bluuebunny/crossref_metadata_2025 huggingface dataset:
Rorschach Tests as a Diagnostic Tool in Adoption Studies
Authors: Kuhlmann Frieda M. , Robinson Helen P.
Published: May 2018

The Rorschach test appears to be decidedly useful as a diagnostic tool. The test interpretations supply a concise picture of the individuals’ outstanding personality characteristics and the underlying dynamics of behavior. Adoption studies are completed with far greater understanding and certainty on the part of the caseworker than when subjective evaluation alone is relied upon.

The most important factor to be looked for in adoption applicants is the ability to relate to other people. Not only does the inability to relate to others indicate a poor adoption risk, but it would also raise serious question as to the accessibility of the person to treatment or modification of personality trends during a period of supervision.

Another area in which the Rorschach gives specific evidence difficult to obtain in the interview is that related to the individuals’ feelings of security and adequacy. In studying interview and test material there appears to be a dearth of evidence in the former and a wealth of findings in the latter as to the way in which individuals use their inner resources to maintain themselves.

The Rorschach test is a valuable tool in pointing up defenses and in revealing the ego strengths of the individual who must deal with these problems. The projective test is also of great value in indicating marked deviations and emotional disturbances, particularly in the psychosexual sphere, which might have a destructive influence on the child. The test findings can help define the extent to which the individual accepts his own femininity or masculinity.

The use of Rorschach tests is not a substitute for skilled casework, and, in fact, should only be used where such workers are available. The test itself is of value only when it is conducted by a highly trained and experienced Rorschach expert and when a psychiatrist is available for consultation.

The trend in adoption practice is toward placement of babies soon after birth when this plan appears sound so far as the natural mother is concerned. This implies additional risk as well as additional satisfaction for adoptive parents. It insures more security for a child. In view of this trend agencies are faced with the need to select couples with maximum surety as to their potentialities as parents. This use of Rorschach tests as a diagnostic tool is a step in that direction. Its results so far point to many other areas for research. Perhaps the findings of such additional research projects are the only means of proving the soundness of the study process used in this experiment.
Observation Programs in the United States: A Meeting of Social Work Colleagues
Authors: Minton Eunice
Published: May 2018

In a challenging and refreshing way these colleagues have been able to strip away the chaff and quickly isolate many of the basic fundamentals in our social work practice. Perhaps their limitations in the use of the English language proved to be an asset by preventing their becoming lost in our extensive professional vocabulary. They found that this is a land of wide contradiction—of great wealth, yet much need. They also found this contradiction in our social work—great resources and a high degree of specialization, yet many gaps in basic services to people.

Perhaps this presentation of a few of the comments and reactions of these fellow social workers indicates the range of their social work interests, the keenness of their perception, and the depth of their professional consciousness. These comments may also indicate some of the possible values that accrued to them through the observation and study of social work in the United States. The reactions of agencies and social workers who have participated in their study programs indicate that American social workers have been enriched through their association with these social workers of other lands; perhaps their earnest and intense seeking of knowledge about the best ways to serve people has stirred American social workers in their particular specialization grooves to think of their international responsibilities and of the fundamental objectives in our total social work practice, and to examine American social work, not only in relation to its effectiveness in achieving adequate social services, but also, of perhaps greater importance, in achieving basic social justice.
The Caseworker's Use of Collateral Information
Authors: Perlman Helen Harris
Published: May 2018

It has seemed to me that in order to clarify our theories and practices in the use of collaterals these considerations are important: Our emotions about the instrument of the social service exchange and of protectiveness of the client against that instrument need to be faced and examined for their validity. In our thinking, which will affect those feelings, we need to pierce the shell of certain concepts that have become shibboleths among us, to seek for the core of their actual meaning, and to try to establish their particular relationship to social casework practice. I refer especially to the concepts of confidentiality and self-determination, and to the concept of professional authority as a counterpart of professional responsibility. It is only as our feeling is accounted for and our operational philosophy is clarified that we are prepared to identify the useful purposes which information from collateral sources may serve for the client himself. These purposes, in the large, are the facilitation and the integration of the help that is given him. Cognizance must be taken, too, of the limitations in the use of secondary sources. Finally, since the end must preexist in the means, the ways in which collateral information is used will largely determine whether in general and in the individual case it will be of small or great value in promoting the joint purposes of agency and client.
Stages in the Progress of First-Year Students in the Veterans Administration
Authors: Dowling Jessie P.
Published: May 2018

There are probably two general stages in the field experience in this setting in which the student shows the most genuine desire to learn. The first period is at the beginning of the placement when he is receptive and eager, even though suffering anxiety about beginning. The second period comes when he recognizes his own developing skill and begins to use it. In between there is a long period when the supervisor needs to sustain the student through disappointment, error, and regression. In some situations, the student's desire to retreat may be so strong as to cause the supervisor much concern about whether he will be able to progress further. At these points the supervisor should be especially careful about evaluating the student's ultimate capacity to move ahead.

In the field work training of students in this setting, these stages of development are discernible. This does not mean that the development of all the students is uniform, or that they all arrive at the same stage at the same time. One student may spend half of his placement period in the first two stages; another may progress with seemingly little difficulty to the last stage but show little change within it. Nor has it been found that one stage of development is mastered before the student moves into the next; the development of two stages in a student can occur almost simultaneously. Individual differences inevitably come into play, and the stages of learning, as described in this paper, have meaning only when applied to the individual student and his particular learning experience.
Group Process in Social Habilitation of the Retarded
Authors: Richards Larry D. , Lee Kenneth A.
Published: May 2018

Techniques are used to emphasize the importance of each member's improving his self-esteem and achieving a self-sustaining status in his community
Conferences with Parents of Children with Cystic Fibrosis
Authors: Driscoll Chancellor B. , Lubin A. Harold
Published: May 2018

Unstructured and open-ended group sessions prove to be an effective tool for service to families and also valuable for education of medical staff
Children's use of Humor in Psychotherapy
Authors: Orfanidis Monica McGoldrick
Published: May 2018

Instances of humor are analyzed in regard to theme, target, form, function, and relationship to the child's personality and development
Traditional Knowledge Reaffirmed
Authors: Mishne Judith
Published: May 2018

In the interest of responsible agency service, the skilled caseworker interested in sustained therapy must be given sanction to offer such services
Bicultural Social Work and Anthropology
Authors: Keller Gordon N.
Published: May 2018

A field study of Navajos in Utah reveals many changes in their culture, some direct and some indirect results of Anglo-American social welfare programs
Social Work Service to Abortion Patients
Authors: Ullmann Alice
Published: May 2018

Group sessions give patients useful information, enable them to express their ambivalent feelings, and result in mutual support and relief of tension
Values and Planned Change
Authors: Levy Charles S.
Published: May 2018

Clients’ values in relation to personal and social change—toward which a social worker has a positive affective regard—discipline his choices of action
Easing the Pain of Termination for Adolescents
Authors: Bolen Jane K.
Published: May 2018

What happens when a child ends residential treatment may make the critical difference between whether he maintains his gains or casts them off in angry defiance
From ‘Separation’ to a ‘Turned on’ Model of Services
Authors: Weber Shirley
Published: May 2018

During a two-year evolutionary process, administration and staff moved into the mainstream of controversies current in public welfare and social work practice
Reciprocal Aspects of Mental Health and Family Service
Authors: Hill William G. , Silber Stanley C.
Published: May 2018

A study of the relationships between two types of agencies in several communities indicates that benefits accrue when there are formal affiliations
Family Therapy for Divorced Fathers and Others out of Home
Authors: Leader Arthur L.
Published: May 2018

It is essential to include the separated member and thereby move beyond the symbol of finality, trauma, and old wounds to an examination of present ties
Usefulness of the Home Visit for Diagnosis and Treatment
Authors: Bloom Mary Larkin
Published: May 2018

Staff of a children's psychiatric hospital reach out to families as a first step in the admissions process and for on-the-spot child management coaching
The Legacy of Mary Richmond in Education and Practice
Authors: Goldmeier John
Published: May 2018

There is ample testimony that the vision and insights of a pioneer theoretician continue to be a rich source of stimulation as others build on her ideas
An Ecological Perspective in Casework Practice
Authors: Germain Carel B.
Published: May 2018

Services that make help available when and where it is needed in the life-space of people represent a beginning commitment to a new point of view
Issues in Corrections from Both Sides of the Bars
Authors: Sternbach Jack C.
Published: May 2018

Including prisoners in class with social work students and using the prison as the campus introduced powerful dynamics to a social policy course
Readoption with a Minimum of Pain
Authors: McEwan Margaret T.
Published: May 2018

The need to re-place an adoptive child provides an opportunity to try innovative ways to make the experience a growth-producing one for everyone concerned
The Generic Stance and the Family Agency
Authors: Hartman Ann
Published: May 2018

Reconceptualizing practice in an ecological framework and bridging the dichotomies existent in the profession can stimulate the development of new models of practice
Paraprofessional Parent-aides and Disadvantaged Families
Authors: Epstein Norman , Shainline Anne
Published: May 2018

Former recipients of social services are trained to provide rehabilitation and guidance to families experiencing severe problems in child-rearing
Counseling Middle-class University Students
Authors: Kaplan Mildred Fine
Published: May 2018

Casework help for emotional obstacles to intellectual and social functioning enables students to make maximum use of their educational opportunities
Limitations and Prospects of Internal Advocacy
Authors: Patti Rino J.
Published: May 2018

Impediments are examined and suggestions are made regarding conditions necessary to initiate and sustain organizational intervention by practitioners
Home Visits for Family Treatment
Authors: Moynihan Sharon K.
Published: May 2018

A simple technique which expands the worker's professional knowledge of a family has intrinsic value in current efforts to strengthen family life
Advice-Giving in Parent Counseling
Authors: Davis Inger P.
Published: May 2018

The giving of advice by caseworkers and the reactions of parents to advice are explored by analysis of tape-recorded caseworker-parent interviews
Group Work with Hospitalized Stroke Patients
Authors: Singler Judith R.
Published: May 2018

An open-ended group proves beneficial, especially in a setting where individuals remain for an extensive and indeterminate period of time
Factors in Mergers of Voluntary Agencies
Authors: Cole James P.
Published: May 2018

Voluntarism must grow in organizational and structural capacity if it is to remain a strong and collaborative partner of the public sector
A Proposal to Merge Humanist and Behaviorist Perspectives
Authors: Saleebey Dennis
Published: May 2018

Any theory of therapy or image of human nature must proceed from the assumption that man, whatever else he is, importantly is the creator of meaning
On Becoming an Executive Director
Authors: Elbow Margaret
Published: May 2018

Internal stresses that are related to the demands of a change in role are usually not anticipated and, as a consequence, may present problems in adaptation
The Role of the Mini-Meal in Therapeutic Play Groups
Authors: Troester James D. , Darby Joel A.
Published: May 2018

Refreshments provided by the therapists prove to be an invaluable tool in aiding the group process and promoting the learning of social skills
Characteristics of Contrasting Chinatowns 1. Philadelphia, Pennsylvania
Authors: Jung Marshall
Published: May 2018

Unlike most ethnic population centers, this small area benefits from having Chinese American social workers, but fails to meet even local residents' needs
The Korean Personality and Treatment Considerations
Authors: Yun Hum
Published: May 2018

Social workers from this ethnic group face the risk of identifying too fully with their clients, while other workers may fail to empathize for lack of understanding
Elderly Asian Americans and use of Public Services
Authors: Fujii Sharon M.
Published: May 2018

Changes, including the elimination of sociocultural barriers, must be effected both within the groups requiring services and within service delivery systems
New Directions for Work with Parents of Retarded Children
Authors: Proctor Enola K.
Published: May 2018

Social workers must first adopt for themselves new, healthier expectations, and then instill them in parents to help a child acquire adaptive behavior
News and Views
Authors: Einstein Gertrude
Published: May 2018

A professional volunteer in a mental health center
Family Treatment of Poverty Level Families
Authors: Orcutt Ben A.
Published: May 2018

Changes in family functioning are complex, especially when there is a parental life pattern of self-defeating behavior with few nurturant and stimulating resources
A Social Work response to the Middle-aged Housewife
Authors: Klass Shirley B. , Redfern Margaret A.
Published: May 2018

A particular age group, caught in the swirl of shifting social values and role expectations, may be a high-risk group in need of social intervention
The Van: A Mobile approach to Services for Adolescents
Authors: Pellman Renee , McDonald Rory , Anson Susan
Published: May 2018

The novelty of an innovative setting attracts young persons who then begin to cope with their individual and familial relationship problems
Community Mental Health Centers at the Turning Point
Authors: Kuramoto Ford H.
Published: May 2018

Social workers need to consider issues related to a topic of major importance and extraordinary opportunity for interdisciplinary practice and leadership
A Situational Perspective in Casework Theory
Authors: Mailick Mildred D.
Published: May 2018

Attempts in social casework to develop a unifying theory have tended to show either an emphasis on theories of the individual or the social system
Individualism, Society, and Social Work
Authors: Glick Peter M.
Published: May 2018

The pursuit of individualism and self-realization has led to a loss in the balance between acceptance of social responsibility and desire for personal freedom
Intercultural Marriage: The Korean-American Experience
Authors: Ratliff Bascom W. , Moon Harriett Faye , Bonacci Gwendolyn A.
Published: May 2018

Casework intervention can aid in reconciling conflicting values and concerns in an intercultural marriage that might otherwise end in unhappiness and separation
Family Systems and Learning Problems: A Treatment Model
Authors: Haufrecht Betty , Mitchell Celia
Published: May 2018

Combining educational intervention with family therapy can contribute to the easing of family tensions and the improvement of a family member's performance in school
Community Participation in Mental Health
Authors: Pargament Kenneth I. , Habib Miriam , Antebi David
Published: May 2018

Building community participation into the operation of a mental health center may be difficult, but staff and community residents can gain from the process
Long-range Planning for Family Service Agencies
Authors: Sprafkin Benjamin R.
Published: May 2018

Providing for the future can best be accomplished by long-range planning that considers both the known and the unknown and prepares an organization for change
The Attorney Ad Litem: Guardian of the Rights of Children and Incompetents
Authors: Bernstein Barton E.
Published: May 2018

The guardian or attorney ad litem represents persons who cannot represent themselves, whether children or incompetent adults, to assure procedural and substantive due process of law. This article explores the rights and duties of the attorney ad litem and highlights the benefits and the limitations of this role.
Enhancing Listening Skills for Work with Abusing Parents
Authors: Anderson Gary D.
Published: May 2018

The severe interactional and communication difficulties that often characterize abusive parents can be best handled by attentive listening by the worker. Related aids to effective intervention are the worker's ability to overcome institutional impediments and to react with nonjudgmental, empathetic, and multifaceted awareness.
Short-Term Treatment with the Adolescent Client
Authors: Norman Jennie Sage
Published: May 2018

Short-term treatment is proposed as the treatment of choice for adolescents because it is consistent with the developmental needs and goals of that age group. Several case illustrations have been provided to show the value and benefit of such an approach for the adolescent client as well as for the therapist.
A Model for Conceptualizing Child Abuse Causation and Intervention
Authors: Ostbloom Norman , Crase Sedahlia Jasper
Published: May 2018

A seesaw model is utilized to illustrate both functional and nonfunctional familial states. In functional states, resources equalize stress; in nonfunctional states, stress outweighs resources. Stress-relieving services (crisis intervention) and resource strengthening (treatment) help restore functionality.
Self-Actualization: A Midlife Problem
Authors: Zacks Hanna
Published: May 2018

Reevaluation typical of the period around age forty originates in a need for self-actualization in view of the rising awareness of death. Based on new findings about midlife transition, an educational program is suggested for developing problem-solving techniques useful in dealing with issues typical of this stage.
Intervention at Times of Transition: Sources and Forms of Help
Authors: Golan Naomi
Published: May 2018

When individuals and families experience difficulties during transitional phases in their lives, they rarely apply directly to professionals at the outset. They turn to a range of help alternatives: themselves, family and friend networks, mutual help groups, community caregivers, and, finally, to professionals.
Family Structure and Value Orientation in American Indians
Authors: Horse John G. Red
Published: May 2018

Program planners must be aware of the historical emphasis placed on the extended family, recognize the importance of family structure patterns, and analyze the value orientation and purposeful behavior of the American Indian people to assure the delivery of quality services to American Indian communities.
Student Training in an American Indian Setting
Authors: Larsen Barbara W. , Jesch Gerald W.
Published: May 2018

A field placement unit for undergraduate social work students in a typical American Indian off-reservation boarding school is discussed. The goals of the program were to help the school's students with their emotional, psychological, and social problems and to offer the interns experience in counseling American Indians.
The Enabler: A Motivational Tool in Treating the Alcoholic
Authors: Koppel Flora , Stimmler Leo , Perone Frank
Published: May 2018

Counselors working with alcoholic clients can use potential enablers effectively as a tool to engage what might be an unmotivated client in treatment. Workers must appeal to the potential enablers' vested interests, educated them regarding alcoholism, and then establish a therapeutic contract with them.
A Family Agency Integrates Planned Short-Term Treatment
Authors: Rosenberg Blanca N. , Klein Joan M.
Published: May 2018

Planned short-term treatment was introduced as a modality for treatment in a family agency in response to growing waiting lists at intake and an increasing demand for immediate service. This article examines the preparation and planning, the process of staff training, and the implementation of this service in the agency.
Theories of Adult Development: Creating a Context for Practice
Authors: Brennan Eileen M. , Weick Ann
Published: May 2018

The assumptions of life-cycle theorists can serve as a basis for reappraising the theoretical underpinnings of practice and establishing a larger context for intervention with adults. A theory of adult development and a view of social work intervention from a developmental framework are discussed.
Politics of Interprofessional Collaboration: Challenge to Advocacy
Authors: Mailick Mildred D. , Ashley Ardythe A.
Published: May 2018

Both interprofessional collaboration and advocacy for clients are highly valued social work activities; yet, when pursued jointly, they pose political dilemmas. An exploration of these activities reveals the potential for ethical dissonance and highlights the need for clear guides to professional behavior.
Adjuncts to Social Casework in the 1980s
Authors: Schodek Kay
Published: May 2018

The need for linkage among various service components, work with members of other disciplines, and a demand for accountability are all characteristics of current practice settings that require social caseworkers to expand their repertoire of skills and then to reevaluate their programs and teaching curricula.
Family Therapy with Low-Income Blacks: A Tool or Turn-Off?
Authors: Gwyn Felisha S. , Kilpatrick Allie C.
Published: May 2018

The low-income black family has needs that are not being met by traditional family therapy approaches. This article examines the literature on the effectiveness of typical treatment methods, presents an illustrative case study, and then describes more specialized family therapy models for reaching this population.
Treating Children with Learning Disabilities
Authors: Lippmann Sylvia B. , Lippmann Daniel B.
Published: May 2018

Many workers find children with learning disabilities difficult to treat because specific learning disabilities interfere with effective communication between the client and the therapist. Specific treatment techniques for counteracting the communication difficulties are discussed, with clinical examples for illustration.
Police-Social Work Cooperation: Problems and Issues
Authors: Treger Harvey
Published: May 2018

An innovative program which diverts people from the justice system toward social service delivery is described. Through a cooperative effort with the police, social work's competence in interdisciplinary practice is extended, while new populations are provided with the supports they need to cope effectively.
The Prior Question: How do Supervisors Learn to Supervise?
Authors: Akin Gib , Weil Marie
Published: May 2018

The literature on supervision presents many models of supervisory practice, but ignores the prior issue of how supervision is learned. The assumptions about supervisory learning that are embedded in the literature are made explicit, and the need for development of new models of supervisory learning is discussed.
A Holistic Approach to the Treatment of Violent Families
Authors: Holmes Sally Ann
Published: May 2018

A close working relationship between police and social workers, mobilization of extensive community resources, and the extension of crisis intervention into immediate outreach and long-term intervention facilitate the engagement of these families, often highly resistant to treatment, in a meaningful change process.
Concurrent Group and Family Treatment for Young Adults
Authors: Dublin Richard A.
Published: May 2018

A treatment method that is uniquely suitable for young adults combines the use of long-term, intensive group therapy with short-term family treatment. This approach addresses clients' defects, builds on their strengths, and, finally, reconnects them in an improved and more mature fashion with their families.
Pregnant Adolescents: Cost-Benefit Options
Authors: Abel Rhoda , Jackson Janet L. , Fein Edith , Al-Sagaf Elizabeth L. , Shuster Dawn
Published: May 2018

A treatment approach with pregnant teenagers has as its emphasis not the prevention of pregnancies, but the interruption of the cycle of intergenerational conflict of which pregnancy is only a symptom. Treatment focuses on the entire family as a decisionmaking unit, and on the “cost accounting” required of each member.
Implications of the Holocaust for Social Work
Authors: Rosenbloom Maria
Published: May 2018

Studying the Holocaust teaches moral and behavioral lessons and helps social workers understand and respond to the special needs of Holocaust survivors and their children. This activity has implications for working with the victims of other human catastrophes of our time.
A Guide to Information Sources on Psychoactive Drug Therapies
Authors: Mendelsohn Henry N.
Published: May 2018

Helping professionals frequently need technical information on drug treatment therapies. The basic literature in the field is described and guidelines are offered to the best use of reference books, indexing and abstracting services, and computerized databases.
Identity and the Experience of Crisis
Authors: Dixon Samuel L. , Sands Roberta G.
Published: May 2018

A sense of identity provides a person with wholeness, continuity, and purpose. When an event is seen as a threat to identity, a person is vulnerable to the experience of crisis. Perspectives on crisis and identity are explored and practice implications are drawn.
Adapting to Parenthood: Negotiating New Roles
Authors: Winborn Rebecca
Published: May 2018

With the birth of the first child, couples, whatever their ideological positions, need to work out sex role differentiations. Case examples illustrate the wide spectrum of options, ranging from an egalitarian distribution of roles to a more traditional model.
A Group Design to Help Children Adjust to Parental Divorce
Authors: Bonkowski Sara E. , Bequette Shelly Q. , Boomhower Sara
Published: May 2018

Children of divorce are a vulnerable and largely unreached population. An eight-week semistructured group intervention was designed to mitigate the effects of divorce on latency-age children. The group's objectives, format, and interventive techniques are discussed.
Marital Therapy in the Treatment of Incest
Authors: Taylor Ronald L.
Published: May 2018

Marriages in which incest has taken place can benefit from marital therapy and can even achieve renewal. Fears of intimacy and abandonment—as expressed in sexuality and marital interactions—are discussed and a model for treatment is proposed.
Mental Health Services for Chinese in a Community Health Center
Authors: Lorenzo May Kwan , Adler David A.
Published: May 2018

Serious mental health problems exist within the Chinese population of the United States. This article describes one center's attempt to meet the psychiatric needs of both nonpsychotic and psychotic Chinese patients through bilingual, culturally relevant treatments.
Role Orientations and Intergenerational Welfare Use
Authors: Chambre Susan Maizel
Published: May 2018

Is intergenerational welfare dependency a valid concept? By examining orientations to work and family roles, this study raises questions concerning the supposedly differing attitudes of women who are and who are not on welfare.
Clinical Issues in Alcoholism Treatment
Authors: Chernus Linde A.
Published: May 2018

Though no consensus has been reached regarding the superiority of inpatient versus outpatient treatment for alcoholism, there are clinical factors, discussed in this article, that may lead a therapist to choose one setting over the other.
A Family Systems Perspective on Acting-Out
Authors: Frager Adena R.
Published: May 2018

Acting-out is viewed as a symptom reflecting one of four operating principles activated when a family is undergoing transitional stress. The principles are boundary dysfunction, systemic void, systemic intensity, and systemic rocking. Appropriate treatment recommendations are offered.
Disturbances of Perception in Adult Female Incest Survivors
Authors: Ellenson Gerald S.
Published: May 2018

Perceptual disturbances appear to occur in all adult female incest survivors, and failure to address them in therapy may compromise treatment. Certain recurring hallucinations are described in detail, and their diagnostic and treatment implications, including group therapy, are discussed.
The First Session: An Interpersonal Encounter
Authors: Marziali Elsa
Published: May 2018

The first meeting between the client and the worker has both treatment and assessment aims. Clients' and workers' subjective responses to initial interviews provide essential information for understanding the client and the potential effects of treatment.
The Role of the Field Instructor in the Socialization of Students
Authors: Webb Nancy Boyd
Published: May 2018

The author discusses the role of the field instructor as an agent of socialization into the social work profession. A self-assessment profile is presented to help students and field instructors identify their physical and personality attributes as well as their cognitive styles.
Sex Therapy with Female Incest Survivors
Authors: Rowe William , Savage Sandra
Published: May 2018

Female incest survivors experience difficulties in adult relationships, often years after the abuse has ceased. The authors outline a threefold typology for understanding the differential dynamics of father–daughter incest, the resulting sexual problems, and differential treatment techniques.
Losses and Grief in Old Age
Authors: Conway Pat
Published: May 2018

As a person ages, he or she increasingly experiences losses and, consequently, grief. The grieving process varies according to the characteristics of the individual, the loss, and the person's situation. Knowledge of this variation allows workers to intervene at the least intrusive level.
Surgical Correction of Metopic Craniosynostosis: A 3-D Photogrammetric Analysis of Cranial Vault Outcomes
Authors: Linden Olivia E. , Baratta Vanessa M. , Gonzalez Jose A. , Byrne Margaret E. , Klinge Petra M. , Sullivan Stephen R. , Taylor Helena O.
Published: May 2018

Objective:

To evaluate 3-dimensional (3-D) photogrammetry as a tool for assessing the postoperative head shape of patients who had undergone cranial vault remodeling for metopic synostosis.

Design:

We prospectively analyzed images of patients with metopic craniosynostosis who had undergone anterior cranial vault remodeling and age-matched controls. To ensure standardized facial orientation, each 3-D image was positioned to “best fit” the preoperative face by aligning 6 soft tissue landmarks. Forehead measurements were taken from a standardized position behind the surface of the face to landmarks placed in a ray configuration across the forehead.

Setting:

Academic teaching hospital.

Patients, Participants:

Thirteen pediatric patients with metopic craniosynostosis who had undergone anterior cranial vault remodeling and age-matched controls.

Interventions:

Images were taken preoperatively, immediately postoperatively, and over 1-year postoperatively.

Main Outcome Measures:

Forehead contours preoperatively and postoperatively, with statistics performed using a multivariate analysis of variance shape analysis.

Results:

Mean postoperative follow-up was 1.8 (0.6) years. The average distance from the origin to forehead landmarks was 55.1 (3.4) mm preoperatively, 59.3 (0.7) mm immediate postoperatively, 59.1 (1.0) mm 1-year postoperatively, and 59.4 (0.6) mm in controls. Postoperative metopic forehead contours varied significantly from preoperative contours ( P < .01), while there was no statistical difference between the 2 postoperative time points ( P = .70). One-year postoperative patients were not significantly different from their age-matched controls ( P > .99).

Conclusions:

Preoperative metopic forehead contours varied significantly from postoperative contours. Cranial reconstructions approximated the foreheads of normal controls, and reconstructions were stable at more than 1-year follow-up.
Damage and perforation resistance behaviors induced by projectile impact load on bonding-patch repaired and scarf-patch repaired composite laminates
Authors: Jiang Hongyong , Ren Yiru , Zhang Songjun , Liu Zhihui , Yu Guoqing , Xiang Jinwu
Published: May 2018

A three-dimensional continuum damage model is proposed to analyze the damage and perforation resistance behaviors of bonding-patch and scarf-patch repaired composite laminates under projectile impact load. Coupling with modified 3D-Hashin failure criteria, a linear-exponential law due to fiber pull-out failure and an exponential law are used to predict tensile and compressive softening processes of materials, respectively. A cohesive interaction based on triangle traction–separation law and mixed-mode fracture energy method is applied for interface debonding damages between patch/lamina, patch/patch and lamina/lamina. Comparisons are made between numerical results and several available test data for different impact offsets. The perforation resistance and interface debonding damage mechanisms are extensively discussed using finite element analysis. Further, perforation resistance behaviors of laminate with six different patch-repair patterns are assessed. Effects of initial velocity of projectile on residual velocity and energy-absorption are discussed. A residual velocity error within 7.3% and energy-absorption error within 9.2% is found between simulations and tests. Consistent failure modes including fiber fracture, matrix cracking, delamination and interface debonding are also identified. As the projectile invades patches, interface debonding damage in patches is accumulated rapidly, especially for larger impact offset. The combined patch-repairs show a reduction of at the most 48.3% in velocity and higher ballistic limit velocities which implies better perforation resistance capacity. The energy-absorption almost increases with increasing the initial velocity and a decreasing trend in average energy-absorption is found with the increase of impact offset.
HCAHPS Scores and Community Factors
Authors: Herrin Jeph , Mockaitis Kathleen G. , Hines Stephen
Published: May 2018

The objective was to examine associations between patient experience, as measured by Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores, and the sociodemographic, cultural, and access-to-care factors of the surrounding community. Using an empty model, this study found that 27% of the variation in HCAHPS scores was at the level of the county in which the hospital was located. The county factors examined explained about half of this county-level variation. Among community factors most strongly associated with increased HCAHPS scores were higher numbers of primary care physicians per capita, fewer specialists per capita, and smaller percentages of African Americans and Hispanics in the county. A number of community factors beyond the hospitalization experience may influence HCAHPS scores. As HCAHPS gains importance as a measure of quality of care and is linked to higher payments over time, it will be essential to understand the possible effects of community factors.
Effects of Long- and Intermediate-Acting Dihydropyridine Calcium Channel Blockers in Hypertension
Authors: Chaugai Sandip , Sherpa Lhamo Yangchen , Sepehry Amir Ali , Kerman Scott Reza Jafarian , Arima Hisatomi
Published: May 2018

Background:

Dihydropyridine calcium channel blockers are a heterogeneous group of antihypertensive drugs. Long-acting dihydropyridine agent amlodipine is widely used for monotherapy and combination therapy for hypertension in clinical practice, while intermediate-acting dihydropyridine agents have shown inconsistent results in randomized clinical trials (RCTs).

Methods and Results:

A meta-analysis of 18 RCTs enrolling a total of 80,483 patients with hypertension followed for a mean of 51.4 months was performed. Amlodipine therapy was associated with 25% higher risk of heart failure (relative risk [RR]: 1.25, 95% confidence interval [CI], 1.05-1.49, P = .019) but 17% lower risk of stroke (RR: 0.83, [95% CI, 0.72-0.97], P = .009) without statistically significant effect on acute myocardial infarction (AMI) compared to major alternative antihypertensive therapy (MAAT), including β-blocker, diuretic, angiotensin-converting enzyme inhibitor, or angiotensin-receptor blocker. Intermediate-acting dihydropyridine calcium channel blocker therapy was associated with 25% higher risk of heart failure (RR: 1.25, [95% CI, 1.06-1.47], 0.005, P = .005) and 26% higher risk of AMI (RR: 1.26, [95% CI, 1.05-1.51], 0.019, P = .019) compared to MAAT. Results of the subgroup analysis suggested that the intermediate-acting dihydropyridine calcium channel blocker was associated with higher risk of heart failure (RR: 1.30, [95% CI, 1.08-1.56], P = .005) and AMI (RR: 1.50, [95% CI, 1.01-2.22], P = .043) compared to renin–angiotensin system blockers and a trend toward higher risk of AMI (RR: 1.17, [95% CI, 0.99-1.38], P = .064) compared to conventional therapy, including β-blockers and diuretics. Meta-regression analyses suggested that long-acting dihydropyridine calcium channel blocker is associated with lower risk of AMI ( B: −0.327, [95% CI, −0.530 to −0.123], P = .002) with a trend toward lower risk of stroke ( B: −0.203, [95% CI, −0.410 to 0.003] P = .054).

Conclusions:

This study suggests that Amlodipine offers greater protection against major complications of hypertension compared to intermediate-acting dihydropyridine calcium channel blockers.
Sleep Outcomes for Parents of Children With Neurodevelopmental Disabilities: A Systematic Review
Authors: Micsinszki Samantha K. , Ballantyne Marilyn , Cleverley Kristin , Green Pamela , Stremler Robyn
Published: May 2018

Parents of children with Neurodevelopmental Disabilities (NDDs) are at risk of sleep loss. No comprehensive systematic reviews examining parental sleep outcomes in caregivers of children with NDDs exist. A systematic search was conducted between June and August 2016 examining sleep quantity, quality, sleepiness, and fatigue outcomes of caregivers of children with NDDs. Of 7,534 citations retrieved, 33 met eligibility criteria. Most studies ( n = 27) were cross-sectional, included a range of NDDs and were of “poor” ( n = 14) or “fair” ( n = 17) quality. Few good quality studies compared objectively measured sleep in parents of children with NDDs with parents with typically developing children. Parents of children with NDDs consistently reported significantly poorer subjective sleep quality. There is a paucity of good quality comparative studies, using well-validated measures, examining parental sleep outcomes. Future research should aim to fill this gap, providing greater insight to parents’ experiences, and identifying targets for intervention design and evaluation.
Comparison of the Coagulation Effect Achieved by OctaplasLG Versus Fresh Frozen Plasma in Pediatric Cardiac Surgical Patients
Authors: Kalsi Amanpreet S. , Al-Azzawi Omar , Gill Ravi
Published: May 2018

OctaplasLG is indicated for use in patients undergoing cardiac surgery who require replacement of multiple clotting factors. The use of OctaplasLG over single-donor fresh frozen plasma (FFP) may have beneficial effects when considering the transmission of enveloped viruses. Additionally, it has the potential for fewer adverse reactions, reduced disease transmission, and a more homogenous coagulation factor composition. However, its efficacy and safety have not yet been evaluated in the pediatric population. Pediatric patients aged less than 2 years old and less than 10 kg, who underwent complete tetralogy of Fallot repair and received either OctaplasLG or FFP intraoperatively were identified over a 10-year period for this retrospective analysis. A review of case notes, intra-operative, and laboratory data were used to assess intraoperative blood product usage, blood loss, and postoperative coagulopathy. Data were analyzed to assess the efficacy of OctaplasLG in achieving hemostasis when compared to FFP. Results showed clinically better hemostasis postoperatively in OctaplasLG group compared with FFP group and better coagulation results. OctaplasLG was as effective as FFP when used in pediatric patients undergoing cardiac surgery.
Influence of needle gauge used for venipuncture on measures of hemostasis in cats
Authors: Solbak Susanna , Epstein Steven E , Hopper Kate
Published: May 2018

Objectives

The objective of this study was to evaluate the effect of different needle sizes used to obtain blood via jugular venipuncture in cats on routine measures of hemostasis.

Methods

This was a prospective, observational, randomized, clinical study carried out at a university teaching hospital. Twenty healthy, client-owned cats were used. Each cat had blood collected via direct venipuncture from both jugular veins. Sampling of the right and left jugular vein was randomized to be collected with either a 22 G or a 25 G needle, respectively, and routine coagulation variables and platelet count were performed on all samples. Values were analyzed for differences in needle size, and site of sample collection.

Results

There was no difference between the two needle gauges in activated partial thromboplastin time, platelet count, fibrinogen degradation products, or fibrinogen, or between sampling from the left and right jugular vein. Prothrombin time (PT) was significantly higher when drawn from a 25 G needle (11.7 s) compared with a 22 G needle (11.4 s) ( P = 0.01), but not different in left vs right jugular vein samples. Bland–Altman analysis of PT comparing for 25 G minus 22 G needle vs the average, calculated a mean bias (95% limits of agreement) of 0.49 s (–1.4 s to 2.4 s).

Conclusions and relevance

This study of 20 healthy cats found that the use of either a 25 G or 22 G needle for jugular venipuncture did not introduce any clinically meaningful difference in routine coagulation variables or platelet count.
Hierarchy, social pathology and the failure of recognition theory
Authors: Thompson Michael J.
Published: May 2018

This article argues that the dynamics behind the generation of social pathologies in modern society also undermine the social-relational framework for recognition. It therefore claims that the theory of recognition is impotent in face of the kinds of normative power exerted by social hierarchies. The article begins by discussing the particular forms of social pathology and their relation to hierarchical forms of social structure that are based on domination, control and subordination and then shows how the internalization of the norms that shape and hold together hierarchical social formations causes pathologies within the self. As a result of these processes, the recognitive aspects of social action that the theory of recognition posits are unable to overcome and in fact reproduce and in many instances reinforce the pathologies themselves.
Abdominal Pain After Roux-En-Y Gastric Bypass for Morbid Obesity
Authors: Mala T. , Høgestøl I.
Published: May 2018

Background and Aims:

Roux-en-Y gastric bypass is widely used as treatment of morbid obesity. Weight loss, effects on obesity-related co-morbidities and quality of life are well documented post Roux-en-Y gastric bypass. Other outcome measures are less well studied. This review explores aspects of prevalence, diagnostic evaluations, etiology, and treatment of abdominal pain specific to Roux-en-Y gastric bypass.

Methods:

The review is based on PubMed searches and clinical experience with Roux-en-Y gastric bypass. Symptoms in the early postoperative phase (<30 days) were not included.

Results:

Based on limited evidence, up to about 30% of the patients may perceive recurrent abdominal pain post Roux-en-Y gastric bypass in the long term. A substantial subset of patients will need health-care evaluation for acute abdominal pain and hospital admission. The etiology of abdominal pain is heterogeneous and includes gallstone-related disease, intestinal obstruction, anastomotic ulcerations and strictures, intestinal dysmotility, dysfunctional eating, and food intolerance. Surgical treatment and guidance on diet and eating habits may allow symptom relief. The cause of pain remains undefined for a subset of patients. Impact of abdominal pain post Roux-en-Y gastric bypass on the perception of well-being, quality of life, and patient satisfaction with the procedure needs to be further evaluated and may be influenced by complex interactions between new symptoms post Roux-en-Y gastric bypass and relief of pre-existing symptoms.

Conclusion:

Abdominal pain should be part of follow-up consultations post Roux-en-Y gastric bypass. Future studies should focus on combined evaluations before and after surgery to enlighten potential casual relationships between abdominal pain and Roux-en-Y gastric bypass.
Measuring individual legitimacy perceptions: Scale development and validation
Authors: Alexiou Kostas , Wiggins Jennifer
Published: May 2018

To fully understand legitimacy as a complex construct, it is necessary to capture both collective perceptions and individual judgments. Much of the empirical research on legitimacy has focused on measuring the collective perceptions of groups of evaluators or critical institutions. This research develops and validates a psychometric measure of individual perceptions of pragmatic, moral, and cognitive legitimacy. Across seven studies, we demonstrate consistent reliability and scale structure, as well as convergent, discriminant, nomological, and predictive validity. We further show the generalizability and robustness of the measure across a variety of organizations and industries. This measure will advance empirical research on legitimacy by enabling researchers to capture the perceptions of individual evaluators directly and permit the comparison of results across studies.