Editorial: Special Issue: Relational trauma and family therapy

No abstract is available for this editorial

Differentiation of self: Enhancing therapist resilience when working with relational trauma

Clinicians are charged with being diligent in gaining competency in the latest trauma‐informed interventions when working with relational trauma. This may invest therapists with an overresponsibility that is not only overwhelming and unrealistic, but serves to reduce autonomous functioning in family members. Therefore, clinicians need to become clear about what they are responsible for and what they are not, particularly when family members present as irresponsible or too anxious to think and act more effectively. Using a case vignette, this paper discusses how a clinician\u27s focus on increasing their differentiation of self, a concept embeded in Bowen family systems theory, protects against vicarious traumatisation, secondary traumatic stress, and burnout whilst contributing to more autonomous functioning and better wellbeing outcomes for both clinicians and clients alike

Payer le prix? Conciliation travail universitaire et famille pendant la pandémie de la COVID-19

Introduction: The shift to remote working/learning to slow transmission of the SARS-CoV-2 virus has had widespread mental health impacts. We aimed to describe how the COVID-19 pandemic impacted the mental health of students and faculty within a health sciences faculty at a central Canadian university. Methods: Via an online survey, we queried mental health in the first four months of the COVID-19 pandemic quantitatively (scale: 1 (most negative)-100 (most positive)) and qualitatively. Results: The sample (n = 110) was predominantly women (faculty 39/59; [66.1%]; students 46/50; [92.0%]). Most faculty were married/common law (50/60; [84.8%]) and had children at home (36/60; [60.0%]); the opposite was true for most students.  Faculty and students self-reported comparable mental health (40.47±24.26 and 37.62±26.13; respectively). Amongst women, those with vs. without children at home, reported significantly worse mental health impacts (31.78±23.68 vs. 44.29±27.98; respectively, p = 0.032). Qualitative themes included: “Sharing resources,” “spending money,” “few changes,” for those without children at home; “working at home can be isolating,” including the subtheme, “balancing act”: “working in isolation,” “working more,” for those with children at home. Discussion: Amongst women in academia, including both students and faculty, those with children at home have disproportionately worse mental health than those without children at home.Introduction : Le virage vers le travail et l’enseignement à distance pour ralentir la transmission du virus SRAS-CoV-2 a eu des répercussions étendues sur la santé mentale. Notre étude vise à décrie l’impact de la pandémie de la COVID-19 sur la santé mentale des étudiants et du corps professoral au sein Faculté des sciences de la santé d’une université du centre du Canada. Méthodes : Un questionnaire en ligne a été administré pour récolter des données qualitatives et quantitatives (échelle : de 1 [le plus négatif] à 100 [le plus positif] à l’égard de la santé mentale des participants au cours des quatre premiers mois de la pandémie. Résultats : L’échantillonnage (n = 110) était majoritairement composé de femmes (membres du corps professoral : 39/59 ou 66,1 %; étudiantes 46/50 ou 92,0 %). La plupart des répondants du corps professoral étaient mariés ou en union libre (50/60 ou 84,8 %) et avaient des enfants à la maison (36/60 ou 60,0 %). Le contraire était vrai pour la plupart des étudiants. L’état de santé mentale déclaré par le corps professoral et les étudiants était comparable (40,47±24,26 et 37,62±26,13 respectivement). Parmi les femmes, autant celles qui avaient des enfants à la maison que celles qui n’en avaient pas, ont déclaré que leur santé mentale était nettement moins bonne (31,78±23,68 contre 44,29±27,98 respectivement; p = 0,032). Pendant l’analyse des données qualitatives, on a identifié les thèmes « le partage de ressources », « les dépenses » et « peu de changements » pour les répondants qui n’avaient pas d’enfants à la maison alors que les thème « le télétravail accentue l’isolement », ainsi que lessous-thèmes « maintien de l’équilibre : travailler en isolement’’ et ‘’travailler plus » ont émergé pour ceux qui avaient des enfants à la maison. Discussion : Parmi les femmes œuvrant dans le milieu universitaire, qu’elles soient étudiantes ou membres du corps professoral, la santé mentale de celles qui ont des enfants à la maison est davantage affectée que celle des femmes qui n’en ont pas

Impact of the Anesthesiologist and Surgeon on Cardiac Surgical Outcomes

ObjectiveTo determine the impact of anesthesiologists, surgeons, and their monthly caseload volume on mortality after cardiac surgery.DesignTen-year audit of prospectively collected cardiac surgical data.SettingLarge adult cardiothoracic hospital.ParticipantsA total of 18,569 cardiac surgical patients in the decade from April 2002 through March 2012, plus 21 consultant surgeons and 29 consultant anesthesiologists.InterventionsMajor risk-stratified cardiac surgical operations.MethodsThe primary outcome was in-hospital death. Random intercept models for the surgeon and anesthesiologist cluster, respectively, were fitted, achieving risk-adjustment through the logistic EuroSCORE. The intraclass correlation coefficient (ICC) subsequently was used to measure the amount of outcome variation due to clustering.Measurements and Main ResultsAfter exclusions (duplicates, very-short-term appointments, and cases performed by more than one consultant), there were 18,426 patients with 581 (3.15%) in-hospital deaths. The overwhelming factor associated with outcome variation was the patient risk profile, accounting for 97.14% of the variation. The impact of the surgeon was small (ICC = 2.78%), and the impact of the anesthesiologist was negligible (ICC = 0.08%). Low monthly surgeon volume of surgery, adjusted for average case mix, was associated with higher risk-adjusted mortality (odds ratio = 0.93, 95% CI 0.87-0.98).ConclusionsOutcome was determined primarily by the patient. There were small but significant differences in outcome between surgeons. The attending anesthesiologist did not affect patient outcome in this institution. Low average monthly surgeon volume was a significant risk factor. In contrast, low average monthly anesthesiologist volume had no effect

Predicting and understanding the stability of G-quadruplexes

Motivation: G-quadruplexes are stable four-stranded guanine-rich structures that can form in DNA and RNA. They are an important component of human telomeres and play a role in the regulation of transcription and translation. The biological significance of a G-quadruplex is crucially linked with its thermodynamic stability. Hence the prediction of G-quadruplex stability is of vital interest

How do anxiety and relationship factors influence the application of childbirth education strategies during labor and birth : a Bowen family systems perspective

The effectiveness of childbirth education (CBE) has long been debated with studies showing contradictory outcomes for mothers and babies. Understanding how what is learned in CBE is translated into practice during labor and birth is an area that requires investigation as this may be a mediating factor in its effectiveness. Bowen family system theory’s concept of differentiation of self, the ability to be guided by and to act from one’s beliefs and values, is an organizing principle that may affect how relational factors affect the use and application of CBE at the time of birth. The ability to act with emotional maturity when faced with a stressor, such as childbirth, depends on an individual’s capability to separate thoughts from the more reactive feeling process. Recognizing how one’s level of differentiation interacts with the anxious responses of others may assist pregnant women and birth partners to make decisions more objectively about how they want to manage the birthing process. For the health professional, understanding the interplay of relationship variables, physiological stress, anxiety and individual reactivity may allow for the provision of more thoughtful evidence-based practice, which may increase objectivity, and aid communication and decision-making for women during birth. Bowen theory, as a comprehensive systems-based approach to understanding human functioning under stress, offers a novel approach to exploring the application of CBE during birth

You’re in your own time now: Understanding current experiences of transition to civilian life In Scotland. Interim Report

This report is structured as follows:❖ Chapter 2 briefly outlines the background and context for the research.❖ Chapter 3 outlines the research framework in relation to the mixed qualitative and quantitative methodologies and discusses the research design.❖ Chapter 4 provides an overview of the literature on what is known in relation to military to civilian transition in Scotland.❖ Chapter 5 discusses the early quantitative findings as well as the early findings from key stakeholders to capture the most significant changes to transition in Scotland.❖ Chapter 6 presents our conclusion and outlines our approach for Phase 2 and 3 of the study

You’re in your own time now: Understanding current experiences of transition to civilian life In Scotland. Interim Report

This report is structured as follows:? Chapter 2 briefly outlines the background and context for the research.? Chapter 3 outlines the research framework in relation to the mixed qualitative and quantitative methodologies and discusses the research design.? Chapter 4 provides an overview of the literature on what is known in relation to military to civilian transition in Scotland.? Chapter 5 discusses the early quantitative findings as well as the early findings from key stakeholders to capture the most significant changes to transition in Scotland.? Chapter 6 presents our conclusion and outlines our approach for Phase 2 and 3 of the study