bluuebunny/crossref_metadata_2025 huggingface dataset:
Negative Acting in
Authors: Paniagua Cecilio
Published: April 2008

Little has been written on the analysand's failure to act in the session when some form of motoric reaction or behavior seems appropriate and expectable. This phenomenon is conceptualized as negative acting in. Several clinical vignettes are provided. The importance of analytic interventions at these moments of behavioral omission, the possible countertransferential interferences, and the frequent use by the patient of rationalizations are commented on. The point is made that even though the exploration of these nodal points does not always lead to the discernment of psychodynamics, it usually contributes to the fostering of ego-observing capacities. Detection of episodes of negative acting in may pose special difficulties for the analyst, since it requires that attention be focused on events that do not take place, but their exploration is considered important for an analysis of the patient's psychic life.
Contributions of Psychoanalysis To the Understanding and Treatment of Depression
Authors: Blatt Sidney J.
Published: April 2008

Psychoanalysis continues to make important contributions to basic clinical understanding of adaptive and maladaptive psychological development, and particularly to the understanding of depression and its treatment. This paper demonstrates that a basic theoretical conceptualization, central to many of Freud's fundamental contributions, has provided the basis for a wide range of contemporary psychoanalytic and nonpsychoanalytic formulations of personality development and organization; for understanding various forms of psychopathology in adults as deriving from disruptions of normal developmental processes, especially personality disorders and depression; and for conducting research on psychotherapeutic process and outcome in both brief and long-term intensive treatment.
An Empirical Study of the Psychodynamics of Suicide
Authors: Kaslow Nadine J. , Reviere Susan L. , Chance Susan E. , Rogers James H. , Hatcher Carrie A. , Wasserman Frances , Smith Lisa , Jessee Salley , James Mark E. , Seelig Beth , Kaslow Nadine J.
Published: April 2008

This paper presents results from an empirical study of four key psychodynamic concepts (self-directed aggression, object loss, ego functioning disturbance, pathological object relations) of suicidal behavior. The sample consists of hospitalized psychiatric patients following a suicide attempt (attempters: n = 52) and demographically similar hospitalized psychiatric patients with no history of suicidal behavior (controls: n = 47). The study was designed to ascertain whether attempters differed from matched psychiatric control patients on the four psychodynamic constructs hypothesized to be associated with suicide. It was predicted that attempters would manifest higher levels of depression and self-targeted anger, a more significant history of loss, less adaptive defenses, and more primitive object representations. Results strongly supported an object-relational view of suicidal behavior. In addition, support for the loss hypothesis was found in the identification of one specific constellation of losses. Namely, attempters were significantly more likely to report a history of childhood loss combined with a recent loss in adulthood than were their nonattempter counterparts. Limited support was provided for the other two hypotheses in differentiating suicidal from nonsuicidal severely ill psychiatric patients. This unexpected finding is examined and suggestions are made for the refinement and greater specification of psychodynamic theories regarding the etiology of suicidal behavior, with the aim of differentiating individuals prone to such action from those with similar psychopathology and dynamic issues who do not actually attempt suicide. Limitations of the study are discussed and implications of the findings for the theory and treatment of suicidal behavior are offered.
The “Unobjectionable” Positive Countertransference
Authors: Fox Richard P.
Published: April 2008

Even though Freud said that “the secret of therapy is to cure through love,” the “unobjectionable” positive countertransference has remained a neglected topic in clinical and theoretical writings. This paper explores a number of personal and historical reasons to account for this avoidance. A case vignette is presented to highlight the facilitating and therapeutic role of the positive countertransference. It also demonstrates the analyst's struggles with his loving feelings and some of the reasons behind this conflict. The case is then used to explore the functions that the positive countertransference serves for the analysand, the analyst, and the analytic process. In conclusion, a number of questions are posed for an emerging model of psychoanalytic technique that would encompass the analyst's noninterpretive contributions to the process.
Where the Action Is: the Enacted Dimension of Analytic Process
Authors: Katz Gil A.
Published: April 2008

Enacted processes—variously addressed in the current literature by such terms as enactment, actualization, and interaction—represent the conceptual reuniting of Freud's concepts of transference and acting out. These various concepts include a recognition that transference may be represented not only on the verbally symbolized level but also on the enacted level, through psychic organizations and processes that use behavior, silence, and even speech as symbolic vehicles. Countertransference too finds representation within the enacted realm, in response to and in concert with the patient's enacted processes, though in more attenuated fashion. Enacted transference-countertransference processes are conceptualized as a continuously evolving second dimension of analytic treatment. This enacted dimension of analytic process exists alongside, and inextricably interwoven with, the treatment's verbal content, with characteristics unique to each analytic dyad. It occurs naturally and inevitably, without conscious awareness or intent, and is outside the domain of explicit technical interventions. The observable outcroppings or end points of processes within the enacted dimension are what are currently referred to as enactments. Attention to these unintended but meaningful and often elaborately developed characteristics of the treatment process furthers our understanding of the therapeutic action of psychoanalysis. The process of integrating the enacted with the verbal dimension of treatment enables the analysand to achieve higher levels of psychic organization.
Neutrality, Abstinence, and the Therapeutic Alliance
Authors: Meissner W.W.
Published: April 2008

Concepts of neutrality and abstinence are discussed in terms of the variant opinions about them, pro and con, with particular reference to efforts to dispense with them based on the unavoidable role of the analyst's personal influence and subjectivity in the analytic process. Stereotypes of both neutrality and abstinence are examined, and the therapeutic alliance established as the most appropriate context within which to articulate the essential and constructive role of effective analytic neutrality and abstinence. The alliance is not possible without the persistent exercise of both neutrality and abstinence; conversely, other components of the alliance are intended to facilitate and preserve neutrality and abstinence on the part of both analyst and analysand. These elements are essential factors in effective analytic practice.
A New Analytic Dyad: Homosexual Analyst, Heterosexual Patient
Authors: Phillips Sidney H.
Published: April 2008

The paradoxical thesis is presented that the extraordinary aspect of the analytic experience of a homosexual male analyst and his heterosexual male analysand is that it was ordinary, that the fundamental processes of transference, countertransference, and analysis of defense and resistance were determinative. The unique variations of these processes with this particular patient are explored. The patient entered treatment unaware of the analyst's homosexuality, which he discovered during the analysis. The course of this discovery, its transformations, its defensive uses, its transference meanings, and its fate in the termination are delineated. Through viewing the patient's reactions to the analyst's homosexuality as potential entry points to the transference, the analytic process was enhanced and facilitated.
“Traveling Affectively Alone”: a Personal Derailment in Analytic Listening
Authors: Schwaber Evelyne Albrecht
Published: April 2008

Questioning whether or not we have entered a new “two-person” paradigm, the author shares a traumatic personal experience, considers its impact on her work with a patient, and discusses some clinical and epistemological dilemmas in self-disclosure.
Telephone Analysis: Out of Sight, But Not Out of Mind
Authors: Zalusky Sharon
Published: April 2008

Past traditions and prejudices may have precluded many analysts from openly considering the use of telephone analysis as a viable treatment option. However, at times psychoanalysis by telephone may represent the best treatment available for a particular patient. Use of the telephone in clinical practice evokes complex feelings and raises a number of important issues for both patient and analyst. A case of telephone analysis is presented to illustrate the poignancy of initial telephone contact, issues associated with the decision to do psychoanalysis by telephone, some of the paradoxes and complexities of telephone work itself, and the termination process. Initial resistances by both patient and analyst are discussed, and modification of technique and its applicability to psychoanalysis in general are examined. Indicators for telephone analysis are considered.
The Distinction Between Needs and Wishes: Implications for Psychoanalytic Theory and Technique
Authors: Akhtar Salman
Published: April 2008

After a comprehensive survey of the literature is presented and some caveats entered, this paper delineates the concept of a psychological “need,” noting that it bears a complex relation to the concept of a “wish.” Need is universal, wish experience-bound. A need, unlike a wish, is not subject to repression. In addition, although a wish can be replaced by another wish, a need cannot be replaced by another need. Whereas the frustration of a wish causes dynamic shifts, the frustration of a need leads to structural disintegration. Needs and wishes can be in harmony or in opposition. The paper also identifies six basic psychological needs, which would seem to be ubiquitous, though the degree to which they are overt and the ways in which they are met vary across cultures. Their gratification seems necessary for healthy psychic development to occur, for relationships to survive, and for psychoanalytic work to take hold and to continue optimally. These needs are (1) the need for one's physical needs to be deemed legitimate; (2) the need for identity, recognition, and affirmation; (3) the need for interpersonal and intrapsychic boundaries; (4) the need for understanding the causes of events; (5) the need for optimal emotional availability of a love object; and (6) the need for a resilient responsiveness by one's love objects under special circumstances. Ordinarily these needs are met during the course of treatment with no deliberate effort by the analyst. In the treatment of some patients, however, they require more direct attention. A number of clinical vignettes are presented to elucidate these ideas.
The Patient's Part in Analytic Process: the Influence of the Analyst's Expectations
Authors: Almond Richard
Published: April 2008

The psychoanalyst's expectations of the patient are complex and crucial to the work of analysis. These expectations, operating at a level generally outside the consciousness of patient and analyst, are part of the `microstructure` of analysis, the interactional give-and-take that brings about change. The view taken here is that analytic process is necessarily interactive, as well as intrapsychic. In addition to transference-countertransference motivations, both parties to an analysis operate in a social context that prescribes a range of desired and undesired behavior. The analyst brings to the interaction professional analytic attitudes about how to listen and act, and a set of expectations of the patient. These attitudes and expectations modulate subjective reactions to the patient's transferentially driven actions, and influence the expression of countertransference. The mutative process of psychoanalysis involves the action of these attitudes and expectations on the patient, both in ways specific to individuals and in more general ways. Such expectations lie behind analytic tactics and, though not often written of, are part of the oral tradition of psychoanalysis. Here the expected patient role is described in terms of five bipolar continua: (1) reporting and editing; (2) transferring and containing; (3) thinking about oneself and thinking about the analyst; (4) regressing and listening/self-observing; (5) initiating trial action and mediating among inner states. The activity and thinking of the dyad move constantly along these continua. A clinical example from the beginning of an hour illustrates how these expectancies emerge in analytic work.
On Subjectivity and Objectivity in Psychoanalysis
Authors: Hanly Charles
Published: April 2008

Epistemological subjectivism has found its way into psychoanalysis along several theoretical and clinical paths. It has developed out of the clinical interest in transference and countertransference and, in particular, from the broadly generalized definition of countertransference now popular. The clinically necessary attention to analyst-analysand interaction has been turned into interactionism or intersubjectivism and a denial of epistemological subject-object differentiation.These perspectives transform a clinical focus on the here and now of the analytic relation into the determination of the past by the present and a teleological reversal of causality. Once this reversal is made, narrative in the analytic situation becomes the co-creation of the analysand's past by the present analyst-analysand relation. Psychoanalysis, on this view, can at best substitute a coherent, novelistic account for the life history of a person. Some of the problems of subjectivism are examined here with a view to restoring to psychoanalysis the epistemology of science and common sense.
Toward a Postmodern Realism for Psychoanalysis
Authors: Kirshner Lewis A.
Published: April 2008

The current status of psychoanalysis is explored in the light of the postmodern critique of forms of knowledge. Analysts have tended to respond by redefining psychoanalysis in the language of the exact sciences or by finding a language that includes both (Kuhn, Rorty), thereby falling either into a reductive “scientism” or the fallacies of the “strong program” in postmodern thought. However, psychoanalytic theories do not meet the probative requirements of science. Neither is the serious problem of competing theories and interpretations adequately addressed by hermeneutics. Philosophical realism (Putnam 1981, 1988) offers some helpful ways to look at this problem. Following Lacan, we define psychoanalysis as a clinical discipline which has as its unique object of study the human subject, an indeterminate and language dependent entity. Concepts and rules specific to our field make an internal realism of psychoanalytic inquiry possible. An extended case vignette accompanies this philosophical discussion.
Subjectivity and Objectivity in Analytic Listening
Authors: Smith Henry F.
Published: April 2008

Analysts use the concepts of subjectivity and intersubjectivity to support many different technical recommendations; this represents a misuse of theory. The dichotomy between subjectivity and objectivity is a false one. Arguing against the notion of objectivity, analysts conflate it with the idealized notion of pure objectivity and then eliminate various technical devices in its name. One cannot have a concept of subjectivity without a concept of objectivity, or an intersubjective perspective that does not include some agreed-upon concept of objectivity. The simplest definition of objectivity is a directional one. Objectivity is the perception or experience of the external; subjectivity is the perception or experience of the internal. Subjectivity and objectivity are both necessary pathways to knowledge and are dependent on each other. Any form of looking or listening does to some extent preclude another, but to speak solely from a subjective or an objective perspective represents a regression in thinking to a form of naive objectivism or naive subjectivism. Clinical examples illustrate how the forming and testing of hypotheses require the cooperation of both subjective and objective listening.
Oedipal Dynamics in Panic Disorder
Authors: Busch Fredric N. , Milrod Barbara L. , Rudden Marie , Shapiro Theodore , Singer Meriamne , Aronson Andrew , Roiphe Jean
Published: April 2008

Both research and clinical work have revealed factors that can lead to the onset and persistence of panic disorder. Preoedipal conflicts intensify the danger of oedipal longings for panic patients. Competition with the same-sex parent is linked with angry preoedipal fantasies and associated fears of disruption in attachments. Fantasied or actual successes can thus trigger panic episodes. Regression to a helpless, dependent state such as panic defends against the danger of aggressive, competitive fantasies and actual achievements. However, the regressive state can also be experienced as dangerous, and can be linked with frightening homosexual fantasies. A reactive aggressive oedipal stance can sometimes result, triggering escalating turmoil. The panic episode serves a series of compromise formations in dealing with these conflicted wishes.
The Effectiveness of Psychoanalytic Psychotherapy: the Role of Treatment Duration, Frequency of Sessions, and the Therapeutic Relationship
Authors: Freedman Norbert , Hoffenberg Joan D. , Vorus Neal , Frosch Allan
Published: April 2008

This is an effectiveness study of treatment outcome that relies on patients' perception of their mental health during and after psychoanalytic psychotherapy. Ninety-nine outpatients attending the IPTAR Clinical Center (ICC) responded to the Effectiveness Questionnaire (EQ) adapted from that developed by Consumer Reports. Effectiveness is studied from various perspectives. Findings indicated (1) an incremental gain in effectiveness scores from six to over twenty-four months of therapy; (2) an incremental gain with greater session frequency from one to two or three weekly sessions; (3) facilitation of effectiveness by the experience of a positive relationship with the therapist; (4) an interplay between clinical syndrome and treatment conditions. A method giving clinical validity to the quantitative findings is described. Brief summaries of two recorded interviews reveal differential reconstruction of events that had occurred during treatment. The findings are discussed from the vantage point of two hypotheses: cognitive dissonance and internalization of therapeutic experience.
Toward a General Theory of CSRs
Authors: Godfrey Paul C. , Hatch Nile W. , Hansen Jared M.
Published: April 2008

Corporate social responsibility (CSR) is a tortured concept. A number of alternative definitions of the construct exist at the theoretical level, and much debate surrounds the meaning (and its related implications for practice) of the term. Empirically, CSR research reaches few remarkable conclusions. In this article, the authors reconceptualize CSR into a number of discrete corporate social responsibilities (CSRs), each of which can have a positive or negative social impact, and each of which has an endogenous managerially driven component and an exogenous stakeholder-driven component. Using an industry-level sample drawn from the KLD database, the authors test the impact of hypothesized drivers of CSR on various CSRs.
Does Education Influence Pediatricians' Perceptions of Physician-Specific Barriers for Maternal Depression?
Authors: Head Julia G. , Storfer-Isser Amy , O'Connor Karen G. , Hoagwood Kimberly E. , Kelleher Kelly J. , Heneghan Amy M. , Park Elyse R. , Chaudron Linda H. , Stein Ruth E. K. , McCue Horwitz Sarah
Published: April 2008

Pediatric residency reforms have increased emphasis on psychosocial issues, but we do not know whether this has changed pediatricians' perceptions of barriers to addressing maternal depression. A survey of 1600 members of the American Academy of Pediatrics investigated whether training in adult mental health issues and perceived barriers to addressing maternal depression differed for current pediatric residents, pediatricians in practice <5 years, and those in practice ≥5 years. Training did not differ for respondents who were currently in training, in practice <5 years, or in practice ≥5 years. Those in practice ≥5 years reported more barriers to addressing maternal depression compared with current residents. Current residents with training in adult mental techniques reported fewer barriers to the care of maternal depression. However, in spite of residency reforms, 81% of current residents reported no training in adult mental health issues.
No Technological Innovation Is a Panacea: A Case Series in Quality Improvement for Primary Care Mental Health Services
Authors: Horwitz Sarah McCue , Hoagwood Kimberly Eaton , Garner Andrew , Macknin Michael , Phelps Thomas , Wexberg Steven , Foley Conrad , Lock Joseph C. , Hazen Jacalyn E. , Sturner Raymond , Howard Barbara , Kelleher Kelly J.
Published: April 2008

Evaluations of quality improvement efforts targeted at mental health services in primary care pediatrics are rare. We evaluated a short-targeted educational session, a Web-based system, the Child Health and Development Interactive System, and a local area mental health services resource guide. Most physicians believed the information in the educational session was at least somewhat likely to change their practice. However, only 9.2% of the families invited to complete the Web-based system did so. Physicians found access to the Web-based system time consuming and, because the billing code for the screening activity was carved out of most of Ohio's privately-insured contract, physicians received no reimbursement for the screenings. Physicians were unenthusiastic about the local resource guide because the resources were not rated for quality. This quality improvement effort demonstrates that there are not easy solutions to practice change and highlights the need for implementation support when introducing new technology.
Development and Psychometric Evaluation of the Counseling Women Competencies Scale (CWCS)
Authors: Ancis Julie R. , Szymanski Dawn M. , Ladany Nicholas
Published: April 2008

This article describes the development and psychometric evaluation of the Counseling Women Competencies Scale (CWCS). The CWCS is designed to assess clinicians' self-perceived competencies with regard to therapeutic practice with diverse female clients. Through an extensive review of the literature on counseling women and expert review by 32 members of the Section for the Advancement of Women (Division 17, APA), content validity was supported. Exploratory factor analysis, conducted on a sample of 321 male and female counseling and psychology graduate students and professionals, supported a two-factor model consisting of knowledge/skills and self-awareness factors. Findings also provided support for the internal consistency reliability and construct (convergent, divergent, and incremental) validity of the scale.
A Person-Centered Approach to the Treatment of Combat Veterans With Posttraumatic Stress Disorder
Authors: Quinn Adam
Published: April 2008

Posttraumatic stress disorder as attributed to military combat trauma results in a breakdown of a combat veteran's sense of self and the world. In the effective treatment of combat-related posttraumatic stress disorder, a therapist must help the veteran reorganize the self-structure that has become incongruent with his or her precombat-trauma self following his or her return home from war. For the therapist to facilitate a veteran's becoming whole, he or she must be genuinely congruent in the relationship. Carl Rogers's person-centered therapy and theory of personality change emphasize a unique subjective way of being, in which a therapist's genuine congruence is of utmost importance in the wounded combat veteran's healing and rebuilding of life.
On the Road to Being
Authors: Badiee Manijeh
Published: April 2008

This article reflects my introspective journey as a student into the world of existential theory and my struggle to find an identity in the profession. The purpose of the excursion was to clarify my conceptualization of clients, understand my goal as a practitioner, and determine practical ways of implementing existential ideas. First, this article provides a conceptualization about how I view clients as an existential psychotherapist. Second, I elaborate on my goal of providing clients with existential clarity. Third, I address the integration of acceptance and commitment therapy and existential theory to apply theory to practice. The final section describes some of my own existential exploration and the evolving clarity of my beliefs.
To See or Not To See “Schizophrenia” and The Possibility of Full “Recovery”
Authors: Breeding John
Published: April 2008

Since the beginning of modern psychiatry, the diagnosis of “schizophrenia” has epitomized the idea of chronic, severe mental illness. This engaging article looks at the beliefs and practices of biological psychiatry regarding “schizophrenia.” Guiding beliefs, however flawed they might be, determine perception and action, and this is very true in psychiatry. There are, however, significant differences between belief and fact in psychiatric theory. The author examines these differences and presents research about the safety and efficacy failures of treatment, especially regarding the antipsychotic drugs. He reviews important dissident literature from both psychiatric survivors and professionals showing that recovery from extreme states, from “schizophrenia,” is quite possible. Although the standard psychiatric outlook for recovery from schizophrenia is virtually nil, the essay concludes with an inspiring story of musical artists who have demonstrated a reemergence from diagnoses of severe mental illness and treatment with antipsychotic drugs and electroshock.
Social Information Processing, Security of Attachment, and Emotion Regulation in Children With Learning Disabilities
Authors: Bauminger Nirit , Kimhi-Kind Ilanit
Published: April 2008

This study examined the contribution of attachment security and emotion regulation (ER) to the explanation of social information processing (SIP) in middle childhood boys with learning disabilities (LD) and without LD matched on age and grade level. Children analyzed four social vignettes using Dodge's SIP model and completed the Kerns security scale and the children's self-control scale. Study results demonstrated major difficulties in SIP, lower attachment security, and less ER in children with LD compared to children without LD. Attachment as well as the interaction between attachment and ER emerged as important contributors to most SIP steps, suggesting that children with higher security who also have better ER skills will have better SIP capabilities along the different steps, beyond group inclusion. Results were discussed in terms of practical and clinical implications regarding the importance of mother-child attachment and ER skills for social cognitive capabilities in children with LD.
John Locke, Christian Liberty, and the Predicament of Liberal Toleration
Authors: De Roover Jakob , Balagangadhara S.N.
Published: April 2008

Recently, scholars have disputed whether Locke's political theory should be read as the groundwork of secular liberalism or as a Protestant political theology. Focusing on Locke's mature theory of toleration, the article raises a central question: What if these two readings are compatible? That is, what would be the consequences if Locke's political philosophy has theological foundations, but has also given shape to secular liberalism? Examining Locke's theory in the Letter Concerning Toleration (1689), the article argues that this is indeed the case. The liberal model of toleration is a secularization of the theology of Christian liberty and its division of society into a temporal political kingdom and the spiritual kingdom of Christ. Therefore, when liberal toleration travels beyond the boundaries of the Christian West or when western societies become multicultural, it threatens to lose its intelligibility.
Relationship between GST Yp Induction and Hepatocyte Proliferation in Rats Treated with Phase II Drug Metabolizing Enzyme Inducers
Authors: Makino Toshihiko , Ishikawa Kayoko , Igarashi Isao , Yamoto Takashi , Manabe Sunao , Nakayama Hiroyuki
Published: April 2008

Butylated hydroxyanisole (BHA) and 1,2-bis(2-pyridyl)ethylene (2PY-e) are phase II drug metabolizing enzyme inducers which cause hepatomegaly without hepatocyte hypertrophy and induce glutathione S-transferase Yp (GST Yp, pi-class GST), which is known as a tumor marker. To evaluate the relationship between GST Yp induction and hepatocyte proliferation, male F344/DuCrj rats were treated with BHA, 2PY-e, or phenobarbital (PB) for three or seven days. All three chemicals caused increases in liver weight after three and seven days. Immunohistochemical examinations revealed that BHA and 2PY-e induced GST Yp in the hepatocytes of the periportal and centrilobular areas at three and seven days, respectively, whereas PB did not. Significant increases in the BrdU labeling indices were found in the livers of rats in each of the three-day treatment groups, but the labeling index of rat livers treated with BHA was decreased to the control level at seven days, although the high labeling indices of 2PY-e and PB persisted at seven days. Double immunostaining confirmed that BrdU-positive nuclei corresponded to GST Yp-positive hepatocytes in both BHA and 2PY-e treated rats. These results suggest that the GST Yp induction caused by BHA or 2PY-e has some kind of relationship with hepatocyte proliferation.
The Female Rat Reproductive Cycle: A Practical Histological Guide to Staging
Authors: Westwood F. Russell
Published: April 2008

During preclinical investigations into the safety of drugs and chemicals, many are found to interfere with reproductive function in the female rat. This interference is commonly expressed as a change in normal morphology of the reproductive tract or a disturbance in the duration of particular phases of the estrous cycle. Such alterations can be recognized only if the pathologist has knowledge of the continuously changing histological appearance of the various components of the reproductive tract during the cycle and can accurately and consistently ascribe an individual tract to a particular phase of the cycle. Unfortunately, although comprehensive reports illustrating the normal appearance of the tract during the rat estrous cycle have been available over many years, they are generally somewhat ambiguous about distinct criteria for defining the end of one stage and the beginning of another. This detail is absolutely essential to achieve a consistent approach to staging the cycle. For the toxicologic pathologist, this report illustrates a pragmatic and practical approach to staging the estrous cycle in the rat based on personal experience and a review of the literature from the last century.
Trans-Species Comparison of PPAR and RXR Expression by Rat and Human Urothelial Tissues
Authors: Chopra Bikramjit , Hinley Jennifer , Oleksiewicz Martin B. , Southgate Jennifer
Published: April 2008

Because some investigational peroxisome proliferator-activated receptors (PPAR) agonists cause tumors in the lower urinary tract of rats, we compared normal human and rat urothelium in terms of PPAR and retinoid X receptor (RXR) expression and proliferation-associated phenotypes. In situ, few human but most rat urothelial cells were Ki67 positive, indicating fundamental differences in cell cycle control. Rat and human urothelia expressed all 3 PPAR and the RXRα and RXRβ isoforms in a predominantly nuclear localization, indicating that they may be biologically active. However, immunolocalization differences were observed between species. First, whereas PPARα and PPARβ/δ were expressed throughout the human bladder or ureteric urothelium, in the rat urothelium PPARα was primarily, and PPARβ/δ exclusively, restricted to superficial cells. Second, RXRβ was restricted to intermediate and superficial layers of the human urothelium but tended to be absent from the rat superficial cells. Third, PPARγ expression was present throughout the urothelia of both species but was most intense in the superficial human urothelium. Species differences were also observed in the expression of PPAR and RXR isoforms between cultured rat and human urothelial cells and in the smooth muscle. Our findings highlight the unique coexpression of multiple PPAR and RXR isoforms by urothelium and suggest that species differences in PPAR function between rat and human urothelia may be explored in an in vitro setting.
Spontaneous Occurrence of a Distinctive Renal Tubule Tumor Phenotype in Rat Carcinogenicity Studies Conducted by the National Toxicology Program
Authors: Hard Gordon C. , Seely John Curtis , Kissling Grace E. , Betz Laura J.
Published: April 2008

The Toxicology Data Management System (TDMS) of the National Toxicology Program, National Institutes of Environmental Health Sciences, National Institutes of Health, was surveyed for occurrence and distribution of a distinctive renal tubule tumor type in rats. The hallmark features of this tumor included eosinophilic/amphophilic staining, large finely granular cells, and numerous vacuoles and/or minilumens. It is referred to here as the amphophilic-vacuolar (AV) variant of renal tubule tumor. Of 154 studies in which renal tubule tumors had been recorded in the standard single sections of kidney in the TDMS, there were collectively 1012 rats with renal adenomas, carcinomas, or adenocarcinomas, and of these, 100 displayed the distinctive AV morphology, representing 74 studies involving mostly the F344 rat, but also the Sprague-Dawley and Wistar strains. The AV tumors (mainly adenomas but also some carcinomas) occurred usually as solitary lesions in the affected animals. However, they were multiple and bilateral in a few cases. They were equally distributed between the sexes, did not metastasize (at least to the lung), and were not associated with chronic progressive nephropathy. The distribution of this renal tumor type was random across studies and dose groups, underscoring the likelihood that it was of spontaneous origin and not chemically induced. Accordingly, it is suggested that this distinctive renal tumor phenotype be recorded as a separate category from conventional RTT when assessing the carcinogenic potential of a test compound.
Arthroscopic Rotator Cuff Repair in Overhead-Throwing Athletes
Authors: Liem Dennis , Lichtenberg Sven , Magosch Petra , Habermeyer Peter
Published: April 2008

Background

When overhead-throwing athletes suffer from a rotator cuff tear, their ability to perform sporting activities is significantly impaired.

Hypothesis

Arthroscopic rotator cuff repair allows amateur overhead-throwing athletes to return to their preoperative level of overhead-throwing sports.

Study Design

Cohort study; Level of evidence, 3.

Methods

Twenty-one overhead-throwing athletes (14 male and 7 female; average age, 58.9 years, range, 46-69 years) were reviewed for clinical outcome with the Constant Score and structural integrity of the repair on magnetic resonance imaging. The average follow-up was 25.7 months (24-29 months). Athletes were asked to retrospectively assess their sporting activity for pain, strength, endurance, and range of motion before onset of symptoms, preoperatively and at follow-up. They also were asked to evaluate their overall performance as a percentage of their original performance (0% to 100%). Retear rates and Constant Scores were compared with those of 32 patients who were not overhead-throwing athletes and who were operated on during the same time span.

Results

Patients significantly improved their Constant Score from 54.9 to 84.2 ( P < .001). Sporting activity was not significantly influenced by repair integrity; the retear rate was 23.8% (5/21). There was no significant difference for retear rate (25%; 8/32) or clinical outcome (Constant Score 84.5, P = .993) compared with patients who were not involved in overhead-throwing sports or any sports. All patients returned to their overhead-throwing sport an average of 6.3 months (3-12 months) after the surgery. Participation (2.1 per week) and duration (2.3 hours) of overhead-throwing activity postoperatively were not significantly lower than before the Patient was injured (2.2 per week, P = .290; and 2.4 hours, P = .285). Patients estimated their overall activity level to be 91.9% of their original, noninjured condition, which was significantly improved from the preoperative condition of 34.8% ( P < .001).

Conclusion

Arthroscopic rotator cuff repair led to good clinical results in this group of overhead-throwing athletes. Patients were able to return to overhead-throwing sports, most of them at the same preoperative level.
Bridging the Gap in Immobile Massive Rotator Cuff Tears
Authors: Rhee Yong Girl , Cho Nam Su , Lim Chan Teak , Yi Jin Woong , Vishvanathan Thimurayan
Published: April 2008

Background

Numerous operative techniques have been described for the treatment of massive rotator cuff tears with severe retraction where anatomical repair is impossible.

Purpose

To evaluate the outcome of massive rotator cuff tears repaired using the biceps interposition technique.

Study Design

Case series; Level of evidence, 4.

Methods

Between April 2000 and April 2004, 31 shoulders with irreparable massive rotator cuff tears and associated degenerative lesions of the biceps tendon were included for analysis. Open procedures were performed in 15 cases (open group), while 16 patients underwent arthroscopic procedures (arthroscopic group). The mean follow-up period was 32 months (range, 24-67 months).

Results

The overall University of California at Los Angeles score at the last follow-up was 31.1 points (range, 21-35). The clinical outcome was excellent in 15 (48.4%) and good in 13 (41.9%) cases. Three patients (9.7%) had poor outcome. There was 1 case of reoperation in the open group for a retear. The mean preoperative Constant score, which was 44.6 points (range, 8-70) in the open group and 51.8 points (range, 24-70) in the arthroscopic group, improved to 80.7 points (range, 37-88) in the former and 83.5 points (range, 57-96) in the latter. The University of California at Los Angeles score improved from preoperative means of 11.3 points (range, 6-16) and 13.6 points (range, 6-19) to 29.5 points (range, 9-33) and 32.6 points (range, 21-35), respectively. However, the differences between the scores in both the categories were not statistically significant ( P = .412 and .198, respectively). According to the postoperative repair integrity analyzed with use of magnetic resonance imaging in 14 of 16 cases with arthroscopic augmentation, 9 (64.3%) presented complete healing.

Conclusion

The biceps tendon interposition technique for massive rotator cuff tears offers a possible improvement in the clinical outcomes and is comparable to that of conventional repair. As well, the augmentation technique using the tenotomized biceps as potential graft for rotator cuff tears is particularly useful in bridging the gap in immobile massive rotator cuff tears with posterior defects and retraction.
Epidemiology of National Football League Training Camp Injuries from 1998 to 2007
Authors: Feeley Brian T. , Kennelly Steve , Barnes Ronnie P. , Muller Mark S. , Kelly Bryan T. , Rodeo Scott A. , Warren Russell F.
Published: April 2008

Background

Football is one of the leading causes of athletic-related injuries. Injury rates and patterns of the training camp period of the National Football League are unknown.

Hypothesis

Injury rates will vary with time, and injury patterns will differ between training camp practices and preseason games.

Study Design

Descriptive epidemiology study.

Methods

From 1998 to 2007, injury data were collected from 1 National Football League team during its training camp period. Injuries were recorded as a strain, sprain, concussion, contusion, fracture/dislocation, or other injury. The injury was further categorized by location on the body. Injury rates were determined based on the exposure of an athlete to a game or practice event. An athlete exposure was defined as 1 athlete participating in 1 practice or game. The injury rate was calculated as the ratio of injuries per 1000 athlete exposures.

Results

There were 72.8 (range, 58-109) injuries per year during training camp. Injuries were more common during weeks 1 and 2 than during weeks 3 to 5. The rate of injury was significantly higher during games (64.7/1000 athlete exposures) than practices (12.7/1000 athlete exposures, P < .01). The rate of season-ending injuries was also much higher in games (5.4/1000 athlete exposures) than practices (0.4/1000 athlete exposures). The most common injury during the training camp period was a knee sprain, followed by hamstring strains and contusions.

Conclusion

Muscle strains are the most common injury type in practices. Contact type injuries are most common during preseason games, and the number of significant injuries that occur during preseason games is high.
Review of A Large Clinical Series: Paroxysmal Atrial Fibrillation in Critically Ill Patients With Sepsis
Authors: Salman Salam , Bajwa Abubakr , Gajic Ognjen , Afessa Bekele
Published: April 2008

The objective of this retrospective cohort study was to describe the incidence of paroxysmal atrial fibrillation and to determine its risk factors and effect on outcome in critically ill patients with sepsis. The study included 81 patients with sepsis admitted to an intensive care unit. In all, 25 patients (31%) developed paroxysmal atrial fibrillation. Advanced age, history of paroxysmal atrial fibrillation, higher severity of illness at intensive care unit admission, and lower left ventricular ejection fraction were risk factors for paroxysmal atrial fibrillation. Multiple logistic regression analysis showed that paroxysmal atrial fibrillation was independently associated with 28-day mortality (odds ratio = 3.284; 95% confidence interval, 1.126-9.574). The incidence of paroxysmal atrial fibrillation is high in critically ill patients with sepsis. It occurs more frequently in patients with advanced age, history of paroxysmal atrial fibrillation, high severity of illness, and lower left ventricular ejection fraction and is associated with increased mortality.
A Qualitative Study of Preservice Teachers' Understanding of Self-Determination for Students With Significant Disabilities
Authors: Thoma Colleen A. , Pannozzo Gina M. , Fritton Sandra C. , Bartholomew Christina C.
Published: April 2008

Teaching self-determination to students with disabilities has long been a focus of the fields of special education and psychology, with much of the research focusing on why self-determination is important, the effects of self-determination skills on academic and adult outcomes, and identifying strategies teachers can use to teach self-determination in the classroom. The current study attempted to develop a greater understanding of how special education teacher candidates define and discuss self-determination within the context of a course on secondary special education and transition planning for students with significant intellectual disabilities. Researchers examined teachers' understanding of self-determination, their ability to incorporate self-determination into their daily instruction, and if their understanding reflected common misconceptions and misinterpretations.
Identifying Predictors of Negative Psychological Reactions to Stalking Victimization
Authors: Johnson Matthew C. , Kercher Glen A.
Published: April 2008

Victims of stalking often experience a number of negative psychological problems including such things as fear, symptoms of depression, and anger. However, research on factors that lead to these outcomes is limited. The goal of this study was to first identify distinct subgroups of stalking victims based on measures of psychological problems resulting from being stalked. Once identified, the next step was to examine the influence of demographic and stalking-related variables on the probability of subgroup membership. The results revealed that respondents who were female, had a prior relationship with the stalker, experienced a greater variety of stalking behaviors, were divorced/separated, and reported receiving government assistance were more likely to be classified into subgroups characterized by a high probability of experiencing multiple negative outcomes.
Identity and Civil Society in Latvia, Poland, and Ukraine
Authors: Orr Scott D.
Published: April 2008

This research tests the hypothesis that social identities play a key role in the success or failure of democracy, since individuals often hold ethnic and regional identities in particular in a mutually exclusive fashion, resisting calls to act politically on other identities that cut across them. Activists in women's non-governmental organizations (NGOs) were interviewed in Latvia, Poland, and Ukraine, in order to examine the policy process in an area that cuts across ethnic and regional lines. In newer democracies, the effects of identities should be strongest, since institutions are new, and have less ability to constrain political behavior. The hypothesis that ethnic and regional divisions inhibit cooperation within and between NGOs was tested against alternative hypotheses that attribute cooperation, or the lack of it, to outside funding. The results support the argument that ethnic and regional divisions harm cooperation on women's issues, though the other hypotheses cannot be ruled out.
Preparation, Properties, and Mechanism of Novel Polyurethane Adhesive/Organic Montmorillonite Nanocomposites
Authors: Jincheng Wang  , Yuehui Chen  , Yuan Tang  , Minming Xu
Published: April 2008

Novel polyurethane adhesives (PUA) were prepared by the incorporation of organic montmorillonite (OMMT). The structure of the PUA/OMMT adhesives was analyzed by wide angle X-ray diffraction, Fourier transform infrared spectroscopy, and transmission electron microscopy. It was observed that the OMMT layers in the PUA were of nanometer dimensions and the molecular structure of PUA was perturbed by the presence of OMMT. This was due to the reaction between the monomers and the intercalation agent. Physico-mechanical properties such as adhesion and thermal stability were investigated. Results showed that the PUA system with 3 phr OMMT has the best physical and mechanical properties due to the exfoliation of OMMT. The nano-reinforcing effect caused by the exfoliated silicate layers may reduce the amount and size of voids during peeling, which can increase the length of the crack path in their vicinity, leading to improved adhesive properties. This is postulated as the mechanism for improved adhesion in the PUA/OMMT adhesive.