bluuebunny/crossref_metadata_2025 huggingface dataset:
Ontario Child Health Study: Reliability and Validity of the General Functioning Subscale of the McMaster Family Assessment Device
Authors: BYLES JOHN , BYRNE CAROLYN , BOYLE MICHAEL H. , OFFORD DAVID R.
Published: August 2004

The reliability and validity of the 12‐item General Functioning (GF) subscale of the McMaster Family Assessment Device (FAD) is reported here. Psychometric properties of the FAD have been previously determined, but no independent assessment has been made of the GF subscale, which was used to measure family functioning in the Ontario Child Health Study (OCHS). Reliability was measured by Chronbach's alpha and split‐half correlation. Validity was assessed by hypothesizing the relationships expected between the GF scores and other family variables included in the OCHS data set. The results indicate good reliability, and all hypotheses of validity were supported. The brevity and ease of administering the GF subscale recommend it for further use in survey research in which a global assessment of family functioning is required.
Systemic Optimism — Systemic Pessimism: Two Perspectives on Change
Authors: STIERLIN HELM
Published: August 2004

Therapists have a mandate to bring about change, and family therapists appear to have unusual leverage to fullfill such a mandate, that is, to facilitate changes rapidly and effectively. Because and in spite of this mandate, the very notion of change deserves critical reflection. The history of ideas and our clinical experience teach us that changes may be problematic. They may come too fast or too slowly, may endure or fade away, may turn out to be desirable or undesirable, equitable or inequitable, and may, when further consequences and larger systems levels are taken into account, be beneficial or disastrous. This essay examines some of the problematical and contradictory aspects of change and delineates two perspectives on change — systemic optimism and systemic pessimism.
Symbiosis, the Family, and Natural Systems
Authors: NOONE ROBERT J.
Published: August 2004

Family systems theory, as developed by Murray Bowen, has its conceptual basis in natural systems. A basic premise is that emotional process is not unique to homo sapiens and that human behavior might better be understood by observing this process in the broader context of all natural systems. This essay discusses the phenomenon of symbiosis as it is used in the natural sciences and as it relates to the emergence of increasingly complex systems in nature. Finally, the emergence of the parent/offspring symbiosis from its possible origins to its development in the human family is discussed.
Obsessions/Counter‐Obsessions: A Construction/Reconstruction of Meaning
Authors: SHEINBERG MARCIA
Published: August 2004

In this article, obsessions and phobic responses are examined in relation to the maintenance and development of a cross‐generational coalition organized by a premise about exclusivity, as well as the specific, idiosyncratic “signature premises” characteristic to each case. It is suggested that the obsession develops when a developmental or situational crisis conflicts with the exclusive relationship definition (that is, coalition). Two forms of intervention for disrupting obsessions — the “conversation” and the “counter‐obsession”— are discussed and illustrated. Both interventions conceptualize the obsession as an oscillation between remaining in the coalition and not remaining in the coalition, and both interventions challenge the signature premise that defines the coalition.
Graduate Student Marriages:An Organizational/Interactional View
Authors: SCHEINKMAN MICHELE
Published: August 2004

This article describes an organizational/interactional model for understanding and working with graduate student marriages. The model first distinguishes symmetrical (student/student) from asymmetrical (student/working spouse) marriages. Then, the major focus is on asymmetrical marriages and the disengagement process that is typical among these couples. Asymmetrical organization, especially within today's ethos of equal roles and equal responsibilities, presents graduate student couples with several dilemmas: (a) it promotes hierarchical confusion, (b) it makes for a problematic marital quid pro quo, and (c) it fosters contextual gaps between the two partners. When these inherent difficulties are misconstrued and mishandled, dysfunctional sequences lead the couple into progressive disengagement. Even as dissatisfaction in the marriage increases, graduate student couples have a tendency to postpone and suspend negotiations. Over time, there is an intensification of the coupIe's unhappiness but, at the same time, the relationship remains structurally unchanged. The building tension in the marriage typically culminates in a crisis when a milestone in the student's course of work precipitates a major disorganization of the system. Clinical implications of the model are outlined with recommendations for focused interventions.
Violence and the Systemic View: The Problem of Power
Authors: DELL PAUL F.
Published: August 2004

Violence is a strikingly lineal concept that is difficult to address from a systemic perspective. Bateson's epistemological disqualification of the concept of power is often understood to imply a corresponding systemic disqualification of the concept of violence. This position is examined in light of recent feminist criticism. It is argued that (a) violence and power belong essentially to the domain of human experience and (b) human experience cannot be invalidated by theory. Accordingly, it is suggested that the (appropriate) invalidation of power and violence in the domain of systemic explanation should probably understood both as a deliberate choice that necessarily follows from adopting a systemic perspective, and as a fundamental limitation of that perspective. In neither case, however, should the systemic view be considered to be a valid disqualification of the human experience of violence and power.
Putting the Illness in Its Place: Discussion Groups for Families with Chronic Medical Illnesses
Authors: GONZALEZ SANDRA , STEINGLASS PETER , REISS DAVID
Published: August 2004

A new psychosocial intervention for families and patients experiencing the chronic phase of a disabling medical illness is described. The intervention, a short‐term, highly structured, psychoeducationally oriented, multiple‐family discussion group (MFDG), was developed within the context of a clinical research program and has been successfully applied to a heterogeneous range of disabling medical illnesses. This report includes a detailed description of the treatment model, the format and content of group meetings, and initial clinical impressions regarding MFDG efficacy.
Gender Differences in Marital Communication Patterns
Authors: WHITE BARBARA B.
Published: August 2004

This study examined conflict‐resolution interactions of couples, and related marital satisfaction to sequential and nonsequential communication patterns. Couples' satisfaction with marriage has been differentiated on the basis of the degree of coercive versus affiliative communication between partners. Results of this study indicate that this pattern differs, however, for individuals within couples on the basis of gender. Females and males were found to demonstrate different styles of response to dissatisfaction in marriage; men assume a coercive stance toward their partners while women take an affiliative position. Drawing on systemic and gender‐difference theoretical perspectives, these patterns are interpreted as attempts by individuals with different world views to resolve conflict. A view is discussed whereby systems and gender differences can be integrated into a unified conceptual formulation upon which to base future development in research and therapeutic interventions.
Action Methods in Systemic Therapy: Dramatizing Ideal Futures and Reformed Pasts with Couples
Authors: Chasin Richard , Roth Sallyann , Bograd Michele
Published: August 2004

This article presents a method for conducting a couple session that illustrates a theoretically valid role for action techniques (as opposed to verbal methods) in post‐Milan systemic interviewing. Useful in an opening meeting or in consultation, it pointedly activates client resources while deemphasizing current problems. The interview format begins with contracting for ground‐rules and listing clients' strengths. Each partner then creates and enacts: a scene illustrating that partner's ideal future for the relationship; a related past painful scene (usually from childhood); and a “reform” of that scene “as it should have occurred.” Both partners play multiple roles in all scenes. Last and least, each partner succinctly describes his or her view of the current problem. In the enactments, rapid shifts in time dimension and multiple novel roles played by both partners efficiently promote in the couple the release from constraining beliefs and interactional patterns that is ordinarily sought by purely verbal methods in Milan‐derived systemic interviews.
Is Expressed Emotion an Index of a Transactional Process? I. Parents' Affective Style
Authors: MIKLOWITZ DAVID J. , GOLDSTEIN MICHAEL J. , DOANE JERI A. , NUECHTERLEIN KEITH H. , STRACHAN ANGUS M. , SNYDER KAREN S. , MAGAÑA‐AMATO ANA
Published: August 2004

The degree to which expressed emotion (EE) attitudes in key relatives reflect ongoing transactional processes in families is a topic of controversy. The associations between EE attitudes, as measured during an acute hospitalization (using the Camberwell Family Interview) and during the aftercare period (using 5‐minute speech samples), and interactional behavior in parents of recent‐onset schizophrenics (this article) and in patients themselves (second article), were investigated. In the first study, EE attitudes manifested by parents during the aftercare period were stronger correlates of their interactional behaviors during the aftercare period than were EE attitudes measured during the inpatient period, despite the frequent correspondence between the two EE measures. The pattern of attitudes shown between the inpatient and outpatient periods also predicted transactional styles in parents during the outpatient period, findings not accounted for by clinical attributes of patients. When high‐EE attitudes persist during the aftercare period and are reflected in transactional behaviors, the risk for subsequent patient relapse may be enhanced.
Is Expressed Emotion an Index of a Transactional Process? II. Patient's Coping Style
Authors: STRACHAN ANGUS M. , FEINGOLD DOROTHY , GOLDSTEIN MICHAEL J. , MIKLOWITZ DAVID J. , NUECHTERLEIN KEITH H.
Published: August 2004

This article examines the extent to which expressed emotion (EE) indexes not only relatives' behavior toward schizophrenic patients but also patients' behavior toward their relatives. The coping styles (CS) of schizophrenic patients were assessed during interactions with their parents and were compared with parental EE attitudes assessed during an acute hospitalization and during the aftercare period. It was found that parental EE attitudes measured during the inpatient period strongly predicted patients' outpatient transactional behavior: patients interacting with low‐EE relatives showed significantly fewer critical and more autonomous statements than patients interacting with high‐EE relatives. Further, the dominant patient coping style (autonomous, neutral, externalizing, or internalizing) was strongly related to the relatives' interactional affective style (AS) and to their pattern of EE attitudes. Patient coping style was not related to clinical attributes of these patients themselves. This article and its preceding companion (17) together suggest that EE indexes a transactional process so that the quality of both parents' and patients' transactional behaviors may predict subsequent patient functioning.
Intergenerational Relations and Family Therapy Research’ What We Can Learn from Other Disciplines
Authors: FINE MARSHALL , NORRIS JOAN E.
Published: August 2004

Although there are a number of theories regarding intergenerational relations within the family therapy field, few of these theories have been empirically examined. Indeed, intergenerational family research is in its infancy in the family therapy world. This article explores the literature on intergenerational relations within the sociological and psychosociological disciplines in order to understand what is known, and how this information could assist family therapy researchers interested in developing systematic studies of intergenerational relations for the family therapy field.
The Role of the Family Therapist in Divorce: Benevolent Healer or Agent of Social Change?
Authors: WHITESIDE MARY F.
Published: August 2004

Essay Review of:

The Dynamics of Divorce: A Life Cycle Perspective, F. W. Kaslow and L. L. Schwartz, New York: Brunner/Mazel, 1987.

Divorced Families: A Multidisciplinary Developmental View, C. R. Ahrons and R. H. Rodgers, New York: W. W. Norton, 1987.

The Difficult Divorce: Therapy for Children and Families, M. B. Isaacs, B. Montalvo, and D. Abelson, New York: Basic Books, 1986.
Outcomes of Systemic/Strategic Team Consultation: II. Three‐Year Followup and a Theory of “Emergent Design”
Authors: GREEN ROBERT‐JAY , HERGET MARY
Published: August 2004

This is the second in a series of articles on an experimental, small‐sample study of systemic/strategic team consultations. It presents the 3‐year outcomes of clients whose 1‐month progress was described in an earlier report (12). The 8 therapists in the current study originally were asked to select two ongoing cases matched for difficulty (n = 16). While all cases continued their regular therapy sessions, one of each therapist's two cases were selected at random to participate in a “Milan‐in formed,” five‐part team consultation. At 3‐year followup, clients who participated in team consultations had maintained significantly higher levels of goal attainment than nonteam clients (p < .05). For interpreting these results, we propose a developmental theory (“emergent design”) to explain therapy impasses, team effects, the impact of termination, and long‐range outcomes of therapy.
The Unraveling of a Treatment Paradigm: A Followup Study of the Milan Approach to Family Therapy
Authors: MASHAL MEEDA , FELDMAN RONALD B. , SlGAL JOHN J.
Published: August 2004

A 2‐year followup study was conducted to determine the efficacy and degree of satisfaction with Milan‐style family therapy with families refractory to other treatment interventions. Fourteen families and 5 couples who received Milan‐style family therapy participated in the study. Family outcome was found to be improved in 56% of parents and 89% of identified child‐patients at followup. Improved self‐outcome at followup was reported by 56% of fathers, 67% of mothers, and 78% of identified child‐patients. A substantial percentage of fathers (68%) and mothers (59%) reported that at least one family member sought further therapy posttreatment. Factors associated with either parent's positive perception of the treatment in general included the time interval between sessions, experiencing the treatment as brief rather than long, and positive feelings for the group behind the mirror. Mothers who reported liking the treatment reported better family outcome. For mothers, disliking the treatment was related to family members seeking further treatment. The more negative the mothers' and fathers' spontaneous comments about therapy were, the more likely that a family member would seek further alternative psychotherapy. The outcome results are explained in terms of the treatment families' negative reactions to some aspects of the therapist's stance and to the group behind the one‐way mirror, as in Milan‐style therapy. The importance of modifying Milan‐type therapy to foster a positive attitude toward the treatment procedures and the therapist's interventions is discussed.
A Paradigm for Construction of Family Therapy Tasks
Authors: BROWN‐STANDRIDGE MARCIA D.
Published: August 2004

Typically, family therapy task interventions involve direct assignment of specific behaviors, which may or may not encourage client compliance. To enhance the clinician's probability of bringing about progress in treatment, this article broadens the parameters of task intervention to include (a) Direct versus Indirect, (b) Behavioral versus Nonbehavioral, and (c) Paradoxical versus Nonparadoxical dimension alternatives. The resulting 2 × 2 × 2 model, the Family Therapy Task Construction Paradigm, yields eight possible choices for end‐of‐the‐session punctuation. Each option is linked to corresponding treatment contexts and illustrated with examples from productive case vignettes.
Generalized Osteosclerosis in a Cat
Authors: Hanel Rita M. , Graham John P. , Levy Julie K. , Buergelt Claus D. , Creamer Jeff
Published: August 2004

A 12‐year‐old, neutered male, domestic long‐hair cat was evaluated for a 6‐month history of inspiratory stertor and epiphora. In computed tomography of the skull and pelvis, and radiographs of the thorax, right femur and stifle there was generalized osteosclerosis, with obliteration of the nasal turbinates and nasolacrimal duct obstruction. The cat also had a large fibrosarcoma involving the right pelvic limb. Osteosclerosis is a rare disorder that is poorly understood but has been described in several species. Various manifestations, potential causes, and radiologic findings of osteosclerosis are discussed.
Urinary Bladder incarceration and Infarction by an Intra‐Abdominal Fat Pad in a Virginia Opossum (Didelphis Virginiana)
Authors: De Voe Ryan S. , Spaulding Kathy A. , Rotstein Jack , Rotstein David S.
Published: August 2004

A 2.5‐year‐old, female opossum had acute stranguria. Based on radiography and ultrasonographic examination a cystic structure was identified in the caudal abdomen associated with bilateral hydroureter and hydronephrosis. This structure contained a neutrophilic fluid, determined to be urine. There was a neutrophilic leukocytosis. Serum chemistry values were within normal limits. The opossum was euthanized. An intra‐abdominal fat pad incarceration of the urinary bladder above the trigone was present, resulting in complete obstruction of the urinary bladder and partial obstruction of the ureters. Vessels to the bladder were involved in the incarceration which resulted in vascular compromise and infarction of the bladder. Mild to moderate hydroureter and hydronephrosis were present.
Skeletal Atavism in a Miniature Horse
Authors: Tyson Reid , Graham John P. , Colahan Patrick T. , Berry Clifford R.
Published: August 2004

An 8‐month‐old miniature horse filly was presented for evaluation of severe rotational and angular limb deformities of the thoracic and pelvic limbs. On radiographic examination, complete ulnas and fibulas were identified. These findings are consistent with a condition previously described as a form of atavism. The term atavism is used to describe the reappearance of a trait or character that was seen in all earlier evolutionary specimens of a particular species, but has not been seen in recent ancestors. The atavistic traits of complete ulnas and fibulas have previously been described in Welsh and Shetland Ponies, all of which had severe rotational and angular limb deformities. In this horse, bilateral osteochondritis dissecans of the medial trochlear ridge of the talii were also identified. To the authors' knowledge, this is the first report of the atavistic traits of complete ulnas and fibulas seen in the miniature horse.
Thoracic Ultrasonography Technique in Newborn Calves and Description of Normal and Pathological Findings
Authors: Jung C. , Bostedt H.
Published: August 2004

The aim of this study was to establish whether thoracic ultrasonography is a viable screening method for detecting respiratory disorders in newborn calves. Thoracic ultrasonography was performed on 66 newborn calves. There were 10 normal control animals with healthy lungs and 56 newborn calves suffering from respiratory disorders such as lung atelectasis, aspiration of amniotic fluid, pulmonary edema, pneumonia, and lung abscesses. Ultrasonography of the lung enabled rapid classification of the severity, extent and type of pulmonary lesion found, thus supplementing the clinical examination. Processes deep to the pleura were not amenable to thoracic diagnosis by ultrasonography. This is due to the inability of sound waves to penetrate normally ventilated lung. Despite this problem, ultrasonography of the lung is suitable for assessment of clinically unclear respiratory disorders in calves.
Ultrasonographic Appearance of Dandy Walker‐Like Syndrome in a Boston Terrier
Authors: Noureddine Clarissa , Harder Rebecca , Olby Natasha J. , Spaulding Kathy , Brown Talmage
Published: August 2004

Congenital cerebellar disorders can be caused by in utero or neonatal infections, genetic aberrations causing malformations, and neurodegenerative processes. Most congenital cerebellar disorders are diagnosed definitively with histopathology. However, antemortem diagnosis of cerebellar malformations can be made by imaging the brain. This paper describes the antemortem appearance of a congenital cerebellar malformation in a Boston Terrier puppy on ultrasound images. This appearance was compared with the postmortem findings that were comparable to Dandy Walker Syndrome in humans. A previous report of this syndrome in Boston Terriers suggests the problem may be inherited in this breed.
ORGANIZING FOR (SPARE) CHANGE? A RADICAL POLITICS FOR AMERICAN LABOR
Authors: Day Benjamin
Published: August 2004

Union renewal in the United States has been framed as an organizing project. But will “reinvesting in organizing” be enough to reverse membership decline and the growing marginality of organized labor as a social and political force? This article focuses on the comparative experience of labor movements in different countries, showing the importance of strategies broader than the shift from business unionism. Most important are unions’ ability to organize the margins of the labor market (at the point of unemployment), to act collectively across local union organizations and police their own labor standards, and to pursue political and institutional change through social movements of noncompliance and resistance.
CONSOLIDATION AND LABOR IN ARTS AND ENTERTAINMENT: A PEEK AT CLEAR CHANNEL
Authors: Richardson Damone , Figueroa Maria
Published: August 2004

In the past eight years the multinational, multimedia conglomerate Clear Channel has come to exemplify what opponents of media deregulation predicted would happen as a result of the Telecommunications Act of 1996. Before 1996, Clear Channel was merely an obscure regional player in radio and TV. Today, on the strength of $22 billion in acquisitions, the company is an international powerhouse that dominates the radio, concert and live theater industries, and is a major owner of TV stations. Clear Channel has a long history with Bush family politics, exclusively promoting a conservative agenda, and regularly engaging in partisan politics. Still, the company is somewhat unique among its peers because it has quickly developed a near‐uniform reputation as a bad actor and has drawn comparisons to Wal‐Mart because of the way it victimizes workers, competitors, communities, and consumers. The company is overwhelmingly nonunion, and actively seeks to undermine work and employment standards for its employees. Clear Channel presents a huge organizing challenge to unions, because left unchecked, many of its worst cost‐cutting practices threaten to become the industry standard.
Summary of the Recommendations on Sexual Dysfunctions in Women
Authors: Basson Rosemary , Althof Stan , Davis Susan , Fugl-Meyer Kirsten , Goldstein Irwin , Leiblum Sandra , Meston Cindy , Rosen Raymond , Wagner Gorm
Published: August 2004

Introduction

Women's sexual dysfunctions include persistent or recurrent disorders of sexual interest/desire, disorders of subjective and genital arousal, orgasm disorder, pain and difficulty with attempted or completed intercourse. There are limited recommendation/guideline documents pertaining to the diagnosis and treatment of women's sexual dysfunctions.

Aim

To provide recommendations/guidelines concerning state-of-the-art knowledge for the clinical management of women's sexual dysfunctions.

Methods

An International Consultation in collaboration with the major sexual medicine associations assembled over 200 multidisciplinary experts from 60 countries into 17 committees. Committee members established specific objectives and scopes for various sexual medicine topics. The recommendations concerning state-of-the-art knowledge in the respective sexual medicine topic represent the opinion of experts from five continents developed in a process over a 2-year period. Ten experts from four countries compiled the Recommendations on Sexual Dysfunctions in Women.

Main Outcome Measure

Expert opinion was based on grading of evidence-based medical literature, widespread internal committee discussion, public presentation and debate.

Results

Recommendations and guidelines concerning the various sexual dysfunctions were updated. A comprehensive assessment of medical, sexual and psychosocial history is recommended for diagnosis and management planning. Indications for general and focused pelvic genital examination and laboratory testing are included. Recently revised definitions for sexual desire/interest disorder, arousal disorders (genital, subjective, combined and persistent), orgasm disorder, dyspareunia and vaginismus are presented. An evidence-based approach to management is provided.

Conclusions

There is a need for more research and scientific reporting, re-assessment, and management of women's sexual dysfunction including long-term outcome studies.
Epidemiology/Risk Factors of Sexual Dysfunction
Authors: Lewis Ronald W. , Fugl-Meyer Kersten S. , Bosch R. , Fugl-Meyer Axel R. , Laumann Edward O. , Lizza E. , Martin-Morales Antonio
Published: August 2004

Introduction

Accurate estimates of prevalence/incidence are important in understanding the true burden of male and female sexual dysfunction and in identifying risk factors for prevention efforts.

Aim

To provide recommendations/guidelines concerning state-of-the-art knowledge for the epidemiology/risk factors of sexual dysfunctions in men and women.

Methods

An International Consultation in collaboration with the major urology and sexual medicine associations assembled over 200 multidisciplinary experts from 60 countries into 17 committees. Committee members established specific objectives and scopes for various male and female sexual medicine topics. The recommendations concerning state-of-the-art knowledge in the respective sexual medicine topic represent the opinion of experts from five continents developed in a process over a 2-year period. Concerning the Epidemiology/Risk Factors Committee, there were seven experts from four countries.

Main Outcome Measure

Expert opinion was based on grading of evidence-based medical literature, widespread internal committee discussion, public presentation and debate.

Results

Standard definitions of male and female sexual dysfunctions are needed. The incidence rate for erectile dysfunction is 25–30 cases per thousand person years and increases with age. There are no parallel data for women's sexual dysfunctions. The prevalence of sexual dysfunction increases as men and women age; about 40–45% of adult women and 20–30% of adult men have at least one manifest sexual dysfunction. Common risk factor categories associated with sexual dysfunction exist for men and women including: individual general health status, diabetes mellitus, cardiovascular disease, other genitourinary disease, psychiatric/psychological disorders, other chronic diseases, and socio-demographic conditions. Endothelial dysfunction is a condition present in many cases of erectile dysfunction and there are common etiological pathways for other vascular disease states. Increasing physical activity lowers incidence of ED in males who initiate follow-up in their middle ages.

Conclusions

There is a need for more epidemiologic research in male and female sexual dysfunction.
Endocrine Aspects of Sexual Dysfunction in Men
Authors: Morales Alvaro , Buvat Jacques , Gooren Louis J. , Guay Andre T. , Kaufman Jean-Marc , Tan Hui Meng , Torres Luiz O.
Published: August 2004

Introduction

Endocrine disorders of sex steroid hormones may adversely affect men's sexual function.

Aim

To provide expert opinions/recommendations concerning state-of-the-art knowledge for the pathophysiology, diagnosis and treatment of endocrinologic sexual medicine disorders.

Methods

An International Consultation in collaboration with the major urology and sexual medicine associations assembled over 200 multidisciplinary experts from 60 countries into 17 committees. Committee members established specific objectives and scopes for various male and female sexual medicine topics. The recommendations concerning state-of-the-art knowledge in the respective sexual medicine topic represent the opinion of experts from five continents developed in a scientific and debate process. Concerning the Endocrine committee, there were eight experts from seven countries.

Main Outcome Measure

Expert opinions/recommendations are based on grading of evidence-based medical literature, extensive internal committee discussion over 2 years, public presentation and deliberation.

Results

Hypogonadism is a clinical and biochemical syndrome characterized by a deficiency in serum androgen levels which may decrease sexual interest, quality of erections and quality of life. Biochemical investigations include testosterone and either bioavailable or calculated free testosterone; prolactin should be considered when hypogonadism has been documented. If clinically indicated, androgen therapy should maintain testosterone within the physiological range avoiding supraphysiologic values. Digital rectal examination and determination of serum prostate specific antigen values are mandatory prior to therapy and regularly thereafter. Androgen therapy is usually long-term requiring regular follow-up, frequent monitoring of blood levels and beneficial and adverse therapeutic responses.

Conclusions

Safe and effective treatments for endocrinologic sexual medicine disorders examined by prospective, placebo-controlled, multi-institutional clinical trials are needed.
The Penile Implant for Erectile Dysfunction
Authors: Mulcahy John J. , Austoni Edouardo , Barada James H. , Choi Hyung Ki , Hellstrom Wayne J.G. , Krishnamurti Sudhakar , Moncada Ignacio , Shultheiss Dirk , Sohn Michael , Wessells Hunter
Published: August 2004

Introduction

Penile prostheses, introduced as the first effective organic treatment for erectile dysfunction over three decades ago, have an important role in the treatment of erectile dysfunction when other nonprosthetic treatment options have proven unsatisfactory. Although they are the least chosen and most invasive treatment option, they have the highest satisfaction rate of all available ED options and provide a predictable and reliable result.

Aim

To provide recommendations/guidelines concerning state-of-the-art knowledge for utilization of the penile prosthesis in the management of men with erectile dysfunction.

Methods

An International Consultation in collaboration with the major sexual medicine associations assembled over 200 multidisciplinary experts from 60 countries into 17 committees. Committee members established specific objectives and scopes for various sexual medicine topics. The recommendations concerning state-of-the-art knowledge in the respective sexual medicine topic represent the opinion of experts from five continents developed in a process over a 2-year period. There were 10 experts from seven countries concerning the Penile Implant for Erectile Dysfunction.

Main Outcome Measure

Expert opinion was based on grading of evidence-based medical literature, widespread internal committee discussion, public presentation and debate.

Results

Recommendations/guidelines for penile prosthesis (hydraulic, semi-rigid and soft silicone) insertion for management of men with erectile dysfunction were updated. Consensed issues included: criteria for patient selection, informed consent procedures, strategies for preoperative preparation, operative incisions/technical considerations and outcome results in terms of patient satisfaction and device survival. Updated information was reviewed concerning therapies for device failures, device insertion in scarred corporal bodies and strategies for managing implant infections.

Conclusions

There is a need for more research in developing management strategies for insertion of penile prostheses in men with ED.
Peyronie's Disease
Authors: Pryor John , Akkus Emre , Alter Gary , Jordan Gerald , Lebret Thierry , Levine Laurence , Mulhall John , Perovic Sava , Ralph David , Stackl Walter
Published: August 2004

Introduction

Peyronie's disease is a sexual medicine condition that may adversely affect male sexual function.

Aim

To provide expert opinions/recommendations concerning state-of-the-art knowledge for the pathophysiology, diagnosis and treatment of Peyronie's disease.

Methods

An International Consultation in collaboration with the major urology and sexual medicine associations assembled over 200 multidisciplinary experts from 60 countries into 17 committees. Committee members established specific objectives and scopes for various male and female sexual medicine topics. The recommendations concerning state-of-the-art knowledge in the respective sexual medicine topic represent the opinion of experts from five continents developed in a scientific and debate process. Concerning the Peyronnie's disease committee, there were 10 experts from six countries.

Main Outcome Measure

Expert opinions/recommendations are based on grading of evidence-based medical literature, extensive internal committee discussion over 2 years, public presentation and deliberation.

Results

Peyronie's disease is characterized by an inflammatory response beneath the tunica albuginea with fibroblast proliferation forming a thickened fibrous plaque that may cause penile pain, penile curvature and erectile dysfunction. Medical treatments have been described but few prospective controlled trials have revealed significant clinical benefits. Surgical treatments (penile plication, Nesbit excision, plaque incision and grafting and penile prosthesis insertion) should be considered after Peyronie's disease has stabilized. Surgical outcome studies reveal that a stable deformity is best corrected with the least postoperative ED by a Nesbit procedure. Plaque incision and grafting should be reserved for men with good erectile function and marked penile shortening although there is a higher prevalence of postoperative ED. Implantation of a penile prosthesis is an excellent option for men with an accompanying erectile deficit.

Conclusions

Safe and effective treatments for Peyronie's disease examined by prospective, placebo-controlled, multi-institutional clinical trials are needed.
A nonreciprocal implementation of time reversal in the ocean
Authors: Roux Philippe , Kuperman W. A. , Hodgkiss W. S. , Song Hee Chun , Akal T. , Stevenson Mark
Published: August 2004

The performance of a time reversal mirror (TRM) in complex ocean scenarios can be evaluated without invoking spatial reciprocity in the experimental procedure. The experimental implementation requires connectivity between a source array and a receiver array but eliminates the requirement of actually having a probe source collocated with the receiver array. It is shown with data taken in a recent experiment that this streamlined, nonreciprocity-based time reversal procedure yields results potentially better than the classical time reversal method. Further, it provides a more versatile method to study a TRM in a fluctuating medium.
The effect of loading on disturbance sounds of the Atlantic croaker Micropogonius undulatus: Air versus water
Authors: Fine Michael L. , Schrinel Justin , Cameron Timothy M.
Published: August 2004

Physiological work on fish sound production may require exposure of the swimbladder to air, which will change its loading (radiation mass and resistance) and could affect parameters of emitted sounds. This issue was examined in Atlantic croaker Micropogonius chromis by recording sounds from the same individuals in air and water. Although sonograms appear relatively similar in both cases, pulse duration is longer because of decreased damping, and sharpness of tuning (Q factor) is higher in water. However, pulse repetition rate and dominant frequency are unaffected. With appropriate caution it is suggested that sounds recorded in air can provide a useful tool in understanding the function of various swimbladder adaptations and provide reasonable approximation of natural sounds. Further, they provide an avenue for experimentally manipulating the sonic system, which can reveal details of its function not available from intact fish underwater.
On formulation of a transition matrix for poroelastic medium and application to analysis of scattering problem
Authors: Yeh Chau-Shioung , Teng Tsung-Jen , Shih Po-Jen
Published: August 2004

Based on the approach of Pao (1978) for elastic medium, we propose a set of the basis functions and an associated relationship of the material properties of the dilatational wave in the poroelastic medium. A transition matrix, which relates the coefficients of scattered waves to those of incident waves, is then derived through the application of Betti’s third identity and the associated orthogonality conditions for the poroelastic medium. To illustrate the application, we consider a simple case of the scattering problem of a spherical inclusion, either elastic or poroelastic, embedded within the surrounding poroelastic medium subjected to an incident plane compressional wave.
Fine structure of hearing threshold and loudness perception
Authors: Mauermann Manfred , Long Glenis R. , Kollmeier Birger
Published: August 2004

Hearing thresholds measured with high-frequency resolution show a quasiperiodic change in level called threshold fine structure (or microstructure). The effect of this fine structure on loudness perception over a range of stimulus levels was investigated in 12 subjects. Three different approaches were used. Individual hearing thresholds and equal loudness contours were measured in eight subjects using loudness-matching paradigms. In addition, the loudness growth of sinusoids was observed at frequencies associated with individual minima or maxima in the hearing threshold from five subjects using a loudness-matching paradigm. At low levels, loudness growth depended on the position of the test- or reference-tone frequency within the threshold fine structure. The slope of loudness growth differs by 0.2 dB/dB when an identical test tone is compared with two different reference tones, i.e., a difference in loudness growth of 2 dB per 10-dB change in stimulus. Finally, loudness growth was measured for the same five subjects using categorical loudness scaling as a direct-scaling technique with no reference tone instead of the loudness-matching procedures. Overall, an influence of hearing-threshold fine structure on loudness perception of sinusoids was observable for stimulus levels up to 40 dB SPL—independent of the procedure used. Possible implications of fine structure for loudness measurements and other psychoacoustic experiments, such as different compression within threshold minima and maxima, are discussed.
Equal-loudness-level contours for pure tones
Authors: Suzuki Yôiti , Takeshima Hisashi
Published: August 2004

Equal-loudness-level contours provide the foundation for theoretical and practical analyses of intensity-frequency characteristics of auditory systems. Since 1956 equal-loudness-level contours based on the free-field measurements of Robinson and Dadson [Br. J. Appl. Phys. 7, 166–181 (1956)] have been widely accepted. However, in 1987 some questions about the general applicability of these contours were published [H. Fastl and E. Zwicker, Fortschritte der Akustik, DAGA ’87, pp. 189–193 (1987)]. As a result, a new international effort to measure equal-loudness-level contours was undertaken. The present paper brings together the results of 12 studies starting in the mid-1980s to arrive at a new set of contours. The new contours estimated in this study are compared with four sets of classic contours taken from the available literature. The contours described by Fletcher and Munson [J. Acoust. Soc. Am. 5, 82–108 (1933)] exhibit some overall similarity to our proposed estimated contours in the mid-frequency range up to 60 phons. The contours described by Robinson and Dadson exhibit clear differences from the new contours. These differences are most pronounced below 500 Hz and the discrepancy is often as large as 14 dB.
Compensation for pitch-shifted auditory feedback during the production of Mandarin tone sequences
Authors: Xu Yi , Larson Charles R. , Bauer Jay J. , Hain Timothy C.
Published: August 2004

Recent research has found that while speaking, subjects react to perturbations in pitch of voice auditory feedback by changing their voice fundamental frequency (F0) to compensate for the perceived pitch-shift. The long response latencies (150–200 ms) suggest they may be too slow to assist in on-line control of the local pitch contour patterns associated with lexical tones on a syllable-to-syllable basis. In the present study, we introduced pitch-shifted auditory feedback to native speakers of Mandarin Chinese while they produced disyllabic sequences /ma ma/ with different tonal combinations at a natural speaking rate. Voice F0 response latencies (100–150 ms) to the pitch perturbations were shorter than syllable durations reported elsewhere. Response magnitudes increased from 50 cents during static tone to 85 cents during dynamic tone productions. Response latencies and peak times decreased in phrases involving a dynamic change in F0. The larger response magnitudes and shorter latency and peak times in tasks requiring accurate, dynamic control of F0, indicate this automatic system for regulation of voice F0 may be task-dependent. These findings suggest that auditory feedback may be used to help regulate voice F0 during production of bi-tonal Mandarin phrases.
Analysis of the acoustical edge flexural mode in a plate using refined asymptotics
Authors: Zakharov Dmitry D.
Published: August 2004

The dispersion properties of bending wave, localized near the stress-free edge of a thin isotropic plate, are investigated for relatively high frequency. In order to clarify the nature of the wave, attention is focused to the sensibility to the improved boundary conditions and to the iterations of the main differential operator when describing by two-dimensional (2-D) approximate plate theories. As shown, the boundary conditions of next asymptotic order do not change too much the leading part of the desired wave, but the corrections of the main operator lead to dramatical changes. Finally, beginning with its simplest Kirchooff’s plate model only the leading part of wave may be subjected to asymptotic correction. For applications the wave speed calculation is reduced to two simple analytical formulas. The results agree well with experiments and finite element testing. The alternative approach related to the Timoshenko–Reissner–Mindlin theory is discussed.
Monaural and interaural intensity discrimination: Level effects and the “binaural advantage”
Authors: Stellmack Mark A. , Viemeister Neal F. , Byrne Andrew J.
Published: August 2004

This study examined whether the level effects seen in monaural intensity discrimination (Weber’s law and the “near miss”) in a two-interval task are also observed in discrimination of interaural intensity differences (IIDs) in a single-interval task. Both tasks were performed for various standard levels of 4-kHz pure tones and broadband noise. The Weber functions (10 log ΔI/I versus I in dB) in the monaural and binaural conditions were parallel. For noise, the Weber functions had slopes close to zero (Weber’s law) while the Weber functions for the tones had a mean slope of −0.089 (near miss). The near miss for the monaural and binaural tasks with tones was eliminated when a high-pass masker was gated with the listening intervals. The near-miss was also observed for 250- and 1000-Hz tones in the binaural task despite overall decreased sensitivity to changes in IID at 1000 Hz. The binaural thresholds showed a small (about 2-dB) advantage over monaural thresholds only in the broadband noise conditions. More important, however, is the fact that the level effects seen monaurally are also seen binaurally. This suggests that the basic mechanisms responsible for Weber’s law and the near miss are common to monaural and binaural processing.
The stability of multichannel sound systems with frequency shifting
Authors: Poletti Mark A.
Published: August 2004

Time-varying components are used in some multichannel sound systems designed for the enhancement of room acoustics. Time-variation can usefully reduce the risk of producing ringing tones and improve stability margins, provided that any modulation artefacts are inaudible. Frequency-shifting is one form of time-variation which provides the best case improvement in loop gain, and for which the single channel stability limit has been derived. This paper determines the stability limit for multiple channel systems with frequency-shifting by generalizing the previous single-channel analysis. It is shown that the improvement in stability due to frequency-shifting reduces with the number of channels. Simulations are presented to verify the theory. The stability limits are also compared with those of time-invariant systems, and preliminary subjective assessments are carried out to indicate useable loop gains with frequency-shifting.
Perceptual evaluation of multi-dimensional spatial audio reproduction
Authors: Guastavino Catherine , Katz Brian F. G.
Published: August 2004

Perceptual differences between sound reproduction systems with multiple spatial dimensions have been investigated. Two blind studies were performed using system configurations involving 1-D, 2-D, and 3-D loudspeaker arrays. Various types of source material were used, ranging from urban soundscapes to musical passages. Experiment I consisted in collecting subjects’ perceptions in a free-response format to identify relevant criteria for multi-dimensional spatial sound reproduction of complex auditory scenes by means of linguistic analysis. Experiment II utilized both free response and scale judgments for seven parameters derived form Experiment I. Results indicated a strong correlation between the source material (sound scene) and the subjective evaluation of the parameters, making the notion of an “optimal” reproduction method difficult for arbitrary source material.
Statistical-acoustics models of energy decay in systems of coupled rooms and their relation to geometrical acoustics
Authors: Summers Jason E. , Torres Rendell R. , Shimizu Yasushi
Published: August 2004

An improved statistical-acoustics model of high-frequency sound fields in coupled rooms is developed by incorporating into prior models geometrical-acoustics corrections for both energy decay within subrooms and energy transfer between subrooms. The conditions under which statistical-acoustics models of coupled rooms are valid approximations to geometrical acoustics are examined by comparison of computational geometrical-acoustics predictions of decay curves in two- and three-room systems with those of both improved and prior statistical-acoustics models. The accuracy of the decay model used within subrooms is found to have a primary influence on the accuracy of predictions in coupled systems. Likewise, nondiffuse transfer of energy is shown to significantly affect decay of energy in systems of coupled rooms. The decrease in energy density of the reverberant field with distance from the source, which is predicted by geometrical acoustics, is found to result in spatial dependence of decay-curve shape for certain coupling geometries. Geometrical effects are shown to contribute to the failure of statistical-acoustics models in the case of strong coupling between subrooms; thus, previously proposed statistical-acoustics criteria cannot predict the point at which the models break down with consistent accuracy.