bluuebunny/crossref_metadata_2025 huggingface dataset:
A Survey of Neurologists on Self‐treatment and Treatment of Their Families
Authors: Evans Randolph W. , Lipton Richard B. , Ritz Kristin A.
Published: November 2006

Background.—Although neurologists commonly self‐treat for migraine and other conditions, little is known about the patterns of self‐treatment by physicians in the United States.

Objectives.—The aim was to obtain information about neurologist's self‐treatment and treatment of family members and their attitudes about self‐treatment by other physicians.

Methods.—A survey was performed among neurologists attending the Texas Neurological Society's Winter Conference using a questionnaire about self‐treatment and treatment of family members during the prior 12 months and attitudes about self‐treatment by other physicians.

Results.—Among 186 physicians invited to participate, the response rate was 48%. Although 76% reported having primary care physicians, neurologists reported the following behaviors: 38% self‐diagnosed or self‐treated medical conditions including migraine in 25%; 56% started themselves on prescription medications including 21% who used triptans and 15% who used migraine preventive medications; 33% ordered blood tests on themselves; and 20% ordered imaging studies on themselves. Sixty percent reported missing no work due to illness, 87% missed 2 days or less, and 99% reported missing 1 week or less. Eighty percent reported treating their family members for acute minor illnesses and 33% for chronic conditions. The following percentage of participants reported that they would be likely to self‐diagnose and self‐treat the following hypothetical illnesses: 70%, migraines which were not severe; 19%, new onset frequent headaches; and 48%, chronic daily headaches. The following percentage of participants agreed or strongly agreed that the following behaviors were acceptable for physicians: 94%, self‐treat acute minor illnesses; 37%, self‐treat chronic conditions; 42%, order blood test for diagnostic purposes; 40%, order imaging studies for diagnostic purposes; 87%, treat family members for acute minor conditions; and 36%, treat family members for chronic conditions.

Conclusions.—Neurologists commonly treat themselves and family members.
A Validation Study of an Italian Version of the “ID Migraine”
Authors: Brighina Filippo , Salemi Giuseppe , Fierro Brigida , Gasparro Antonio , Balletta Antonio , Aloisio Antonina , La Pegna Giovanni , Randisi Giovanna , Saporito Vincenzo , Calagna Giuseppe , La Naia Filippo , Morana Rossana
Published: November 2006

Background.—Migraine is a highly prevalent and disabling disease which is substantially underdiagnosed in primary care. Recently, the ID Migraine, a self‐administered questionnaire, consisting of only 3 items, was shown to be a valid and reliable screening instrument for migraine in primary care in the United States.

Objective.—The aim of the present study was to validate an Italian version of the “ID Migraine” questionnaire.

Methods.—Two hundred and twenty‐two consecutive headache patients referring to 8 headache centers in Sicily (Italy) completed an Italian version of the ID Migraine. The responses to the questionnaire were compared with the diagnosis of headache made by a headache specialist blind to the result of the questionnaire. Sensitivity, specificity, positive and negative predictive values for migraine were calculated.

Results.—The statistical analysis of 222 patients examined showed a very good performance of the ID Migraine with high sensitivity: 0.95 (95% CI, 0.91 to 0.98), specificity: 0.72 (95% CI, 0.62 to 0.82), and positive predictive value: 0.88 (95% CI, 0.82 to 0.93). ID Migraine showed also a very good accuracy level: 0.87 (95% CI, 0.83 to 0.92).

Conclusion.—This validation study showed “ID Migraine” as a valid tool for migraine screening also in Italian patients referring to headache centers. If confirmed in a primary care setting, these results establish the “ID Migraine” as a valid screening instrument for migraine in Italian population.
Improvement of Chronic Headache After Treatment of Unruptured Intracranial Aneurysms
Authors: Kong Doo‐Sik , Hong Seung‐Chyul , Jung Young‐Jo , Kim Jong Soo
Published: November 2006

Objective.—The objective of this study is to determine the incidence, character, and outcome of headache in patients with unruptured intracranial aneurysms who had been treated to avoid the risk of rupture.

Background.—There are a variety of clinical manifestations associated with unruptured intracranial aneurysms. Among them, chronic headache is the most common presenting and/or accompanying symptom.

Methods.—Among the 137 patients with unruptured aneurysms who had been treated, we collected 81 patients excluding 30 on the basis of inclusion criteria. Twenty‐six patients were lost to follow‐up. We collected data by medical record review and a telephone survey. Included in the information collected was the analysis of presenting symptom, location and size of each aneurysm, location, quality, intensity and duration of headaches, associated symptoms, triggering and alleviating factors, and precipitating events.

Results.—Forty‐nine patients (60.5%) of 81 had chronic headaches before the diagnosis of unruptured intracranial aneurysm. Forty‐four patients (89.8%) answered that their headaches were improved slightly (12 patients) or markedly (32 patients) (P <.05). The clinical pattern of the headache worsened in only 1 patient and did not change in 4 patients. When the surgical group (40 patients) and the coil embolization group (41 patients) were compared, there was no significant difference observed in outcome (P >.05).

Conclusion.—Either by employing the technique of clipping or by coil embolization, treatment of unruptured intracranial aneurysms resulted in relief of headaches in majority of patients who had headaches pre‐operatively.
Hemicrania Continua‐Like Headache Associated With Internal Carotid Artery Dissection May Respond to Indomethacin
Authors: Ashkenazi Avi , Abbas Muhammad A. , Sharma Dinesh K. , Silberstein Stephen D.
Published: November 2006

Hemicrania continua (HC) is an idiopathic, chronic disorder characterized by a continuous, strictly unilateral headache associated with ipsilateral cranial autonomic symptoms. The symptoms of HC typically respond dramatically to indomethacin therapy. We describe a patient with traumatic internal carotid artery dissection, who presented with a clinical picture mimicking HC that initially responded to indomethacin. Patients with a clinical picture similar to HC should be managed with a high index of suspicion for a possible cervical arterial dissection.
Novel sites of aldose reductase immunolocalization in normal and streptozotocin‐diabetic rats
Authors: Jiang Yun , Calcutt Nigel A. , Rames Khara M. , Mizisin Andrew P.
Published: November 2006

Abstract  Glucose metabolism by aldose reductase (AR) is implicated in the pathogenesis of many diabetic complications, including neuropathy. We have re‐evaluated the distribution of AR in the sciatic nerve and dorsal root ganglion (DRG) of normal rats, expanded these observations to describe the location of AR in the spinal cord and footpad skin, and investigated whether diabetes alters the distribution of AR. In sciatic nerve, AR was restricted to cytoplasm of myelinated Schwann cells and endothelial cells of epineurial, but not endoneurial, blood vessels. AR immunoreactivity (IR) was present in satellite cells in the DRG. In skin, AR‐IR was detected in vascular endothelial cells, Schwann cells of myelinated fibers, and axons of perivascular sympathetic nerves. AR was localized selectively to oligodendrocytes of the white matter of spinal cord. The distribution of AR‐IR in sciatic nerve, DRG, skin, and spinal cord was not altered by up to 12 weeks of streptozotocin‐induced diabetes. Identification of perineuronal satellite cells, oligodendrocytes, and perivascular sympathetic nerves as AR‐expressing cells reveals them as cellular sites with the potential to contribute to diabetic neuropathy.
Expression of the antioxidant enzyme peroxiredoxin 5 in the human peripheral nervous system
Authors: Lu Jun Lan , Vallat Jean‐Michel , Pollard John D , Knoops Bernard , Ouvrier Robert
Published: November 2006

Abstract  Peroxiredoxins (PRDXs) belong to a family of peroxidases that are highly expressed in mammalian tissues. Comparatively, little is known about their expression in the nervous system. In this study, we examined in human sural nerve, the expression of PRDX5, the most recently defined peroxiredoxin family member. Immunohistochemical staining of paraffin sections showed that PRDX5 expression was mainly localised to the axon and, to a lesser extent, to the Schwann cells. Immunogold labelling electron microscopy further revealed that PRDX5 is widely distributed in multiple cellular compartments, most importantly in mitochondria but also in axoplasm, Schwann cell cytosol, nucleus, and myelin. A progressive decline in PRDX5 expression with advancing age was identified in human nerves at different ages. The wide distribution of PRDX5 in cellular and sub‐cellular structures indicates that it may play important roles in a wide range of tissue components in normal peripheral nerves.
Preparedness for Influenza Pandemic in Hong Kong Nursing Units
Authors: Tiwari Agnes , Tarrant Marie , Yuen Kwan Hok , Chan Sophia , Kagan Sarah , Ching Patricia , Wong Alan , Wong Samson SY
Published: November 2006

Background: To present preparedness planning for an influenza pandemic for two nursing subunits: nursing services in hospitals and schools of nursing in universities.

Discussion: The preparedness plan is modeled on a modified Haddon matrix, a logical approach to identify measures appropriate for the pre‐event, event, and postevent phases of an influenza pandemic. For the pre‐event phase, the objective is to ensure preparedness for the potential pandemic outbreak through training, communication, surveillance, infection control, and vaccination. Once the pandemic outbreak is declared, the aim is to implement effective measures to ensure a rapid and appropriate response. For the postevent phase, the plan is focused on the restoration of core functions, vigilance for a second or possibly more waves of the pandemic, and psychosocial support to staff and students.

Conclusion: Measures required to prepare for, respond to, and manage the consequences of influenza pandemic are identified. This planning indicates the need to balance a logical approach with contextual perspectives and the importance for nursing leaders to develop plans for subunits of larger entities.
Injury as a Global Phenomenon of Concern in Nursing Science
Authors: Sommers Marilyn Sawyer
Published: November 2006

Purpose:To discuss injury research as a phenomenon of concern in nursing science.

Organizing Construct: Injury is defined as the physical damage that results when the human body is briefly subjected to intolerable levels of energy. It is the leading cause of death in the first 4 decades of life in high‐income nations and is second only to infectious diseases as a leading cause of death in low‐ and middle‐income nations.

Methods:Review and discussion of relevant scientific and theoretical literature in both injury and nursing science.

Findings: Nurse scientists can apply unique perspectives to increase understanding of injury and its consequences. Fertile areas for nursing inquiry include identifying people at risk, developing models to explain the association between risk‐taking and injury, testing interventions to prevent and limit injury, and creating and refining interventions that are culturally relevant to subpopulations most at risk for injury.

Conclusions:The mandate to improve global heath should lead to nursing inquiry about this phenomenon, including developing and testing interventions to prevent and reduce injury.
Chronic Dementing Conditions, Genomics, and New Opportunities for Nursing Interventions
Authors: Schutte Debra L. , Holston Ezra C.
Published: November 2006

Purpose: To (a) provide an overview of chronic dementing conditions; (b) discuss the etiologic and clinical characteristics of Alzheimer disease (AD) and Parkinson disease (PD) within the framework of the family systems genetic illness model; and (c) to explore opportunities to enhance outcomes through the integration of genomics information and technologies into nursing practice.

Design: An integrated review of the literature, including the organizing construct of the family systems genetic illness model.

Findings: AD and PD are both influenced by genetic and environmental factors; in a small percentage of families, gene mutations are the primary etiologic factor. Genetic testing is an option for some families experiencing early‐onset, familial disease. Presymptomatic and diagnostic genetic testing have limited clinical utility for the more common late‐onset AD and PD.

Conclusions: The current abilities of healthcare professionals to effectively intervene in people with AD and PD are limited by an incomplete understanding of the biologic basis of these diseases. Advances in genomics research and technology are providing the information and tools necessary to understand the molecular basis of these devastating disorders toward the goal of more specific and effective interventions.
Non‐Hodgkin's Lymphoma as an Exemplar of the Effects of Genetics and Genomics
Authors: Calzone Kathleen A. , Lea Dale Halsey , Masny Agnes
Published: November 2006

Purpose: To discuss the interface of genetics and genomics science in the identification and management of non‐Hodgkin's lymphoma. The field of oncology is an exemplar of how the genomic revolution is influencing more individualized care and treatment of people with cancer and their families.

Design: Integrated review of the cancer genetics and genomics literature.

Methods: Published peer‐reviewed research, conference proceedings, and peer‐reviewed internet sites regarding the genetics and genomics of cancer and non‐Hodgkin's lymphoma were reviewed, analyzed, and data synthesized.

Findings: All malignancies have a genetic and genomic basis. Genetic and genomic breakthroughs are rapidly being applied to all aspects of cancer care including: (a) identification of at‐risk individuals before disease occurs, (b) diagnosis and characterization of disease and its aggressiveness when it appears via gene expression, (c) and individualization of therapies over the disease course based on these new molecular technologies.

Conclusions: Oncology nurses in every role, clinical subspecialty, and type of education are among the first nurses to integrate genetic and genomic information in such a broad context. This experience shows how genetic and genomic discoveries will interface with other health conditions and ultimately, will affect the practice of all nurses.
Metabolic Control of Adults With Type 2 Diabetes Mellitus Through Education and Counseling
Authors: Gallegos Esther C. , Ovalle‐Berúmen Fernando , Gomez‐Meza Marco Vinicio
Published: November 2006

Purpose: To test the efficacy of a controlled nursing intervention focused on education and counseling to improve metabolic control of adults diagnosed with diabetes mellitus type 2 in (DMT2) ambulatory care.

Design: A quasi‐experimental design with repeated measures was selected. A sample of 45 subjects participated, of which 25 were in the experimental group, and 20 in the comparison group. Measures were taken at 0, 3, 6, 9, and 12 months, including glycosylated
hemoglobin (HbA1c), psychosocial, and clinical variables.

Findings: Results showed a significant decrease in HbA1c in the experimental group, as well as positive effects of self‐care agency, adaptation, and barriers to treatment (plus one interaction) on the HbA1c levels and on the scores of self‐care actions.

Conclusions: The counseling and educational model applied in the intervention was effective to improve the metabolic control of diabetic patients in the experimental group. Self‐care agency, adaptation, and barriers were predictors of self‐care measures and level of HbA1c.
Improving Cognition and Function Through Exercise Intervention in Alzheimer's Disease
Authors: Yu Fang , Kolanowski Ann M. , Strumpf Neville E. , Eslinger Paul J.
Published: November 2006

Purpose: To analyze the effects of cognition on function and to explore the potential of aerobic exercise for promoting cognitive and functional capacities.

Design: Integrative review of literature.

Methods: Studies were selected based on an extensive search of electronic databases and manual cross‐referencing for 1980 to 2006, using the combination of key words: Alzheimer's disease (AD), dementia, or cognitive impairment with function or activities of daily living.

Findings: Three broad themes were identified from the literature analysis. First, global cognition has mainly been used to examine the effect of cognition on function, indicating an assumption that functional decline progresses in a hierarchical manner in AD. Second, specific cognitive domains affect functional decline in different ways. Executive functioning might have more effect on function than does memory. Third, aerobic exercise might promote cognitive and functional capacities in people with AD by modifying neuropathological changes in the brain.

Conclusions: Specific cognitive domains such as executive functioning are important for understanding function in people with AD and are potentially modifiable by aerobic exercise.
Nurses' Narratives of Unforgettable Patient Care Events
Authors: Gunther Mary , Thomas Sandra P.
Published: November 2006

Purpose:To explore the experience of registered nurses (RNs) caring for patients in contemporary hospitals.

Design:The descriptive phenomenological study was based in the philosophical perspectives of Husserl and Merleau‐Ponty.

Methods:A purposive sample of 46 RNs employed in acute care hospitals in the southeastern United States (US) were recruited by network sampling. Data from unstructured interviews were analyzed in an interpretive group and themes were identified.

Findings:Four themes were identified: (a) extraordinary caregiving events, (b) incomprehensibility, (c) questioning whether anything else could have been done, and (d) “alone or together,” indicating the isolation nurses often experience while giving care as well as profound moments of connection, especially with patients.

Conclusions:Caregiving experiences resulted in an accumulating residue of moral distress which in turn became ground for future experiences in the everyday work life of RNs. Sometimes years later, participants were still trying to justify and understand the outcomes and perhaps to absolve themselves from blame. Participants were confronted with the limits of science and skill and plunged into the realm of existential questions for which they had no ready answers.
Sexual Harassment of Female Nurses by Patients in Japan
Authors: Hibino Yuri , Ogino Keiki , Inagaki Michiko
Published: November 2006

Purpose: To determine the prevalence and details of sexual harassment of female nurses by patients and nurses' reactions in Japanese hospitals.

Methods: A research survey with a self‐administered questionnaire was conducted. Questionnaires were distributed to hospital nurses, and 473 of 600 (78.8%) questionnaires were returned. A content analysis was done with descriptive data from the questionnaires.

Findings: The proportion of female nurses who have ever been sexually harassed by patients was 55.8%. Sexual harassment was prevalent in the hospital environment and some details were serious. Conversely, nurses tended to react passively and moderately and, in many cases, they did not attempt to stop the patients. Relatively few incidents were reported to the appropriate supervisors.

Conclusions: This sample of Japanese hospital nurses were at high risk for sexual harassment, and administrators tended to underestimate the problem. No effective policies to combat this situation have yet been established in Japanese hospitals.
Targeting leukocyte trafficking to inflamed skin – still an attractive therapeutic approach?
Authors: Zollner Thomas M. , Asadullah Khusru , Schön Michael P.
Published: November 2006

Abstract:  Research into leukocyte trafficking and its therapeutic exploitation appears to be a multistep process, just like the trafficking cascade itself. The initial euphoria evoked by an early understanding of the trafficking steps was followed by considerable disappointment following the clinical failure of the first selectin antagonist Cylexin (CY‐1503), a sialyl LewisX mimetic. The research area recovered and identified additional attractive pharmacological targets such as chemokine receptors and integrins. However, after lack of efficacy in anti‐chemokine trials and the fatalities associated with anti VLA‐4 therapy (Tysabri), the question arose again whether targeting leukocyte trafficking is really promising or whether such a complex, multistep process with many redundant and/or functionally overlapping molecules is simply too challenging to deal with. In this article, we delineate some pros and cons of this approach followed by a brief update on where we stand in the field and where we might move in the future.
Early cutaneous gene transcription changes in adult atopic dermatitis and potential clinical implications
Authors: Plager Douglas A. , Leontovich Alexey A. , Henke Susan A. , Davis Mark D.P. , McEvoy Marian T. , Sciallis Gabriel F. , Pittelkow Mark R.
Published: November 2006

Abstract:  Atopic dermatitis (AD) is a common pruritic dermatitis with macroscopically non‐lesional skin that is often abnormal. Therefore, we used high‐density oligonucleotide arrays to identify cutaneous gene transcription changes associated with early AD inflammation as potential disease control targets. Skin biopsy specimens analysed included normal skin from five healthy non‐atopic adults and both minimally lesional skin and nearby or contralateral non‐lesional skin from six adult AD patients. Data were analysed on an individual gene basis and to identify biologically relevant gene networks. Transcription levels of selected genes were also analysed by quantitative PCR. Differential transcription occurring early in AD skin was indicated for (i) individual genes such as C‐C chemokine ligand (CCL)18, CCL13, and interferon‐α2 (IFNα2), (ii) genes associated with peroxisome proliferator‐activated receptor (PPAR)α‐ and PPARγ‐regulated transcription, and possibly for (iii) immunoglobulin J‐chain and heavy chain isotype transcripts. These data suggest that local changes in immunoglobulin‐associated transcription may favour IgE over secretory immunoglobulin (multimeric IgM and IgA) expression in AD skin. Decreased PPAR activity appears common to both AD and psoriasis, and reduced cutaneous IFNα2 transcription also appears characteristic of AD. Identification of these genes and pathways will direct future research towards controlling AD.
Spectral karyotyping demonstrates genetically unstable skin‐homing T lymphocytes in cutaneous T‐cell lymphoma
Authors: Padilla‐Nash Hesed M. , Wu Kaida , Just Helle , Ried Thomas , Thestrup‐Pedersen Kristian
Published: November 2006

Abstract:  We initially established cell lines from skin biopsies from four patients (MF8, MF18, MF19 and MF31) in early stages of cutaneous T‐cell lymphoma (CTCL) in 1999. After 3 weeks of culture, skin‐homing T lymphocytes were stimulated with phytohaemagglutinin. Metaphase spreads were analysed using spectral karyotyping (SKY), a molecular cytogenetic technique. MF18 and MF19 had predominantly normal karyotypes. MF8 had recurrent numerical aberrations resulting in two T lymphocyte clones: one with trisomy 21 (12/20 cells) and the other with monosomy chromosome 22 (3/20 cells). MF8 also exhibited a clonal deletion, del(5)(p15.1), as well as multiple non‐clonal structural aberrations. MF31 had a clonal deletion, del(17)(p12) and other non‐clonal deletions involving chromosomes 2, 5, 10, 11. MF18 had a single abnormal cell that contained two reciprocal translocations t(1;2)(q32;p21) and t(4;10)(p15.2;q24).

In 2001, three of the original patients had new skin biopsies taken and cell lines were established. SKY analysis revealed the continued presence of a T‐cell clone in MF8 with trisomy 21 (4/20 cells). Additionally, a new clone was seen with a del(18)(p11.2) (17/20 cells). MF31 had only one aberrant cell with a del(17)(p12). MF18 had a clonal deletion, [del(1)(p36.1) in 3/20 cells] and non‐clonal aberrations involving chromosomes 3, 4, 5, 6, 12, 13, 17 and 18.

Thus, three of four patients continued to show numerous numerical and structural aberrations, both clonal and non‐clonal, with only MF8 having a recurring T lymphocyte clone (+21). Our findings demonstrate high genetic instability among skin‐homing T lymphocytes even in early stages of CTCL. We did not see genetic instability or evidence of clones in cell lines from a patient with atopic dermatitis and one with psoriasis.
Calcium movements during pigment aggregation in freshwater shrimp chromatophores
Authors: Ribeiro Márcia , McNamara John Campbell
Published: November 2006

Pigment granule migration within crustacean chromatophores provides an excellent model with which to investigate cytoplasmic movements, given the antagonistic, neurosecretory peptide regulation of granule translocation, and the absence of innervation in these large, brightly colored cells. Red pigment‐concentrating hormone (RPCH) induces pigment aggregation in shrimp chromatophores via an increase in intracellular Ca2+; however, how this increase is brought about is not known. To examine the putative Ca2+ movements leading to pigment translocation in red, ovarian chromatophores of the freshwater shrimp, Macrobrachium olfersii, this study manipulates intra‐ and extracellular Ca2+ employing ER Ca2+‐ATPase inhibitors, ryanodine‐sensitive, ER Ca2+ channel blockers, and EDTA/EGTA‐buffered A23187/Ca2+‐containing salines. Our findings reveal that during pigment aggregation, cytosolic Ca2+ apparently increases from an intracellular source, the abundant SER, loaded by the SERCA and released through ryanodine‐sensitive receptor/channels, triggered by capacitative calcium influx and/or calcium‐induced calcium release mechanisms. Aggregation also depends on external calcium, which may modulate RPCH/receptor coupling. Such calcium‐regulated pigment movements form the basis of a complex system of chromatic adaptation, which confers selective advantages like camouflage and protection against ultra‐violet radiation to this palaemonid shrimp.
Cellular Localization and Function of the Antiviral Protein, Ovine Mx1 (oMx1): II. The oMx1 Protein Is a Regulator of Secretion in an Ovine Glandular Epithelial Cell Line
Authors: Toyokawa Koji , Leite Fabio , Ott Troy L.
Published: November 2006

Problem  Embryonic loss is a major contributor to infertility. Understanding factors affecting embryonic loss will help increase fertility.

Method of study  We investigated if ovine Mx1 (oMx1) mediated secretion by ovine glandular epithelial (oGE) cells using small interfering RNA (siRNA). Effects on secretion were examined through the conventional endoplasmic reticulum‐Golgi pathway using β2‐ microglobulin (β2MG) as a marker, and interferon‐stimulated gene 15 (ISG15) as a marker for unconventional secretion.

Results  Mx1 siRNA reduced oMx1 mRNA levels at 12 and 24 hr after IFN‐τ treatment (P < 0.05), without affecting levels of oMx2, ISG15, 2′,5′‐oligoadenylate synthetas or β2MG. Mx1 siRNA reduced Mx1 protein levels at 48 and 120 hr after treatment (P < 0.05) and protein levels remained low at 120 hr. Transient oMx1 knock‐down reduced secretion of oMx1 (P < 0.01). ISG15 protein in secretions was reduced without affecting intracellular levels (P < 0.05). Levels of β2MG in secretions were not affected by Mx1 siRNA.

Conclusion  We showed that oMx1 protein is secreted by oGE cells and that reduction in oMx1 protein levels by siRNA reduced secretion of ISG15, but not β2MG. Results support the hypothesis that oMx1 is a regulator of secretion through unconventional secretory pathway(s).
BAKING PERFORMANCE AND CONSUMER ACCEPTABILITY OF RAW AND EXTRUDED COWPEA FLOUR BREADS
Authors: MCWATTERS K.H. , PHILLIPS R.D. , WALKER S.L. , MCCULLOUGH S.E. , MENSA‐WILMOT Y. , SAALIA F.K. , HUNG Y.‐C. , PATTERSON S.P.
Published: November 2006

Cowpea flour was used to partially replace wheat flour in yeast bread, using automatic household‐type bread machines for mixing, proofing and baking. Loaves containing 15 or 30% extruded cowpea flour weighed more (683.4 g) than loaves from other treatments (641.1–652.6 g). The 100% wheat had the highest loaf volume (2.58 L) and the 30% extruded cowpea the lowest (1.64 L). Cowpea flour breads contained more protein (13.9–15.4%) than the 100% wheat (4.1% fat, 12.5% protein). Bread made with 15% extruded cowpea flour was not different (P < 0.05) from the all‐wheat control in sensory quality and acceptability. Hedonic ratings for the control and 15% extruded cowpea flour ranged from 6.6 (like slightly) to 7.4 (like moderately) for all sensory attributes. The least liked samples contained either 30% raw or 30% extruded cowpea flour, receiving ratings for all attributes ranging from 4.8 (disliked slightly) to 6.2 (liked slightly). Overall, 15% extruded cowpea flour demonstrated successful bread making performance without compromising sensory quality.
MICROBIOLOGICAL AND NUTRITIONAL QUALITY OF SOUS VIDE OR TRADITIONALLY PROCESSED FISH: INFLUENCE OF FAT CONTENT
Authors: GARCÍA‐LINARES M.C. , GONZALEZ‐FANDOS E. , GARCÍA‐FERNÁNDEZ M.C. , GARCÍA‐ARIAS M.T.
Published: November 2006

Sous vide technology, which implies vacuum packaging, pasteurization and storage at a chill temperature, also implies a challenge to obtain a balance between an extended shelf life and microbiological safety of the product with a fresh‐like appearance and a high nutritional value. The aim of this work was to determine the effect of fat content of two fish species (salmon and trout) on survival of mesophilic, psychrotrophic, Enterobacteriaceae, Micrococaceae and anaerobes during sous vide cooking and their control during chilled storage for 3, 20 and 45 days. Proximate and fatty acid composition was also determined using a traditional cooking method. Analyses were undertaken comparatively with the same culinary technique for sous vide and traditionally cooked fish. Higher fat levels in all products resulted in fewer microbial reductions. In order to establish adequate pasteurization (temperature/time) combinations for the assurance of microbial quality and shelf life of sous vide processed fish, fat content and fatty acid composition of food should be considered.
CATASTROPHE, OBJECTS AND REPRESENTATION: THREE LEVELS OF INTERPRETATION
Authors: Hinshelwood R.D.
Published: November 2006

ABSTRACT
This paper discusses the under‐used ideas of Esther Bick. In recapitulating briefly her discoveries, I have tried to show that in effect she was attempting to reach a third layer of experiencing in the unconscious; a neonatal struggle for containment which underlies Klein's descriptive level of object‐relations involved in primitive defence mechanisms in the infant, and Freud's further developed layer of repression and symbolization (and representation). With a brief piece of clinical material I indicate how each layer is linked to the others. This layering model helps, conceptually, to define interpretative choices. It remains, however, for further debate to decide how to choose which layer(s) for interpretation.
MAKING SENSE OF HOMOSEXUALITY
Authors: Wolf Darren J.
Published: November 2006

ABSTRACT
This paper examines how homosexuality has been described by a number of writers on the subject, and compares these accounts with the author's experience of his own sexuality. A critique is offered of contemporary accounts of homosexuality on grounds of their inconsistency and inadequacy: this is illustrated with specific examples of sexual behaviour from research findings and the press. Clinical material shows clients' sexual experiences are as varied and diverse as the multiplicity of theoretical accounts which seek to explain them. The importance of caution on the part of the psychotherapist when making sense of sexual material is emphasized.
FACTORS ASSOCIATED WITH THE OUTCOME OF PSYCHOANALYSIS OF HOMOSEXUAL PATIENTS
Authors: Macintosh Houston
Published: November 2006

ABSTRACT
In a survey of 422 psychoanalysts, 287 (68 per cent) reported data regarding 1222 homosexual patients. The database was analysed in regard to variables relating to the outcome of analysis. Change to heterosexuality was associated with the analyst's expectation that such change will occur. Significant therapeutic benefit was associated with greater length of analysis. Female analysts reported greater therapeutic benefit with their female patients than did male analysts. Nearly two‐thirds of patients received significant therapeutic benefit, without changing to heterosexuality. Higher rates of change were associated with higher rates of benefit for male patients. Greater analyst experience may also be important.
WHO SPEAKS? WHO LISTENS? DIFFERENT VOICES AND DIFFERENT SEXUALITIES
Authors: Ellis Mary Lynne
Published: November 2006

ABSTRACT
Psychoanalytic theories of sexuality have regarded homosexuality as a symptom of arrested sexual development. Such theorizing fails to acknowledge the prejudicial values that underpin it. The work of the philosopher, Michel Foucault, can offer psychotherapists new possibilities of considering sexual orientation that do not presuppose a split between the psychic and the socio‐political. The complexity and diversity of lesbian roles, identities, experiences and cultures are particularly highlighted by Audre Lorde (a Black lesbian feminist theorist). The two cases illustrate how a Foucauldian analysis, combined with a psychoanalytic approach, can enable us to respond more sensitively to questions of identity in our work with patients.
THE SAVIOUR IN THE GAP: A COMPARISON OF LACAN WITH FREUD AND LAING
Authors: Wall Judy Tame , Loewenthal Del
Published: November 2006

ABSTRACT
This article is about the location of meaning and‘truth’in what our clients say. The concept of cover story is outlined and this is then applied to a‘Freudian slip’. Various positions we take relative to the story are outlined. This is followed by three imaginary analyses by Freud, Laing and Lacan which demonstrate how the locus of truth can vary depending on our approach. The discussion of Lacan compares him favourably with many postmodernists, for whom the notion of truth has slipped away altogether.
IN TWO MINDS ABOUT COGNITIVE‐BEHAVIOURAL THERAPY: TALKING TO PATIENTS ABOUT WHY THEY DO NOT DO THEIR HOMEWORK
Authors: March Paul
Published: November 2006

ABSTRACT
In this paper I use three case studies to describe my attempts to understand and discuss with patients the difficulties that they often experience when trying to carry out tasks that have arisen from a collaborative relationship between us in cognitive‐behavioural therapy. The difficulties seem to appear because of a conflict between two quite different views of the predicted outcome of collaboration. The conflict can occur both within patient and therapist as well as between them. I suggest that it can be understood by use of the concept of internal cohabitation (Sinason 1993; Richards 1993, 1994, 1995), the premise of which is that each human body contains two autonomous minds. One mind has the capacity to collaborate and develop, while the other believes only ill can come from such a venture.
FORENSIC PSYCHOTHERAPY WITH A POTENTIAL SERIAL KILLER
Authors: Polledri Patricia
Published: November 2006

ABSTRACT
Treatment with the patient described here, a 28‐year‐old man in a Regional Secure Unit on a Pre‐Discharge ward who had murdered his mother during late adolescence, was aimed at altering the intrapsychic factors through transference‐based psychoanalytical psychotherapy in order to facilitate a change of attachment to the internal mother/object and to women, whom he had devalued at part‐object level, based on his primitive perception of his mother as 'Satan's dog’and the‘devil's jackal’. There was an apparent change in the way he eventually interacted with the therapist as a whole object. Where the condition of latent murderousness exists, internal (intrapsychic) factors, or external ones, can become the reactivating agents which set into motion a sequence which ends in actual murder. The relationship of such events to a psychotic personality organization is variable and often difficult to delineate because the catastrophic deed itself greatly alters the intrapsychic as well as the external situation. More importantly, the control should be intrapsychic and not externally imposed if we are to deal adequately not only with murder but murderousness.
FREUD'S CONSULTING ROOM ARCHAEOLOGY AND VICO'S PRINCIPLES OF HUMANITY: A COMMUNICATION
Authors: Verene Donald Phillip
Published: November 2006

ABSTRACT
Giambattista Vico (1668‐1744) and Freud both claim to have discovered a‘new science’of the human. This essay considers some intellectual connections between their two views of man, consciousness and history. Both Vico and Freud find burial and origin to be keys to an understanding of the psyche and culture. Although some attention has been given to a connection between these two thinkers, this is the first time the fundamentals of their views have been explored in philosophical terms.
'SOUND’AND THE 'SENSE’OF SOUND IN THE THERAPEUTIC RELATIONSHIP: A FACTOR IN THE MECHANISM OF PROJECTIVE IDENTIFICATION
Authors: Norton Sheila
Published: November 2006

ABSTRACT
This paper will discuss the dual nature of sound and explore its effects in the therapeutic relationship. I will begin by looking at the auditory sensory perception of sound and its role in the development of the infant, our perception of the world, the self and others. I will then focus on the objective, physiological nature of sound in an attempt to answer some of the questions raised in my own mind about the possibility of this playing a vital role in our subjective experience of being with patients, with particular reference to the phenomenon of projective identification.
MEN WHO LEAVE TOO SOON: REFLECTIONS ON THE EROTIC TRANSFERENCE AND COUNTERTRANSFERENCE1
Authors: Schaverien Joy
Published: November 2006

ABSTRACT
It is observed that certain male patients, in psychotherapy with female therapists, end prematurely. Attention to common factors in the cases of the ‘men who leave too soon’ reveals a pattern. Some leave to avoid intimacy, others to avoid consciousness of erotic/aggressive impulses where the feminine may be alternately idealized and denigrated in the transference. Unconscious collusion in traditional gender dynamics may contribute to avoidance of consciousness of sexual feelings in the countertransference. This may sometimes result in interpretation of eros in infantile terms in denial of the adult, sexual dynamic. Vignettes from clinical practice illustrate the theoretical discussion.
BION, THE PARIAH OF‘O’
Authors: Grotstein James S.
Published: November 2006

ABSTRACT
Bion's elaboration of transformations and evolutions in‘0’represents one of the profoundest paradigm changes within psychoanalysis to date. The sweep of its epistemological embrace is so radical that it understandably dismayed many of his analytic cohorts, who thereupon marginalized him in the British Psycho‐Analytical Society. The concept of‘0′, I am arguing, unites all the existing branches of culture and epistemology from the religious to the scientific and allows us to begin to conceptualize a boundless horizon of containment for our boundless anxieties about our being‐in‐the‐world.
ENTERING THE WORLD OF PSYCHOTHERAPY: GENERAL PSYCHIATRIC TRAINEES TAKE THEIR FIRST STEPS
Authors: Paul Moli , Bluck Gill
Published: November 2006

ABSTRACT
Publication of the Royal College of Psychiatrists’guidelines for provision of psychotherapy training for general psychiatric trainees led to the implementation of the pilot scheme described in this paper. The scheme offered an experience of individual psychodynamic therapy, with group supervision, for the beginning therapist. The authors describe the induction programme, the group experience, the experience of being supervised, working with the patient and ending. A personal view is offered, aiming to provide an understanding of the nature and quality of this experience, highlighting its benefits and difficulties. Conclusions are drawn as to the usefulness of the scheme in personal and professional spheres and in relation to the Royal College guidelines.
TRANSFERENCES AND COUNTERTRANSFERENCES: THE COGNITIVE ANALYTIC THERAPY PERSPECTIVE
Authors: Ryle Anthony
Published: November 2006

ABSTRACT
Transference‐countertransference phenomena are examined from the theoretical viewpoint of Cognitive Analytic Therapy. Patient‐therapist relationships are described as one example of a more general model of relationships. The common origins and parallel features of intrapersonal relationships between aspects of the self and interpersonal relationships with others are emphasized. The practical value of describing these features early in therapy, so that the shifting, complex course of the therapy relationship can be precisely recognized, is presented. As part of this, the model proposes a distinction between identifying and reciprocating transference and countertransference patterns. These CAT understandings can be of value in supervision and case management as well as in therapy, and may be of value to therapists working in other modes.
PUBLISH AND BE DAMNED
Authors: Polden Jane
Published: November 2006

ABSTRACT
The dilemma of using case material for publication is considered in the light of the conflicting claims upon the practising psychotherapist to provide convincing clinical substantiation of theory and at the same time to protect patients’confidentiality. Professional ethical codes and commonly employed safeguards are reviewed in terms of their efficacy, and the significance of obtaining patients’consent to publication is discussed.
SEPARATION STRUGGLES AND THE TRAUMA OF BIRTH
Authors: Gomez Anthea
Published: November 2006

ABSTRACT
In this infant observation paper, I discuss how the experience of birth by emergency Caesarean section was reflected in the subsequent relationship between a mother and her baby. I explore the way in which the anxieties evoked were expressed between them in later separations, notably at weaning, and give thought as to how the psychic state of the mother's internal world, in the later stages of pregnancy, appeared to predispose her to such an experience of birth.
THE REVERSAL OF PATHOLOGICAL PROJECTIVE IDENTIFICATIONS: THE PROBLEM OF PATIENT RECEPTIVITY
Authors: Cartwright Duncan
Published: November 2006

ABSTRACT
The author explores some of the theoretical and clinical problems that the therapist is faced with when dealing with pathological projective identifications. Focusing on the patient's receptive capacity, it is argued that the successful containment of projective identifications, whilst an important part of the therapeutic process, does not adequately account for the patient's capacity to be receptive to realizations pertaining to split off parts of the self. To understand this further, the author makes a conceptual distinction between two inseparable components of the mechanism of projective identification: the affective component and self/object component. It is suggested that the affective component gives rise to problems of receptivity characterized by resistance, whereas the self/object component leads to more difficult problems of incapacity and deficit. The implications this has for therapeutic technique are discussed with particular emphasis placed on the nature, and analysis, of interactive experience as a means of altering the patient's receptivity to previously’ unthinkable’ parts of the self.
WHAT DOES THE THERAPIST FEEL? COUNTERTRANSFERENCE WITH BULIMIC WOMEN WITH BORDERLINE PERSONALITY DISORDER
Authors: Russell Gillian , Marsden Patricia
Published: November 2006

ABSTRACT
This paper considers individual psychotherapy with bulimic patients with borderline personality disorder and the feelings that may be engendered in the therapist during the course of treatment. It suggests that intense countertransference reactions are likely to be experienced and that, if the therapist is able to tolerate and process these feelings, they can be a powerful tool in treatment.
Theoretical Paper THE WORKING ALLIANCE: IS IT NECESSARY?
Authors: Kitto Jane
Published: November 2006

ABSTRACT
This paper was stimulated by the recent paper by Charlotte Wynn Parry and Diana Birkett (1996) in which the authors suggest that the idea of the working alliance has dropped out of analytic discourse and they suggest that it be brought back. In this paper I suggest that, rather than having dropped out, the idea of the working alliance has some inherent difficulties and also that it arises in relation to a particular view of the mind and mental functioning and correspondingly of the nature of the therapeutic process. Since we do not always distinguish clearly enough between these different models there is room for confusion. This paper does not aim to resolve confusion but to make some suggestions about why some of the confusions arise in the first place.
INHERITANCE: JEWISH IDENTITY AND THE LEGACY OF THE HOLOCAUST MEDIATED THROUGH ART PSYCHOTHERAPY GROUPS
Authors: Schaverien Joy
Published: November 2006

ABSTRACT
This paper is offered with the aim of alerting practitioners to the implications of the Holocaust in the experiences of Jewish clients who may themselves be unaware of its significance. Many Jewish people who come for psychotherapy today were not necessarily, nor apparently, directly affected by the Holocaust and yet they carry the inter generational scars. Beginning with my own personal experience, as well as the insight I have gained from conducting analytical art psychotherapy groups on Jewish identity, I will show how subtle and pervasive is the legacy of the Holocaust. The paper is based in Jewish experience but there are implications for work with refugees and immigrants from many other current situations. Discussion includes consideration of some of the psychological affects of anti‐semitism. The intention is to draw attention to issues which may not be immediately apparent when people first come for analysis or psychotherapy.
ENURESIS, EARLY ATTACHMENT AND INTIMACY
Authors: Stein Samuel M.
Published: November 2006

ABSTRACT
Enuresis is a common childhood problem which, although it causes considerable distress to both children and parents, nearly always responds to at least one of the available treatment modalities. These treatment options include behavioural techniques, cognitive therapy, medication and psychotherapeutic interventions. However, both behavioural treatment and pharmacotherapy have high relapse rates. In spite of the general acknowledgement that enuresis (especially secondary enuresis)indicates underlying psychological problems, few cases are described in the literature where a psychodynamic approach was used successfully. This is especially noticeable given the growing acceptance that enuresis is related to sub‐optimal parenting, poor child‐rearing practices and disruption of maternal care. The clinical vignette described is a case of secondary enuresis in a 10‐year‐old boy which responded favourably to psychodynamic input after behavioural, cognitive and family therapies failed to resolve the problem. The dynamic formulation postulated a desire for intimacy, following failed mother‐infant bonding due to maternal depression, which was obtained through enuretic symptoms and interpersonal conflict. This quest for intimacy through replication of early pleasurable somatic sensations and the utilization of conflict for attention‐seeking may rapidly develop into a repetitive cycle involving delinquency, crime and sexual perversions later in life. In such cases, a psychodynamic understanding is most likely to succeed as the enuresis represents an ego‐syntonic solution to possible ego‐fragmentation, or an attempt at preventing pending psychological breakdown.