What Are the Unique Clinical Experiences of Bilingual Couple Psychotherapists Whose Mothertongue Is Not English but Who Work in Their Mothertongue in an English-Speaking Professional Environment?

This phenomenological qualitative study arises from the context of the contemporary globalised field of couple psychotherapy and highlights unique clinical phenomena in an under-researched area. The aim is to identify the ways in which bilingual couple psychotherapists who have been trained and work in English professional environments, make sense of their clinical experiences when they use their mothertongue to conduct couple psychotherapy. Some literature addressing the issue of working in the mothertongue exists regarding individual psychotherapy. However, in the field of couple psychotherapy, attention has not been paid to the clinical implications resulting from the use of a language in which the practitioners have not been professionally trained. In accordance with the exploratory nature of this study, semi-structured interviews were specifically designed and conducted with nine English-trained bilingual couple psychotherapists. The emergent data was analysed using Interpretive Phenomenological Analysis. The analysis identified four major themes: ‘Dualness’; ‘Embracing English Speaking Identities’; ‘Clinical Advantages of working in the mothertongue’ and ‘Clinical Challenges of working in the mothertongue’. Unconscious elements of the bilingual participants’ subjective processes connected to each language are identified, lending themselves to the creation of a symbolic space. This space is understood through the development of the concept of ‘Internal Linguistic Liminality’. This concept illuminates key clinical issues relating to the bilingual participants’ unique internal emotive associations to the experience of the sound of their mothertongue and their impact on the therapeutic process. The ways that the use of the mothertongue influences moments of connection or disconnection between the participants and their same-mothertongue patients are explored. Innovative findings from this small scale study, generate clinical questions for the research field. It alerts the couple psychotherapy community of the need for appropriate training, supervisory and policy provision

Diminished Bone Formation During Diabetic Fracture Healing Is Related to the Premature Resorption of Cartilage Associated with Increased Osteoclast Activity

Histological and molecular analysis of fracture healing in normal and diabetic animals showed significantly enhanced removal of cartilage in diabetic animals. Increased cartilage turnover was associated with elevated osteoclast numbers, a higher expression of genes that promote osteoclastogenesis, and diminished primary bone formation. Introduction Diminished bone formation, an increased incidence of nonunions, and delayed fracture healing have been observed in animal models and in patients with diabetes. Fracture healing is characterized by the formation of a stabilizing callus in which cartilage is formed and then resorbed and replaced by bone. To gain insight into how diabetes affects fracture healing, studies were carried out focusing on the impact of diabetes on the transition from cartilage to bone. Materials and Methods A low-dose treatment protocol of streptozotocin in CD-1 mice was used to induce a type 1 diabetic condition. After mice were hyperglycemic for 3 weeks, controlled closed simple transverse fractures of the tibia were induced and fixed by intramedullary pins. Histomorphometric analysis of the tibias obtained 12, 16, and 22 days after fracture was performed across the fracture callus at 0.5 mm proximal and distal increments using computer-assisted image analysis. Another group of 16-day samples were examined by μCT. RNA was isolated from a separate set of animals, and the expression of genes that reflect the formation and removal of cartilage and bone was measured by real-time PCR. Results Molecular analysis of collagen types II and X mRNA expression showed that cartilage formation was the same during the initial period of callus formation. Histomorphometric analysis of day 12 fracture calluses showed that callus size and cartilage area were also similar in normoglycemic and diabetic mice. In contrast, on day 16, callus size, cartilage tissue, and new bone area were 2.0-, 4.4-, and 1.5-fold larger, respectively, in the normoglycemic compared with the diabetic group (p \u3c 0.05). Analysis of μCT images indicated that the bone volume in the normoglycemic animals was 38% larger than in diabetic animals. There were 78% more osteoclasts in the diabetic group compared with the normoglycemic group (p \u3c 0.05) on day 16, consistent with the reduction in cartilage. Real-time PCR showed significantly elevated levels of mRNA expression for TNF-α, macrophage-colony stimulating factor, RANKL, and vascular endothelial growth factor-A in the diabetic group. Similarly, the mRNA encoding ADAMTS 4 and 5, major aggrecanases that degrade cartilage, was also elevated in diabetic animals. Conclusions These results suggest that impaired fracture healing in diabetes is characterized by increased rates of cartilage resorption. This premature loss of cartilage leads to a reduction in callus size and contributes to decreased bone formation and mechanical strength frequently reported in diabetic fracture healing

One Language and Two Mother Tongues in the Consulting Room: Dilemmas of a Bilingual Psychotherapist

The purpose of the present study is twofold: first, to explore the bilingual therapist's experience of working in a second language; and second, to explore the major functions of language within the therapeutic setting. Interpretative phenomenological analysis is used to explore in depth the experience of 16 bilingual therapists of different professional orientations: psychoanalysts, psychotherapists, counselling psychologists, clinical psychologists and counsellors. Semi-structured life-world interviews were employed in accordance with the exploratory nature of the research. Four major themes were identified: ‘Listening and understanding the client’; ‘Interventions and interpretations’; ‘Potential impact of language on the therapeutic encounter: Therapist's point of view’; and ‘Therapist's experience of self’. The data demonstrated differences in the understanding of functions of language within the therapeutic setting among psychotherapists. The importance of the symbolic functions of language in therapeutic discourse is discussed. In addition, the specifics of language within the therapeutic encounter are explored and outlined

Impaired fracture healing in diabetes may be due to increased osteoclast activity

PLEASE NOTE: This work is protected by copyright. Downloading is restricted to the BU community: please click Download and log in with a valid BU account to access. If you are the author of this work and would like to make it publicly available, please contact [email protected] (MSD) -- Boston University Goldman School of Dental Medicine, 2006 (Oral Biology)Includes bibliographic references : (leaves 56-69).It is well known that patients with diabetes type I exhibit significant problems with fracture healing due to delayed or inadequate bone formation. We tested the hypothesis that diabetes impairs the healing process by delaying or inhibiting chondrocyte apoptosis, thereby interfering with the conversion of cartilage to bone in the fracture callus. Chondrocyte apoptosis was examined in two groups of CD1 mice; the experimental group was rendered diabetic by multiple low dose strepozotocin treatment, which induces diabetes via an autoimmune response in the pancreas, and the control group was treated with vehicle alone, citrate buffer. A previously validated method was used to produce standardized tibial fractures and mice were sacrificed at 12, 16 and 22 days post-fracture. Samples were prepared for histomorphometric analysis. New bone, cartilage and chondroclast formation were determined using Van Gieson, Saffranin-O and TRAP staining, respectively. The TUNEL assay together with Saffranin-O staining was used to detect apoptotic chondrocytes, which were normalized per cartilage area. The center of the fracture callus was determined with the use of H&E stain and radiographically, and all measurements were made for the center of the fracture. There was 10-fold lower new bone formation in the diabetic group on day 12 compared to non-diabetic controls (p[less than]0.05). Although not as marked, less new bone formation was also found in the diabetic group on day 22 (p[less than]0.05). In contrast, on day 12 cartilage formation was similar between the two groups (p[more than]0.05), whereas on day 16 the diabetic group demonstrated about 50% less cartilage and this difference was significant (p[less than]0.05). Chondroclast number on day 12 was about 2.5-fold greater in the diabetic group (p[less than]0.05), possibly explaining the decreased amount of cartilage on day 16. Most interestingly, the number of apoptotic chondrocytes was 4-fold lower (p[less than]0.05) in the diabetic group for both days 12 and 16. These results indicate that diabetes may affect fracture healing by increased formation of chondroclasts and diminished apoptosis of chondrocytes, consistent with delayed and diminished conversion of cartilage to bone

GRADUATE STUDENT SATISFACTION WITH THEIR EDUCATION AND ITS RELATIONSHIP TO DEGREE COMPLETION

Graduate students enrolled in chemistry (N = 94), electrical engineering (N = 109), English (N = 66), and psychology (N = 78) at Purdue University expressed level of satisfaction with various aspects of their programs and views toward graduate education. Data were collected by means of a survey questionnaire (Purdue Graduate Student Survey). The internal reliability and construct validity of the instrument used suggest that it is relevant for diagnosing student satisfaction, productivity, and persistence. Chi-square analyses were employed to examine the data. Results indicated that marital status was related to gender and degree objective, age was related to degree objective and departmental affiliation, and citizenship was related only to departmental affiliation. Undergraduate background and expected graduation date were related to all three variables, while work load, length and stage of graduate study were related only to degree objective and field of study. While pattern of social interaction with peers within departments was related to all three major variables, professional recognition (paper presentation/publication) and sources of financial support were related only to departmental affiliation and degree objective. Level of satisfaction with graduate program/faculty and views toward graduate education were not related significantly to gender or degree objective. Women were somewhat less satisfied than men, and Master\u27s students more uncertain than PhD candidates concerning graduate study. On the other hand, departmental affiliation was related significantly to expressed levels of program satisfaction and views toward graduate education. Few students indicated they would change their major, transfer to another university, or drop out of graduate study. Factor analyses indicated that satisfaction with graduate programs depended primarily on perceived program quality and efficiency and, secondarily, to faculty-student interaction. Views toward graduate education reflected perceptions of (a) faculty responsiveness to students, (b) student scholarship/disillusionment, (c) program difficulty, and (d) program product quality. Minor interdepartmental differences were observed. The factors most likely to prevent degree completion were emotional strain and disillusionment with graduate education. Students generally expressed satisfaction with their major but were less satisfied with the degree to which the respective department had lived up to their expectations