When hearing clients work with a deaf therapist.

Not being able to hear can present significant challenges for the therapist and for the deaf therapist/hearing client dyad. It can also create opportunities. Although the literature indicates that most culturally Deaf therapists work with Deaf clients due to their mutual use of American Sign Language, I describe (a) the background of an audiologically deaf therapist who relies on speech reading rather than sign language, and (b) this therapist's clinical work with hearing clients. Some of the relational dynamics of these treatments are identified, and I conclude by noting how attention to communication can benefit the work of all psychotherapists. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Vulvovaginitis. When Candida becomes a problem

Problematic vaginitis due to Candida presents both a diagnostic and therapeutic challenge. An essential first step is confirmation of clinical diagnosis and avoidance of empiricism. Once correctly diagnosed, most episodes of vaginitis due to Candida are uncomplicated, responding to all forms of antifungal therapy. Unfortunately, increased numbers of complicated cases now occur requiring additional microbiological study and longer duration therapy with selected antifungal agents.     

When implicit learning fails: amnesia and the problem of error elimination

We propose that one of the major functions of explicit memory is the elimination of learning errors. The hypothesis is explored by means of a stem completion task in which subjects are presented with stems having many potential completions, and in the initial phase are either encouraged to guess, the "errorful" procedure, or are provided with the correct completion, the "errorless" condition. Learning is then tested over a sequence of nine trials. The performance of amnesic subjects who are assumed to have good implicit but bad explicit learning is compared with that of normal elderly subjects, who are assumed to have an intermediate level of explicit learning skill, and young controls who are expected to be high in both implicit and explicit learning capacity. As predicted, errorless learning is beneficial, with the effect being particularly marked for the amnesic group. A detailed analysis of the intrusion errors supports an interpretation of the results in terms of the relative contribution to the three groups of implicit learning, which is assumed to be particularly vulnerable to interference. Implications for the analysis of normal learning, and for the rehabilitation of brain damaged patients are discussed.     

When problem solving is superior to studying worked examples.

Interactions between levels of learner knowledge in a domain and levels of instructional guidance were investigated. Inexperienced mechanical trade apprentices were presented with either a series of worked examples to study or problems to solve. On subsequent tests, inexperienced trainees benefited most from the worked examples condition, with this group performing better with lower ratings of mental load than similar trainees who solved problems. With more experience in the domain, worked examples became redundant and problem solving proved superior. It is suggested that the relative effectiveness of either worked examples or problem solving depends heavily on levels of learner knowledge. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Contrast effects and judgments of physical attractiveness: When beauty becomes a social problem.

Conducted 3 studies to test the hypothesis that judgments of average females' attractiveness or dating desirability will be adversely affected by exposing judges to extremely attractive prior stimuli (i.e., judgments will show a "contrast effect"). Study 1 was a field study in which 81 male dormitory residents watching a popular TV show, whose main characters were 3 strikingly attractive females, were asked to rate a photo of an average female (described as a potential blind date for another dorm resident). These Ss rated the target female as significantly less attractive than did a comparable control group. Two other studies with 146 undergraduates demonstrated analogous effects in a more controlled laboratory setting. In addition, the 3rd study indicated a direct effect of informational social influence on physical attractiveness judgments. Implications are discussed with particular attention to mass media impact. (40 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

When interventions harm: Peer groups and problem behavior.

This article explored developmental and intervention evidence relevant to iatrogenic effects in peer-group interventions. Longitudinal research revealed that "deviancy training" within adolescent friendships predicts increases in delinquency, substance use, violence, and adult maladjustment. Moreover, findings from 2 experimentally controlled intervention studies suggested that peer-group interventions increase adolescent problem behavior and negative life outcomes in adulthood, compared with control youth. The data from both experimental studies suggested that high-risk youth are particularly vulnerable to peer aggregations, compared with low-risk youth. We proposed that peer aggregation during early adolescence, under some circumstances, inadvertently reinforces problem behavior. Two developmental processes are discussed that might accounts fro the powerful iatrogenic effects. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effect of a hearing aid on progressive hearing loss

A group of 72 children with hearing aids followed in 4 different clinical settings presented progressive increase in sensorineural hearing loss. The mean hearing loss over time, the duration of hearing aid use and the gain were studied to test the hypothesis that continued progression in hearing loss was due to overly powerful amplification. No correlation was found between the progressive increased gain levels were associated with less progression in hearing loss than at lower gain levels. Therefore, the use of hearing aids was not directly and significantly related to the increase in hearing loss in the population studied. However according to the above criteria a few cases (4%) of progressive hearing loss did seem to be associated with hearing aid use.     

When the CNS needs a consultant

Mycoplasma hominis and Ureaplasma urealyticum are species closely related to urogenital diseases such as pyelonephritis, nongonococcal urethritis, urinary calculi, epididymitis, pelvic inflammation, infertility, abortions and post-delivery fever. They can also cause pneumonia and meningitis in newborn infants. In this paper we used nucleic acid hybridization and polymerase chain reaction to analyze 22 samples from patients with different urogenital symptoms in order to detect mycoplasmas and ureaplasmas. We obtained 10 positive samples and 12 were negative. From positive samples we identified two with Mycoplasma hominis, two with Ureaplasma and six with both species. The results obtained by these molecular techniques were compared with reference methods and we found coincident results in 18 samples, while in four the results were discordant. These discordant findings were not statistically significant.     

Implantable hearing devices for sensorineural hearing loss: a review of the audiometric data

BACKGROUND: Child fatality review (CFR) by interagency teams can contribute to the prevention of childhood deaths. We investigated the potential usefulness of Georgia's CFR, legislated in 1990 primarily to prevent death from child maltreatment, for identifying preventable deaths from injury and sudden infant death syndrome (SIDS). METHODS: Using CFR report data and death certificate data, we examined reviewed and nonreviewed childhood deaths in Georgia in 1991 and examined data by etiology, county, risk factors, and preventability. RESULTS: Injury or SIDS caused 33.2% of childhood deaths in Georgia in 1991; CFR reviewed 29.4% of these. Child fatality review was most sensitive for investigating death from intentional injury (40.5%) and SIDS (35.3%). Review teams reassigned the cause of five deaths (2.0%) to child abuse or neglect. County participation was low (31.4%). Overall, 29.0% of deaths were judged preventable. CONCLUSIONS: Georgia's CFR has potential for identifying preventable childhood deaths. Refinements in the system can increase the number and accuracy of death investigations. By participating in the system, physicians may make meaningful contributions to preventing childhood death in their own communities.     

Psychoanalysis and learning: Rounding up the usual suspects?

In this critical review, the author surveys the literature on learning as a field of psychology including current studies and the contributions of cognitive neuroscience. Two clinical puzzles, one about remembering rape and the second about teaching that changes attitudes, are presented as data samples. A consideration of learning as applied psychoanalysis is divided into 3 historical periods: early history, intermediate period, and recent work. The discussion suggests strategies for implementation of a working link between the 2 fields. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Agenesis of the corpus callosum in a mother and son

Most reported familial cases of agenesis of the corpus callosum have followed either an autosomal recessive or an X-linked recessive pattern of inheritance. To the best of our knowledge, there is only one previous report of a family showing clear-cut autosomal dominant inheritance. We present the second such family, among whom a mother and her son had moderately severe coordination problems and low-normal intelligence. We suggest that agenesis of the corpus callosum, when transmitted as an autosomal dominant trait, is clinically characterized by a relatively milder phenotype than that occurring when inheritance is either autosomal or X-linked recessive and may be more common than has been thought.     

When a physician makes a mistake

Inevitably, doctors make mistakes in the normal course of providing care. Making a mistake often causes distress for the doctor involved, but it can also be an important source of knowledge and self-reflection. This article discusses central aspects with respect to mistakes and medical malpractice. The doctor's relationship to ethics and legislation is discussed, and an overview of the administrative action taken by the Norwegian health authorities is presented. The organisations and offices a physician may come into contact with when involved in a patient's complaint are briefly presented. "Meldesentralen" was formed in 1993 by the Norwegian Directorate of Health for the purpose of collecting reports on accidents in medical practice. We argue that the accidents reported to "Meldesentralen" do not reflect the true situation on this issue. We introduce a model for a systematic approach towards a colleague who has made a mistake or who is suspected of having made one.     

When the operating room has a multicultural team

Working with a culturally diverse team can be enlightening but challenging. Healthy interpersonal relationships are essential in a culturally diverse OR team. Communication, understanding, and tolerance are crucial for all members of the team.     

Rater bias in psychological research: When is it a problem and what can we do about it?

Rater bias is a substantial source of error in psychological research. Bias distorts observed effect sizes beyond the expected level of attenuation due to intrarater error, and the impact of bias is not accurately estimated using conventional methods of correction for attenuation. Using a model based on multivariate generalizability theory, this article illustrates how bias affects research results. The model identifies 4 types of bias that may affect findings in research using observer ratings, including the biases traditionally termed leniency and halo errors. The impact of bias depends on which of 4 classes of rating design is used, and formulas are derived for correcting observed effect sizes for attenuation (due to bias variance) and inflation (due to bias covariance) in each of these classes. The rater bias model suggests procedures for researchers seeking to minimize adverse impact of bias on study findings. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Neutropenia in a newborn secondary to sulfamethoxazole-trimethoprim administered to the mother

As Markowitz et al. explain, the atypical antipsychotics should become the first-line agents for the treatment of schizophrenia. There is much to be learned about these drugs, but their displacement of the conventional antipsychotics will be a continuous process. The loss of the older drugs will not be mourned.     

Severe pseudoachondroplasia in a mother and her son

A 33 year old man with recurrent respiratory tract infections was admitted to surgery ward. During esophagoscopy and bronchoscopy--esophago-tracheal fistula was found. Diagnosis was confirmed by radiologic examination of esophagus. Surgical treatment was performed with good result.     

Familial neurilemoma of the spinal cord in a mother and daughter

Giant cells and macrophages play important roles in defence and in reparative functions of the body. This paper describes a giant cell and macrophage present in an inflammatory mass in the temporal bone. X-ray microanalysis performed at the ultrastructural level revealed the presence of a very high iron content in the electron dense precipitates observed in both types of cells. The high iron content is probably due to phagocytosed haemosiderin, a breakdown product of free haemoglobin since there was evidence of haemorrhage present in the biological sections. As the tissue was chemically fixed, it also demonstrates that there is still a place for electron probe microanalysis in tissues (including archived specimens) which have undergone chemical fixation.