Providing the Advanced Life Support in Obstetrics Course within the military family practice training system

"The Advanced Life Support in Obstetrics (ALSO) Course is designed to assist health professionals in developing and maintaining the knowledge and skills they will need to effectively manage the emergencies which arise in obstetrics." Given the fact that the vast majority of military family physicians provide maternity care, often in small overseas facilities without in-hospital obstetrician backup, inclusion of this course into the military family practice residency training curriculum would be very beneficial to the mission of family practice within the military. A brief background of the ALSO movement and the ALSO course curriculum are provided. Lessons learned to aid military family practice departments in providing quality ALSO courses are described, as are arguments for the inclusion of ALSO training into military family practice training curriculums.     

Overcoming language barriers when teaching the Advanced Trauma Life Support course

OBJECTIVES: To determine whether blurred vision caused by exposure to triethylamine (TEA) can be detected by the measurement of contrast sensitivity. METHODS: 41 cold box core makers of three foundries and 82 control workers were examined. A detailed ocular and medical history was obtained from the subjects. The contrast sensitivity of the core makers was measured on Monday and Friday of the same week both before and immediately after work and also on a third day, when air samples of TEA were collected. Contrast sensitivity and visual acuity were measured by optotype figures at full contrast, 2.5% contrast, and 0.6% contrast. The changes in contrast sensitivity were used for the analysis. The results of binocular vision and the results of the dominant eye were analysed. Urine specimens for the analysis of TEA were collected on every occasion when contrast sensitivity was measured. RESULTS: 78% of the core makers had had symptoms of blurred vision, and 31% had had trouble driving or working. The breathing zone eight hour time weighted average TEA concentrations were 0.3-60 mg/m3. The mean urinary TEA concentration after the shift was 35 mmol/mol creatinine. Continuous monitoring showed high peaks of TEA leakage at a core making machine. Changes in binocular visual acuity did not differ between the exposed and unexposed workers. The contrast sensitivity decreased in 49% of the core makers and 21% of the controls (P = 0.002). CONCLUSIONS: The blurred vision caused by exposure to TEA can be documented by measuring contrast sensitivity. The mechanism by which TEA produces symptoms remains an issue of further study.     

Meditation as an intervention in stress reactivity.

Compared the ability of meditation and relaxation to reduce stress reactions in a laboratory threat situation. 60 18-31 yr old Ss, 30 experienced mediators and 30 controls, either mediated or relaxed with eyes closed or open and then watched a stressor film. Stress response was assessed by phasic skin conductance, heart rate, self-report, and personality scale (State-Trait Anxiety Inventory, Affect Adjective Check List, and Activity Preference Questionnaire). Meditators and the meditation condition habituated heart rate and phasic skin conductance responses more quickly to the stressor impacts and experienced less subjective anxiety. Meditation can produce a psychophysiological configuration in stress situations opposite to that seen in stress-related syndromes. Research is indicated on clinical applications and on the process whereby meditation state effects may become meditator traits. (33 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The Support Network: Crisis intervention for extrafamilial child sexual abuse.

Describes the establishment of the Support Network, a community-based treatment program for children and families facing crises due to extrafamilial child sexual abuse. The components necessary to establish a Support Network are discussed. A crisis intervention model of treatment is proposed that provides these children and families with immediate contact with a therapist, emotional support, education, and problem-solving strategies, thus enabling some resolution of the crisis and a return to precrisis routines and adaptation. Termination and follow-up issues are also addressed, and a case example of 4-yr-old sexually abused girl is presented to illustrate the usefulness of the Support Network. It is contended that, by providing services to these children and their families, Support Network therapists also help to sensitize and educate other community professionals to the needs of the sexually abused child and his/her family. A list of selected references for use with children and families is appended. (48 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The Ontario Prehospital Advanced Life Support (OPALS) Study: rationale and methodology for cardiac arrest patients

Modalities of management of arterio-venous malformations are discussed according to natural history and size of lesion, patient clinical status, and potential side effects of available techniques (microsurgery, radiosurgery, ambolization). Clinical cases illustrate this discussion.     

Sustained effects of high participation in an early intervention for low-birth-weight premature infants.

Effects of high participation in the Infant Health and Development Program (IHDP), an 8-site randomized trial that targeted low-birth-weight (LBW) premature infants (N=1,082), were estimated. Children in the treatment group were offered high-quality center-based care in their 2nd and 3rd years of life (full-day care, 50 weeks per year). High-dosage effects were estimated with a new methodology that found a matched comparison group within the follow-up group for those with high participation rates; these estimates were compared with traditional intention-to-treat (ITT) estimates. At age 8, effects on the Wechsler Intelligence Scale for Children Full and Verbal scales for children who attended >400 days ranged from 7 to 10 points. For the heavier LBW infants (2,001-2,500 g), the effects were about 14 points for >400 days; for the lighter LBW infants (≤2,000 g), the effects were about 8 points. These effects were all substantially higher than corresponding ITT effects. Similar but smaller effects were found for children who attended >350 days. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Assessment as an intervention in the child and family forensic setting.

Before a Children's Court decision is reached, a clinical assessment may be ordered by the court. This assessment often occurs when tension is high for the family and when well-established defenses may falter, and it can provide a prime, critical opportunity to facilitate positive change. Comprehensive psychological assessment at the Children's Court Clinic in Melbourne, Australia, indicates the intervention value of a serious attempt to understand the complexity of the psychological issues facing a child and family. With the aid of illustrative case studies, this article discusses the therapeutic aspects and implications of such assessment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effect of the Advanced Trauma Life Support program on medical students'' performance in simulated trauma patient management

The effect of exogenous transforming growth factor beta (TGF-beta) on Mycobacterium bovis BCG-induced tumor necrosis factor alpha (TNF-alpha) production by human mononuclear cells was studied. It was found that TNF-alpha production by human cells stimulated with BCG was significantly inhibited by TGF-beta. The specificity of the observed inhibition was demonstrated, since the addition of an anti-TGF-beta neutralizing monoclonal antibody completely reversed the inhibitory effect. Furthermore, the suppressive effect of TGF-beta on TNF-alpha secretion in this system was not due to a direct cytotoxic effect, since cell viability was comparable in the presence or absence of TGF-beta. Interestingly, our results demonstrated comparative suppressive effects of TGF-beta and interleukin-10 on BCG-induced TNF-alpha secretion. Together, the data demonstrate, for the first time, that TGF-beta inhibits BCG-induced TNF-alpha secretion by human cells.     

Assertiveness training as an intervention technique for low performance self-esteem women.

20–58 yr old women were given assertiveness training in 1 of 12 treatment groups. Outcome measures included the Performance-Self-Esteem Scale (PSES) and self-ratings of job performance. Follow-up data at 9–12 mo were available for 79.3% of the original sample. The PSES scores increased significantly in the training sample from pretesting to follow-up but not in a control group of 20 women. Perceived situational support for assertive behavior was not related to increases in PSES scores but was related to increases in self-ratings of job performance (p?     

The specific effects of a Gestalt intervention.

Reports 3 cases in which the effects on client depth of experiencing and voice quality of the Gestalt "2-chair" operation were investigated. In a design using the clients as their own controls, the effects on each client of 3 Gestalt operations, applied under experimental control to client statements of conflict, were compared with the effects of 3 active-empathy operations at similar points. Results confirm that following the Gestalt operation the depth of experiencing was significantly higher for each of the 3 clients selected as good prognosis clients for client-centered therapy. Two Ss used significantly more emotionally expressive voice after the Gestalt operation. The implications of the change in depth of experiencing on shifts in awareness and on the client's ability to cope with and resolve conflict are discussed. (22 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The time course of repetition effects for words and unfamiliar faces.

The repetition effect on reaction time to words and unfamiliar faces was examined at lags of 0, 4, and 15 items between 1st and 2nd presentations. For words, Ss made either a lexical decision or a decision based on the stimulus's structural attributes. In the lexical decision task, a significant repetition effect was found at all 3 lags for words, whereas for nonwords the effect was significant only at Lag 0. In the structural decision task, the repeated decision was facilitated for both words and nonwords only at Lag 0, despite a word superiority effect at all lags. Target faces were presented either 0, 1, or 5 times before testing. Ss made either structural discriminations (face/nonface) or recognition judgments. In the structural discrimination task, the effect of repetition was significant only at Lag 0 (regardless of the number of pretest presentations). In the recognition task, the repetition effect was longer lasting, and its magnitude increased with the number of presentations which, presumably, determined the strength of the episodic memory trace. These results are taken as showing that repetition effects, like other measures of memory, are influenced by the type of stimulus, its preexperimental history, the level to which it is processed, and the lag between the initial presentation and the test. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Mathematical background and grade-point average as predictors of course grade in an undergraduate behavioral statistics course.

Presents data suggesting that success in undergraduate behavioral statistics courses has little to do with mathematical background and seems to depend on overall ability as a student, as measured by cumulative grade point average (GPA). (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Life circumstances and personal resources as predictors of the ten-year course of depression

A 10-year naturalistic study of 313 patients who entered treatment for unipolar depression and a community comparison group of 284 nondepressed adults was conducted. We compared life stressors, social resources, personal resources, and coping among patients who were remitted (N = 76), partially remitted (N = 146), or nonremitted (N = 91). Compared with the controls and the remitted patients, the partially remitted and nonremitted patients consistently experienced more life stressors and fewer social resources, were less easygoing, and relied more on avoidance coping. A less easygoing disposition, fewer close relationships, and more reliance on avoidance coping were associated with higher odds of experiencing a course of partial remission or nonremission. In addition, more depressive symptoms and medical conditions predicted nonremission.     

The power of Filial Relationship Enhancement therapy as an intervention in child abuse and neglect.

Identified variables that influence intervention in child abuse and neglect and proposes a constructive approach that can help these children and their families change. This is a difficult and complex societal problem, and it is difficult to tease out the specific elements that are responsible for the frequency of its occurrence. The family context is often recognized as having a significant influence. Filial Relationship Enhancement, using an improved family context to support gains, has a long history of research and practice to support its efficacy to intervene in difficulties that impede optimum functioning in children. Filial Relationship Enhancement helps parents learn to conduct weekly child-centered play therapy sessions with their own children at home. This article presents the basic assumptions and the rationale for considering the potential power of this approach. It also describes a program of intervention incorporated by a child protective unit of a county agency. Using informal measures, outcomes are described as well. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Life events can trigger depressive exacerbation in the early course of schizophrenia.

Previous studies have linked life events with depression in chronic schizophrenia, but those studies had methodological limitations. Using a prospective research design and examining events that were clearly independent of the patients' illnesses, the authors sought to determine whether stressful life events could trigger depressive symptoms in the early course of schizophrenia. Schizophrenia patients (n?=?99) were followed for 1 year from a point of outpatient stabilization. Life event interviews were conducted every 4 weeks and symptom assessments every 2 weeks. Survival analyses showed a significantly increased risk for an exacerbation of significant depressive symptoms following an independent life event. Of interest is that an analysis of competing risk showed that the odds of psychotic exacerbation following a major independent life event were not significantly greater than the odds of depressive exacerbation. The risk of depression and of psychosis after experiencing a stressful life event is significantly increased for the first month, but the risk period can extend to 3 months. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The patient exit interview as an assessment of physician-delivered smoking intervention: A validation study.

In evaluating the efficacy of physician-delivered counseling interventions for health behavior changes such as smoking cessation, a major challenge is determining the degree to which interventions are implemented by physicians. The Patient Exit Interview (PEI; J. Ockene et al., 1991) is a brief measure of a patient's perception of the content and quantity of smoking cessation intervention received from his or her physician. One hundred eight current smokers seen in a primary care clinic completed a PEI following their physician visit. Participants were 45% male, 95% Caucasian, with a mean age of 42 years and an average of 22 years of smoking. The PEI correlated well with a criterion measure of an audiotape assessment of the physician–patient interaction (r?=?.67, p?