On the practice of psychotherapy by the nonmedically trained.

Freud in his writing indicated that medical training was not necessary for psychoanalytic qualification. The problem (of the practice of psychotherapy by the nonmedically trained) is still very much with us; and it may be profitable to re-examine the arguments pro and con for allowing nonmedically trained individuals to perform psychotherapy. The positions of persons opposed to nonmedically trained psychotherapy are presented. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cues trained apart compete for behavioral control in rats: Convergence with the associative interference literature.

Contemporary theories of associative learning require cues be trained in compound for cue competition (interference) to occur. That is, Cues A and X should compete for behavioral control only if training consists of AX-outcome (O) trials and not if each cue is separately paired with O (i.e., X–O and A–O). Research with humans challenges this view by showing that A–O trials interpolated between training and testing of a X–O association impair responding to X (i.e., retroactive interference). In six conditioned suppression studies with rats, the authors demonstrate that two cues trained apart can each interfere with the potential of the other to predict the outcome. The authors conclude that this type of interference (a) reflects a failure to retrieve the target association due to priming at test of the interfering association and (b) is attenuated if the outcome is of high biological significance. These findings parallel previous reports in verbal learning research and suggest that a similar associative structure underlies some types of associations in nonverbal subjects. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Perception of pitch and timbre by musically trained and untrained listeners.

Investigated how musicians and nonmusicians differentially perceive the dimensions of pitch and timbre. A categorization task was used in Exp 1 to assess Ss' ability to identify how 2 consecutively presented tones changed along these dimensions. A speeded classification task was used in Exp 2 to measure Ss' ability to ignore or take advantage of information in one dimension while attending to the other. The 2 groups differed in the degree to which variation along the dimensions influenced responses. Timbre variation affected nonmusicians' judgments of pitch more than the reverse. Musicians showed no such asymmetry. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Migraine preventive medications: a reappraisal

Newer acute care migraine medications demonstrate improved rapidity of action, consistent effectiveness, excellent safety profiles, and rarely cause rebound headaches. Their use could decrease the need for migraine-preventive medication. The present analysis derives a formula that can be used by practitioners to determine the cost-effectiveness of various migraine-preventive medications relative to selected acute-care medications. We propose a measure called the cost-equivalent number (CEN), the number of headaches per month at which the cost of the preventive medication equals the cost savings in acute-care treatment realized by using the preventive medication. The use of the CEN individualizes the decision of whether to use a migraine-preventive medication, weighing both the efficacy and cost of the preventive medication against the cost of the acute-care medication. A CEN lower than the migraine frequency suggests that use of a preventive medication will be cost-effective.     

A review of the treatment of primary headaches. Part I: Migraine

Finding the best treatment for a patient's migraine is often a problem in clinical practice since the condition is very common, often debilitating and may prove refractory to therapy. Over recent years, more effective migraine treatments have been found and validated, and the traditional remedies have undergone controlled testing. This article reviews the various therapies available for both the acute treatment and prevention of migraine. Treatments often effective against migraine attacks are: aspirin, analgesics, non steroid anti-inflammatory drugs (NSAIDs), ergot derivatives and sumatriptan. Five main classes of prophylactic drug are currently used: beta-blockers, calcium antagonists, serotonin modulators, NSAIDs and ergot compounds. Biofeedback, one of the most efficacious non-pharmacological preventive treatments of migraine, is also discussed. The variables influencing the choice of acute and preventive treatments, including contraindications and drug availability, are also described in order to provide a practical and up-to-date guide to migraine therapy.     

Pulmonary vasoconstriction induced by mitral valve obstruction in sheep

We hypothesized that left atrial hypertension results in pulmonary vasoconstriction, which is obscured by the expected passive decrease in pulmonary vascular resistance. The objectives of this study were to demonstrate and quantify the vasoconstrictive changes that occur in the pulmonary circulation during experimental left atrial hypertension, to determine the site of vasoconstriction, and to explore its mechanism. Sheep were instrumented for measurement of pulmonary arterial (Ppa), left atrial (Pla), and systemic arterial pressures (Psa) with a Foley balloon catheter to variably obstruct the mitral valve. Distal pulmonary arterial wedge pressure (Ppaw) was determined by using a 5-Fr Swan-Ganz catheter that was advanced until it wedged with the balloon deflated. Cardiac output (CO) was estimated by thermodilution; pulmonary vascular resistances (PVR) were calculated as mean (Ppa - Pla)/CO = total PVR, (Ppa - Ppaw)/CO = upstream PVR, and (Ppaw - Pla)/CO = downstream PVR. We studied 15 awake sheep at baseline and during increases in Pla of 10 and 20 cmH2O, with and without inhalation of approximately 36 parts per million of nitric oxide. Left atrial hypertension resulted in elevation of Ppa. CO decreased only slightly at both levels of Pla elevation. Nitric oxide inhalation caused a significant decrease in PVR, which was greater as Pla increased. This vasodilator effect was most striking in downstream vessels. Experiments with phentolamine, atropine, and ibuprofen failed to reveal the mechanism of the reactive pulmonary vasoconstriction.     

Applying trained skills on the job: The importance of the work environment.

The influence of the work environment on the transfer of newly trained supervisory skills was examined. Participants were 505 supermarket managers from 52 stores. The work environment was operationalized in terms of transfer of training climate and continuous-learning culture. Climate and culture were hypothesized to have both direct and moderating effects on posttraining behaviors. Accounting for pretraining behaviors and knowledge gained in training, the results from a series of LISREL analyses showed that both climate and culture were directly related to posttraining behaviors. In particular, the social support system appeared to play a central role in the transfer of training. Moderating effects were not found. Implications for enhancing the transfer of training are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Treatment of posttraumatic stress disorder by trained lay counselors in an African refugee settlement: A randomized controlled trial.

Traumatic stress due to conflict and war causes major mental health problems in many resource-poor countries. The objective of this study was to examine whether trained lay counselors can carry out effective treatment of posttraumatic stress disorder (PTSD) in a refugee settlement. In a randomized controlled dissemination trial in Uganda with 277 Rwandan and Somalian refugees who were diagnosed with PTSD the authors investigated the effectiveness of psychotherapy administered by lay counselors. Strictly manualized narrative exposure therapy (NET) was compared with more flexible trauma counseling (TC) and a no-treatment monitoring group (MG). Fewer participants (4%) dropped out of NET treatment than TC (21%). Both active treatment groups were statistically and clinically superior to MG on PTSD symptoms and physical health but did not differ from each other. At follow-up, a PTSD diagnosis could not be established anymore in 70% of NET and 65% TC participants, whereas only 37% in MG did not meet PTSD criteria anymore. Short-term psychotherapy carried out by lay counselors with limited training can be effective to treat war-related PTSD in a refugee settlement. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychological testing and the analytically trained child psychologist.

The author reviews some of the unique contributions that psychoanalytic theory brings to the testing of children and adolescents. Although demand for child evaluations has burgeoned in recent decades, the trend is toward atheoretical assessment; test findings are rarely linked to a coherent theory of personality and a developmental framework. The author delineates skills that analytically trained child psychologists bring to the testing situation, allowing them to place clinical observations and results within the context of the child's ongoing development and emerging sense of self. These include recognizing characteristic modes of thinking, relating, and fantasizing during different developmental phases; making meaningful use of transference and countertransference reactions; examining the quality of children's play and narratives; and using the feedback process to help parents contemplate their child's inner life. In conclusion, the author suggests that the testing tradition of Rappaport, Gil, and Schafer is highly relevant for contemporary child evaluation. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Facilitation of Chemoreceptor-induced reflex vasoconstriction by intravertebral arterial administration of clonidine

The influence of clonidine on the reflex vascular responses to stimulation of carotid body chemoreceptors and bilateral carotid occlusion was studied in morphine, chloralose-urethane anesthetized dogs. Bilateral carotid occlusion and intracarotid injection of nicotine (30 and 100 microgram) or sodium cyanide (200 and 500 microgram) elicited reflex vasoconstriction in the perfused gracilis muscle vascular bed. Infusion of clonidine (2-4 microgram/kg) into the vertebral artery significantly lowered blood pressure. Reflex vasoconstrictor responses to chemoreceptor stimulation were significantly enhanced after clonidine administration whereas reflex vasoconstrictor responses to carotid occlusion were markedly reduced. The facilitation of chemoreceptor reflex responses by clonidine was observed in dogs with intact or sectioned vagi and in animals in which the carotid arteries were perfused at constant blood flow. Inhibition of carotid occlusion responses by clonidine was observed in dogs with intact or sectioned vagi. Infusion of clonidine directly into the carotid arteries did not significantly alter responses to chemoreceptor stimulation. These experiments demonstrate that clonidine antagonizes the reflex vasoconstriction caused by carotid occlusion while potentiating the vasoconstriction elicited by chemoreceptor stimulation. The data suggest that clonidine exerts central actions which result in a facilitation of the chemoreceptor reflex and a simultaneously occuring hypotension which is probably due to an action on baroreceptor pathways.     

Retention of advanced cardiopulmonary resuscitation knowledge by intensive care trained nurses

The teaching and reinforcing of advanced cardiopulmonary resuscitation (ACPR) is an important part of the role of an intensive care nurse manager. This study highlights the need for a structured training programme, as well as regular updates in ACPR. Current research shows poor retention of CPR skills amongst nursing staff. A small study was undertaken amongst intensive care trained nurses at The Middlesex Hospital intensive care unit (ICU). 18 nurses took part in the study, and were each interviewed with regard to their knowledge of ACPR in December 1990. The period of time since last trained in ACPR ranged from 2 months-4 years. Those who had been recently updated in ACPR (up to 4 months prior to interview) scored higher than those who were updated more than 2 years ago. The results showed that most nurses interviewed were only able to answer correctly half the questions asked. These results indicate that the nurses in the study generally demonstrated a severe lack of knowledge of ACPR. This indicates the need for a structured training package in ACPR, followed by frequent reinforcement of ACPR knowledge and skills for nurses practising in an ICU environment.     

Inhibition of hypoxic pulmonary vasoconstriction by dipyridamole is not platelet mediated

Dipyridamole, which is known to alter platelet function, has also been shown to reduce hypoxic pulmonary vasoconstriction. This latter effect could result from dipyridamole either acting on a platelet-mediated system, or acting directly on pulmonary vascular smooth muscle. To investigate these two possibilities, normal dogs were compared with dogs rendered thrombocytopenic by a platelet antiserum. Compared with the hypoxic pressor response before drug treatment, the hypoxic response following dipyridamole was only 32% as great in the normal dogs and only 38% as great in the thrombocytopenic dogs. Thus, dipyridamole was no less effective in reducing the hypoxic pressor response in the virtual absence of platelets. This supports a direct effect of dipyridamole on pulmonary vascular smooth muscle, which could be mediated by an increase in adenosine levels.     

Performance of goldfish trained on multiple schedules of response-independent reinforcement.

In 3 experiments, 2 with appetitively elicited target striking and a 3rd with aversively elicited shuttling, 42 goldfish were trained on variable time schedules of response-independent reinforcement with or without a correlation between conditioned stimulus color and probability of reinforcement. Unlike pigeons in keypecking situations, Ss responded strongly even on uncorrelated schedules. In the 2nd and 3rd experiments—in which density of reinforcement and contingency were unconfounded—the level of response to a color was determined only by probability of reinforcement, independently of stimulus-reinforcer contingency. Except on the assumption that both measured responses are products entirely of adventitious response-reinforcer control, which seems particularly unlikely in the case of shuttling, the results cast doubt on the generality of the contingency interpretation of classical conditioning. (25 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Endothelin B receptor-mediated vasoconstriction induced by endothelin A receptor antagonist

BACKGROUND: Capacity limitation theories have proved to be surprisingly resilient in characterizing some of the cognitive deficits in schizophrenia. However, this perspective has not generally been applied to short-term verbal memory tasks. We explored this issue by first attempting to ascertain if gross misallocations of processing resources might explain impairments in short-term memory in schizophrenia on a classic digit span task and in a second study by attempting to determine what effects delay and memory set size had on a divided attention short-term verbal memory paradigm. METHODS: In the first study 16 patients with schizophrenia and 21 normal controls received 40 trials of a three digit task and 20 trials of a six digit span task. As the absolute number of digits presented and duration of presentation in two conditions were identical, subjects thus had equivalent 'opportunities' to make errors if distraction, in the sense of misallocation of cognitive resources, were at the root of poor performance. In the second study 15 patients with schizophrenia and 15 normal controls were tested in conditions in which two, four or six words were presented and in which rehearsal was prevented by an interference task (colour naming) for delays of 5, 10 or 15 s. RESULTS: Patients had disproportionate difficulty on the six digit rather than the three digit condition, suggesting that deficits in the verbal working memory short-term store may not be the result of attentional factors. In the second study, patients' performance was differentially worsened by the interference task, by memory set size (i.e. a capacity limitation) and by delay, a measure of decay rate. CONCLUSIONS: In concert, these studies demonstrate that schizophrenia patients have difficulties on verbal short-term memory span tasks not because of misallocation of resources, but rather because of limitations in 'representational capacity' and maintenance of information over delays.     

Cyclic hypoxic pulmonary vasoconstriction induced by concomitant carbon dioxide changes

We examined the stability of acute lobar hypoxic pulmonary vasoconstriction. In 12 mongrel dogs the left lower lobe (LLL) was selectively ventilated with a constant minute molume with nitrogen and the electromagnetically measured fraction of the cardiac output perfusing the LLL and the LLL end-tidal CO2 concentration were observed for 1 h. We found that both the fraction of the cardiac output perfusing the LLL and the LLL end-tidal CO2 concentration initially decreased during LLL hypoxia and then oxcillated in a progressively damped fashion. When LLL end-tidal CO2 was kept constant by CO2 infusion during LLL hypoxia or when LLL hypoxia was induced by LLL atelectasis, no oscillations were observed. We conclude that if minute ventilation of a hypoxic area of lung is kept constant, then decreased regional blood flow decreases regional alveolar PCO2. As a consequence of these two opposing influences, blood flow to an acutely hypoxic area will be oscillatory.     

Huddling by rat pups: Multisensory control of contact behavior.

Huddling, or clumping behavior, begins in the litter situation and persists throughout the adult life of the rat. In pups, as in adults, the behavior provides a metabolically important means of reducing heat loss. The sensory stimuli that elicit, direct, and maintain huddling in developing pups (5–20 days of age) were studied in 5 experiments with a total of 432 rats in a standardized testing situation by using long-term time-lapse video observations. All Ss huddled with a single, immobile sibling. A loop of warm tubing also elicited huddling. It appears that other, nonthermal cues can elicit huddling, since a dead, ambient-temperature pup was a sufficient stimulus for the behavior. Disruption of normal olfactory input by intranasal infusion of zinc sulfate interfered with the maintenance of contact. In addition, 2 kinds of tactile stimuli—vertical contours and furry "comfort" cues—and photic responses appeared to participate in the mediation of huddling. Huddling in the altricial rat is under multisensory control, although the number of cues used by pups for huddling appears to increase with age. (30 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)