bluuebunny/crossref_metadata_2025_split huggingface dataset:
Group Psychological Therapy for Cancer Patients: A Point of View, and Discussion of the Hierarchy of Options
Authors: Cunningham Alastair J. , Edmonds Claire V. I. 
Published: May 2005

Objective: We present here a point of view about the logical role of group psychological therapies in the care of cancer patients, and propose a comprehensive, four-stage program that could be implemented at any large cancer treatment center. Method: Our proposals rest on a review of the literature, and on our own experience with various kinds of psychological help for cancer patients, some of which is described. Results: It is clear that group psychological therapies improve the quality of life of many participating cancer patients, and there is preliminary evidence that it may prolong life in some cases. We describe five main kinds of adjuvant psychological therapy, arranging them on a hierarchy of increasingly active participation by the recipient, and noting the status of evidence for their efficacy. They are: providing information, emotional support, behavioral training in coping skills, psychotherapy (of various kinds), and, more speculatively, spiritual/existential therapy. Conclusions: We propose that it is time to consider psychological therapy as an adjuvant in cancer management, analogous to adjuvant chemotherapy. The main indication for advocating group psychological therapy to patients should, we argue, be an expert assessment that the patient is likely to benefit, and should not (as is usual at present) be restricted to either 1) those patients with overt psychopathology, or 2) those few who specifically request it.
Do Family Physicians and Internists Differ in Knowledge, Attitudes, and Self-Reported Approaches for Depression?
Authors: Gallo Joseph J. , Meredith Lisa S. , Gonzales Junius , Cooper Lisa A. , Nutting Paul , Ford Daniel E. , Rubenstein Lisa , Rost Kathryn , Wells Kenneth B. ,   Quality Improvement for Depression Consortium
Published: May 2005

Objectives: The purpose of this investigation was to assess the relationship of primary care specialty training with self-assessed skill, knowledge, attitudes, and behavior toward depression recognition and management. Method: A baseline self-report questionnaire was administered to 184 internists and 138 family physicians participating in a multisite depression intervention study. Results: There were no marked differences in knowledge of internists and family physicians regarding depression, in attitudes about the effectiveness of specific therapies, or in barriers to providing optimum treatment for depression. However, compared to internists, family physicians rated themselves as more skilled in the management of depression. When considering management of patients with moderate to severe depression, family physicians were more likely to report that they prescribed a selective serotonin-reuptake inhibitor (relative odds (RO) = 3.51, 95 percent Confidence interval (CI) [2.19, 5.60] and to personally counsel patients (RO = 1.97, 95 percent CI [1.16, 3.38]) more than half the patients, but were less likely to refer to a specialist in mental health (RO = 0.52, 95 percent CI [0.33, 0.82]) than were internists. Additional potentially influential characteristics did not wholly account for the reported differences in practice according to specialty. Physicians of both specialties expressed considerable uncertainty in their knowledge of psychotherapy and in their evaluation of the effectiveness of other strategies for the prevention of recurrence of depression. Conclusion: Strategies to improve mental health care should account for the orientation of primary care physicians to mental health issues.
Individuation-Attachment and Suicide Trajectory: A Developmental Guide FOR the Clinician
Authors: Kaplan Kalman J. , Worth Shirley A. 
Published: May 2005

This article applies a two-axis model of human development to the problem of suicide trajectory. The two-axis approach represents a fundamental shift in the way Eriksonian stages are viewed. Typical interpretations of Erikson suggest healthy development is achieved by resolving each stage crisis horizontally in favor of the syntonic as opposed to the dystonic ego quality. A two-axis view proposes that an organism begins each stage at the negative or dystonic position in reaction to the stage-initiating life event and must move ahead vertically to achieve the positive syntonic quality and the attaining of a stage-specific syntonic equilibrium. We are suggesting that successful development involves not the avoidance of the negative or dystonic ego qualities at each stage but the very plunging into each of them as the natural sequela of the preceding life event. Successful development involves working through a stage vertically to attain the respective stage-specific positive or syntonic ego position, followed by forward regression to the next advanced stage. The logic of this developmental axis is simply that the loosening of one's defenses (i.e., greater permeability of walls) should occur in conjunction with the strengthening of one's ego (i.e., greater definition of boundaries). Incongruent resolution of the individuation-attachment dilemma results in “enmeshment” (attachment to the external world without individuation), or in “disengagement” (remaining detached even after becoming sufficiently individuated). Extreme distress can result from the attempt to simultaneously apply enmeshed and disengaged styles to cope with the overwhelming challenges of the new life stage, creating a potentially suicidal level of stress.
Identification and Classification of Factitious Disorders: An Analysis of Cases Reported during a Ten Year Period
Authors: Goldstein Amy B. 
Published: May 2005

Objective: The current article offers a new conceptualization of Factitious Disorders based on Cases Reported in the Literature. Method: The Current Analysis Examines Twenty-Nine Cases Of Factitious Disorder Patients Over The Course Of Ten Years (1986–1996). Cases Were Found Through Psychlit And Medline Searches. Patient Variables Examined Include: Demographics, occupational status, marital status, childhood history, extent of medical history, the presence of a borderline personality disorder, and presence of a psychosocial stressor prior to the onset of the factitious disorder. Results: An examination of the cases found demographic patterns of illness presentation consistent with previous reviews of the disorder. From the examination emerged two distinct types of factitious presentations—one acute, one chronic. A two-dimensional approach is introduced in an attempt to understand various disease presentations. Cases were classified based on proposed Current Life Stress and Chronic Life Pattern dimensions. These dimensions are measures of the extent to which the patient's factitious presentation is in response to an immediate psychosocial stressor, or an action consistent with a long-term maladaptive behavior pattern resulting from an underlying character pathology. Three patient groups were identified based on estimated patient levels of each dimension. The three groups are: Stress Response, Life Response, and Mixed Response. Conclusion: Recommendations are made to increase the role of physicians in the detection of factitious patients, as well as to move toward a more uniform reporting of cases of factitious disorders in the literature.
Evidence Based Health Care in Old Age Psychiatry
Authors: Banerjee Sube , Dickinson Edward 
Published: May 2005

Objective: The purpose of this article is to present the current status and future needs of old age psychiatry in relation to evidence-based health care. Method: The opportunities and difficulties of evidence-based medicine as applied to old age psychiatry are described. Depression is used as a specific example. The role of the Cochrane Collaboration and of clinical guidelines in dealing with these difficulties are discussed. Results: There has been a tendency for drug studies to focus on younger age groups and to exclude patients with comorbidity or polypharmacy. Aspects of clinical management separate from drugs are given insufficient attention. The generalizability of current studies is a problem in old age psychiatry. Conclusions: Psychiatry is no less part of medicine than any other specialty. Increased attention to studies of effectiveness, as opposed to efficacy, is indicated. The Cochrane Collaboration is an international network which promotes and conducts systematic reviews of the effectiveness of health care. Systematic reviews can increase the generalizability of the current knowledge base and better define the needs for future research.
Use of Psychotropic Drugs in Gynecological, Surgical, and Medical Wards of General Hospitals
Authors: Wancata J. , Benda N. , Meise U. , Müller C. 
Published: May 2005

Objective: The purpose of the present study was to investigate the prevalence of psychotropic drug use and the predictors of use during hospitalization. Method: We investigated 728 patients admitted to medical, gynecological, and surgical wards of two non-university general hospitals in Austria for psychotropic drug use, psychiatric morbidity, and sociodemographic characteristics. Results: The use of psychotropics was highest in medical wards (67.6%), followed by surgical (59.3%), and gynecological wards (37.8%). Older age, psychiatric caseness, consultation by psychiatrists and use of psychotropics before admission were predictors for psychotropic drug use. Psychotropics were given for a longer duration to psychiatric cases than to non-cases. Anxiolytics were prescribed most often (39.6%), followed by hypnotics (16.9%), neuroleptics (10.7%), and antidepressants (7.0%). Conclusions: The fact that psychiatric illness is a significant predictor of psychotropic drug use suggests that these drugs were prescribed aptly. The longer duration of use among psychiatric cases supports the idea of appropriate prescriptions.
Serotonin Irritation Syndrome: An Hypothesis
Authors: Giannini A. James 
Published: May 2005

Two patients were seen with multisystemic complaints and anxious feelings. Their history was similar for chronic exposure to potentially ionized atmospheric environments–a waterfall and high-voltage equipment. Physical examination showed various signs sometimes associated with hyperserotonergic states. Laboratory testing showed increased levels of serum serotonin and decreased levels of its metabolite, urinary 5-hydroxyindoleacetic acid (5-HIAA). Removal of the patients from these environments or the use of a serotonin-blocker ameliorated all symptoms and reestablished normal serotonin and 5-HIAA levels. A literature-review disclosed a similar symptom-complex reported with airionization during the sweep of hot winds across desert lands. Animal studies are cited in which cation aerosols are used to block serotonin metabolism, producing clinical and laboratory results some of which are similar to those seen in the patients described. It is suggested that a “serotonin irritation syndrome” might be related to cation-induced serotonin metabolic dysfunctions.
The Concept of “Stress” in the Biological and Social Sciences
Authors: Hinkle Lawrence E. 
Published: May 2005

The concept of “stress” was applied to biological and social systems in the first half of this century because it appeared to provide an explanation for the apparently “non-specific” effects of biologic agents, and for the occurrence of illness as a part of the response of people to their social environment. Evidence subsequently accumulated has confirmed that a large proportion of the manifestations of disease are produced by reaction of the host and not directly by the “causal agents” of disease, and that the components of the host's reactions are not in themselves “specific” to any given “causal agent”; it has confirmed that reactions of people to other people, or to the social environment may influence any physiological process or any disease; but it has also indicated that the concept of “stress” does not provide an adequate explanation for these phenomena. Living organisms are highly ordered and complex biological organizations that maintain themselves precariously over a limited period of time by the interchange of energy and information with the environment. Their reactions to the environment are complex and highly ordered, are based upon information, and are communicative and “logical” in nature. Although the components are “not specific,” the reactions themselves may be highly specific to the stimulus that initiates them. These reactions are not random but are “directed” (apparently “purposeful”) and tend to preserve the integrity of the organism, and the integrity of its relation to its social group and to its environment. The concept of “stress,” which was derived partly from popular usage, and based upon 18th and 19th century mechanical models of “force,” “counterforce,” and “distortion,” does not provide a meaningful scientific description of organism-environment relationships. These are better described by other concepts. The “stress concept” was heuristically valuable in the past, but it is no longer necessary, and it is in some ways hampering at the present.
Using Exchange Tapes in the Preparation and Training Program for Student Teachers
Authors: Llewellyn Gerald C. 
Published: May 2005

The extensive use of tape recordings has been employed to assist in training science teachers. Benefits observed included an increase in personal awareness of the classroom atmosphere for both teacher and listener, an increase in the quality of teaching, and an increase in the quality and efficiency of supervision. The tape exchange system, between student teacher and college supervisor, was used to supplement regular classroom visits. Besides providing the student teacher with the operational skills and potential innovative classroom use of recorders and tapes, the exchange program allowed the teacher to share his best teaching efforts with his peers and the college supervisor. The college supervisor was able to benefit by using the “dead time” resulting from travel between schools to listen to the tapes and become familiar with the classroom environment and the progress for that particular student teacher. Each tape included an introduction and the objectives for the lesson taught, a recording of the actual class taught, and the recorded comments of the college supervisor.
Agricultural Science and Food Policy for Consumers and Workers: Recipes for Public Health Successes or Disasters?
Authors: Watterson Andrew 
Published: May 2005

In the world of high speed globalization, the search for global food and water security has failed despite being driven by aggressive agribusiness and aided all too often by so-called “Green Revolution” research scientists and technologists. In the process, agricultural workers, rural communities, and food production workers face significant occupational and environmental hazards. Countervailing forces to the World Trade Organization (WTO) and agribusiness food strategies are needed. Critical to these forces will be Non-Governmental Organizations (NGOs) working toward non-toxic, non-destructive, community-based agriculture informed by integrated humanistic, scientifically cautious, worker-sensitive, and ecologically located principles. Sharpen the sickle! The fields are white: Tis the time of the harvest at last —Quoted in Groves 1949 [1]
Development, Reliability and Validation of the Diabetes Emotional Adjustment Scale in Spanish: Preliminary Findings
Authors: De Leóan Ovidio A. 
Published: May 2005

Objective: The development of instruments to measure emotional maladjustment in diabetic Hispanic populations has received little attention. We present the development and validation of the Diabetes Emotional Adjustment Scale in Spanish. Method: An eighteen-item self-administered scale was construed to assess emotional adjustment in Spanish-speaking diabetic patients and the psychometric properties of the scale were assessed. The scale was applied to a sample of sixty patients and scale scores were correlated with scores on a battery of Spanish versions of established measures of psychological distress, to assess concurrent validity. Test-retest reliability was established four years later re-examining thirty-eight of the initial sixty-patients sample. Results: Split-half reliability and test-retest reliability were satisfactory. There were significant correlations between the scale results and measures of depression, trait-anxiety, family adjustment, and locus of control of behavior. A principal component analysis with varimax rotation yielded a six-factor solution explaining 50.4 percent of the total variance. Conclusions: The scale is useful as a screening instrument, but the confirmation of factor structure stability and the correlation of the scale results with objective measures of metabolic control, require further investigation.
The Family Doctor and Patients' Secrets
Authors: Balint Michael 
Published: May 2005

One of the most difficult decisions for the family physician is when and to what extent to inquire into his patients' private thoughts and emotions. Asking too many questions may be just as hazardous as asking too few. The delicate art of timing requires that the physician “listen with his third ear,” and know his patient, the family, and himself. The experience of psychoanalysts can be of considerable help to physicians in helping them to recognize and use important cues in the patient's history and conversation that can be relevant to understanding and treating problems encountered in medical practice.
A Chicken in Every Pot: At What Price?
Authors: Nowell Jacqueline 
Published: May 2005

The poultry industry is one of the fastest growing industries in the United States. “Big chicken,” however, has created big problems. Consumers and the environment, as well as people who grow, catch, slaughter, and process chicken are all impacted by the practices and policies of the poultry industry. This paper sheds some light on serious problems caused by production practices that put profits above human dignity, food safety, and the environment and proposes some needed regulations and actions. When Jurgis had first inspected the packing-plants with Szadwilas, he had marveled while he listened to the tale of all the things that were made out of the carcasses of animals, and of all the lesser industries that were maintained there; now he found that each one of these lesser industries was a desperate little inferno, in its way as horrible as the killing-floor, the source and fountain of them all. The worker in each of them had their own peculiar diseases … the worker bore the evidence of them about on his own person—generally he had only to hold out his hand. —Upton Sinclair, The Jungle [1] … it is human hands that must make the same knife or scissors cut to slit open carcasses from anus to breast or the same twist of the hand to yank out viscera at a grueling pace, set by a relentless conveyor belt and reinforced by circulating foremen, while workers are standing in pools of water and grease in temperatures that range from freezing to ninety-five degrees and being pelted by flying fat globules or dripping blood…. The painful damage to tendons and nerves can permanently cripple fingers, hands, wrists, arms, and shoulders. It has required thousands of poultry workers to undergo corrective surgery and made it difficult or impossible for them to perform such simple motions or tasks as raising their arms above their heads, holding things, sweeping, washing dishes, or removing clothes from a washing machine. —Mark Linder [2]
The Implications of Work Organization for Occupational Health Policy: The Case of Canada
Authors: Sass Robert 
Published: May 2005

This article examines occupational health and safety developments in Canada during the decade of the 1970s when most government jurisdictions replaced former factory Acts with new health and safety legislation recognizing the right of workers to be involved in work environment matters. During the latter part of the 1970s, health and safety “activists” and trade unionists began to perceive the need for a wider conception of occupational health and safety. Canadian reformers were influenced by Scandinavian developments, especially the research of Dr. Bertil Gardell and his associates. Unfortunately, during the late 1970s Canada experienced a recession and a political shift to conservatism. Consequently, during the 1980s there have been no meaningful workplace health and safety reforms. Further, the article suggests that there is strong resistance by management and government to extension of worker rights in occupational health and safety. All major political parties ground their work environment policies in utilitarian concepts that trade worker health and safety for economic considerations. The author, therefore, argues for the development of an “ethics of the work environment” based upon egalitarian principles, and the transformation of the primary work group into a community of workers who can shape the character of their work environment. Ideally, the relationship between the major “actors” in our industrial relations system ought to be based on obligation instead of the present language of worker protest based on rights. Nonetheless, there is a need to extend and deepen worker rights in the workplace. Finally, the author argues that the appropriate relationship in industry to reflect a democratic work environment is “partnership”–the coming together of the primary work groups as equals.
Simulated Maintenance Training
Authors: Karentz Varoujan 
Published: May 2005

Maintenance training exercises a number of specific individual skills. The ability of the computer to assist in problem solving and stimulate the student by simulation permits practice, thus allowing proficiency to be achieved. The application of the computer for purposes of practical equipment maintenance training requires development of different rules than those required for operational, theoretical or basic instruction. This paper describes how parameters are defined, transformed and weighted, and how the resultant training tasks configured a Training Computer Exerciser. The criteria for hands-on practical exercises are determined and applied to the computer/equipment configuration by priority. Training equipment versus on the job training is traded off by examining related costs, criticality, availability, safety, MTBF and MTTR.
Writing for Publication
Authors: Estrin Herman A. 
Published: May 2005

Addressing both students and technical writers, Dr. Estrin discourses on the subject of why write for professional journals. The four benefits are an effect on professional advancement, an enhancement of prestige, financial payment, and “psychological” compensation. Some manuscripts are rejected because editors have similar articles, because the subject matter has been recently printed, and because the article may not hold the reader's interest. Five guidelines for selecting a subject are its timeliness, the availability of equipment, the contribution to the profession, one's interest in the subject, and the subject's objectivity. In selecting a journal, one must consider its editorial policy, its use of graphic aids, style sheet, and review policy, and the average length.