced linoleic and alpha-linolenic acid, plus omega-3 docosahexaenoic acid (DHA), supports long-term cognitive recovery. DHA is prone to degradation due to peroxidation, possibly exacerbated by the iron inherently in RUTF. Our goals were to prepare benchtop and manufacturing scale of RUTF formulations that include DHA and measure its retention. Twenty-seven RUTF formulas with base ingredients, including oats, high oleic or commodity peanuts, and encapsulated or oil-based DHA at various levels were prepared at benchtop scale, followed by seven months of climate-controlled storage. These pilot samples had similar relative DHA retention. At the manufacturing scale, DHA was added at one of two stages in the process, either at the initial or the final mixing stage. Samples taken at preliminary or later steps show that less than 20% of DHA added at the early stages disappeared prior to packaging for any recipe tested. Overall, our data indicate that most DHA included in RUTF is retained in the final product and that DHA is best retained when added at the latest manufacturing stage

A prescription for the Epley maneuver: www.youtube.com?

OBJECTIVES: Video-sharing Web sites are being used for information about common conditions including dizziness. The Epley maneuver (EM) is a simple and effective treatment for benign paroxysmal positional vertigo (BPPV) of the posterior canal. However, the maneuver is underused in routine care. In this study, we aimed to describe and analyze the available information about the EM on youtube.com. METHODS: A YouTube search was performed on August 31, 2011, for videos that demonstrated the entire EM. Detailed data were abstracted from each video and corresponding Web site. Videos were rated on the accuracy of the maneuver by 2 authors, with differences resolved by adjudication. Comments posted by viewers were assessed for themes regarding video use. RESULTS: Of the 3,319 videos identified, 33 demonstrated the EM. The total number of hits for all videos was 2,755,607. The video with the most hits (802,471) was produced by the American Academy of Neurology. Five of the videos accounted for 85% of all the hits. The maneuver demonstration was rated as accurate in 64% (21) of the videos. Themes derived from the 424 posted comments included patients self-treating with the maneuver after reviewing the videos, and providers using the videos as a prescribed treatment or for educational purposes. CONCLUSION: Accurate video demonstration of the Epley maneuver is available and widely viewed on YouTube. Video-sharing media may be an important way to disseminate effective interventions such as the EM. The impact of video Web sites on outcomes and costs of care is not known and warrants future study