bluuebunny/crossref_metadata_2025_split 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.
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.
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.
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.
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.
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.
The Association Between Adverse Child Health, Psychological, Educational and Social Outcomes, and Nondependent Parental Substance: A Rapid Evidence Assessment
Authors: McGovern Ruth , Gilvarry Eilish , Addison Michelle , Alderson Hayley , Geijer-Simpson Emma , Lingam Raghu , Smart Debbie , Kaner Eileen 
Published: May 2018

Background: Between 5% and 30% of children in high-income countries live with a substance misusing parent, the majority of which is below dependent levels. However, little is understood about the impact of nondependent parental substance misuse upon children. Methods: We searched the international literature using rigorous systematic methods to identify studies examining parental substance misuse and adverse outcomes in children. The inclusion criteria were cross-sectional, longitudinal, case-control, and cohort studies; of children aged 0–18 years whose parents are high-risk substance misusers; reporting on their health, psychological, substance use, educational, and social outcomes. Results: We identified 36 papers (from 33 unique studies), most of which were assessed as being of medium to high methodological quality ( N= 28). Parental nondependent substance misuse was found to be associated with adversity in children, with strong evidence of an association with externalizing difficulties ( N = 7 papers, all finding an association) and substance use ( N = 23 papers, all finding an association) in adolescents and some evidence of adverse health outcomes in early childhood ( N = 6/8 papers finding an association). There is less evidence of an association between parental substance misuse and adverse educational and social outcomes. The body of evidence was largest for parental alcohol misuse, with research examining the impact of parental illicit drug use being limited. Conclusion: Methodological limitations restrict our ability to make causal inference. Nonetheless, the prevalence of adverse outcomes in children whose parents are nondependent substance misusers highlights the need for practitioners to intervene with this population before a parent has developed substance dependency.
Alosetron use in clinical practice: significant improvement in irritable bowel syndrome symptoms evaluated using the US Food and Drug Administration composite endpoint
Authors: Lacy Brian E. , Nicandro Jean Paul , Chuang Emil , Earnest David L. 
Published: May 2018

Background: Alosetron is approved to treat women with severe IBS and diarrhea (IBS-D) who have failed standard therapy. In our study, we aimed to evaluate alosetron efficacy using new US Food and Drug Administration (FDA) endpoints and utilization in clinical practice. Methods: This prospective, open-label, multicenter, observational 12-week study evaluated women with severe IBS-D enrolled in the alosetron prescribing program. The coprimary FDA endpoints were changes from baseline in stool consistency and abdominal pain severity. Responders achieved a 30% decrease compared with baseline in weekly average of the worst abdominal pain in the past 24 h, and a 50% or greater reduction from baseline in the number of days/week with at least one stool of type 6 (mushy) or type 7 (watery) consistency. Secondary endpoints included changes from baseline in stool frequency, fecal urgency and fecal incontinence. Results: Enrolled patients ( n = 192) were primarily White (90.6%), with a mean age of 44.5 years. Patient and physician rating of IBS severity was between moderate and severe (85.9% concordance, Spearman coefficient 0.429, p < 0.0001). Alosetron 0.5 mg twice daily (82.8%) was the most common dosing regimen. A total of 152 alosetron-treated patients completed the study. Of 105 fully evaluable patients, 45% met the FDA composite endpoint responder criteria for ⩾50% of the study period. Improvements in all individual symptoms were statistically significant compared with baseline. There were no serious adverse events, cases of colonic ischemia, or complications of constipation. Conclusion: In a clinical practice setting study, alosetron demonstrated treatment success using a rigorous FDA composite endpoint and also improved multiple other IBS symptoms, including fecal urgency and incontinence in women with severe IBS-D [ ClinicalTrials.gov identifier: NCT01257477].
Bronchoscopic debulking of a feline tracheobronchial carcinoma and long-term outcome
Authors: Ruiz Marina Dominguez , Grant Jessica , Hernandez Juan 
Published: May 2018

Case summary This report describes a 10-year-old female spayed Russian Blue cat presented with a 5 month history of respiratory difficulty. Thoracic radiographs were suggestive of a central airway obstruction. Bronchoscopy revealed a broad-base mass in the region of the carina. Bronchoscopic debulking was performed using a urinary catheter. Histopathology confirmed the presence of a tracheobronchial carcinoma. Survival from diagnosis was 16 months (480 days), over which time the cat underwent three endoscopic debulking procedures in combination with doxorubicin chemotherapy. Relevance and novel information To our knowledge, this is the first report of a tracheobronchial carcinoma in a cat treated by endoscopic debulking with a urinary catheter and adjuvant chemotherapy with long-term survival time. A review of interventional bronchoscopy performed in humans and in veterinary medicine is described.
Investigating the origin and evolution of cerebral small vessel disease: The RUN DMC – InTENse study
Authors: ter Telgte Annemieke , Wiegertjes Kim , Tuladhar Anil M , Noz Marlies P , Marques José P , Gesierich Benno , Huebner Mathias , Mutsaerts Henk-Jan MM , Elias-Smale Suzette E , Beelen Marie-José , Ropele Stefan , Kessels Roy PC , Riksen Niels P , Klijn Catharina JM , Norris David G , Duering Marco , de Leeuw Frank-Erik 
Published: May 2018

Background Neuroimaging in older adults commonly reveals signs of cerebral small vessel disease (SVD). SVD is believed to be caused by chronic hypoperfusion based on animal models and longitudinal studies with inter-scan intervals of years. Recent imaging evidence, however, suggests a role for acute ischaemia, as indicated by incidental diffusion-weighted imaging lesions (DWI+ lesions), in the origin of SVD. Furthermore, it becomes increasingly recognised that focal SVD lesions likely affect the structure and function of brain areas remote from the original SVD lesion. However, the temporal dynamics of these events are largely unknown. Aims (1) To investigate the monthly incidence of DWI+ lesions in subjects with SVD; (2) to assess to which extent these lesions explain progression of SVD imaging markers; (3) to investigate their effects on cortical thickness, structural and functional connectivity and cognitive and motor performance; and (4) to investigate the potential role of the innate immune system in the pathophysiology of SVD. Design/methods The RUN DMC – InTENse study is a longitudinal observational study among 54 non-demented RUN DMC survivors with mild to severe SVD and no other presumed cause of ischaemia. We performed MRI assessments monthly during 10 consecutive months (totalling up to 10 scans per subject), complemented with clinical, motor and cognitive examinations. Discussion Our study will provide a better understanding of the role of DWI+ lesions in the pathophysiology of SVD and will further unravel the structural and functional consequences and clinical importance of these lesions, with an unprecedented temporal resolution. Understanding the role of acute, potentially ischaemic, processes in SVD may provide new strategies for therapies.
Electronic Cigarette Awareness, Use, and Perceptions among Cancer Patients
Authors: Buczek Erin J. , Harrington Kathleen F. , Hendricks Peter S. , Schmalbach Cecelia E. 
Published: May 2018

ObjectiveElectronic cigarettes (e‐cigs) are an emerging trend, yet little is known about their use in the cancer population. The objectives of this study were (1) to describe characteristics of e‐cig use among cancer patients, (2) to define e‐cig advertising exposure, and (3) to characterize perceptions of traditional cigarettes versus e‐cigs.Study DesignCross‐sectional study.SettingComprehensive cancer center.Subjects and MethodsInpatient, current smokers with a cancer diagnosis. E‐cig exposure and use were defined using descriptive statistics. Wilcoxon rank test was used to compare perceptions between e‐cigs and traditional cigarettes.ResultsA total of 979 patients were enrolled in the study; 39 cancer patients were identified. Most cancer patients were women (59%), with an average age of 53.3 years. Of the patients, 46.2% reported e‐cig use, most of which (88.9%) was “experimental or occasional.” The primary reason for e‐cig use was to aid smoking cessation (66.7%), alternative use in nonsmoking areas (22.2%), and “less risky” cigarette replacement (5.6%). The most common sources for e‐cig information were TV (76.9%), stores (48.7%), friends (35.9%), family (30.8%), and newspapers or magazines (12.8%). Compared with cigarettes, e‐cigs were viewed as posing a reduced health risk (P <. 001) and conferring a less negative social impression (P <. 001). They were also viewed as less likely to satisfy nicotine cravings (P =. 002), to relieve boredom (P =. 0005), to have a calming effect (P <. 001), and as tasting pleasant (P =. 006)ConclusionsE‐cig use and advertising exposure are common among cancer patients. E‐cig use is perceived as healthier and more socially acceptable but less likely to produce a number of desired consequences of cigarette use.