The purpose of this qualitative study was to elicit women's perceptions of their experiences with hysterectomy, oophorectomy, and surgical menopause. Focus group and individual interviews were used to obtain data from a sample of southern urban women who had had hysterectomies for benign reasons. Of the 38 women who participated, 22 were African American and 16 were Caucasian, the mean age was 48 years, and most were low to middle income. Findings revealed that biophysical, psychosocial, and spiritual domains were important in the decision to have a hysterectomy. For many, the choice to have a hysterectomy was a last resort and was viewed as a technique that could relieve a myriad of symptoms. Although most participants described the hysterectomy experience as positive, they expressed a variety of concerns from diagnosis through recovery. Participants expressed a need for information about women's gynecological health for themselves and their male partners. African American women expressed a need for change in attitudes and beliefs in the black community about women undergoing hysterectomy. Many spouses, brothers, uncles, and other African American male friends were nonsupportive, and a few women revealed that they had not told a new partner about the surgery. The findings have implications for women's healthcare providers. Provider training and education are needed that integrate biophysical care of women with the psychological, sociological, and spiritual domains. Efforts must be directed to the community to enlighten men and families about hysterectomy by dispelling myths and providing current health information related to women's gynecological health and alternatives to, indications for, and types of hysterectomy.

The purpose of this single-blinded randomized clinical trial was to determine whether therapeutic touch (TT) versus sham TT could produce greater pain relief as an adjunct to narcotic analgesia, a greater reduction in anxiety, and alterations in plasma T-lymphocyte concentrations among burn patients. Therapeutic touch is an intervention in which human energies are therapeutically manipulated, a practice conceptually supported by Rogers' (1970) theory of unitary human beings. Data were collected at a university burn centre in the south-eastern United States. The subjects were 99 men and women between the ages of 15 and 68 hospitalized for severe burns, and they received either TT or sham TT once a day for 5 days. Baseline data were collected on day 1, data were collected before and after treatment on day 3, and post-intervention data were collected on day 6. Instruments included the McGill Pain Questionnaire, Visual Analogue Scales for Pain, Anxiety and Satisfaction with Therapy, and an Effectiveness of Therapy Form. Blood was drawn on days 1 and 6 for lymphocyte subset analysis. Medication usage for pain in mean morphine equivalents, and mean doses per day of sleep, anxiety and antidepressant medications were recorded. Subjects who received TT reported significantly greater reduction in pain on the McGill Pain Questionnaire Pain Rating Index and Number of Words Chosen and greater reduction in anxiety on the Visual Analogue Scale for Anxiety than did those who received sham TT. Lymphocyte subset analyses on blood from 11 subjects showed a decreasing total CD8 + lymphocyte concentration for the TT group. There was no statistically significant difference between groups on medication usage.

A correlational field survey was used to describe sleep disturbance and explore the relationship of that sleep disturbance to the psychological and menopausal status of 23 mid-life women. Subjects were 40-55 years of age and had self-reported sleep problems. Instruments included the sleep disturbance questionnaire (SDQ), Centre for Epidemiologic Studies depression scale (CES-D), Speilberger state-trait anxiety scale (STAI), a demographic form, 4 cc blood sample for follicle stimulating hormone analysis, and a 7-night sleep diary ('self report of sleep', or SRS). Ten of the 23 subjects reported periodic limb movement on the SDQ. Sleep diaries (SRS) revealed a characteristic sleep disturbance among 13 of the 23 subjects, which paralleled in some respects the changes in sleep efficiency observed with advancing age, but was more pronounced and was present at an earlier age. There was no statistically significant relationship between sleep disturbance and menopausal status or symptoms, or anxiety and depression among subjects, as shown by correlational coefficient and chi-square statistical tests. Results suggest that a characteristic sleep disorder accompanied by periodic limb movement may be responsible for sleep disturbance in mid-life women. What remains unclear is whether this sleep disturbance is related to aspects of the perimenopause not addressed in this study or to other aspects of ageing.

In the past two decades, neuroscientific investigations such as postmortem and neuroimaging studies have revealed a variety of regional brain disturbances in major mental illnesses. These emerging findings are difficult to appreciate fully without a sufficient grasp of the neuroanatomy of the regions identified in these studies. The authors have developed, for psychiatrists-in-training, a braincutting exercise designed to highlight the neuroanatomical features of specific regions; namely, regions with behavioral affiliations relevant to contemporary hypotheses about the brain bases of major mental disorders. The focus of the braincutting is markedly different from the traditional braincuttings that have been available to trainees in neurology, neurosurgery, and neuropathology. This article describes the authors' approach to braincutting and the behavioral neuroanatomy seminar of which it is a part.

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