bluuebunny/crossref_metadata_2025_split huggingface dataset:
Union and separation in the therapy of pervasive developmental disorders and ADHD
Authors: Kawai Toshio 
Published: October 2009

Abstract:  This paper discusses the characteristics of psychotherapy for pervasive developmental disorders (PDD) in the context of the curative effects of the movement of images. The ‘autistic spectrum’ is widened here and includes not only PDD, but also ADHD. The main common characteristic in these two sets of disorders seems to be the lack of a subject, which manifests itself as the absence of awareness of otherness and difficulties with boundaries and language.In these cases a normal psychotherapy is ineffective as it presupposes an established subject. However a psychotherapeutic approach with these patients can contribute to the emergence of a subject. In severe cases the process of union and separation which is enacted either in the therapeutic relationship or in symbolic play leads to the birth of a subject, and of language. In milder cases, such as ADHD, the moments of separation and confrontation with the therapist suffice.I will discuss a case of my own with Asperger's syndrome in which union and separation in the play therapy occurred simultaneously. This indicates that union and separation are not a consecutive process, but are simultaneous and lead to dialectical movement. However, in neurotic cases with an established subjectivity the symbolic meaning of image plays a central role. This corresponds to Jung's understanding of image in alchemy.
Quantitative analysis of patch patterns in mosaic tissues with ClonalTools software
Authors: Mort Richard L. 
Published: October 2009

AbstractQuantitative analysis of mosaic tissues is a powerful method for following developmental lineages; however, analytical techniques are often subjective and repetitious. Here a flexible, semi‐automated image analysis method for mosaic patterns is described. ClonalTools is a free customizable tool‐set designed for the open‐source image analysis package ImageJ. Circular, polygonal or linear one‐dimensional mosaic arrays can be interrogated to provide measurements of the total number and width of positive and negative patches in a region of interest. These results are adjusted for the effects of random clumping using a previously described method to correct for differences in the contribution of the positive and negative cell type. The applicability of ClonalTools to different systems is discussed with reference to the analysis of mosaic patterns in the mouse corneal epithelium and adrenal cortex and in the outgrowth of neurites from explant cultures of mouse retina as example systems. To validate ClonalTools quantitatively, a recently published manual clonal analysis of the corneal epithelium of X‐inactivation β‐Gal‐mosaic mice was re‐analysed. The semi‐automated results did not differ significantly from the published data. Rapid quantification of such patterns to produce biologically relevant results represents a welcome improvement in terms of ease and speed of use over previous methods.
Fetal growth from mid‐ to late pregnancy is associated with infant development: the Generation R Study
Authors: HENRICHS JENS , SCHENK JACQUELINE J , BARENDREGT CHARLOTTE S , SCHMIDT HENK G , STEEGERS ERIC AP , HOFMAN ALBERT , JADDOE VINCENT WV , MOLL HENRIETTE A , VERHULST FRANK C , TIEMEIER HENNING 
Published: October 2009

Aim  The aim of this study was to investigate within a population‐based cohort of 4384 infants (2182 males, 2202 females) whether fetal growth from early pregnancy onwards is related to infant development and whether this potential relationship is independent of postnatal growth.Method  Ultrasound measurements were performed in early, mid‐, and late pregnancy. Estimated fetal weight was calculated using head and abdominal circumference and femur length. Infant development was measured with the Minnesota Infant Development Inventory at 12 months (SD 1.1mo, range 10–17mo). Information on postnatal head size and body weight at 7 months was obtained from medical records.Results  After adjusting for potential confounders and for postnatal growth, faster fetal weight gain from mid‐ to late pregnancy predicted a reduced risk of delayed social development (odds ratio [OR] 0.82; 95% confidence interval [CI] 0.71–0.95, p=0.008), self‐help abilities (OR 0.84; 95% CI 0.73–0.98, p=0.023), and overall infant development (OR 0.65; 95% CI 0.49–0.87, p=0.003). Similar findings were observed for fetal head growth from mid‐ to late pregnancy.Interpretation  Faster fetal growth predicts a lower risk of delayed infant development independent of postnatal growth. These results suggest that reduced fetal growth between mid‐ and late pregnancy may determine subsequent developmental outcomes.
Fertility and pregnancy following pelvic arterial embolisation for postpartum haemorrhage
Authors: Sentilhes L , Gromez A , Clavier E , Resch B , Verspyck E , Marpeau L 
Published: October 2009

Objectives  To determine and compare the fertility and pregnancy outcomes following embolisation with or without uterine‐sparing surgery for postpartum haemorrhage, and to attempt to identify specific risk factors associated with an increased likelihood of intrauterine synechia.Design  Retrospective study.Setting  University‐affiliated tertiary referral centre.Population  All consecutive women who had an embolisation with or without uterine‐sparing surgery (vessel ligation and/or uterine compression) for postpartum haemorrhage between 1994 and 2007 were included.Methods  Data were retrieved from medical files and telephone interviews.Main outcome measure(s)  Fertility and pregnancy outcomes, synechia.Results  Data were available for 68 of the 85 women (80%) included in the study. Among the 15 women who complained of amenorrhoea or decreased flow of menstruation, synechia was found in all those who decided to undergo an ambulatory hysteroscopy (n = 8). Seventeen women had 26 pregnancies with 19 term deliveries, one ectopic pregnancy, two abortions and four miscarriages. The clinical courses of the 19 complete gestations were uneventful, but postpartum haemorrhage recurred in six women (31.6%) (caused by placenta accreta in two women). Fertility and pregnancy outcomes did not differ between women who had undergone embolisation versus both embolisation and a uterine‐sparing surgical procedure. The occurrence of synechia was significantly associated with a higher rate of placenta accreta/percreta (P < 0.001) and postpartum fever above 38.5 °C (P = 0.04).Conclusions  Embolisation, whether or not associated with a uterine‐sparing surgical procedure, for postpartum haemorrhage does not appear to compromise a woman’s subsequent fertility and obstetric outcome. Nevertheless, these women should be considered at high risk for postpartum haemorrhage during future deliveries.
A rapid evidence‐based service by librarians provided information to answer primary care clinical questions
Authors: McGowan Jessie , Hogg William , Rader Tamara , Salzwedel Doug , Worster Danielle , Cogo Elise , Rowan Margo 
Published: October 2009

AbstractBackground:  A librarian consultation service was offered to 88 primary care clinicians during office hours. This included a streamlined evidence‐based process to answer questions in fewer than 20 min. This included a contact centre accessed through a Web‐based platform and using hand‐held devices and computers with Web access. Librarians were given technical training in evidence‐based medicine, including how to summarise evidence.Objectives:  To describe the process and lessons learned from developing and operating a rapid response librarian consultation service for primary care clinicians.Methods:  Evaluation included librarian interviews and a clinician exit satisfaction survey.Results:  Clinicians were positive about its impact on their clinical practice and decision making. The project revealed some important ‘lessons learned’ in the clinical use of hand‐held devices, knowledge translation and training for clinicians and librarians.Conclusions:  The Just‐in‐Time Librarian Consultation Service showed that it was possible to provide evidence‐based answers to clinical questions in 15 min or less. The project overcame a number of barriers using innovative solutions. There are many opportunities to build on this experience for future joint projects of librarians and healthcare providers.
The impact of shrub encroachment on savanna bird diversity from local to regional scale
Authors: Sirami Clélia , Seymour Colleen , Midgley Guy , Barnard Phoebe 
Published: October 2009

AbstractAim  Evidence is accumulating of a general increase in woody cover of many savanna regions of the world. Little is known about the consequences of this widespread and fundamental ecosystem structural shift on biodiversity.Location  South Africa.Methods  We assessed the potential response of bird species to shrub encroachment in a South African savanna by censusing bird species in five habitats along a gradient of increasing shrub cover, from grassland/open woodland to shrubland dominated by various shrub species. We also explored historical bird species population trends across southern Africa during the second half of the 20th century to determine if any quantifiable shifts had occurred that support an ongoing impact of shrub encroachment at the regional scale.Results  At the local scale, species richness peaked at intermediate levels of shrub cover. Bird species composition showed high turnover along the gradient, suggesting that widespread shrub encroachment is likely to lead to the loss of certain species with a concomitant decline in bird species richness at the landscape scale. Finally, savanna bird species responded to changes in vegetation structure rather than vegetation species composition: bird assemblages were very similar in shrublands dominated by Acacia mellifera and those dominated by Tarchonanthus camphoratus.Main conclusions  Shrub encroachment might have a bigger impact on bird diversity in grassland than in open woodland, regardless of the shrub species. Species recorded in our study area were associated with historical population changes at the scale of southern Africa suggesting that shrub encroachment could be one of the main drivers of bird population dynamics in southern African savannas. If current trends continue, the persistence of several southern African bird species associated with open savanna might be jeopardized regionally.
Using the biogeographical distribution and diversity of seaweed species to test the efficacy of marine protected areas in the warm‐temperate Agulhas Marine Province, South Africa
Authors: Anderson R. J. , Bolton J. J. , Stegenga H. 
Published: October 2009

AbstractAim  To study the siting of marine protected areas (MPAs) with respect to the biogeographical distribution of seaweeds within the Agulhas Marine Province and to assess the effectiveness of current MPAs in including (conserving) seaweeds of the South African south coast.Location  South Africa – the south coast between Cape Agulhas and the Eastern Cape/Kwazulu‐Natal border, and eight MPAs within that area.Methods  We used interpolated seaweed distribution records from all available sources, in 50‐km coastal sections. Cluster analysis (Jaccard Average Linkage) of species presence/absence data provided measures of similarity between coastal sections and between MPAs. Complementarity analyses identified the sequence of ‘importance’ of sections/MPAs for conserving seaweed species.Results  Species presence/absence data indicated two main groups, representing western (cooler water) and eastern (warmer water) biogeographical divisions, as well as several biogeographical subdivisions within each of these groups. Complementarity analysis yielded a sequence of ‘importance’ of coastal sections (in terms of the highest number of species included) that began with a section just east of central in the Agulhas Marine Province, around Port Alfred, where there is no MPA. This was followed by the easternmost section (warmest water), which contains the Pondoland MPA, and then by the westernmost (coolest water) section, containing the De Hoop MPA. Similar analysis of the actual species collected in MPAs showed a generally similar pattern.Main conclusions  Seven current MPAs and one proposed coastal MPA in the Agulhas Marine Province appear to be well distributed and well sited to include (conserve) the full biogeographical range of seaweeds. However, if further MPAs are to be considered, the Port Alfred area is recommended for improved conservation. This study did not examine estuaries, which may require improved conservation efforts. Seaweed distribution data, which are often relatively complete, offer a good tool for planning the siting of coastal MPAs.
Drug reimbursement and GPs’ prescribing decisions: a randomized case‐vignette study about the pharmacotherapy of obesity associated with type 2 diabetes: how GPs react to drug reimbursement
Authors: Verger Pierre , Rolland Sophie , Paraponaris Alain , Bouvenot Julien , Ventelou Bruno 
Published: October 2009

AbstractThis study sought to identify the effect of drug reimbursability – a decision made in France by the National Authority for Health – on physicians’ prescribing practices for a diet drug such as rimonabant, approved for obese or overweight patients with type‐2 diabetes. A cross‐sectional survey of French general practitioners (GPs) presented a case‐vignette about a patient for whom this drug is indicated in two alternative versions, differing only in its reimbursability, to two separate randomized subsamples of GPs in early 2007, before any decision was made about reimbursement. The results indicate that (i) more than 20% of GPs in private practice would be willing to prescribe a non‐reimbursed diet drug for patients with obesity complicated by type 2 diabetes; (ii) the number of GPs willing to prescribe it would increase by 47.6% if the drug were reimbursed, and (iii) such a drug would be adopted at a higher rate by GPs who have regular contacts with pharmaceutical sales representatives. In France, unlike most other countries, drug reimbursement status is a signal of quality. However, our results suggest that a significant proportion of GPs would spontaneously adopt anti‐obesity drugs even if they were not reimbursed. Decisions about reimbursement of pharmaceutical products should be made taking into account that reimbursement is likely to intensify prescription.
Arterial transducer placement and cerebral perfusion pressure monitoring: a discussion
Authors: Jones Helen A. 
Published: October 2009

ABSTRACTAim: To discuss existing disparity of practice and clinical implications of measuring cerebral perfusion pressure (CPP) from differing reference points thus highlighting the need for standardized benchmarks.Background: When managing traumatic brain injury (TBI), the arterial transducer level is a key to an accurate CPP reading; however, there is a lack of national standards about where to zero arterial transducers when monitoring CPP.Methods: A systematized search using the Cochrane library database, Pubmed database, Medline, British Library on line, CINAHL and PROQUEST using key search terms was used to identify articles that could form a basis for a discussion. Papers published between 2000 and 2008 were included. Papers that did not discuss arterial transducer level placement and CPP were excluded. The Brian Trauma Guidelines 2007 were scrutinized for recommendations.Results: Of 57 empirical studies accessed, none reported or explored the placement of the arterial transducer during CPP measurement. Conflicting opinions were identified within the literature and there were no recommendations made for practice within the Brain Trauma Foundation Guidelines 2007.Discussion: At the present time, there is insufficient evidence for recommending standard placement for mean arterial pressure (MAP) measurements for patients with TBI. There are implications to consider as the treatment prescribed will differ depending on where the arterial transducer is placed because the MAP and CPP displayed will fall by 15 mm Hg at a head elevation of 30 degrees. This poses a number of questions: is the CPP underestimated with the arterial transducer placed at head level? Is the CPP overestimated if the transducer is placed at mid axilla level?Recommendations: Further research is recommended. However, studies would be difficult to power as head‐injured patients constitute a heterogeneous population. Professional consensus should be applied and standardized benchmarks agreed.
Recovering from the psychological impact of intensive care: how constructing a story helps
Authors: Williams Susan Lecky 
Published: October 2009

ABSTRACTBackground:Numerous studies have demonstrated both the risk of post‐traumatic stress as a result of intensive care unit (ICU) treatment and the efficacy of successful narrative processing for recovery from psychological trauma.Aim:This article is based on recent doctoral research exploring the impact of unanticipated life threats after admission to hospital. It examines the difficulties ICU patients have with constructing coherent narratives of their illness experience and the significance of those difficulties for psychological recovery from critical illness.Methods:The original research used a qualitative design blending discourse, narrative, and phenomenological approaches guided by hermeneutical sensitivity to the evolving language of narrative processing. Patients chosen from ICU discharge summaries showing a critical life‐threatening event after admission to hospital were interviewed soon after discharge from hospital and then again 1 year later. Unstructured interviews explored participant experience of a critical event and its aftermath.Results:This article focuses in particular on one finding from the doctoral research. Unanticipated critical illness presented some patients with difficulties in accomplishing the fundamental human task of constructing a narrative of their experience. Risk factors were observed identifying specific vulnerabilities. The extent to which difficulties were overcome impacted positively on the patient's sense of well‐being 1 year after discharge.Conclusions:In order to recover psychologically, some ICU patients need help overcoming obstacles to their ability to construct an adequately coherent narrative of their experience.Relevance to clinical practice:ICU follow‐up clinics could gain increased clarity of purpose from this narrative conceptual framework, eventually evaluating and validating benchmarks for assessing psychological recovery in relation to specified dimensions of narrative processing. Practice development informed by narrative process theory could also enhance ICU nursing communication. Since story construction is central to a person's core identity processes, person‐centred nursing would also be implicated.
The importance of knowing the patient in weaning from mechanical ventilation
Authors: Crocker Cheryl , Scholes Julie 
Published: October 2009

ABSTRACTAim: The aim of the research was to understand how nurses used technology to wean patients from mechanical ventilation.Background: The literature concerned with the development of critical care centres on the role of technology with little emphasis on the nursing contribution.Design: An ethnographic approach was used to understand how nurses used technology to wean patients from mechanical ventilation.Methods: Data were gathered by participant observation and interviewing over a 6‐month period. In total, 250 h of field notes were recorded.Results: Data were analysed by the content analysis method. Knowing the patient was a central theme identified. Three sub‐themes were identified: ways of knowing, continuity of care and the role of the patient in the weaning trajectory.Conclusion: ‘Knowing the patient' was implied during the interviews as essential to the delivery of patient‐centred care. There were two main factors that needed to be present in order for nurses to know their patients: continuity of care and expertise. ‘Ways of knowing’ was reliant on gaining information about the patient. The role of the patient was a passive recipient of treatment.Implications for practice: Knowing the patient has been defined as a characteristic of expert nursing. To be truly patient‐centred nursing needs to address the barriers that prevent nurses from getting to ‘know’ their patients.
Mechanism leading to the development of pressure ulcers based on shear force and pressures during a bed operation: Influence of body types, body positions, and knee positions
Authors: Mimura Maki , Ohura Takehiko , Takahashi Makoto , Kajiwara Ryuji , Ohura Jr. Norihiko 
Published: October 2009

ABSTRACTSurface pressures and shear forces were measured in order to clarify the mechanism leading to the development of a pressure ulcer at five sites on the body during the operation of a bed (bed) using a device for simultaneously measuring pressure and shear force. Changes of shear force and pressure when three body types adopted different supine positions, with or without raising/bending the knees (raising the knees), were investigated and analyzed. The results are as follows: a slender body type tends to have the highest shear force at the coccygeal bone site and also has a higher surface pressure at the coccygeal and at the lateral sacral bone sites than an obese body type. On the other hand, an obese body type has a higher surface pressure at the other sites than the slender type. Shear forces at the sacrum and coccygeal bone sites can be reduced during a bed operation by raising the knees. Furthermore, shear forces can be reduced during a bed operation in a supine position by matching the body's bending points with those of the bed or by shifting the subjects 10 cm toward the head of the bed. These new findings are clinically useful in the treatment and the prevention of the onset of pressure ulcers.