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Medium 9781930538757

3 Getting Started: Finding Ideas for Research

Christine Hedges Sigma Theta Tau International ePub

“The journey of a thousand miles begins with a single step. Let your journey begin.”

–Chinese philosopher Lao-tzu

Marianne Chulay


• Your own clinical experience is a good place to start for research ideas.

• Myriad other resources can help you find a good research idea.

• Good potential research questions have important characteristics that you should adhere to when devising your question.

• A formal rating process will help you to objectively evaluate your potential research study.

After you have a strong supportive research infrastructure in place, you can begin to think about topics for research studies. The first step in the research journey is to identify a topic for a research study. Of all the steps in the research process, none could be more important than finding a good research idea that can lead to a potential research question. If you rush through this beginning step without making sure you select a research question appropriate to your practice situation that is feasible for conduct by clinicians and important to patient care, you could go down a path that will make completion of your research journey difficult or impossible.

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Medium 9781855752627

CHAPTER FIVE. Body language and verbalization: the analysis of an acute psychotic crisis

Salomon Resnik Karnac Books ePub

In this chapter I discuss the analysis of a female psychotic patient whom I treated over several years. I deal particularly with the period corresponding to the acute psychotic crisis; it was then that primary models of object relation appeared with maximum clarity in the transference.

In the previous chapter, I referred to the idea of communication and in particular to that rudimentary form of communication consisting primarily of body language which is so typical of both the young infant and the psychotic adult. I return to that theme here and deal particularly with its influence on the transference situation. The first encounter with the patient is, to my mind, fundamental because that is where in the dual relationship between patient and analyst the initial patterns of contact emerge. Analysis reactivates models belonging to the patient’s past in a new context in such a way that the analyst cam observe them; the analytic field of operations gives us the opportunity of observing how the analytic phenomenon is “born”. The past integrated with the present takes the form of primary relational models dramatized in the hie et nunc of the session. The ways in which this occurs are unpredictable; they are the consequence of the need to communicate. The analytic session is the experiential field in which the analyst is both observer and witness.1 Arranging what he has discovered in some kind of order and using it in the transference relationship help to structure the field.

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Medium 9781609947897

5 The Warmth of a Mother’s Touch: Maternal and Child Health

Eric Bing Berrett-Koehler Publishers ePub

Sadiki lay in pain, exhausted, on the floor of her home in Malindi, a rural village in Kenya. She had been in labor for more than twenty hours. She wondered why this birth was so much more difficult than her previous one. Maybe it was because her husband had been by her side back then. But after a roadside accident made her a widow at twenty-four with a set of twins at home and a baby on the way, all of life seemed different.

After her husbands death, Sadiki received aid from the Caris Family Foundation, an international NGO focused on helping single mothers develop health and business skills. Entrepreneurial by nature and now even more motivated, she began mastering skills and dreamed of opening a small daycare center after the baby was born.

But for now, her only desire was to end the pain.

This baby seemed way too big. So much bigger, she thought, than her twinscombined. Maybe she shouldnt have listened to the community health workers suggestion to get prenatal care. Maybe the supplements theyd given her and the healthier food she was eating had made the baby too big for her small body to handle.

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Medium 9780755250301

Chapter 4 Internal Operations

Yasmin Khan Bright Pen ePub
Medium 9781780490045

9. The family therapists’ experience

Gillian Miles Karnac Books ePub

Sue McNab, David Pentecost, Vicky Bianco, & Henia Goldberg

The research context

We are four family therapists who worked in London on the BioMed/ERC outcome study on childhood depression, based in three European cities. This research study set out to compare (1) individual psychotherapy combined with parent work with (2) family therapy, as a treatment for children under the age of 15 who had been given a diagnosis of depression based on a self-report measure and a psychiatric interview using DSM–IV criteria (APA, 1994). Our task as family therapists was to offer up to 14 sessions of family therapy to these children and their families. Between 1999 and 2003 the four of us met twelve families comprising six boys and six girls: eight were white, three from a dual heritage background and one Asian. Three families were made up of two parents both living at home: three were families being raised by sole mothers with no contact with fathers, and the remaining six families were mothers with varying amounts of contact with fathers following family separation. We worked in pairs, using either a one-way screen or in-the-room consultation, coupled with a reflecting-team approach.

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Medium 9781855753365

CHAPTER TEN. Towards a neuroanatomy of the mental apparatus

Karen Kaplan-Solms Karnac Books ePub

In this chapter, we propose a general model of how the human mental apparatus—as we conceive of it in psychoanalysis— might be represented in the tissues of the brain. Since this is a first approach at something unknown, it goes without saying that our proposals are subject to substantial revision. The hypotheses that we present are based on a small amount of empirical data, derived from psychoanalytic investigations of 35 patients with localized cerebral lesions, 12 of whom we described in part II. In all likelihood, our perspective on these problems will alter radically as we continue to test our hypotheses against clinical reality. However, excessive caution should not prevent from us pausing at this point to gain a first, schematic perspective on what our efforts have yielded thus far. The aim of a preliminary overview of this sort is for us to take our bearings for the research that still needs to be done if we are properly to rejoin psychoanalysis with the neurosciences.

The first problem that we face when we attempt to integrate psychoanalytic observations with neuroscientific knowledge is that of having to decide which conceptual frames of reference to use. For reasons that we outlined in part I, we have chosen to be guided on the one hand by the classical metapsychological concepts of Sigmund Freud, and on the other hand by the dynamic neuropsychological model of Aleksandr Romanovich Luria. We chose these relatively conservative models for the following two reasons: first, in our view, they still represent the most comprehensive models that we have of the two domains we are attempting to correlate, and, second, these two approaches to the human mind are conceptually and methodologically compatible with one another.

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Medium 9781855759688

9. The aesthetic object

Donald Meltzer Karnac Books ePub

Donald Meltzer

This essay, which has clearly the character of a “manifesto”, includes in a nutshell the themes that Meltzer was to develop in later years, outlining an innovative path of psychoanalytic thought, specifically in relation to the concepts of “aesthetic object”, “aesthetic conflict, and “claustrum”, with the complex clinical and theoretical problems that are linked to them.

Many will have noticed, as indeed I did, that more and more frequently I talk about “aesthetic objects”. It is true that in my analytic practice there have been some changes with respect to my ideas on the nature of psychic pain and on the organization of defensive processes in relation to them. These ideas depart somewhat from those of Melanie Klein; this is due in part to the progressive absorption of the ideas of Dr Bion on what he calls the “birth break”, on the transition from the condition of a water animal to the condition of an air animal. Let us focus now on this transition. We can begin by thinking of intra-uterine life, or at least at the last months of it, as a period in which the child has emotional experiences. On the basis of what the clinical material shows us, we can try to grasp conceptually the nature of this experience and the way in which it prepares the child for the transition to a life outside the mother’s body. One can take into consideration something that is in the domain of instinctual preparation or, as Bion would say, of “innate preconceptions”, which are already about to take their place in the uterus: the sensorial apparatuses (visual, auditory, gustative, etc.) are already stimulated by the nature of the object in which the child is, even though in an indistinct and filtered way. One can equally take into consideration that in the last two months of intra-uterine life the child feels increasingly constrained by this container; now he/she has almost no room to move, although he/ she can turn and change position, but in my opinion he/she must feel terribly squeezed in there and his/her body yearns to escape from this constraint. I believe that Bion was completely right to think that the foetus has no consciousness of his/her own growth; it is much more likely that, as one can see in some dreams, he/she perceives that the claustrum is tightening around him/her.

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Medium 9781937554996

2 Redefining Who We Are

Lucia Thornton Sigma Theta Tau International ePub

We are all elements of spirit, indestructible and eternal, and multiplexed in the divine.”

–William A. Tiller, PhD, Professor Emeritus Stanford University

Defining who we are is the first step in establishing a model of care. The way we perceive ourselves as human beings guides our practice, our research, and ultimately our body of knowledge. The way we define ourselves is one of the deepest underlying assumptions in a culture. Assumptions at this level are often taken for granted and are not usually articulated. However, deeply rooted assumptions are what affect why things happen or fail to happen in a culture (Carroll & Quijada, 2004).

The biomedical model that guides health care practices today has its origin in the mechanistic and reductionist thinking of the 17th century. In this model, guided by the discoveries and theories of such notables as Descartes and Newton, people are perceived to be the amalgamation of molecules and atoms that interact in a predictable fashion based on laws of mathematics, chemistry, and physics (Curtis & Gaylord, 2004). What can be seen, dissected, examined, and quantified are the phenomena of interest in modern medicine. This approach is responsible for many of the wondrous advances in medicine and health care over the last century. The advents of antibiotics, vaccinations, anesthesia, DNA research, advanced imaging, surgical interventions, and organ transplants, to name a few, are the products of mechanistic and reductionist methodology. It is a way of thinking, practicing, and perceiving that is deeply embedded in the health care and scientific communities.

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Medium 9781780644479

10: Microencapsulation for Controlled Gastrointestinal Delivery of Probiotics and Prebiotics

Kharkwal, H. CABI PDF


Microencapsulation for Controlled

Gastrointestinal Delivery of Probiotics and


Preeti Panthari1,* and Harsha Kharkwal2

Amity Institute of Phytochemistry and Phytomedicine, Amity University, Noida, India;


Amity Center for Carbohydrate Research and Amity Institute of Phytomedicine and

Phytochemistry, Amity University Uttar Pradesh, Noida, India



Microencapsulation of bioactive compounds (such as antioxidants, vitamins, minerals, omega-3 lipids and probiotics) has been increasingly studied extensively due to interest in nutraceutical components and functional foods. The main objective of this technique is to protect the bioactive compounds from diminished functionality due to environmental conditions such as oxygen, pH, humidity, light or temperature. Among the different microencapsulation processes, spray drying produces a final powder product with good-quality properties for distribution, transportation and storage. In this regard, a wide variety of encapsulation agents have been studied for increasing the viability of the bioactive compounds and to promote an additional functionality in the final product as well, such as prebiotics. Prebiotics are soluble carbohydrates that humans are unable to digest, which selectively enhance Bifidobacterium and Lactobacillus growth (microorganisms commonly present in the human gut). Some examples include inulin, fructans (fructo-oligosaccharides) and galacto-saccharides. In addition, several microorganisms (probiotics) have demonstrated beneficial effects in humans, and these have been attributed to lactic acid and short-chain fatty acid production, as well as to a reduction in the pH of the colon, which causes a decrease in the survival of pathogenic bacteria. This chapter considers the enhanced efficacy of probiotics and prebiotics through microencapsulation in addressing gastrointestinal diseases.

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Medium 9781855751101

Three. Autistic Processes in Action

Frances Tustin Karnac Books ePub

‘A neat example of a psychical system shut off from stimuli of the external world, and able to satisfy even its nutritional requirements autistic-ally … is afforded by a bird’s egg with its food supply enclosed in its shell.’


IN the previous chapter clinical material was presented to demonstrate the operation and origin of psychotic depression. In the present chapter therapeutic sessions from another psychotic child will be presented to demonstrate processes of secondary autism which arise to protect against psychotic depression (die ‘hole’).


David was referred aged 10:10 with the diagnosis of child psychosis. The significant facts in his early history were that David was the younger of two boys. Mother had wanted a girl and when David was born with a slightly twisted spine, she felt that she had a flawed child. The father had had the same defect but it had not greatly incommoded him. This was long before the work on the effect of early separation from the mother had become a subject for the popular press. When David’s mother read of a masseuse in London who could cure his physical abnormality, she decided that he should have treatment even though it meant being separated from her baby. Widi great feelings of unhappiness, she strong-mindedly began weaning him from the breast at five months, so that at six months he could go to London to have treatment. David stayed in what she called a Baby Hotel from whence he went for daily massage. The parents lived some distance from London and so could only visit very rarely. At thirteen months, the masseuse decided that he needed his mother more than he needed treatment, so he returned home with his spine straight but with the stage set for a typical development.

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Medium 9781855754324

Being (Continuity of)

Jan Abram Karnac Books ePub

1   The centre of gravity

2   The true incommunicado self

3   Creative apperception

4   Being and the female element

5   What life is all about

T he continuity of being may be described as a state or feeling that comes about as a result of the infant's subjective experience of being merged with a good-enough mother. Winnicott also describes this sense of “being” as the “centre of gravity”, which has to occur in the very early weeks of the infant's state of absolute dependence and is only possible if the mother is in a state of primary maternal preoccupation.

Being belongs to the true self and the inherited potential. Being is linked with unintegration, which is the precursor of the ability to relax and enjoy. The ability to “be” derives from the experience of a holding environment at the very start. From the experience of “being” can develop the capacity to “live creatively” and “play”, which are aspects of integration and lead on to doing.

Winnicott places the experience of “being” with the female element—and he also states that, at the heart of being, culture is located.

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Medium 9781855751972

5. Of teeth and theft and Poe: non-Lacanian purloining

Richard Ekins Karnac Books ePub

Ronnie Bailie

In Charles Baudelaire, Edgar Allan Poe—newly dead and released at last from the insoluble problem of gratitude— founda dazzlingly eloquent and passionate advocate. In one memorable outburst, the great French poet denounced the “vampire-pedagogue” and called for a by-law “to keep dogs out of cemeteries” (Baudelaire, 1856). He had in mind in particular the violence done to Poe’s memory immediately after his death by Rufus Griswold and did not pause to reflect that Poe had—for reasons to which we will come—assiduously created enemies for the greater part of his short life. Viewed from the closing years of the twentieth century, the outburst has, notwithstanding, its posthumous justness. For while full-length biographies of Poe continue to appear (Myers, 1992; Silverman, 1991) and while he continues to be read and to provoke the extreme reactions in which he took no little pleasure, psychoanalysis, despite the auspicious beginning represented by the work of Marie Bonaparte (Bonaparte, 1933), has in the main—paradoxically—failed to do justice to a man whose life seems almost to have been created for psychoanalytic investigation. This has been, in essence—to continue Baudelaire’s metaphor—because his body has been stolen, which is to say, less fancifully, that it has dropped out of the question because the peculiar emphases of Lacanian psychoanalysis have, for some decades now, dominated psychological approaches to Poe.

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Medium 9781855753259

CHAPTER FIVE. How come your house never falls down?

Luis Rodriguez De La Sierra Karnac Books ePub

Luis Rodr?guez de la Sierra

João’s mother telephoned me in the autumn of 1998, saying that she was worried about her nine-year-old son and wondered if she could come to talk to me about him. I indicated that it would be a good idea if her husband could come along also. She told me that he was away on a business trip and she very much wanted to talk to me as soon as possible, so I gave her an appointment for two days later. She is an attractive woman in her late thirties, well dressed and slightly over made-up. There was something a bit anxious and irritating in her manner. I detected a subtle hostility in her, which provoked some negativism in me. I was bothered about my reaction to her, which I questioned. She spoke in broken, heavily accented English, and never spoke to me in her mother tongue in spite of the clear indication that I also spoke it. She is the youngest of a family of four girls and she described a rather typical, close Portuguese family background. She told me that she was quite concerned about her youngest son who, for the last few months, had been exhibiting a somewhat precocious and provocative sexual behaviour, i.e. talking about sex, making sexual gestures, easily stripping off his clothes, using four-letter words, etc. João was also very jealous of his thirteen-year-old brother Xavier, and kept complaining that his parents favoured him. He also said he was unhappy at home. On the other hand—she said—he was very popular at school, where both his peers and his teachers, apparently, thought highly of him. He admired his older brother enormously and got on well with him. The relationship with his father, though, was not so good. She seemed perplexed by the fact that, although he claimed not to like his father, his behaviour became worse when father was absent, like now, for instance. Xavier, on the other hand, gave them no reason to worry. I suggested we should meet again when her husband returned. She said she would try her best to persuade him to come; he travelled often and worked all the time so she did not know if he would find the time.

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Medium 9781780647463

Appendix D: Wrapper Patterns

Scott, D.E. CABI PDF

Appendix D:

Wrapper Patterns

Velcro® (Velcro® USA Inc., Manchester, NH, USA) wrappers are very useful for restraint since the wings are effectively immobilized in a comfortable position after the bird is slid into the wrapper and the Velcro® is secured. There are three types of wrappers:

Open-ended body wrappers: these are useful for eye examinations and for force-feeding, or when carrying and weighing larger birds such as vultures or eagles.

• Closed-ended body wrappers: these do not allow for good air flow so should only be used for very short periods (i.e. 10–15 s) but are very useful when weighing birds. The bird is slid into the wrapper, the Velcro® is secured and the bird is placed on its back on the scale (Fig. D.1).

• Wing wrappers: these are great as a replacement for the traditional Vetrap figure-8 bandage and are especially useful when there are

feathers in blood, since these wraps allow the feathers to continue to grow and slide underneath. They are reusable, can be applied and removed quickly, and save on the use of bandage material. They can also be placed over a normal figure-8 bandage to help protect it from the bird picking at it. Duct tape should be placed over the Velcro® to prevent the bird from removing the wrapper. See Figs 4.13, 4.14 and 8.3.

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Medium 9780253357090

3 Health Security on the Move: Biobureaucracy, Solidarity, and the Transfer of Health Insurance to Senegal

Dilger, Hansjörg ePub

Angelika Wolf

“Ce n’est pas facile!” Mr. Dembele shook his head. He was trying to understand the difference between budget and capital, as well as between budget and money Understanding this was necessary to evaluate the financial viability of his mutual health organization in one of the quarters of Diourbel town in Senegal. As one of the many volunteers in the administration of such an organization, he had been invited to participate in a workshop on “planning, monitoring and evaluation for administrators of mutual health organizations.”1 For two days he and the other 30 participants attempted to learn how the administration of a mutuelle de santé—a mutual health organization—should work, in particular how its staff should organize, oversee, and assess their organization. The workshop was conducted by one of the district hospital’s vice directors under the auspices of the regional office of the Health Ministry. It was, however, organized by the umbrella organization of the regional health insurance initiative Coordination Régionale des Mutuelles de Santé de Diourbel (CORMUSAD) and financed by the German Society for Technical Cooperation (Gesellschaft für technische Zusammenarbeit, GTZ), a development organization working on behalf of the German government. Such events occasionally occur in Diourbel and comprise part of development organizations’ activities to set up mutual health organizations (MHOs) in Senegal.

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