bluuebunny/crossref_metadata_2025 huggingface dataset:
An Inquiry into The Fate of The Transference in Psychoanalysis
Authors: Abend Sander M.
Published: January 2017

Despite universal agreement about the importance of transference, there is no single, comprehensive, generally accepted explanation for the place transference occupies in clinical psychoanalytic theory. In this presentation, I trace the origins of some major trends prominent in theoretical controversy to their antecedents. Some seminal contributions which introduced important issues into the evolving theory of transference are highlighted; this is followed by a brief outline of the ideas of a representative sample of current theorists. This comparison of the appearance of fundamental evolutionary modifications of transference theory with present-day differences in theoretical emphasis leads to the identification of four persistent themes: (1) the nature of the influence of the patient's relationship with the analyst in the analytic experience, (2) how to account for the analyst's subjectivity and its role in the analytic process, (3) what weight to assign to the interpersonal dimension of the transference, and (4) differences among theoretical perspectives as reflected in the precise content of transference interpretations. Difficulties in the path of comparative evaluation of differences in theoretical accounts of the transference and its handling are noted. A few reasons for my adherence to the theory I prefer are mentioned solely for the purpose of underlining areas of controversy that require serious attention and further clarification.
A New Political Generation: Millennials and the Post-2008 Wave of Protest
Authors: Milkman Ruth
Published: January 2017

Building on Karl Mannheim’s theory of generations, this address argues that U.S. Millennials comprise a new political generation with lived experiences and worldviews that set them apart from their elders. Not only are they the first generation of “digital natives,” but, although they are more educated than any previous U.S. generation, they face a labor market in which precarity is increasingly the norm. And despite proclamations to the contrary, they confront persistent racial and gender disparities, discrimination against sexual minorities, and widening class inequality—all of which they understand in the framework of “intersectionality.” This address analyzes the four largest social movements spearheaded by college-educated Millennials: the young undocumented immigrant “Dreamers,” the 2011 Occupy Wall Street uprising, the campus movement protesting sexual assault, and the Black Lives Matter movement. All four reflect the distinctive historical experience of the Millennial generation, but they vary along two cross-cutting dimensions: (1) the social characteristics of activists and leaders, and (2) the dominant modes of organization and strategic repertoires.
Appropriate Patient Selection for Carotid Revascularization Procedures is Urgently Needed
Authors: Paraskevas Kosmas I. , Veith Frank J. , Mikhailidis Dimitri P. , Liapis Christos D.
Published: January 2017

The identification/selection of appropriate patient subgroups with asymptomatic carotid artery stenosis and the performance of prophylactic carotid endarterectomy (CEA)/carotid artery stenting (CAS) exclusively on these asymptomatic patient subgroups is currently one of the “hottest” topics in vascular surgery. It is now clear that offering CEA/CAS to asymptomatic carotid patients based only on the degree of carotid stenosis is unjustified and scientifically flawed. On the other hand, offering only best medical therapy to every asymptomatic patient, irrespective of certain high-risk criteria (such as the detection of microemboli by transcranial Doppler, intraplaque hemorrhage, silent embolic infarcts on brain computed tomography/magnetic resonance imaging, elevated biomarkers, family history), is equally wrong. The validation of specific measures to identify those asymptomatic patients at high risk for developing symptoms is crucial to achieve optimal use of carotid interventions and avoid wasting stroke prevention resources.
From Crisis to Transformation: Education in Post-Apartheid South Africa
Authors: Christie Pam
Published: January 2017

As South Africa moves towards political change at the start of the 1990s, issues of educational transformation have assumed new prominence for post-apartheid planners. This article outlines the crisis of provision in black education, arguing that the challenge is to develop equity policies to redress historical imbalances between races. Using Gramscian theory, the article also explores the crisis of legitimacy in black education. It suggests that the state has relied on coercive measures to contain resistance in black education and that it has focused on maintaining control rather than meeting demands for change. It is on the basis of this twofold crisis that post-apartheid planners are working towards a new educational dispensation.
Oppression at Trade School
Authors: Hollis Maree A.
Published: January 2017

Sixty-two women in the first to fourth year of an apprenticeship in various traditionally male-dominated trades described their experiences at trade school and their responses to the generally oppressive environment. Although some teachers and male classmates were supportive, most were not and the women were isolated, verbally abused and sexually and physically harassed. A macho-male atmosphere existed where women were not wanted and were not regarded as competent. The women felt excluded from male groups and were under pressure to perform. The women were strong-minded, resilient and successful and felt competent and able to fit in with the men. Most support came from parents. The cultural background of the ‘tradesman’ was discussed to help understand why the women were treated in such a discriminatory way in the trade school classes.
A Literal Translation of Mark 1 in Balinese
Authors: Swellengtebel J. L.
Published: January 2017

A literal translation of the renderings in another language affords an excellent basis for comparing syntactic and lexical problems. The following “translation” (though by no means word for word), together with the accompanying notes, provides an instructive insight into many of the complex problems of Balinese. (Ed. note.)
Aspects of Canadian evangelical historiography
Authors: Burkinshaw Robert K.
Published: January 2017

This 1995 presidential address to the Canadian Society of Church History (CSCH) examines the study of the history of evangelicalism in Canada. It describes and attempts to explain the enormous changes which have occurred over the last several decades as historians have turned from virtual neglect of evangelical history to a significant and growing emphasis upon it. The article also outlines some of the directions in that historiography, as indicated by works published over the last decade and by papers presented at a major conference held at Queen's University in May 1995.
Approaching church history with T.A.C.T
Authors: Steinacher C. Mark
Published: January 2017

T.A.C.T., a bundle of analysis applications for MS-DOS computers originally developed for computational linguists, may be used profitably by historians of religion. It converts an ASCII text file into a "database," which may be queried to produce indicators of broad trends in language use and word counts, as well as isolating "node collocate pairs" and "phrasal repetends." The article is based on results of actual research projects, from different periods and of radically different-sized original documents. From these, T.A.C.T.'s tests were able to extract otherwise irretrievable evidence
The Changing Swedish Electorate
Authors: Stephens John D.
Published: January 2017

This article attempts to assess the contribution of long-term changes in Swedish social structure to three recent developments in Swedish electoral behavior: the decline of the Social Democrats, the decline in class voting, and the increase in the volatility of party preference. The author argues that the decline of the Social Democrats cannot be attributed to long-term structural changes in the electorate but rather is a product of the policies and electoral strategies pursued by the parties. The decline in class voting is found to be partly attributable to long-term structural change. Original secondary analysis of survey data is then presented to show that the socioeconomic composition of individuals' places of residence affects their voting behavior independent of individual-level characteristics. The author then argues that the parties' policies and electoral strategies have reinforced the tendency toward decreasing class voting. Finally, both long-term structural changes and the decline in class voting itself appear to have caused the increase in the volatility of party choice.
Portability: A New Look at an Old Problem
Authors: Carlock Jack , Weasner M. Harold , Strauss Paul S.
Published: January 2017

Increased interest in portability and load-carrying problems among Army human factors specialists is hading to the eventual compilation of a handbook for these areas. Available research material and handbook data are summarized and evaluated. The nature of portability research is examined, and the work required for the preparation of a useful handbook is indicated. Emphasis is placed upon the critical areas of criteria selection, training and motivation.
A Review of Suicide within the State Hospital, Carstairs 1972–1996
Authors: Ramsay Louise , Gray Colin , White Tom
Published: January 2017

This retrospective case note review describes the demographic, forensic and psychiatric backgrounds of 14 in-patient suicides in a maximum secure hospital. The majority were schizophrenic with chronic treatment-resistant illnesses, who had committed proportionally more violent offences, had a history of serious self-injury but no recognized clear depressive episodes. This profile is markedly different from that reported in general psychiatric inpatients, out-patients and suicides in prison, but is similar to that described in a maximum secure hospital in the United States and in long-stay patients in Canada. Many of the patients had continued to experience significantly subjective distress over many years. The clinical relevance of this series is discussed in the context of the assessment of suicidal intent in psychotic patients. We speculate that the decrease in in-patient suicides in the State Hospital may be due to a less restrictive ward milieu, increased staff/patient ratios, or the introduction of Clozapine.
The Jehovah's Witnesses' Refusal for Blood Transfusions: The Jurisprudence and the Medico-Legal Debate in Italy
Authors: Fineschi Vittorio , Albano Maria Grazia , Turillazzi Emanuela
Published: January 2017

The Jehovah's Witnesses (JWs) patient's refusal of a lifesaving transfusion creates a conflict for the physician. In Italy, we are met with a great disparity of behaviour among physicians; the JW's eventual refusal for transfusional therapy often necessitates the physician's recourse to the court. Jurisprudence has thus arrived at an analysis of the juridical value of so-called advance directives. The analysis demonstrates a noteworthy argumentative coherence and reflects a specific doctrinaire development in transfusional therapy. In fact, in Italy most of medicolegal doctrine recognizes, in the JW's blood refusal, the physician's limited position whereby, it seems, he or she must submit legally to an expressed therapeutical dissent even when the patient is in a condition of incompetence and is no longer capable of expressing his or her refusal, or else must risk an indiscriminate violation of the patient's right to religious freedom and choice. According to the Constitutional Chart, the physician's duty to respect the JW's refusal of blood transfusions is absolute in order to avoid any treatment that is in conflict with the religious faith that each patient is free to profess.
The Federal Administrative Maximum Penitentiary, Florence, Colorado
Authors: Coid Jeremy W
Published: January 2017

Policies for the control of dangerous and disruptive prisoners in European penal institutions depend upon social regimes managed by prison staff. These contrast with certain US regimes where there is increasing use of the incapacitation approach. This paper describes an incapacitation regime developed in the US Federal Administrative Maximum Penitentiary (ADX), Florence, Colorado which is complemented by an architectural design minimizing contact between prisoners and staff. This is reported to have been highly effective in controlling violent and predatory behaviour, escapes, drug-taking, and the influence of members of criminal gangs and notorious prisoners transferred to the ADX. Despite a shift of policy from therapeutic intervention towards deterrence of problem behaviour in prisons in some European countries, such as the UK, it is unlikely that such a regime would be acceptable in Europe.
Traumatic Deaths in Jamaica: A Coroner's (Medico-Legal) Autopsy Study from the University Hospital of the West Indies
Authors: Escoffery Carlos T , Shirley Suzanne E
Published: January 2017

This study reviewed the trauma-related deaths in a coroner's (medico-legal) autopsy series at the University Hospital of the West Indies and represents only the second such study reported from Jamaica. The autopsy protocols of all coroner's autopsies performed during the 15-year period January 1, 1983 to December 31, 1997 were reviewed retrospectively, and the clinico-pathological characteristics of trauma-related deaths were analysed.

Trauma accounted for 470 (28.7%) of the 1,640 coroner's autopsies and the causes of death in descending order of frequency were motor vehicle accidents [MVAs] (44.9%), blunt injuries (17.7%), burns (16.8%), firearm injuries (13.6%) and stab injuries (7.0%). The 21–30 age group was the most commonly affected and the overall male: female ratio was 4:1. The distribution of injuries (excluding burns) by anatomical region was head and neck (43.8%), chest (8.9%), abdomen and pelvis (4.3%), extremities (0.9%) and multiple sites (25.3%). Forty-nine (23.2%) of the victims of MVAs were documented to have been pedestrians. Blunt trauma was most commonly due to accidental falls followed by assaults. Flame burns accounted for 90% of burn cases. There were seven (1.5%) cases of suicide overall.

In this series the majority of trauma-related deaths occurred in young males and were due to MVAs. Strategies aimed at reducing trauma-related mortality should therefore emphasize road traffic safety programmes, particularly targeting the young.
Study on the Specificity of Fibronectin for Post-Mortem Diagnosis of Early Myocardial Infarction
Authors: Hu Bing-Jie , Chen Yu-Chuan , Zhu Jia-Zhen
Published: January 2017

In order to investigate the specificity of fibronectin (Fn) in the post-mortem diagnosis of myocardial infarction, the changes of Fn staining in normal, infarcted and other non-infarcted myocardial injuries resulting from myocarditis, mechanical asphyxia, electrocution, hemorrhagic shock, cardiac contusion and organophosphate poisoning were studied with an immunohistochemistry and image analysis system. The results showed that positive Fn staining could only be observed in groups of myocardial infarction and myocarditis, but could not be found in groups of mechanical asphyxia, electrocution, hemorrhagic shock, cardiac contusion, and organophosphate poisoning. Our findings indicate that positive staining of Fn in cardiomyocytes could be affected only by myocarditis, so it is quite specific for the diagnosis of myocardial infarction.
Evaluating Alleged Drinking after Driving — The Hip-Flask Defence
Authors: Iffland R , Jones A W
Published: January 2017

This two-part article examines the strengths and weaknesses of various ways of investigating claims of drinking alcohol after driving, commonly known as the hip-flask or glove-compartment defence. In many countries the onus of proof in hip-flask cases rests on the prosecution. With good co-operation from the police and timely sampling of body fluids, such as blood and urine for forensic analysis of ethanol, useful evidence can be mustered to support or challenge the truthfulness of alleged drinking after driving. The person's blood-alcohol concentration (BAC) can be compared with values expected on the basis of the amount of alcohol consumed after driving, according to theoretical Widmark calculations. The actual BAC measured is then adjusted for the additional amount of alcohol consumed in the after-drink. Double blood samples, that is, taking two specimens of venous blood about 30–60 minutes apart and looking at the magnitude and direction of change in BAC provides little or no more information than a single blood specimen. However, the relationship between alcohol in blood and urine is very useful in hip-flask cases whereby the concentration expected in the primary urine is compared with the concentration in the bladder urine voided. The concentration of alcohol determined in a second urine sample collected 30–60 min later gives supporting evidence in hip-flask cases. A graphical method, which entails plotting ethanol concentrations in blood and urine as a function of time provides a robust and practical way to investigate hip-flask defences. In the second part of the review, congener analysis is presented, which entails comparing the concentrations of n-propanol, isobutanol and occasionally other congeners in the alcoholic beverage allegedly consumed after driving with the volatiles present in the suspect's blood and urine determined by headspace gas chromatography.
Sudden Adult Death: A Medico-Legal Series of 77 Cases between 1995 and 2000
Authors: De La Grandmaison G Lorin , Durigon M
Published: January 2017

Among all the autopsies performed between 1995 and 2000 in our Department, 77 adult cases of sudden death were selected. Sex, age, place of death, circumstances of death, causes of death and heart weight were reported from these 77 post-mortem records. A complete forensic autopsy was performed in every case.

Sudden death occurred more frequently in males at rest. Strenuous activity was rarely involved in sudden death and 72.7% of the cases died from cardiovascular disease, mainly coronary atherosclerosis. Non-cardiac causes were dominated by pulmonary and neurological diseases. Cardiomegaly was a frequent finding in cases who died from cardiac pathology.

This study underlines the importance of complete medico-legal investigations in case of sudden death. Multiple heart samples are required in order to detect focal microscopic lesions, such as myocarditis and some forms of cardiomyopathy with minimal gross abnormalities. The post-mortem diagnosis of such cardiomyopathies is very important because the family of the deceased may undergo a possible screening. Toxicology is useful in the diagnosis of epileptic seizure and in identifying drugs like metamphetamine as a risk factor for some lethal cardiovascular pathologies such as aortic dissection. Molecular biology can also be helpful when limits of morphological diagnosis have been reached.
1. A Curious Autopsy Case of a Car Crash in Which Self-Strangulation and Lung Collapse Were Found: A Case Report
Authors: Watanabe-Suzuki K , Suzuki O , Kosugi I , Seno H , Ishii A
Published: January 2017

A curious autopsy case following the car crash of a 20-year-old male, in which self-strangulation and lung collapse were observed, is presented. His motor vehicle had crashed into a restaurant as a result of self-strangulation using an electrical cord wound four times around his neck. At autopsy, we found small rupture holes of spontaneous bullae in both lung apices, which had probably taken place upon collision during driving, petechial hemorrhages in the face skin and the absence of severe injuries. Since it seemed unlikely that the small holes in both lung apices caused fatal pneumothorax instantly, the cause of his death was judged to be asphyxia due to self-strangulation. It is not clear whether the self-strangulation was suicidal or autoerotic, because neither traces of suicidal intent nor circumstances suggesting either of them were disclosed.
A Report of a Fatal Case of Accidental Methanol Self Poisoning
Authors: Bohn G. , Nicolson I. C. , Owens J. M.
Published: January 2017

A 45-year-old housewife was admitted to hospital as a result of methanol poisoning from which she died. This is an account of the case to show co-operation between medicine, science, and the law.
Post-Mortem Examination and the Cervical Spine Injury
Authors: Williams David J. , Cassidy Marie T.
Published: January 2017

Post-mortem artefacts simulating bruises are well known, especially in the tissues of the neck. Experimental work is presented which demonstrates that removal of the spinal cord by the anterior approach is not associated with spurious post-mortem ‘bruising’ in the neck. A case report is described which initiated this study.
Cervical Osteophytosis and Laryngeal Trauma
Authors: Vanezis Peter , Tate Graham P.
Published: January 2017

Anterior cervical osteophytes by virtue of their location may give rise to or compound laryngeal trauma, particularly in the elderly. In two of our three cases the injuries followed relatively minor falls.
Male Victims of Sexual Assault
Authors: Mezey Gillian , King Michael
Published: January 2017

Adult male victims of sexual assault appear to have similar reactions to female victims, but are more stigmatized, may experience greater subsequent anger and guilt, and are even less likely to report the offence than females.

Increased recognition of these assaults is called for, both in law and by victim support agencies, in order to reduce the stigma, encourage reporting and facilitate the enforcement of criminal justice.
Fitness to Plead and Psychiatric Reports
Authors: Larkin E P , Collins P J
Published: January 2017

The role of the psychiatrist in the determination of fitness to plead is reviewed by reference to 77 pre-trial psychiatric reports prepared on 31 Special Hospital patients detained under the provision of Section 5(1)(c) (Unfit to Plead) of the Criminal Procedure (Insanity) Act 1964. Each psychiatric report was analysed using a standardized checklist which addressed the legal criteria used to determine fitness to plead, the nature of the alleged offence and the clinical diagnosis. The results showed that almost 40% of the reports made no mention of fitness to plead at all and that only one-third of the reports made a statement about fitness to plead which was supported by reference to standard legal criteria.

The results of this study support earlier work which has suggested that psychiatrists have a poor understanding of the issues surrounding fitness to plead and criminal responsibility. These findings are discussed in relation to recommendations made by the Report of the Committee on Mentally Abnormal Offenders, 1975 (Butler Report) and legislative changes introduced by the Mental Health Act 1983.
Medico-Legal Issues in Detecting and Proving the Sexual Abuse of Children
Authors: Indest George F.
Published: January 2017

In this article the author reviews the scope and magnitude of the problem currently faced by medical and investigative personnel in detecting and proving the sexual molestation of children. The legal effects of poor medical records are discussed in detail. Various medical and legal issues that may present pitfalls for the unwary examining physician are identified and discussed. The admissibility of various portions of the medical examination and medical report as evidence in courts of law is reviewed as well as newly emerging forensic tests and techniques for collecting medical evidence. The author provides a comprehensive and detailed summary of steps to be followed in the physical examination of a child sex abuse victim, emphasizing the importance of a strict, thorough procedure for protecting the interests of the patient, the physician and society.
Suicide among AIDS Patients
Authors: Copeland A R
Published: January 2017

I studied 25 cases of suicide in people diagnosed as having the acquired immunodeficiency syndrome (AIDS) or who thought that they had that disorder, during 1985–1989. Case reports are presented. A discussion ensues concerning the occurrence of this phenomenon and the medical examiner's role in AIDS' public health situation in general.
1. An Autopsy Case of Suicide by Hanging with Multiple Stab Wounds of the Neck and Chest
Authors: Maeda H , Imura M , Higuchi T , Noguchi K
Published: January 2017

We report, from the aspect of “acting” capability, an autopsy case of suicide by hanging in which multiple deep stab wounds were observed in the neck and chest.

A 49-year-old man was found dead in a state typical of hanging. His car was found about 100m away with a blood-stained climber's knife on the seat. Multiple incised and stab wounds were in the neck, with a lesion of the right inner jugular vein. Three penetrating stab wounds of the chest punctured the lungs, with pooling of about 500ml of blood in the left thorax and about 100ml in the right. Two other shallow stab wounds were in the chest. All the above wounds were explainable as self-inflicted. From the autopsy findings and the circumstantial evidence, it was concluded that he walked approximately 100m after stabbing his neck and chest and finally committed suicide by hanging
5. Condylomata Acuminata in Pre-Pubertal Children
Authors: Ross J D C , Scott G R , Busuttil A
Published: January 2017

The medico-legal significance of anogenital warts as a marker of sexual abuse in children is unclear. This review article presents three case reports and discusses the possible modes of transmission of papilloma virus in children. Although genital warts can indicate sexual abuse, non-sexual transmission may also occur.
Munchausen's Syndrome: A Medico-Legal Dilemma
Authors: Mydlo Jack H , MacChia Richard J , Kanter Jolie L
Published: January 2017

In his or her life-long career, the physician will eventually encounter a patient with factitious disorder, or Munchausen's syndrome. We discuss two patients complaining of renal colic that were identified as having Munchausen's syndrome. We review the literature to identify certain aspects of the disease and to discuss the medical and legal implications for the treating physician and hospital.
Psychiatrie In-Patient Suicide Rates: A 21-Year Study
Authors: Ganesvaran T , Shah A K
Published: January 2017

Psychiatric in-patient suicides were traced from the hospital death register for the 21-year period 1973 to 1993. Suicide rates for each of the 21 years were calculated and an overall rate of 3.68 per 1,000 admissions was found. Suicide rates for the period after 1987 were significantly lower than for the period before 1987. However, there was a significant upward trend during the last three years of the study period.

The role of the new Mental Health Act (introduced in 1987) on reducing the suicide rate and the effects of the amalgamation of three hospitals on increasing the rate are discussed.
‘Fitness to Be Interviewed’ — A Proposed Definition and Scheme of Examination
Authors: Norfolk Guy A
Published: January 2017

Police surgeons are frequently asked by the police to assess whether suspects held in police custody are fit to be interviewed. The lack of any clear medical and legal criteria by which fitness for interview can be assessed has left many doctors confused about what exactly the term means. This paper draws attention to the importance of the topic and suggests a working definition of‘fitness to be interviewed’. A scheme of examination is proposed which should enable the police surgeon to make a meaningful assessment of a suspect's fitness for interview.
Religious Fundamentalism, Humor, and Treatment Outcomes in Individuals in Court-Mandated Substance Abuse Outpatient Treatment
Authors: Holcomb William R. , Ivey William S.
Published: January 2017

The relationship between religious fundamentalism, humor, and psychological well-being was examined with a sample of individuals ( n = 109) being treated for drug abuse in a court-mandated AA outpatient program. Three separate factors of religious fundamentalism were found through exploratory factor analysis of the Revised Religious Fundamentalism Scale, and these were named Righteous-Evil Worldview, True Religion, and Scriptural Literalism. Psychological well-being of individuals in court-mandated outpatient substance abuse treatment was found to be correlated with high levels of humor but not religious fundamentalism. Psychological well-being and humor were found to be related to satisfaction with services; no relationship was found between religious fundamentalism and satisfaction with services. One factor of religious fundamentalism, Scriptural Literalism, was found to be associated with high levels of depression and paranoia/hostility. Implications of these relationships for treatment and understanding of religious fundamentalism and psychological well-being are discussed.
An Update on Using the Range to Estimate σ When Determining Sample Sizes
Authors: Rhiel George Steven , Markowski Edward
Published: January 2017

In this research, we develop a strategy for using a range estimator of σ when determining a sample size for estimating a mean. Previous research by Rhiel is extended to provide dn values for use in calculating a range estimate of σ when working with sampling frames up to size 1,000,000. This allows the use of the range estimator of σ with “big data.” A strategy is presented for using the range estimator of σ for determining sample sizes based on the dn values developed in this study.
Children With Developmental Coordination Disorder
Authors: Loftesnes J. M. , Ingvaldsen R. P. , Sigmundsson Hermundur
Published: January 2017

This study tested the effect of task-specific training of a perceptual ability for children with Developmental Coordination Disorder (DCD) compared to control children. A manual matching task (target location and pointing task) was used, which required the children to locate target pins either visually (seen target) or proprioceptively (felt target), while matching to the located target was always carried out without vision. Thirty-one children (11–12 years) were selected based on teacher statements regarding everyday motor skill performance, the DSM-IV criteria, and the Movement ABC test. Based on this, 10 children with obvious motor problems were placed in the DCD group (Trg-DCD), 9 children with no identified motor problems were placed in a training group (Trg-N), and 12 children also with no identified motor problems were placed in a control group. All the children were tested pre and post to training on a manual matching task. In the pretest, the children in the DCD group were significantly inferior to the control groups in the proprioceptive condition with both the preferred and nonpreferred hands. In the posttest, after the training periode was completed, the DCD subjects showed significant improvement in the proprioceptive condition for both preferred and nonpreferred hands. For the other groups, no significant training effects were observed across the training period. It is concluded that children in the DCD group may benefit from specific training of perceptual abilities, because they have motor control resources not exploited due to a lack of relevant experience.
Rollerblading Injuries in Children Attending an Accident & Emergency Department: Should the Use of Wrist Splints be Compulsory?
Authors: Boyce S. H. , Quigley M. A.
Published: January 2017

Our aim was to determine the incidence and nature of injuries in children from rollerblading attending a district general hospital Accident & Emergency (A&E) department in Scotland. Children, aged between 5–16 years, presenting with an injury from rollerblading, were studied prospectively over a three month period. A total of 34 children attended the department with a rollerblading injury. Boys (53%) and girls (47%) were injured almost equally. The wrist was the most frequently injured area of the body (62%) with 12 fractures and 9 soft tissue injuries. No children were wearing any form of protective equipment. Rollerblading is an increasingly popular, but expensive, activity amongst children in Scotland. Wrist injuries from falling were the most common presentation which may result in prolonged school absenteeism. Emphasis is normally placed on protective headgear, however, with wrist injuries more common, consideration must be given to the active promotion of injury prevention and the wearing of wrist splints.
Progressive Pneumonia Complicating Steroid-Dependent Asthma
Authors: Hart S.P. , Brown M.I. , Gaddie J.
Published: January 2017

We describe a patient who developed pulmonary nocardiosis whilst taking long term oral steroids for asthma. Nocardiosis is more common than is generally appreciated by clinicians, is notoriously difficult to diagnose, and is associated with significant mortality. This patient developed progressive pneumonia despite antibiotic therapy, which is typical of pulmonary nocardiosis. It is important to consider this treatable condition in the differential diagnosis of pneumonia.
The Role of Joseph Lister in Developing the Absorbable Ligature
Authors: Hall M.J.
Published: January 2017

Joseph Lister is associated with pioneering work on antisepsis. However an important but less well-known contribution to surgical progress was his work on the absorbable suture. This article details the problems Lister faced in operative surgery, his observations and experiments that lead to his development of an absorbable suture.
Helicobacter Pylori Eradication for Peptic Ulceration: An Observational Study in a Scottish Primary Care Setting
Authors: Forrest E. H. , MacKenzie J. F. , Stuart R. C. , Morris A. J.
Published: January 2017

Despite being established for the treatment of peptic ulcer (PU) disease, few studies have assessed the long-term effectiveness and economic benefits of Helicobacter pylori (Hp) eradication in primary care. Our aim was to investigate the effect of community based Hp eradication for patients with chronic peptic ulcer disease requiring maintenance acid suppression.

The endpoints used were the patient s dyspeptic symptoms and the requirement for the prescription of maintenance acid suppression therapy. The study area covered seven general practices in the Glasgow area. Patients with previously diagnosed peptic ulcer disease receiving prescribed acid suppression therapy were invited to a dyspepsia clinic. Hp status was assessed by Helisal rapid blood test (HRBT). Positive patients received Hp eradication therapy and were reviewed six weeks later. At six months a review of practice records was carried out, and two years after eradication a postal questionnaire was sent to participating patients. A total of 243 patients attended the initial clinic of which 81.9% were HRBT positive. 156 of 196 patients offered Hp eradication re-attended at six weeks. The per protocol eradication rate was 91.7%. After six months patients who had received eradication therapy were less likely to require maintenance acid suppression therapy compared with those to whom eradication was not given. Two years after treatment 76.5% of patients felt their symptoms were improved, but 42.2% were still receiving maintenance therapy. The estimated cost of treatment per month per patient had fallen from £20.23 to £9.39 after eradication. In conclusion we felt that community based Hp eradication for patients with chronic PU disease is effective, however it does not completely alleviate dyspepsia. Predictors of symptomatic response or of no longer requiring acid suppression therapy after two years were younger age of onset of PU disease and absence of pre-documented gastro-oesophageal reflux disease or hiatus hernia. Hp eradication improves patient s symptoms, reduces the requirement for maintenance acid suppression and is cost-effective after two years follow-up in this targeted group.
Cadasil: Presenting as a Mood Disorder
Authors: Thomas N. , Mathews T. , Loganathan A.
Published: January 2017

CADASIL is an autosomal dominant non-atherosclerotic vasculopathy that frequently presents as recurrent subcortical strokes, or vascular dementia in middle age. Some patients may have prominent mental symptoms or migraine. Widespread white matter demyelination and subcortical lacunar infarcts are demonstrated by magnetic resonance imaging. Demonstration of granular osmophilic material in arteries in skin biopsies is a useful diagnostic tool. CADASIL has been linked to mutation in the Notch 3 gene locus on chromosome 19. Genetic testing is available for clinical diagnosis.
Thrombolysis and its Implications in the Management of Stroke in the Accident and Emergency Department
Authors: Quaba O. , Robertson C. E.
Published: January 2017

Objectives: Examination of initial management of stroke patients in the emergency setting to assess feasibility of thrombolysis for acute ischaemic stroke.

Methods: Retrospective analysis of all patients presenting with a clinical diagnosis of stroke over a two month period. Exclusion criteria for thrombolysis were applied to assess the number of patients that would potentially have been eligible for thrombolysis.

Results: Of 94 patients identified with clinical stroke, only 57 (60.6%) had a CT scan; 23 (24.4%) were confirmed as having had an acute ischaemic stroke. Mean delay in scanning was 2.2 days (range 0–15 days). Even if all patients had presented and been scanned within three hours (as required for thrombolysis), only six (6.4%) patients would have been eligible for thrombolysis.

Conclusions: The great majority of patients presenting with clinical stroke do not fulfil the criteria for thrombolysis. Current practice involves significant delays in CT scanning, which has implications for resource structuring should thrombolysis become widely available.
Prospective Observational Survey of the Utilisation of Anaesthetists and the Outcome following Cardiac Arrest Calls
Authors: Price R J , Garrioch M A
Published: January 2017

Background and Aims: We wanted to determine whether the practice of routinely sending an anaesthetist to cardiac arrests is common within Scotland. We also wished to evaluate the interventions performed by our intensive care anaesthetist when responding to cardiac arrest calls. Methods: We performed a telephone survey of the 26 Scottish hospitals with an intensive care unit. We conducted a prospective observational survey over a period of six months in one Scottish teaching hospital. Structured interviews with the anaesthetist who responded to the cardiac arrest call were undertaken. Results: Routine attendance of an anaesthetist at cardiac arrests occurs in 25 of the 26 hospitals surveyed. We analysed 68 of 73 arrest calls. In 28 calls (41%) there was no requirement for anaesthetic intervention. In 40 (59%) the anaesthetist intervened. The interventions were for cardiac arrest procedures in 33 cases and ventilatory failure in the remaining 7 cases. One patient survived to hospital discharge: a mortality of 98%.

Conclusions: Patients who remain in cardiac arrest upon the arrival of the anaesthetist have a very high mortality. The practice of routinely sending an anaesthetist to cardiac arrest calls is not justified.
Review of Patients in General Practice with a Diagnosis of Epilepsy: Development of a Practice Nurse Checklist and an Assessment of Resource Implications
Authors: Duncan R , Barlow G , Smith A C
Published: January 2017

Background: SIGN has recommended annual review of all patients with epilepsy. Annual review is rewarded in the new GMS contract. There is no information on how or by whom reviews should be carried out, nor on resource implications for secondary care. Aims: To determine whether a practice nurse can deliver annual review of patients with epilepsy, and to estimate the resource implications of such review. Methods: Evaluation of a practice nurse checklist against review by neurologist in 62 patients with epilepsy identified from a practice list of 6240 from Southwest Glasgow LHCC, and audit of case records in 1259 patients with epilepsy identified from the whole LHCC population of 96,565. Results: There were 8 discrepancies between nurse and doctor reviews in a first iteration, but none in the second. Changes suggested a training effect. The review process generated 19 epilepsy nurse appointments, 7 requests for cerebral imaging and 3 requests for video EEG. Twelve patients required continuing follow up. The LHCC audit identified a large number of patients who had inadequate documentation of information and advice (over 90% in some domains). 28.6% had not been seen by a specialist, 40.7% had not had cerebral imaging, and only 37.4% were seizure free. Conclusion: Annual reviews of patients with epilepsy can be carried out by practice nurses, but some training is required. The review process is likely to increase the burden on secondary care and have a significant adverse effect on neurology waiting times.
The Effect of Steroid Therapy on Riedel's Thyroiditis
Authors: Thomson J. A. , Jackson I. M. D. , Duguid W. P.
Published: January 2017

A patient is described who passed from a clinical state consistent with Hashimoto's thyroiditis to Riedel's thyroiditis over a period of 6 months. Serum levels of thyroid antibodies were high and there was a family history of Hashimoto's thyroiditis. A good therapeutic response to steroids was observed but these were without effect in a further patient with Riedel's thyroiditis of 10 years' duration. It is suggested that Riedel's thyroiditis is an uncommon variant of Hashimoto's thyroiditis.
The Accuracy of Barium Enema Examination: An Appraisal of Two Techniques
Authors: Pacsoo C. , James W. B.
Published: January 2017

The radiological and clinical diagnoses in 622 patients submitted to barium enema examination have been compared. A conventional technique was used in 315 cases and double contrast in the remaining 307. Though the two groups are not strictly comparable, it is probable that the double contrast method is more accurate in diagnosing both pathology and normality. It is suggested that double contrast barium enema should be the method of choice in radiological examination of the colon.
Nephroblastoma in Childhood
Authors: Milligan G. F. , Young D. G.
Published: January 2017

The results of treatment of 45 patients with nephroblastoma in the period 1953–1968 are presented. The overall three year survival rate is 27% while for those given radiotherapy and repeated courses of Actinomycin D following operation the three year survival rate is 40%. The results reported from other centres are discussed.
Effect of Iron and Calcium on Salicylazosulphapyridine Metabolism
Authors: Das K. M. , Eastwood M. A.
Published: January 2017

Acute experiments involving a single dose of salicylazosulphapyridine (SASP) were performed in 5 volunteers. The peak serum concentration of SASP was found within 3 to 5 hours whereas for sulphapyridine derived from SASP it occurred at 12 to 24 hours. The addition of ferrous sulphate caused a significant decrease in the serum SASP concentration whereas the addition of calcium gluconate delayed the absorption of SASP without disturbing the degree of absorption. Total sulphapyridine concentration did not show any variation.
High Incidence of ‘Asymptomatic’ Urinary Tract Infection in Infant Schoolgirls
Authors: Mair Marie I.
Published: January 2017

Two thousand one hundred and sixty five Renfrewshire entrant schoolchildren were screened for bacteriuria and pyuria. The correlation between these two criteria of urinary tract infection was found to be very high.

Two of 960 boys and 31 of 1205 girls were found to have persistent significant bacteriuria and pyuria.

The method used is described and compared with other methods. Investigation, treatment and follow-up of the affected children is described.
Laparoscopy in the Investigation of Infertility
Authors: McDougall A. Neil
Published: January 2017

Gynaecological units in Great Britain are using the laparoscope increasingly frequently to investigate the infertile woman; in this paper the need for this form of investigation is emphasised. In the Professorial Unit at Glasgow Royal Infirmary, the findings (over a three years period), obtained by the laparoscopic investigation of the infertile woman, are given. It is found that laparoscopy frequently identifies a possible cause of infertility in women whose failure to conceive has remained unexplained by other methods of investigation.
The Prevalence of Ampicillin, Cephalosporin and Sulphonamide Resistance Amongst Urinary Tract Pathogens
Authors: Andrews J. , Bywater M. J. , Emmerson A. M. , Keane C. , Reeves D. S. , Wise R.
Published: January 2017

A total of 2,031 clinical isolates of Gram negative bacilli was obtained from hospitals in 4 centres and these cultures were tested for resistance to ampicillin, cephazolin and sulphonamide.

Ampicillin and sulphonamide resistance in outpatients ranged from 15 to 28 per cent of E. coli strains and 4 to 11 per cent of Proteus mirabilis strains. Resistance to cephazolin in outpatients ranged from 0 to 3 per cent of E. coli and 0 to 6 per cent of Proteus mirabilis. Resistance patterns for E. coli, Proteus mirabilis and Klebsiella strains isolated from inpatients were much higher and varied widely. These patterns are presented and the reasons for these variations discussed.
Reconstructive Surgery in Gangrene
Authors: O'Connor J. , Reid W. , Watt J. K. , Pollock J. G.
Published: January 2017

The results of reconstructive arterial surgery in 113 critically ischaemic limbs during 1958 to 1972 are presented. There were 61 aorto-iliac reconstructions with 4 operative deaths (6.5%), resulting in a limb salvage rate of 75.4 per cent and 49 femoro-popliteal operations with 3 deaths (6.1%) and a limb salvage rate of 73.5 per cent.
Endometrioma of the Perineum Associated with Episiotomy Scars
Authors: Sully L.
Published: January 2017

Two cases of endometrioma occurring in the perineum, associated with episiotomy scars and involving the external anal sphincter are described. Previous similar cases in the literature are reviewed and discussed. Misdiagnosis of this uncommon lesion is the rule when it is seen outside gynaecological practice. If, however, its existence is appreciated then correct diagnosis is simple and treatment is straight forward.
Penicillins in Perspective
Authors: McAllister T.A.
Published: January 2017

Fifty-three years after their discovery the penicillins still present a challenge to laboratory workers and clinicians. They are members of the broader beta-lactam group and are susceptible to inactivation by beta-lactamases from Gram-positive and Gram-negative bacteria. Countering these enzymes is achieved by producing more stable penicillin molecules or by using enzyme-blocking agents like clavulanic acid to protect the antibiotics.

The field is confusing and to assist in defining the present-day role of the group, the concept of a microbiological profile is considered. The modes and sites of action of the penicillins and the beta-lactamases are presented and both are classified. The place of penicillins in the treatment of life-threatening and lesser infections, and in prophylaxis, is discussed.
The Prevention of Recurrent Variceal Haemorrhage by Chronic Injection Sclerotherapy
Authors: Garden O. J. , Utley R. J. , Carter D. C.
Published: January 2017

Forty eight patients who have survived admission with acute variceal haemorrhage have been readmitted and entered into a programme of chronic injection sclerotherapy to prevent recurrent variceal haemorrhage. Two hundred and nineteen elective courses of injections were performed at fibreoptic endoscopy with minor complications occurring in six patients. Twenty three patients rebled on 33 occasions but in only five instances did haemorrhage occur following variceal obliteration. With 67 per cent of patients surviving one year, this treatment option offers a satisfactory means of preventing recurrent haemorrhage when variceal obliteration is achieved.
Erythema Nodosum following Typhoid Vaccination
Authors: Thomson B. J. , Nuki G.
Published: January 2017

Erythema nodosum has recently been recognised in association with salmonella infection (1). We report a case of classical erythema nodosum which developed following a typhoid vaccination.