Natural course of Perthes disease

The natural history of Perthes' disease can be followed in children with low Catterall rating, absent head-at risk signs and in the age group below 5 years. Thirty-one out of 34 patients who had been followed without active treatment healed with excellent results according to Stulberg's classification. Three unfavorable results were seen in patients who had refused treatment when suggested or who had failed to come in for the follow-up examination for an extensive period of time. Catterall's grading and head-at-risk signs must be watched carefully in order not to overlook cases where active treatment is mandatory. The described concept has been critically monitored and has proven to work with reliable results.     

Death caused by Perthes pressure congestion

In this paper considerations from the view-point of forensic examiners are presented on various issues in fatal traumatic asphyxia such as reconstruction and frequently difficult evaluation of the survival time. The study includes several autopsy cases with diverse mechanisms of compression and graduated importance of asphyxia for death. The reconstruction of the diagnosis of traumatic asphyxia was possible in a case of exhumation after more than 5 months in the synopsis of necropsy and judicial inquiry. Very short survival periods of minutes and compression times of seconds are sufficient for the production of the typical external characteristics. Thoracic compression can cause death within minutes (limiting factor: resuscitation time of the brain). In addition to other well-known local and general vitality markers, clods or parts of plants in the hands of the decedents can point to vain attempts of self-escape and confirm the diagnosis of vitality.     

The concept and potentials of cardiovascular gene therapy

TOPIC: A nursing theory framework for teaching health assessment. PURPOSE: To improve teaching of health assessment and nursing process to beginning-level baccalaureate nursing students. SOURCES: The Assessment and Analysis Guideline Tool, published and unpublished literature, personal observation, and faculty feedback were used in tool development. CONCLUSIONS: Faculty concluded that students who could envision the connection of the Neuman Systems Model and NANDA nursing diagnoses through the nursing process would be better able to understand the nursing model and choose appropriate nursing diagnoses for client care.     

Yamakawa prosthesis with prolonged placement as a therapy concept exemplified by benign biliary stricture

AIM: As an alternative method to the operative revision of benign bile duct strictures, we report the use of a large-bore bile duct prosthesis (Yamakawa prosthesis) in one patient. METHODS: Bilateral percutaneous transhepatic implantation of Yamakawa prostheses (14 F right side, 12 F left side) was performed without adjunctive balloon dilatation. The prostheses were exchanged every 8 weeks under continuous antibiotic treatment and were finally removed after 8 months. RESULTS: Control cholangiography showed a normal intrahepatic biliary system on the right side and a 50% stenosis at the orifice of the left hepatic duct. Follow-up over 18 months showed no signs of recurrent disease. CONCLUSIONS: In comparison to balloon dilatation and implantation of metallic stents, prolonged bilateral splinting with large-bore Yamakawa prostheses seems to be an alternative for the treatment of benign bile duct strictures.     

The effects of client-centered group play therapy on self concept.

V. M. Axline's (1969) basic principles for client-centered play therapists direct the therapist to create an environment in which clients are granted the basic freedoms that V. Satir (1976) has delineated as necessary for self concept enhancement. This relationship between client-centered play therapy and self concept enhancement is evident when comparing their histories. This study investigated the effects of client-centered play therapy on self concept in a 10 session client-centered play therapy group involving 3 male and 3 female 6-9 yr olds with a variety of clinical problems. Two individual case studies from the group are presented which indicate that client-centered group play therapy enhances self concept. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Overconfidence: a concept analysis

Overconfidence has an effect on clinical practice and patient outcomes. The author utilizes Walker and Avant's procedure for conceptual analysis to give a systematic definition to overconfidence as it relates to decision-making in nursing. The characteristics that demonstrate the presence of overconfidence are: (a) failure to consider alternative perspectives, (b) failure to distinguish inferences from assertions, (c) favoring positive over negative information, (d) unwarranted certainty in the prediction of accuracy, and (e) control. An increased awareness of the existence of overconfidence can increase the reliability of nursing judgment.     

Quantitative connotation of a concept.

Trait referent terms (adjectives) were rated on the "bad-good" scale and the mean rating of each word computed. Based on these ratings, lists of 3 terms were constructed with varying distributions, and Ss formed impressions of a person therefrom. Results showed that (a) a positively skewed list produced a more positive (good) impression than one composed of terms having almost identical values, and (b) of 2 lists having identical means and midranges, the 1 including a more highly positive term produced the more positive impression. It was suggested that the connotation of an impression is influenced more by extreme terms than by relatively neutral ones. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

First results of radioiodine therapy of multifocal and disseminated thyroid gland autonomy and use of a TcTUs-adapted dose concept

AIM: The presented study examines prospectively the efficiency of a dose concept for radioiodine therapy (RIT) adapted to the pretherapeutic 99mTc-pertechnetate thyroid uptake under suppression (TcTUs) in patients with multifocal (MFA) and disseminated (DISA) autonomy. This concept considers the total thyroid as target volume and uses target doses from 150 Gy to 300 Gy according to the TcTUs, which is as a measure for the "autonomous volume" of the thyroid. METHODS: The data of 75 patients (54 female, 21 male; age 71 +/- 9 years) with MFA of DISA were evaluated. RIT was performed on patients presenting with normal values for free triiodothyronine and thyroxine and endogenous suppression of the basal thyrotropin (TSH). The following target dose were used for a TcTUs of 1.5-2.5% 150 Gy, for 2.51-3.5% 200 Gy, for 3.51-4.5% 250 Gy, and for > 4.5% 300 Gy. The radiation dose to be administered was calculated using a modified Marinelli formula. The therapy was considered as successful. When the basal TSH was above 0.5 mU/l and autonomous areas had disappeared in thyroid scintigraphy or the TcTU was below 1.5%, respectively. The average follow-up period was 8 +/- 4 months. RESULTS: The success rates average to 92%. Only in one case a subsequent subclinical hypothyroidism and in a further case an immunogenic hyperthyroidism occurred. CONCLUSION: The presented data indicate that even patients with a marked autonomy (TcTUs > 3.5%) can thus expected to be cured by of a one time therapy with success rate of over 90% using the presented dose concept. The rate of early hypothyroidism can altogether be estimated as very low.     

Towards a concept of food-related life style

Body height and height velocity were analysed in 54 children with obstructive urinary tract malformations over a mean period of 8.7 years, using new auxological methods. At the time of diagnosis, 9% of patients had a height of more than 2 standard deviations below the normal mean. Mean relative height changed significantly from the first to the last observation, the standard deviation score (SDS) increasing from -0.16 to +0.36 in patients with hydronephrosis compared with normal children (P < 0.05) and from -0.63 to +0.02 SDS in those without hydronephrosis (P < 0.005). The pathogenesis of the described growth disturbance is not clear. Stepwise multiple regression analysis pointed to a possible link between the duration of antibiotic treatment and the recovery of growth capacity, but improved growth could not clearly be attributed to any medical or surgical treatment. The synchronized average growth velocity curve was similar to that of healthy children and showed a normal pubertal spurt. Final height and target height calculated from parents' height differed only slightly from that of the normal population.     

Toward a concept of personality integration.

A central idea in thinking about effective behavior is "organismic integration" which suggests an inclusive phenomenon and suggests also "some form of interaction which takes place among subsystems of the organism—more specifically, an interaction which is adaptive or self-enhancing." Personality integration "is a many vectored thing, that is defined by events which go on within a variety of specific behavioral planes within the organism." Systems are grouped "on a continuum ranging from microcosmic to macrocosmic, or from molecular to molar, or even from the inside of the organism out… . The model covers events from a single heartbeat to the behavior of peoples… . The variables tentatively identified as relevant to personality integration include stability, high environmental contact, high internal communication, and affective complexity." (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Relational learning of a size concept.

Administered relational size problems in the context of ordinal series to 72 4-5 yr olds. Solution was facilitated when Ss were directed to locate a terminal member (the smallest) of the series. In contrast, Ss who were instructed to locate a nonterminal member without prior designation of a terminal member were unable to achieve solution of the problem. Age- and sex-related differences in performance were observed as well as differences associated with stimulus arrangements and stimulus sizes. The outcomes are discussed in terms of composite task demands. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

On the concept of concept.

This commentary is in two parts: 1) a short review of problems with representational theories of mind, and 2) a critique and diagnosis of what I claim are fundamental problems with Wittgensteinian notions of grammatical analysis. These problems turn on an incomplete characterization of normativity in Wittgenstein's (and others') work. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Lecturer practitioner: a concept analysis

The concept of the lecturer practitioner arose in one health authority in Britain in the late 1980s. Since its inception there, the concept has been widely adopted across the country suggesting that there is a perceived need for this role. However, there is much confusion over what a lecturer practitioner is, since each post is multifaceted, complex and unique. Rodgers' (1993) evolutionary concept analysis is used in an attempt to clarify and to identify those elements that are common to this concept. Through a review of all the available literature on this concept, the attributes, antecedents and consequences are identified and their implications discussed. Rodgers' evolutionary method is described and critiqued throughout the paper and is shown to be a suitable method for clarifying a complex concept.