Career versus motherhood? A case study describing a cognitive-existential approach to the dilemma

The present paper reports a case study concerning a professional woman in her 30s, who presented to the Occupational Health department of a metropolitan hospital with work stress stemming from accelerating work demands and marital problems related to the decision about whether to start a family or continue her career. No clinical diagnosis was warranted; however, Maslach Burnout Inventory Scores indicated a high degree of emotional exhaustion and moderate levels of depersonalisation, offset by a high sense of personal accomplishment in her work role. The client also demonstrated severe stress and moderate depression on the Depression-Anxiety-Stress Scale (DASS-21). The case was conceptualised from a combined cognitive-existential perspective. The woman's cognitions about her work, relationship, and prospective motherhood roles were identified, as well as underlying existential issues such as finding a meaning in life and a fear of being alone and unloved. Eight sessions of therapy incorporated components of cognitive and existential therapies, aimed at managing stress and improving marital adjustment. Posttreatment results showed substantial reductions in all the measures of distress, while personal accomplishment remained high. The woman and her husband decided to defer starting a family until other issues had been addressed.

Disability, religion and health: a literature review in search of the spiritual dimensions of disability

Religious belief and practice plays an important role in the lives of millions of people worldwide, and yet little is Known of the spiritual lives of people with a disability. This review explores the realm of disability, religion and health, and draws together literature from a variety of sources to illustrate the diversity of the sparse research in the field. An historical, cross-cultural and religious textual overview of attitudes toward disability throughout the centuries is presented. Studies in religious orientation, health and well-being are reviewed, highlighting the potential of religion to effect the lives of people with a disability, their families and caregivers. Finally, the spiritual dimensions of disability are explored to gain some understanding of the spiritual lives and existential challenges of people with a disability, and a discussion ensues on the importance of further research into this new field of endeavour.

A refinement calculus for logic programs

Existing refinement calculi provide frameworks for the stepwise development of imperative programs from specifications. This paper presents a refinement calculus for deriving logic programs. The calculus contains a wide-spectrum logic programming language, including executable constructs such as sequential conjunction, disjunction, and existential quantification, as well as specification constructs such as general predicates, assumptions and universal quantification. A declarative semantics is defined for this wide-spectrum language based on executions. Executions are partial functions from states to states, where a state is represented as a set of bindings. The semantics is used to define the meaning of programs and specifications, including parameters and recursion. To complete the calculus, a notion of correctness-preserving refinement over programs in the wide-spectrum language is defined and refinement laws for developing programs are introduced. The refinement calculus is illustrated using example derivations and prototype tool support is discussed.

Development of the HIV/AIDS stress scale

Development of a self-report measure of stress specific to HIV/AIDS is needed to advance our understanding of the role of stress in adaptation to HIV/AIDS: hence, the aim of this study was the development of the HIV/AIDS Stress Scale. A total of 132 homosexual/bisexual men with HIV/AIDS v ere interviewed and completed the HIV/AIDS Stress Scale and measures of coping strategies, appraisal, social support and adjustment (global distress, depression, social adjustment, number of HIV symptoms, and subjective health status) at three time points. Thirty-nine primary caregivers were interviewed and completed measures of stress and adjustment. Exploratory factor analyses of the HIV/AIDS Stress Scale items revealed three factors: Social, Instrumental and Emotional/Existential Stress. Factors had adequate internal reliabilities and were stable over 12 months. Construct validation data are consistent with recent stress/coping research that links higher levels of stress with more HIV symptoms. reliance on emotion-focused coping, lower social support, poorer levels of adjustment and higher levels of caregiver stress. Results extend this research by revealing new differential relations between various stress dimensions and stress/coping variables. Convergent validation data suggest that the HIV/AIDS Stress Scale shares conceptual similarity with threat appraisal. and differs from control liability and challenge appraisals. The HIV/AIDS Stress Scale shows potential for the elucidation of the role of stress in coping and adaptation to HIV/AIDS and disease progression in both research and clinical applications.

Democracry and the Individual

The main question informing this paper is whether it is possible to extend democracy beyond its liberal forms. The paper reflects upon this question with regard to its implications for the individual. For the radicalization of democracy implies a need for self-transformation, if the everyday egoism of contemporary citizens is not to thwart reasonable discussion and participation. Theorists such as Richard Rorty argue that the philosophical resources required to guide such self-transformation can be made available only by sacrificing the political freedom and cultural diversity liberalism has been able to precariously establish. Other theorists insist that the thresholds of pluralism and tolerance that existing liberal democracies are struggling to maintain actually require an extension of democracy. The paper evaluates two different theoretical strategies that aim to identify potentials for democratization without falling prey to the dilemma identified by Rorty: a ‘ deliberative’ strategy explicated with reference to Jürgen Habermas and an ‘existential’ approach represented here by William Connolly.

Medicalizing meaning: demoralization syndrome and the desire to die

Objective: To critically analyse the proposed new psychiatric condition, demoralization syndrome, and the implications drawn by its proponents for the clinical-ethical status of requests by terminally ill patients for assistance to die. Method: The diagnostic features of demoralization syndrome, a proposed new psychiatric disorder, recognizable particularly in palliative care settings, are summarized. The consequences of proposed therapeutic interventions are described, one of which is relief of the desperation which motivates some demoralized patients to consider ending their lives and to seek assistance in dying. The connections between the proposed condition and the desire to die are analysed in the context of the continuing tensions surrounding the ontological status and sociopolitical implications of psychiatric categories and the pervasive medicalization of modern life. Results: The analysis suggests that by medicalizing existential cognitions at the end of life, the proposed diagnostic category also normalizes a particular moral view concerning assistance in dying. Conclusions: While further research into the issues described in this provisional syndrome may benefit some patients, the categorization of demoralization as a medical diagnosis is a questionable extension of psychiatry's influence, which could serve particular social, political and cultural views concerning the end of life.

Quality of life compared during pharmacological treatments and clinical monitoring for non-localized prostate cancer: a randomized controlled trial

To investigate the effects of different management strategies for non-localized prostate cancer on men's quality of life and cognitive functioning. Men with prostate cancer were randomly assigned to one of four treatment arms: leuprorelin, goserelin, cyproterone acetate (CPA), or close clinical monitoring. In a repeated-measures design, men were assessed before treatment (baseline) and after 6 and 12 months of treatment. A community comparison group of men of the same age with no prostate cancer participated for the same length of time. The men were recruited from public and private urology departments from university teaching hospitals. All those with prostate cancer who were eligible for hormonal therapy had no symptoms requiring immediate therapy. In all, 82 patients were randomized and 62 completed the 1-year study, and of the 20 community participants, 15 completed the study. The main outcome measures were obtained from questionnaires on emotional distress, existential satisfaction, physical function and symptoms, social and role function, subjective cognitive function, and sexual function, combined with standard neuropsychological tests of memory, attention, and executive functions. Sexual dysfunction increased for patients on androgen-suppressing therapies, and emotional distress increased in those assigned to CPA or close clinical monitoring. Compared with before treatment there was evidence of an adverse effect of leuprorelin, goserelin, and CPA on cognitive function. In deciding the timing of androgen suppression therapy for prostate cancer, consideration should be given to potential adverse effects on quality of life and cognitive function.

The nomenclature of style: Brutalism, Minimalism, art history and visual style in architecture journals

The naming of styles or movements is a basic mechanism of the architectural journals. The announcement of new tendencies, groups or philosophies, gives a journal its character as ‘news’, and if such terms are taken up in general discourse this demonstrates the prescience of the editor and enhances the repute of the journal. The announcement of phenomenon such as ‘critical regionalism’ or ‘deconstructivism’ referred architectural developments to a context in socio-politics or philosophy, and thus aimed to provide at least an initial resistance to their understanding as the formal styles which they quickly became. A different strategy, or occasion, which this paper will discuss, is where the name of an architectural moment is given in the traditional form of an art historical style. Here the nomenclature of style and a certain attitude to form is introduced as the starting point for a more open ended critical inquiry. Two examples of this strategy will be given. The first is Peter Reyner Banham and the Architecture Review’s promotion of ‘Brutalism’ as an anti-aesthetic which took its conceptual form from early twentieth century art movements, particularly Futurism. The second, identified with Architectural Design in the 1990’s is ‘Minimalism’, a term describing a strand of the visual arts of the 1960’s which can be understood as an attempt to nuance and add seriousness to the present rampant nostalgia for the style of the architecture of the 1960’s.

Fighting, anger, frustration and tears: Matthew's story of hegemonic masculinity

This paper draws on Matthew's story to illustrate the conflicting discourses of being a boy and being a student. Matthew is 12 years old and in Grade Six, his final year at Banrock Primary ( a K- 6 Australian State School). School is far from a happy place for Matthew - his tearful accounts of his combative relationships with his peers and his teacher highlight his emotional distress. The paper's analytic focus draws attention to some of the ways Matthew's harmful storylines of hegemonic masculinity are made possible through, in particular, his teacher's gendered philosophies and her strategies of individualism and control. In this regard, Matthew's story provides insight into the potentially counterproductive realities of teacher practice in relation to addressing issues of masculinity within the school environment. Against this backdrop, the paper stresses the importance of teachers drawing on a sound research-based framework of gender knowledges that can illuminate how masculinities are constructed, regulated and, indeed, transformed through the power relations of everyday social practice, including teacher practice.

Neoliberalism, Gender Inequality and the Australian Labour Market

Over the past 25 years neoliberal philosophies have increasingly informed labour market policies in Australia that have led to increasing levels of wage decentralization. The most recent industrial relations changes aim to decentralize wage setting significantly further than has previously been the case. We argue that this is problematic for gender equity as wage decentralization will entrench rather than challenge the undervaluation of feminized work. In this article we provide an overview of key neoliberal industrial relations policy changes pertinent to gender equity and examine the current state of gender equity in the labour market. Results show that women's labour force participation has steadily increased over time but that a number of negative trends exclude women with substantial caring responsibilities from pursuing a career track. The implications of increasing levels of wage deregulation are that gender wage inequality and the potential for discrimination will grow.

Sustainable tourism planning: A content analysis of local tourism plans

Tourism planning has been advocated by many as a possible means of alleviating some of the negative impacts of tourism. While a number of approaches have evolved, tourism planning based on the philosophies of sustainability has emerged as the most comprehensive approaches. To investigate the tourism planning approaches of local tourism destinations in Queensland, particularly the extent to which tourism plans exhibit the sustainable approach to tourism planning, 30 local tourism planning documents have been reviewed. Despite claims that sustainable tourism planning is one of the most accepted approaches the study has shown that this is not necessarily the case in practice. It was found that although a number of plans addressed the issue of sustainability, the subsequent strategies and actions suggest that the sustainable approach is not the dominant planning approach, but in fact the economic and infrastructure approaches are the primary planning methods.

Achieving key dimensions of sustainability: Strategic visioning as a tourism destination planning tool

Tourism has had, and is continuing to have, a profound impact upon destinations, economically, environmentally and socially. The negative impacts of tourism have been attributed, among other things, to inadequate or non-existent planning frameworks for tourism development, and it has therefore been advocated that tourism planning is vital to offset some of these negative impacts. While several different approaches have been supported over the years, tourism planning based on the philosophies of sustainability has emerged as one ofthe most comprehensive approaches. However, two critical concepts have been identified as precursors to sustainable development: a strategic Qrientation towards tourism planning and enhanced levels of multiple stakeholder participation in the tourism planning process (Simpson 2001 ). While both strategic tourism planning and stakeholder participation and collaboration, have received considerable attention in the academic literature, there has been relatively little written about its practical application. However, the somewhat recent emergence of the strategic visioning concept as a destination planning tool may provide the necessary practical framework for incorporating stakeholder collaboration into destination strategic planning and management. This paper will provide a synthesis of the stakeholder collaboration, strategic planning and strategic visioning literatures, before conceptually examining the potential applicability._ of the strategic visioning process in achieving meaningful stakeholder participation and collaboration in destination planning.

Online help systems: Learning while working

Most widely-used computer software packages, such as word processors, spreadsheets and web browsers, incorporate comprehensive help systems, partly because the software is meant for those with little technical knowledge. This paper identifies four systematic philosophies or approaches to help system delivery, namely the documentation approach, based on written documents, either paper-based or online; the training approach, either offered before the user starts working on the software or on-the-job; intelligent help, that is online, context-sensitive help or that relying on software agents; and finally an approach based on minimalism, defined as providing help only when and where it is needed.