Miracle-dz/UniFAR-FTUs huggingface dataset:
Therapist interventions and client ambivalence in two cases of narrative therapy for depression

Abstract Aim: We understand ambivalence as a cycle of opposing expressions by two internal voices. The emergence of a suppressed voice produces an innovative moment (IM), challenging the dominant voice, which represents the client’s problematic self-narrative. The emergence of the IM is opposed by the dominant voice, leading to a return to the problematic self-narrative. This study analyzed therapist and client responses to each other in episodes of ambivalence. Method: The therapeutic collaboration coding system (TCCS) assesses whether and how the therapeutic dyad is working within the therapeutic zone of proximal development (TZPD) by examining client responses to therapist interventions. We applied the TCCS to episodes in which a good- and a poor-outcome client in narrative therapy expressed ambivalence. Results: In both the good- and poor-outcome cases, the therapist responded to the emergence of ambivalence similarly, balancing challenging and supporting. The good-outcome case responded at the developmental level proposed by the therapist when challenged, while the poor-outcome case lagged behind the level proposed. Discussion: This supports the theoretical explanation that the therapist did not match client’s developmental level in the poor-outcome case, working beyond the client’s current TZPD and contributing to the maintenance of ambivalence.
Synthesis of Bipartite Tetracysteine PNA Probes for DNA In Situ Fluorescent Labeling

“Label‐free” fluorescent probes that avoid additional steps or building blocks for conjugation of fluorescent dyes with oligonucleotides can significantly reduce the time and cost of parallel bioanalysis of a large number of nucleic acid samples. A method for the synthesis of “label‐free” bicysteine‐modified PNA probes using solid‐phase synthesis and procedures for sequence‐specific DNA in situ fluorescent labeling is described here. The concept is based on the adjacent alignment of two bicysteine‐modified peptide nucleic acids on a DNA target to form a structurally optimized bipartite tetracysteine motif, which induces a sequence‐specific fluorogenic reaction with commercially available biarsenic dyes, even in complex media such as cell lysate. This unit will help researchers to quickly synthesize bipartite tetracysteine PNA probes and carry out low‐cost DNA in situ fluorescent labeling experiments. © 2017 by John Wiley & Sons, Inc.
Patient demographics and psychological functioning as predictors of unilateral termination of psychodynamic therapy

Abstract Approximately one in five patients drops out of treatment before its completion. Little is known about consistent predictors of dropout, and most studies focus on patients’ demographic characteristics. A mass of information is collected daily at intake in clinical practice. Based on psychodynamic theoretical conceptualizations and accumulative clinical experience, this information may help predict dropout, and thereby expand the empirically based predictors of dropout. Objective: The present study aims at bridging between scientific research and clinical practice by investigating potential predictors of unilateral termination collected at intake, before therapy, in addition to predictors already identified in the literature. Method: The study was based on data from 413 patients from a university consulting center. Each patient completed a pre-intake questionnaire collecting demographic information, and underwent an interview conducted by a professional intaker. Results: Results indicate that the consistent predictors described in the literature, education, and age, were related to unilateral termination rates. Additionally, lower intrapsychic functionality, as evaluated by the intakers, was also found to contribute uniquely to higher unilateral termination rates. Conclusion: This finding attests to the unique value of professional evaluations of patients’ intrapsychic functionality, frequently conducted in clinical practice, to detect patients at risk of unilateral termination of treatment.
Forensic Analysts’ Perspectives: Sexual Assault Kits Under the Microscope

ABSTRACT Properly collected evidence from a sexual assault examination can assist in the prosecution of the suspected perpetrator or in the exoneration of the wrongfully accused. Previous studies have documented the increased quality of evidence collected by sexual assault nurse examiners (SANEs) versus non-SANE trained providers (Ledray & Simmelink, 1997; Sievers, Murphy, & Miller, 2003) as well as the effectiveness of SANE programs (Campbell, Patterson, & Lichty, 2005; National Institute of Justice, 1999). SANE nurses attempt to collect appropriate specimens through the correct means and in sufficient quantities for forensic analysis with every examination. Samples of good analytical quality offer the best chance of obtaining deoxyribonucleic acid (Burg, Kahn, & Welch, 2011). As one method of quality improvement, SANE nurses can learn to increase the consistency of quality evidence collection by eliciting feedback from the analysts who receive and process the specimens. A national survey of crime laboratories that analyze sexual assault kits was conducted. This paper will present forensic analysts’ perspectives about the quality of data collection, feedback for improvement, and resources for further education.
Patient and Staff Views of Quality in Forensic Psychiatric Inpatient Care

Abstract The study describes and compares perceived quality of care among patients and staff using the Quality in Psychiatric Care–Forensic In-Patient and the Quality in Psychiatric Care–Forensic In-Patient Staff questionnaires. The questionnaires are both based on the perception of the quality of the forensic psychiatric care given to the patients, but the wording is adjusted to fit patients or staff. The study sample consisted of 66 patients and 202 staff members from 12 forensic units in Sweden. Using multiple regression analyses to adjust for demographic variables, it was found that patients perceived the quality of support and secluded environment lower than did staff, whereas staff had lower perceptions than patients of the quality of secure environment. The combination of these questionnaires provides new possibilities for assessing the quality of forensic psychiatric care and evaluating interventions, important factors in the management and planning of forensic care.
House to House, Shelter to Shelter: Experiences of Black Women Seeking Housing After Leaving Abusive Relationships

Abstract Locating safe and affordable housing is a vital step for women who decide to leave their abuser. Without housing, many women, particularly those who live in poverty, are forced to remain in abusive relationships, accept inadequate or unsafe housing, or become homeless (Menard, 2001; Moses, 2010). Women who choose to leave their abusers are faced with multiple barriers in establishing their independence such as limited financial resources, mental illness, and the lack of affordable housing (Botein & Hetling, 2010), putting them at risk of revictimization. This pilot study explores the narratives of Black mothers currently residing at an emergency intimate partner violence shelter to discover their experiences in seeking housing after leaving abusive relationships with a focus on housing instability and mental health. Utilizing a qualitative descriptive design, four major themes emerged: (a) unstable/insecure housing over time, (b) limited support, (c) survival, and (d) mental health Implications for clinicians are discussed.
Component studies of psychological treatments of adult depression: A systematic review and meta-analysis

Abstract Objectives: A recent report from the US Institute of Medicine indicated that identifying core elements of psychosocial interventions is a key step in successfully bringing evidence-based psychosocial interventions into clinical practice. Component studies have the best design to examine these core elements. Earlier reviews resulted in heterogeneous sets of studies and probably missed many studies. Methods: We conducted a comprehensive search of component studies on psychotherapies for adult depression and included 16 studies with 22 comparisons. Results: Fifteen components were examined of which four were examined in more than one comparison. The pooled difference between the full treatments and treatments with one component removed was g = 0.21 (95% CI: 0.03∼0.39). One study had sufficient statistical power to detect a small effect size and found that adding emotion regulation skills increased the effects of CBT. None of the other studies had enough power to detect an effect size smaller than g = 0.55. Only one study had low risk of bias. Conclusions: The currently available component studies do not have the statistical power nor the quality to draw any meaningful conclusion about key ingredients of psychotherapies for adult depression.
Immunohistochemical detection of EGFR, p185erbB-2, Bcl-2 and p53 in breast carcinomas in pre-menopausal and post-menopausal women

Young pre-menopausal women with breast carcinomas have an overall worse prognosis than older, post-menopausal women. Because histologic grade is a major predictor of tumor behavior and correlates with biomarker expression, we assessed the immunohistochemical expression of epidermal growth factor receptor (EGFR), p185erbB-2 and Bcl-2, and nuclear accumulation of p53 in breast carcinomas in pre- and post-menopausal women with equivalent histologic grades. This allowed identification of differences in biomarker expression and prognostic significance in pre- and post-menopausal women independent of histologic grade. We investigated 100 infiltrating ductal carcinomas (IDC) in pre-menopausal women, ages 45 years and younger, and 100 IDC in post-menopausal women, ages 65 years and older. The IDC were selected so that the proportions of high and low/moderate grade carcinomas were equal in the pre- and post-menopausal groups. Prognostic utility of biomarker expression in pre- and post-menopausal groups was determined by product limit and multivariate analysis of survival. There were statistically significant differences in cytoplasmic expression of EGFR and Bcl-2 and nuclear accumulation of p53, but not in the expression of p185erbB-2, in carcinomas of high vs. low histologic grade. There was no difference in the expression of EGFR, p185erbB-2 or Bcl-2, or in nuclear accumulation of p53 in these IDC from pre- vs. post-menopausal women. Bcl-2 and the nuclear accumulation of p53 were of prognostic significance in our overall study population; however, when assessing pre- and post-menopausal women separately, Bcl-2 and p53 were of prognostic significance only in pre-menopausal, but not post-menopausal women. In summary expression of EGFR and Bcl-2 and nuclear accumulation of p53 were significantly associated with histologic grade, but not with menopausal status. In addition, there were differences in the prognostic effectiveness of these biomarkers in pre- vs. post-menopausal women.
Mental health service use by older adults: the role of chronic pain.

OBJECTIVE Mental health disorders commonly co-occur in patients with chronic pain, but little is known about the role of chronic pain in mental health service use. In this study, the authors explored the role of chronic pain in mental health service use by adults according to age group. METHOD The authors conducted a cross-sectional analysis of survey data from the second wave of the Health Care for Communities telephone survey collected in 2000-2001. Participants consisted of U.S. civilian adults (N = 6629) from randomly selected U.S. households. Common mental disorders were assessed using the short-form versions of the World Health Organization's Composite International Diagnostic Interview. Chronic pain conditions and mental health services received were identified by self-report. Physical and mental functioning was assessed using the Short Form-12. RESULTS Adults older than age 60 had higher rates of chronic pain and lower rates of mental health service use compared with those aged 18-60 years. In multiple logistic regression models, an interaction effect was found between age and chronic pain (odds ratio: 3.0 [1.1-8.0]) with chronic pain significantly increasing the odds of any mental health care in the past year in adults older than 60 years of age. CONCLUSIONS Chronic pain increases the likelihood of mental health service use among older adults. Chronic pain may facilitate the presentation of distress in medical settings for these adults.
Minidose Warfarin and Failure to Prevent Deep Vein Thrombosis After Joint Replacement Surgery Despite Inhibiting the Postoperative Rise in Plasminogen Activator Inhibitor Activity

In a prospective randomised study in patients undergoing elective total hip or knee replacement surgery, the antithrombotic efficacy of fixed-minidose warfarin (1 mg daily commenced 7 days before surgery) was compared with that of subcutaneous calcium heparin (Calciparine, 5,000 IU t.d.s. commenced 2 h before surgery). Both regimens were continued until venography of the operated limb was performed 9-14 days postsurgery. Venographically detected deep vein thromboses (DVTs) occurred in 15 of the 31 patients (48.4%) in the minidose warfarin group and in eight of the 37 patients (21.6%) receiving heparin. The absolute difference in the incidence of DVT was 26.8% in favour of heparin (95%l confidence interval [CI] -4.&--48.8%; p = 0.039). Proximal DVTs were detected in three patients receiving minidose warfarin and in none of those on heparin (p = 0.09). Minidose warfarin appeared to prevent the postoperative rise in the activity of plasminogen activator inhibitor (PAI) that occurred with heparin, although preoperative PAI activity was greater in the warfarin group. The prothrombin time (PT) and activated partial thromboplastin time (APTT) were within the normal range on the day of surgery in both treatment groups. Postsurgery, the minidose warfarin regimen produced a small, but significant prolongation of the PT compared with the group receiving heparin, In contrast to heparin, 1 mg warfarin daily failed to prevent postoperative acceleration of the APTT. There was no significant difference between the two regimens in bleeding complications. In conclusion, the fixed-minidose warfarin regimen cannot be recommended for prevention of DVT after hip or knee replacement surgery. Inhibition of the postoperative rise in PAI activity appears not to protect against DVT after major joint replacement surgery. Key Words: Warfarin—Heparin—Deep vein thrombosis prophylaxis—Coagulation—Fibrinolysis— Plasminogen activator inhibitor.
Hemipelvectomy: outcome in 84 dogs and 16 cats. A veterinary society of surgical oncology retrospective study.

OBJECTIVE To report clinical findings, perioperative complications and long-term outcome in dogs and cats that had hemipelvectomy surgery for treatment of neoplasia. STUDY DESIGN Multi-institutional retrospective case series. ANIMALS Dogs (n = 84) and cats (16). METHODS Medical records (January 2000 to December 2009) of dogs and cats that had hemipelvectomy at participating institutions were reviewed. Postoperative progress and current status of the patient at the time of the study was determined by either medical record review, or via telephone contact with the referring veterinarian or owner. RESULTS Complications were infrequent and usually minor. Hemorrhage was the main intraoperative complication; 2 dogs required blood transfusion. One dog developed an incisional hernia. In dogs, hemangiosarcoma had the worst prognosis with a median survival time (MST) of 179 days. MST for chondrosarcoma (1232 days), osteosarcoma (533 days), and soft tissue sarcoma (373 days) were not statistically different. Median disease-free interval (DFI) for local recurrence of all tumor types was 257 days. Cats had 75% survival at 1 year, which was significantly longer than dogs. CONCLUSIONS Survival times for most tumor types can be good, but surgical margins should be carefully evaluated to ensure complete tumor removal. Adjuvant therapies may be advisable particularly for dogs to reduce rates of local recurrence or distant metastasis.
How acute is delirium in nursing homes: an observational study from Wesley Woods at Emory.

EDITOR: Delirium is a common syndrome in elderly patients. In contrast to younger patients, recovery (defined as return to baseline within 6 months) is only about 20%. In most instances, delirium develops insidiously. The following is an observational study of 42 patients admitted from nursing facilities to the Wesley Woods Neuropsychiatry Inpatient Unit with the admitting complaint of delirium complicated by agitation. Demographics of this population have been published elsewhere. Careful histories were taken from: family, nursing staff, including nursing assistants, and patient nursing home records. The following prodromal symptom clusters were identified: These observations suggest that before the onset of symptoms of frank delirium, there are often subsyndromal clinical ‘warning signs’ of incipient delirium. The pressing clinical question is that if these early warnings are identified, and the cause identified early (e.g., urinary tract infection), can frank delirium be avoided. Inouye and Charpentier and Duppils and Wikblad found that the following simple interventions led to a 25% decrease in the development of delirium, compared to usual care controls: early mobilization, early aggressive treatment of dehydration, reorientation, insistence that glasses and hearing aids be used. Duppils and Wilkblad found that the prevalence of increased anxiety, calls for assistance, disorientation, psychomotor restlessness, and decreased attention were found in 62% of elderly hip fracture patients who became delirious in the subsequent 6–48 hours. In a smaller investigation of 64 elderly postoperative patients, Matsushita et al., found that simple confusional states often preceded the onset of clinical delirium by 1–2 days. Lastly, studies of subsyndromal delirium (symptom clusters that may or may not progress to frank delirium), disorientation and inattention were common. This observational study and the modest literature review highlighting the critical need for further work. Delirium in the elderly is often associated with greatly increased morbidity and mortality. Perhaps by identifying prodromal symptoms, the development of the full-blown syndrome of delirium can be avoided.
Effect of an intervertebral disk spacer on stiffness after monocortical screw/polymethylmethacrylate fixation in simulated and cadaveric canine cervical vertebral columns.

OBJECTIVE To determine the biomechanical effect of an intervertebral spacer on construct stiffness in a PVC model and cadaveric canine cervical vertebral columns stabilized with monocortical screws/polymethylmethacrylate (PMMA). STUDY DESIGN Biomechanical study. SAMPLE POPULATION PVC pipe; cadaveric canine vertebral columns. METHODS PVC model-PVC pipe was used to create a gap model mimicking vertebral endplate orientation and disk space width of large-breed canine cervical vertebrae; 6 models had a 4-mm gap with no spacer (PVC group 1); 6 had a PVC pipe ring spacer filling the gap (PCV group 2). Animals-large breed cadaveric canine cervical vertebral columns (C2-C7) from skeletally mature dogs without (cadaveric group 1, n = 6, historical data) and with an intervertebral disk spacer (cadaveric group 2, n = 6) were used. All PVC models and cadaver specimens were instrumented with monocortical titanium screws/PMMA. Stiffness of the 2 PVC groups was compared in extension, flexion, and lateral bending using non-destructive 4-point bend testing. Stiffness testing in all 3 directions was performed of the unaltered C4-C5 vertebral motion unit in cadaveric spines and repeated after placement of an intervertebral cortical allograft ring and instrumentation. Data were compared using a linear mixed model approach that also incorporated data from previously tested spines with the same screw/PMMA construct but without disk spacer (cadaveric group 1). RESULTS Addition of a spacer increased construct stiffness in both the PVC model (P < .001) and cadaveric vertebral columns (P < .001) compared to fixation without a spacer. CONCLUSIONS Addition of an intervertebral spacer significantly increased construct stiffness of monocortical screw/PMMA fixation.
Emotional Processing Theory Put to Test: A Meta-Analysis on the Association Between Process and Outcome Measures in Exposure Therapy.

In order to test the predictions derived from emotional processing theory (EPT), this meta-analysis examined correlations between outcome of exposure therapy and three process variables: initial fear activation (IFA), within-session habituation (WSH) and between-session habituation (BSH). Literature search comprised a keyword-based search in databases, a reverse search and the examination of reference lists. Of the 21 studies included in the analyses, 17 provided data concerning IFA (57 endpoints, total N = 490), five concerning WSH (7 endpoints, total N = 116) and eight concerning BSH (22 endpoints, total N = 304). Owing to this data structure, analyses were performed using robust variance estimation with random-effects models being assumed a priori. Results indicated that WSH and BSH are positively related to treatment outcome. By contrast, the statistical association between IFA and outcome of exposure was not confirmed, whereas our moderator analysis suggested that physiological process measures lead to higher correlations than non-physiological ones. The results for IFA and BSH were affected by selective reporting. In sum, our results do not specifically strengthen EPT while matching other theoretical perspectives such as inhibitory learning and reality testing. Further research is needed to provide recommendations concerning the best way of delivering exposure therapy. Copyright © 2016 John Wiley & Sons, Ltd. KEY PRACTITIONER MESSAGE This meta-analysis examined three variables of emotional processing theory (EPT). Initial fear activation was not linearly related to outcomes of exposure therapy. Habituation within and between sessions were shown to correlate with outcome. Outcome reporting bias was shown to play a crucial role in this meta-analysis. Results do not specifically support EPT.
Perceptions of Blame and Credibility Toward Victims of Childhood Sexual Abuse: Differences Across Victim Age, Victim-Perpetrator Relationship, and Respondent Gender in a Depicted Case

This study investigated victim culpability, credibility, and assault severity in a hypothetical sexual abuse case. A 2 (respondent gender) × 3 (victim age) × 3 (perpetrator type) between-subjects design was employed. Members (391) of the U.K. general public read the depiction of a female child assaulted by an adult male perpetrator. Respondents then completed an attributions questionnaire. Findings showed that male respondents were less positive toward victims and considered the victim less credible than female respondents. Younger victims (aged five years) were considered more credible than older children (aged 15 years). Victims of strangers were considered more positively and more credible than victims of someone known to them (their father or a family friend). Suggestions for future work are proposed.