Accomplishing intimacy : self and relationships in the counselling context.

SIGLEAvailable from British Library Document Supply Centre-DSC:DXN011724 / BLDSC - British Library Document Supply CentreGBUnited Kingdo

The Senatorial Years of Hugo Black

This thesis examines the life of Hugo Lafayette Black from his early years in Clay County, Alabama, through his time at the University of Alabama\u27s law school, his judicial and senatorial career

FAILURE OF U.S. DRUG POLICY: WOMEN AND THE OPIOID CRISIS

Over a century of drug policy and law has failed to stop the flow of illegal drugs into the U.S. Drug policy and law have focused on reducing the supply of illicit drugs but have failed to consider factors that influence the demand for those drugs. The U.S. now faces an unprecedented crisis of opioid use, abuse, overdose, and death largely due to these failures.A gap analysis was conducted to identify shortcomings in existing policy. Gap analysis is used to determine whether a policy as written reaches desired goals and outcomes through its implementation. Biopsychosocial theory (BPS) was used to frame the recommendations for policy change. The BPS framework of human behavior and well-being encompasses all known influences on a person when attempting to diagnose or treat an illness, permitting a thorough examination of a policy’s ability to meet the needs of a population. The gap analysis shows the current policy does not produce desired outcomes in terms of drug abuse prevention, and women are affected more negatively than men. Women are at greater risk of losing their children, losing their jobs, being unable to find educational resources, and becoming homeless if they become addicted to opioids. The BPS suggests a shift in policy and law from supply reduction to demand reduction, which is critical to the future of women most at risk for drug abuse, overdose, and death.Civilian, Department of Social Services, State of CaliforniaApproved for public release. Distribution is unlimited

Courtly banter in The Duchess of Malfi (iii.ii.1-57): not “so merry”

Situated midway through the play in the Duchess’s bedchamber, act III scene ii is the fulcrum of The Duchess of Malfi. The Duchess enters the scene and her bedchamber a free woman, she leaves it a virtual prisoner. Coming after two acts that have covered several years since the beginning of the play, this intense night scene unfolds in a swift succession of sequences, all revolving around the Duchess. This essay focuses on the first sequence, a domestic, seemingly light-hearted moment (lines 1-57) that brings together the Duchess, her husband, Antonio, and her maid, Cariola. Looking at the use of courtly rhetoric in a scene framed by references to personal appearance (jewellery and hairdo), this article suggests that the impression of happiness and the tropes of a wooing scene are undermined by a sense of displacement and inappropriateness. John Webster draws on recognisable codes to subvert them: the mythological references and conventions of courtly discourse are there, but in the wrong place. Words, props and gestures are transformed and distorted.Située au cœur de la pièce, dans la chambre de la Duchesse, l’acte III scène ii est le moment pivot de La Duchesse d’Amalfi. La Duchesse pénètre sur scène et dans sa chambre une femme libre, c’est en prisonnière virtuelle qu’elle quitte les lieux. Venant après deux actes qui ont vu plusieurs années s’écouler depuis le début de la pièce, cette scène de nuit intense se déploie en une succession rapide de séquences qui tournent autour de la Duchesse. Cet article s’intéresse à la première séquence, un moment de domesticité apparemment léger (vers 1-57) qui réunit la Duchesse, son époux, Antonio, et sa servante, Cariola. Une analyse de l’utilisation de la rhétorique de cour dans une scène de chambre encadrée par des références à l’apparence personnelle (les bijoux et la coiffure) fait apparaître que l’impression de bonheur et les tropismes d’une scène de cour sont minés par un sentiment de déplacement et d’inadéquation. John Webster utilise des codes que le spectateur ou le lecteur croit reconnaître, pour mieux les subvertir : les références mythologiques et les conventions du discours amoureux sont présentes, mais au mauvais endroit. Les mots, les accessoires et la gestuelle sont transformés et déformés

“As she had some good, so had she many bad parts”: Semiramis’ Transgressive Personas

Bâtisseuse de Babylone et d’autres cités, guerrière, impératrice et amante, Sémiramis inspira aux auteurs de l’Antiquité de nombreux récits contrastés de ses faits et gestes. Les Pères de l’Église, dont Saint Augustin, l’associaient à la cité de Babylone et, en prolongement, à la tour de Babel. Le présent article explore quelques facettes de la figure de Sémiramis telle qu’elle s’est recomposée dans des textes européens de la fin du Moyen Âge et de la première modernité, et d’étudier les représentations contrastées qui en découlèrent dans la littérature anglaise, grâce au matériau qui circulait dans les dictionnaires et les traductions. Il en ressort une figure plurielle, lieu d’interaction des traditions mythologique et biblique, qui invite à une exploration et réévaluation des codes de représentation de la femme et de l’homme

REMCARE : pragmatic multi-centre randomised trial of reminiscence groups for people with dementia and their family carers : effectiveness and economic analysis

Background Joint reminiscence groups, involving people with dementia and family carers together, are popular, but the evidence-base is limited. This study aimed to assess the effectiveness and cost-effectiveness of joint reminiscence groups as compared to usual care. Methods This multi-centre, pragmatic randomised controlled trial had two parallel arms: intervention group and usual-care control group. A restricted dynamic method of randomisation was used, with an overall allocation ratio of 1:1, restricted to ensure viable sized intervention groups. Assessments, blind to treatment allocation, were carried out at baseline, three months and ten months (primary end-point), usually in the person's home. Participants were recruited in eight centres, mainly through NHS Memory Clinics and NHS community mental health teams. Included participants were community resident people with mild to moderate dementia (DSM-IV), who had a relative or other care-giver in regular contact, to act as informant and willing and able to participate in intervention. 71% carers were spouses. 488 people with dementia (mean age 77.5) were randomised: 268 intervention, 220 control; 350 dyads completed the study (206 intervention, 144 control). The intervention evaluated was joint reminiscence groups (with up to 12 dyads) weekly for twelve weeks; monthly maintenance sessions for further seven months. Sessions followed a published treatment manual and were held in a variety of community settings. Two trained facilitators in each centre were supported by volunteers. Primary outcome measures were self-reported quality of life for the person with dementia (QoL-AD), psychological distress for the carer (General Health Questionnaire, GHQ-28). Secondary outcome measures included: autobiographical memory and activities of daily living for the person with dementia; carer stress for the carer; mood, relationship quality and service use and costs for both. Results The intention to treat analysis (ANCOVA) identified no differences in outcome between the intervention and control conditions on primary or secondary outcomes (self-reported QoL-AD mean difference 0.07 (-1.21 to 1.35), F = 0.48, p = 0.53). Carers of people with dementia allocated to the reminiscence intervention reported a significant increase in anxiety on a General Health Questionnaire-28 sub-scale at the ten month end-point (mean difference 1.25 (0.25 to 2.26), F = 8.28, p = 0.04). Compliance analyses suggested improved autobiographical memory, quality of life and relationship quality for people with dementia attending more reminiscence sessions, however carers attending more groups showed increased care-giving stress. Economic analyses from a public sector perspective indicated that joint reminiscence groups are unlikely to be cost-effective. There were no significant adverse effects attributed to the intervention. Potential limitations of the study include less than optimal attendance at the group sessions—only 57% of participants attended at least half of the intervention sessions over the 10 month period, and a higher rate of study withdrawal in the control group. Conclusions This trial does not support the clinical effectiveness or cost-effectiveness of joint reminiscence groups. Possible beneficial effects for people with dementia who attend sessions as planned are offset by raised anxiety and stress in their carers. The reasons for these discrepant outcomes need to be explored further, and may necessitate reappraisal of the movement towards joint interventions

Distance to food stores & adolescent male fruit and vegetable consumption: mediation effects

<p>Abstract</p> <p>Background</p> <p>The physical environments in which adolescents reside and their access to food stores may influence their consumption of fruit and vegetables. This association could either be direct or mediated via psychosocial variables or home availability of fruit and vegetables. A greater understanding of these associations would aide the design of new interventions. The purpose of this study was to examine associations between distance to food stores and restaurants and fruit and vegetable consumption and the possible mediating role of psychosocial variables and home availability.</p> <p>Methods</p> <p>Fruit and vegetable consumption of 204 Boy Scouts was assessed by a food frequency questionnaire in 2003. Participant addresses were geo-coded and distance to different types of food stores and restaurants calculated. Fruit and vegetable preferences, home availability and self-efficacy were measured. Regression models were run with backward deletion of non-significant environmental and psychosocial variables. Mediation tests were performed.</p> <p>Results</p> <p>Residing further away from a small food store (SFS) (convenience store and drug store) was associated with increased fruit and juice and low fat vegetable consumption. Residing closer to a fast food restaurant was associated with increased high fat vegetable and fruit and juice consumption. Vegetable preferences partially mediated (26%) the relationship between low fat vegetable consumption and distance to the nearest SFS.</p> <p>Conclusion</p> <p>Distance to SFS and fast food restaurants were associated with fruit and vegetable consumption among male adolescents. Vegetable preferences partially mediated the distance to low fat vegetable relationship. More research is needed to elucidate how environmental variables impact children's dietary intake.</p

Development of scales to assess children's perceptions of friend and parental influences on physical activity

<p>Abstract</p> <p>Background</p> <p>Many children do not meet physical activity guidelines. Parents and friends are likely to influence children's physical activity but there is a shortage of measures that are able to capture these influences.</p> <p>Methods</p> <p>A new questionnaire with the following three scales was developed: 1) <it>Parental influence on physical activity</it>; 2) <it>Motives for activity with friends </it>scale; and 3) <it>Physical activity and sedentary group normative values</it>. Content for each scale was informed by qualitative work. One hundred and seventy three, 10-11 year old children completed the new questionnaire twice, one week apart. Participants also wore an accelerometer for 5 days and mean minutes of moderate to vigorous physical activity, light physical activity and sedentary time per day were obtained. Test-retest reliability of the items was calculated and Principal Component analysis of the scales performed and sub-scales produced. Alphas were calculated for main scales and sub-scales. Correlations were calculated among sub-scales. Correlations between each sub-scale and accelerometer physical activity variables were calculated for all participants and stratified by sex.</p> <p>Results</p> <p>The Parental influence scale yielded four factors which accounted for 67.5% of the variance in the items and had good (α > 0.7) internal consistency. The Motives for physical activity scale yielded four factors that accounted for 66.1% and had good internal consistency. The Physical activity norms scale yielded 4 factors that accounted for 67.4% of the variance, with good internal consistency for the sub-scales and alpha of .642 for the overall scale. Associations between the sub-scales and physical activity differed by sex. Although only 6 of the 11 sub-scales were significantly correlated with physical activity there were a number of associations that were positively correlated >0.15 indicating that these factors may contribute to the explanation of children's physical activity.</p> <p>Conclusion</p> <p>Three scales that assess how parents, friends and group normative values may be associated with children's physical activity have been shown to be reliable and internally consistent. Examination of the extent to which these new scales improve our understanding of children's physical activity in datasets with a range of participant and family characteristics is needed.</p

Physical activity and sedentary behaviour typologies of 10-11 year olds

<p>Abstract</p> <p>Background</p> <p>Targeted interventions may be more effective at increasing children's physical activity. The aim of this study was to identify clusters of children based on physical activity and sedentary patterns across the week.</p> <p>Methods</p> <p>Participants were 761, 10-11 year old children. Participant's self-reported time spent in eight physical activity and sedentary contexts and wore an accelerometer. Cluster analysis was conducted on the time spent in the self-reported physical activity and sedentary contexts. Mean minutes of accelerometer derived of moderate to vigorous physical activity (MVPA) and sedentary time were derived for the entire week, weekdays only, weekend days and four different time periods across each type (weekend or weekday) of days. Differences in the physical activity patterns of the groups derived from the cluster analysis were assessed for overall physical activity as well as for the four time periods on weekdays and weekend days.</p> <p>Results</p> <p>Three clusters emerged: 1) High active/Low sedentary; 2) Low active/Moderate sedentary; and 3) High Active/High sedentary. Patterns of activity differed across the week for each group and the High Active/High sedentary obtained the most minutes of MVPA.</p> <p>Conclusions</p> <p>Patterns of physical activity and sedentary time differed across the week for each cluster. Interventions could be targeted to the key periods when each group is inactive.</p