DOCSLIB.ORG

The Relationship of Fathers with Sons Who Have

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
The Relationship of Fathers with Sons Who Have View metadata, citation and similar papers at core.ac.uk brought to you by CORE provided by The University of Utah: J. Willard Marriott Digital Library THE RELATIONSHIP OF FATHERS WITH SONS WHO HAVE TOURETTE SYNDROME AND THE IMPACT ON THE FAMILY by Calvert F. Cazier A dissertation submitted to the faculty of The University of Utah in partial fulfillment of the requirements for the degree of Doctor of Philosophy Department of Health Promotion and Education The University of Utah August 2012 Copyright © Calvert F. Cazier 2012 All Rights Reserved The University of Utah Graduate School STATEMENT OF DISSERTATION APPROVAL The dissertation of Calvert F. Cazier has been approved by the following supervisory committee members: Glenn E. Richardson , Chair 5/7/2012 Date Approved Sue Morrow , Member 5/7/2012 Date Approved Patrick Panos , Member 5/7/2012 Date Approved Richard Ferre , Member 5/7/2012 Date Approved Julia Franklin Summerhays , Member 5/7/2012 Date Approved and by Les Chatelain , Chair of the Department of Health Promotion and Education and by Charles A. Wight, Dean of The Graduate School. ABSTRACT Tourette syndrome (TS) is a misunderstood complex, chronic, neuropsychiatric disorder known for both involuntary muscle and vocal tics which manifests itself in childhood and usually has a lifelong duration. Little research has been done on how families are impacted by having a child with (TS) and even less has been done on how fathers in particular are affected. Dealing with a child who has TS can be stressful to the parents as well as to the dynamics of and the family. While children with TS have many obvious challenges, their families face similar problems which may not be so readily apparent. This study used qualitative research methods to study the relationships of fathers and their sons with TS. Qualitative research is useful for examining aspects of social life that are not easily accessed through quantitative data collection techniques. The overarching finding which emerged in this study was that the fathers experienced a waxing and waning pattern of response in the face of an uncertain future which seemed to be influenced by the intrinsic nature of TS. They reported experiences along a continuum of success, ranging from effective responses which seemed to lead to personal growth and resilience and stronger relationships with their sons and families, to ineffective responses, difficulty developing personally, and relationship strain or deterioration. The waxing and waning pattern of responses occurred along five major themes: 1) the question of normalcy, 2) pride in son, 3) hope in the future, 4) acceptance, and 5) role satisfaction. Each father had his own unique challenges to his son with TS which impacted his relationships with this son, his other children, and his wife. As a whole these fathers appeared to find effective ways over time to develop strong family relationships. Factors which seemed to propel these fathers forward included a clear understanding of and commitment to their roles as a father and husband and the successful development of a strong husband and wife team. iv TABLE OF CONTENTS ABSTRACT ................................................................................................................. iii LIST OF FIGURES ..................................................................................................... vii ACKNOWLEDGEMENTS ......................................................................................... viii Chapters 1. INTRODUCTION AND REVIEW OF LITERATURE ....................................... 1 Introduction to the Problem ................................................................................... 1 Overview of Tourette Syndrome ........................................................................... 4 Family Systems Theory and Resiliency ................................................................. 22 Purpose of the Study .............................................................................................. 27 Research Questions ................................................................................................ 28 Rationale for Qualitative Methods ......................................................................... 28 Data Analysis ......................................................................................................... 33 Explanation of Reporting Format .......................................................................... 41 Appendix A: Interview Question Guide ................................................................ 43 References .............................................................................................................. 46 2. THE RELATIONSHIP OF FATHERS WITH SONS WHO HAVE TOURETTE SYNDROME AND THE IMPACT ON THE FAMILY ................. 54 Abstract .................................................................................................................. 54 Introduction ............................................................................................................ 55 Purpose ................................................................................................................... 56 Literature Review................................................................................................... 56 Methods.................................................................................................................. 57 Results .................................................................................................................... 62 Discussion .............................................................................................................. 90 Appendix A: Selection Criteria .............................................................................. 95 Appendix B: Interview Question Guide ................................................................ 97 References .............................................................................................................. 100 3. APPLICATION OF THE METATHEORY OF RESILIENCE AND RESILIENCY IN FAMILIES WITH CHILDREN WITH TOURETTE SYNDROME: WAVES ONE AND TWO.................................................................................................... 102 Abstract ................................................................................................................ 102 Introduction .......................................................................................................... 103 Purpose ................................................................................................................. 104 Overview of TS-Related Disruptive Challenges .................................................. 104 The First Wave of Resiliency Inquiry: Resilient Qualities .................................. 106 The Second Wave of Resiliency Inquiry: Resiliency ........................................... 109 Discussion ............................................................................................................ 121 References .............................................................................................................. 123 4. APPLICATION OF THE METATHEORY OF RESILIENCE AND RESILIENCY IN FAMILIES WITH CHILDREN WITH TOURETTE SYNDROME: WAVE THREE ................................................................................................................... 126 Abstract .................................................................................................................. 126 Introduction ............................................................................................................ 127 The First and Second Waves of Resiliency Inquiry ............................................... 128 The Third Wave of Resiliency Inquiry .................................................................. 129 Integrating Resilient Qualities, Resiliency, and Resilience ................................... 135 Discussion .............................................................................................................. 140 References .............................................................................................................. 141 5. CONCLUSION ...................................................................................................... 143 Review of Findings ................................................................................................ 143 Suggestions for Future Research ........................................................................... 145 References .............................................................................................................. 147 vi LIST OF FIGURES Figure Page 1. Richardson’s resiliency mapping model 2002 ..............................................27 2. Father’s waxing and waning responses .........................................................64 3. Richardson’s resiliency mapping model 2002 ..............................................111 4. TS resiliency mapping model: description of a family’s journey: single tic ........................................................................................................114 5. TS resiliency mapping model: description of a family’s journey: multiple tics ...................................................................................................115 6. TS adapted resiliency mapping model: accounting for secondary Challenges ......................................................................................................117
Load more

Recommended publications
  • Neurobiology of the Premonitory Urge in Tourette Syndrome: Pathophysiology and Treatment Implications
    View metadata, citation and similar papers at core.ac.uk brought to you by CORE HHS Public Access provided by Aston Publications Explorer Author manuscript Author ManuscriptAuthor Manuscript Author J Neuropsychiatry Manuscript Author Clin Neurosci Manuscript Author . Author manuscript; available in PMC 2017 April 28. Published in final edited form as: J Neuropsychiatry Clin Neurosci. 2017 ; 29(2): 95–104. doi:10.1176/appi.neuropsych.16070141. Neurobiology of the premonitory urge in Tourette syndrome: Pathophysiology and treatment implications Andrea E. Cavanna1,2,3,*, Kevin J Black4, Mark Hallett5, and Valerie Voon6,7,8 1Department of Neuropsychiatry Research Group, BSMHFT and University of Birmingham, Birmingham, UK 2School of Life and Health Sciences, Aston University, Birmingham, UK 3University College London and Institute of Neurology, London, UK 4Departments of Psychiatry, Neurology, Radiology, and Anatomy & Neuroscience, Washington University School of Medicine, St. Louis, MO, USA 5Human Motor Control Section, Medical Neurology Branch, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA 6Department of Psychiatry, University of Cambridge, Cambridge, UK 7Behavioural and Clinical Neurosciences Institute, Cambridge, UK 8Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK Abstract Motor and vocal tics are relatively common motor manifestations identified as the core features of Tourette syndrome. Although traditional descriptions have focused on objective phenomenological
    [Show full text]
  • The Clinical Presentation of Psychotic Disorders Bob Boland MD Slide 1
    The Clinical Presentation of Psychotic Disorders Bob Boland MD Slide 1 Psychotic Disorders Slide 2 As with all the disorders, it is preferable to pick Archetype one “archetypal” disorder for the category of • Schizophrenia disorder, understand it well, and then know the others as they compare. For the psychotic disorders, the diagnosis we will concentrate on will be Schizophrenia. Slide 3 A good way to organize discussions of Phenomenology phenomenology is by using the same structure • The mental status exam as the mental status examination. – Appearance –Mood – Thought – Cognition – Judgment and Insight Clinical Presentation of Psychotic Disorders. Slide 4 Motor disturbances include disorders of Appearance mobility, activity and volition. Catatonic – Motor disturbances • Catatonia stupor is a state in which patients are •Stereotypy • Mannerisms immobile, mute, yet conscious. They exhibit – Behavioral problems •Hygiene waxy flexibility, or assumption of bizarre • Social functioning – “Soft signs” postures as most dramatic example. Catatonic excitement is uncontrolled and aimless motor activity. It is important to differentiate from substance-induced movement disorders, such as extrapyramidal symptoms and tardive dyskinesia. Slide 5 Disorders of behavior may involve Appearance deterioration of social functioning-- social • Behavioral Problems • Social functioning withdrawal, self neglect, neglect of • Other – Ex. Neuro soft signs environment (deterioration of housing, etc.), or socially inappropriate behaviors (talking to themselves in
    [Show full text]
  • Catatonia: an Under-Recognised, Acutely Treatable Condition in Young People with Intellectual Disability/ASD
    Catatonia: an under-recognised, acutely treatable condition in young people with intellectual disability/ASD. Associate Professor David Dossetor The Children’s Hospital at Westmead Area Director for Mental Health Child Psychiatrist with a Special interest in Intellectual Disability A case example inaudible words in the consultation and didn’t A 15-year-old girl with Down Syndrome was referred to respond to questions. She had waxy flexibility and neurology due to a neurocognitive decline over a two- mild increased muscle tone. She drew a few small month period. She had been socially active, happy, indistinct pictures and was eventually able to write cheeky, talkative and an enthusiastic school attender. her name. She appeared to respond to unseen She had acquired basic self-care and hygiene skills, stimuli. There was no access to her internal mental and achieved primary school educational skills. At a state but she did laugh to herself regularly, out of school swimming carnival, the girl was severely context. It was not possible to assess her cognitive sunburnt. That night she became a little delirious and skills. was uncharacteristically incontinent; this incontinence persisted. The next day she was found sitting in bed The girl was diagnosed with a psychotic disorder with with arms out stiff and staring blankly. A GP review catatonic features and started on olanzapine 2.5mg revealed nothing, with a normal urine screen. Over the three times daily (tds), adding 0.5mg lorazepam tds next month she became progressively quieter until she a week later which was increased to 1mg tds two became mute. She also became apathetic and lost weeks later.
    [Show full text]
  • Tourette's Syndrome
    Tourette’s Syndrome CHRISTOPHER KENNEY, MD; SHENG-HAN KUO, MD; and JOOHI JIMENEZ-SHAHED, MD Baylor College of Medicine, Houston, Texas Tourette’s syndrome is a movement disorder most commonly seen in school-age children. The incidence peaks around preadolescence with one half of cases resolving in early adult- hood. Tourette’s syndrome is the most common cause of tics, which are involuntary or semi- voluntary, sudden, brief, intermittent, repetitive movements (motor tics) or sounds (phonic tics). It is often associated with psychiatric comorbidities, mainly attention-deficit/hyperac- tivity disorder and obsessive-compulsive disorder. Given its diverse presentation, Tourette’s syndrome can mimic many hyperkinetic disorders, making the diagnosis challenging at times. The etiology of this syndrome is thought to be related to basal ganglia dysfunction. Treatment can be behavioral, pharmacologic, or surgical, and is dictated by the most incapacitating symp- toms. Alpha2-adrenergic agonists are the first line of pharmacologic therapy, but dopamine- receptor–blocking drugs are required for multiple, complex tics. Dopamine-receptor–blocking drugs are associated with potential side effects including sedation, weight gain, acute dystonic reactions, and tardive dyskinesia. Appropriate diagnosis and treatment can substantially improve quality of life and psychosocial functioning in affected children. (Am Fam Physician. 2008;77(5):651-658, 659-660. Copyright © 2008 American Academy of Family Physicians.) ▲ Patient information: n 1885, Georges Gilles de la Tourette normal context or in inappropriate situa- A handout on Tourette’s described the major clinical features tions, thus calling attention to the person syndrome, written by the authors of this article, is of the syndrome that now carries his because of their exaggerated, forceful, and provided on p.
    [Show full text]
  • Tourette's Syndrome: a Review from a Developmental Perspective
    Isr J Psychiatry Relat Sci - Vol. 47 - No 2 (2010) Tourette's Syndrome: A Review from a Developmental Perspective Tamar Steinberg, MD, 1 Robert King, MD, 2 and Alan Apter, MD 1 1 The Harry Freund Neuro-Psychiatric Clinic, Schneider Children's Medical Center, Petah Tikva, Israel 2 Yale Child Study Center, New Haven, Connecticut, U.S.A. izations. Simple motor tics are sudden, fleeting or ABSTRACT fragmentary movements such as blinking, grimacing, head jerking, or shoulder shrugs. Complex motor tics The object of this review is to summarize some of the consist of several simple motor tics occurring in an recent developments in the understanding of Tourette’s orchestrated sequence or semi-purposeful movements, Syndrome which can be regarded as the prototype of a such as touching or tapping; these may also have a more developmental psychopathological entity. The review sustained, twisting, and dystonic character (2). covers the following topics: tics and their developmental Simple phonic tics consist of simple, unarticulated course; sensory phenomena related to tics including sounds such as throat clearing, sniffing, grunting, measurement of these phenomena; pathophysiology squeaking, or coughing. Complex phonic tics consist of of tics and compensatory phenomena and the parallel out-of-context syllables, words, phrases or paroxysmal development of the various psychiatric comorbidities as changes of prosody. they emerge over the life span. Finally there is an attempt Complex tics may involve socially inappropriate or to summarize the major points and future directions. obscene gestures (copropraxia) or utterances (coprola- lia), as well as echo phenomena, such as echolalia or echopraxia (repeating others’ words or gestures), which exemplify the suggestibility of tics.
    [Show full text]
  • Ziprasidone Monotherapy for Tourette Syndrome with Comorbid ADHD
    f Ps al o ych rn ia u tr o y J Journal of Psychiatry Naguy and At-Tajali, J Psychiatry 2015, S1 DOI: 10.4172/2378-5756..S1-002 ISSN: 2378-5756 ShortResearch Communication Article OpenOpen Access Access Ziprasidone Monotherapy for Tourette Syndrome with Comorbid ADHD Ahmed Naguy1* and Ali At-Tajali2 1Child and Adolescent Psychiatrist, Kuwait Centre for Mental Health (KCMH), Kuwait 2General Adult Psychiatrist, Head of Neuromodulation Unit, KCMH, Kuwait Abbreviations: TS: de la Tourette Syndrome; OCD: Obsessive- There is no hard and fast rule, but antipsychotics, especially atypical Compulsive Disorder; PANDAS: Paediatric Autoimmune (AAPs), by and large, produce the most robust results controlling tics Neuropsychiatric Disorders Associated with Streptococcal Infection; when socially-embarrassing or functionally impairing. Nonetheless, ADHD: Attention-Deficit/Hyperactivity Disorder; AAP: Atypical clinicians ’enthusiasm is commonly tempered by the ominous Antipsychotics; ECG: Electrocardiogram; OPD: Outpatient metabolic and/or neurologic syndromes subsequent to antipsychotic Department; HRT: Habit Reversal Therapy; Y-GTSS: Yale-Global use. Pharmacologic options for TS are legion [11] (Table 4). Tic Severity Scale; IQ: Intelligence Quotient; DSST: Digital Symbol Here, we are reporting a case of adolescent TS with comorbid Substitution Test; CPT: Continuous Performance Test. severe ADHD where stimulants were deleterious for tics, atomoxetine (Strattera®) was ineffective addressing ADHD, and clonidine (Catapres®) Short Communication was too soporific
    [Show full text]
  • The ICD-10 Classification of Mental and Behavioural Disorders : Clinical Descriptions and Diagnostic Guidelines
    ICD-10 ThelCD-10 Classification of Mental and Behavioural Disorders Clinical descriptions and diagnostic guidelines | World Health Organization I Geneva I 1992 Reprinted 1993, 1994, 1995, 1998, 2000, 2002, 2004 WHO Library Cataloguing in Publication Data The ICD-10 classification of mental and behavioural disorders : clinical descriptions and diagnostic guidelines. 1.Mental disorders — classification 2.Mental disorders — diagnosis ISBN 92 4 154422 8 (NLM Classification: WM 15) © World Health Organization 1992 All rights reserved. Publications of the World Health Organization can be obtained from Marketing and Dissemination, World Health Organization, 20 Avenue Appia, 1211 Geneva 27, Switzerland (tel: +41 22 791 2476; fax: +41 22 791 4857; email: [email protected]). Requests for permission to reproduce or translate WHO publications — whether for sale or for noncommercial distribution — should be addressed to Publications, at the above address (fax: +41 22 791 4806; email: [email protected]). The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted lines on maps represent approximate border lines for which there may not yet be full agreement. The mention of specific companies or of certain manufacturers' products does not imply that they are endorsed or recommended by the World Health Organization in preference to others of a similar nature that are not mentioned. Errors and omissions excepted, the names of proprietary products are distinguished by initial capital letters.
    [Show full text]
  • Tourette Syndrome in Children
    Focus | Clinical Tourette syndrome in children Valsamma Eapen, Tim Usherwood UP TO 20% OF CHILDREN exhibit rapid jerky peak severity at the age of approximately movements (motor tics) that are made 10–12 years, and typically improve by without conscious intention as part of a adolescence or thereafter.6 Background Gilles de la Tourette syndrome (GTS), developmental phase that often lasts a few 1 characterised by motor and vocal tics, weeks to months. Similarly, involuntary has a prevalence of approximately 1% sounds, vocalisations or noises (vocal or Clinical features in school-aged children. Commonly phonic tics) such as coughing and even In addition to simple motor and vocal/ encountered comorbidities of GTS brief screams or shouts may be observed in phonic tics, complex tics may be present include attention deficit hyperactivity some children for brief periods of time. Tics (Table 1). Some complex tics – such as disorder (ADHD) and obsessive- lasting for a few weeks to months are known spitting, licking, kissing, etc – may be compulsive behaviour/disorder (OCB/ OCD). Genetic factors play an important as ‘transient tic disorder’. When single misunderstood or misinterpreted and part in the aetiology of GTS, and family or multiple motor or vocal tics – but not a may result in the young person getting members may exhibit tics or related combination of both – have been present in trouble, especially if these tics include disorders such as ADHD, OCB or OCD. for more than one year, the term ‘chronic involuntary and inappropriate obscene tic disorder’ is used. When both (multiple) gesturing (copropraxia) or copying the Objective The aim of this article is to present a motor and (one or more) vocal tics have been movements of other people (echopraxia).
    [Show full text]
  • The ICD-10 Classification of Mental and Behavioural Disorders Diagnostic Criteria for Research
    The ICD-10 Classification of Mental and Behavioural Disorders Diagnostic criteria for research World Health Organization Geneva The World Health Organization is a specialized agency of the United Nations with primary responsibility for international health matters and public health. Through this organization, which was created in 1948, the health professions of some 180 countries exchange their knowledge and experience with the aim of making possible the attainment by all citizens of the world by the year 2000 of a level of health that will permit them to lead a socially and economically productive life. By means of direct technical cooperation with its Member States, and by stimulating such cooperation among them, WHO promotes the development of comprehensive health services, the prevention and control of diseases, the improvement of environmental conditions, the development of human resources for health, the coordination and development of biomedical and health services research, and the planning and implementation of health programmes. These broad fields of endeavour encompass a wide variety of activities, such as developing systems of primary health care that reach the whole population of Member countries; promoting the health of mothers and children; combating malnutrition; controlling malaria and other communicable diseases including tuberculosis and leprosy; coordinating the global strategy for the prevention and control of AIDS; having achieved the eradication of smallpox, promoting mass immunization against a number of other
    [Show full text]
  • Tourette Syndrome— Much More Than Tics Moving Beyond Misconceptions to a Diagnosis
    Cover article LOWELL HANDLER First of two parts Tourette syndrome— much more than tics Moving beyond misconceptions to a diagnosis By Samuel H. Zinner, MD Far more people have heard of Tourette syndrome than know what it actually looks and sounds like—or how it feels to the person who has it. That’s a major reason the diagnosis of this condition—the most severe tic disorder—is often missed. A change of perception begins with understanding the breadth and variability of symptoms and being aware of comorbidity. ore than a century has passed since the ical figures (including the Roman Emperor Claudius, French neurologist Georges Gilles de la Wolfgang Amadeus Mozart, and 18th century English Tourette first described the condition literary scholar Samuel Johnson) testify to the wide- that bears his name, a name familiar to spread awareness of TS across cultures and time, de- the lay public and health professionals spite (or perhaps because of) its perceived rarity. So it alike. Once considered so rare that neurologists might seems that the medical community trailed the un- Mexpect to witness the disorder perhaps once in their trained community by centuries in recognizing the professional lifetime, Tourette syndrome (TS) is, in syndrome. fact, common enough that virtually all pediatricians From the time of its initial medical description in will have several patients with this condition in their 1885 until the 1960s, medical experts viewed TS as a practice. Yet, despite its name recognition and the psychological disorder, and treatment was customarily number of people it affects, TS often goes undiag- directed toward psychotherapy.
    [Show full text]
  • Eye Movement Measures of Cognitive Control in Children with Tourette Syndrome
    The Texas Medical Center Library DigitalCommons@TMC The University of Texas MD Anderson Cancer Center UTHealth Graduate School of The University of Texas MD Anderson Cancer Biomedical Sciences Dissertations and Theses Center UTHealth Graduate School of (Open Access) Biomedical Sciences 5-2010 Eye Movement Measures of Cognitive Control in Children with Tourette Syndrome Cameron B. Jeter Follow this and additional works at: https://digitalcommons.library.tmc.edu/utgsbs_dissertations Part of the Cognitive Neuroscience Commons, Nervous System Diseases Commons, Other Psychiatry and Psychology Commons, and the Systems Neuroscience Commons Recommended Citation Jeter, Cameron B., "Eye Movement Measures of Cognitive Control in Children with Tourette Syndrome" (2010). The University of Texas MD Anderson Cancer Center UTHealth Graduate School of Biomedical Sciences Dissertations and Theses (Open Access). 26. https://digitalcommons.library.tmc.edu/utgsbs_dissertations/26 This Dissertation (PhD) is brought to you for free and open access by the The University of Texas MD Anderson Cancer Center UTHealth Graduate School of Biomedical Sciences at DigitalCommons@TMC. It has been accepted for inclusion in The University of Texas MD Anderson Cancer Center UTHealth Graduate School of Biomedical Sciences Dissertations and Theses (Open Access) by an authorized administrator of DigitalCommons@TMC. For more information, please contact [email protected]. EYE MOVEMENT MEASURES OF COGNITIVE CONTROL IN CHILDREN WITH TOURETTE SYNDROME by Cameron Beth
    [Show full text]
  • TSP Vol. 65, No. 1 (January)
    APA Division 16 School Psychology Vol. 65, No. 1 | Winter 2011 A m e r i c A n psychologic A l A s s o c i A t i o n 4 | President’s Message 33 | Book Review Concluding Thoughts Behavioral Interventions in Schools: Bonnie Nastasi, Tulane University Evidence-Based Positive Strategies: A Book Review 7 | Research Forum Mark Terjesen, St. John’s University Sluggish Cognitive Tempo Robert Eme, The American School of 40 | SASP – The Student Corner inside Professional Psychology, Argosy University, “I’d Love To, But Money’s Tight” Schaumburg Campus A Student Survival Guide to Finding Funding in a Low-Budget World 11 | Research Forum Lindsey DeBor and Kristin Rezzetano, Duquesne University Tourette Syndrome: Social Implications and Treatment Strategy Review Katlyn Conville, Flagler College 43 | People & Places Ara Schmitt, Duquesne University 22 | Practice Forum Illusions of Competence in Children 45 | Announcements with Attention-deficit/Hyperactiviy Disorder Division of General Psychology: Julia Ogg, Sarah Fefer and Ashley Chappel, Awards Nominations The University of South Florida Theory into Practice: 28 | Practice Forum Call for Proposals Careers Classroom-based Tiered Anti-Bullying Program Utilizing Group Cooperative Teaching and Peer Support: A Pilot Study Steven Hershey, Gregory Paquin, and Marilyn Banigan, Pawtucket School Department, Rhode Island t h e s c hool p s ychologist – winter 2011 The School Psychologist Advertising & Submission Info are preferred. Test reviews, book reviews, and comments Moving or missing your newsletter? Display Ad Rates* for The Commentary Section are welcome. All submissions Ad Size Rate More information about Di vi sion 16 should be double spaced in Times New Roman 12 point Full page (6.625” x 9.25”) $625 font and e-mailed to the Editor.
    [Show full text]