Biomedical subjects

M Sheinberg

Publications and source records attributed to M Sheinberg.

8 recordsLinked to original sources

PubMed1995

Forming a consortium: a design for interagency collaboration in the delivery of service following the disclosure of incest.

A central issue in the treatment of intrafamilial sexual abuse is the "secondary trauma" experienced by both the victimized child and her family when the wider system of regulatory and treatment agencies present redundant, incongruent, or conflicting perspectives and demands. This article describes an attempt to effect second-order change through formation of a consortium of regulatory and treatment agencies to develop a consistent and coordinated response to the disclosure of sexual abuse. Feminist, social constructionist, and organizational development ideas are used to develop principles of intersubjectivity, collaboration and a "both-and" stance, which have guided both the clinical and wider systems work.

Child↗

PubMed1994

Treating the sexually abused child: a recursive, multimodal program.

This article describes a recursive, multimodal therapy approach for children who have been sexually abused by members of their family. The different therapeutic modalities (family, group, and individual) are conceived of as different "communities" that provide a variety of relationships, information, and perspectives on the incest experience. The child's involvement in these different communities allows her or him to develop a multiplicity of self-accounts. Meaning is further expanded through the recursive transfer of material across modalities. By determining the content that is discussed in any particular session, and by participating actively in decisions about transferring material across modalities, the child both develops an enhanced sense of personal agency and a connection to trustworthy family members. This approach is designed to allow each child's unique experience with incest to emerge. Clinical examples are provided, along with a description of the program that provides the setting for our multimodal approach to incest.

Adult↗

PubMed1992

Navigating treatment impasses at the disclosure of incest: combining ideas from feminism and social constructionism.

This article describes an approach to the social and emotional schisms that characterize the disclosure of intrafamilial sexual abuse (incest). It argues that ideas from social constructionism and feminism can be combined in such a way that what appear as either/or choices become both--and possibilities. These include: social control versus therapy, shame versus pride, attachment to one's abusive partner versus attachment to one's injured child, and "justice" versus "care."

Adolescent↗

PubMed1992

Continuous monitoring of jugular venous oxygen saturation in head-injured patients.

The continuous measurement of jugular venous oxygen saturation (SjvO2) with a fiberoptic catheter is evaluated as a method of detecting cerebral ischemia after head injury. Forty-five patients admitted to the hospital in coma after severe head injury had continuous and simultaneous monitoring of SjvO2, intracranial pressure, arterial oxygen saturation, and end-tidal CO2. Cerebral blood flow, cerebral metabolic rates of oxygen and lactate, arterial and jugular venous blood gas levels, and hemoglobin concentration were measured every 8 hours for 1 to 11 days. Whenever SjvO2 dropped to less than 50%, a standardized protocol was followed to confirm the validity of the desaturation and to establish its cause. Correlation of SjvO2 values obtained by catheter and with direct measurement of O2 saturation by a co-oximeter on venous blood withdrawn through the catheter was excellent after in vivo calibration when there was adequate light intensity at the catheter tip (176 measurements: r = 0.87, p less than 0.01). A total of 60 episodes of jugular venous oxygen desaturation occurred in 45 patients. In 20 patients the desaturation value was confirmed by the co-oximeter. There were 33 episodes of desaturation in these 20 patients, due to the following causes: intracranial hypertension in 12 episodes, hypocarbia in 10, arterial hypoxia in six, combinations of the above in three, systemic hypotension in one, and cerebral vasospasm in one. The incidence of jugular venous oxygen desaturations found in this study suggests that continuous monitoring of SjvO2 may be of clinical value in patients with head injury.

Adult↗

PubMed1990

Love and violence: gender paradoxes in volatile attachments.

This article presents a multidimensional, theoretical model for the understanding of relationships in which men are violent toward women. It argues that abusive relationships exemplify, in extremis, the stereotypical gender arrangements that structure intimacy between men and women generally. Moreover, it proposes that paradoxical gender injunctions create insoluble relationship dilemmas that can explode in violence. A multifaceted approach to treatment, which incorporates feminist and systemic ideas and techniques, is described.

Family Therapy↗

PubMed1988

Obsessions/counter-obsessions: a construction/reconstruction of meaning.

In this article, obsessions and phobic responses are examined in relation to the maintenance and development of a cross-generational coalition organized by a premise about exclusivity, as well as the specific, idiosyncratic "signature premises" characteristic to each case. It is suggested that the obsession develops when a developmental or situational crisis conflicts with the exclusive relationship definition (that is, coalition). Two forms of intervention for disrupting obsessions--the "conversation" and the "counter-obsession"--are discussed and illustrated. Both interventions conceptualize the obsession as an oscillation between remaining in the coalition and not remaining in the coalition, and both interventions challenge the signature premise that defines the coalition.

Compulsive Behavior↗

PubMed1985

The debate: a strategic technique.

This paper describes the work of a strategic team that came out from behind the one-way mirror. A debate among the team is enacted before the family as a strategy for change. The case of a family that refused to provide information illustrates an application of this method. The debate among the therapists represents a dilemma that is a strategically constructed isomorph of the family situation. From this position, therapists have the option of changing levels between themselves and the family, asking the family to help solve the therapists' dilemma so that they in turn can be free to help the family. The combination of the debate and the change of levels between the therapists and the family creates a therapeutic neutrality for the family. From their meta position, they observe the therapists' struggle to solve the family's problem, which is re-presented as a problem among the therapists. This perspective offers the family the choice of more adaptive solutions to their own dilemma.

Adolescent↗

PubMedDate not supplied

Application of telethermography in the evaluation of preterm premature rupture of the fetal membranes.

The development of chorioamnionitis is a serious complication associated with preterm premature rupture of the fetal membranes (PPROM). There is no reliable early indicator of this infection. The objective of this study was to determine the sensitivity of telethermography (TTG) in the detection of subclinical chorioamnionitis in women with PPROM. Fourteen pregnant women with PPROM between 23 and 34 weeks' gestation were the subjects of the study. Serial frontal-abdominal TTG scans were obtained up to the time of delivery using the MARK-1026 telethermography imager. Following delivery, placental cultures and pathology results were obtained and infant sepsis evaluation was performed. Images were analyzed for temperature differences between umbilical, inguinal, four-quadrant average, and abdominal-wall hot spots. Data were compared with norms obtained from 12 pregnant women with intact membranes who served as gestational age-matched controls. Of five patients with pathology-proven chorioamnionitis and TTG scans within three days of delivery, four demonstrated significant increases in temperature differences between umbilical and abdominal-wall hot spots versus inguinal and four-quadrant averages (z-scores > or = 2.0). All three patients with negative pathology and cultures as well as scans within three days of delivery showed no increase in temperature differences of the above variables. No patient had any overt clinical sign of chorioamnionitis. This limited but consistent evidence demonstrates that telethermography is a sensitive, noninvasive diagnostic method for detecting subclinical chorioamnionitis in pregnant women with preterm rupture of the fetal membranes.

Chorioamnionitis↗