Healing the Heart: A Qualitative Study of Challenges and Motivations to Cardiac Rehabilitation Attendance and Completion among Women and Men

Heart disease is the leading cause of death in the United States. Given that cardiovascular rehabilitation (CR) participation is the best secondary prevention of cardiac mortality, it is important to understand the challenges and motivations people experience while taking part in rehabilitation. The present qualitative study explored the treatment experiences of 20 women and 20 men at urban and rural rehabilitation clinics in Minnesota. Participants were equally divided based on the number of CR session completed (less than or equal to 18 vs. more than 18). The study’s primary aim was to articulate similarities and differences in the CR treatment experiences by gender. Data were gathered from individual interviews and analyzed using an inductive content analysis. Findings revealed that both women and men view CR as a means to move forward from their cardiac incident and achieve good health. Women were more likely than were men to be motivated by a perceived obligation to CR staff and improved quality of life. Men, in comparison, identified their commitment to CR as a need to complete a task. The study findings can help inform the design of rehabilitation programs and strengthen patient-centered interventions to enhance participation in treatment.     

Academic Performance of High School Students as a Function of Mental Capacity,Cognitive Style,Mobility‐Fixity Dimension,and Creativity

The purpose of this study is to explore how creativity and the cognitive variables (mental capacity, cognitive style & mobility‐fixity dimension) can explain academic performance of high school students. Students at a high school in Maturin (Venezuela) were tested to determine creativity (Torrance Tests), cognitive variables and academic performance. Results based on multiple regression analyses showed that the mobility‐fixity dimension was the most consistent predictor of academic performance, by explaining a significant amount of the variance in Spanish, English, Geography, Biology, Chemistry, Earth Science, Mathematics, Physics and the Mean score. Creativity scores explained a significant amount of the variance in Spanish, Geography, Earth Science and the Mean score. It appears that the mobility‐fixity dimension and creativity although related, perhaps represent different aspects of academic performance.     

BIOFEEDBACK,AUTOGENIC TRAINING,AND PROGRESSIVE RELAXATION IN THE TREATMENT OF RAYNAUD'S DISEASE: A COMPARATIVE STUDY

Twenty-one female patients suffering from diagnosed idiopathic Raynaud's Disease were trained to raise digital skin temperature using either autogenic training, progressive muscle relaxation, or a combination of autogenic training and skin temperature feedback. Patients were instructed in the treatment procedures in three one-hour group sessions spaced one week apart. All patients were instructed to practice what they had learned twice a day at home. Patients kept records of the frequency of vasospastic attacks occurring over a four-week baseline period, and during the first four weeks and the ninth week of training. In addition, patients underwent four laboratory cold stress tests during which they were instructed to maintain digital temperature as the ambient temperature was slowly dropped from 26° to 17°C. Cold stress tests were given during week 1 of baseline and during weeks 1, 3, and 5 of training. Results indicated that all patients improved during the first four weeks of training. No significant differences between the three behavioral treatment procedures were obtained. In addition, the ability of patients to maintain digital temperature during the cold stress challenge showed significant improvement from the first to the last tests. Symptomatic improvement was maintained by all patients nine weeks after the start of the training. The implications of these findings for the behavioral treatment of Raynaud's Disease are discussed.     

Clinician's molar and molecular stuttering analyses of expanded and nonexpanded speech

Twenty speech pathologists measured total words and completed molar and molecular stuttering analyses from audio-recorded contrived samples of stuttered speech. Each subject completed a criterion referenced test prior to performing the experimental tasks. Analyses were performed under two conditions: Condition I consisted of samples presented at 100 wpm as recorded (nonexpanded); Condition II consisted of parallel samples recorded at 100 wpm as recorded (nonexpanded condition); Condition II consisted of parallel samples recorded at 100 wpm but presented at 59 wpm via a speech time expander. Results indicate that presentation of expanded samples (Condition II) significantly increased subject accuracy for the specific disfluency form-types word repetitions and part-word repetitions. Similar trends were noted for sound prolongations and hard contacts. Theoretical, experimental, and clinical implications are offered.     

Changes in Family Structure After a Renal Transplant

Two girls (9 and 10 years old) and one male adolescent (19 years old) with chronic renal failure (CRF) were studied along with their families in order to evaluate their family structure before (4–5 weeks) and after (3–5 weeks) a renal transplant from a live donor. After the renal transplant there was a close association between the donor and the recipient that led to the creation of an alliance or the reinforcement of an alliance already present before the transplant. This may favor a family disruption or a better family equilibrium depending upon whether the donor ranked highest in the family hierarchy and was already in a rigid alliance with the patient before the transplant. It is suggested that the study and diagnosis of the family structure before the renal transplant may help to: (a) select the most suitable donor candidate from a biological as well as psychological point of view so as to allow a better possibility of success in the structural functioning of the family after the transplant; (b) predict changes that will appear within the family after the transplant, which in turn may alert the personnel to detect changes in the family structure as early as possible; and (c) offer more rapid therapeutic assistance to bring the family back to a functional level within its social framework.     

Pain: Biopsychosocial Mechanisms and Management

Traditionally, pain has been viewed as a sensory event warning of tissue damage or illness. This explanation fails to account for many of the experiences of people suffering from clinically painful conditions. Over the past two decades, a new biopsychosocial perspective on pain has emerged. This perspective emphasizes that pain is a dynamic process that not only is influenced by biological, psychological, and social mechanisms of pain, but also produces biological, psychological, and social changes that can affect future responses to pain. This review presents findings from recent studies of the biological, psychological, and social mechanisms of pain and discusses the implications of these findings for pain research, assessment, prevention, and treatment, as well as for health care policy.