After the death of literature
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In the Bireme database, a search was performed using the same terms in Portuguese e. The following inclusion criteria were used: empirical articles published in scientific journals in English, Portuguese or Spanish that evaluated family dynamics during the grieving period. The following types of articles were excluded: theoretical articles, opinions and commentaries, articles in which the sample did not consist of adult family members and studies investigating perinatal loss.
Master's theses and doctoral dissertations were not included in the research. The articles were evaluated and selected according to the inclusion and exclusion criteria. The initial selection was performed by reading the title and abstract of each article.
The exclusion of duplicates was performed by the principal author MD Figure 1. Two independent investigators MD and JP read the selected articles in their entirety and completed a second selection round, which included an evaluation of the studies' quality. Doubts or disagreements were resolved by a third investigator AC. Figure 1. Process for selecting the articles included in the review. To evaluate the quality of the studies, an evaluation tool developed by the authors was used. Its criteria were based on an evaluation criteria checklist for use in observational studies the STROBE statement published by von Elm et al.
The total score is obtained by summing the scores of the items. Higher scores indicate higher-quality studies. Of the articles found, were duplicates and were excluded in the first selection round because they were not related to the research question, did not evaluate the variables in question, did not meet the inclusion criteria or were not empirical articles.
Forty articles were read in their entirety, but only fifteen articles met all the inclusion criteria. Twenty-five studies were excluded after being read completely. Seven of these articles were not empirical studies but were only literature updates; in thirteen of the articles, the participants did not meet the inclusion criteria relatives of cancer survivors, children or adolescents, health professionals ; two of the articles did not evaluate the family dynamics variable; in two of the articles, the authors only performed evaluations in the care phase and not during the grieving process; and it was not possible to access the full text of one of the articles Figure 1.
Chart 1 presents the articles selected for analysis and their study quality evaluation scores. The selected articles were published between and Nine of the studies were performed in the United States and six in Australia. Chart 1. Articles selected for evaluation.https://vapylyjyxiti.gq
28 Profoundly Beautiful Quotes About Life And Death
Regarding the study design, seven of the studies were cross-sectional and eight longitudinal. The longitudinal ones evaluated participants at up to three steps that ranged from the beginning of the grieving process until 24 months after the family member's death. In seven of the studies, the deceased family members were cancer patients, two of whom were children.
One study investigated patients in palliative care.
Reading Through Grief: 5 Books on Death and Mortality
In two studies, the cause of death was not specified. In one study, only spouses of the deceased participated; in two, spouses and children. Five investigations included parents couples , one only mothers and another parents and children.
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In four studies, participants were required to have a partner and at least one child over 12 years old to complete the instruments and be categorized as a family member. Another study characterized family members as couples with at least one child.
Sample sizes ranged between 37 and participating family members Chart 1. All the studies evaluated family dynamics, and five studies used more than one instrument for this purpose. Studies that used the FES employed either its full form or the family relationships subscale. Table 1. Instruments used to evaluate family dynamics. Table 2.
Instruments used to evaluate grief. To better explain the results, the selected articles were divided into groups according to the cause of death of the deceased family member. The earliest relevant study was performed by Jordan in This study found that husbands with higher rates of sudden death in their families tended to be more dissatisfied with family functioning and that husbands with higher rates of traumatic death in their families tended to have wives and children who were more dissatisfied with family functioning.
Wives who reported higher levels of stress and had a history of more losses in their families reported more psychological symptoms, worse satisfaction with their families and had more similarities to the group of couples and families who reported lower levels of cohesion, greater divergence in perception of family functioning between husbands and wives, and a family organization that deviated more from general population norms. However, the most recent study, which also does not specify the cause of death of the participants' family members, found that families that were more cohesive, freely expressed affection and had better communication after a loss had fewer grief symptoms six months after the loss, i.
Kissane et al. They screened and classified the families according to the typology described above. Their two articles, published in the same journal issue, described one longitudinal study and revealed that a family's typology as identified at the first evaluation point in the study predicted its classification at the second and third steps six and thirteen months after the death of the family member, respectively. Families classified as functional supportive and conflict resolving experienced more successful grief resolution, made more adaptive adjustments and used more coping strategies.
28 Profoundly Beautiful Quotes About Life And Death
Sullen families experienced a more intense grieving process and greater psychosocial morbidity increased risk of depression but made more use of religious, social and community resources. Hostile and sullen families experienced poorer social adjustment, experienced poorer social and overall functioning and were also less functional at work. Hostile families reported little or no social support. Brintzenhofeszoc et al. They observed that the more dysfunctional the family was, the more complicated the reaction could be to the loss of a loved one.
In a study published in , Kissane and colleagues 11 evaluated the psychosocial morbidity of grieving families and found that dysfunctional families had poor social, overall, domestic and leisure functioning and greater psychosocial morbidity.
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They also reported worse relationships with their children. Hostile families were more likely to have depressed, anxious and obsessive members than other families, higher levels of anxiety and poorer social adjustment. Sullen families had higher levels of anger and higher scores on the psychosis and paranoid ideation subscales. In a study published in , Kissane et al.
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The experimental group underwent therapeutic intervention, and both the experimental group and the control group were evaluated at three steps before therapy began, immediately after the loss of the loved one and six and thirteen months after the death of the family member. The authors concluded that family-oriented grief therapy had the potential to reduce the complications of grief and pathological grief.
They further found that, over 13 months, psychological distress, as evaluated by the BSI, was reduced significantly more than among the control group, as was depression, except among hostile families in the experimental group. Subjects in the experimental group with high distress and depression scores at the first evaluation showed significant improvement in these indices after the intervention.
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The benefit was most pronounced for intermediate and sullen families, who achieved better results after the therapeutic intervention. The conflict levels of the intermediate families in the experimental group were reduced significantly more than those of the intermediate families in the control group six months after the loss. However, hostile families should receive special attention because their conflict levels increased over the course of thirteen months. The Kramer et al. In studies in which the participants were parents of children who had died of cancer, Drew et al.
These authors noted, however, that the fathers and mothers of children who died in hospitals had higher depression results. Furthermore, fathers whose children died in the hospital reported significantly higher levels of depression, anxiety and stress, and the mothers of such children showed more complicated grief symptoms. In Drew et al. Nelson and Frantz 26 investigated the family members of children and adolescents who died sudden or violent deaths e. After comparing the effect of cause of death suicide or non-suicide on family dynamics, the authors found no significant differences in the perceived closeness of family members before or after the death.
However, surviving siblings mentioned feeling closer to their parents after their sibling's death than before. In families with higher levels of family conflict, parents reported feeling more distant from their surviving children, and families classified as disconnected or conflicted also reported greater distance.
Cohesive or expressive families, however, reported more closeness among family members. In a study by Lohan and Murphy 22 , no differences were found in family functioning based on cause of death, though adaptability scores at initial evaluation were significantly higher for parents whose children had committed suicide. If literature is primarily a social construct, why then should it survive the social arrangements that gave rise to it?
Nor is it only in what he says that Kernan gives aid and comfort to the enemy but in the very way he says it. Deconstruction has become so aggressive a mode of thought today that one can succumb to it almost without recognizing it; a lot of the time Kernan sounds more like a postmodern, deconstructed man than the distinguished traditional scholar that he is.
It confronts deconstruction with the monstrous and passionately felt fact of the Holocaust and asks, is this too only a text? Can its meaning be endlessly deferred? Can it too be interpreted in any way deemed suitable? This discussion marks a kind of high point in the book. Be that as it may, it was a famous, overexcited and overcited essay on Heart of Darkness by the African novelist Chinua Achebe that helped clue Graff in.
This essay is just about the worst thing that Achebe ever wrote, and in any other time it would probably have been dismissed as a tendentious diatribe. As it is, since it involves an African writer leveling a charge of racism against a Western work, our progressive critics now happily surrender. When he first read it in his college days, he said in an interview some time ago, he saw himself in Marlow, the main narrator, the man of civilization coming upon nineteenth-century Africa for the first time; but then with the raised racial consciousness of more recent times, he identified himself with the primitive Africans Conrad portrays.
In this we witness one of the little deaths of the literary imagination that theory has helped bring about: individuals can no longer read freely but feel forcibly constrained by theory - the real hegemony today - to identify with literary characters who share sex, race, class, etc. It is true that the novella contains passages that are offensive by current standards of sensitivity on race, but Achebe deliberately takes these descriptions out of context and denies Conrad the larger balance his work achieves.
What is most significant about his approach, then, is the way its deconstructed, decentered, putatively uncommitted manner allows for the promotion of politically correct opinion. After all, the West produced both colonialism and the critique of colonialism - the very critique that is at the heart of Heart of Darkness. The Graff-Achebe approach implies that the West is blind to its own faults and that an alternative African point of view must be sought to register balance.
The three of us wait for the elevator, our arms full. Dad starts up the stairs with his load and Mich and I follow. Mich drops a bag on the bed opposite mine, into the mess of my schoolwork and discarded outfits. The first place George takes me is the diner. They call him Georgie and wink at him while looking me over. He directs me to a stool at the end of the counter; he fills a cup with water for me. Through the window that leads to the kitchen, George says something to the cooks in broken Spanish.