Application of a family systems approach to working with people affected by HIV disease – two case studies

HIV infection, with its particular modes of transmission, affects relationships, interrupts the normal life-cycle and brings different challenges to patients and their contacts as they pass through the asymptomatic and symptomatic phases to the terminal stages of illness. This paper describes a family systems approach to therapy with people affected by HIV disease, illustrated by two case examples.     

Marital Status and Outcome in Patients with Coronary Heart Disease

The purpose of this study was to examine the relationship of marital status to health outcomes in 818 post-MI, coronary artery bypass surgery, and angioplasty patients (651 males, 157 females) from seven Northern California hospitals who completed 12 months of a nurse-managed, home-based multifactorial risk reduction program. Compared to married patients, nonmarried patients were significantly less likely to complete the program than married patients, more likely to smoke at baseline, and drank significantly less alcohol at baseline. At 12 months there were no significant differences between married and nonmarried groups on smoking cessation rates, HDL, LDL, triglycerides, or exercise treadmill test results. When patients were categorized as married, divorced, separated, widowed, or single, similar results were found for the analyses using two groups (married versus nonmarried), with the following exceptions. Separated patients were significantly less likely to quit smoking. In addition, separated patients showed significantly higher rates of starting (and continuing) to smoke during the time following their MI. Mortality was not significantly different between married and unmarried patients. Implications for intervention with separated patients and the importance of assessing both marital status and marital quality are discussed.     

Another View of Translation Manuals and the Study of Science

The article argues for the possibility of translation manuals having an implicit internal structure. This structure is composed of specific methodological assumptions and techniques. Using the (N)-type and (G)-type distinction developed by Fuller for the study of scientific behavior, it is shown that these are incomplete characterizations of translation manuals. A more complete characterization must involve an analysis of how the presence or absence of methodological rules influences the interpretation of specific research questions. It is further argued that while Quine's original indeterminacy thesis cannot be completely rejected, in some cases it can be modified to reflect the importance of the methodological constraints. Finally, it is suggested that the more critical analysis of translation manuals will benefit the on-going debates in the study of scientific behavior.